King’s College Hospital Foundation Trust

Baroness Harman Excerpts

Tuesday 12th December 2017 Commons Chamber

[Ms Harriet Harman (Camberwell and Peckham) (Lab)]

(Urgent Question): To ask the Secretary of State for Health if he will make a statement on the resignation of Lord Kerslake as chair of the King’s College Hospital NHS Foundation Trust.

[The Minister of State, Department of Health (Mr Philip Dunne)]

I would like to begin by paying tribute to Lord Kerslake, whom I have met in his role as chair of King’s, which he has served with great commitment for two years during a period of significant challenge. While we may differ on some matters of policy, this should not blind us to the service that he has given to the NHS.

The context of Lord Kerslake’s departure from King’s is the very real financial challenges faced by the trust and the way in which these have or have not been addressed. A number of other trusts have similar challenges, but none has deteriorated as far or as fast as King’s, especially in the past few months. This is why it was placed into financial special measures by NHS Improvement yesterday.

There has been a consistent pattern of financial projections by the trust that have not been met during Lord Kerslake’s tenure as chairman. In 2016-17, a planned deficit of £1.6 million deteriorated over the year to an actual deficit of £59.6 million. For the current year, a budget deficit of £38.8 million was agreed in May. At month 5, the chairman confirmed to NHS Improvement that the trust was on track to meet this deficit, but by October there had been significant deterioration in the trust’s position, with a projected deficit of £70.6 million at October—£32.l million worse than planned. NHS Improvement was informed last week that this had deteriorated further to a mid-case projection of a deficit of £92.2 million, which would be £53.4 million worse than the original planned deficit. Indeed, Lord Kerslake indicated that the final position could be even worse.

King’s is receiving substantial financial support from the Department of Health. During this financial year, the trust is receiving £135 million of support to maintain frontline services. That is the second highest level of support across England. Both the level of deficit and the speed of deterioration are unacceptable, as I am sure all hon. Members will agree. Although no trust or hospital is an island, it is right that those charged with leading it should take responsibility for such results. The chief financial officer and chief operating officer both resigned last month, and, as we know, Lord Kerslake left on Sunday.

The trust will now receive even more support with the appointment of a financial improvement director. The organisation will be required to implement a plan to improve its finances, which will be closely monitored by NHS Improvement. On top of special measures and subject to due process, NHS Improvement intends to appoint Ian Smith as a new and experienced interim chair for King’s to take control of the organisation’s position.

[Ms Harman]

Does the Minister not realise that the problem at King’s is not the leadership, any more than it is the growing number of patients or the dedicated staff? The problem at King’s is that there is not enough money. He shows no recognition of the fact that over the past two years, King’s has already cut £80 million—double the rate that other hospitals have had to cut—and taken on an ailing trust to help out the wider NHS. King’s is now being told that it has to make even further cuts. How can it keep its A&E waiting times down, prevent waiting lists from growing and continue to meet cancer targets if it goes on to make further cuts?

Will the Minister face up to the fact that problems caused by lack of money are simply not going to be solved by blaming the leadership? King’s is an amazing hospital and a specialist world centre of research, which is also there for local people. It was there after the Grenfell Tower fire and the terrorist incidents we have had in London. Is it too much to ask the Government to recognise the reality of the situation and pull back from imposing further cuts, which will make patients suffer? No amount of changing the faces at the top will make that difference. It is the Minister’s responsibility.

[Mr Dunne]

The right hon. and learned Lady said on the radio yesterday,

“just because they’re the regulator, when these judgments have to be made, doesn’t mean that they are actually right”.

I have to ask her about that, in the light of the comments made by NHSI, the regulator. I will give her a couple of quotes. Jim Mackey, who was until recently the chief executive of NHSI, has said:

“Honestly, I don’t think they have in my time hit a single set of their re-forecasted numbers”.

The current chief executive, Ian Dalton, has said that no other trust in the country

“has shown the sheer scale and pace of the deterioration at King’s”.

This is not just about the numbers; it is about the way in which the trust is managed.