Accountability and Transparency in the NHS

Jim Dowd Excerpts

Thursday 14th March 2013 Commons Chamber

[Jim Dowd (Lewisham West and Penge) (Lab)]

It is a pleasure to follow the hon. Member for Southport (John Pugh), who always makes thoughtful contributions.

I congratulate those Members who tabled this motion, to which I was happy to add my name. I am grateful to the Backbench Business Committee for agreeing to this debate, but, like others, I feel that the issue is so important that it should be debated in Government time. However, I suspect that, in the light of developments, we have not heard the last of the issues raised by the Francis report. The Secretary of State outlined a few of the measures he is intending to bring before the House, so we will have opportunities for other such debates.

I will not refer in any great detail to the Mid Staffs fiasco, serious though that is, and the obvious implications for other areas across the country. I want to concentrate on transparency, and to avail the House of the experience in south-east London of the tender mercies of the first, and so far only, trust special administrator, who was appointed to the trust next door to Lewisham—the South London Healthcare NHS Trust. That trust comprises the Princess Royal University hospital, in Orpington; the Queen Elizabeth hospital, in Greenwich; Queen Mary’s hospital, in Sidcup; and the Orpington hospital—although that was actually subject to a separate consultation.

The then Secretary of State said in a statement on 12 July last year:

“I wish to inform the House that I have made an order to appoint a trust special administrator to South London Healthcare NHS Trust…The regime, included by the last Government in the Health Act 2009, offers a time-limited and transparent framework to provide a rapid resolution to the problems within a significantly challenged NHS trust”—

trust, singular. He continued:

“The trust special administrator’s regime is not a day-to-day performance management tool for the NHS or a back-door approach to reconfiguration.”—[Official Report, 12 July 2012; Vol. 548, c. 47-48 WS.]

On 13 July, he issued the order to give effect to those measures.

I raise this as a transparency issue because the trust special administrator brought forward proposals that damage, downgrade, devastate, destroy—whichever word one wants to use—Lewisham hospital, which is a completely separate trust. The right hon. Member for Charnwood (Mr Dorrell), who is the Chair of the Health Committee and has great knowledge and experience of these matters, said that accountability and transparency are interlinked: we cannot have one without the other. I agree with him wholeheartedly, but that has not been the experience of the people in Lewisham: the TSA is entirely unaccountable. The TSA stands at the head of a disgraceful, disreputable conspiracy—launched in the Department of Health, aided and abetted by NHS London and handled in the most autocratic manner—to downgrade Lewisham hospital.

The titles of both the orders issued by the Secretary of State, copies of which I have here, start with the words:

“The South London Healthcare National Health Service Trust”.

The order setting up the administrator states:

“That draft report to the Secretary of State must state the action which the trust special administrator recommends the Secretary of State should take in relation to the South London Healthcare National Health Service Trust.”

It contains no mention of anybody else, yet the Department now says, “Of course we needed to look at the whole of south London and the whole of the health economy of south-east London, because everything connects to everything else.” Well, that is true of everything in the whole wide world.

From day one, all the documents of the TSA included the phrase “Securing sustainable NHS services”. One such document was headed: “Securing sustainable NHS services—Consultation on the Trust Special Administrator’s draft report for South London Healthcare NHS Trust and the NHS in south east London”. This House did not give the administrator that authority—the law does not provide for the administrator to look at the situation across south-east London—and he has acted beyond his powers.

I come now to the most interesting thing, and I accept that the current Secretary of State has had this matter dropped in his lap. If this was always about the whole of south-east London, why when the former Secretary of State had a meeting in July to discuss this did he invite the Members who represented Bromley, Bexley and Greenwich—rightly, because they cover the South London Healthcare NHS Trust area—and the Members for Lewisham? One could say that it was because they were looking more widely. Of course that is so, but he did not invite the Members representing Lambeth or Southwark. However, when we met this Secretary of State in January, after the TSA’s final report had been published, the Members for Lambeth and Southwark were included; we were told that this was a south London-wide issue. The reason for the discrepancy is obvious: they knew what they wanted to do. They wanted to get an old plan that NHS London had fostered to try to get Lewisham hospital closed. That took place under a proper clinical review under “A picture of health” four years ago, which concluded that Lewisham hospital deserved to survive and that the services it provided for the people of Lewisham should continue.

Some 10,000 people marched in November to oppose the proposals. When the final report came out, 25,000 people marched because of the outrageous actions of this administrator and the activities he has undertaken. The manner in which he dealt with the consultations was dismissive, disdainful and high-handed. Whether the objections were from members of the public, GPs or other clinicians, he behaved in line with the instructions from his bosses, which were simply to close Lewisham hospital. The people of Lewisham will not stand for it.