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18 Mar 2010 : Column 358WHcontinued
Mr. Barron: I am not tempted to fill in the remaining time available for the debate, but perhaps you would allow me to respond to the debate, Mr. Russell, and to thank everybody who has taken part. The Minister spoke about the impending retirement of my hon. Friend the Member for Dartford (Dr. Stoate), who has played a solid role on the Health Committee for many years. May I also mention my hon. Friend the Member for Bristol, North-West (Dr. Naysmith), who is present this afternoon but has not spoken in the debate? Both will be retiring at the next election, and from my perspective as quite a green Chair of a Select Committee when I moved to the Health Committee in 2005, they have been of enormous use, not only for the report, but to me as an individual. Their experience has helped me on many occasions to chair the Committee and to bring reports such as this to the House. I wish them both well in whatever they plan to do once they leave the House.
The Minister has mostly responded positively to the outcome of our inquiry into patient safety, both this afternoon and in her written responses. I would like to address three areas, one of which was mentioned by the hon. Member for Romsey (Sandra Gidley) and relates to the evidence we took about the European working time directive. I do not want to rehearse the issue now, but there was concern about the ability of young surgeons to get appropriate experience and training.
When the Committee looked at independent sector treatment centres, phase 1, which took uncomplicated orthopaedic cases, we found an absence of training for our young surgeons in those establishments. At the time, it was said that the surgeons would be trained in phase 2 of the ISTCs, although we know that many of
them have not taken part. I emphasise to my hon. Friend the Minister that we must seize such opportunities. No matter what is happening with the working time directive and changing hours, we must seize opportunities to train young surgeons, so that they can go into such institutions and train on a daily basis. Someone in the Committee mentioned practice, but intense training in doing that type of surgery is the best way. We did not serve those young surgeons well by agreeing to have the ISTCs and an absence of training. That was one area I wanted to mention, because the real issue is what will happen in the future, and whether there will be any diminution in the quality of our surgeons. I am sure that all future Health Committees will want to look into the matter.
One issue that all speakers mentioned during the debate, which I touched on too, was the use of technology, particularly information technology. Everybody who spoke in the debate agreed that we need to use such technology. The summary care record was mentioned, and there have been recent BMA outpourings on that. The issue is not new. About three years ago when we began to look at IT in the national health service, I visited a local GP surgery in a village that I represent, and I was told that there were great issues of confidentiality. I was told that a pass card was needed to get into the system. I asked how many people had a pass card, and found that although there were five GPs in the practice-it was quite large-there were 11 pass cards. I asked who had the other six cards if there were only five GPs, and I was told, "Well, the people who do the letters have got the other six." I said, "It doesn't seem to me that there is a great concern about confidentiality in your practice, if six non-clinical people have access to your electronic records".
The BMA must get a grip on that issue. Everybody knows about the potential not only for summary care records but for other records to improve patient safety and look after patients, but some people have had their heads in the sand for a number of years. The hon. Member for Romsey said that we cannot alter patient records, but it is possible to trace who opens an electronic record. We can go back and see whether anybody has gone into it who should not have done, but who knows who looks into the paper records in a GP's surgery-the Lloyd George records as they are called? There is no trace of who does that.
There is also the issue of patients' records being altered when things have gone wrong. I have personal experience of that from when I sat on the General Medical Council as a lay member and looked at fitness to practise many years ago. There were occasions when people altered records because something had gone wrong with a patient. That is wholly unacceptable, and a way of getting round it is to introduce proper electronic records together with confidentiality.
My hon. Friend the Member for Dartford mentioned the time we went to the USA. We visited the veterans agency that looks after ex-service men and women. It has a database of 4 million people. During the hurricane in New Orleans, all the local records were lost, but the records of the ex-service men and women were still
there because they were held on a central database. If those records had not been held in that way, it would have been a catastrophe for the management of some of those people. That has been well written about since, but the Health Committee knew about it then. Everybody who has attended the debate will see the point of that-I am looking at the hon. Member for Guildford (Anne Milton) because one or two of her colleagues have questioned this issue on occasion. If millions of people can have individual banking records, why can we not have that for public sector records, certainly for the management and the safety of patients? I hope that people will read and listen to this debate, and take that into account.
I agree with the Minister not only about the work of the NPSA up to now, but about the potential for that work to bring in more data and for people to learn from such data. I am sure that in a decade's time-even I will not be in this place talking about health and patient safety then-we will be far more knowledgeable.
I want to finish on what is in part a negative note. None the less, I think that I should bring this up, because the Minister brought up the fact that the culture of openness was lacking and the challenge back in the 1980s by Nurse Pink. I have the press report that came out when the final report of the independent inquiry into the events at Mid Staffordshire NHS Foundation Trust was published and I shall read out one paragraph from it. Speaking at the publication of his final report, Robert Francis, QC, said:
"The Inquiry found that a chronic shortage of staff, particularly nursing staff, was largely responsible for the substandard care. Morale at the Trust was low, and while many staff did their best in difficult circumstances, others showed a disturbing lack of compassion towards their patients. Staff who spoke out felt ignored and there is strong evidence that many were deterred from doing so through fear and bullying."
That is not acceptable in any health care system. It certainly is not acceptable in a 21st century health care system that is more than 60 years old, as the NHS is now. We have a long way to go to improve our health care system if reports such as that are now and again coming before us. I hope that the Health Committee report and what has been said about it in today's debate go some way towards improving patient safety in this country. We need to get away from the blame situation. We need to be more open. We need to learn what aviators learn. When there is a near miss, everyone should know about it, so that if such an incident can be avoided, it will be avoided in the future.
I thank all hon. Members for taking part and you, Mr. Russell, for giving us the opportunity to debate the report. This will be the last debate that we have on a Health Committee report in this Parliament.
Bob Russell (in the Chair): I thank the right hon. Gentleman for bringing the debate to a close and I thank all those who participated. For what it is worth, from the Chair it was a delight and a pleasure.
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