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The Government have said that they remain unconvinced, which carries the implication that they could be convinced, and we all hope that they will be, following tonights debate. They will only have had to listen to the excellent speech of my hon. Friend. He asked directly whether the official Opposition would consider initiating an independent public inquiry, and I can tell him that we do not exclude the possibility, if we are in office, of establishing such an independent public inquiry. However,
I emphasise that todays debate is taking place because the people of Staffordshire and beyond want an inquiry to be set up now, so our efforts need to be focused on that, not least to persuade the Government to do just that.
My hon. Friend the Member for Lichfield (Michael Fabricant) focused on the justice of the case, and on what lessons could be learned straight away, right across the NHS. He said that it was necessary to have an inquiry in order to assuage the publics concerns from the past and to learn all the necessary lessons for the future. With local and national health officials, Ministers and Government policy implicated in the problems, it is difficult to contend that a review conducted by officials in the Department of Health will deliver the thorough, all-encompassing, plain appraisal needed to reduce the chance of this happening again.
Mr. Cash: I want to take my hon. Friend one tiny stage further in his answer to my question. Will he also bear it in mind that the Leader of the Opposition, my right hon. Friend the Member for Witney (Mr. Cameron), was a parliamentary candidate in Stafford, and that he has taken a specific interest in this hospital, for all the right reasons? I am sure that my hon. Friend and the shadow Secretary of State will want to have a word with him about this.
Mr. O'Brien: I am absolutely sure that such words will be had. My right hon. Friend the Leader of the Opposition went to see for himself on 14 April, which is testimony to the deep personal concern that he has for this matter.
My hon. Friend the Member for South Cambridgeshire, in his close exegesis of the Colin-Thomé and Alberti reviews, described why both reviews were limited in their scope. He said that the reports lacked the independence required to give them sufficient perspective on the events, to call people properly to account, or to satisfy the needs of families and survivors in Staffordshire and beyond. The reports have not given the people of Staffordshire an opportunity to make the points and to ask the questions that they feel are important. Neither Colin-Thomé nor Alberti held public evidence sessions to provide an opportunity for depositions and questions to be asked by the bereaved and the survivors. As a result, the reports do not show the necessary rigour in relation to the culpability of NHS officials, the Department and the Government, either in political or executive terms. Such rigour is necessary to provide the answers for the people of Staffordshire, and to prevent such a tragedy from occurring again.
Mr. Kidney: I cannot fully answer the hon. Gentlemans question, but I am sure that he will be pleased to know that Dr. Colin-Thomé and Professor Alberti have agreed to come to Stafford and to face an audience consisting of members of the public and the relatives of those who died, in order to answer their questions. I am sure that the hon. Gentleman will welcome that as a good step forward, although it does not provide a complete answer to his question.
I am grateful to the hon. Gentleman for that intervention. He made an important speech on behalf of his constituents this evening, and I look
forward to welcoming him into our Lobby this evening. I also welcome the opportunity for questions that he has just mentioned. However, as I have just said, the opportunity for those people to answer is limited by the scope of their reviews, which is never going to be as wide or as deep as that of an independent public inquiry.
We need to ensure that we keep our discussion focused on the Ministers who have the power to make this decision, rather than on two well-respected people from civil service and departmental backgrounds. I hope that the Minister will recognise that we need to understand why lacunae exist in both reports, and tell us what role Ministers had to play in that. David Colin-Thomé and Sir George Alberti are civil servants employed by the Department of Health, and have been for a number of years. They may take to heart the independence of the civil service, but I think that the House would agree that they lack independence so far as their interest as members of the Executive, through the Department, is concerned.
For example, the House will be aware that the chief executive of the Shropshire and Staffordshire strategic health authority in 2005 to 2006 is now the chief executive of the NHS, and that the subsequent chief executive of West Midlands SHA is now the chief executive of the Care Quality Commission. A necessary requirement of any review should be to lay bare the management of the SHA between 2002 and 2008, and to provide an opportunity for the reputations of these two very senior civil servants in our NHS and the Care Quality Commission to be cleared.
It is clear that West Midlands SHA failed in its duty of performance management; it was more bothered about Department of Health initiatives, finance and reconfigurations and relied on performance assessment bodies to consider the quality of patient care. Cynthia Bower, now of the Care Quality Commission, only once raised mortality rates, for instance, in her routine briefings to the board. It would be helpful to have an independent public inquiry at which many other issues could be addressed and Cynthia Bower and others would have an opportunity to give their side of the story.
In the Alberti and Colin-Thomé reports, there is little evidence of any rigorous treatment of the impact of the Governments policies on the trust. Although Ministers might say that the policies are in no way linked to the events that occurred, if they were that confident, would not an independent public inquiry provide a stronger opportunity for them to disprove any such link between their policies and anything that took place at Stafford general hospital?
Three of the solutions identified by David Colin-Thomé are actions that should be taken by the Department of Health. That suggests that, in his mind, there are three actions that the Department might have taken to avoid the tragedy happening. Hon. Members might assume from that that the Department of Health would be mentioned at least three times in the body of the reviewyet the Department of Health is not mentioned once in its substantive body.
Clearly, we can see the effect of the chaos arising from the near-perennial reorganisations of the NHS and the suppression of a powerful patient and public voice. Like my hon. Friend the Member for Poole
(Mr. Syms), I hark back to the late lamented community health councils that were killed off by this Government, as they were independent and able to aggregate individual circumstances to draw general conclusions that were extremely helpful in advising Governments and the public about the performance of the NHS. We also have to remember the failure to act on events at Maidstone and Tunbridge Wells. They all had a part to play in the tragedy.
It is vital to remember that, in his opening remarks, the Minister mentioned that there was continuing contemptcertainly on the basis of the discussions we have hadfor a real complaints process in the Care Quality Commission and the Healthcare Commission. We have advocated proper complaints processes, but they were refused by the Government, who have relied on an over-burdened and under-resourced health services ombudsman. An independent public inquiry would be able to demonstrate how these processes should work.
In arguing the case for an independent public inquiry, it is important that both the policy and the individuals are properly scrutinised. The Secretary of State said that he remained unconvinced, but we hope that the right hon. Gentleman, who promised Julie Bailey of the Cure the NHS campaign that he would think again, will actually do so. We salute that campaign and we hope that when the Under-Secretary replies, she will do the right thing, support our motion and launch the public inquiry. On behalf of all those who are grieving and those who have suffered, we hope that she makes the best and shortest speech she has ever made and simply says yes.
The Parliamentary Under-Secretary of State for Health (Ann Keen): The events at Stafford hospital were totally unacceptable. The hospital badly let down its patients and their families, and it has let down our national health servicean institution that has been providing the very highest standards of care for more than 60 years. I worked as a nurse in the NHS for more than 25 years and whenever the tragedies, complaints and reality of what happened at Mid Staffordshire become clear to us when we read these reports, we feel shame and we feel that we have let many people down.
I would like to thank Professor Alberti and Dr. Colin Thomé for their timely and informative investigations. I am sorry that the Opposition Front-Bench team feel that their lack of independence in any way deflects from their absolutely renowned work as well-respected clinicians. I feel that the reports have, quite rightly, been critical. Those, combined with the original report of the Healthcare Commission and the ongoing reviews of individual patient records have brought, and continue to bring, rigour, clarity and understanding about what happened at Mid Staffordshire and the reasons behind it.
I believe, however, that the hospital has, importantly, begun to start to make the significant improvement to patient care and safety that we were looking for and that, certainly, those who use Stafford as their hospital were looking for.
The Healthcare Commission, the independent regulator expressly established by Parliament to scrutinise and investigate the NHS, has conducted a full investigation and produced a detailed report laying bear the failures at Stafford hospital. The reviews from Professor Alberti and Dr. Colin-Thomé provide us with further reassurance in relation to the trust and greater insight into the reasons why those failures remained undetected for so long. In addition, the trust has invited in people who are not just concerned, but devastated, about the care that they or a close relativea mum or a dadreceived. What those relatives feel about the care at Mid Staffordshire goes right to the core of us as people.
On the request for an independent clinical review, that process is under way and, to date, about 85 reviews have been requested. Those will be difficult and painful, but I believe, like many others, that the fact they are being taken in this way shows that this is the best way forward.
Mr. Cash: On a point of order, Mr. Deputy Speaker. The Minister has been talking about the question of how these matters should be conducted, but, unfortunately, the governance for NHS foundation trusts says that the board of directors of a trust
In the light of that, we believe that a public inquiry would, at this stage, obviously be very time consuming. It would add little more to our understanding of what happened and distract the new management and staff from improving the quality of care for local people, which we so want them to do.
Public inquiries can be an important mechanism independently to establish the cause of a problem or a disaster, and I can understand that there are many who consider a public inquiry into the events at Mid Staffordshire to be appropriate and necessary, but in this case, even Sir Ian Kennedy, who we respect so much and who chaired the public inquiry into the tragic events at Bristol royal infirmary, has said that he does not feel that one is necessary.
There has already been an independent examination of what went wrong and a public account of the failure at Mid Staffordshire, but if hon. Members believe that there are significant issues or lines of inquiry that have not been addressed, either by the Healthcare Commission report or by the subsequent reviews, the Secretary of State will be only too happy to consider that. That also appears to be the view of Opposition Front Benchers. The hon. Member for Eddisbury (Mr. O'Brien) said that even Opposition Front Benchers have not ruled out that possibility, so I am at a loss to see what is the difference between the two sides of the House.
Mr. Deputy Speaker: Order. I understand the hon. Gentlemans strength of feeling on this matter, but that is shared by colleagues across the House. The Minister must be allowed to make her winding-up speech.
Mr. Stephen O'Brien: On a point of order, Mr. Deputy Speaker. Before there is any danger of a possible distortion of any words and any commitment that we have given, I hope that you can assist me in ensuring that the record, including that of the debate, shows that we gave an undertaking that we would look at ordering an independent public inquiry in the absence of the Government ordering one now, which is where our efforts are focused.
I wish in particular to mention the Royal College of Nursing. It is our understanding that since the publication of the two reviews, the RCN is calling no longer for a full public inquiry but rather for a review of any new issues.
Many hon. Members have taken part in the debate, but the issues that the Opposition Front Benchers raised shared the theme of whistleblowing. I intend to address that, but I am sure that hon. Members will understand it if I praise my hon. Friend the Member for Stafford (Mr. Kidney).
The reality is that Sir George Alberti and Dr. Colin-Thomé have agreed to present their findings about what happened at Stafford at a public meeting in Staffordshire. I understand that my hon. Friend the Member for Stafford is facilitating that meeting, and I congratulate him on that. He is aware of the importance of the recruitment of good-quality staff at Mid Staffordshire, and that issue was raised by the hon. Members for Lichfield (Michael Fabricant), for Stone (Mr. Cash), for Wyre Forest (Dr. Taylor) and for Poole (Mr. Syms). My hon. Friend the Member for Cannock Chase (Dr. Wright) reminded the House of how we have to work together to see that these incidents do not happen again.
If I may go into the heart of the problem at Mid Staffordshire, it is about reporting bad care and whistleblowing. Our next stage review by Lord Darzi is about quality and safety. We cannot have quality and safety in patient care, which is paramount to every health professional, if we do not have the appropriate work force. Every patient journey must start by having quality and being safe. We cannot have safety if we do not operate in an environment of an open culture and a management who show real leadership. That encouragement of leadership at all times throughout the review has raised the quality of leadership within the Mid Staffordshire trust.
It was this Government who brought in a whistleblowing charter. [Interruption.] Opposition Members may shout, but if they are concerned about the reality and quality of patient care and safety, I suggest that they work
within the next stage review at all times, because the quality and safety of patient care are paramount. I appeal to the new leadership that is in place at Mid Staffordshire to get in place the consultants, nurses and health professionals who can provide a quality work force, so that they can lead quality patient care and so that Mid Staffordshire is known as a centre of excellence in future. We shall bring that about through our education and training system.
The Prime Minister has commissioned a commission on nursing and midwifery, which I am privileged to chair. I shall attend Mid Staffordshire trust to consult nurses about how they feel things went wrong. With the serious comments that have been made in the House, we need to address why people did not feel they could report such serious incidents. From the top doctors to everyone else who works at the hospital, from the ward to the board, every one of us is responsible for patient care, and every one of us will continue to administer the quality and safety that our national health service should deliver, and that our patients have every right to expect us to deliver.
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