Oral Answers to Questions

Jerome Mayhew Excerpts

Tuesday 19th October 2021 Commons Chamber

[Edward Argar]

The hon. Lady is right to highlight that, essentially, social care and the NHS go hand in hand; they are two sides of the same coin. That is why we have made ambitious proposals, and will bring forward further proposals, for furthering the integration of those two sides.

The hon. Lady raised a specific case to illustrate her point. I, or perhaps more appropriately the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), would be happy to meet her to discuss the details of that situation.

[Jerome Mayhew (Broadland) (Con)]

12. What steps his Department is taking to build new hospitals.

[The Minister for Health (Edward Argar)]

I am grateful to my hon. Friend for his question. In October 2020 the Prime Minister announced details of 40 schemes that we will be taking forward in line with our manifesto commitment to deliver 40 new hospitals by 2030, supported by an initial £3.7 billion investment for them.

[Jerome Mayhew]

This seems to be the crumbling hospital corner of the House, as we have already heard from my hon. Friend the Member for Don Valley (Nick Fletcher) about his concerns. In Norfolk, we have the Queen Elizabeth Hospital, which is physically crumbling, and the ceilings and roofs are held up by wooden staves and acrow props. Although it is not in my constituency—it is in the constituency of my hon. Friend the Member for North West Norfolk (James Wild)—it serves the entire county, and eight Members of Parliament have written in support of the bid. Could I invite the Minister to visit the Queen Elizabeth Hospital to see for himself the state of its structure?

[Edward Argar]

I am very grateful to my hon. Friend, who quite rightly recognises and highlights the work that my hon. Friend the Member for North West Norfolk (James Wild) has put into championing the cause of this hospital. I understand that it has put in an application to be one of the next eight hospitals, which will of course be considered very carefully. I am very happy to visit Norfolk as well, but I would also highlight that one of the key issues at this particular hospital is the existence of RAAC—reinforced autoclaved aerated concrete—planks, for which we have already provided £20 million for remedial works this year.

Cawston Park Hospital: Norfolk Safeguarding Adults Board Review

Jerome Mayhew Excerpts

Tuesday 21st September 2021 Commons Chamber

[Jerome Mayhew (Broadland) (Con)]

We are here this evening because of Joanna, Jon and Ben. Joanna had autism and was epileptic, Jon was autistic too, and Ben had Down’s syndrome. Their learning disabilities led to mental health difficulties, and they were consequently sectioned under the Mental Health Act 1983 and sent to the private Jeesal Cawston Park Hospital in my constituency. It is an assessment and treatment unit, and assessment and treatment is exactly what was meant to happen to these people: they were meant to be assessed and then treated, the objective being their discharge back into community care. But that did not happen.

Joanna was kept in the hospital for 11 months before she died in April 2018. Jon was kept in the hospital for 24 months before he died in October 2019. Ben was kept in the hospital for 17 months before he, too, died, in July 2020. All of them were in their early 30s, and all of them suffered from neglect. They were neglected through uncontrolled weight gain, through a lack of meaningful physical or mental activities, and through a lack of effective treatment through continuous positive airway pressure—CPAP—machines, which help people to sleep at night. The staff neglected the raising of concerns by members of their families; and, worst of all, they neglected even to attempt to resuscitate them when resuscitation was desperately needed.

Joanna was found unresponsive in her bed. A nurse and five carers—all of them trained—attended, but not a single one attempted resuscitation. Joanna died. Jon had swallowed a piece of a plastic cup. He told staff:

“I cannot breathe. I am dying.”

The CCTV footage proves that the staff just stood there for several minutes without attempting resuscitation. He died.

The day before Ben died, it was obvious that he was extremely unwell. He had blue lips and blue nails because of a lack of saturated oxygen in his blood. His mother was there on a visit and she raised the alarm. She demanded that an ambulance be called, but the hospital refused. Even later that day when Ben’s oxygen saturation levels were measured and found to be 35%, no ambulance was called. He died. The hospital neglected the families, and neglected to use their expertise and experience.

The families describe indifferent, harmful hospital practices, excessive use of restraint and seclusion by unqualified staff, and overmedication. A mother has contacted me in the past week to describe her child’s matted hair, her uncut fingernails and toenails, and the soiled clothing piled in a corner of the room. By chance, CCTV footage reviewed after Ben’s death uncovered a casual physical assault on him by a carer on the day he died. He was pulled down by his arms and then slapped around the head. What have we not seen?

This was supposed to be a specialist assessment and treatment unit, yet records were not even kept by the hospital for prolonged periods. Joanna was at the hospital for 11 months, but there are no records for 179 days of those 11 months. Ben was there for 17 months, but for an amazing 450 days during that 17-month period, no records were kept. So what assessment was undertaken? What treatment was given? My first request of the Minister is this: we need to acknowledge the scale of this scandal and its impact on real people, the most vulnerable in our society. We also need to acknowledge that we should all be ashamed.

This is not unique. We have heard this before. It sounds familiar, and that is because exactly the same thing happened at Winterbourne View Hospital back in 2012. We have had the report. This was another assessment and treatment unit where people with learning disabilities or autism were abused. The 2012 report criticised the development of assessment and treatment units, saying that they were

“not part of current policy, and certainly not recommended practice…Containment rather than personalised care and support has too easily become the pattern in these institutions.”

Of course lessons were learned. Department of Health reports described the abuse of people at Winterbourne View Hospital as “horrifying”. A Department of Health programme of action was agreed, and I have it with me today. Following the statement:

“We the undersigned commit to a programme for change”,

the very first undertaking is that

“Health and Care Commissioners will review all current hospital placements and support everyone inappropriately placed in hospital to move to community-based support as quickly as possible and no later than 1 June 2014.”

That did not happen. Today, in 2021, more than 2,000 patients are still contained in assessment and treatment units. I use the word advisedly: they are “contained”.

This is my second request to the Minister. Will she, on behalf of the Government, recommit this evening to the needed closure of all assessment and treatment units? That is what the coalition Government committed to doing in 2012, but by 2014 it had still not been done. We need to do it now. Why do we need to do it? There is a monumental conflict of interest for these private hospitals. Beyond being merely inhumane, there is a huge commercial incentive to maintain residency, because each of these patients comes with a fat cheque of £26,000 per month.

We can see where the conflict lies and why one family member, when they went to Cawston Park Hospital, was handed a piece of paper on which was written the address of a firm of solicitors. Her statement said:

“Once people are in Cawston Park Hospital you can’t get them out.”

Patients did not leave Cawston Park Hospital, and the problem is structural. If a hospital is paid £26,000 a month to assess and treat a patient, is it surprising that the hospital does not release them?

We have had another review of this latest scandal, and the Norfolk Safeguarding Adults Board’s review of Cawston Park Hospital is excellent. I have read it. It is 105 pages long and there are 13 recommendations. I recommend it wholeheartedly to the Minister, and the Government should apply all the recommendations.

The report has been followed by the usual handwringing responses from the agencies. Action plans have been created and there have been multidisciplinary stakeholder reviews. Profound apologies have been given, and I believe they are profound apologies. Lessons have been learned, but in my submission they have not really been learned, because without a profound culture change in residential care, we will be back here again. We all know it and the public know it.

[James Wild (North West Norfolk) (Con)]

I am grateful to my hon. Friend for securing this debate on the tragic events in Norfolk and for the powerful case he is making.

One of the most alarming elements of this very shocking report is the final hours of Ben, which my hon. Friend mentioned. Ben’s mum, Gina, said:

“If you ill-treat an animal, you get put in prison. But people ill-treated my son and they’re still free.”

That is completely unacceptable, and the police and the authorities should look again at all the leads and all the evidence to hold those people to account.

[Jerome Mayhew]

My hon. Friend is absolutely right that management teams and owners should personally fear prison as a response to a culture failure. If a culture of neglect is tolerated by their acts or, more likely, by their omissions, there needs to be personal liability. People need to fear prison, because there will be no change without individuals being held personally to account for allowing this culture of indifference. I profoundly hope that the most rigorous investigations are undertaken by the police and the Care Quality Commission, with a focus on individual prosecutions if justified by the evidence. There have been no prosecutions to date.

More generally, and widening the conversation away from the individual, directors need to be held to account if we are to restore public trust in the system. The Law Commission is aware of this, and it is undertaking a consultation on the issue of corporate criminal liability. It is consulting on how we can make improvements primarily, in the first instance, in economic crime, but how much more important is it to get equity where the victims are the most vulnerable in society, people in care, people who cannot argue their own case because of their age, because of illness or because of their condition?

The current rules on the definition of a controlling mind are often too narrow for individual prosecutions to succeed. The legislation has been on the statute book since about 2007, and there have been hardly any successful prosecutions because of that narrow definition. This needs to be changed.

I am meeting the Law Commission in October, along with the authors of the Safeguarding Adults Board review, to press the case for a widening of the definition to make the people who run such hospitals fear personal prosecution, because that is how we will change the culture.

That leads me to my third request of the Minister. If she really wants to prevent a repeat, will her Department commit to making a submission to the Law Commission consultation on criminal corporate liability so that we strengthen the personal responsibility for providers of residential care? The Chinese general Sun Tzu, who is very famous now, said “Kill one, terrify 1,000”, and he was right. The problem is that families of patients are concerned; they are the ones who are fearful and have no confidence in the current system. They fear the consequences and we need to change that; it should be the directors of care businesses. If they allow abuse and neglect, they should be fearful—they should pay with the fear of a prison sentence. Only then will we get change.

Covid-19: Contracts and Public Inquiry

Jerome Mayhew Excerpts

Wednesday 7th July 2021 Commons Chamber

[Jerome Mayhew (Broadland) (Con) [V]]

Madam Deputy Speaker, I will be as quick as I can. I am just sorry I am not with you in person today.

Opposition day debates are a precious opportunity to direct the subject of debate and focus national attention on areas of utmost concern to the country, yet today the SNP has used one of these few debates to repeat last week’s attempt by the right hon. Member for Ross, Skye and Lochaber (Ian Blackford) to smear mud on the Government’s handling of PPE contracts back in 2020, hoping that some of it will stick. When we are still facing momentous decisions on how to handle covid, and with Scotland right now, as we have heard, being the covid capital of Europe, that tells us a lot about the SNP. With speech after speech starting with unsubstantiated accusations of sleaze and ending with the goal of separation, it feels as though it is more important for the SNP to build up the UK Government as some kind of bogeyman figure to boost support for separation than to try to make Scotland better, so here we go once again.

The motion asserts that

“the Government has failed to give full details of the process”

for granting

“emergency covid-19 contracts”,

which is just not correct. SNP Members should look at regulation 32(2)(c) of the Public Contracts Regulations 2015, which sets out the power used by the Government. Early on, the Cabinet Office published guidance on how procurement should take place in this framework, referring to the need to keep proper records of decisions; transparency and publication requirements; and the need to achieve value for money and to use good commercial judgement during any direct award. This guidance was published, and it is still on the gov.uk website. It is there for SNP Members to see, but they must know that because, after all, it was exactly the same approach that they used themselves in Scotland. There was one difference: in Scotland, the SNP Government tried to remove the ability of the public to question their procurement decisions by excluding freedom of information requests. They were foiled only by a parliamentary revolt. When it comes to their own record in government, this debate tells us a lot about the SNP.

As for the Government not giving details of the procurement process, SNP Members well know that the PPE offer was put through the same process by civil servants, working round the clock to save lives, no matter where the offer came from. The NAO made it clear that

“we found that the ministers had properly declared their interests, and we found no evidence of their involvement in procurement decisions or contract management.”

I hold my hands up, like so many others today. At the height of the emergency, I was personally inundated with offers to help from random businesses in my constituency. I have no idea whether they were Conservative, Liberal Democrat or Labour supporters, but I am pretty confident that they were not Scottish National party supporters. I passed them all on to the VIP inbox in the same way as other MPs, including Ministers, and thank goodness we did. One was from those at the Black Shuck distillery in Fakenham. They looked up the recipe for hand sanitiser on the World Health Organisation website. They made it themselves and donated it to local medical facilities—at least they wanted to. Was I wrong to help them to get around regulatory difficulties and pass that offer on?

Mistakes were definitely made—probably lots of them. After all, a lot of decisions had to be made very quickly and there was no precedent to follow. However, as we have heard, the Boardman review reported on that back in December 2020 and it made 28 recommendations on how the system should be improved. The Government welcomed those recommendations and agreed to implement them in full. SNP Members already know that. It feels as though they are less interested in the facts than in creating this image of a UK bogeyman in Westminster. They are less interested in improving government in Scotland than in their obsession with separation. This debate teaches us that.

Covid-Secure Borders

Jerome Mayhew Excerpts

Tuesday 15th June 2021 Commons Chamber

[Jerome Mayhew (Broadland) (Con) [V]]

We have a number of weapons with which to fight covid. The key one is the vaccine programme, on which even Labour is struggling to criticise the Government’s performance. There is an additional weapon, which is the control of our borders, to minimise the importation of additional infection and new variants from elsewhere.

What is the right policy to apply to international travel in the midst of a pandemic? A knee-jerk reaction would be to close our borders, and to sound tough on covid. Labour now talks of a ring of steel, but sensible Government need to recognise that no modern trading country can totally prevent new covid variants from crossing borders. Even a country as geographically remote as Australia, which does not rely on thousands of border crossings every day for the supply of food, has not been able to keep the delta variant out.

As for the United Kingdom, 38% of all of our food is imported every day—much of it in the bellies of passenger airliners, let us not forget—and that is just a single example of our absolute need to continue international travel. What we can do is slow down the arrival of new variants and the spread from countries with higher infection rates by prohibiting all travel to the highest risk countries, by limiting international travel to high-priority activities for the medium-risk countries, by quarantining new arrivals from at-risk countries and by aggressive test and trace, including surge testing when new outbreaks emerge. I break off to take this opportunity specifically to pay tribute to NHS Test and Trace. This is an organisation that is habitually traduced as an article of faith by Labour, but which is in fact a highly effective operation that has saved many lives.

All these actions by the Government have bought us time—time that allows our vaccination programme to get to a level that provides us all with an effective defence so that we can truly live with covid. As we were reminded just yesterday, we are tantalisingly close to achieving this milestone, but not quite yet. There is a criticism of the Government implicit in this motion that they were late in imposing travel restrictions to India in response to the emergence of the delta variant, but despite the protestations of the shadow Home Secretary, the right hon. Member for Torfaen (Nick Thomas-Symonds), this really is just another shameless example of Labour hindsight hard at work.

As the right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper) admitted in her speech, it was the emergence of the delta variant, not India’s pre-variant infection rates, that changed the risk profile of travel, yet the Government placed India on the red list two weeks before the delta variant was identified as a variant of concern. In fact, it was six days before it was even deemed a variant of interest. The Labour fox is truly shot on that very important issue.

The UK does have a strong policy of restrictions at the border and remains vigilant to new variants, but it is a complicated, nuanced issue. We cannot just sound tougher on borders—it will have huge complicating and unintended consequences. I fail to understand Labour’s call for the removal of the amber list, other than that it is some kind of attempt to politicise public health messages. The traffic light system is a sensible approach, and amber covers countries where the risk of some travel with caution can be accepted if the benefit of that travel is high. It is a classic risk analysis—the risk of an event happening and its severity, and mitigation to reduce that risk to an acceptable level. In business, we do it all the time.

To remove this classification would be to prohibit important business and humanitarian travel to amber list countries without supporting data, putting at risk even more aviation and travel jobs. I suppose it would be called collateral damage. This should not be an issue for party manoeuvres. We should not be trying to out-tough each other in areas such as this. Labour should be working with the Government in the national interest to drive home simple travel messages. I am surprised and very disappointed that it is not.

Oral Answers to Questions

Jerome Mayhew Excerpts

Tuesday 17th November 2020 Commons Chamber

[Gareth Bacon (Orpington) (Con)]

What steps his Department is taking to support the provision of non-covid-19 healthcare treatment.

[Jerome Mayhew (Broadland) (Con)]

What steps his Department is taking to support the provision of non-covid-19 healthcare treatment.

[The Minister for Health (Edward Argar)]

The Government are supporting the NHS’s ambition to continue to restore elective services for non-covid patients, while of course recognising the pressure on services from covid-19 infection control, with September statistics showing services already restored to about 80% of last year’s levels. Some £2.9 billion of additional funding has been made available from 1 October to manage ongoing covid-19 pressures, alongside recovering non-covid activity levels.

[Edward Argar]

The NHS is working hard to maintain elective activity as far as possible during the second wave with extra funding, as has been set out. As shown in published September data, hospitals are carrying out more than 1 million routine appointments and operations per week, with around three times the levels of elective patients admitted to hospitals than in April, with many hospitals innovating to get through their lists. For example, Buckinghamshire, Oxfordshire and West Berkshire sustainability and transformation partnership has set up additional bespoke cataract units to deliver services. In addition, we have been making use of independent sector sites to assist the NHS with almost 1 million NHS patient appointments taking place within those facilities.

[Jerome Mayhew]

One adverse consequence of the first lockdown was that many people failed to seek treatment because they were afraid of the virus, but due to good planning and hard work, the staff of the Norfolk and Norwich University Hospital are able to treat covid patients while still undertaking the normal work of the hospital. Does my hon. Friend agree that the people of Broadland should continue to seek medical assistance when they need it, confident in the knowledge that it will be provided in a covid-safe and effective manner?

[Edward Argar]

I share my hon. Friend’s fulsome praise of the staff at Norfolk and Norwich University Hospital and the work that they are doing. They have a strong champion in him. Indeed, I pay tribute to all the health and social care staff who have worked so magnificently throughout the pandemic. I can wholeheartedly agree with everything he says. My right hon. Friend the Secretary of State has been clear throughout this pandemic that anyone who needs medical help should continue to seek it in the knowledge that they will be treated in a safe and effective manner appropriate to their needs. To put it bluntly, it is a case of help us to help you.

Axial Spondyloarthritis

Jerome Mayhew Excerpts

Thursday 17th September 2020 Commons Chamber

[Tom Randall]

My hon. Friend neatly explains the consequences of delayed diagnosis. A recent systematic review of the available literature found that, overall, patients with a delayed diagnosis of AS had worse clinical outcomes, including higher disease activity, worse physical function and more structural damage compared with patients who had an earlier diagnosis. Those with a delayed diagnosis also had higher healthcare costs and a greater likelihood of work disability, as well as a worse quality of life, including a greater likelihood of depression. Those are the consequences of not giving a prompt diagnosis.

We spoke earlier about the National Axial Spondyloarthritis Society, or NASS, which has identified four factors that contribute to delay: a lack of awareness among the public that AS might be the cause of their chronic pain; GPs failing to recognise the features of AS; referral to non-rheumatologists who might not promptly recognise AS; and failure by rheumatology and radiology teams to optimally request or interpret investigations. AS cannot be cured, but reducing the eight-and-a-half-year average delay in diagnosis will lead to better outcomes for those living with the condition.

The all-party group for axial spondyloarthritis, of which I am a vice-chair, suggests three steps that would help to reduce the delay in diagnosis. The first is the adoption of a local inflammatory back pain pathway to support swift referral from primary care directly to rheumatology. Low levels of referral to rheumatology from primary care represent one of the key barriers to achieving an early diagnosis of AS, and a national audit by the APPG found that 79% of clinical commissioning groups do not have a specified inflammatory back pain pathway in place, despite NICE guidelines recommending that.

[Jerome Mayhew (Broadland) (Con)]

My hon. Friend makes reference to the NICE guidelines and the quality standard on spondyloarthritis not being implemented by 79% of clinical commissioning groups. Does he agree that that simply relates to primary carers referring directly to rheumatology departments, which is not a cost issue but one of professional education?

[Tom Randall]

My hon. Friend is absolutely right, and that neatly leads me on to the APPG’s second proposal. I appreciate that the NHS is rather busy at the moment with public health messaging of one kind or another, but awareness of AS remains low and support for an awareness campaign would help to significantly raise the visibility of the condition not only among the public, but for example among GPs.

Thirdly, the APPG suggests encouraging the routine adoption of minimum service specifications across the NHS to help to reassure patients, particularly in the context of covid-19 and the difficulties many patients face in accessing key services during the recent lockdown. I would welcome any opportunity to meet Ministers separately to discuss those proposals in detail, if that were possible.

I will leave the last word to Zoë Clark, who addressed the APPG’s last physical meeting in January. She told attendees how, after getting AS symptoms aged 20, incorrect diagnoses and the impact of her condition left her socially isolated and unable to live independently, at a time when she was trying to complete a demanding four-year master’s degree in osteopathy. She said that living with undiagnosed AS was a frightening time and she ended up having to largely sacrifice her social life, due to the difficulties of balancing her degree with the pain and fatigue she regularly experienced.

No one should have to wait eight and a half years to find out what is wrong with them. I hope that we can begin to put that right.

Covid-19 Update

Jerome Mayhew Excerpts

Tuesday 8th September 2020 Commons Chamber

[Matt Hancock]

I regret the tone of the question. I think it is far better for everybody if we all work together. I know the hon. Member and the hon. Member for Bootle (Peter Dowd) seem to have taken the attitude that it is better to have brickbats thrown across this House, but I think the public would expect us to work together—to work together for the benefit of South Shields and to work together for the benefit of the north-west. I am very happy to meet her to discuss the situation in South Shields and see what we can do to try to tackle the problem, and it is better to do that together.

[Jerome Mayhew (Broadland) (Con)]

My right hon. Friend has identified that our response to covid is about personal responsibility, but it is made much harder when the young have the lure of socialising and the risks are substantially borne by unseen others. However, in my view, the young are just as civic-minded as all the rest of us, but it is a complex message, so what is the communication strategy to get that message over effectively to our young people, particularly when access to Parliament TV seems unaccountably low?

[Matt Hancock]

It is so important that we explain to everybody that they have a responsibility to “hands, face and space”—to their social distancing. The two critical messages for younger people who may think that this is not a disease that affects them are, first, that they can transmit this disease and cause great harm or death to their loved ones, but, secondly, that nobody is immune from this disease. The long-term impact of covid—so far, we have seen this with 60,000 people who have suffered for more than three months—can be devastating, and that can happen to anyone.

Social Distancing: 2 Metre Rule

Jerome Mayhew Excerpts

Monday 15th June 2020 Commons Chamber

[Edward Argar]

The hon. Lady is right, and I suspect that, like other Members, she has had many constituents coming to her to explain how this could make a real difference to the financial viability or otherwise of reopening their businesses. We are incredibly sensitive to that. The Chancellor said over the weekend that it could make a difference between a third of pubs being able to open up or three quarters, depending on where the distancing level is set. I am incredibly sensitive to this, but as I said, it is not a binary choice; a number of measures will be considered in the context of this review. As I am sure her constituents and mine would wish, it is important that we strike a balance between protecting public health, going on the basis of the best scientific and clinical evidence we have, which is what the review will look at, and getting the economy up and running again as soon as we safely can.

[Jerome Mayhew (Broadland) (Con)]

If our objective is to work towards social and economic normality while maintaining our hard-won control over the virus, as the incidence of infection in the general population reduces day by day, would it not be possible to reduce the social distance from 2 metres while maintaining downward pressure on the rate of infection? Is the acceptable rate of infection—below 1—a scientific or political decision?

[Edward Argar]

My hon. Friend makes a good point. Through the package of measures we have put in place to protect public health and press down on the transmission of this disease, we are seeking to do exactly that—as the incidence and infection levels go down, to start relaxing those restrictions where we can, step by step and in a cautious way, to allow businesses to operate. It is quite right and understandable that Members have different views on the pace at which we should be going on either one of those, but it is exactly those considerations that this review is looking to investigate.

Covid-19

Jerome Mayhew Excerpts

Monday 16th March 2020 Commons Chamber

[Matt Hancock]

These are all important considerations. The financial ones are of course a question for the Treasury, which is looking at how to address all these things.

[Jerome Mayhew (Broadland) (Con)]

Hundreds of thousands of students are currently revising for their public examinations. Does the Secretary of State have a contingency plan for GCSEs and A-levels to be sat on time?

[Matt Hancock]

That is a matter that the Education Secretary is considering.

NHS Funding Bill

Jerome Mayhew Excerpts

Legislative Grand Committee & 3rd reading: House of Commons & Legislative Grand Committee: House of Commons & Programme motion: House of Commons & 3rd reading & Programme motion
Tuesday 4th February 2020 Commons Chamber

[Jeremy Hunt]

They are both interesting ideas. The plan at the moment is that resource will be given to schools for a teacher to volunteer to devote a proportion of their time to this, and that there will be funding for them to do so, similar to the way in which schools have a special educational needs co-ordinator who is a teacher devoted to the special needs of the pupils in that school. I personally would have no objection if that were a separate counsellor, but this needs to be a resource inside the school—someone who is regularly at the school and who knows the children there. That is the important thing.

With permission, Dame Rosie, I would like to comment on some of the other amendments and on some of the comments made by the hon. Member for Ellesmere Port and Neston. He rightly talked about the issues around maternity safety, and I agree that it is vital that we continue the maternity safety training fund. That is not directly the subject of one of his amendments, but it is indirectly connected to it. Twice a week in the NHS, the Health Secretary has to sign off a multi-million pound settlement to a family whose child has been disabled for life as a result of medical negligence. What is even more depressing is that there is no discernible evidence that that number is going down. The reason for that is that when such tragedies happen, instead of doing the most important thing, which is learning the lesson of what went wrong and ensuring that it is spread throughout the whole country, we end up with a six-year legal case. It is impossible for a family with a child disabled at birth to get compensation from the NHS unless they prove in court that the doctor was negligent. Obviously, the doctor will fight that. That is why we still have too much of a cover-up culture, despite the best intentions of doctors and nurses. This is the last thing they want to do, but the system ends up putting them under pressure to do it. That is why we are not learning from mistakes. I am afraid that that is the same thing that was referred to in the Paterson inquiry report that was published today: the systemic covering up of problems that allowed Mr Paterson’s work to carry on undetected for so long. The hon. Member for Ellesmere Port and Neston is absolutely right on that.

I think it is a fair assessment of safety in the NHS to say that huge strides have been made in the past five or six years on transparency. It is much more open about things that go wrong than it used to be, and that is a very positive development. But transparency alone is not enough. We have to change the practice of doctors and nurses on the ground, and that means spreading best practice. Unfortunately, that is not happening, which is why, even after the tragedies of Mid Staffs, Morecambe Bay and Southern Health, we are facing yet another tragedy at Shrewsbury and Telford—I see my hon. Friend the Member for Telford (Lucy Allan) in her place, and she has campaigned actively on that issue. The big challenge now is to think about ways to change our blame culture into a learning culture.

[Jerome Mayhew (Broadland) (Con)]

I declare an interest in that, a long time ago, I was a personal injury barrister, including in cases of medical negligence. Does my right hon. Friend think a possible solution to the resistance to blame in the national health service might be the adoption of a no-fault compensation scheme much like that in the personal injury sphere in New Zealand, for example?

[Jeremy Hunt]

My hon. Friend makes an important suggestion. We considered such a thing when I was at the Department of Health and Social Care, but we decided that it would be very expensive. One of the tragedies is that many people who suffer actually make no legal claim because they are so committed to the NHS, so we have a system that gives huge amounts of money to one group of people and nothing at all to those who decide that they do not want to sue the NHS.

We need to look at tort reform, because most barristers and lawyers working in this field want the outcome of their cases to be that the NHS learns from what went wrong and does not repeat it. Unfortunately, that is not what happens with the current system. The involvement of lawyers and litigation causes a defensive culture to emerge, and we actually do the opposite. We do not learn from mistakes, and that is what we now have to grip and change.

I want to say something positive, because if we do change that we will be the first healthcare system in the world to do it properly. We are already by far the most transparent system in the world, mainly because people in this place are always asking questions about the NHS—and rightly so. Healthcare systems all over the world experience the same problem. It is difficult to talk openly about mistakes because one can make a mistake in any other walk of life and get on with one’s life, but if someone dies because of the mistake, that is an incredibly difficult thing for the individuals concerned to come to terms with. That is why we end up on this in this vicious legal circle.

On capital to revenue transfers, I was a guilty party during my time as Health Secretary. There were many capital to revenue transfers because we were running out of money, so capital budgets were raided. I fully understand why the Opposition wanted to table amendment 3, but I respectfully suggest that the trouble is that it would result not in more money going into the NHS but in more money going back to the Treasury from unspent capital amounts. The real issue of capital projects is getting through the bureaucratic processes that mean that capital budgets are actually spent.