Paterson Inquiry

Jeremy Wright Excerpts

Tuesday 4th February 2020 Commons Chamber

[Ms Dorries]

The hon. Lady raises a wide range of issues, which I will try to go through. First, I reassure her that, at the time Paterson was practising, the CQC was not investigating or assessing the private sector; that was introduced in 2015. Whistleblowing was in an entirely different place from where it is now. We now have 500 lanyard-wearing national guardians across the NHS, and we encourage people to raise their concerns with those national guardians, the guardians to listen and the trust to act quickly on the concerns raised. I think it is fair to say, that since 2012, when the CQC introduced revalidation, a number of regulatory processes have been put in place. There was shockingly little at the time that Paterson was practising. The system is now much more robust—and yet, I completely take her point; much more still needs to be done.

We are learning the lessons from Getting it Right First Time. In fact, that is a subject of discussion within the Department. We are looking at how the lessons have been applied and what we can learn.

The hon. Lady is right about revalidation and 365° appraisal every five years. As she will know, the CQC is an independent body. It introduced revalidation and appraisal. Our job is now to ask the CQC to make that system more robust and look at how to improve it, because that is an important part of the equation, ensuring that something like this does not happen again. I say here and now at the Dispatch Box that I would like the CQC, as a matter of urgency, to look at how it can make that system more robust and effective, so that we can quickly identify doctors—not those like the hon. Lady—who are not up to standard, who are outliers and who should not be practising.

We will look at the hon. Lady’s point about the HSSIB. I do not think that there is a role for the HSSIB in the private sector. The private sector is a matter of personal choice. It is our job to ensure that healthcare reaches the same standard across the board, whether it is in the private sector or the NHS. The CQC does that, and that is how we hold the private sector to account. Then it is down to patients to make the choice about where they wish to be treated; that is their independent choice. That is a matter of consent, which is something else we need to look at—how do conversations about consent take place? Does the patient have the capacity to take in the information being given to them? Are they making an informed choice? Do they have enough information about the surgeon they are seeing to make the right choice? Those are the issues we need to focus on.

[Jeremy Wright (Kenilworth and Southam) (Con)]

If patients are to be kept safe, several things need to be true. First, as the hon. Member for Central Ayrshire (Dr Whitford) said, medical professionals who have concerns about the practice of other medical professionals need to have their concerns properly listened to. Is it not therefore a matter of serious concern that four of the six whistleblowers in this case—one of whom I have the privilege to represent in this place—found themselves subject to fitness-to-practise reviews after reporting their concerns?

Secondly, is it not right that medical organisations—public or private—need to act on those concerns? It is profoundly troubling that concerns were reported to the Heart of England NHS Foundation Trust in 2003, but it did not suspend Paterson until 2011.

Thirdly, is it not important that regulators do what they need to do? It is also profoundly troubling that concerns about Paterson’s malpractice were reported to the GMC in 2007, and his suspension by the GMC came only in 2012.

[Ms Dorries]

I would like to make an apology. I mentioned the CQC in response to the hon. Member for Central Ayrshire (Dr Whitford)—the acronyms!—but it was the GMC.

My right hon. and learned Friend is absolutely right. I reiterate that Paterson is in jail, and that the processes now in the regulatory framework did not exist at the time Paterson was practising. The culture towards whistleblowers is very different now from what it was then, as demonstrated by the roll-out of the national guardians scheme. The national guardians are there for whistleblowers to go to. We want—we absolutely want—people to report when they think somebody is acting inappropriately, or a surgeon or doctor is not practising to the standards they should be. We want to know that as soon as possible. There will be no investigations of whistleblowers’ fitness to practise; that will apply to the people they are reporting. I do not think the national guardians scheme has had enough press or that people are aware enough of it. It is about speaking up, listening and then the trust acting on the information it has. One of the outcomes of this report will be that we can reassure both healthcare professionals and the public that we want them to speak up. We actually want them to be a whistleblower because only by doing that can we guarantee patient safety.