Managing Risk in the NHS

Jim Cunningham Excerpts

Wednesday 17th July 2013 Commons Chamber

[Andy Burnham]

If the hon. Gentleman was listening, I said just a few seconds ago that the Secretary of State will not improve care for patients if he continually blames nurses and doctors. It is not one or the other, although Government Members seem to think they can attack the health unions for somehow being the enemy of patients. Ordinary people do not see it that way. They know that the staff are there for them day in, day out. We support the staff to help the patients. If staff are rewarded properly and have good working conditions, they will provide better care to patients. These are not opposites; the two go together, and the Conservative party would do well to remember that.

[Mr Jim Cunningham (Coventry South) (Lab)]

Some of us were here during the time of the previous Conservative Government, and I can remember that one of the hospitals in Coventry badly needed repair. After 1997, we got a new hospital. More importantly, one thing that Government Members always boast about is that they have increased the number of trainee doctors. It takes seven years to train a doctor. This Government are in their third year, so the credit goes to us.

[Andy Burnham]

As so often with the spin that we hear from Government Members, it is our achievements they are trying to claim credit for. I left behind the plans for the training of those doctors, but we do not hear much credit coming in this direction, do we? Government Members are happy to take the credit and then they try to cast off all the blame for everything else. My point is that criticism must be fair and made with care. We all have a duty to point out the failings of the NHS, in our own constituencies and nationally, and that is what I did when I did the Secretary of State’s job. However, we have to do that responsibly and fairly, especially for hospitals and those who manage them.

Hospitals are not the architects of all the problems we read about. For example, they are all struggling with the fallout of severe cuts to social care budgets, the appalling cost of which I recently revealed: a 66% increase over two years in the number of over-90s coming into A and E via blue-light ambulances. In human terms, more than 100,000 very frail and frightened people have been speeding through the streets of our communities in the back of ambulances. Hospitals have to absorb that extra pressure and also struggle with longer delays in getting people back home. We are in real danger of asking too much of our hospitals by allowing them to be the last resort for people who would be better supported elsewhere. Without a greater understanding of that situation in the current debate, and if the trend towards the vilification of NHS managers continues, who will take on the job of running our acute trusts? Good people will walk away and no one will want to do the job. Again, the NHS simply cannot afford that.

This crude blame game is an election strategy with two components: run down the NHS; and pin all the failings on the previous Government. The NHS cannot take 20 months of that until May 2015. It has been destabilised and demoralised already; if the Government are not careful, they will push it over the edge.

The Secretary of State needs to change course and find a way of bringing people back together, so the purpose of the debate is to put forward two constructive proposals to manage risk in the NHS—one for now, the other for the long term. First, I turn to the immediate proposal. It is clear that the best way to draw a line under recent events and unify people would be for the House to embrace today the analysis and main recommendations of the Francis report. The motion highlights the three most significant recommendations: benchmarks on safe staffing; a duty of candour on individual NHS staff; and the regulation of health care assistants. If all parties endorsed those proposals, it would send staff a message of support and recognition of the pressure that they are under, while the patients who have suffered poor care would receive the positive message that the parties are working together to prevent that from happening to others.

Given the tragic events that lie behind them, public inquiries should, when possible, produce consensus. It is extraordinary that, having commissioned a three-year public inquiry, the Government have slowly been distancing themselves from the Francis report’s analysis and conclusions ever since its publication. It is hard not to conclude that the report did not deliver what the Government wanted and that they have spent the past five months rewriting it. They have come up with their own recommendations on chief inspectors for hospitals, general practice and social care, yet dragged their feet on the actual recommendations. They have substituted the verdict of Francis on Ministers in the previous Government with that of the kangaroo court of Lynton Crosby. We do not oppose chief inspectors, but if the Government believe that ever-tougher central regulation will bring about the culture change locally that everyone agrees is necessary, they are mistaken. We need change that will have an immediate effect on the ground, and that will support staff and improve care for patients.