Francis Report

Andrew Gwynne Excerpts

Wednesday 5th March 2014 Commons Chamber

[Jonathan Reynolds (Stalybridge and Hyde) (Lab/Co-op)]

I will focus on the impact of the Francis report on my local hospital in Tameside.

Tameside hospital has been a major issue for me, as the MP for Stalybridge and Hyde, and it featured prominently in my election literature in 2010. At the general election, I pledged to work with my hon. Friends the Members for Denton and Reddish (Andrew Gwynne) and for Ashton-under-Lyne (David Heyes), to resolve what we believed to be the serious problems at Tameside hospital by building on their work and statements in the previous Parliament. Securing improvements at the hospital has been a priority for all of us and it will continue to be so. The stance that we have taken, combined with the work of Sir Bruce Keogh, has allowed genuine improvements to take place at Tameside and I am proud of that work.

I regret the journey that there has been in this Parliament towards making Francis a more partisan issue. The Prime Minister’s initial statement on the matter was quite admirable and the work of Sir Bruch Keogh offered a way forward for problem hospitals such as mine. We all stand to lose that if we try to game it for partisan advantage. There is a feeling that the Government have tried to obscure the unpopularity of the NHS reorganisation by doing so. Surely we can all agree that the two matters should not be conflated.

I love the NHS, but I love my constituents even more. If any institution is letting them down, I will not hesitate to call it out. I believe that that is true of all my Opposition colleagues.

The recommendations of the Francis report were, without doubt, an important contribution to improving the quality of health care in England. The circumstances that led to the creation of the Francis inquiry threatened to undermine public faith in the NHS, and a serious and independent investigation into those factors was crucial to maintain people’s trust in the NHS. That investigation was begun by my right hon. Friend the Member for Leigh (Andy Burnham), in whom I have tremendous faith.

The stories of poor care at Mid Staffordshire and other NHS trusts were indefensible and often heartbreaking. I hope that we never see such instances again in the NHS. However, it is important that we also take this opportunity to commend the thousands of doctors and nurses who work tirelessly to provide people in this country with the very best of care. The people who work for the NHS, including those from overseas who choose to come and work in the NHS, do an incredible job and they must always know that we appreciate them greatly.

Following the publication of the Francis report, my local trust, Tameside Hospital NHS Foundation Trust, was one of five trusts that were investigated by Sir Bruce Keogh. It was not the work or recommendations of the Francis inquiry that were of the most immediate significance to my area, but the fact that the publication of the report sparked a chain of events that had a significant impact on the delivery of care at the local hospital in Tameside.

At the time of publication, Tameside had the second worst record for hospital deaths. Data from the summary hospital-level mortality indicator showed that 18% more patients than expected died at Tameside in the 12 months leading up to June 2012. The standards of care at the hospital had been of concern to the public for some time. I should perhaps mention that the information on Tameside hospital was complicated by the legacy of the crimes of Harold Shipman in my constituency. That had a huge impact on how people thought about care at the end of their life and on where they went for that care. That was always a plausible excuse for the mortality scores, but there was a need to push past the excuse and discover the real causes.

In the light of those problems, I cited my concerns about aspects of care at Tameside hospital on the record on several occasions, acting in conjunction with my hon. Friends the Members for Denton and Reddish and for Ashton-under-Lyne. We had already called for the resignation of the trust’s chief executive so that the hospital could improve.

The problems at Tameside were indicative of the broader issues that Francis and Keogh were attempting to address. The confidence of the local community in members of the senior management team had all but disappeared. That led to problems often not being adequately addressed or even acknowledged. The hospital became defensive and saw the issue as one of public relations management, rather than service improvement.

There is a fundamental point that we must grasp if we are properly to understand what factors contribute to the level of public trust. People understand that mistakes are sometimes made. That is the case in all professions and walks of life. However, people cannot understand it—and nor should they—when mistakes happen but no serious attempt is made to address the concerns of patients or clinicians in an open and transparent way to resolve the issues.

Sadly, that is exactly what happened for too long at Tameside hospital. In the worst cases, the hospital management actively tried to downplay the problems raised by patients, family members, elected representatives and even, in some cases, each other. That behaviour is not acceptable and a failure to address it undermines public faith in the NHS.

Putting the spotlight on these hospitals has had some success in breaking through this culture, and Tameside now has a clear set of objectives on which to develop a strategy for improvement. Without the Francis report and the subsequent work of Sir Bruce Keogh, that long overdue process of improvement at Tameside hospital might not have happened. We as local MPs would still be calling for those changes to happen, but we would not have had the expert analysis that the process provided to back up what we were saying.

[Andrew Gwynne (Denton and Reddish) (Lab)]

I am grateful to my hon. Friend for setting out the case. Does he share my confidence that the hospital has indeed turned a corner? Part of that is down to the buddying arrangements with the University Hospital of South Manchester in Wythenshawe and the excellent interim leadership of Karen James.

[Jonathan Reynolds]

I endorse those comments entirely and thank my hon. Friend for his contribution. The negative attention that the hospital received as part of the Keogh investigation was undoubtedly the catalyst for the departure of the former chief executive in 2013, and the first step on the road to improvement.

It is important, however, for us to note the limits of Government’s capacity to push this agenda. Of course, Government have to be the ones who set the framework for improvement in the NHS, but cultural changes can properly come only from the front line. What Tameside hospital now has is a set of recommendations to be implemented, a framework for the delivery of those changes, and new leadership which, ultimately, will deliver the improvements that patients in our area need. I still visit the hospital regularly; indeed, I was there on Friday last week, and I am pleased to say that in my view it is certainly turning a corner. I hope the Government maintain their commitment to all the Francis recommendations, and ensure that the high expectations are hardwired into the NHS’s leaders.

Just before Christmas, I was walking my dogs in Stalybridge as usual, and a friend of mine whom I had not seen for quite a long time shouted over to me. He explained that he had been receiving treatment for more than a year at Tameside hospital. Over that time he had been able to witness, in his words, visible improvements to his care and to how the hospital was run and how it functioned, due to the changes facilitated by the Francis report, the Keogh inquiry and, I believe, the work of myself and my hon. Friends. We will not stop that work or feel self-satisfied because of it, but I am pleased that we have been able to make that difference. That, ultimately, is what we should all be trying to bring about by discussing the anniversary of the Francis report.