Underperforming NHS Trusts: Government Oversight

Caroline Voaden Excerpts

Wednesday 14th October 2026 Westminster Hall

[Helen Morgan (North Shropshire) (LD)]

It is a pleasure to serve under your chairmanship, Mr Stuart. I congratulate my hon. Friend the Member for Chelmsford (Marie Goldman) on securing this important debate.

Tackling underperforming NHS trusts is essential if we are serious about taking the necessary strides forward for patient safety and experience—as well as for the wellbeing of NHS workers, who are suffering anxiety and burnout at an unprecedented and frankly unacceptable scale. The Liberal Democrats have put forward our robust plan to end corridor care and transform patient safety, with essential measures needed to fix our NHS and relieve the pressure at both the front door and the back door of the service.

Years of Conservative mismanagement and neglect of the NHS have left many trusts on their knees, with huge challenges from which to recover. The onus is now on the new Labour Government, with their intensive recovery programme, to finally create the right conditions for failing trusts to succeed where their predecessors have failed.

[Caroline Voaden (South Devon) (LD)]

My hon. Friend talks about the challenges that NHS trusts face. My local hospital, Torbay hospital, has an ageing tower block that has now received a fire enforcement notice, which could affect up to a quarter of the beds in the hospital. Panic is spreading today in the local community about what this means for future treatment. Does she agree that when things become as urgent as that, with a quarter of the beds in the hospital potentially having to be closed by the fire brigade, the Government desperately need to bring forward the new hospital programme funding, so that repair and remedial work can begin immediately to restore this part of the hospital?

[Helen Morgan]

I do agree, and I echo my hon. Friend’s call. The estate that people work in is part of the fundamental problem that we are trying to tackle across the NHS.

I hope all the Members here who have made excellent speeches highlighting shocking failures in their own trusts can take heart from the fact that it is possible to tackle the issues in underperforming trusts. In my time as the MP for North Shropshire, I have seen meaningful changes for my constituents. From 2018 to 2023, Shrewsbury and Telford hospital trust was obviously underperforming, with CQC inspections consistently rating it as inadequate. That included inadequate levels of safety and services—reflected in the horrifying stories received at the time in my inbox and those of the other Shropshire MPs, and on doorsteps—and a churn in the management team that led to constant uncertainty about what was going to happen there. The human consequence of those stories was devastating.

When I was first elected, the overwhelming issue was the abysmal ambulance waiting times, related to poor handover times, as the hon. Member for Stoke-on-Trent South (Dr Gardner) highlighted. I will never forget the letter I received from a headteacher: after a pupil dislocated his knee playing football, he and the teachers waited so long for an ambulance in the dark and cold on a winter night that he was at risk of developing hypothermia by the time the ambulance arrived. We heard countless devastating stories, including ones where the ambulance had taken so long to arrive that it was too late, and the outcome was fatal.

Following a targeted campaign, which included me joining the West Midlands ambulance service team for an eye-opening shift, wait times have significantly improved, and we see far fewer of these cases in our inboxes. But challenges remain, not least in corridor care in the accident and emergency department, which has at times been rated one of the worst in the country.

A constituent told me of the shocking experience of her aunt Cath during this period, who was admitted to Royal Shrewsbury hospital following a serious stroke. One night, Cath fell out of her hospital bed and broke her hip after staff had failed to put up the necessary guardrails. She spent nearly half an hour trying to attract the attention of staff on the ward with the alert bell, but they were so overworked that they did not respond, and in the end she was forced to dial 999 from the floor of the ward. She was left in the ridiculous position of explaining to the call centre staff that she was actually on the floor of a ward in Royal Shrewsbury hospital before the staff reached her. That cannot be right. We heard of many heartbreaking situations where cancer patients’ scans could not take place because waiting lists had meant that they were booked in the wrong order and of fatally long waits for diagnosis in some cases, with the trust failing to hit key targets across the board.

Finally, the 2022 Ockenden report shook my community with its devastating finding of over 200 preventable deaths of babies and unimaginable harm done to families. Campaigning and voicing justified anger, which everyone has done today, and working with Ministers on the failings can bring about change. That was essential in Shropshire, and though things are not perfect, it is encouraging to see the improvements that have been made so far. It has been a really difficult environment for staff to work in. I pay tribute to them and the new leadership team for all the hard work that they have put into turning this extremely difficult situation around. The trust’s CQC rating has recently been upgraded, although it still requires improvement, with emergency department waiting times and understaffing as key focuses. However, there is much to be pleased with. Reviews have noted a positive culture, and the trust has recently been shortlisted for several awards for its performance improvements.

We must celebrate the many trusts in the UK that provide high levels of care and innovation, and support those making significant improvements. For underperforming trusts, it is our duty to our patients and constituents to ensure that we campaign to bring them up to good standards, and I congratulate everyone here today on doing just that. However, if conditions for care are stretched and staff are expected to deliver the impossible with limited time and resources, it is patients who suffer. How can we transform patient safety? To start, we need to hold failing leaders to account, as I have discussed. Reports have pointed to a culture of unaccountability among NHS leaders, which has accompanied recent scandals and undermines public confidence. Failing trusts need to be held to account, and our amendments to the Health Bill would help do that by retaining the necessary structures for accountability.

First, we must retain the independent patient voice, Healthwatch, which was established in the wake of the Mid Staffordshire scandal. Although still in its infancy, HSSIB, the Health Services Safety Investigations Body, should also be retained because it promises to improve the patient safety environment. Our amendments would also introduce duties and a standardised framework for the reporting of suspected health system failings and medical malpractice by coroners, medical examiners and members of ICB and NHS trust boards.

Whistleblowing routes to the CQC, the Department of Health and Social Care, HSSIB and the police would be accompanied by statutory protections. We would also place a corresponding duty on senior leadership to escalate any concerns they have about safety or malpractice to the relevant boards. My colleagues in the other place will be re-tabling those amendments at the next stage of the Health Bill, and I urge the Government to accept them.