East of England Ambulance Service

Debate between Douglas Carswell and Priti Patel

Tuesday 25th June 2013 Westminster Hall

[Priti Patel]

My right hon. Friend is right. The issue is the turnaround of the trust and a key thing is to learn from successful ambulance trusts. That means looking at skills and capabilities as well as at times, both in urban centres and rural parts of constituencies. The east of England is a big region, and we must consider how resources can be correctly allocated to ensure that patients are not left waiting as they have been in the past.

Most of the executive directors at the trust have moved on, and the former chair, Maria Ball, resigned recently after the CQC report earlier this year. However, it is deeply alarming and thoroughly disgraceful that five non-executive directors who have presided over the mismanagement of the trust still sit on the board. They are Paul Remington, Phil Barlow, Margaret Stockham, Anne Osborn and Caroline Bailes. They all seem to refuse to take any responsibility for the failure that they have presided over, and they continue to receive funds from the taxpayer to continue in their role. By choosing to remain in post they are putting their own interests above those of the public, patients and front-line staff.

[Mr Douglas Carswell (Clacton) (Con)]

I congratulate my hon. Friend on bringing the issue up for discussion. There has been a series of appalling incidents in my part of Essex as well, in Tendring. Are not all the failures further evidence that the ambulance trust is run for the convenience of the senior management on the payroll, and not that of the taxpayer who pays taxes to be provided with an ambulance? Surely we need proper accountability, which means examining the regional structure, which is too cumbersome, and perhaps adopting a system of local accountability, putting it at county level as it once was. We should also make sure that the service is not stuffed full of quangocrats, and that the people who are there to speak for the taxpayer are accountable to the taxpayer, rather than having CVs full of parasiting off the taxpayer.

[Priti Patel]

My hon. Friend makes some pertinent and valid points. Transparency and accountability are key things. I have touched on the issue of the revolving door in the NHS, but cronyism is another issue. We must stop the same people being placed on and recycled around various boards in the NHS. NHS board members should put patients first, but, as the governance review by Dr Marsh concluded,

“there is a lack of focus and grip from the Board which has contributed towards the deterioration of performance across the Trust.”

The question, as we have already heard, is whose interests the board is serving. It should be putting patients first.

The Minister will know that the review is full of many other statements about the board, each of which is a damning indictment of each non-executive director and of the board. As to the quality risk profile showing that a number of outcomes relating to patient care and welfare were not being achieved, the review states at page 13:

“The Board should be taking leadership decisions and actions on these Outcomes and holding others to account,”

but of course there has been collective failure and

“this doesn’t appear to be happening.”

On page 14 the review refers to the current trust board and senior management team appearing to have developed “a sense of ‘helplessness’” and states that

“the Board have not been taking both the responsibility collectively as well as they could or should have and that Board members have not been held to account”.

On page 18 the report highlights

“a lack of confidence and trust that the Board has the expertise, experience or gravitas to respond to the substantial challenges facing the organisation.”

Page 22 contains the conclusion that

“the overall Governance arrangements cannot have been adequate for the Trust to get into this much difficulty.”

The non-executive directors’ fingerprints are, to be frank, all over the crisis. The trust is experiencing major failures, and every day that the individuals remain on the board they are being financially rewarded for blatant failure. Their poor leadership and inability to acknowledge and deal with the challenges facing the trust have led to patients’ lives being put at substantial risk. The trust’s staff survey results have demonstrated the lowest morale in the country.

My hon. Friend the Member for Suffolk Coastal and I wrote to Paul Remington while he was acting chair, to ask him and his fellow non-executive directors to explain their actions and what they had done about improving the trust. We wanted to give them a fair and proper chance to explain themselves in the aftermath of the CQC’s report earlier in the year. We received a substantive reply from Mr Remington two months later, on the eve of the publication of the Government’s review, and it was light on information and did not acknowledge the mess that the trust was in. It was thoroughly unconvincing. In view of those poor responses I hope that the Minister will appreciate that the presence of those non-executive directors on the board is undermining public and staff confidence in the trust. It is scandalous that they have not already been dismissed, and shocking that, despite the publication of the Marsh review, board members whose terms are due to expire this year are to be reappointed for the foreseeable future. The report of the chair and chief executive for tomorrow’s board meeting states that, during the recruitment process for the new non-executive directors,

“the TDA has agreed to extend Mr Remington’s period of service on an interim basis.”

That is utterly unacceptable. Why should Mr Remington and other non-executive directors be allowed to continue on their taxpayer-funded ride, when they have failed so miserably to fulfil their responsibilities? What will happen to the other non-executive directors, whose terms do not end this year? How much longer will they be permitted to remain in post? They refuse to do the right thing and step down, so I urge the Minister to recommend to the Secretary of State and the NHS Trust Development Authority that they should use their powers to remove them with immediate effect, before the board meets in Bedford tomorrow.

In addition to the board’s inability to lead the trust, its secretive and unaccountable handling of criticism by Members of Parliament is also disturbing.