Managing Risk in the NHS

Debate between Charlie Elphicke and Charlotte Leslie

Wednesday 17th July 2013 Commons Chamber

[Charlotte Leslie]

That is very encouraging to hear post-event, but unfortunately it still leaves some questions as to why the Cure the NHS group was not able to go along and formally deliver the case studies of Bella Bailey at the Department of Health but instead had to go and see the former Secretary of State outside his constituency office—and for those who want to deny yet more evidence, that is on YouTube.

We have to ask why this review was not commissioned at the time if there were, through 81 requests, serious concerns raised. What did people have to hide? In 2009 the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson) said fairly clearly that Mid Staffs was a one-off, but unfortunately we know from the Labour “lines to take”—which are in the inquiry so are in the public domain—that Labour knew there were 12 hospitals with equal or even worse mortality rates. That was denied, but, tellingly, that brief says Labour should try to avoid naming them. That stands in stark contrast to the approach taken in the Keogh report, which has been transparent in naming those trusts where there are problems. Unlike Labour, I do not think being honest about the situation prevents improvement; actually, I think it helps improvement.

[Charlie Elphicke]

I congratulate my hon. Friend on making such a powerful speech. Does she agree that we have got to put patients first? If we put institutions first, and if we worry about staff and staff morale and how they might feel about things, we will inevitably slide in the direction of having a culture of sweeping things under the carpet and—dare I say it—covering things up. Unless we put patients first, we will not ensure there is a proper, sensible culture in our health service.

[Charlotte Leslie]

I absolutely agree with my hon. Friend. I would draw a distinction, however, as I think many members of staff in the NHS want, and wanted, nothing more than to put patients first. I was slightly surprised that only two Opposition Members mentioned patients and patient safety in their contributions yesterday. That was very upsetting.

Big Society

Debate between Charlie Elphicke and Charlotte Leslie

Monday 28th February 2011 Commons Chamber

[Charlotte Leslie (Bristol North West) (Con)]

It is a pleasure to follow the great contributions that have been made, particularly the one by my hon. Friend the Member for Hereford and South Herefordshire (Jesse Norman), who provided a fantastic intellectual framework for the concept of the big society. If I can add anything to it, I hope to illustrate what that intellectual framework means on the ground for all our constituents outside these walls. He hit on the heart of a debate that is not new in this Chamber: the relationship between the state and the individual and society. Because “the big society” is a new phrase, people expect to see a new thing, but of course it is not new; the big society has been going on for as long as this country has been great—indeed, it is what made this country great. I cannot pass from that point without mentioning amateur sports clubs and other things that often go unmentioned in the big society debate.

A great man posed the question:

“Ask not what your country can do for you, but what you can do for your country”.

Of course, that is already happening, but it is not wrong to say that although the big society is already very much in place in this country, it is possible to detect a shift in which people are beginning to ask less what they can do for their country and are more inclined to ask what their country can do for them. This is interesting, because the population of our great country has not changed. It is not the people who have changed, but the circumstances around, and it is important that we look at those circumstances to see what has brought about this shift—a shift that becomes very apparent if we talk to the older generation. Many people express it to me in terms of the shift from responsibilities to rights, and from a view that sees rights as the product of collective responsibility first, towards one that sees rights as a concept somehow dislocated from anything else. That is very interesting.

If the big society had another name, it might be “power to the people”. This concept of empowerment hits very much on the question of why there might be a shift towards a concept of rights, and away from one of responsibility and the question of what we ourselves can do. No one can be a candidate in a marginal seat—or any seat—and not find multitudes of situations in which normal people want to do normal, neighbourly, everyday things, but find themselves unable to do them because of a piece of well-meaning legislation—often vetting and barring legislation or something like it.

When someone who wants to do something good, such as driving their elderly neighbours to the next nearest post office because their previous one was shut down or helping a child who has fallen over in the street but worrying that it might be misinterpreted and so cannot do so, there are two reactions. The first is disbelief: they say, “This is nuts. In what way is this common sense?” The second reaction, when they find that they still cannot do the intuitive thing, is despair: “If I cannot do this, because I need to go through endless paperwork and CRB checks, what is the point in even caring?” When people get to the point of asking, “What’s the point of even caring?”, we realise why the concept of taking responsibility begins to mean less. What is the point of trying to take responsibility, if at every point there are small well-meaning reasons why we cannot? I am beginning to see a fundamental shift in this country, and it is fundamental to who we are.

On that note, I would like to bust a few myths that perhaps divide the Chamber on this issue—an issue on which we are very much of the same heart in a lot of ways. The first myth is that people do not want to get involved. One Opposition Member said that we would need a stick to get people volunteering. Well, people want to volunteer, whether formally or informally, but too often, instead of saying, “We’re going to help you”, the state, however well meaning it might be, puts up barriers. The second myth is that people are not competent. I have been involved in a free school bid in my constituency, and I heard all the criticisms from people saying, “We can’t have parents running schools. They’re not going to know how to do it.” But I have news. Those parents are absolutely capable of organising the set-up of the school. Of course they are not going to run it or teach, but over the time they have been involved, they have developed and proved that, if we trust people, my goodness they are more than capable of reciprocating that trust and delivering.

The idea of the big society matters for another reason. The very fact that cuts have been brought into this debate illustrates how dependent on public funding the idea of civil society and normal people doing good things has become. I know that we had a Prime Minister and Chancellor who perhaps honestly believed that he had abolished boom and bust. Of course, if we believe that we have abolished boom and bust, it makes no sense not to hose out public money to every good cause that in an ideal world we would like to, but the fact is that the economic cycle carries on, and there is boom and bust. We need to change dramatically the balance in our voluntary sector to ensure that it is safeguarded against what will inevitably always be a turbulent economic cycle.

Two things that I have come across in the past couple of months have given me great cause for concern. The first was when I was talking to some providers of youth services—in many areas, they do a fantastic job—about the inevitable lack of public funds. While we were discussing how they might get around this, I mentioned something that I had done in my constituency when a group had wanted to set up street dancing classes but the money was not available. Part of the youth activity of the street dancing group was raising the money themselves, and I mentioned this to the providers. They said, “Oh yes, we give our young people an identity and control over their activities by letting them decide how the grant is spent.” I said, “No, that’s not the point. That is not making the money; it’s spending someone else’s money.” It was that fundamental conceptual barrier that gave me cause for great concern.

[Charlie Elphicke]

Does that not exactly highlight the need to encourage people to take charge, to raise money, and to not be so dependent on public money being handed out to them?

[Charlotte Leslie]

Very much so. I thank my hon. Friend for that point. A belief has grown up that there is no money except state money. Were there limitless state money, that would not matter, but as we can see, state money is limited. A Government organisation that I will not name, but which does fantastic work, came to me and said, “We are very concerned about the cuts. We won’t be able to carry on.” I am no genius on this front, but in the half-hour meeting that we had, I suggested four ways in which it could seek alternative funds. They might not have been very good ways and they might not have worked, but I said, “Have you thought of these ways?”, and they said, “Oh no, we hadn’t thought of anything like that.” That to me was a great signal for concern.

Finally, this debate matters because we need the state to do what it has to do. The big state, small state debate sometimes misses the point. I want a competent state that is strong where we really need it, not a panicking, out-of-control, flabby state that interferes in areas that it should not be in at all because it is worried about how things are going and does not have control. Where people have been victims of crime, for instance, I want to see a strong state to ensure that they are looked after properly.

T. S. Eliot defined the difference between the views of those on either side of this House when he warned against people who talked about

“devising systems so perfect that nobody needs to be good.”

I am a Conservative because I believe in devising systems that are so perfect that they enable people to be good.