Jimmy Savile: NHS Investigations

Earl Howe Excerpts

Thursday 26th February 2015 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con)]

My Lords, with the leave of the House, I shall now repeat a Statement made earlier today by my right honourable friend the Secretary of State for Health in another place on the investigations into the activities of Jimmy Savile in the NHS. The Statement is as follows.

“With your permission, Mr Speaker, I would like to make a Statement on the NHS Jimmy Savile investigations.

This morning, a further 16 investigations into the activities of Savile in the NHS were published. These include the main report from Stoke Mandeville Hospital and reports from 15 other hospitals. One report relates to Johnny Savile, the older brother of Jimmy Savile. These reports have now been placed in the Library. While no system can ever be totally secure from a manipulative and deceitful predator such as Savile, we learned last year that there were clear failings in the security, culture and processes of many NHS organisations, allowing terrible abuse to continue unchecked over many years.

Some victims are, sadly, no longer with us and others continue to suffer greatly as a result of what happened. On behalf of the Government I apologised to them last June and today I repeat that apology: what happened was horrific, caused immeasurable and often permanent damage and betrayed vulnerable people who trusted us to keep them safe. We let them down. As one of the Stoke Mandeville victims said,

‘there are so many messed up lives—although people have built up lives, you have children, you make a life, it ruins everything, your relationships with another human being—the things you are supposed to have’.

Today we must show by our deeds as well as by our words that we have learned the necessary lessons.

The new reports, like those released last year, make extremely distressing reading. In total, 177 men and women have now come forward with allegations of abuse by Jimmy Savile, covering a period from 1954 to just before his death in 2011. At least 72 people who gave evidence were children at the time of the abuse, with the youngest being only five years old. The allegations included rape, assault, indecent assault and inappropriate comments or advances. Allegations were made not in one or two places but in more than 41 acute hospitals—that is almost a quarter of all NHS acute hospitals—as well as five mental health trusts and two children’s hospitals. Further investigations have happened at a children’s convalescent home, an ambulance service and a hospice. There are three new investigations under way at Humber NHS Foundation Trust, Mersey Care NHS Trust and Guy’s and St Thomas’ NHS Foundation Trust. Any further allegations will, of course, be investigated as serious incidents.

In addition, the Department for Education has today published 14 reports on investigations in children’s homes and education settings, and the review by Dame Janet Smith into Savile’s activities at the BBC is ongoing. These investigations have been deeply harrowing for victims but also for the investigators. I would like to put on record my thanks to everyone involved, particularly Kate Lampard and the NHS Savile legacy unit, which provided robust oversight and assurance in an incredibly difficult job.

I now turn to Stoke Mandeville, the hospital with which Savile was most closely associated. The report published today reveals shocking abuse of 60 victims that took place over more than 20 years between 1968 and 1992. From the brave victims who have come forward we know that Savile’s activities there included groping, molestation and rape of patients, staff and visitors. Victims were predominantly but not exclusively female, 20 were vulnerable patients disabled with severe spinal injuries, and one was a child as young as eight. Savile deliberately exploited these people because he understood that their reliance on specialist care they might be able to receive only at Stoke Mandeville made it even harder for them to speak up. This was calculating behaviour of the most abhorrent kind. Victims included 26 visitors and six staff. Six victims reported being raped, one as young as 11 or 12. Most victims were too frightened to come forward, but there were nine informal complaints and one made formally. None was taken seriously.

There is no suggestion that Ministers or officials knew about these activities, but accepted governance processes were not followed in the decision to allow Savile to acquire and maintain a position of authority at the hospital. In particular, Ministers made the expedient decision to use Savile not just to raise funds to redevelop Stoke Mandeville’s National Spinal Injuries Centre, but to oversee the building and running of the centre even though he had no relevant experience. Because of his celebrity and useful fundraising skills the right questions—the hard questions—simply were not asked, suspicions were not acted on and patients and staff were ignored. People were either too dazzled or too intimidated by the nation’s favourite celebrity to confront the evil predator we now know he was. Never again must the power of money or celebrity blind us to repeated, clear signals that some extremely vulnerable people were being abused.

I spoke last June about how changes to processes, policies and laws over the last 30 years have made it much less likely that a predator like Savile would be able to perpetrate these crimes today. Charity legislation is much tougher, setting out specific requirements for the auditing and examination of NHS charities’ accounts, and the safeguarding system now in place is significantly improved. The Children Act 1989, the first child sex offender register, Criminal Records Bureau checks and the Disclosure and Barring Service have all provided further protection. From 1 April, for the first time, the Care Act 2014 puts adult safeguarding on a legal footing and safeguarding adults boards will ensure that local safeguarding arrangements act to help and protect adults. We have also enshrined the right to speak up in staff contracts. We are amending the NHS constitution and have changed the law to make employers responsible if whistleblowers are harassed or bullied by fellow employees. We are also consulting on how best to implement the recommendations in Sir Robert Francis’s whistleblowing review.

However, proper policies and processes will not succeed if they do not go hand in hand with a change in culture, whereby patients and staff alike feel able to speak out with any concerns and can be confident that they will be listened to. It is particularly important that children and those with physical and mental illnesses are listened to, because they are the most vulnerable. While we are proud to live in a society in which people are innocent until proven guilty, we have a collective responsibility to investigate all serious allegations properly in a way that simply did not happen, time after time.

In the light of these disturbing reports, I also asked Kate Lampard to outline key themes across all the NHS investigations and to consider any further action that needs to be taken. She considered the extent to which Savile was a product of the culture of his time and concludes that, while he was a one-off, there are important improvements that need to be made to protect patients today. It is a thoughtful and comprehensive report, and I am today accepting in principle 13 recommendations she makes, including on access, volunteering, safeguarding, complaints and governance.

Trusts should develop policies on visits by celebrities and internet and social media access in hospitals. They should review voluntary service arrangements, safeguarding resources and the consistency of employment practices, ensuring clear executive responsibility. They should consider whether policies on the impact of volunteers on a trust’s reputation are adequate. The department, with its arm’s-length bodies, will examine: the possible development of a forum for NHS voluntary service managers; raising awareness of safeguarding referrals among NHS trust staff and volunteers; and to what extent NHS trust staff and volunteers should undergo refresher training in safeguarding.

I know some trusts which produced reports last summer have started to make improvements. One trust has already encouraged staff to raise concerns, updated the trust’s whistleblowing and complaints policy and published policy on the recruiting and management of volunteers. It is this kind of sensible, swift action that I want to see across the NHS. I have therefore asked the chief executives of Monitor and the TDA to ensure that all trusts review their current practice in three months against these recommendations and to write back to me with a summary of plans and progress at each one. These plans will be fed into the Government’s ongoing work to tackle child sexual exploitation.

One welcome practice that Kate Lampard’s report highlights is the growth in volunteering to support the work of the NHS. Overall, across the NHS we estimate that there are 78,000 volunteers, including 1,500 at just one trust, King’s in London. They do a magnificent job in improving patient care every single day throughout the NHS. We welcome this civic revolution and today need to make sure that any safeguards put in place support its further growth by helping to protect the reputation of volunteering as well as the safety of patients. Hard cases make bad law, and it would be the ultimate tragedy if Savile’s legacy was to hold back the work of the NHS’s true heroes, who give so much to their local hospital by volunteering their time. So while I agree that all volunteers working in regulated activity, typically having close or unsupervised contact with patients, should have an enhanced DBS check, I am not today accepting the recommendation that this should apply to all volunteers. As Kate Lampard acknowledges in her report, such a system may not in itself have stopped Savile. Rather, trusts should take a considered approach to checks on all volunteers, particularly using the enhanced DBS service if there is a possibility they will be asked at a future date to work closely with patients. They should also ensure that proper safeguarding procedures are in place locally as well as the DBS process, because it would be wrong to rely on the national database as a substitute for local common sense and vigilance.

The report also recommends that DBS checks are redone every three years. I believe the report is correct to say that trusts must make sure that their information on volunteers is up to date, but they can achieve this through asking volunteers to make use of the DBS update service, which enables trusts to check DBS information regularly and avoids volunteers having to go through the DBS process multiple times. We will be advising all trusts to do this.

Finally, I intend to take action in one area of great concern that the report highlights—namely, the responsibility and accountability of staff working with vulnerable people to take appropriate action when alerted to potential abuse. As the report recognises, the Government have substantially strengthened safeguarding arrangements since these dreadful events, but it is clear from these reports that there should have been a much stronger incentive on staff and managers to pass the information on so that a proper investigation happened. This is clearly unacceptable, and the Government have already said that we will consult on introducing a new requirement for mandatory reporting of abuse of children and vulnerable adults. The outcome of such a consultation must take full account of the need to avoid unintended consequences.

Let me conclude with a tribute to the victims who have had the courage to come forward. Without them, these investigations would not have been possible. It is our society’s shame that you were ignored for so long, but it is a tribute to your bravery that today we can take actions to prevent others going through the misery you have endured. As a result, our NHS will be made safer for thousands of children and vulnerable adults as we learn the uncomfortable lessons from this terrible tragedy. I commend this Statement to the House”.

That concludes the Statement, but since it was delivered in the other place, I have been advised that two passages require clarification. In repeating the Statement I said in relation to the victims at Stoke Mandeville that:

“20 were vulnerable patients disabled with severe spinal injuries”.

That should have read: “20 were vulnerable patients, some of whom were disabled with severe spinal injuries”. In addition, I said at the start that the reports that I mentioned had been placed in the Library. In fact, copies of the Stoke Mandeville and lessons-learnt reports have been placed in the Library. The remainder of the reports are available on the GOV.UK website.

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[Earl Howe]

My Lords, I am very grateful to the noble Baroness for her comments and for the constructive way in which she has approached these distressing matters. She referred to the issue of accountability and, of course, that is one of the first issues that springs to mind when hearing about these dreadful events. The noble Baroness said that there were people who knew and failed to act. The tragedy was that there were so many victims who knew exactly what had happened but whose cries were left unheard. As she said, picking up on the Statement, there were nine informal complaints and one formal complaint, none of which was followed through. I understand that the investigators have not been able to trace the members of staff involved in those complaints, so that with the passage of time it is difficult to establish exactly what was said and when. However, the facts speak for themselves.

The noble Baroness also asked about the value left in the Jimmy Savile estate. My advice is that last March the Jimmy Savile Charitable Trust had a capital balance of just short of £3.5 million. I understand that that balance may be a little less now, but that trust is being used to compensate the victims. If and when the money runs out, the Department of Health will step in. Although the compensation scheme has now officially closed, it is open to anyone else who has not yet come forward to make a claim, and they can also do so to the NHS Litigation Authority. Public funding is there to underpin the money from the Savile trust.

The noble Baroness also asked about the possibility of a further inquiry. Kate Lampard’s lessons-learnt report will feed into the findings of the national group on sexual violence as well as the work of the Independent Panel Inquiry into Child Sexual Abuse. This inquiry, chaired by Justice Lowell Goddard, will consider whether public bodies and other non-state institutions have taken seriously their duty of care to protect children from sexual abuse.

Regarding support and counselling for victims, which the noble Baroness also mentioned, people who have experienced abuse and need advice or support can contact the free confidential support line from the National Association for People Abused in Childhood. They can also contact the National Society for the Prevention of Cruelty to Children’s free confidential support line. During the investigations, each part of the investigation was responsible for ensuring that victims and vulnerable witnesses had access to appropriate support as required. Kate Lampard and the Savile Legacy Unit assured that these processes were put in place. Sir Bruce Keogh, the medical director of NHS England, wrote to all CCGs in May 2013 to ensure that all GPs within each area were alerted to the possibility of victims and witnesses presenting for help and support. He also asked that arrangements should be put in place with mental health services in each area so that the victims and witnesses could have their support needs, of whatever degree, met in a timely and appropriate fashion.

As regards compensation, slightly more than £58,000 has been paid out so far by the NHS Litigation Authority on behalf of the Secretary of State, of which a third is damages. As I have said, the NHSLA will meet the balance of valid NHS claims on behalf of the Secretary of State.

The noble Baroness asked about the proposal for mandatory reporting of suspected abuse. We have said that we will consult on this issue, which is essentially one of whether people feel that there is a need for legislation. It will be a full 12-week public consultation on the advisability, the risk, the nature and the scope of any reporting duty, including questions on which forms of abuse it should apply to and to whom it should attach. Inevitably, the process of consultation on this issue is complex. It requires careful handling and we believe that it should not be rushed. It will be critical that we consult as widely as possible. The available evidence is inconclusive as to whether mandatory reporting regimes help or hinder or make no difference to child safeguarding outcomes. The Government have no preconceived view on this. However, we are clear that we should consult on the matter as soon as possible.

Reverting to the point made by the noble Baroness at the start of her remarks, the report concludes that it was reasonable for Ministers to pledge government support for the rebuilding of the National Spinal Injuries Centre. However, the processes did not work as they should. It is the job of civil servants to provide full and impartial advice, and it would appear from the surviving documentation that DHSS officials may not have presented the full spectrum of issues concerning the NSIC to Ministers at the outset of the project. That served to minimise the complexity of the situation. It did not specify any potential consequences. It set the scene for the project to be agreed with minimal strategic planning in place that took into account what we would expect to see today, which is both long-term service forecasts and revenue costs. That had the effect of placing a dependence on Jimmy Savile as a continuing fundraiser from that moment on.

I simply say again that the investigation concludes that there was no evidence that either Ministers or officials knew about Savile’s predatory behaviour. Clearly, a number of people within the NHS had strong suspicions about it, but the celebratory status of Savile and the fact that everyone knew that Stoke Mandeville in particular depended on his fundraising skills clearly acted as a brake on people’s ability to speak up when they should have done so.

[Baroness Barker (LD)]

My Lords, there is one fact about this excellent report on a very difficult subject which is so obvious that it is in danger of being overlooked. We are talking here about events within the NHS and specifically about events within NHS organisations which had among their staff people who, due to their professional expertise, should have been able to spot the signs of abuse, as they are experts to whom people turn for treatment when they have been abused. I am not talking about the BBC; I am talking about the NHS. Repeatedly they did not see it or did not speak about it. That makes me draw an uncomfortable conclusion which goes to the heart of a couple of the recommendations—that is, that it is possible, even in the best of organisations which exist for the best of reasons, for there to be a culture so powerful that people can ignore things which are bad almost to the point of disbelief.

Therefore, when the Government consider their response to all this, I ask them to look at recommendations R5 and R8 in the lessons-learnt section. Those recommendations talk about trusts having a review process of their own procedures. They also make reference to the local authority designated officer and the role that he or she might play. I put it to the Minister that, in order to break a culture of silence, it must be possible to bring in a reference to an external expert. If victims and staff had access to such a person as a backstop, it would be a very important means of ensuring that we never saw organisations operating in this way again.

[Earl Howe]

My noble friend makes a series of extremely powerful and pertinent points and I am in agreement with the thrust of them. She is absolutely right that this is a matter of the culture of an organisation. While I think we can say hand on heart that the culture in the NHS has in many respects changed for the better in recent years, we must never be complacent about this. This matter was particularly identified by Sir Robert Francis in his recent report on whistleblowing, and we have accepted his recommendations. For example, we will ask every NHS organisation to identify one member of staff to whom other members of staff can speak if they have particular concerns and are not being listened to. We will also consult on establishing a new independent national whistleblowing guardian as a full-time post within the CQC to fulfil the kind of independent role that my noble friend refers to. In that context we are legislating to protect from discrimination whistleblowers who apply for NHS jobs. Therefore, I think that there are things that we can do with the mechanisms to ensure that the NHS is a more benign place for people who would otherwise feel too frightened to speak up.

Nevertheless, the further consultation on mandatory reporting which I have undertaken we will carry out will, I am sure, bring all this into the frame again. I have no doubt—at least, I hope—that my noble friend will feed into that consultation in the way that she has just indicated.

[Baroness Masham of Ilton (CB)]

My Lords, I declare an interest as I have been a patient at the Stoke Mandeville spinal unit since 1958, when I broke my back. I knew Jimmy Savile to some extent over the years. He was very autocratic and very clever, but I never saw his dark side. Many of the people working at Stoke Mandeville did not see that side of him because he was so clever.

There is a problem with hospitals. They do not like bad publicity and there can be cover-ups. We need openness and honesty. I should like to ask the Minister about the present procedure for patients, who need an easy and quick way of raising their concerns. That is very important because many patients are at risk of having bad things done to them. Sometimes those bad things may be done by people on the ward, so patients need to bypass the ward but they cannot just be told that they have to go to the health ombudsman. That takes too long. Therefore, I hope that the procedure for patients will be given great consideration in the future.

[Earl Howe]

The noble Baroness has our admiration for the way in which she has coped with her spinal injury over these many years. She is, of course, absolutely right about the way in which Jimmy Savile duped so many people. He was a forceful character as well as somebody with a superficial charm, and he got away with what he did. She is, of course, correct that the protection of patients lies at the centre of all this and we must ensure that we have proper systems in place to make them feel confident that they can come forward.

I take the noble Baroness’s point about patients perhaps not feeling able to complain to the ward staff. The answer to her question is that the patient, or someone on their behalf, can complain to the chairman of the organisation or trust or to a member of the board, and thus bypass the clinical staff. There should always be a member of the board at the hospital whose responsibility is the protection of patients above all. In the end, it is for that organisation to investigate its own supposed failings. If somebody is not satisfied with the result of that investigation, it is then open to them to go to the ombudsman. We believe that complaints should be investigated at a local level, either with the provider of the service or, if that is not thought appropriate for any reason, with the commissioner of the service.

[Baroness Manzoor (LD)]

My Lords, in relation to the protection of patients, I ask the Minister whether it would it be possible, each time a patient is seen by anyone—whether it is an external visitor or, indeed, a doctor—to ensure that there is another person present, such as a nurse. Just recently, a colleague went for a breast examination. She was seen by only one person, a male doctor; no safeguarding was available there. As part of that consultation, I would welcome this assurance.

[Earl Howe]

I take my noble friend’s point. However, I would hesitate before committing to a situation where, in every instance that a doctor or nurse examined a patient, they had to have somebody with them. In the real world, I do not think that is going to be practical. What one should have, however, is an assurance that whoever examines the patient, or performs some intimate caring service with the patient, should have been checked for both a criminal record and a previous employment history. I will take my noble friend’s point away, but I think that what I have said would be accepted by those in the National Health Service as the only practical way forward.

[Baroness Hollins (CB)]

My Lords, senior hospital administrators were criticised in these reports, but senior civil servants were also responsible for facilitating Savile’s influence and access to Broadmoor and Stoke Mandeville hospitals. Have the civil servants been identified? How have they been held accountable? Have the survivors received an individual apology for the governance failures that allowed this catalogue of abuse to take place? I understand the Secretary of State’s general apology, but I think an individual apology would be appropriate for each and every survivor.

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[Earl Howe]

My Lords, I agree with the noble Baroness’s last point. My understanding is that each survivor and each victim has had an apology, but I will look into the possibility of my right honourable friend adding to that.

As regards the civil servants involved, only one has been identified: Mr James Collier, who was, at the time, deputy secretary of the DHSS. Dr Gerard Vaughan, who was the Minister most closely involved with the building of Stoke Mandeville’s spinal injuries centre, assigned Mr Collier to ensure that the project went ahead. The inquiry found that Collier’s role was essentially to remove obstacles to the project. In effect, he was both an enabler and an instrument of the whole project. However, the report says:

“If criticism is to be levelled at James Collier it is because he did not just sweep aside bureaucracy to enable the project, he was instrumental … in sweeping aside some legitimate concerns raised by statutory bodies such as the Oxford Regional Health Authority”,

once he had been placed in charge of the project. So the duty of a senior civil servant to “speak truth unto power” was not, I am afraid, one that he fulfilled. Mr Collier is still alive, and I do not think that it would be proper for me to criticise him other than in the terms that the inquiry has done, but essentially the investigation concludes that,

“it would appear that Savile’s authority was given at the behest of politicians and then made possible by senior civil servants”.

[Lord Brooke of Sutton Mandeville (Con)]

My Lords, in congratulating my noble friend and his department on the fullness of the information contained in these reports—their very fullness makes one wonder how so much of the evidence passed people by—perhaps I may make one suggestion of presentation. When you read the two reports side by side, the grey-blue report about Stoke Mandeville contains far more upper-case letters as the initial letters of words. The pale mauve report of Kate Lampard is not addicted to that. The consequence is that it is much more difficult with the Stoke Mandeville report to recognise the comparative importance of the information given because it is always in headline elements.

[Earl Howe]

I understand the point made by my noble friend. At the same time, it is clear from the executive summary of Kate Lampard’s report that Stoke Mandeville is by far the most important and salient element of the report and I had hoped that that would have guided readers’ attention towards the section of the report that deals with Stoke Mandeville. Nevertheless, I am sorry that my noble friend has found it necessary to say that and I understand why he has.

[Baroness Walmsley (LD)]

My Lords, the Statement referred to inadequate systems and the need for a culture change. Does the Minister accept that many people are of the view that what we have is inadequate law and not only inadequate systems? I do not know whether my noble friend heard the “Today” programme this morning in which Mr John Humphrys, in interviewing a lawyer acting for one of the many Jimmy Savile victims, was astonished to discover that there is no offence of ignoring knowledge of child abuse that has been reported. Indeed, a majority of the British public think that it is already the law but the Minister knows that it is not.

I welcome the commitment to a public consultation that resulted from an amendment I tabled to the Serious Crime Bill, but several months have passed since that commitment was made by the Government and we still do not know which department will lead the consultation. Will it be the Home Office, the Department of Health or the Department for Education, or will it be a combination? I heard that in another place the Minister undertook that the consultation would be complete and the Government’s response given within 18 months of the Bill becoming an Act. Can the Minister confirm that that undertaking stands and say whether there has been any progress on which department will lead on this consultation?

[Earl Howe]

My Lords, I cannot give a specific undertaking on the timescale that we envisage for the consultation or on any legislation that might ensue from it because that raises the question of whether any legislation is necessary. That is what we want to know from the consultation process. However, I can tell my noble friend that the Home Office will be leading the consultation in conjunction with all the other relevant government departments.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, the noble Earl repeated a phrase in the Statement referring to Jimmy Savile as a one-off. Although that is qualified in the sentence that follows, nevertheless the reference is made. Does he consider that describing these incidents as a one-off characteristic of an unusual individual is tremendously helpful? We know that he was not a one-off because a number of other people working in NHS settings engaged in similar behaviour and have already been convicted. Many other people who were not working in NHS settings but doing other kinds of job—for example, in the rock music business—were also engaging in this kind of behaviour. Perhaps we need to take more account of the fact that, hard as it is for us to recognise, there are circumstances in which people, given the opportunity, will engage in this kind of behaviour and will continue to do so. Thinking of them as, as it were, bad apples does not help us to grapple with that reality.

[Earl Howe]

My Lords, the noble Baroness is right. It is with that thought in mind that Kate Lampard did not simply pigeonhole Savile as a one-off but has come forward with recommendations, most of which we have accepted, as to the wider lessons we should learn from this sorry saga. We know that, while the scale of Savile’s activities was probably unprecedented, there are others who have been found guilty of similar offences.

[Baroness Seccombe (Con)]

My Lords, my noble friend the Minister referred in the Statement to the review by Dame Janet Smith into Savile’s activities at the BBC. This review is ongoing. Of course, it was the BBC which gave Jimmy Savile this extraordinary platform in the first place. Will my noble friend confirm that this ongoing review is entirely independent of the BBC’s management and the BBC Trust? Can he also indicate when the review will be completed?

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[Earl Howe]

My Lords, I have only limited information about the BBC review. Dame Janet Smith’s review was established by the BBC, in October 2012, as an independent review of its culture and practices during the years that Jimmy Savile worked there. It will receive evidence from those who may have been the subject of inappropriate sexual contact by Jimmy Savile. As my noble friend knows, Dame Janet is a former Court of Appeal judge. The review has been in contact with approximately 740 people. It has had more than 350 telephone conversations with witnesses and almost 190 witness interviews have taken place. The completion of the review has faced delays due to criminal proceedings and new evidence. One instance was that of Stuart Hall, who pleaded guilty to 14 charges of indecent assault. Another was the Dave Lee Travis case, but I do not want to go into detail about that. I do not have information about when the review is likely to be concluded, but if I can find out I will write to my noble friend.

[Baroness Benjamin (LD)]

My Lords—