NHS Shared Business Services

Jonathan Ashworth Excerpts

Monday 27th February 2017 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab)]

(Urgent Question): To ask the Secretary of State for Health to make a statement on the loss of confidential NHS correspondence by NHS Shared Business Services.

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

On 24 March 2016, I was informed of a serious incident involving a large backlog of unprocessed NHS patient correspondence by the company contracted to deliver it to general practitioners’ surgeries, NHS Shared Business Services—SBS. The backlog arose from the primary care services GP mail redirection service that SBS was contracted to run between 2011 and 2016. However, in three areas of England—the east midlands, north-east London and the south-west of England—this did not happen, affecting 708,000 items of correspondence. None of the documents was lost and all were kept in secure storage, but my immediate concern was that patient safety might have been compromised by the delay in forwarding correspondence, so a rapid process was started to identify whether anyone had been put at risk. The Department of Health and NHS England immediately established an incident team led by Jill Matthews, who heads the NHS England primary care support services team.

All the documentation has now been sent on to the relevant GP surgery, where it is possible to do so, following an initial clinical assessment of where any patient risk might lie. Some 200,000 pieces were temporary residence forms, and a further 500,000 pieces were assessed as low risk. A first triage identified a further 2,500 items that had potential risk of harm and needed further investigation, but follow-up by local GPs has already identified nearly 2,000 of those as having “no patient harm”. The remainder are still being assessed, but so far no patient harm has been identified.

As well as patient safety, transparency for both the public and this House has been my priority. I was advised by officials not to make the issue public last March until an assessment of the risks to patient safety had been completed and all relevant GP surgeries informed. I accepted that advice, for the very simple reason that publicising the issue could have meant GP surgeries being inundated with inquiries from worried patients, which would have prevented them from doing the most important work—namely, investigating the named patients who were potentially at risk.

For the same reasons, and in good faith, a proactive statement about what had happened was again not recommended by my Department in July. However, on balance I decided it was important for the House to know what had happened before we broke for recess, so I did not follow that advice and placed a written statement before the House on 21 July. Since then, the Public Accounts Committee has been kept regularly informed, most recently being updated by my permanent secretary only last Friday. The Information Commissioner was updated in August, and the National Audit Office is currently reviewing the response. I committed in July 2016 to keeping the House updated once the investigations were complete and more was known, and will continue to do so.

[Jonathan Ashworth]

Let us be under no illusions: this is a catastrophic breach of data protection. More than half a million pieces of patient data—including blood test results, cancer screening results, biopsy results, and even correspondence relating to cases of child protection—were all undelivered, languishing in a warehouse, on the Secretary of State’s watch. It is an absolute scandal.

Time and again this Health Secretary promises us transparency; today, he stands accused of a cover-up. The Department of Health knew about this in March 2016, so why did it take this self-proclaimed champion of transparency until the last day before the House rose last summer to issue a 138-word statement to Parliament? That statement said that just “some correspondence” had not reached the intended recipients. When the Secretary of State made that statement, was he aware that it amounted to more than 700,000 letters? If so, why did he not inform Parliament? If he did not know, does that not call into question his competence?

What guarantees can the Secretary of State give us that no more warehouses of letters are yet to be discovered? Was the private contractor involved paid for the delivery of the letters? If so, what steps are being taken to recover the money? How many patients were harmed because their GP did not receive information about their ongoing treatment? Do patients remain at risk? The Secretary of State talks about NHS England’s ongoing investigation into 2,500 items; when are we likely to know the outcome?

We understand that Capita now has the contract to deliver these services. What scrutiny is the Secretary of State putting Capita under so that it does not happen again? Is it not better that, rather than this relentless pursuit of privatisation, we bring services back in-house?

Two months into 2017 and the Health Secretary lurches from one crisis to another: hospitals overcrowded and waiting lists out of control. He cannot deliver the investment that our NHS needs; he cannot deliver a social care solution; he cannot deliver patient safety; and now he cannot even deliver the post. He has overseen a shambles that puts patient safety at risk. Patients deserve answers and they deserve an apology.

[Mr Hunt]

The hon. Gentleman is reasonable and sensible, but sadly those commendable sides to his character have not been on display this afternoon, not least because I answered a number of his questions before he read out his pre-prepared script. He said that there had been a catastrophic breach of data protection. Let me remind him that no patient data were lost and all patient data were kept in secure settings. I know that it is a great temptation to go on about the privatisation agenda, but may I gently tell him that, since SBS lost this account, this particular work has been taken in-house? It is being done not by Capita, but by the NHS—so much for the Government’s “relentless pursuit” of the private sector.

More seriously, the hon. Gentleman is quoted in this morning’s edition of The Guardian as saying:

“Patient safety will have been put seriously at risk.”

As he knows, patient safety is always our primary concern, but if he had listened to my response he would have heard that, as things stand, there is no evidence so far that patients’ safety has been put at risk. [Interruption.] Well, we have been through more than 700,000 documents, and so far, we can find no such evidence. We are now doing a second check, with GPs, on 2,500 documents—so a second clinical opinion is being sought—nearly 2,000 of which we believe will not show any evidence, and we are now going through the remaining ones.

Let me say that it was indeed totally incompetent of SBS to allow this incident to happen, and we take full responsibility as a Government, because we were responsible at the time. None the less, the measure of the competence of a Government is not when suppliers make mistakes—I gently remind the hon. Gentleman that that did happen a few times when Labour was running the NHS—but what we do to sort out the problem. We immediately set up a national incident team. Every single piece of correspondence has been assessed, and around 80% of the higher risk cases have been assessed by a second clinician.

The hon. Gentleman then went on to suggest that the Government have been trying to hide the matter. If he had listened to what I said, he would have heard that I did not follow the advice that I got from my officials, which was not to publicise the matter. I actually decided that the House needed to know about it. It was only a week after I was reappointed to this job last summer that I not only laid a written ministerial statement, but referred to the matter in my Department’s annual report and accounts. He said this morning that I played down the severity of what happened, but what did that annual report say? It said that a “serious incident was identified”, and it talked about

“a large backlog of unprocessed correspondence relating to patients.”

It could not have been clearer.

This Government have always cared about patient safety. We have listened to the advice of people—as the hon. Gentleman would have done had he been in office—who said that if we had gone public right away, GP surgeries could have been prevented from doing what we needed them to do, which is making detailed assessments of a small number of at-risk cases. That was why we paused, but as soon as we judged that it was possible to do so, we informed this House and the public and we stayed absolutely true to our commitment both to patient safety and to transparency.