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I would also remind hon. Members that public inquiries take a long time. The Bristol inquiry took three years and the Shipman inquiry took five. We have concerns that, as well as not adding to the sum of our knowledge of what happened at Stafford hospital, a public inquiry could distract the new management and the staff at the hospital from focusing on further improving the quality of care for local people.
Norman Lamb: I am grateful to the Minister for giving way and apologise for nagging him. The Governments amendment says that an inquiry would not be appropriate at the present time. Earlier in his speech he said that an inquiry would not be appropriate at this stage. He seems to be leaving the door open. Is that the case and will he consider further representations about the possibility of establishing a public inquiry?
Mr. Bradshaw: As I hope the Secretary of State and I have made clear, we are always open to representations. We have listened carefully to those that have already been made, by both hon. Members from all parts of the House and Julie Bailey, to whom I join the Opposition spokesman in paying tribute. However, so far we remain unconvinced, and that is as far as I can go.
In a letter to my hon. Friend the Member for Cannock Chase (Dr. Wright) from Sir Ian Kennedy, the outgoing chairman of the Healthcare Commission who chaired the Bristol babies inquiry, Sir Ian said that he did not think that a public inquiry would be justified in this case. However, as we have repeatedly made clear to hon. Members and to the local patients organisations and others, if there are significant issues or lines of inquiry that they do not think have been addressed, either by the Healthcare Commission report or by the subsequent reviews, the Secretary of State will be only too happy to consider them.
Mr. Cash: Is the Minister aware of the fact that, before he became the chairman of the Healthcare Commission, on the Bristol inquiry, Sir Ian Kennedy said that the importance of a public inquiry is that it offers an opportunity for people to be heard and to listen to others? He also said that a public inquiry
allows for the public venting of anger, distress and frustration; it provides a public stage on which this can take place.
Mr. Bradshaw: For once I am grateful for the hon. Gentlemans intervention, because it makes my case exactly for me. If someone such as Sir Ian Kennedy, who said that about the importance of public inquiries, does not believe that a public inquiry is necessary or desirable in this case, that absolutely makes the point for me. I am grateful to the hon. Gentleman.
Martin Yeates, the former chief executive at the foundation trust, stepped down from his post on 3 March 2009. The interim chair of Mid Staffordshire, David Stone, subsequently suspended Mr. Yeates, pending an investigation. That investigation has now concluded and the foundation trust has decided to accept Mr. Yeatess resignation, with no disciplinary procedures being invoked.
I accept that that is a matter for the foundation trusts board, in conjunction with Monitor. Both the Secretary of State and I have been clear all along that the proper process must be followed in relation to any individuals.
However, given the grave events at Stafford hospital and the understandable level of public concern, I find it hard to understand why the decision was made not to go through a disciplinary process. The Secretary of State has accordingly written to Monitor today, asking to see a copy of the investigation into Mr. Yeates. If we still have concerns after we have seen that report and heard the explanation, we will consider what further action needs to be taken. The Secretary of State could not have made it clearer that there can be no rewards for failure in the NHS.
We did that in the case of Rose Gibb, the former chief executive of Maidstone and Tunbridge Wells hospital, and we won. We expect the whole of the NHS to understand that the public will not tolerate cosy deals when they have suffered from such abject management failure.
Mr. Bradshaw: I am sure that the Secretary of State will want to consider that question, but given that he commissioned that workjust as he did all the other reports, all of which have been put in the public domainI should be very surprised if he did not agree. However, we need to see the report first.
The Healthcare Commissions report laid bare appalling failure at Mid Staffordshire. The two subsequent reports made further and far-reaching recommendations, which are being implemented locally and nationally, in order to ensure that every hon. Member will be satisfied that such terrible failure can never be allowed to happen again.
Norman Lamb (North Norfolk) (LD): I welcome this debate and I am pleased that it has been called. I join the Minister and the Conservative spokesman in paying tribute to the work of Julie Bailey who, together with others, has been persistent in refusing to be fobbed off in the pursuit of complaints. They are to be applauded for their persistence.
Ever since then, I have maintained my view that a public inquiry must be set up. There are Labour Members who feel the same way, and it is important that we all maintain the pressure on the Government to accept our pleas. It was interesting to hear the Ministers response regarding the wording of the Governments amendment.
The words that he used in his speech seemed to suggest that there was a chink of light there. It seemed to me that the Government might just be open to persuasion.
Michael Fabricant: I am pleased that the hon. Gentleman thinks the Government might be open to persuasion, but what I heard from the MinisterI hope he will correct me if I misheard himwas that the Government were always willing to entertain representations. That is fine, but he also said that a public inquiry would be a distraction to the management. To me, that certainly does not suggest a chink of light; it merely suggests that the Government will listen but take no action.
Norman Lamb: I understand that concern, and all hon. Members on both sides of the House who feel strongly about this should combine to put the maximum pressure on the Government, not only in tonights vote but subsequently, to ensure that the issue does not just go away. There is always a danger, as events move on, that these issues can slip down the agenda, but we must not let that happen in this case.
Mr. Cash: Does the hon. Gentleman accept that, when this matter comes before the Health Select Committee, as I understand it will, the preliminary debate that takes place here will be followed by significant evidence that will be impossible for the Government to ignore?
To date, the Governments response has been to scapegoat the local leadership. The local leadership absolutely has to take responsibility for what happened, but the Governments strategy appears to be to apologise on its behalf and to move on. That will not do. It is right that those in a position of leadership at the hospital should be held to account, but that strategy fails to recognise that wider lessons need to be learned from this awful horror. The former chairman of the Healthcare Commission described the events as the worst care ever witnessed in the NHS. That in itself is a pretty compelling reason for a public inquiry in this case. Those wider lessons seem to have been brushed aside by the Government, reflecting their stubborn resistance to recognising that, for example, the four-hour target played any part in what happened.
I want to run through some of the key reasons for holding a public inquiry. They relate to the specific situation at the hospital and to the wider issues involved. The first involves the position of Mr. Yeates. The Minister said that he was concerned because the board had allowed Mr. Yeates to resign without going through a disciplinary process. I am pleased that the Minister said he expected the report into these events to be published. He said that the Government would need to see it first, but it should be placed in the public domain irrespective of what it says. It was commissioned by the Secretary of State to look into what led to this awful disaster, and to examine Mr. Yeates role in it, and that information should be put into the public domain straight away.
Is the hon. Gentleman perplexed, as I am, about why, if the Secretary of State commissioned Peter Garland to undertake this work, Peter Garland
did not report to the Secretary of State? If the foundation trust has the degree of independence that I think it does, and it has now made its decision, the Secretary of State must surely be powerless to do anything about it now.
In regard to the resignation, it is now too late to institute disciplinary proceedings. We have been presented with a fait accompli, and the former chief executive is now being paid to be on gardening leave for the rest of his notice period. The NHS is paying for that, despite the fact that there appears to be good evidence to justify a disciplinary inquiry. I also agree with the hon. Gentleman that the report should have gone to the Secretary of State, given that it was commissioned by him.
Mr. Lansley: I hesitate to intervene on the hon. Gentleman again, because he is an employment lawyer by profession. Mr. Yeates might not necessarily be beyond disciplinary action, but would there not need to be substantive evidence of a breach of his fiduciary duties to the board in order for such penalties to be contemplated? A public inquiry might be a principal mechanism by which such evidence could be gathered.
Mr. Bradshaw: It might be helpful to both hon. Members if I clarify who commissioned the report. As a foundation trust was involved, the report was of course commissioned by the trust itself, but that decision came out of the overall response to the Healthcare Commission inquiry by the Secretary of State, in conjunction with Monitor. So in legal terms, it is absolutely right that the report should go back to the trust, but that does not take away from the points that I made earlier about what needs to happen now.
The second reason why there should be a public inquiry is the role of the clinicians in the hospital. Many people have expressed their concern that, despite the awful things going on therethe dreadful care to which the former chair of the Healthcare Commission referredit appears that no clinician saw fit to report their concerns to senior management or elsewhere, with the possible exception of one nurse, about whom we heard last weekend. It could be argued that they felt prevented from doing so by the bullying culture in the organisation. However, they have a professional clinical duty to their patients, and, irrespective of the extent to which the unit was understaffed, if they saw that there was inadequate care, it was their duty to report their concerns and to get something done about it. That did not happen, and that in itself is a scandal that should be investigated by way of a public inquiry. It is not being looked at in any other way. None of the reports that the Secretary of State has commissioned has looked at that issue. As things stand, those clinicians who participated in the care that has been so heavily criticised are presumably continuing to work in the NHS. Should we not be concerned about that? That issue is not being addressed, and it ought to be.
The other issue relating to clinicians is the culture of bullying that appears to exist. The Sunday Telegraph this weekend reported concerns raised by a nurse who had previously worked in the A and E department at the hospital. She raised those concerns in November 2007, yet nothing appears to have been done. She referred to racist abuse, and to the fact that nurses were
routinely ordered to lie about how long patients had been waiting.
Junior doctors were bullied into discharging patients before they had been properly examined in order to meet targets.
Mr. Cash: The hon. Gentleman might know that many of those allegations were also made during Simon Coxs programme on Radio 4, which many of us have on disc. These questions must be looked into properly because they are so grave, as some of the quotations that I shall give the House from the statement by that nurse will amplify.
It is easy to say that this culture exists in only one hospital and could not exist in any other, but we hear too many stories of a similar culture existing elsewhere. That is why the wider implication of the management of the NHS and the extent to which clinicians and other hospital staff feel constantly under pressure because of targets imposed from above, and the way those targets are enforced, should be looked into by a public inquiry.
The third reason why there should be a public inquiry is to secure justice for the families that have been so horrendously affected by this awful scandal. So many of them have refused to be fobbed off, but the fundamental question remains about how justice will be secured for families of the victims of this dreadful care. That is another issue that is not being properly addressed in any systematic way other than by this review of patient notesa review that looks at each case individually, which is not sufficient if we want to see the whole picture and understand how this happened. We need to give those families a real sense that their concerns are being properly addressed.
The fourth issue, which I raised in an intervention on the Minister, is the role of the coroner. The Minister made the point that there appears to be some challenge to the conclusions of the Healthcare Commission report; I understood the Minister to dispute the fact that the inquiry was obstructed in some way. Surely, however, we need to address the fact that there is potential for coroners to obstruct inquiries, so we need clear rules and clear guidelines about coroners responsibilities to co-operate fully in such circumstances.
When the Minister referred to legislation going through Parliament, I assume he meant the Coroners and Justice Bill. He said that there were measures in it to address some of these concerns, but will he clarify whether any thought is being given to the possibility of tabling an amendment to place a specific statutory duty on coroners to co-operate in inquiries of this sort? I would be happy to allow him to intervenenow or laterto confirm that it will be possible to amend this draft legislation.
The next reason why we need a public inquiry relates to the roles of the PCT and the SHA in the context of what this whole scandal means for commissioning. We hear a lot about the pursuit of world-class commissioning, but in this particular case it is clear that the PCT and the SHA failed abysmally to play an adequate role as commissioners of care at this hospital.
Greg Mulholland (Leeds, North-West) (LD): Does this case not show that this health authority tier or level is, frankly, unnecessary? We know that the health service needs to rationalise and save money, so is it not time to abolish a failing tier of the NHS that did not do its job in this case?
The responsibility for managing performance, including effecting necessary improvements, lay and lies with the trust and its performance manager, the Strategic Health Authority, the commissioning PCT and, after the award of Foundation Trust status, Monitor. These performance managers
are able to visit any trust and call for whatever information that they believe is necessary from the Trust to carry out their duties.
Following normal practice, efforts were made
to liaise with the trust and the SHA to explore what was needed.
The investigation team at the Commission did not know that the Trust was being considered for this status
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