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Written Statements

Monday 15 October 2007

Health: C. Difficile

The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): My right honourable friend the Secretary of State for Health (Alan Johnson) has made the following Written Ministerial Statement.

The Healthcare Commission (HCC) published a report on 11 October 2007 titled Report of the Investigation Following Outbreaks of Clostridium difficile at Maidstone and Tunbridge Wells NHS Trust following its investigation into Clostridium difficile.The report has been placed in the Library.

The HCC commissioned its investigation into the trust following a request by the then Kent and Medway Strategic Health Authority following concerns that there had been a significant increase in the numbers of Clostridium difficile at the trust.

There were two outbreaks of Clostridium difficile at Maidstone and Tunbridge Wells Hospitals NHS Trust between April 2004 and September 2006. The findings of the report show that there were 1,176 patients with Clostridium difficile at the trust between April 2004 and September 2006, of whom at least 345 died.

The report estimates that if the 50 cases that were reviewed as part of the HCC’s investigation were representative of the 345 who died, and the reviewer’s assessments are extrapolated to all, of the 345 deaths, Clostridiumdifficile was probably or definitely the main cause of death in approximately 90 patients, and definitely the cause in 21 cases.

The report calls for immediate changes to improve the care of patients and control of infection at the trust, which I fully support. The report has exposed significant failings in the duty of care at the trust, which I do not expect to see replicated elsewhere in the country. The HCC is continuing to work with the trust and NHS South East Coast to ensure an appropriate action plan is agreed and implemented.

Following the recommendation of the Healthcare Commission report, the South East Coast Strategic Health Authority has commissioned an independent review into the leadership of the trust during the period of the outbreaks. This will be carried out by an independent consultancy with experience in this area, and an interim report will be made available to the strategic health authority by November.

In addition, I have asked the department to carry out a separate review into the role of the chair of the trust and the decision-making process that led to the terms and conditions of the chief executive’s departure. This will conclude urgently, will be shared with the Appointments Commission and will inform what action is taken with regard to the position of the chair.

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This is an alarming and distressing case and the trust and the department have offered their sincere condolences to the patients and families who have been affected by these outbreaks.

In line with national guidelines, trusts should deliver clean, safe treatment for every patient in their care, every time. Where senior management and trust boards fail to act to deliver this expected standard they must and will be held accountable.

In addition, the NHS chief executive will write personally to every NHS trust appending a copy of the Healthcare Commission’s report and seek reassurances from every chief executive in the country that the drive to improve infection control is a major priority in every organisation.

Although employment is a matter for the local NHS trust board, I have instructed the trust in this exceptional case to withhold any severance payment to the former chief executive of Maidstone and Tunbridge Wells NHS Trust, pending legal advice.

Housing: Social Housing Regulation

The Parliamentary Under-Secretary of State, Department for Communities and Local Government (Baroness Andrews): My honourable friend the Minister for Housing has made the following Written Ministerial Statement.

I am announcing today decisions on the location and scope of the new social housing regulator following Professor Martin Cave’s review of social housing regulation in England earlier this year (Every Tenant Matters: A Review of Social Housing Regulation, Professor Martin Cave, June 2007) and our subsequent consultation (Delivering Housing and Regeneration: Communities England and the Future of Social Housing Regulation, Communities and Local Government, June 2007).

I am announcing that the regulator will be established as an independent, standalone body called the Office for Tenants and Social Landlords. We intend to implement this through the forthcoming Housing and Regeneration Bill which was included in the Government’s draft legislative programme published on 11 July 2007. I am also appointing an independently chaired advisory panel to give further advice on the technical work needed to bring local authority landlords within the regulator’s scope.

The Office for Tenants and Social Landlords will take on the regulatory functions of the Housing Corporation. The investment functions of the Housing Corporation will pass to the Homes and Communities Agency.

Unlike under the current regulatory framework, the new regulator will have the power to reduce red tape and regulation for registered social landlords that are performing well, and will also have stronger and more wide-ranging powers to take action where tenants are not getting a good service. The new regulator will therefore put a much greater emphasis on service to tenants, with tenants groups able to trigger inspections and interventions when problems arise.

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Background

Martin Cave published his review of social housing regulation in June, recommending the establishment of a new independent regulator, responsive to tenants and applying the principles of modern, risk-based regulation. He proposed that tenants should have a central role—and should be able to trigger intervention by the regulator when they identified systemic failings by their landlord.

The Government immediately accepted the bulk of his recommendations, but consulted on two key questions: the location of the regulator, and whether local authority landlords should fall within the regulator’s scope.

Regulating local authority landlords

The Cave review recommended that the regulator’s responsibilities should cover all social housing providers—registered social landlords, local authorities, arm’s-length management organisations (ALMOs) and others. The Government were clear in their response to Cave that tenants should be able to expect the same minimum standards of service and have similar opportunities for empowerment, to influence delivery and to seek redress regardless of their social housing provider. However we also recognised that the funding, governance and accountability arrangements vary significantly between providers, and we were mindful of our commitments in the local government White Paper to implement a new, single, performance framework for outcomes secured by local authorities working alone or in partnership. We therefore invited views on this issue through consultation.

Respondents to the consultation were overwhelmingly in favour of bringing local authority landlords into the scope of the regulator in principle. But a large number of them also highlighted the importance of recognising the significantly different governance and finance arrangements between the different sectors, and making arrangements which were consistent with the single performance framework for local authorities.

I am announcing, therefore, that while we see a strong case for bringing local authorities into the regulator’s scope, we need to do further detailed work with stakeholders on a range of detailed issues. I therefore propose to appoint an independently chaired advisory panel to provide support on handling these issues. It is my intention that cross-domain regulation should be in place within two years of the regulator coming into operation.

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The location of the regulator

The Cave review recommended that there should be a separation of investment and regulation functions—both currently carried out by the Housing Corporation. He said that the new regulator could be established as part of the Audit Commission, but that he would prefer a new standalone regulator.

Our consultation document recognised that locating the regulatory functions in the Audit Commission would build on its existing strengths and consumer focus, and it could be implemented quickly. However we also recognised that a standalone regulator may be better at this stage at commanding the confidence of those who provide private finance for social housing. We consulted openly on this issue.

In responding to the consultation document, registered social landlords, tenant representative bodies and lenders all favoured a standalone regulator because of the greater clarity of purpose of an independent regulator, and because of the importance of the regulator maintaining expertise in private finance issues. As it is vital that the new regulatory arrangements command the confidence of lenders in order to support increasing new social housing, I therefore propose to establish the new regulator as a standalone body.

Railways: Franchise Enforcement Policy

Lord Bassam of Brighton: My honourable friend the Parliamentary Under-Secretary of State for Transport (Tom Harris) has made the following Ministerial Statement.

The Department for Transport has today published a consultation paper on rail franchise enforcement policy. The document details the department's stepped and pragmatic approach to enforcement. It also contains a statement of policy with respect to the imposition of penalties and the determination of their amount, which the department has a legal obligation to consult on.

The purpose of the document is to ensure that the department's current policy is transparent and easily understood, and to ascertain from stakeholders whether further clarification on any element of the enforcement process is required.

Copies have been sent to rail industry stakeholders and it will be available on the DfT's website for the 12-week consultation period, running from 15 October 2007 to 4 January 2008. Copies have been placed in the Libraries of the House.

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