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31 Oct 2002 : Column 1108—continued

7.17 pm

The Minister of State, Department of Health (Mr. John Hutton): I warmly congratulate my hon. Friend the Member for Warrington, North (Helen Jones) on drawing the attention of the House to the case of her constituent, Mr. Stanley Ford. I also warmly congratulate her on presenting her arguments so clearly and effectively.

Let me say at the outset that I agree with my hon. Friend that the way in which Mr. Ford and his family have been treated is completely unacceptable and falls well short of the standards that we are all entitled to expect from our national health service. I shall say more about that in a few minutes. The case has rightly raised a set of wider concerns to which my hon. Friend referred, including the question of how confidential patient information can be shared with right hon. and hon. Members who make inquiries on behalf of their constituents. I shall say more about that in a moment. I am grateful to my hon. Friend for her warm remarks about the nurses and doctors at Wythenshawe hospital.

I begin by apologising to Mr. Ford and his family for the cancellation of his treatment at Wythenshawe hospital on six separate occasions between 22 March and 14 June. Clearly, that was completely unsatisfactory for everyone concerned, and particularly frustrating and stressful for the patient and his closest relatives and friends. The trust has apologised to Mr. Ford and his family, and rightly so. It is extremely sorry for the three-month delay in treatment that Mr. Ford endured as a result of his operation being cancelled on so many occasions, and the inevitable effect of consecutive postponements on his family. Mr. Ford eventually had his operation on 24 June, and I am sure that the House will join me and my hon. Friend in wishing him and his family well at this difficult time.

Mr. Ford's experience highlights many of the problems in the NHS that we as a Government, through our investment and reform programme, are determined to tackle. As I am sure my hon. Friend is aware, we are making available a substantial increase in the level of funding for the NHS during the next few years. That investment, coupled with the wider reforms that we are making to the service, should deliver an NHS that is better equipped and enabled to respond much more effectively to the individual needs of its patients, something that should have happened in this case, but clearly did not.

The NHS is still short of capacity. We need more staff, beds, operating theatres and equipment. Since 1997, we have made some progress in expanding the NHS. There are more nurses and doctors. The numbers of beds in the NHS is rising again for the first time in more than 30 years. We are in the middle of the biggest hospital building programme in the history of the NHS, which will see the NHS grow in size as well as capability. In the north-west alone my hon. Friend will want to know that

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eight new hospitals have been given the go ahead since 1997, and together with the changes that we are making to the way in which we deliver our services—for example, separating emergency cases from elective activity—we shall be able to make faster progress in reducing the number of operations that have to be cancelled at short notice.

I know that that will provide no direct comfort to Mr. Ford and his family. I accept that. But I hope that Mr. Ford and his family will be able to accept that we are fully committed to improving the NHS, and making sure that the extra investment makes a real difference to the way in which the NHS operates.

This case raises concerns in a number of areas, including the NHS's approach to cancelled operations and the standards of cleanliness in our hospitals. The Government are committed to ensuring that the NHS takes action to address the concerns that my hon. Friend has raised tonight.

It is clearly unacceptable that pre-planned operations are cancelled. An operation can be a traumatic enough experience without the added concern of it being cancelled at short notice. That is why from April 2002, under the NHS plan, when a patient's operation is cancelled by the hospital on the day of surgery for non-clinical reasons, the hospital must offer another binding date within 28 days, or fund the patient's treatment at the time and place of the patient's choice.

The NHS also has to improve the way it manages operating theatre lists. The NHS modernisation agency is helping to develop and spread good practice across all NHS trusts, including that in south Manchester, with dedicated support provided to the worst performing trusts. As part of that project, South Manchester University Hospitals NHS trust has been given additional resources this year to help it to implement the new guidance and reduce the incidence of cancelled operations.

As my honourable Friend has mentioned, Mr. Ford's operation was cancelled three times because of an MRSA outbreak at the hospital. MRSA is a serious problem in the NHS, as it is in hospitals throughout the world. The Government are aware of the seriousness of the problem and that is why we have set standards to ensure that there is a managed environment that minimises the risk of infection to patients, staff and visitors. Recent analysis of how hospitals perform in that area has shown an improvement during the past two years, but more needs to be done and actions are under way nationally, regionally and locally.

For example, we have taken action to improve the standards of hospital cleanliness including the investment of an additional #60 million over the next two years, and the institution of a nationwide clean-up campaign with unannounced inspections of cleanliness. We recognised that not all hospitals were as clean and tidy as patients wanted and that in some places standards of cleanliness had deteriorated to a point where they were no longer acceptable. The clean hospitals programme has seen significant improvements. The new patient environment action teams have carried out nearly 1,400 inspections in around 500 NHS hospitals during the past 21 months. By September 2001, there were no hospitals deemed to

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have unacceptable levels of cleanliness. In particular, levels of hospital cleanliness have risen, in particular in the South Manchester University Hospitals NHS trust.

Most of us would accept that it might be necessary sometimes to cancel elective surgery for legitimate reasons—for example, the ill-health of the patient concerned. In Mr. Ford's case, staffing shortages and an infection outbreak contributed to a number of the delays. But six cancellations is obviously an excessive number. They could and should have been avoided. I know that South Manchester University Hospitals NHS trust has taken the matter seriously and is committed to taking the necessary action to address the problems exposed by Mr. Ford's ordeal.

My hon. Friend raised particular concerns about answers to parliamentary questions that she has received in relation to staffing levels in the trust on the day that Mr. Ford's hospital treatment was initially cancelled. I assure her that I shall look into the points that she has raised with me this evening because the trust does have a high rate of cancelled operations—too high. That fact was reinforced when the Commission for Health Improvement reported in July. Under its new management team, which has been in place since the events in the spring to which my hon. Friend referred, the trust has re-examined its internal procedures to identify areas of weakness in which immediate remedial action is necessary.

The trust acknowledged that it lacked a robust and clear system for dealing with cancellations. Too many different systems were in use, with insufficient co-ordination and understanding. The trust has already reviewed its cancelled operations policy and will take decisive measures designed to make certain that staff are available at all times to carry out trans-oesophageal echocardiograms. The trust has also reviewed the capacity of Wythenshawe hospital and is implementing a plan to increase its number of beds by 36. The majority of those beds are already in place, which will be of particular help in reducing the number of cancelled operations.

I was encouraged by the trust's own candid assessment that its performance had not been adequate in terms of cancelling and rescheduling operations. It has resolved to ensure that it has a senior manager with overall responsibility for ensuring that the number of cancelled operations is reduced substantially. The trust will also carry out an evaluation of its pre-operative assessment procedures with the objective of reducing cancellations, improving patient care and modernising communication systems in the hospital.

I can tell my hon. Friend that the trust is now working to a clear objective of an 80 per cent. reduction in cancelled operations on the current rate. I am pleased to note that the number of cancelled operations at the trust has fallen significantly in recent months. However, I will pay close attention in future to how the trust performs in that area. I am sure that the trust and all its staff want the service that they provide to patients to be improved in that regard, as they are absolutely committed to the welfare of all their patients. So do I, and so, I am sure, does she. The trust and the wider NHS in the Greater Manchester area are looking at a number of other ways to improve on current performance, including

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identifying spare capacity in other trusts in the area, investing in additional capacity and making better use of existing capacity.

On the problem of MRSA at the trust, in the cardiac intensive care and high-dependency units, new and more rigorous cleaning arrangements have been introduced following the recommendations of the infection control team. The trust's management is continuing to monitor the situation closely and I will ensure that my hon. Friend is kept informed of progress.

I am also aware that my hon. Friend has raised concerns with the trust about its willingness to share information with her about Mr. Ford's treatment. We recognise that the matter of trusts sharing information with MPs about their constituents raises sensitive issues. The Department recently issued for consultation a draft code of practice for NHS staff on confidentiality issues. Specifically, the code recommends that where a Member of Parliament states in writing that he or she has a patient's consent for disclosure, that should be accepted without further resort to the patient.

I am also aware of the exchange of correspondence in the summer between my hon. Friend and the Greater Manchester strategic health authority. Clearly, there was an unacceptable delay in responding to her concerns. Both the director of health and social care in the north and the chair of the strategic health authority have reviewed those events, as well as investigating the reasons for Mr. Ford's cancelled operations. By now, she will have seen their respective conclusions and have had time to reflect on their comments.

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The trust, the strategic health authority and my officials agree that action needs to be taken, and it is being taken. The South Manchester University Hospitals NHS trust is already taking action to reduce the number of cancelled operations at Wythenshawe hospital. The Greater Manchester strategic health authority has instructed trusts to include more information about rescheduled operations in their weekly performance management returns and will monitor carefully south Manchester's rate of cancellations. The strategic health authority has overhauled its own procedures for responding to inquiries from hon. Members. The directorate of health and social care in the north will oversee the implementation of all those performance improvements.

I reassure my hon. Friend that I believe that lessons have been learned. Action is now being taken. Mr. Ford and his family should not have been put through their ordeal. There can be no doubt about that whatever and I regret very much what has happened. It is now the job of the trust and the local NHS to ensure that, as my hon. Friend has said, such cases are not repeated.

7.29 pm

Sitting suspended, pursuant to order [29 October].

12.13 am

On resuming—

Question agreed to.

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