Barts Health NHS Trust

Andy Burnham Excerpts

Thursday 19th March 2015 Commons Chamber

[Andy Burnham (Leigh) (Lab)]

(Urgent Question): To ask the Secretary of State for Health if he will make a statement on Barts Health NHS Trust being placed into special measures.

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

The NHS Trust Development Authority announced on Tuesday 17 March that Barts Health would be placed into special measures. This followed a report by the Care Quality Commission which rated services at the Barts Health site at Whipps Cross as inadequate. As a result of this decision the trust will receive a package of tailored support to help it rapidly make the necessary improvements for patients. This will include the appointment of an improvement director and the opportunity to partner with a high-performing trust. The chief inspector of hospitals has highlighted the scale of the challenge ahead and this is an opportunity to ensure that the trust has the extra support it needs to meet that challenge. Barts Health has already announced that it has begun to strengthen management arrangements at Whipps Cross, in response to concerns raised by the CQC.

We make no apology for the fact that, under the new rigorous inspection regime led by the chief inspector of hospitals, if a hospital is not performing as it should, the public will be told. If a hospital is providing inadequate care and we do not have confidence in the ability of its leadership to make the required improvements without intensive support, it will be put into special measures. It will remain in special measures until it is able it to reach the quality standards that patients rightly expect.

While the trust is in special measures, it will receive increased support and intensive oversight to help it address its specific failings. This process is publicly transparent, so patients and the public can see and track for themselves, online through the NHS Choices website, the progress that their trusts are making. Any changes or additional support required for the trust leadership are put in place early on in the improvement process, as has already taken place at Barts Health.

The expectation is that an NHS trust or foundation trust will be re-inspected by the CQC within 12 months of being placed in special measures. It is the job of the chief inspector of hospitals to recommend when a trust is ready to exit special measures. The NHS TDA or Monitor will then formally decide to take the trust out of special measures when it considers the trust is able to sustain the quality of care at the level patients rightly expect.

[Andy Burnham]

Barts Health NHS Trust is no ordinary hospital trust: it is the largest NHS trust in England, employing more than 14,000 staff and treating patients from all over London and indeed the whole country. Importantly, it is also one of the few trusts directly managed by the Trust Development Authority and the Department of Health.

Is it not true that the problems at Whipps Cross have been known for some time and have not just been uncovered this week? Is it not also true that these problems have been allowed to get worse over the past two years, with 208 serious incidents in the last year alone, and that specific warnings have not been acted on? Given all this, is it not a cause for real concern that this trust has become the 20th to be placed in special measures under this Government? People in east London need to know why, and what is being done to bring their hospital back up to an acceptable standard. Does the Minister accept that, given the seriousness of this issue, they are entitled to be disappointed that the Secretary of State is not here today to respond to these concerns?

One of the report’s main conclusions is that the root cause of care problems in the past two years was the reorganisation of the trusts in 2013. It states that

“the decision…to remove 220 posts across the trust and down band several hundred more nursing staff had a significant impact on staff morale and has stretched staffing levels in many areas”.

These findings raise significant questions for the Department and Ministers. Given that it is a directly managed trust, was a proper assessment made of the reorganisation plans, and was it signed off by Ministers? Why did Ministers overrule the Co-operation and Competition Panel, which advised against the proposed merger and warned of material costs to patients? What action did the TDA, the Department and Ministers take on the warnings raised at the time?

The Minister will know that my hon. Friend the Member for Leyton and Wanstead (John Cryer)—I am afraid he has a constituency engagement this morning; otherwise, he would have been here—and, as I understand it, her Cabinet colleague the right hon. Member for Chingford and Woodford Green (Mr Duncan Smith), raised specific concerns about the decision to remove the management structure from Whipps Cross Hospital, concerns echoed by my hon. Friend the Member for Walthamstow (Stella Creasy). Why were those concerns ignored, leaving Whipps Cross without an adequate management structure?

Looking ahead, can the Minister say more about what is now being done to improve management at Whipps Cross, and to reassure local people that their hospital is safe? What immediate steps are being taken to improve staff numbers? On finance, is she aware that the bill for agency staff across the trust has gone up by a huge 44% in the last year alone, and what is she doing to bring that down? It is unsustainable and unaffordable, but it is also damaging standards of patient care on the ward and continuity of care.

The inspection took place in November. Why was it published only this week—one day before the Budget? Given that this is about a failure of NHS management, why is the Department of Health still sitting on the report by Lord Rose on NHS management? Will the Minister give a firm commitment to this House today that it will be published before Parliament is dissolved?

This report has been widely described as the worst assessment ever seen from the CQC. It will be seen as a symbol of the decline of the NHS on this Government’s watch, and people are looking now, today, for an urgent plan to turn things around.

[Jane Ellison]

The whole House will have noted that the right hon. Gentleman asked why the report has only just come out. He might reflect on his own time in office, when there were reports that did not come out at all just before the general election. If there is any better example of weaponising the NHS—we have just seen it. Instead of trying to make political capital, should the right hon. Gentleman not admit that the new CQC inspection regime illustrates exactly why transparency is so important, and why this Government were right to implement it?

Under the previous Government, failures of care were swept under the carpet and not acted on, which led to the tragic consequences we know about. Before the last general election, Labour tried to block the publication of a devastating report into Basildon and Thurrock hospital. [Interruption.] These are serious matters, and that is exactly why the CQC inspection has to be taken seriously. As I have said, local management is looking at these important issues, some of which we have debated before in the House, and which need to be addressed very seriously. However, the hospital management are beginning to do that, and they must take such action to ensure that they bring care up to the right standards.

All the things that the CQC has identified have to be addressed. As I have said, this illustrates exactly why the new CQC inspection regime is so important. Even now, a week before Parliament dissolves before the general election, this Government are committed, without fear or favour, to transparency and to bringing out this report. We are committed to ensuring that we put into the public domain the measures that need to be taken to put that hospital back on track and to ensuring that its patients can have confidence in the safety of its operation.

--- Later in debate ---

[Mr Speaker]

Order. I note the interest—

[Andy Burnham]

On a point of order, Mr Speaker—

[Mr Speaker]

Yes, in a moment. I notice that the interest in this debate grew as it was taking place. The First Deputy Chairman of Ways and Means, the hon. Member for Epping Forest (Mrs Laing), and the right hon. Member for Chingford and Woodford Green (Mr Duncan Smith) have toddled into the Chamber. [Interruption.] Yes, I understand that the right hon. Gentleman has a constituency interest, and that others have taken a keen interest.

I will now allow a point of order, because it relates directly to the exchanges that have just taken place. I know that the right hon. Member for Leigh (Andy Burnham) will not abuse his privilege.

[Andy Burnham]

I am grateful to you, Mr Speaker, for allowing this point of order.

In the Minister’s non-reply to my questions, she inadvertently misled the House. She said that, before the last election, I had blocked a report on Basildon hospital. I wish to place it on the record that I made an oral statement to this House about Basildon hospital and published reports on it on 30 November 2009. I followed that up with a written statement to the House on 5 March 2010. I would be grateful to the Minister if she withdrew her comments.

[Mr Speaker]

I note what the shadow Secretary of State has said. He has put it on the record. The Minister is welcome to respond if she wishes, but she is not obliged to.