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Clifford Ayling

The Secretary of State for Health (Dr. John Reid): The report of the committee of inquiry into how the National Health Service handled allegations about the conduct of Clifford Ayling (Cm 6298) is being published today and copies have been placed in the Library. This is one of the three inquiries announced in July 2001 by my right hon. Friend, Alan Milburn, the then Secretary of State for Health. The other two inquiries were to consider how the NHS handled allegations about the conduct of Richard Neale, a former gynaecologist; and William Kerr and Michael Haslam, former psychiatrists.

The Government would like to thank Dame Anna Pauffley, the chairman of the inquiry, and the two members of her panel, Peter Berman and Mary Whitty, for their delicate handling of undoubtedly sensitive issues. Their report is painstakingly researched and
 
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provides in clear detail a history of events in the NHS that led, in December 2000, to Clifford Ayling's conviction on 12 counts of indecent assault. It charts the procedures then in place through which patients could raise concerns about their treatment; and the failures in those systems that let down many of Clifford Ayling's patients so badly. The Government are very grateful to Dame Anna and her panel for producing such a comprehensive report and to the secretariat and legal team for their tremendous support.

The Government are also grateful to those former patients of Clifford Ayling who came forward and provided evidence to the inquiry which must, at times, have been very difficult and painful. The systems in place in the NHS to help and support these patients who raised concerns about Clifford Ayling's behaviour and treatment let them down. No patient should be left in a position where those in charge of their care are able to abuse their trust and take advantage. My sympathies go to the patients involved in this case. They will have the benefit of knowing that their evidence will help to ensure that better and more robust systems will be put in place to avoid similar incidents in the future.

Similarly, the evidence provided by former colleagues was clearly very important to the inquiry in determining how the systems worked, or failed. Their candour in giving evidence is very much appreciated.

Since these events have come to light, we have taken a number of steps to help avoid similar incidents in the future and the report itself recognises that considerable change has taken place in the NHS since Clifford Ayling practised, concluding . . .

"The impact of the Government's plans and investment in health services has dramatically altered the landscape of the NHS. At an organisational level, it is almost unrecognisable as the NHS in which Ayling practised. The emphasis on patient safety, remedial action for poor clinical performance, closer scrutiny of untoward events and empowering patients in the management of services are greatly welcomed."

The changes introduced in recent years have already sought to address the weaknesses found by the inquiry as being a cause for concern. For this reason the inquiry has directed its recommendations towards strengthening the systems now in place rather than offering new or alternative proposals for action.

The Government welcome the recommendations in the report which include proposals both to address the issue of sexualised behaviour and to ensure that guidance is available for dealing with it; and that all trusts and primary care practices should have an explicit policy on the use of chaperones. These are important issues that will require detailed consideration if changes are to be implemented effectively. Likewise, the role of patient advocacy when dealing with 'sexualised behaviour' in both the hospital and the primary care setting will also require further detailed consideration.

The report acknowledges that considerable changes have already been made. These include substantial changes to the NHS complaints procedure and the current development of guidance to trusts on how to handle untoward incidents. Further changes are in hand and planned.
 
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It recommends improvements to the recording of complaints against individual practitioners and the importance of co-ordinating complaints, coupled with the need to ensure that employers are aware of other employment being undertaken by their medical staff.

Other recommendations include requiring staff of NHS trusts and other healthcare organisations employing staff, such as deputising services, to declare concurrent employment and for this requirement to be suitably adapted to ensure that PCTs are kept informed of other professional work undertaken by GPs; the provision of better support for single-handed practitioners and their practice managers; and clarification of the roles of the respective professional and local bodies in primary care.

The Department of Health is also asked to develop a memorandum of understanding with professional regulatory bodies and the Crown Prosecution Service; and to work with strategic health authorities to provide guidance to trusts on handling untoward incidents.

Issues around complaints are also being considered by the Shipman inquiry, which is likely to produce recommendations in its fifth report due later this year. They are also being considered by the William Kerr/Michael Haslam inquiry whose report is also expected later this year. We will therefore consider these recommendations together with those of the Shipman, Neale and William Kerr/Michael Haslam inquiries and give a detailed response in due course.

The Department of Health is asked to take account of the inquiry's recommendations in the development of its current work on a memorandum of understanding with the NHS, the police and the Health and Safety Executive. We shall of course ensure that the report and its recommendations are brought to the attention of the project board taking this work forward. As part of this work, guidance is currently being developed for the NHS including a strategy for involving patients and others.

Our purpose in setting up this inquiry, as with all investigations of errors in the NHS, is to learn the lessons and put in place procedures to minimise the risk of similar errors occurring in the future. As already indicated, much work has already been done and further work is in hand. We very much welcome this report and its recommendations, and those of the Richard Neale inquiry also published today, with their emphasis on putting patients at the centre of health care. These reports will provide an important contribution to a continuing process of improvement.

We have made clear that patient safety is a priority and the UK has led the way in pushing forward in this area. Tomorrow, I will be talking to fellow EU health ministers about the lessons EU members can learn from one another and make clear that patient safety will be a key issue during the UK presidency of the EU next year.

It is completely unacceptable that the events described in this report were allowed to happen. In acting on the inquiry's recommendations we will be guided by the need to prevent future patients having to suffer in the same way as many patients of Clifford Ayling.
 
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FOREIGN AND COMMONWEALTH AFFAIRS

Libya: Future Defence Requirements

The Parliamentary Under-Secretary of State for Foreign and Commonwealth Affairs (Mr. Bill Rammell): On 19 December 2003, Libya announced that it would dismantle its weapons of mass destruction programmes, and limit its ballistic missiles to a range of less than 300km. Since then, Libya has been working to put these commitments into effect, and has been pursuing a course of reintegration into the international community. The Government welcome and fully supports this process.

The Government recognise that Libya, following its decision to renounce weapons of mass destruction, has legitimate defence requirements. The United Kingdom has a clear interest in developing an open and co-operative relationship with Libya on defence matters. During his visit to Libya on 25 March, my right hon. Friend the Prime Minister announced the appointment of General Robin Searby as the United Kingdom Defence Co-ordinator for Libya in order to offer Libya a new military relationship with the United Kingdom. As a natural part of progress towards full normalisation of the United Kingdom's relations with Libya, the Government intend to respond to Libyan requests to discuss their legitimate defence requirements in detail.

The Government welcome news of Libyan and German agreement on a compensation package for the victims of the 1986 La Belle disco bombing as a significant milestone in the process of rebuilding the United Kingdom's and the European Union's relations with Libya. In light of this agreement, the United Kingdom expects to revisit the issue of the EU arms embargo imposed on Libya in 1986 with EU partners over coming months. If the embargo were removed, the Consolidated EU and National Arms Export Licensing Criteria (which apply to all countries) would be the test against which any proposed export of defence equipment to Libya would be assessed.

While the embargo remains in place, all contact with Libya in this area must fall within the terms of the EU arms embargo and United Kingdom law. This means that no commitments in relation to the actual supply of licensable defence equipment will be made while the embargo is in place.

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