Francis Report: Update and Response

Debate between Jeremy Hunt and Charlotte Leslie

Wednesday 11th February 2015 Commons Chamber

[Mr Hunt]

I remember the good meeting I had with the hon. Lady and the former Secretary of State about that issue, which we are looking into. I hope she will understand that it would not be right for me to comment on that individual case, but let me say that it seems to exemplify exactly how things have gone wrong. That is why we need to look into it very carefully. We need to create a culture through which the management actually want to listen to their staff. I do not want managers to do so because of something I say; I want them to feel that they want it happen. It is as much about making sure that organisational priorities are correctly set from the centre, as it is about changing the law.

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

Culture change is a big tanker to turn, and senior managers under pressure from targets and headlines need significant sanctions and incentives to reveal rather than smother or downplay difficult truths. Doctors have the General Medical Council, although it needs improvement, but managers have no regulatory body to make them accountable. Will the Secretary of State consider doing something about that?

[Mr Hunt]

I thank my hon. Friend, whom I know has thought extremely hard about this issue. Indeed, we talked yesterday about getting the fit and proper persons test to work properly. It is still in the early stages, so it is difficult to assess whether it is having the impact we want. We certainly hope it will have some impact. There is an unfairness about the fact that a clinician as a chief executive of a hospital is accountable to the GMC as a doctor, whereas a chief executive who is not a doctor is not accountable. We actually want more doctors to become chief executives. On the whole, they do a really good job, and we should give further consideration to that.

NHS (Five Year Forward View)

Debate between Jeremy Hunt and Charlotte Leslie

Monday 1st December 2014 Commons Chamber

[Mr Hunt]

The reason we decided to give that decision to NHS England—it is now decided at arm’s length from Ministers—was to remove the worry people had that politicians might make these decisions for political purposes, rather than for what is right for the NHS. I encourage the hon. Lady to make representations to NHS England before its board meeting on 17 December.

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

I very much welcome the “Five Year Forward View” and the new investment, but does the Secretary of State agree that it is not so much a five-year forward view we need as a 20 or 50-year forward one, if we are to begin to meet the tsunami of demand we face? We will have to work together across the House as we face the tough questions on how to fund and manage the NHS. Otherwise, we will be accused by future generations of bickering while our NHS burns.

[Mr Hunt]

I hear what my hon. Friend says, but it is also important to have a clear plan of action to take us in the right direction over the next six years, which is what the plan from NHS England and Simon Stevens provides and what the Government have said we support. She is right that the demographic trends will get worse. By 2030 the number of over-80s will have doubled to 5 million. That is the sobering reality that we all have to face up to.

Special Measures Regime

Debate between Jeremy Hunt and Charlotte Leslie

Wednesday 16th July 2014 Commons Chamber

[Mr Hunt]

The examples of poor care I gave happened under this Government. I am therefore being absolutely clear that failures in care happened under both the previous Government and this one. The difference is that this Government are doing something about it. We are taking action and taking the difficult steps to get those trusts out of special measures. The public are beginning to have confidence that, when there are problems, they are not being swept under the carpet but being dealt with.

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

Bad care is unacceptable, but what turns bad care toxic is covering it up and denying that it is happening. I am pleased that we are beginning to get a consensus across the House that transparency and unearthing problems is the beginning of solving them. On that note, will my right hon. Friend the Secretary of State work on a cross-party basis with the right hon. Member for Leigh (Andy Burnham) and the Labour party on Wales, which was also targeted by Bruce Keogh’s expertise? He has suggested that it would be sensible to have a Keogh-style investigation in Wales, not only because of mortality statistics and diagnostic waiting times, but because tales coming to me and the right hon. Member for Cynon Valley (Ann Clwyd) are raising the alarm. I urge hon. Members on both sides of the House who are worried about patients in Wales to urge such an investigation there, because the investigation here unearthed problems.

[Mr Hunt]

I totally agree with my hon. Friend. It is an absolute tragedy for people who use the NHS in Wales and Welsh NHS workers that they are not getting the support that people in England get to deal with poor care. For some reason, the Labour Administration in Wales believe that it would be incredibly embarrassing to find problems, but that is what hospitals and hospital staff are crying out for. The staff did not go into those jobs to deliver poor care. They want the support to deliver the best care. It is time that Labour in Wales understood that and got the support of Labour in England to do so.

Patient Safety

Debate between Jeremy Hunt and Charlotte Leslie

Tuesday 24th June 2014 Commons Chamber

[Mr Hunt]

I am afraid I will take no lessons in spin and game playing after what the hon. Gentleman wrote in local election leaflets in Hammersmith and Fulham, failing to tell his own constituents about the brand new hospitals, the opening of a seven-day GP surgery and the 800 out-of-hospital professionals. I think he behaved absolutely disgracefully.

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

I very much welcome the Francis review into whistleblowing, which does indeed focus on transparency, and I am bemused and depressed that we cannot get universal welcome for it across the House. In addressing the name, shame and blame argument, does my right hon. Friend recognise that many front-line staff will be relieved at what he has announced because it will force management priorities to be the same as their priorities, which are overwhelmingly about patient safety?

[Mr Hunt]

My hon. Friend speaks wisely, and I commend her for her work in championing whistleblowers. In her relatively brief time here, she has made a big difference on that issue. Personally, I do not like to use the term “naming and shaming” because I think identifying problems should always be the first step to sorting them out. What we are doing today by identifying trusts that do not have a proper open and honest reporting culture is also helping them to change that reporting culture while at the same time identifying trusts that have a good culture. It is all about changing the culture, so this is a positive move, and I think that NHS staff will really welcome it.

Oral Answers to Questions

Debate between Jeremy Hunt and Charlotte Leslie

Tuesday 10th June 2014 Commons Chamber

[Mr Hunt]

I hope so, but I want to be honest with the House. It takes time to change a culture, and that is the big change we have to make. Whistleblowers are now coming forward from Coventry, Cambridge, Ealing and all over the country. That is why I am afraid that I profoundly disagree with the shadow Health Secretary, who said that the lessons of the Francis report were about a local failure. This is about a systemic problem and we have to change it across the NHS.

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

Given there are so many emerging cases of whistleblowers—both current and historic—being treated with injustice, a precedent will not be set for accountability until these injustices are actually faced. Will the Secretary of State set up a truth and reconciliation committee to look at historic and current cases so that accountability becomes a reality?

[Mr Hunt]

First, I commend my hon. Friend for her campaigning on this issue in the House and on the Health Committee. We have not done everything we need to do to change the culture within the NHS, and we are looking at what more needs to be done to get a culture change profound enough to make it easier for people to speak out. This is not just about whistleblowing. If it is whistleblowing, we have failed because it means that someone has had to go to the press or outside their organisation when they were worried. We need an NHS where people within their own organisation are listened to when they have concerns, and we are looking at what we need to do to take that forward.

--- Later in debate ---

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

As he heralds an era of transparency, can the Secretary of State update us on what steps he has taken to ensure that private providers in the NHS are every bit as transparent and accountable as public ones?

[Mr Jeremy Hunt]

I think they absolutely should be, and the changes that we introduced in the Care Act 2014 relating to the transparency of the inspection regimes apply to private providers supplying services to the NHS just as they do to NHS providers. Let us be absolutely clear: poor care is poor, whether it happens in the public sector or the private sector, and we must clamp down on it wherever it happens.

Oral Answers to Questions

Debate between Jeremy Hunt and Charlotte Leslie

Tuesday 22nd October 2013 Commons Chamber

[Mr Hunt]

I am pleased to tell the right hon. Gentleman that we are working closely with the police to try to ensure that some of the people held in police cells are given much faster access to mental health services. That includes a street triage pilot, which has had early and promising results.

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

I was informed this morning that the chair of the NHS property board has resigned. That follows the revelation last week, through parliamentary questions I asked, that the board has been raiding its capital allocation to subsidise its own revenue funding. In the interests of transparency, will the Secretary of State undertake to review and publish the recruitment and employment procedure of executive and non-executive members of the board—including civil servant Peter Coates who created the board, which oversees £3 billion-worth of assets—and conduct careful audit and scrutiny of the board’s accounts and minutes?

[Mr Hunt]

Obviously, the suggestions my hon. Friend makes are extremely serious. If she lets me have a copy of all the things she is directly concerned about, I will look into it with the greatest priority.

Hospital Mortality Rates

Debate between Jeremy Hunt and Charlotte Leslie

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

It is, absolutely. That is the big change. My hon. Friend speaks wisely. That is the big change that we have to make in our NHS. When there is failure, we must be open about it. It has to be public—we have to keep the public in the picture, because that is the best way of putting pressure on the system and on the politicians to make sure that they sort it out. That is not what happened before; it is going to happen now.

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

Does the Secretary of State share my dismay that just as Julie Bailey was hounded out of Mid Staffs by the local Labour party for revealing the truth, some of the tone of this debate—accusations, sanctimoniousness and false victimhood—is a very tangible illustration of what whistleblowers have had to face for the past decade when they have tried to get the truth out? What a tangible demonstration, sadly, this has been.

[Mr Hunt]

My hon. Friend is right. If some of those on the Opposition Benches knew exactly what Julie Bailey had to go through to expose the truth of what happened at Mid Staffs, they might think again about some of their behaviour this afternoon.

Oral Answers to Questions

Debate between Jeremy Hunt and Charlotte Leslie

Tuesday 16th July 2013 Commons Chamber

[Mr Jeremy Hunt]

The hon. Lady asks that question as if that kind of thing never happened under Labour. The answer is that it is not acceptable, which is why we are changing the rules to ensure that people cannot get payoffs and then walk straight into another NHS job. The other answer is that the reorganisation that she criticises means that we have put more money on the front line, including for 6,000 more doctors, which I think was the right thing to do.

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

Does the Secretary of State agree it is a scandal that those, such as Gary Walker, Amanda Pollard and Kim Holt, who have exposed the horrors buried in our NHS have either been fired or do not have jobs, but those who are heavily implicated in such cases, such as Barbara Hakin—about whom I have written to the Secretary of State—David Nicholson, and others, still do?

[Mr Hunt]

My hon. Friend has campaigned long and hard on issues of accountability, and I agree with her basic case, even if I do not agree with her about all the individuals she mentioned. One issue that will arise during today’s statement is that of how people are held accountable. That has been missing in our NHS, and we must put it right.

Care Quality Commission (Morecambe Bay Hospitals)

Debate between Jeremy Hunt and Charlotte Leslie

Wednesday 19th June 2013 Commons Chamber

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

I echo the sentiments of the right hon. Member for Exeter (Mr Bradshaw) and ask the Secretary of State to look urgently at the application of the Data Protection Act if accountability is to mean anything at all. I urge him also to look at the lessons that a change of leadership effected in the CQC and the era of transparency that that heralded. There is a cover-up which is not just about Morecambe Bay; it is about Mid Staffs, and I suspect that, sadly, other stories may emerge of other such horrors. Does my right hon. Friend think there should be an inquiry into the culture of lack of transparency and cover-up that involved senior managers, and will he consider a change of leadership in order to herald a proper culture change in the NHS?

[Mr Hunt]

My hon. Friend has campaigned with great assiduity and distinction on this issue. The report about the culture of cover-ups and secrecy was the Francis report, and my job now is to do what is necessary to bring forward the change so that we move on and have a culture of openness and transparency. That means, yes, openness and transparency in this place and among Government Departments and regulators, but it also means creating a culture for front-line staff where they feel that they can raise concerns. We do not do that as well as we should, and it is even more important.

Oral Answers to Questions

Debate between Jeremy Hunt and Charlotte Leslie

Tuesday 11th June 2013 Commons Chamber

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

Does the Secretary of State agree that any criminal investigation into the 200 to 300 deaths at Mid Staffs should extend not only to front-line staff, who risk getting scapegoated, but to all managerial levels, Department of Health officials and the heart of Government, so that we get answers about who knew what and when, and what action they took or—more importantly—did not take that could have prevented this tragic scandal?

[Mr Jeremy Hunt]

I congratulate my hon. Friend on her determined campaigning on this issue. She will agree that we must allow the law to follow its course. The police are looking at the five reports on hospital safety that were undertaken, the inquests and the lists of patients who appear to have been treated badly, and they are talking to the relatives of those patients. We must allow them to do their work, but no one is above the law, and particularly in this case it is important that justice be done.

Mid Staffordshire NHS Foundation Trust

Debate between Jeremy Hunt and Charlotte Leslie

Tuesday 26th March 2013 Commons Chamber

[Mr Hunt]

We will absolutely do that, but I should also reassure my hon. Friend that the inspection regime will apply to the ambulance service as well as hospital trusts.

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

I very much welcome the Secretary of State’s statement, but does he share my sorrow that it has taken so long and so many deaths to reach this stage, when Labour was presented with reports by Don Berwick himself highlighting bad quality assessment, when 120 bodies had overlapping responsibilities and when he said that patient safety was not central to the NHS? Is it not tragic that it has taken this long?

[Mr Hunt]

I thank my hon. Friend. Sadly, I agree with her sentiments. We have a responsibility to ensure that we have structures in place that make it impossible to delay addressing these difficult issues. That is the central challenge that I now face.