Hospital Car Parking Charges

Lord Field of Birkenhead Excerpts

Monday 1st September 2014 Commons Chamber

[Jackie Doyle-Price]

The hon. Gentleman makes a good point. It is crucial for the Secretary of State to give clear and robust messages about what he expects from NHS trusts. This Secretary of State has probably done more in his period of office to put the patients at the heart of the NHS. We are talking about a rebalancing of the relationship between the patient and the provider. It is simply not appropriate for NHS trusts to decide their car parking charges without considering the impact that those will have on the welfare of patients.

[Mr Frank Field (Birkenhead) (Lab)]

This debate has been part of a campaign initiated by the Opposition on rip-off Britain, and I congratulate the hon. Lady and the hon. Member for Harlow (Robert Halfon) on getting a debate on one aspect of that. I totally welcome the Secretary of State’s guidance on this matter, but we know from our local areas that some hospital trusts will gently put two fingers up to what the Secretary of State says. I very much hope that when the Minister replies he will say what plan B is for those hospitals that continue to charge excessively those who need to continue to visit their relatives in hospital.

[Jackie Doyle-Price]

I humbly suggest to the right hon. Gentleman, who is not backward in coming forward in expressing his views, that it is up to us in this House to challenge the leadership of our trusts where we think they are being unfair with their car parking charges. Quite frankly, we should be prepared to make lots of noise about that when it occurs.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

I would like to begin by congratulating my hon. Friend the Member for Harlow (Robert Halfon) on securing this debate and my hon. Friend the Member for Thurrock (Jackie Doyle-Price) on her opening speech, which outlined a number of the key issues, about which we are all concerned and to which a number of Members have referred. I understand and have listened to the concerns expressed, both in this House and by the public more generally, about car parking in our NHS, especially where the cost is high and can be considered a rip-off for patients, their families and, sometimes, NHS staff. That is why we published the new NHS patient, visitor and staff car parking principles last month, which will lead to new guidelines at the beginning of next year.

Before I address those principles and respond in more detail to some of the points raised, it is important to pick up on the key issue that has been outlined—my hon. Friend the Member for Thurrock raised it in her opening remarks—which is that, for a patient, driving to hospital is not a choice; it is essential in order to receive important and, often, life-saving treatment. It is also important for relatives and those wishing to support and look after friends and others who may be admitted to hospital through no fault of their own. It is right to say, as my hon. Friend did, that Basildon was a challenged trust, but addressing the challenges of that trust, both financial and in terms of patient care, should not come at the expense of short-changing patients. There are many other measures that trusts need to look to—such as improving their procurement practices, better managing the NHS estate and, in the long term, lowering costs by reducing their dependence on temporary staffing—to balance their books and ensure that as much money as possible is directed to front-line patient care.

My right hon. Friend the Member for Sutton and Cheam (Paul Burstow) made a number of important points, including the key one that car parking should not be a cash cow and needs to be seen in the context of the wider sustainability challenge of the NHS, and that many trusts are still paying the price for poor PFI deals that they signed up to under the previous Government. He also asked what role the CQC could play in addressing the issue if parking charges were prohibitive. Of course there is a role for the CQC. If concerns were raised about patients being prevented from accessing the NHS care they needed as a result of prohibitive car parking charges, the CQC could of course make recommendations and raise that with the trust as part of its inspection regime. The power for the CQC to do that exists at the moment, and I am sure the chief inspector of hospitals will be mindful of that as part of the inspection regime.

We had many other good and important contributions, including from my hon. Friends the Members for Harrow East (Bob Blackman) and for Harlow, who spoke very eloquently and outlined clearly the reasons for calling this debate. We also heard from my hon. Friends the Members for Peterborough (Mr Jackson), for South Derbyshire (Heather Wheeler), for Worcester (Mr Walker) and for Hexham (Guy Opperman), all of whom spoke eloquently. In the time available to me, I will do my best to pick up on some of their points in my broader remarks.

We talk about the fact that there are many examples of unacceptable practice in hospital car parking, but it is important to highlight the fact that 40% of hospitals that provide car parking do not charge and of those that do, 88% provide concessions to patients. However, I am aware that there are 40 hospital sites—which is 3.6% of hospitals in acute and mental health trusts—that have charges and do not allow concessions to patients who need to access services. As a Government, we want to see greater clarity and consistency for patients and their friends and relatives about which groups of patients and members of staff should receive concessions and get a fairer deal when it comes to car parking. It is exactly for those reasons that we published the principles that will underpin the guidance that will be published in February or March next year about how we deliver fairer car parking charges, of which all trusts will be expected to be mindful.

I want briefly to outline some of the key points in that guidance. We want to see concessions, including free or reduced charges or caps for the following groups: disabled people, frequent out-patient attenders, visitors with relatives who are gravely ill, visitors to relatives who have an extended stay in hospital, and staff working shifts that mean that public transport cannot be used. Other concessions—for example, for volunteers or staff who car share—should be considered locally. The list I have given is not exhaustive—we will return to it as part of the guidance we produce early next year—but it is important that we have much greater consistency and clarity from all hospitals about which groups should receive parking concessions and free parking when that is appropriate.

[Mr Frank Field]

It is quite clear that the Government have a model in mind of the minimum standards that hospitals should subscribe to, which is welcome. Will the next round of consultations that the Government undertake with hospital trusts outline what will happen to those that pay scant regard to what the Government are suggesting?

[Dr Poulter]

It is exactly because a small minority of hospital sites have no concessions at the moment, which is unacceptable and not fair to patients—I outlined 40 such sites that I am aware of in acute and mental health trusts—that we brought forward the principles and are refreshing the guidance. We need to see hospitals respond to that guidance. Powers are already available to the CQC and the chief inspector of hospitals for the CQC to take action, if appropriate, if there is behaviour in a hospital that makes it prohibitive for patients to receive treatment. However, we also need to look at what other measures we can introduce against trusts that still show disregard for the guidelines, to make it clear that doing so is no longer acceptable. For example, mechanisms are available to us when we give finance to trusts to ensure greater conditionality on that finance in future.

That is something we would certainly look at seriously as a mechanism for enforcing better behaviour, but I am hopeful, thanks to the fact that we will have refreshed guidance and that many patient groups are championing this issue at the local level. My right hon. Friend the Member for Sutton and Cheam made the point articulately that patient action locally meant that St Helier hospital, which was one of the worst offenders for car parking charges and disregarding the rights of patients and staff, has reformed its ways. Patient action has led to improvements. A number of mechanisms are already in place and, with the guidelines, I am sure we will get to a much better place across all trusts. However, if necessary, we have other measures, when we are giving finance to trusts, to put levers in place.

[Mr Frank Field]

Does the inspector have powers to instruct the groups that will probably pay scant attention to the guidelines to make the changes that the whole House wants?

[Dr Poulter]

If concerns are raised as part of a care quality inspection that patients are receiving substandard care or not receiving the quality of care that they should be as a result of being unable to access services, there would of course be a role for the chief inspector of hospitals and the CQC to raise that as part of their inspection report. I am sure the chief inspector will bear that in mind for the 40 hospital sites that at the moment do not have concessions for those who are very unwell or who are disabled. I am sure that those trusts, which will be listening keenly to this debate, will bear that in mind and will want to take action, hopefully before the refreshed guidance is produced.

I know that time is pressing and I do not wish to detain the House much further, but I want quickly to outline a few of the other measures that are in place as part of the principles that will underpin the guidance, which hopefully will reassure right hon. and hon. Members that the Government have taken appropriate steps to address these issues.

Staff parking is an important issue. I probably speak as the only Member—currently, at least—who, as a practising hospital doctor, has genuine, first-hand experience of this issue. It is important to look after our front-line staff. Car parking in hospitals should not be allocated according to staff seniority or because someone happens to be a senior manager; it should be allocated according to the needs of staff and the type of care and shift patterns they provide. That is made very clear in the principles underpinning the guidance to be published.

On payments for hospital parking, our principles say that trusts should consider pay-on-exit or similar schemes, whereby drivers pay only for the time they have used, and fines should be imposed only where they are reasonable and should be waived when overstaying is beyond the driver’s control. Details of charges, concessions and penalties should be well publicised, including at car park entrances, wherever payment is made, including inside the hospital. The issue has been raised of the sharp practice sometimes carried out by the management of car parks in hospitals, and we have made it clear in the principles underpinning the guidance that those practices are unacceptable.

Finally, on contracted-out car parking—another issue raised in the debate—NHS organisations remain responsible for the actions of private contractors who run car parks on their behalf. NHS organisations are expected to act against rogue contractors in line with the relevant codes of practice, where applicable. Contracts should not be let out on any basis that incentivises fines—for example, income from penalties only. This Government expect hospitals to take action against contractors who behave irresponsibly, short-change people and behave badly towards patients, their relatives and staff.

I hope that I have reassured the House, particularly those who brought this debate before us today, that this Government take the issue very seriously and believe that unacceptable behaviour by hospitals and unacceptable hospital car parking charges will become things of the past.

NHS Investigations (Jimmy Savile)

Lord Field of Birkenhead Excerpts

Thursday 26th June 2014 Commons Chamber

[Mr Hunt]

My hon. Friend raises a very important point. We received the reports only this week, but I will certainly take this away with me and look into exactly the point he makes.

[Mr Frank Field (Birkenhead) (Lab)]

I thank the Secretary of State for allowing me early advance notice of the report relating to St Catherine’s hospital in Birkenhead. Much more importantly, may I associate myself with the apology that the right hon. Gentleman gave to my constituent and others? He will know that that hospital has been bulldozed and that we now have a fine community hospital. To bulldoze these practices within the NHS, will the Secretary of State consider and come back to me later on these two issues? First, it took my constituent 48 years before she was believed and 50 years before she received an apology. What steps are we going to take to ensure that justice is provided much more quickly? Secondly, Jimmy Savile was escorted around St Cath’s Birkenhead by officials, who witnessed him jumping into bed with a young patient and who thought it funny. All the rules in the world provide some defence, but how do we get people to exercise judgment—whatever the rules say, whatever the circumstances and whoever does it—and say that this behaviour is not acceptable?

[Mr Hunt]

I would like to associate myself with the right hon. Gentleman’s comments; I share his disbelief and shock that it has taken so long. In some ways justice will never be done, because Savile died before it could be served on him, which is one of the biggest tragedies of all. I agree: there was a major lack of judgment, some of it because of the different attitudes prevailing at those times. One of the big differences today is that we make links between what is disgusting but not illegal behaviour and potential abuse in a way that did not happen in those days. I want to share with the right hon. Gentleman what most shocked me personally in the reports, and it was the way in which Savile interfered and abused people who had just come out of operations and were recovering from them. The fact that Savile was able to do that, without being supervised, is shocking and when those people spoke up about what had happened, they were not believed. That is one of so many lessons that need to be learned; I know that everyone wants to learn them.

Immigrants (NHS Treatment)

Lord Field of Birkenhead Excerpts

Monday 25th March 2013 Commons Chamber

[Mr Frank Field (Birkenhead) (Lab)]

(Urgent Question): To ask the Secretary of State for Health what moves the Government intend to take to prevent the national health service becoming an international health service.

[The Secretary of State for Health (Mr Jeremy Hunt)]

The current system of policing and enforcing the entitlement of foreign nationals to free NHS care is chaotic and often out of control. At a time when we are having to face the challenges of an ageing society, it places a significant and unjustified burden on our GP surgeries and hospitals and may well impact on the standard of care received by British citizens.

As the Prime Minister said earlier today, the Government are determined to ensure that anyone not entitled to receive free NHS services should be properly identified and charged for the use of those services. Currently, we identify less than half of those who should be paying and collect payment from less than half those we identify.

We also have some of the most generous rules in the world on access to free health care. Our rules allow free access to primary care for any visitor to the UK, including tourists, and free access to all NHS care for foreign students and temporary visitors. But ours is a national, not an international, health service, so last year, under my predecessor, we began a wholesale review of the rules and procedures on charging visitors for NHS care, with a view to making the regime simpler, fairer and easier to implement. In particular, we focused on who should be charged and how the rules can be applied and enforced more effectively. We have examined the qualifying residency criteria for free treatment; the full range of other current criteria that exempt particular services or visitors from charges for their treatment; whether visitors should be charged for GP services and other NHS services outside hospitals; establishing a more effective and efficient process across the NHS to screen for eligibility and to make and recover charges; and whether to introduce a requirement for health insurance tied to visas.

The initial phase of the review has concluded and we will shortly start a consultation on a range of options, including plans to extend charging to some visitors and temporary residents who were previously exempt so that the default qualification for free NHS care would be permanent, not temporary, residence; ending free access to primary care for all visitors and tourists; introducing a prepayment or insurance requirement for temporary visitors to pay for NHS health care; and improving how the NHS can identify, charge and recover charges where they should apply. We will retain exemptions for emergency treatment and public health issues.

We will work closely with medical professionals, NHS staff and partner NHS organisations during the consultation and then seek to introduce agreed changes as quickly as possible. We will need to take a staged approach, because some changes are likely to require primary legislation before they can be introduced, which will take longer to put in place. However, some changes can be made immediately, and we should proceed with those as quickly as possible.

--- Later in debate ---

[Mr Field]

I thank the Health Secretary for his reply. If he wants us to take him seriously, will he today give a commitment in respect of the directive his Department issued just as the House was rising for the summer recess, compelling doctors, if they have vacancies, to admit all those who have been in the country for 24 hours or more, including illegal immigrants? Will he ensure that someone in the NHS—not doctors—works out whether or not a person is entitled to claim, and will he implement such proposals forthwith?

[Mr Hunt]

The directive to which the right hon. Gentleman refers was issued by an independent NHS body, not my Department. The sorry truth is that it is consistent with the current rules on access to primary health care, which is what we believe is wrong. I think that one of the big problems in the current system is that we have free access to primary care for anyone visiting the UK, however short their visit is. Through that access to primary care, they get an NHS number, which should not entitle them to free care but is often treated by hospitals as such. That is what we have to put right. He is absolutely right that we need a system that properly identifies whether people should have care that is free at the point of access without impinging on the ease of access for British citizens, which is one of the things they treasure most about the NHS.

Thalidomide Trust (Grant)

Lord Field of Birkenhead Excerpts

Thursday 20th December 2012 Commons Chamber

[Norman Lamb]

I absolutely commit, on behalf of the Government, to do everything we can to support that group of people. As a society, we owe it to them to support them—they are often in very difficult circumstances. He is right to note the bravery that they have shown—not just the individuals, but their families too—in facing those circumstances.

[Mr Frank Field (Birkenhead) (Lab)]

I pay tribute to victims of the drug and to the trust that so admirably serves them, and thank the Minister for his statement, but how did he fix on that sum? Was it the sum that the trust asked for? Does it meet all the trust’s demands, or are other forces at work?

[Norman Lamb]

The right hon. Gentleman is right to pay tribute to the work of the trust over many years. We have based the sum on the amount of money provided as part of the pilot scheme, which appeared to work very well. It does not meet all needs, but many individuals get help in other ways—some have personal budgets, and so on. However, it is acknowledged that the amount is a massive help and support and gives them the reassurance for a lengthy period that continuing support will be available.

Oral Answers to Questions

Lord Field of Birkenhead Excerpts

Tuesday 10th January 2012 Commons Chamber

[Paul Burstow]

We debated these issues before Christmas. I can confirm that advice to local bowel screening programmes on bidding to become pilot sites will be published shortly and the process of recruiting pilots will start this month.

[Mr Frank Field (Birkenhead) (Lab)]

13. What estimate he has made of the cost to the public purse of NHS reorganisation in (a) Birkenhead constituency and (b) England.

[The Minister of State, Department of Health (Mr Simon Burns)]

The cost of the NHS modernisation is estimated to be between £1.2 billion and £1.3 billion. That will save £4.5 billion over this Parliament, and a further £1.5 billion each year thereafter. [Hon. Members: “It is a different question.”] It is the same question. We do not have a local breakdown of these figures, as that will depend on local decisions.

[Mr Field]

Perhaps the right hon. Gentleman will ask the House of Commons Library for the answer so that he can give it to me next time, and also look at the increase in the number of managers in Wirral over the past five years. The number has gone up by more than a quarter. With that size increase, why are those staff not being used to pilot his reorganisation?

[Mr Burns]

The right hon. Gentleman is absolutely right. There was a significant increase in managers in the NHS in the last two or three years of his Government. Since we came to power, there are just under 15,000 fewer managers and administrators, and 3,700 extra doctors.

Life Sciences

Lord Field of Birkenhead Excerpts

Monday 5th December 2011 Commons Chamber

[Mr Lansley]

I am grateful to my hon. Friend. He and I share a vigorous and vibrant life sciences sector, and I hope that the strategy that we have announced today will be taken up rapidly in our constituencies. He asks about the Academy of Medical Sciences. Back in the “Plan for Growth” in the Budget, we responded precisely to that point, and on 1 December, as a consequence of the positive response to what the academy said, I brought into effect the Health Research Authority to ensure that we simplify the process of approval for clinical trials. Through the National Institute for Health Research, as we said earlier in the year, we are seeking to arrive at a point where there is a maximum of 70 days for the first recruitment of patients to clinical trials, and that will get us into an internationally competitive position.

[Mr Frank Field (Birkenhead) (Lab)]

May I ask the Secretary of State a further question about the rights of people to opt out of the scheme? Will he extend the right of opt-out for those people who refuse to participate in the scheme to include a refusal of the advantages that come from sharing such information, which will be gained by the generosity of spirit of their fellow citizens who participate?

[Mr Lansley]

I understand the right hon. Gentleman’s point, but the ethical approach is for everyone to have access to the latest and best available treatments through the NHS. That is the principle that we apply, but we should be aware that, although we offer people the right to opt out, we have seen—for example, in relation to the general practice research database, where patients have the equivalent right to opt out, and in two pilots conducted on the proposals that we have announced—that the rate of opt out is 0.1%.

Ritalin

Lord Field of Birkenhead Excerpts

Tuesday 25th October 2011 Westminster Hall

[Mr Frank Field (Birkenhead) (Lab)]

I am grateful to my right hon. Friend the Member for Wolverhampton South East (Mr McFadden) for securing this debate and for allowing me to address a simple question to the Minister.

Like my right hon. Friend, I am not qualified to say whether people should be on treatments or not, but I am struck by the increasing number of children in Birkenhead who are given what a group of teachers has referred to as “medical coshes” to keep them quiet. In some instances the drugs are no doubt necessary, and they work, but along with my right hon. Friend I question the growth in the number of prescriptions.

Will the Minister work with his colleagues in the Department for Work and Pensions to consider the moral hazard of someone ensuring that their child is on Ritalin so that the prescription gives them access to disability benefits? Clearly, that was never the Government’s intention, but we now have a system in which, if someone can prove that their child is ill, and keep them ill, the likelihood of the child being passported on to disability benefits increases. I know that this is not in the Minister’s sphere of influence, but in his response to my right hon. Friend’s most detailed points will he tell us whether he will co-ordinate with the relevant Minister in the Department for Work and Pensions to look at the moral hazard of someone proving their child needs to be on Ritalin to increase their chances of getting disability living allowance for that child?

Health and Social Care (Re-committed) Bill

Lord Field of Birkenhead Excerpts

Wednesday 7th September 2011 Commons Chamber

[Nadine Dorries]

No, I would like to continue on the financial incentives.

BPAS and other organisations would say that they do not have to meet targets and that they have no financial concerns. However, BPAS has advertised for business development managers, whose primary function is to increase its market share—those are its own words in the advert. If an organisation advertises that it wants to increase the number of abortions, can we trust it to provide vulnerable women who walk through the door with the counselling that they need? On pensions mis-selling, this place has separated by law the people who provide and sell pensions from the people who advise on pensions.

[Mr Frank Field (Birkenhead) (Lab)]

Does the hon. Lady accept that she might further her case if she concluded her contribution soon?

[Nadine Dorries]

Sorry?

[Mr Field]

My advice was that the hon. Lady might further her case if she concluded her remarks shortly.

[Nadine Dorries]

Yes, I will.

I will come to a conclusion now, as time is whizzing away because of the interventions. I thought long and hard before tabling this amendment. Like so many issues—

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[Anne Milton]

The hon. Member for Rhondda (Chris Bryant) is clearly not reassured, but perhaps he will let me finish.

It is a very long time since I worked in a maternity unit, but I worked in one run by the Salvation Army, and I have seen many young women go through the trauma of an unplanned and unwanted pregnancy. Yes, we need to do a great deal more to prevent unwanted pregnancies from happening in the first place, but when faced with such a situation, young, and indeed older, women need help and support to make the decision that is right for them without interference from any vested interests. The amendments were tabled in a spirit of improving services for women, but they will not work. They will not deliver what my hon. Friend the Member for Mid Bedfordshire (Nadine Dorries) wants, or what I want. They will not work for women. I urge my hon. Friend to withdraw her amendment and to work with me to ensure that we secure the right services for women.

[Mr Frank Field]

I will be brief, because I know that others wish to speak.

I thought that I would be addressing the House about an amendment with my name on it, but, for reasons unknown to me, my name was dropped from it. What I wanted to say, however—and it is reinforced by the way in which the Minister has approached the matter—is that while I thought that the original amendment involved an issue that we should consider, I believe that the Minister has dealt with it. The hon. Member for Mid Bedfordshire (Nadine Dorries) and I embarked on this journey together, and my plea to her now is not to press the amendment. The Minister has provided us with an advance which I hope will signal a change in the temper of the abortion debate in the House.

This has been one of those debates in which people emphasise motives and rarely take voting records into account. I put my name to that amendment because in every vote on the subject that has taken place in the 30 years for which I have been in the House, I have voted against wrecking the Abortion Act, and I thought that there was an issue here that should be considered. However, I feel that the Minister has more than met the point, and she has widened the debate about what the inquiry will cover. I hope that the whole House will pay attention to her and to my hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott). Presumably a report will be produced once the consultation has been completed, and perhaps we shall then be able to have a debate opened by Front Benchers in which Back Benchers’ speeches are time-limited.

Despite what has happened today, I think it important for us to try to use this event to make it clear that we will have different debates about abortion in the House of Commons in future, for we should have such debates. We should be more concerned with facts, and less concerned with trying to put our sticky fingers into other people’s souls and pronouncing that they have failed.

[Dr Huppert]

I am delighted to have a chance to speak in the debate. It is tempting to respond to all the comments made by the hon. Member for Mid Bedfordshire (Nadine Dorries), but I shall avoid doing so. Instead, I shall make just two points.

First, let me quote something that was said by the right hon. Member for Bristol South (Dawn Primarolo) before she became Deputy Speaker. She said of the hon. Member for Mid Bedfordshire:

“The hon. Lady has asserted many things to be facts that are not… Some of the things that she is saying are not borne out by the evidence.”—[Official Report, 20 May 2008; Vol. 476, c. 263.]

I think that that is extremely true.

Wirral University Teaching Hospital NHS Foundation Trust (Fraud)

Lord Field of Birkenhead Excerpts

Wednesday 9th June 2010 Commons Chamber

[Mr Frank Field (Birkenhead) (Lab)]

May I, through you, Madam Deputy Speaker, thank Mr Speaker for allowing me this evening’s debate. It is pleasure to see you in the Chair on what I think is your first day. I believe that this is the first time that I have addressed the Minister from the Opposition Benches, and I am very pleased to do so. I assure him that it will not be the last time that we will be engaged in these conversations.

From this Adjournment debate on alleged fraud in the Wirral hospital trust, I am looking for three things. First, I am sure that I am not exceptional in the number of constituent cases about alleged fraud that I refer to the relevant authority. In every case I have passed on, whether it be to the Department for Work and Pensions or to the Department of Health, I have never had a satisfactory reply that I could then refer to my constituent. I would not disclose the information, but if I had such a reply, I could say that I had been able to read the papers and assure constituents that they were mistaken in alleging fraud. I could say that a proper investigation had been carried out and we could leave the case there. As I say, however, that has never occurred. One thing I am looking for this evening, then, is for the Government to consider the particular role in which elected representatives sometimes find themselves in handing to the Government alleged cases of fraud, yet never being able satisfactorily to report back to their constituents.

Secondly, I have tried to use the Freedom of Information Act 2000 in order to gain the information that Wirral hospital trust denied me. I was refused on the basis that disclosure of the information would provide me with sensitive personal information such as the name of the person against whom the allegations of fraud were made. However, given that everybody involved in the case knows the name of the doctor, although I have never used it in public, it seems somewhat farcical to use the Freedom of Information Act in this way to prevent my gaining access to reports that have been commissioned.

Thirdly, this saga has been going on for a long time, and I have no intention of letting go of it, so I hope that the Minister might be able to advise me on the next best steps to take to resolve the issue. Through you, Madam Deputy Speaker, I would like to remind the House of what happened.

All too long ago, one of my constituents was sitting in the surgery at their doctor’s. The doctor was engaged in a telephone conversation with one of his patients, who turned out to be a private patient. During the conversation, for reasons that I cannot possibly explain, the doctor assured the person that they had been treated as an NHS patient although they were being charged as a private patient.

I started to look into the case. I asked both the primary care trust and the hospital trust—Wirral University Teaching Hospital NHS Foundation Trust—to investigate. I had a meeting with the hospital trust at which the chairman and the senior directors were present, as well as the locally based official who was in charge of countering fraud in the health service. At that stage the doctor admitted that, as a result of an error, he had put through as NHS patients about 180 patients whom he was charging as private patients, but who were being given tests as NHS patients.

[Ms Angela Eagle (Wallasey) (Lab)]

rose—

[Mr Field]

I will give way in a moment to my good and hon. Friend from a neighbouring constituency.

The doctor admitted that that had been an error in all cases, and repaid money. I asked, through its chairman, whether the trust—on the basis of the core of cases of private patients being fed through the NHS—would examine other procedures in the hospital to establish whether any of those 180-odd patients had had scans or X-rays, and whether the doctor had again forgotten to declare that they were private patients when ticking the forms assuring the NHS that they were, in fact, NHS patients.

[Ms Eagle]

My right hon. Friend has raised an issue that affects all of us who represent constituents in the Wirral, which is served by the hospital concerned. Does he think that this individual case of fraud involving an individual doctor raises issues about conflicts of interest that may well resonate in other areas of the NHS, and does he agree, on the basis of his experience of this case, that there are general rules that all Members should consider applying more generally throughout the NHS to avoid such financial conflicts of interest?

[Mr Field]

I strongly agree, and I hope that at some stage the medical profession will give serious consideration to how the interface between the public and private sectors might be policed in the context of health.

As the fraud officer present said that it was quite reasonable to undertake the next stage of the inquiries, I left the meeting, only to find that later the chairman of the hospital trust and her senior executives had said that no such investigation would take place, and that I would not have access to their reports on this case of alleged fraud unless I was prepared to sign a document saying that after reading the information I would never use any of it in public debate. I was not prepared to sign such a gagging clause.

I appealed for access to the documents concerned under the Freedom of Information Act. Because the hospital trust is not known for its efficiency, it applied to block my appeal under the wrong section of the Act. When I appealed to the commissioner, he had to point out to the trust that if it wanted to block my original appeal it would have to use another part of the Act, which of course it then did.

I then appealed to the tribunal, which ruled that I should not have access to the document, or documents, because if I had such access I would gain sensitive personal information to which I was not entitled, such as the name of the person against whom the allegations were being made. As at every stage everyone who was in that room has known the name of the doctor concerned but none of us has made it public, it seems bizarre that it was on those grounds that I was denied access to the counter-fraud report which is alleged to have been undertaken.

Since the attempts to grapple with that individual case of fraud, the same hospital trust has had to repay more than £1 million to what was the primary care trust but is now Wirral Health, because it was found to be fiddling its accident and emergency figures. Quite how that came about and how it was decided that the fraud amounted to £1 million-plus I do not know, but that money has been repaid. I allege that there is a culture of fraud in that hospital trust, which is not being taken seriously by the chairman and the directors of the trust. I look forward to hearing what the Minister has to say.

One last point concerns the Freedom of Information Act. I am well aware that the Government have their own legislative programme, but I would be grateful if the Minister would take back the fact that there may be problems in two respects where MPs refer fraud cases to the administration for investigation. One is the one that I touched on at the beginning of my remarks. As elected representatives, we are never put in a position to report back fully to our constituents. Obviously, we deny them any sensitive personal information, but we cannot say that we have read the relevant papers and we would like to be able to assure them that their concerns about fraud are unfounded.

Secondly, I took up the case only because a constituent referred me to a case of alleged fraud. The doctor admits that somehow in 180-odd cases he happened to tick the wrong boxes, claiming the people concerned were NHS patients, rather than private patients. It seems wrong that I am denied access, as the elected representative of an area, to the counter-fraud allegations that have taken place.

There are two issues, and I would be grateful if the Minister reflected on them with his colleagues, although he may wish to comment on them in the debate. The case has dragged on for some time, but as I have said— I know the Minister is convinced of this—I am not going to let it go yet. I would be interested to hear how the Government think that we might take the case forward to a successful conclusion. I wait to hear what the Minister says.