Autumn Statement

Debate between Jeremy Hunt and William Cash

Thursday 17th November 2022 Commons Chamber

[Jeremy Hunt]

I have been pretty straightforward about saying that there were mistakes in the mini-Budget, and within three weeks we reversed them. Long-term gilt yields, which are the thing that really drive the cost of borrowing for the country, are down to the levels they were at before the mini-Budget, and to try to say that all the problems we face now are a result of decisions that were reversed in three weeks does not stand any scrutiny at all.

[Sir William Cash (Stone) (Con)]

My right hon. Friend argued for sound money and sound foundations. Would he be good enough to explain how it is that High Speed 2 will continue beyond Birmingham at a verifiable cost of at least £40 billion, when every independent report on HS2 condemns the project and confirms that phase 2 will make rail services to all west coast destinations north of Birmingham much worse? I ask him to make a clear commitment to keep this matter under review at all costs; it is in the national interest.

[Jeremy Hunt]

My hon. Friend is right that the increases in the budget for HS2 are disappointing, but a strong economy needs to have consistency of purpose, and that means saying we will make sure that we are a better connected country. The lack of those connections is one of the fundamental reasons for the differences in wealth between north and south, which we are so committed to addressing. There is a bigger issue about the way that we do infrastructure projects: it takes too long, and the budgets therefore get out of control. We are just not very good at it, and we have to sort it out.

Francis Report: Update and Response

Debate between Jeremy Hunt and William Cash

Wednesday 11th February 2015 Commons Chamber

[Mr Hunt]

I thank the right hon. Gentleman for what he did when he was Health Secretary. I am well aware that in the world’s fifth-largest organisation, nothing happens just because someone issues a circular, which is why some of what we have announced goes beyond what Sir Robert precisely recommended. For example, by publishing avoidable death rates by hospital trust, we want to make the energy for change come from inside trusts, not from their being told to do things by Ministers. However, I welcome what he did as Secretary of State, and I hope we can do some other positive things.

[Sir William Cash (Stone) (Con)]

May I commend my right hon. Friend for his nuts-and-bolts approach and Sir Robert Francis for what is clearly an extremely good report? My right hon. Friend will know that Helene Donnelly is a constituent of mine, and that I read out a letter from her in Westminster Hall when I called for an inquiry under the Inquiries Act 2005—an inquiry that this Government set up, despite its having been refused by the previous Government and successive Secretaries of State. Will he bear in mind the need to dismiss any chief executive who does not take account of lessons learned and the fact that anyone who puts a whistleblower at risk does not deserve to hold their job?

[Mr Hunt]

I thank my hon. Friend because without his work and that of some of his Staffordshire colleagues we would not have had a public inquiry into Mid Staffs in the first place. Helene Donnelly has been a great inspiration to everyone who has thought hard about this subject. She had the courage and guts to stand up for patients at Mid Staffs, and she experienced terrible bullying as a result, which is why I am delighted that she is helping us. In fact, I think she is the inspiration for Sir Robert’s recommendation on “freedom to speak up” guardians. My hon. Friend is absolutely right that managers and chief executives must be completely accountable for delivering on this agenda, but we also need to send a signal to them that success for a chief executive means more than meeting A and E or 18-week targets; it is about the quality and safety of patient care.

Francis Report

Debate between Jeremy Hunt and William Cash

Wednesday 5th March 2014 Commons Chamber

[Mr William Cash (Stone) (Con)]

May I reiterate what my right hon. Friend has said about the absolute point-blank refusal, repeatedly and whenever I raised the question of an inquiry under the Inquiries Act 2005, to hold such an inquiry? The previous Government would not hold an inquiry; they totally refused to do so, which was an absolute disgrace. To his credit, the present Prime Minister listened to my arguments, and one of the first things he did when he came to government was set up an inquiry, which now has the capacity to transform the national health service.

[Mr Hunt]

We are about to hear from the shadow Health Secretary who will have the chance to put things right on that account. My hon. Friend the Member for Stone (Mr Cash) was extremely courageous, determined and persistent in campaigning for a public inquiry, and with the support of my predecessor and the Prime Minister, that is leading to the profound changes we are seeing today. We would all welcome the Labour party’s support for that.

I opened this debate by paying tribute to a few brave individuals who started a movement in England for safe, effective and compassionate care.

--- Later in debate ---

[Mr William Cash (Stone) (Con)]

It is quite difficult at this stage in the saga—the tragedy—of Stafford hospital to recall how it all came about and the difficulties that those of us who experienced it had to endure, the patients and the victims in particular. There was complete and total resistance—indeed, worse than that, a granite-like refusal—to having a proper look at what was going on. It would take much longer than I have available this afternoon to explain exactly the tooth and nail battle that I had to engage in to get the inquiry in the first place under the Inquiries Act 2005.

In a previous incarnation as the Member for Stafford, I had already had Stafford hospital in my constituency for 14 years, from the date of a by-election some 30 years ago in May 1984. I experienced a tragedy in Stafford hospital during that time with legionnaire’s disease, and I came to this House and asked the then Prime Minister, the late Margaret Thatcher, whether she would give us a full public inquiry—equivalent to one under the provisions of the 2005 Act. I did that because I knew it was impossible to get to the root of what was going on unless we had such forensic evidence, with cross-examination on oath and all the other—not paraphernalia, but necessary ingredients as part of the process, to ensure that we could bring to light what was required.

I was absolutely astonished that successive Secretaries of State completely refused, point-blank, to have such an inquiry in the case of Mid Staffordshire. I have to put it on record that the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson), who is not even in the House this afternoon—perhaps he has some excuse or justification—was the Secretary of State during a lot of the time in question. Patricia Hewitt was also Secretary of State for part of the time when serious problems were going on. The right hon. Member for Kingston upon Hull West and Hessle refused to have a public inquiry. The right hon. Member for Leigh (Andy Burnham) also refused to have an inquiry of the 2005 Act type. Although it is certainly true that he agreed to a Francis inquiry, and that there was also the Alberti report, the Colin-Thomé report and one or two other investigative exercises, none of them had the right ingredients to give them the capacity to get to the root of what was going on.

I am delighted with what my right hon. Friend the Secretary of State has done since then. I was extremely glad that, when we were in opposition, I was able to overcome some resistance to a 2005 Act inquiry from shadow Ministers. The current Prime Minister, then the Leader of the Opposition, listened to the arguments that I and others made and agreed to have a full 2005 Act inquiry, because he understood how important it was, as the Secretary of State does. The consequence has been to enable us to make changes throughout the entire health service that, as Opposition Members have acknowledged today, have enabled us in Staffordshire to be a pathfinder for solving some, if not all, of the problems presented in the health service.

The work of Cure the NHS has included that of my constituent Deborah Hazeldine. She does not get a great deal of publicity, but she was the one who came to me in my office in December 2008, with Julie Bailey, and explained that they were getting nowhere with the complaints and concerns that they were expressing. They asked what could be done about it, and I explained to them that if they did certain things, I thought we would be able to get a campaign moving of the kind that would be needed to get a 2005 Act inquiry. I pay tribute to them, and to Ken Lownds, who has been a tower of strength. He is a man of enormous integrity, knowledge, skill and commitment. I pay tribute to him for what he did to ensure that we got the inquiry, for the evidence that he gave to it and for his continual determined input into improving the health service since the Francis report was produced.

I am delighted that the Francis report came out as it did. It had, I believe, 299 recommendations, and it has been immensely important to the future of the health service. I do not need to go into all the details, but I pay tribute to my hon. Friend the Member for Stafford (Jeremy Lefroy), my next-door neighbour, with whom I worked closely from the beginning. He committed himself to a 2005 Act inquiry when he was in what could be described as the delicate situation of being about to become the Member of Parliament for Stafford but not entirely certain that it would happen. He did it, and he was right, and I pay tribute to him for everything that he has done since.

[Mr Jeremy Hunt]

I am grateful to my hon. Friend for his generous comments. While he is paying tribute to people who have played an important role in getting us to where we are, may I add my thanks to Deborah Hazeldine, and also to Ken Lownds, who was the first person who really talked to me about the important concept of zero-harm health care? I know my hon. Friend will not mind if I also mention campaigners from other hospitals, such as James Titcombe in the case of Morecambe Bay, who have also played an extremely important role in the debate.

[Mr Cash]

I am extremely glad that my right hon. Friend has made that point. The zero-harm policy is so important, and I am grateful for that specific intervention. It will make Ken Lownds’s day. I also pay tribute to people all over the country who have taken up the message and sought to improve the health service in their areas. This has turned into a national campaign, and the Secretary of State deserves great credit for the way he has helped to co-ordinate it.

I was, and remain, completely amazed that the right hon. Member for Kingston upon Hull West and Hessle, and Patricia Hewitt, were not even asked to give evidence to the inquiry. I still find that completely staggering to my way of thinking. I know that the right hon. Member for Leigh was asked to give evidence, and did, but I place the point on the record because I found it extraordinarily difficult to understand then, and I still do now.

I have constantly and repeatedly called for the resignation of Sir David Nicholson. I know he is retiring soon and that that resignation will not happen, but I repeat my concern, as I did in evidence to the inquiry, because the whole target-based policy was very much tied up with his approach to these matters. Indeed, in the last of, I think, about 600 paragraphs of his evidence to the inquiry, he referred in the last two lines to the fact that the Member of Parliament for Stone, Mr Bill Cash, had raised the question of his involvement in target-based policies. He said that there were arguments on both sides of the equation regarding target-based policies, but I do not agree with that. I do not think target-based policies were the right way to go, and I am glad that the hon. Member for Stoke-on-Trent North (Joan Walley) agreed with me. As I pointed out in my evidence to the inquiry, such policies had a terrible effect on the attitude of Monitor regarding the financing issues that provided 39 of the 45 or so questions put by William Moyes to the foundation trust when it received its approbation—something it should never, ever, have got. I say to the right hon. Member for Leigh that through the mechanism of the Department—I cannot point precisely to chapter and verse—the fact that the foundation trust got such status was also the product of a misjudgment by the Government at the time.

I have already referred to correspondence in an intervention, but in the prime ministerial guidelines of 2005, under the previous Government, it was clearly stated that when Members of Parliament write to Secretaries of State and other senior Ministers, they are entitled to receive a full, comprehensive response—personally—from that Minister. I found that wanting during this process. I was glad to note, however, that in the course of evidence to the inquiry, the situation moved from what appeared to be resistance to going down that route, to an acceptance that—to paraphrase from the evidence given by the chief executive of the Department of Health—from now on, when a Member of Parliament writes with a letter from a constituent, and explains that things have not gone properly regarding that constituent’s health problems, there is a mechanism to ensure that the issue is dealt with properly. I will not have to go into all that today, because it has been rectified.

In my evidence, I also raised the issue of whistleblowing. I also tabled amendments to the then health legislation, calling for the repudiation of gagging clauses and providing that any chief executive who endorsed them and got his legal advisers to agree to them should be dismissed. That is another area that has been dealt with, so we are making progress. I very much endorse the views expressed on both sides of the House about having unity across the Floor of the House, as far as we can achieve it, on the central principles.

I agree with what my hon. Friend the Member for Stafford said about the issue, although I have a difference, not of opinion but of emphasis, because my constituency is very rural, and access to the artery of the M6 is not easy. It can be difficult to reach, especially at night, because it can be a long way through small rural lanes, to access the M6 and the University hospital of North Staffordshire or hospitals in Wolverhampton. That is my caveat on that.

We have made enormous progress. I am glad that the Mid Staffs foundation trust is being dissolved, and that—as my hon. Friend the Member for Stafford said—the Prime Minister, at a recent Prime Minister’s questions, backed plans, in as many words, for consultant-led maternity to continue at Stafford hospitals. That service, plus paediatric services, critical care and a 24-hour emergency service, is necessary for constituents in Stone and the rest of Staffordshire. I will work with my hon. Friend to ensure that that is delivered.

Mid Staffordshire NHS Foundation Trust

Debate between Jeremy Hunt and William Cash

Tuesday 19th November 2013 Commons Chamber

[Mr Hunt]

I congratulate the right hon. Lady on the extremely good report that she produced. I hope she will not find herself in a position of wanting to complain to me about the way in which I have implemented her report on complaints, because we intend to take it extremely seriously. She knows that I basically accept everything she said in it, although we will have to work carefully on the implementation of some things to make sure we get them right. She highlights one of the most fundamental problems. Probably the biggest problem is that some hospitals treat their complaints procedure as a process rather than something that they can learn from. Every NHS patient whom I have met who has had problems only ever says the same thing. They just want to know that the NHS will learn from what has gone wrong. That is all that they are interested in.

The point that the right hon. Lady makes is a very important one. People do sometimes feel that it is them against the system, and taking on a big establishment that might be well funded and is not really interested in hearing what they have to say is a very lonely process. It is vital that everyone who wants it can get independent support. One thing that we will be requiring is a sign, prominently displayed in every ward of every hospital, telling people, first, how they can make a complaint, and secondly, how if they want it they can get independent help and support. That could be a very good role for the new healthwatch organisations, but it may not be them in all cases, so most importantly, we will insist that people everywhere can access that independent help.

[Mr William Cash (Stone) (Con)]

Did my right hon. Friend hear my constituent, Debra Hazeldine, this morning on the “Today” programme, with a harrowing description of the way in which her mother was let down and died in Stafford hospital? I agreed with everything she said. Does he acknowledge that, although my right hon. Friend the Prime Minister listened, after correspondence and meetings with him, to my repeated calls and motions for the setting up of an inquiry under the Inquiries Act 2005, which the Prime Minister set up and which has led to a complete shake-up, not only of Mid Staffs but the entire health service, successive Labour Secretaries of State in the last Government disgracefully and repeatedly refused to agree to such an inquiry, and that but for our determined campaign with Cure the NHS, and in particular Julie Bailey, Debra Hazeldine and Ken Lownds and his campaign for zero harm, the 2005 Act inquiry would never have taken place and the Francis report would never have been produced, with all its beneficial consequences, in the Secretary of State’s hands, for the NHS in the national interest? When will the debate take place on this report on the Floor of the House in Government time?

Hospital Mortality Rates

Debate between Jeremy Hunt and William Cash

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

As I said in my statement, in nine of these 14 trusts, the chief executive or chair has been either replaced or moved on. However, the most important thing that we are doing is setting up a transparent failure regime, so that when problems arise they will be made public, so the system will never know something that the public do not, and so that Ministers will be required to take action to sort out failing hospitals. That is what is happening under this Government, but I am afraid that it did not happen when the right hon. Lady’s party was in power.

[Mr William Cash (Stone) (Con)]

The Keogh report, which must be welcomed, followed the Francis report. Despite my continuous attempts to have a full public inquiry under the Inquiries Act 2005, successive Labour Secretaries of State refused. Can my right hon. Friend find out from the Department or in any other way how that happened? Will he be good enough to publish his findings, because the root of the real trouble is that they were not prepared to have an inquiry and it was a cover-up?

[Mr Hunt]

My hon. Friend knows that the Labour party refused 81 requests for a public inquiry into what happened at Mid Staffs—I repeat: 81 requests. He also knows that if it was not for that public inquiry, we would not be here now. That is the biggest lesson to learn about the benefits of a public inquiry, and that is why transparency matters. I hope he is also pleased that we will be having a debate on the Francis report in Government time later this year.

Mid Staffordshire NHS Foundation Trust

Debate between Jeremy Hunt and William Cash

Tuesday 26th March 2013 Commons Chamber

[Mr Hunt]

I am not avoiding it. I agree that adequate staffing levels are essential to patient care. I remind the hon. Lady that the shadow Health Secretary said to the Francis inquiry:

“I do not think that the Government could ever mandate a headcount in organisations. Whilst we could recommend staff levels, we were moving into an era when trusts were being encouraged to work differently and cleverly, and take responsibility for delivering safe care whilst meeting targets”.

[Mr William Cash (Stone) (Con)]

The Secretary of State rightly talks about a betrayal of trust of the worst kind, and he is right. He is also right about zero harm, and about much else that he has done. But there is one serious omission—of accountability—and that must be robust and include the resignation of Sir David Nicholson. I also apportion responsibility to those former Secretaries of State who were not called to give evidence but bear a heavy responsibility for not having done the right thing at the right time.

[Mr Hunt]

My hon. Friend knows that I have a different view of the level of responsibility of Sir David Nicholson, but I agree that everyone working in the system at that time shares some responsibility for what happened. We must make sure that it can never happen again. The accountability that we are introducing, including criminal sanctions for boards that fail in their statutory duties, will be a significant change. The body that was responsible for what went wrong at Mid Staffs, according to Francis, was the board of the hospital, so that is where our focus must be. Today is also about getting the right structures outside the hospital to make sure there is accountability there too.

Accountability and Transparency in the NHS

Debate between Jeremy Hunt and William Cash

Thursday 14th March 2013 Commons Chamber

[The Secretary of State for Health (Mr Jeremy Hunt)]

I congratulate my hon. Friend the Member for Bristol North West (Charlotte Leslie) on securing this important and timely debate.

We should start by remembering why we are having this debate. Truly shameful things happened at Stafford hospital. Patients were left unwashed for days, sometimes in sheets soiled with urine and excrement. Relatives had to take bed sheets home to wash them because the hospital would not. Patients with dementia went hungry with their meals sitting right in front of them, because no one realised or cared that they were unable to feed themselves. If we are to prevent that from happening again, accountability for what happened is vital. I will talk plainly about that, including about the role of Sir David Nicholson.

At the outset, let me reiterate that the NHS is one of our most cherished institutions. We can be proud that for 65 years it has ensured that everyone is entitled to treatment, regardless of their background or income. We can be proud of the excellent treatment and care that is the hallmark of most parts of the NHS. Most of all, we can be proud of the front-line doctors, nurses and health care assistants who look after 3 million people every week, with dedication, commitment and compassion.

If we love the NHS, we must be prepared to be honest about its failures, and to criticise me for doing so suggests, I am afraid, dangerous complacency from the right hon. Member for Leigh (Andy Burnham). The tragedy of Mid Staffs shows how the desire to celebrate success got in the way of speaking out when things went wrong, and if we are to prevent such things from recurring, we must never allow our love of the NHS to stifle our determination to hold systems and individuals to account.

Where does that accountability lie? Sir David Nicholson has been the focus of much attention, and as a manager in the system that failed to spot and rectify the appalling cases at Mid Staffs, he bears some responsibility. As he said, the focus was lost, and he has apologised and been held to account by this House and many others. However, I do not believe that he bears total, or indeed personal, responsibility for what happened. He was at the strategic health authority for 10 months during the period in question, overseeing 50 hospitals at a time when his main responsibility was the merger of three SHAs into one. He consistently warned both Ministers and managers of the dangers of hitting the target and missing the point.

It is just not true that if there had been no David Nicholson at the SHA, there would have been no Mid Staffs; others bear far more direct responsibility and the Francis report tells us who. It makes it clear that the primary responsibility for what went wrong lies with the board of the trust. Astonishingly, members of that board seem to have melted into thin air, some moving to other jobs in the system, and others receiving generous payoffs.

[Mr Cash]

As my right hon. Friend knows, I do not agree with his assessment of Sir David Nicholson in this context. There was a systems failure that affected not only Staffordshire but the entire health service, and that lies very much at the heart of the problem. In my speech I will quote some statements made by Sir David at a conference a few months ago.

[Mr Hunt]

I obviously take on board what my hon. Friend says, but I want to move on to other aspects of the report.