Examination of Witnesses (Questions 400-404)
MS CANDY
MORRIS AND
MR RICHARD
STEIN
1 MARCH 2007
Q400 Dr Naysmith: I think Richard
is going to disagree with you.
Mr Stein: Not at all. Firstly,
I was going to say within the provisions of overview and scrutiny
regulations there is a provision that says that if there is a
risk to the health or safety of patients or staff then no consultation
is required. Obviously in a sense it is usually an emergency measure—and
what is referred to in the guidance is an infection where all
the staff have got a bug or all the patients have got a bug and
clearly then you need to close the ward—but usually if there
is a longer term crisis, I have been in cases where the fire certificate
has been the excuse. This seems to be standard: old crumbling
cottage hospitals that you want to close but you do not really
want to consult because the locals are going to go do-lally. You
say, "We cannot get a fire certificate," but then that
is a question of money. You have got a plan to close the hospital
in five years' time, how much is it going to cost for the fire
doors, is it worth spending £70,000, £80,000 £100,000
to be able to achieve a certificate? What does the Fire Brigade
say; is it reasonable to hold on for a couple of months while
you consult on that? That seems to be a case where there is no
imminent danger and to use that as an emergency reason for not
having a consultation does not seem right to me, and in those
cases what has happened is the trusts have taken legal advice
and backed down, so they agree.
Q401 Dr Naysmith: Even where we are
talking about a clinical situation, it is always possible to say
if you coughed up some money for a couple more staff this situation
would disappear. Is that not right?
Ms Morris: No, that is certainly
not always the case and there is plenty of evidence for some things
such as the fact that staff have to be able to see a certain number
of complex cases a week or a year or whatever to keep their skills
up and so on. So these things are never straightforward. What
is important—and it goes right back to the heart of section
11—is these should not be surprises, these should be things
where the dilemmas and situations are laid out with people, including
the community hospital example.
Q402 Chairman: Could I just clarify
one thing. You said earlier that PPI would be one of the core
standards that the Health Care Commission would look at. Is that
your SHA core standards? My understanding is that it is a not
a national standard that is laid down.
Ms Morris: The Health Care Commission
do as part of their health check with primary care trusts and
trusts have a standard and they test against that for public and
patient engagement. The SHA itself as an organisation is not inspected
or assessed by the Health Care Commission so we do not have a
core standard in that sense.
Q403 Chairman: You do not have a
core standard but you are saying the other NHS organisations do
have a national core standard on PPI?
Ms Morris: You are worrying me
now. It might be a developmental standard rather than a core standard.
Q404 Chairman: We seem to be having
the debate here among ourselves at the moment so thanks for not
clarifying that, we will clarify it elsewhere, but could you check?
Ms Morris: Yes I will do that
and I will write to the Committee.[1]
Chairman: My understanding is that it
is not a common national core standard and it is maybe something
the Committee might want to look at in the next few weeks. Can
I thank both of you very much indeed and apologise for the lateness
of the hour of the session. Hopefully we will have our report
out into the public domain in the not-too-distant future.
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