NHS Negligence Cases

Debate between Andrew Gwynne and Dan Poulter

Tuesday 30th January 2018 Westminster Hall

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

I beg to move,

That this House has considered NHS negligence cases.

As always, Mr Rosindell, it is a pleasure to see you in the Chair. I know that it is highly unusual for a member of the shadow Cabinet to speak from the Back Benches, so I am grateful to the Opposition Whips and to Mr Speaker for allowing me to do so as a final opportunity to seek some form of closure for my constituent in this very serious matter. I am especially grateful to Mr Speaker for granting this debate.

Sadly, I have to publicly outline how my constituent, Mr Hawkins, has been let down by public authorities. The law and NHS rules have been abused to avoid giving him the justice that is rightfully his. His attempts to seek that justice, along with some semblance of honesty and humility, have already passed the decade mark, so I shall be grateful for the Minister’s reply after I set out the case.

Mr Hawkins was admitted to Tameside General Hospital on 28 June 2006 to undergo surgery to repair a ruptured left Achilles tendon. Rupturing an Achilles tendon can tear it partially or completely, making walking difficult and the ankle feel weak. The surgery was listed for theatre in the afternoon under the care of an orthopaedic consultant surgeon, Mr Ebizie, but then postponed to the evening. My constituent believes that the most simple and sensible solution would have been to postpone it until the next day, allowing him to remain under the care of the same surgeon. He believes that that did not happen, however, because it would have meant the hospital missing its five-day Government target for a patient to receive treatment or surgery after attending accident and emergency. Records indicate that the surgery was instead carried out by Dr Manikanti, assisted by Mr Kumar. Mr Hawkins states that the change of surgeon was made without his knowledge or consent. Subsequently, both clinicians have left the hospital and the country, and the names and titles of those who carried out the surgery have been disputed.

Mr Hawkins states that the surgeon made a critical clinical error. He believes that the surgeon misunderstood the positioning of the two diagonal sutures forming part of the modified Kessler suture. They were brought to the surface and closed, which permanently fixed the repaired Achilles tendon to the rear of his leg. On 7 July 2006, nine days after the surgery, the plaster cast was removed, revealing an open wound between the two sutures. Steri-strips were applied in an attempt to close the wound, but the duty consultant wrote in his records that the wound had healed very well after surgery. Mr Hawkins states that despite being aware of the error, the hospital failed to correct it by releasing the repaired tendon from the rear of his leg as soon as was medically possible. This allowed serious adhesion and tethering to form as the sutures disintegrated.

On 12 January 2007, Mr Hawkins was discharged from the care of Tameside Hospital. Throughout the previous months, the repaired Achilles tendon had been continually swollen because of the aggravation of the fixation. Mr Hawkins raised concerns, which were ignored. Weekly and monthly appointments at the hospital were required thereafter. Mr Hawkins believes that he was discharged by Tameside Hospital before he was clinically prepared and regardless of his condition. He feels that that was done to conform to Government targets.

Mr Hawkins immediately made a complaint through the hospital trust’s internal complaints procedures. He believes that on receipt of his letter of complaint, the trust should have called him in for an examination and a scan. It should have admitted that a serious problem had occurred and carried out a further operation to release the Achilles tendon from the rear of his leg. In Mr Hawkins’s mind, the matter would then have been resolved. However, the trust decided to take a different route: it instantly instructed Hempsons solicitors.

Although, obviously, Mr Hawkins is concerned about the clinical errors that have caused him lasting damage, he is rather more appalled by the actions of a variety of organisations afterwards. He believes that those actions were deliberately designed to cover up the fact that a clinical mistake had been made, caused primarily by the replacement of a consultant surgeon with a junior doctor.

In 2008, Mr Hawkins instructed a solicitor, who requested disclosure of all full medical records. The trust passed his request on to Hempsons. However, in the immediate period after his request he received only a very selective number of his own medical files from Hempsons. Mr Hawkins’s solicitor failed to ensure that all full medical evidence was disclosed within statutory time limits and failed to apply for a court controlled disclosure, while knowing that the records he had listed were missing. Mr Hawkins’s solicitor instructed a clinical litigation medical expert, who produced a case-closing report that failed the objectivity test and was therefore invalid. The trust and Hempsons initially failed to disclose relevant medical records, doing so only after continued and considerable pressure from Mr Hawkins.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

The hon. Gentleman is a strong advocate for his constituent and makes a compelling case about the difficulties that his constituent has faced. Does he agree that the case flags up a wider problem? He mentioned solicitors being involved at a very early stage in the process. The current system for dealing with medical negligence in hospitals pushes defensive medicine and defensive approaches from hospitals. That fundamentally needs to change, because it is not good for doctors and it is not good for patients. Does he think that no-fault compensation may be a good way forward?

[Andrew Gwynne]

The hon. Gentleman makes an important point. As Mr Hawkins himself acknowledges, if the hospital trust had taken his complaint down a different route by accepting that it had made a clinical error and deciding to put it right, I would not be standing in Westminster Hall today raising his case.

Mr Hawkins continued with his complaint. In 2013, the trust eventually conceded and his remaining medical records were fully disclosed. On analysis of the records, it was plain to see that there were omissions and that pre-action protocol time limits had been exceeded. In response, Hempsons sought the opinion of a medical litigation expert. A report was produced, but it was based on the selected medical records that I mentioned earlier, as well as on the falsified information. Mr Hawkins believes that that report would fail any objectivity test and is therefore invalid.

Mr Hawkins had involved the Information Commissioner’s Office on two occasions: in 2009 and in 2013. In both instances, it judged that the Data Protection Act 1998 had been breached by the trust’s failure to disclose relevant medical records on several occasions. After much time and effort from Mr Hawkins, on 11 December 2013 the new management team at the trust finally admitted to maladministration and awarded remuneration for it. In a move that Mr Hawkins believes was an attempt to close his complaint and prevent the case from going back to the Information Commissioner, or to the court for disclosure, the new management team disclosed that it would no longer discuss actions taken by the old management team. Mr Hawkins also believes that the Limitation Act 1980 was breached from 2008 and that rules 31 and 35 of the Civil Procedure Rules 1998 were breached in compiling medical reports, because the medical experts failed in their duty to the court to be objective.

The delays in disclosure of information meant that Mr Hawkins’s complaint to the Parliamentary and Health Service Ombudsman was ruled out of time. My constituent believes that that makes a mockery of the trust’s failure to disclose his medical records within statutory time limits, which he believes the ombudsman ignored while upholding the strict time criteria regarding his making a complaint to the ombudsman.

Mr Hawkins appealed the decision on several occasions when the evidence was retrieved through the Information Commissioner. However, he was unsuccessful in overturning their original view that a letter from the trust indicated that the complaint was closed in 2007, which he utterly refutes. Hempsons later apologised and admitted that that letter did not clearly state that the local complaints procedure was closed. However, the ombudsman still refused to investigate the complaint and, in doing so, Mr Hawkins feels that the ombudsman has assisted the trust to conceal the cause and effects of a clinical error.

In 2013, Mr Hawkins wrote to the NHS Litigation Authority, as the trust was not reporting clinical mistakes. Initially, the NHS Litigation Authority would not get involved and requested my involvement, as Mr Hawkins’s Member of Parliament, which I duly offered. Two replies were received that indicated that the NHS Litigation Authority was involved in the case, despite previous assertions and written evidence that it was not involved. Mr Hawkins was notified in writing that the trust, on receipt of his letter of complaint, had instructed Hempsons in January 2007, with the NHS Litigation Authority directly instructing Hempsons and the trust from November 2007 to February 2009.

Hempsons was aware of a breach of the Limitation Act 1980 and the Data Protection Act 1998 when it disclosed to Mr Hawkins his missing medical records in October 2009. This means that the trust and Hempsons had illegally avoided disclosing all full medical records within statutory time limits and successfully passed the three-year limit for litigation. Mr Hawkins believes that indicates that the NHS Litigation Authority was aware that rules had been broken, yet failed to take retrospective action based on the strength of the evidence that he had disclosed to it in 2013.

The actions taken by the trust, assisted by Hempsons and the NHS Litigation Authority from January 2007 to December 2013, clearly indicate that the trust was covering up a clinical incident and its cause. With so much time having passed since my constituent first exited the operating theatre in the summer of 2006, I hope that today the Minister of State will be able to afford Mr Hawkins guidance and support in this matter, and finally bring to some closure what has been a dreadful episode for my constituent.

United Kingdom Statistics Authority

Debate between Andrew Gwynne and Dan Poulter

Tuesday 7th March 2017 Commons Chamber

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

Before I turn to the nomination of Sir David Norgrove as chair of the UK Statistics Authority, I should like to echo the Minister’s tribute to the outgoing chair, Sir Andrew Dilnot. In so doing, I want to acknowledge two important contributions.

First, the outgoing chair, Sir Andrew Dilnot, has, as noted by the Public Administration and Constitutional Affairs Committee in its report published in January, worked tirelessly over the past five years in maintaining both the independence and the overall excellence of the UK Statistics Authority. There is no better example of that approach to independence than when Sir Andrew took the then Prime Minister, David Cameron, and the current Health Secretary to task for presenting to the public misleading figures on supposed increases in NHS spending.

I note how, in the four years that have followed, the Government have been less than attentive to Sir Andrew’s concerns, but it is important to recognise the impartiality that the role brings to challenging the spin and the misuse of data and statistics to which all politicians, if we are honest, succumb from time to time. If we look back over his term, we will see that Sir Andrew has performed his public duties robustly and with complete impartiality, and I am sure that the whole House is grateful to him for his public service.

Secondly, I thank my hon. Friend the Member for Hackney South and Shoreditch (Meg Hillier) and the Select Committee on Public Accounts under her leadership for their engagement in the appointment process. In an age where terms such as “fake news” are bandied around regularly, it is more important than ever that we have an independent, rigorous and reliable official statistics body.

It is also important in the current climate that the public have faith in such an institution. A 2014 report by the Committee on Standards in Public Life found that only 30% of the general public had confidence in Parliament as a public institution, which amplifies the new chair’s task in maintaining the rigid independence demanded by his post. The public deserve accurate statistics, free from political interference, and Members on both sides of the House must do more to ensure that the public have total confidence on the issues that matter most.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I assure the shadow Minister and the Minister that the Public Administration and Constitutional Affairs Committee gave full consideration to ensuring that there is a worthy successor to the current chair of the UK Statistics Authority. As the shadow Minister says, it is vital that the public have faith in public statistics. Does he agree that a key job of the new chair may be to challenge statistics presented in UK referendums? We are aware that the country may face another referendum in Scotland. Some of the statistics used in the EU referendum could usefully have been challenged by the chair of the Statistics Authority.

[Andrew Gwynne]

The hon. Gentleman makes an important point. We are talking about the misuse of statistics and data not just within the parliamentary forum, but in elections. He mentioned the EU referendum, in which the origin and robustness of the statistic about health spending post Brexit, in particular, were quite questionable. I share his view on that.

In respect of Sir David’s professional competence, I agree with the Committee’s report that his extensive experience makes him highly suitable for the role of the chair of the UK Statistics Authority. As the Minister noted, Sir David Norgrove has had a distinguished career, most recently as the chair of the Low Pay Commission, where his leadership in support of campaigns for the national living wage and national minimum wage has been crucial. In addition to that experience, he has also chaired the Pensions Regulator, and that will stand him in good stead in driving forward the structural changes needed in the Statistics Authority, as laid out in the Bean review.

We are convinced that Sir David’s skills and professional background as chair of two highly regarded and statistically driven public bodies will allow him effectively to oversee the twin tasks of statistical production and strictly regulating Government statistics and the veracity of Departments’ claims. Throughout his career, Sir David has been unafraid to question authority when those with power threatened to abuse or distort the process. That was seen when he famously faced down Sir Philip Green after the retail entrepreneur tried to buy Marks & Spencer with a bid that jeopardised the solvency of the pension scheme. Sir David’s record speaks for itself, and I am therefore satisfied—and rather hopeful about the fact—that he will bring the same toughness and fairness to challenging the Government’s use of statistics.

The Opposition are less concerned about the suitability of Sir David for the role in question than they are about the lack of diversity in the wider appointment process, which gives the impression of a closed system. Of the 14 candidates who applied for the chairperson’s position, only three were women and 11 were men. Added to that, all three previous authority chairs have been white, male and Oxbridge-educated. The Labour party recognises the quality that diversity can bring to both the selection and appointment processes, and we urge the Government to take steps to ensure that future candidates are from as diverse a pool as possible to ensure that every part of Britain is represented and that each person has an equal opportunity to aspire to the highest posts in the land.

The post involves the significant responsibility of promoting and safeguarding the production and publication of official figures that serve the public good. Sir David has already made it clear how crucial it is to have consistency in how the Government produce their figures. The appointment of a new chair of the board of the UK Statistics Authority is extremely important. We need a candidate who can maintain the code of practice for official statistics and ensure that Government figures are produced and presented to the highest standards of independence and integrity. We share the view of the Government and the Public Administration and Constitutional Affairs Committee that in Sir David Norgrove we have a candidate who can rise to that challenge.

Oral Answers to Questions

Debate between Andrew Gwynne and Dan Poulter

Tuesday 24th February 2015 Commons Chamber

[Dr Poulter]

There is a lot of work going on in this area. First, we are encouraging and supporting GPs who have had career breaks, perhaps because they have started a family, to get back into the profession more easily than they have been able to do in the past. Secondly, we also have the commitment that 50% of medical students and doctors leaving foundation training will become GPs in future. That will make sure that we have 5,000 more GPs by 2020.

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

But the Government’s reorganisation took billions of pounds away from the NHS front line. Figures released last week show that fewer than a quarter of medical students now enter general practice, because they can see the pressure that Ministers have put on it, while GP morale has collapsed. Should the Minister not now admit that the reorganisation was a mistake and instead match Labour’s pledge to invest an extra £2.5 billion a year to recruit 8,000 more GPs and guarantee appointments within 48 hours?

[Dr Poulter]

I know that the Labour party is full of professional politicians, but medical students do not just leave medical school and straight away become GPs; they become foundation doctors. As I have outlined, 50% of the people leaving their foundation training will become GPs in future, which will increase the number of GPs by 5,000. Under this Government the number of GPs in education, training and working in the NHS has increased by 1,000, which is a move in the right direction.

Oral Answers to Questions

Debate between Andrew Gwynne and Dan Poulter

Tuesday 10th June 2014 Commons Chamber

[Dr Poulter]

My hon. Friend makes a very good point, and we know that rural practices have unique challenges. The point is that because the money from the minimum practice income guarantee is going to be reinvested in a global sum payment, and because the global sum payment per practice is increasing, one of the key determinants of that payment is, in fact, rurality, so that should be of benefit to many rural practices.

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

The situation is far more urgent than the Minister’s complacent answer suggests. One practice in a deprived part of London has said that it is weeks away from laying off staff and just months away from closure. The Royal College of General Practitioners says that 1,700 practices could be affected, with over 12 million patients potentially facing even longer waits for appointments. Is it not the case that until we have a Labour Government, GP services are going to be marginalised and patients are going to face ever-longer waits?

[Dr Poulter]

I am afraid that the distance between the real world out there for patients and the Labour Government’s record is very clear. Under the Labour Government’s record on general practice, 20% of patients were routinely unable to get a GP appointment within 48 hours, and a quarter of patients who wanted to book an appointment more than 48 hours in advance could not get one. That was what happened under Labour; that is Labour’s commitment to general practice and GP patients. Under this Government, we are making sure that there is equality of finance per patient according to patient need, and that is how health care decisions should be made.

National Health Service

Debate between Andrew Gwynne and Dan Poulter

Monday 16th July 2012 Commons Chamber

[Andrew Gwynne]

We set out the Nicholson challenge, but I notice that the hon. Gentleman does not defend the decisions being taken by his Government to restrict or stop these treatments.

It is becoming increasingly clear that there is a gap between Ministers’ statements on the NHS and people’s real experience of it on the ground. In opening, the Minister of State, Department of Health, the right hon. Member for Chelmsford (Mr Burns) incorrectly said that GP referrals have gone down. Figures published by the Department of Health on 13 July 2012 show that GP referrals are up by 1.9% year on year. Those are statistics from the Minister’s own Department’s. He is out of touch. Furthermore, the Minister said that NHS Hull is not restricting procedures on ganglia, but a freedom of information request we received says:

“NHS Hull will not routinely commission excision of ganglia”.

That was in April 2012, and it is a fact, again showing that Ministers are out of touch. The Secretary of State claimed that there is no such evidence of treatments being restricted or decommissioned.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

Will the hon. Gentleman give way?

[Andrew Gwynne]

I will not, as I do not have time now.

In the Secretary of State’s annual report to Parliament, he dismissed restrictions on bariatric surgery as “meaningless” and continued to say:

“Time and again, he says”—

that is my right hon. Friend the Member for Leigh (Andy Burnham)—

‘“Oh, they are rationing.’ They are not”.—[Official Report, 4 July 2012; Vol. 547, c. 923.]

But Opposition Members all know the truth. Aside from the evidence presented by the Labour party and the GP magazine, verified by Full Fact, primary care trusts acknowledge that they are restricting access to bariatric surgery. The National Institute for Health and Clinical Excellence recommends surgery for anyone with a body mass index of 40 or a BMI of 35 and co-morbidity. Many PCTs, including NHS Stockport in my own constituency of Denton and Reddish, impose additional restrictions.

Recent freedom of information requests of PCTs and shadow clinical commissioning groups across England have revealed that 149 separate treatments, previously provided for free by the NHS, have been either restricted or stopped altogether in the last two years, with 41 of those being entirely stopped in some parts of the country. This provides the clearest evidence yet of random rationing across the NHS and of an accelerating postcode lottery, which appears to be part of a co-ordinated drive to shrink the level of NHS free provision. From our study, it is clear that many patients are facing difficulties in accessing routine treatments that were previously readily available, and there is evidence that some patients are being forced to consider private services in areas where the NHS has entirely stopped providing the treatment.

Of course, there has been a real reduction in the number of nurses working in the NHS. The Government have claimed that there are only 450 fewer nurses, and at Health questions last month, the Minister, the right hon. Member for Chelmsford said that the figure was “nowhere near 4,000”. But now we all know the truth: figures for the NHS work force in March 2012 showed clearly that there are 3,904 fewer nurses than in May 2010. We have seen broken promise after broken promise, including on reconfigurations.

It was this Government who, when in opposition, spent millions of pounds during the general election putting up posters throughout the country reassuring the electorate that under the Conservatives there would be a moratorium on hospital and A and E closures. Indeed, in opposition, they pledged to overturn some very difficult reconfiguration decisions taken by the previous Labour Government. Yet, as we have seen, the moratorium has not materialised, and there is now evidence of major changes to hospital services across the country.

It is worth remembering that the Prime Minister gave a firm pledge not to close services at Chase Farm hospital, but in September 2011, this Secretary of State accepted the recommendations and approved the downgrading and closure of services at Chase Farm. And there are several others, such as the Hartlepool, the King George hospital in Ilford, the East London, the Trafford General, the North London, the St Cross in Rugby and, as we have heard today, the West London, too, that have either closed or are set to close. What is becoming clear is that when it comes to reconfiguration, Ministers are hiding behind their new localism and are happy to blame the soon-to-be-abolished structures for the forthcoming closures.

In the brief time remaining, I want to deal with Government spending on the health service. As we have learned, actual Government spending on the NHS in 2011-12 fell by £26 million.