National Health Service
Debate between Jeremy Hunt and Alan Johnson(9 years, 10 months ago)
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Alan Johnson (Kingston upon Hull West and Hessle) (Lab)
Will the Secretary of State give way?
Mr Hunt
But the right hon. Gentleman’s constituency has more doctors and more nurses who are seeing more people every year within four hours and doing 4,000 more operations every year. That is working for his constituents, but there is pressure out there and we need to support people through a difficult winter.
The right hon. Gentleman mentions stories that are, of course, very tragic, but never once has he brought up stories about the problems happening in Wales. Too often, we get the impression that, for Labour Members, poor care under a Labour Government—whether in Wales today or Mid Staffs previously—does not matter as much as poor care under this Government when they can make a political point. A party that really cared about the NHS would be as outraged about problems when they are in power as they are when in opposition. For this Government, poor care is poor care, and we will deal with it wherever and whenever it happens.
Alan Johnson
Does the Secretary of State remember the words of the Prime Minister when he stood at the Dispatch Box and presented the report from Stafford? He said that what happened at Stafford was not the fault of any previous Secretary of State, including my right hon. Friend the Member for Leigh (Andy Burnham). The Prime Minister was a statesman on that occasion; it is a shame that the statesmanship has slipped since.
Mr Hunt
I have a great deal of respect for the former Secretary of State, but if he had followed the debates on Mid Staffs in this Chamber he would know that my disagreement with the shadow Health Secretary is over the reaction to Stafford and whether we will learn from those mistakes. When I have made speeches talking about the problems of poor care in the NHS today, he goes straight out to the TV studios and says that that is running down the NHS. That is not acceptable when we are taking difficult decisions to turn round failing hospitals and face up to problems in exactly the way suggested by the Francis inquiry.
Mid Staffordshire NHS Foundation Trust
Debate between Jeremy Hunt and Alan Johnson(11 years ago)
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Alan Johnson (Kingston upon Hull West and Hessle) (Lab)
We need total candour with regard to avoidable deaths. The only way to determine that is through an independent review of medical case notes by neutral clinicians. That exercise took place at Stafford. Will the Secretary of State remind us of the result?
Mr Hunt
I do not have the results in front of me, but I am happy to supply them. I want to take up the right hon. Gentleman’s point about avoidable deaths, because one of the changes we want to make today is to avoid the temptation, when there is an avoidable death, for people on the front line to say that it was unavoidable. We are trying to create the structures that make it easy for people to speak out if they think that a death was avoidable and to ensure that they are encouraged to do so.
Hospital Mortality Rates
Debate between Jeremy Hunt and Alan Johnson(11 years, 4 months ago)
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Mr Hunt
My right hon. Friend speaks very wisely. As I know he agrees, identifying problems publicly is incredibly difficult, but the way to ensure that those problems are dealt with is to be totally honest and transparent about them in the knowledge that they will be sorted out as a result, and that is what is happening today.
Alan Johnson (Kingston upon Hull West and Hessle) (Lab)
Thankfully, the quality of Sir Bruce Keogh’s report is vastly superior to that of the statement that we heard from the Secretary of State. Is it not the case that Sir Bruce Keogh—[Interruption.]
Alan Johnson
Is it not the case that Sir Bruce may have given us a blueprint for better regulation, provided that the Secretary of State faces up to his responsibility and ends the tawdry and squalid attempts by his party to denigrate his predecessors?
Mr Hunt
I am sure that the right hon. Gentleman, who is one of those predecessors, would accept at a quieter moment outside the Chamber that one of the biggest mistakes made during his time as Secretary of State—or at least it was initiated then—was the appalling change that was made to the regulation of hospitals. The CQC was stripped of expert inspectors, and hospitals began to be inspected by generalists. The same group of people would inspect a slimming clinic, a dental practice, a GP’s surgery, and a major London teaching hospital. That very significant mistake lies at the heart of the reason why the CQC approved and certified so many failing hospitals.
I am happy to work with the right hon. Gentleman, and to say that honest mistakes were made and we will put them right, but today there must be honesty about what those mistakes were.
Accountability and Transparency in the NHS
Debate between Jeremy Hunt and Alan Johnson(11 years, 8 months ago)
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Mr Hunt
I acknowledge the brilliant work done by NHS staff and, contrary to what the right hon. Gentleman says, I do that in every speech that I make on these matters. I will not, however, accept the complacency that says that problems at Stafford hospital were localised and happened only in one place. If we are to sort out those problems, we have a duty to root them out anywhere in the NHS that they occur.
The right hon. Gentleman talked about waiting times targets. Let us be clear: there is an important role for targets in a large organisation such as the NHS. Without the four-hour A and E target, or the 18-week elective waiting time target, access to NHS services would not have been transferred and I accept that the previous Government deserve credit for that. It was right to increase spending on the NHS, although it is curious that Labour now wants to cut the NHS budget. Labour did however—this is where Labour Members should listen rather than barrack—make three huge policy mistakes, and the right hon. Gentleman must accept that it is not simply a question of Government policy not being implemented in every corner of the NHS. Those three mistakes contributed to the culture of neglect that we are now dealing with.
The first mistake—a huge mistake—was that Labour failed to put in place safeguards to stop weak, inexperienced or bad managers pursuing not only bureaucratic targets but targets at any cost. That is exactly what happened at Mid Staffs, where patient safety and care were compromised in a blind rush to achieve foundation trust status. Secondly, Labour failed to set up proper, independent, peer-led inspections of hospital quality and safety that told the public how good and safe their local hospital was. Instead of a zero-harm attitude to patient safety, we have a culture of compliance and the bureaucratic morass that is the current Care Quality Commission. Thirdly, Labour failed to spot clear warnings when things went wrong. The Francis report lays out a timeline of 50 key warning signs between 2001 and 2009. Why did Ministers not act sooner? If those warnings were not being brought to the attention of Ministers, why did they not build a system in which they were? Instead, there was a climate in which NHS employees who spoke out about poor care were ignored, intimidated or bullied.
Alan Johnson
The Secretary of State is making an interesting speech and there is no way that the Labour party can escape criticism for what happened at Stafford. Does he accept, however, that before 2000 there was no independent regulation of the NHS and no standardised mortality ratios, complaints in hospitals stayed in the hospital and there was no recourse to any independent observance of those complaints, and A and E—a particular problem at Stafford—was a data-free zone?
Mr Hunt
I accept that progress was made in the collection of data and that the previous Government set up a star rating system. The problem, however, was what it measured. It did not measure the quality of patient care but basically focused on access targets. It was possible for a hospital to get a three-star rating by transforming its 18-week access targets, even at the expense of patient care.
Alan Johnson
On the question of a public inquiry, when Francis reported on his first inquiry, commissioned by my right hon. Friend the Member for Leigh, he made the point that it was about people affected being able to come and tell their story, and Francis said in his first report:
“I am confident that many of the witnesses who have assisted the inquiry in written or oral evidence would not have done so had the inquiry been conducted in public.”
It is very important that that first inquiry allowed people to come forward. The right hon. Member for South Cambridgeshire (Mr Lansley) may also well have been right to make the second stage of that a public inquiry, which was authorised because of one of the Francis recommendations, because we now have all the information, provided before a Queen’s counsel, about what happened there.
Francis is very clear about no blame being apportioned to any Minister. It is of course right for Ministers to be accountable if anyone knew what was going on and did nothing to stop it, or if something that was going on was a result of a Government edict or policy, but that was not the case at Stafford.
Targets had to be introduced to get a grip on this terrible situation of lack of access to health care. Targets did not cost lives; they helped to save lives. They were accompanied by the resources, the capacity and the political will that transformed waiting lists of 18 months to two years to a maximum of 18 weeks and an average of nine.
This is what Francis said about targets:
“It is important to make clear that it is not suggested that properly designed targets, appropriately monitored cannot provide considerable benefits and serve a useful purpose…indeed the inquiry accepts that they can be an important part of the health system in which the democratically elected Government of the day sets its expectations of providers who are funded by the taxpayer.”
The right hon. Member for Charnwood (Mr Dorrell) was absolutely right to say that long waiting lists have dogged the NHS since it was created in 1948. Rudolf Klein, the great historian of the NHS, says every Health Secretary shouted their orders from the bridge and the crew carried on regardless. Something had to be done to deal with that, and it was done.
Mr Jeremy Hunt
Does the right hon. Gentleman not accept that the issue was not targets, but the failure to put in place safeguards to stop managers twisting a targets culture into a culture of targets at any cost? That was the fundamental policy mistake. The lack of those safeguards meant Mid Staffs could happen.
Alan Johnson
The Secretary of State is right. Of course there need to be safeguards to ensure any system has a backstop to stop people misusing targets. The guidance from the Department of Health was very clear. In no way must the pursuance of targets interfere with the need for good patient care. The Stafford chief executive must have translated that into saying it was fine to put receptionists on triage nursing. With all due respect to the Secretary of State, I do not think that he or any of his successors or predecessors can make regulations to meet every eventuality, including for someone like that chief executive of the Mid Staffs trust.
Phone Hacking and the Media
Debate between Jeremy Hunt and Alan Johnson
Mr Hunt
I completely agree with my hon. Friend. If we are to tackle this very serious cancer that we have seen in our society in the past week, we need a responsible attitude from Members on both sides of the House, and if we are worried about newspapers getting above the law, Ministers need to set an example and ensure that they do not get above the law themselves.
Alan Johnson (Kingston upon Hull West and Hessle) (Lab)
I am surprised that we have the monkey at the Dispatch Box and not the organ grinder—[Interruption.]
Alan Johnson
The Prime Minister said on Friday that he received no “specific” information, but it is clear that that information was passed to Ed Llewellyn. If Ed Llewellyn failed to pass that information to the Prime Minister, will he be sacked or given “a second chance”?
Mr Hunt
I take being called a monkey very seriously, because in my wife’s country they used to eat them.
With regard to what the Prime Minister did or did not know, he will answer for himself, but he has said that he takes full responsibility for the decisions he took and that he had no knowledge of any illegal of criminal activity by Andy Coulson when he decided to employ him.