NHS: Learning from Mistakes

Debate between Baroness Laing of Elderslie and Heidi Alexander

Wednesday 9th March 2016 Commons Chamber

[Heidi Alexander (Lewisham East) (Lab)]

I thank the Secretary of State for his statement. The Opposition support any measures that will improve safety in our NHS and make it more open to learning from mistakes. However, we will also provide robust opposition and scrutiny when we think that the Secretary of State’s actions are having the reverse effect.

Let me start by setting out where we support the Government. On the independent medical examiners, the Secretary of State will know that that is a reform that the Opposition have long pushed for. The previous Labour Government legislated in 2009 for the introduction of medical examiners, following the inquiry into the crimes of Harold Shipman. The call to introduce medical examiners was then repeated in the Francis report and in the report of the Morecambe Bay investigation, chaired by Dr Bill Kirkup. Indeed, last year’s Kirkup report said:

“We cannot understand why this has not already been implemented in full”.

We welcome the implementation of the medical examiners system, but it is concerning that it appears to have been delayed until April 2018. Will the Secretary of State say why progress in that area is so slow? Will he reconsider the timetable for their introduction given that April 2018 is more than two years away? Will he say more about how the reform will be funded? Local government faces further cuts over the coming years and while I understand that local authorities will be reimbursed for set-up costs, they will have to collect fees to fund the service. How will that work in practice? Is the Secretary of State confident that local government, which is already having to do more for less, will be able to take on the role of administering this process?

We also support the changes to the GMC and NMC guidance that the Health Secretary is announcing today, which will recognise the importance of an apology, but it is unclear how that is different from the guidance that came into effect last August. Indeed, the GMC first announced plans to change its guidance in this way more than a year ago, so can he say how his announcement today differs from the plans that were already in place?

On the learning from mistakes league, how will the 32 trusts that have a poor reporting culture be supported to improve? We know from listening to the testimonies of Sara Ryan, the mother of Connor Sparrowhawk, that the learning culture in some trusts just is not good enough. I know, from speaking to the small number of my constituents who have experienced failures of care, that the fight to get mistakes recognised is only part of the battle. They also want to know that the failures they have experienced will never happen to anyone else, yet all too often they are faced with a system that seems as though it simply struggles to learn.

Does the Secretary of State accept that he needs to do much more to develop a positive learning culture in our NHS? How in practical terms will he support clinicians and managers to improve services? Go to any health trust and we will find a director of finance and non-executive directors with financial expertise, but rarely will we see the same attention being paid to quality. Does the Health Secretary not agree that every trust board needs someone whose focus is not short-term firefighting, but co-ordinating and bringing together staff to drive improvements in quality?

I will always support sensible steps to improve safety and transparency in the delivery of health services, but what I cannot do is stand here today and pretend that other actions taken by this Government will not have a detrimental effect on patient care. The Health Secretary’s kamikaze approach to the junior doctor contract means that no matter how the dispute ends, he will have lost the good will of staff, on which the NHS survives. How can he stand here and talk about patient safety when it is him and him alone who is to blame for the current industrial action, for the destruction of staff morale and for the potential exodus of junior doctors to the southern hemisphere? [Interruption.]

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order.

[Heidi Alexander]

Thank you, Madam Deputy Speaker. I ask the Health Secretary: how can he stand here and say that he wants the NHS to deliver the highest-quality care in the world when the people he depends upon to deliver that care for patients have said, “Enough is enough”? How can he talk about patient safety when he knows that his £22 billion-worth of so-called “efficiency savings” in the next four years will lead to job cuts and will heap more pressure upon a service that is about to break?

I know the Health Secretary has been shy about visiting the NHS front line in the past few months, but if we speak to anyone who has any contact with the NHS, the message we will hear is clear: the financial crisis facing the NHS is putting patient care at risk. The independent King’s Fund recently said:

“Three years on from Robert Francis’s report into Mid Staffs, which emphasises that safe staffing was the key to maintaining quality of care, the financial meltdown in the NHS now means that the policy is being abandoned”.

That is simply not good enough. For those people who have experienced failures of care and for those staff working in environments so pressurised that they fear for the quality of care they are able to deliver, the Health Secretary needs to get his head out of the sand. I say this to him: measures to investigate and identify harm are all well and good but there needs to be action to prevent harm from happening in the first place—fund the NHS adequately, staff it properly and you might just give it a fighting chance.

Recreational Sea Bass Fishing

Debate between Baroness Laing of Elderslie and Heidi Alexander

Thursday 11th February 2016 Commons Chamber

[Heidi Alexander]

On a point of order, Madam Deputy Speaker. During today’s oral statement on the junior doctor contract, the Secretary of State for Health said, “Along with other senior NHS leaders…Sir David has asked me to end the uncertainty for the service by proceeding with the introduction of a new contract”. The Health Service Journal has this afternoon contacted the 20 senior NHS leaders the Health Secretary referred to in his statement, and at least five have replied to say that they do not support his decision to impose a new contract. I am concerned that in making this claim the Health Secretary may have inadvertently misled the House. Can you advise me, Madam Deputy Speaker, on how best the Secretary of State can correct the record?

[Madam Deputy Speaker (Mrs Eleanor Laing)]

I am grateful to the hon. Lady for her point of order, but she will appreciate, as the House will, that it is not a point of order for the Chair. She has a point that she wishes to draw to the attention of the House, and she has used this mechanism so to do. I am quite sure that those on the Treasury Bench will have heard what she has said and that her concerns will be conveyed to the Secretary of State. Whatever the Secretary of State says in this House is a matter for him and not a matter for the Chair.