Patient Safety - Health Committee Contents

Memorandum by William Cash MP (PS 103)


  As the Member of Parliament for Stone, my constituents are directly affected because they are within the immediate vicinity of the Stafford Hospital. Indeed, the organisers of what became the Cure the NHS campaign came to see me because one of them was a constituent of mine, Debby Haseldine, and they were in despair. I had several meetings with them and I advised them to organise themselves into a campaign and presented the Healthcare Commission with a detailed list of matters which we insisted that the hospital Trust addressed before the Commission completed their report.

The day this report was leaked by the Daily Mail, I called immediately for a public inquiry under the Inquiries Act 2005 because it was clear that although the Healthcare Commission had done the preliminary work there were other matters before and since their report which required a full inquiry with evidence on oath, calling of witnesses and the production of papers, etc ... There are other inquiries, such as that in Wales of which the Committee will be aware, which will serve as precedents. Indeed in 1985, I called for an inquiry under the then Tribunals and Inquiries Act in the same hospital where there had been an outbreak of Legionnaires' disease and where there had been a tragic number of deaths.

Because I have worked so closely with the Cure the NHS campaign and have helped to campaign using a significant amount of evidence with them on a mutual basis, including minutes of the Strategic Health Authority in the course of reorganisation and subsequently the South Staffs PCT etc ..., I am glad to endorse the views of the Cure the NHS campaign and thereby save the Committee time. However, I do strongly believe that an inquiry under the Inquiries Act 2005 is necessary because it has the powers necessary to get to the bottom of what has gone so tragically wrong and also to protect whistleblowers and where justified to exonerate those who need exoneration.

  I enclose my contributions to the various statements and debates in chronological debate because I have concentrated on each occasion on the reasons why I believe a 2005 Act inquiry is needed and these are all on the record in Hansard.

  In the content of whistleblowing, as I have stated on a number of occasions, although the Public Disclosure Act has many good features, it can be bypassed and in my opinion, has been bypassed. Consequent to this, even the Secretary of State stated that there have been no whistleblowers from Stafford Hospital so far and I would refer the Committee to the recording of the programme produced by the BBC produced by Simon Cox on 16 April 2009. I have however been approached by, in the context of concerns for my own constituents had exchanges with, certain whistleblowers whose evidence I now enclose as Annex A.

  I have indications from as many as 20 Consultants that they are deeply concerned in the public interest but that from their communications to me directly and indirectly, they are exceedingly apprehensive of revealing their names. This demonstrates the need for greater disclosure under the Public Disclosure Act. The only really effective legal protection for whistleblowers would seem to be evidence on oath where they are totally protected by legal privilege.

  In the case of Mr Ahmed, you will notice that although he is currently suspended from the University Hospital of North Staffordshire he has conducted work in relation to Stafford and I understand that either of them may be prepared to give evidence and my office can supply their e-mail addresses and telephone numbers if required.

  For all the reasons I have set out, I strongly believe that the Committee will wish to take oral evidence perhaps more extensive than at first thought and I would strongly urge them to conclude from my close examination of what has happened and the dreadful impact on the victims and the bereaved and my constituents and in order to restore confidence in the future of Mid Staffs NHS Trust that a public inquiry under the Inquiries Act 2005 should be recommended, where all these matters can be dealt with in the manner they deserve. I also believe as I have said in the debate that this is not only a local issue but has profound national implications given the role of the Chief Executive of the NHS, David Nicholson, and the Chief Executive of the Care Quality Commission, Cynthia Bower, both of whose evolving careers parallel closely the course of this tragedy from about 2005.

  I also believe that the minutes of the meeting in December 2007 demonstrate the fact that Bill Moyes, the Chairman of Monitor pursued a line of questioning prior to the giving of Trust status, which was largely inappropriate and contributed to the failures in due course. Of the 46 questions, only relatively few related to patient care and quality—the rest were about finance and governance. The same appears to be true of Strategic Health Authority as they were reorganised and turned into the West Midlands SHA. The reports of Professor Alberti and Colin-Thomé are also critical of the performance of the Trust and the Committee will no doubt form its own judgements about these which have no doubt gone some way but do not get to the bottom of this problem.

May 2009

Annex A


Bill Cash, MP

  Many of you will have heard the Radio 4 show "Any Questions?", broadcast on Sunday from Stafford Gatehouse Theatre, followed by "Any Answers?", about the call for a public inquiry into the Mid Staffs NHS Trust tragedy. As you will know, I was the first MP to call for a public inquiry and at the right time. In parliamentary terms, it was absolutely essential to call for one as the Prime Minister and Secretary of State were in the House of Commons to give their own statements and explanations, which they did on the same day on 18th March, one immediately after the other. I had already called for an inquiry on national radio and television. The reason for my pre-emptive action was to give them the opportunity to give a public inquiry before they locked themselves into a Governmental refusal which involves a U-turn. This is where we are now. This is what I did in 1984 when I won the case for our public inquiry on Legionnaires' disease at Stafford Hospital.

I believe that with the right kind of public inquiry, under the Inquiries Act 2005, we will be able to sort matters out for the future but in order to do so we must establish what went wrong and why. On the day of the statement, Wednesday 18 March, I told the Prime Minister "What we need is a full public inquiry to get to the bottom of the matter. It is not enough simply to deal with the issue in the way that he described." This kind of inquiry involves evidence on oath and compulsion of witnesses and papers, which is absolutely essential and would protect whistleblowers.

I then told the Secretary of State, Alan Johnson, that instead of holding several scattergun reviews, the Government should be "bringing all those matters together in one public inquiry, as we did in different circumstances back in 1984, with Legionnaires' disease in the same hospital ..." A series of mini-reviews commissioned by the Government itself will not deal with the matters adequately and nor will it restore public confidence in the hospital for the future.

The devastating Healthcare Commission report fulfilled a useful preliminary purpose but it is a mere stepping stone. Its investigation would undoubtedly shorten and reduce the cost of an independent inquiry. In Parliament, Shadow Health Secretary, Andrew Lansley, at my suggestion, tabled an Early Day Motion calling for a public inquiry and it has now been signed by over 150 Members of Parliament. The Commission's investigation has achieved a considerable objective, but I call for an independent inquiry because it would be truly "independent". Moreover, it would restore confidence and trust and get to the bottom of the failures of governance and culture as well as specific medical issues and give justice to the bereaved, to the victims and the patients and provide a basis for compensation. It would also, where appropriate, exonerate those who should be exonerated.

  The disaster marks a systemic failure internally and externally at every point on the compass by a wide variety of bodies charged with investigating and providing analysis, statutorily or otherwise. For the reasons that I have given, no confidence can be placed in the arrangements that the Secretary of State has put in place in relation to the Trust, because they lack the fundamental elements of real independence. There is also the problem of conflict of interest because when the Prime Minister said that the Care Quality Commission would review the matter, I pointed out that the Chairman of the Strategic Health Authority at the time is now Executive Director of the Care Quality Commission.

  As I said in a debate in the Westminster Hall in the House of Commons on 1 April, "That is a travesty, given that in the minutes of a meeting of the strategic health authority board on Tuesday 18 March 2008, which I have with me, Cynthia Bower said that `there appeared to be nothing to indicate anything out of the ordinary was taking place on mortality.'" I have also called attention to the methods of self-assessment which the Healthcare Commission report criticises and which the new Care Quality Commission, under the new Act of Parliament, is not going to improve.

  As I further explained in the debate, the Government's reviews of the Trust are not truly independent in the most important sense—"They are scattergun reviews, with different terms of reference and timelines for reporting, and they do not allow the compulsion of witnesses and papers. That is a vital ingredient to get to the bottom of this tragedy. If the Government refuse to have an independent inquiry under the 2005 Act, that will be a local and national disgrace."

  Furthermore, I went on to say "There is no answer to this question other than an independent inquiry—the people of my constituency insist on one, the people of neighbouring constituencies insist on one and every national, regional and local newspaper insists on one. I can think of no reason why the Secretary of State and the Minister should not agree to such an inquiry. If they do not, the Government's integrity will be at stake."

  I could not believe the Health Minister, Ben Bradshaw's response to our calls for a public inquiry in the Westminster Hall debate. I was appalled at his assertion that the Healthcare Commission report was the end of the matter as it was an inquiry of sorts—in other words, this was our justice. And so I will continue to press for a public inquiry.

  To put that in context, now that Local Government Secretary, Hazel Blears, has come to Stafford and seen the full extent and rage of local people, and has even promised to relay the strength of feeling about the Stafford Hospital scandal to Alan Johnson, I am now writing to the Secretary of State again pressing for a public inquiry.

  I was glad to see that Cure the NHS campaign leader, Julie Bailey, who all of us in our area are indebted to, not only vowed to continue pressing for a public inquiry to be held on Stafford Hospital, but gave Hazel Blears a piece of her mind on her visit.

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