Memorandum by William Cash MP (PS 103)
MID STAFFS
NHS TRUST
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
WHY WE
NEED A
PUBLIC INQUIRY
INTO THE
MID STAFFS
NHS TRUST TRAGEDY
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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