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Mike Penning: I could not agree more. We have defence and armed forces debates every year, but this is a specific area that needs help. Servicemen and women would like to hear the House debate matters that are of such importance to them and, most importantly, to their loved ones. Sadly, today, we have seen four of our brave servicemen and women brought back from Iraq after the terrible, tragic deaths on Remembrance day just outside Basra.
The Minister will not be surprised that I come now to the reconfiguration, cuts, closure, sackings, or however one wishes to describe what is going on at this moment at a board meeting of West Hertfordshire Hospitals NHS Trust, which is deciding what to do about local medical provision in south-west Hertfordshire. For some months now a consultation has been under way. Earlier the Secretary of State went on and on about local involvement, democracy or consultation in the way in which the health service is provided within our communities. I was fascinated to hear how she wants more and more people to be involved. I have the honour of representing a constituency that could not be more involved in the future of its general hospital. It has been campaigning for 30 years to try to keep it open, under successive Governments. I freely admit that there were pressures in the ’90s to close Hemel Hempstead hospital, but a decision was made long before 1997 that that general hospital—with full A and E and maternity services, and built for the community as a new town—must stay open because of the services that it provides to 250,000 to 300,000 people.
Investment from the previous Conservative Government—nearly £70 million—was made and massive rebuilding took place. New buildings opened and everybody seemed happy. Then, in 1997, this Government came to power. Within weeks, they closed the consultant-led maternity unit at Hemel Hempstead hospital and moved it to Watford. Since then, there have been continual closures at the hospital—
Sir Nicholas Winterton: Ministers are not listening.
Mike Penning: That is because they have heard it all before. They are not listening to my constituents either. During the ongoing consultation process, we have written to the Secretary of State on many occasions. She has been sent tens of thousands of letters asking her to visit Hemel to explain why she wants to close the local general hospital. Hon. Members may be interested to know that she turned up a couple of weeks ago. She did not go anywhere near the hospital, of course; she went to the local social services department. There was a small demonstration outside comprising ladies with pushchairs, people in wheelchairs, elderly people on walking sticks—oh, and a Member of Parliament, namely myself. The Secretary of State did not come past to look at their banners and try to understand the local community’s concerns. Instead, the police were called and three patrol cars arrived, at huge expense to my constituents. At the same time, she was hopping over a back fence to try to get through the back door and run away from my constituents and the local media. That is the kind of listening process that she has been undertaking in my constituency.
The Parliamentary Under-Secretary of State for Health (Mr. Ivan Lewis): How do the hon. Gentleman’s demands for intervention from the Secretary of State fit with his Front Benchers’ policy of operational independence for the national health service? Has he explained to his constituents that their policy is that the Secretary of State should not interfere at a national level in the local decision-making process?
Mike Penning: That is the most feeble intervention from the Front Bench that I have heard for a long time. Has not the Minister noticed that his Government are in power and that his Secretary of State is in charge of the future of our hospital in Hemel Hempstead?
Daniel Kawczynski: They are in office, but not in power.
Mike Penning: My hon. Friend makes a good point. When we return to power at the next election, we will empower local authorities and local people to ensure that that sort of thing does not happen. At present, sadly, the Secretary of State is in charge of the future of my local health service. The Minister keeps nodding and wittering from a sedentary position—if he would listen for a while he might learn something about what goes on in local democracy.
For months, letters have gone to the Secretary of State asking her to intervene. She has the power to appoint the chairman and the chief executive of the trust and to remove them if she is not happy. The Government have been complicit throughout with the proposals to close the vast majority of the hospital. Nevertheless, there was a consultation process, because that has to take place under the legislation. The results of that consultation were announced a few hours ago in Watford at the meeting of the board of West Hertfordshire Hospitals trust. Eighty-five per cent. of respondents said, “Leave Hemel Hempstead hospital alone—we do not want it to close.” Yet the chief executive of the trust stood up and said that he wanted to go ahead with the proposed closures.
Such closures and amalgamations are devastating for a local community. I agree with the hon. Member for Wyre Forest (Dr. Taylor), my colleague on the Health Committee, who talked about keeping local services local. We hear a lot about choice in the health service these days, but there is no choice if one has nowhere to go. Under the proposals that are being nodded through by the board, the chief executive will order the removal of all acute services from Hemel Hempstead hospital to Watford general hospital. By the way, I should add that Watford is one of the few places left in Hertfordshire with a Labour MP. Elective surgery will go to St. Albans. All the services of a full general hospital, which was built for the new town that was its community—not all constituencies represented by Conservative Members of Parliament are rural; mine is a new town with some serious social and economic problems on the estates—will go. If we are lucky, we may be left with an out-patient and diagnostic department.
Hon. Members may be interested to know that the trust has already been in discussion with developers, and that an informal meeting took place with the local authority—representatives of which had to attend,
whether they wanted to do so or not—about redevelopment and building houses on the hospital site. When the Secretary of State goes on and on about local engagement and involvement, it is frankly a sham. The decisions are based purely on financial deficits.
At a public meeting, when I asked the medical director of the trust whether he would close the hospital and cut all the services if it were not for the deficit problem that he had been told to sort out, he replied that the cuts were based not on clinical need but on financial problems. He will probably get the sack for admitting that, but at least he was honest, which is a damned sight more than Government Front Benchers’ comments on the state of the health service today.
I shall sit down in order to let many of my colleagues talk about the health service and its importance to them. However, I emphasise that decisions are being made today that affect my constituents’ future. I think that we shall be among the first to be hit by the cuts. It appears that, by Easter, there will be no hospital in Hemel Hempstead. That is a disgrace.
3.51 pm
John Hemming (Birmingham, Yardley) (LD): Given that the Department is called the Department for Education and Science—
The Secretary of State for Education and Skills (Alan Johnson): Education and Skills.
John Hemming: Well, it is the Department for education at least— [Interruption.] All right; fair enough—I am slightly out of date.
I shall not cover aspects of health and education that other hon. Members have mentioned but raise some other, novel issues. Several sensitive matters affect the relationship between the authorities and individuals. Let me make a declaration of interest of sorts: I chair an umbrella co-ordinating group that deals with reform in public family law, which is called Justice for Families. I have no financial interest in it or any declarable interest that qualifies for an entry in the Register of Members’ Interests, but I am concerned about children and families.
The Government’s Green Paper on looked-after children demonstrates the difficulty for children who are taken into care. That was reinforced by the recent National Consumer Council report, which showed that children in foster care are moved too frequently. For example, a recently born baby about whom I heard has been with five carers in his first 12 weeks of life.
In essence, the report shows that, on average, being taken into care is not a positive step for children. We must therefore be certain that it is the right thing to do. One of the difficulties in obtaining information about the child protection system is the secrecy of social services. It is claimed that that secrecy exists to protect the child, but it is clear that it is maintained mainly to protect any professionals involved from allegations of misconduct. The intentions of the majority of the people involved are clearly good and many hard-working people care a lot about their clients, but a much smaller number cause great problems. However, the system as a whole is at fault and Ministers need to consider what should be done.
The system’s faults were demonstrated by the current General Medical Council hearing about David Southall, in which the GMC has tried to keep things secret against the express will of the parents. I have, however, published at their request the names of four of the families, who are Janet and Lawrence Alexander, Sharon and Hannah Bozier, Janet Davies, and Davina and Ben McLean.
The case of 15-year-old Heidi Frost in Essex is a good example of the secrecy of the family courts protecting social services, not the child. She is not allowed to answer her friends’ questions about what happened. Social workers and paediatricians were shown to be in the wrong, but she is not allowed to tell people. As a result, she does not have a doctor. She believes that her experiences would be useful for any other children who were falsely accused. The system works against the interests of the children concerned, who remain its victims. There is an element of hypocrisy in adoption, with local authorities actively advertising children for adoption and providing their details, while their birth families are not allowed to talk about things.
It is good that the Government are reviewing secrecy in the family courts. The recent cases of Clayton v. Clayton and the judgment of Justice Mumby in respect of Nicola and Mark Webster have opened up more than a chink in the armour surrounding the family courts. It may be that people like Heidi can now speak out, but the law is not clear, and checking it costs tens of thousands of pounds.
Professionals have avoided scrutiny through secrecy and continually made errors that would have been picked up had matters been considered in public. It is very clear that too many children are taken into care and there are a number of reasons for it. There is the simple failure of the system where the system gets the facts wrong. In the case of the Williams family in Newport, which was recently in the news, a local paediatrician diagnosed “chronic sexual abuse” and split up a family for more than two years, when a more properly handled diagnosis at a later stage found no signs of sexual abuse. In that case, international evidence showed
“that the UK took a wrong turn after the Cleveland Enquiry and has been overtaken by other western nations”.
That evidence also showed that there was
“a tendency in the UK for paediatricians to over-diagnose”
Another worrying case is that of the Webster family in Norfolk. A radiologist diagnosed child abuse based on metaphyseal fractures and the children were taken away from the family. Metaphyseal fractures sound very worrying to a lay person, but they are not the same as a broken limb. Indeed, metaphyseal fractures can be caused by being born or by various bone diseases. It is clearly wrong to claim child abuse merely because of the presence of metaphyseal fractures. The good news is that the Royal College of Paediatrics and Child Health and the College of Radiologists are looking into the matter of non-accidental injury. However, we also need to look into the conflict of interests caused by the way in which payment is received for reports. If people get paid only for diagnosing child abuse, more child abuse will be diagnosed.
Those two cases came about from the actions of almost certainly well motivated physicians. The prosecution of Marianne Williams in Wiltshire—the salt poisoning case—was, however, a very different and more worrying case. It resulted in the person who was responsible for the care of her son—she was an alternative suspect for causing the child’s death—driving the prosecution case.
There are also cases such as that of Ben Hollisey McLean, in which the threat of child protection proceedings was used to force him into dangerous medical research. I have evidence of the threat of child protection proceedings being used to silence parents. Indeed, parents have been forced to admit that they harmed their children—when they did not—simply to keep them. When parents are caught in the Catch-22 world of social services it is one of the most pernicious and invidious aspects of the system, and it provides a reason why it is difficult to get clear understanding from the research.
Roy Meadow, who followed in the tradition of Matthew Hopkins, and David Southall, who shared that ancestry and that of Joseph Mengele combined, should have to account for the misery that they caused. Even if their motivations were good, the consequences will hang over many people’s lives for decades. The witch hunts, where mothers are alleged to have killed their children and are then required to prove their innocence against unfounded medical opinion, need to stop now. That does not require a change to the law, but it does require a change to procedure.
Apart from where the system basically gets things factually wrong, there are issues when the system gets the facts right but takes the wrong action. I know of a woman in Birmingham with epilepsy, whose children are continually taken off her at birth. I think that she has now had five. She has expressed the desire to continue to have babies until social services allow her to keep one because they run out of money. We really need to look at such cases and see why she cannot be supported to keep at least one child.
We also need to look at how issues of domestic violence are handled. It is wrong for a mother who is a victim of domestic violence to find that social services try to remove her children from her without trying alternative approaches. I am aware of a case in Sunderland and a second in Devon where that is happening at the moment. The underlying issue is fear of missing a child at risk, which means that people tend to play safe and treat a normal situation as one where a child is at risk. In cases like that of Victoria Climbié, abuse is obvious and should not haunt the system, driving people to treat normal situations as abusive. Common sense is needed to bring balance back into the system. One key point about the Climbié inquiry was that it showed how social workers were busy chasing up the chimera of a few Munchausen’s syndrome by proxy cases and did not have the time to focus on a serious case of abuse, which was ignored.
We clearly need to separate out the child protection function from the supportive function of social services—under “Every Child Matters” it is being reorganised slightly anyway—and link child protection to the police rather than the local authority. The police
are generally much better at handling such issues. Families are complicated things. Human relationships based mainly on affection rather than contractual arrangements may not seem a reliable system from a legalistic perspective. The evidence, however, is that on average they provide far more security for children than being formally looked after.
The words used in the system cause me some concern as well. I have seen reports in which the phrase “looked-after children” becomes the noun “LAC” with a plural of “LACs”. I have heard of the phrase “trans-racial adoptable commodity”, which means a mixed-race child whom social services think they can easily get adopted. Such phrases demonstrate dehumanising attitudes.
The system’s attitude is that parents do not matter. Case conferences are held at times and places that are inconvenient for parents, who are not given copies of the papers before the meeting, while other professionals are bullied into agreeing with social services as the lead agency. The system ends up careering towards disaster and its attitude is wrong.
Contested adoptions are another area with hazard. Currently, a secret case heard on the balance of probabilities and frequently based on flawed evidence, and in which parents are required to prove their innocence, results in the destruction of a family. That stores up problems for the future, as the case of Yvonne Coulter and her daughter Tammy shows. We must not forget the impact on the adopting family, who believe what they are told, only to find that the errors of the system cause breakdown during adolescence, which is a difficult time for many families. The process for contested adoptions must be changed. A life sentence should require cases to be held in public with a jury, and the evidence to prove them beyond reasonable doubt.
The current General Medical Council hearing over the allegations against David Southall shows how the system tends to maltreat families. It is not clear that the GMC wants to enforce the rules. I am particularly worried that it is not considering the decades of dangerous research on babies that David Southall has managed. The GMC tried to dismiss even the milder allegations currently being considered, and has tried to gag the parents and forced legal and medical advisors on them whom they do not want. The prosecution in that case is acting on behalf of the GMC, not on behalf of the victims of that doctor.
In the meantime, thousands of secret medical files—estimated to be more than 2,000—are being held by the University hospital of North Staffordshire. Many of the parents of the babies who were choked, given carbon monoxide and had their breathing damaged in other ways did not give consent to the experiments. The parents should be told if there are secret files on their children.
Given the regulatory system’s failure to deal with such research, it is worrying that the Department of Health is proposing a further deregulation of research. On a side note, I was contacted by a doctor who was concerned about medical ethics and who believed that those changes could lead to more situations such as that which arose at a hospital in Norwich, where a drug experiment went badly wrong.
The system in the UK has gone wrong in so many ways. It has not served children well. The biggest reason for that is the lack of independent scrutiny. Many changes are needed and many are missing from the Queen’s Speech, but the most important is to bring in independent scrutiny.
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