Oral Answers to Questions

Debate between Justin Madders and Steve Barclay

Thursday 9th May 2024 Commons Chamber

[Justin Madders (Ellesmere Port and Neston) (Lab)]

1. What the locations are of successful applicants to the natural flood management programme.

[The Secretary of State for Environment, Food and Rural Affairs (Steve Barclay)]

Forty projects have been selected to proceed to the development stage of the £25 million natural flood management programme. They include a broad range of locations, from Alnmouth to St Austell.

[Justin Madders]

I am working with residents in the Chase Way and Kendal Drive area of Great Sutton, alongside Environment Agency representatives and members of the local authority, to try to find a solution to the flooding problems that we have there. There are lots of different pots of money available at different times, and sometimes it is difficult to understand what the realistic chances are of our succeeding in getting the funding that we need to bridge the gap that we have at the moment to get the works done. Will it be possible for me to meet with either the Secretary of State or some of his team to talk about what realistic funding options we have for the area?

[Steve Barclay]

I thank the hon. Member for his engagement, and I will arrange a meeting with the relevant member of the team. The information is on gov.uk. Two projects near his constituency—the Cheshire Wildlife Trust and the Mersey Rivers Trust—are involved in the programme. I welcome his engagement. It is a good scheme, and I will ensure that he gets that meeting.

Countess of Chester Hospital Inquiry

Debate between Justin Madders and Steve Barclay

Monday 4th September 2023 Commons Chamber

[Justin Madders (Ellesmere Port and Neston) (Lab)]

As the Secretary of State will be aware, my constituency is served by the Countess of Chester Hospital and many of my constituents work there and are being treated there. There is no doubting the impact this case has had on the whole community, as my hon. Friend the Member for City of Chester (Samantha Dixon) has mentioned. However, as a constituency MP, when I was briefed by the management at the time the issues first emerged, I can say a very different picture was painted from the one we see today. It has been a huge concern that management involved at the time have gone on to work in other parts of the NHS, seemingly with approval from NHS England. I hope the Secretary of State will look into that and that the Kark review recommendations will finally be implemented, because there are serious lessons to be learned from what went on with the senior management.

[Steve Barclay]

The hon. Gentleman raises an extremely important point. It is right that we focus on that and ensure that the concerns about the revolving door are addressed. On the decision taken by my predecessor, my understanding is that the recommendations accepted from Kark were viewed as effective in addressing that—obviously, the events to which this statement relates have happened since—but I have asked NHS England colleagues in the Department to look again at testing them further in the light of the evidence that has come through from the court case in particular.

Junior Doctors’ Strikes

Debate between Justin Madders and Steve Barclay

Thursday 30th March 2023 Commons Chamber

[Steve Barclay]

I would draw an important distinction between a militant group that appears to have taken over the junior doctors committee and the vast majority of junior doctors who do a hugely important job within the NHS. We recognise in Government that they have faced considerable pressures from the pandemic, and we stand ready to work constructively with them. There are, on the other hand, some within the BMA junior doctors committee who appear to have a more political agenda. Indeed, I refer hon. Members to the statements of members of that committee, who have said that they want to move the BMA to more traditional trade union activity and to pursue a more overt political agenda.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

This is an urgent question, but I do not get a sense of urgency from the Secretary of State that he wants to resolve the dispute. I am afraid that standing at the Dispatch Box and traducing the junior doctors for their approach will not help to resolve this matter. I urge him to drop any preconditions on any future meetings, because the only way that this can be resolved is through negotiation. Will he do that now?

[Steve Barclay]

First, there is absolutely no traducing going on. In my last answer, I praised the junior doctors and recognised the fact that they have faced huge pressure from the pandemic, which is why we stand ready to work with them. Some on the BMA junior doctors committee have a different agenda, but we stand ready to work very constructively with that committee. The hon. Gentleman suggested that I drop the precondition. It is not I who set the precondition; it is the junior doctors committee that did so. I remind the House that it includes restoration to 2008 levels of all elements of pay, not just basic pay; parking fees and exam fees; and “radical” reform of the Review Body on Doctors’ and Dentists’ Remuneration. It is the junior doctors committee that set those preconditions, not the Government.

Oral Answers to Questions

Debate between Justin Madders and Steve Barclay

Tuesday 24th January 2023 Commons Chamber

[Justin Madders (Ellesmere Port and Neston) (Lab)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health and Social Care (Steve Barclay)]

I am pleased to announce that we will be developing and publishing a major conditions strategy. Around 60% of disability-adjusted life years in England are accounted for by just six conditions: cancer, cardiovascular disease, chronic respiratory disease, dementia, musculoskeletal disease and mental health. An increasing number of us live with one or more of these conditions. Tackling them is a significant opportunity to improve the lives of millions of people and to support our goal to improve healthy life expectancy.

This work will bring together our existing commitments to develop plans for mental health, cancer, dementia and health disparities, and our new strategy will shift our focus on to integrated, whole-person care, with a focus on prevention, early detection and the use of innovative technology to improve patient outcomes. It will also improve how the NHS functions, relieving pressure on hospitals, promoting integration and putting us on a sustainable long-term footing.

We look forward to involving partners in the NHS, the charitable and voluntary sector and industry in developing this important work. Further detail about the strategy is included in my written statement published today. The statement also confirms that we will publish a suicide prevention plan this year, building on the important work of my predecessor, my right hon. Friend the Member for Bromsgrove (Sajid Javid), and I look forward to updating the House in due course.

[Justin Madders]

During the passage of the Health and Care Bill in 2021, safe staffing levels in the NHS came up, and the Government told us then that they

“do not believe that there is a single ratio or formula that could calculate what represents safe staffing.”––[Official Report, Health and Care Public Bill Committee, 27 October 2021; c. 773.]

Is the truth not that the Strikes (Minimum Service Levels) Bill is not about safe staffing levels, but about preventing nurses, doctors and paramedics from exercising their fundamental right to withdraw their labour, because they have lost all confidence in this Government?

[Steve Barclay]

The hon. Gentleman is right to say that it is a fundamental right that people are able to strike, and the legislation will balance that right, in the same way that other countries in Europe do, with minimum safe staffing levels. That is something that the French, the Italians and many other European countries have, and the Bill is simply bringing the NHS into line with other health systems.

NHS Winter Pressures

Debate between Justin Madders and Steve Barclay

Monday 9th January 2023 Commons Chamber

[Steve Barclay]

On the blue-light ability, I am very happy to take that away and look at it. As is often the case, these things are slightly more nuanced, as I discovered when we were looking at Ministry of Defence ambulance drivers and their interaction with blue lights. I am very happy to look at that.

The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien), is looking at community pharmacy and, in particular, how we better enable patients to get the right treatment in the right place. Given that community pharmacies are accessible and sometimes get higher numbers in more deprived communities, there are significant opportunities for us to do more with them, and I know that that is something the ministerial team is working on.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I listened with some incredulity to the Secretary of State’s explanation—that because the integrated care boards are only six months old they are still getting to grips with the link between health and social care. Who does he think was running health and social care before the ICBs were created? It was the very same people, who know exactly what the issues are; what they are lacking is a Government committed to dealing with the systemic issues facing both sectors.

As we have heard, one of those issues is workforce and social care. A quick internet search reveals that there are 200 social care vacancies within a 10-mile radius of Ellesmere Port; we have heard already that there are 165,000 social care vacancies nationwide. I have not heard anything from the Secretary of State today about what he is actually going to do to address those vacancies. In a year’s time, how many social care vacancies does he expect there to be across the country?

[Steve Barclay]

On the interaction between vacancies and workforce, NHS England is working on a workforce strategy, as has been said, and we will say more on that shortly.

In his wider point, the hon. Gentleman is ignoring examples such as the Jean Bishop Integrated Care Centre—the ability to bring health sector and social care staff to work together in a more integrated way. Yes, the integrated care boards were operational from July. That is a factual statement; I am slightly mystified about why he thinks that was in some way an unusual observation to make. It is just the factual position. The point is that when one looks at the issue, one sees opportunities, particularly around how the data are better integrated, to understand where the workforce pressures and bed capacity are.

One of the causes of delayed discharge is about the interfaces as well as what is domiciliary care, what is step down and what is residential. There are a number of issues. By bringing them together in more integrated way, integrated care boards will be one of the ways we improve the situation. Indeed, that is what the hon. Gentleman’s former colleague Patricia Hewitt is looking at through the Hewitt review.

Urgent and Emergency Care

Debate between Justin Madders and Steve Barclay

Monday 5th September 2022 Commons Chamber

[Steve Barclay]

Far from there being a lack of planning, the very essence of integration between social care and the NHS through the ICSs is that we recognise the importance of both aspects working much more closely together. That is why we are bringing forward initiatives such as the federated data platform.

Monkeypox is outside the scope of today’s statement, but I know the issue is of particular interest to the hon. Gentleman. He will know that, fortunately, we have not yet had any fatal cases in the UK and the rate of infection has been falling. We purchased the maximum number of vaccines that we could; I wrote to the relevant charities with the details. Although smaller doses are being delivered compared with the initial 50,000, we still have doses in the system. We expect a further 20,000 very shortly and a further 80,000 later this month. We have procured doses, we are getting them out and it is fortuitous that cases are falling, but we are obviously keeping the situation under close watch.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

This summer I have heard some horror stories from constituents with life-threatening conditions about the dangerous delays they have faced. When one constituent raised the issue with the NHS, she was told by the senior consultant at the A&E department that the NHS has collapsed. If senior frontline clinicians are saying that in the summer, God help us when we get to winter. I really fear where we are going to be, because there is no doubt that my constituent is very lucky to be alive. We have heard a lot of figures today about the number of excess deaths this year. Will the Secretary of State give us his estimate of the number of people who have died unnecessarily because they have been stuck in an ambulance waiting to get into A&E, or because an ambulance has not turned up at all?

[Steve Barclay]

Again, despite that colourful language, we have more doctors, more nurses and more paramedics. We are training more and meeting more demand, and significant additional funding has been applied to ambulance trusts, call handling and other parts of the system, including primary care. Part of reducing the demand on the ambulance system is related to GP capacity, which is why—to take that as an example—an additional £1.5 billion of funding has gone in.

Lockdown: Economic Support

Debate between Justin Madders and Steve Barclay

Tuesday 3rd November 2020 Commons Chamber

[Steve Barclay]

As I said earlier, these are UK-wide schemes. We continue to listen and engage, but the schemes apply on a UK-wide basis. That has been the case throughout, and that continues to be the case now.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I am sure that we have all heard heartbreaking stories about people who have been unable to claim for self-employment support because they had not registered or submitted a tax return for 2018-19. It seems that those people are still excluded from any support. Some of them have been trading for 18 months now. They are clearly not fraudulent and they clearly deserve some support; why cannot they get some?

[Steve Barclay]

As we referred to earlier, the point is that the package of support includes the £9 billion of welfare measures and the support that is available through local authorities and targeted at their discretion. I have also set out that there are those within that excluded population, for example those who were employed, who may be able to qualify for the extension, but for the reasons that we have covered in a number of earlier replies, part of the challenge from the Public Accounts Committee has been ensuring that we have the right operational controls in place, and that has been one of the difficulties with the cohorts to which the hon. Gentleman refers.

Areas with Additional Public Health Restrictions: Economic Support

Debate between Justin Madders and Steve Barclay

Tuesday 6th October 2020 Commons Chamber

[Steve Barclay]

I gently take issue with the point about coaches not having support. One of the areas where coach firms have been able to benefit hugely from our response, and to work with the Government, has been in school transport. We were able to secure the additional capacity that we needed in part through the willingness of coach companies to adapt as part of our response. It is not the case that coach companies have been unable to get any business during the pandemic.

On more comprehensive measures, the hon. Member is right that the cinema industry has been hit hard. We were all concerned to see the announcement from Cineworld at the weekend. Together with Odeon and Vue that is 75% of the market, but as he knows it is not simply down to one issue. With cinemas, there is the supply of films—the delay of some of the blockbuster films has had an impact—and consumer confidence. Attendance is significantly down compared with last year, and there is also the impact of the non-pharmaceutical interventions. There is not one single factor, but we continue to work with the cinema industry in shaping our response.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

Dominic Harrison, the director of public health for Blackburn and Darwen said that some of the more economically challenged boroughs are

“being placed into more restrictive control measures at an earlier point in their…case rate trajectory. This has the effect of exacerbating the economic inequality impacts of the virus in those areas.”

Why are some areas being treated differently from other areas, and can the Minister not see the need to have greater transparency and equity across the board?

[Steve Barclay]

The pace of those medically driven decisions is more, perhaps, a matter for my right hon. Friend the Secretary of State, who I know has been to the Chamber and answered such questions. I am willing to flag the hon. Gentleman’s concern about the transparency of that process.

European Union (Withdrawal Agreement) Bill and Extension Letter

Debate between Justin Madders and Steve Barclay

Monday 21st October 2019 Commons Chamber

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I return to the economic impact assessment, because the effect of all this on manufacturing, particularly in my constituency, is critical. I do not know whether the Government are unwilling or unable to release any information they have on this, but surely the Minister can see how important it is that we have all this information before we make any decisions. After all, he would not buy a house without looking at the deeds, would he?

[Stephen Barclay]

The point the hon. Gentleman is missing is that the free trade agreement has still to be negotiated, and what is causing damage to businesses in his constituency and elsewhere is reflected in the comments of people such as Lord Rose, a leader of the remain campaign who now recognises that what is damaging to business is the ongoing uncertainty. We need to bring that uncertainty to an end, and the hon. Gentleman’s continued refusal to vote for a deal—while opposing no deal—is prolonging the uncertainty and damaging the interests of businesses in his constituency.

Oral Answers to Questions

Debate between Justin Madders and Steve Barclay

Thursday 24th January 2019 Commons Chamber

[Stephen Barclay]

The crux of the issue is that the industries concerned want a deal and support the deal. The hon. Gentleman’s party, and indeed he, stood on a manifesto commitment to delivering on the biggest vote in our history. The issue for those workers whose jobs are in question—and the question that the hon. Gentleman needs to answer for them—is why he is going back on a manifesto that he gave his own voters.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

13. What recent discussions he has had with representatives of the business community on the UK leaving the EU.

Oral Answers to Questions

Debate between Justin Madders and Steve Barclay

Tuesday 23rd October 2018 Commons Chamber

[Stephen Barclay]

My hon. Friend is right to draw attention to the valuable role played by pharmacies. This is part of a wider education campaign within the NHS and increased access to clinicians, such as through 111, is another component of that. We want to ensure that rather than people’s first port of call being a GP, they access the NHS and pharmacies at the appropriate time.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

At the end of the last financial year, trusts owed the Department a staggering £11 billion. NHS providers say that this is locking some trusts into

“a vicious circle of inevitable failure”,

and the King’s Fund says that there is no prospect of them ever repaying. Trusts with the biggest debts are forced to pay the highest levels of interest. How can the Minister expect trusts to be efficient when they are paying an interest rate of 6% on debts to his Department?

Draft Nursing and Midwifery (Amendment) Order 2018

Debate between Justin Madders and Steve Barclay

Wednesday 20th June 2018 General Committees

[Stephen Barclay]

From memory, the fee is the same as for a nurse in the NMC, which is £120, although I am sure that my colleagues will correct me if my memory is misplaced on that. That is a flat rate applied by the NMC across the board.

The hon. Member for Huddersfield and the Opposition Front Bencher also raised the issue of overseas staff. This will be a new role, and the Prime Minister’s announcement on tier 2 visas applies to existing roles, such as doctors and nurses, whereas this role is not currently in place. However, the opening of the nursing associate part of the register will provide a new registration route for overseas nursing staff whose competence and qualifications fall short of those of a registered nurse, providing that they can demonstrate that they meet the same high standards expected of a nursing associate trained in England. Again, just as it is a ladder for his constituents, it is a pathway through which European staff could potentially enter the NHS. [Interruption.] My memory was correct: the NMC has consulted on applying a fee of £120.

The hon. Member for Ellesmere Port and Neston mentioned the guidance. The Department is working with arm’s length bodies, NHS Employers, healthcare environment inspectorates and the regulators—the NMC and the CQC—to develop guidance. That will obviously need to be in place before the first tranche of nursing associates come out of their training in January ’19. I also note his point on panels. It is a perfectly fair observation, and I take it on board.

[Justin Madders]

I think the fee is still out for consultation.

[Stephen Barclay]

It is.

--- Later in debate ---

[Justin Madders]

The figure is proposed to be set at the same rate as for a nurse. I understand that, once the NMC sets up this process, the costs will be broadly similar to those for a nurse, but the fact is that this role is designated to be on “Agenda for Change” band 4, whereas nurses are in band 5. Does the Minister agree that there is possibly an argument that the proposed fee should be slightly lower to reflect that?

[Stephen Barclay]

I see exactly the point that the hon. Gentleman raises. The NMC is consulting on that, and I think that consultation should be allowed to run its course, but I am sure that his points will have been heard by those undertaking it.

Agency spend was raised. Again, that is an area of considerable focus within the Department. It is part of the transformation that the Prime Minister signalled with the investment announced on Monday, and there is a lot of work on, for example, e-rostering and how to give staff greater predictability and flexibility, and how we can use technology to facilitate that, because that also has an impact on retention rates.

I hope I have addressed the hon. Gentleman’s points. I am grateful for his and the Opposition’s support for the new role. It is important that we increase the number of people able to access roles in the NHS, and this is a valuable pathway to enable that. I commend the draft order to the Committee.

Question put and agreed to.

Resolved,

That the Committee has considered the draft Nursing and Midwifery (Amendment) Order 2018.

Oral Answers to Questions

Debate between Justin Madders and Steve Barclay

Tuesday 8th May 2018 Commons Chamber

[Stephen Barclay]

The distinction the hon. Lady fails to make is that in England we are increasing the number of nurses in training by 25%; we are ensuring that nurses who have left the profession can return through the return-to-work programme; and we are introducing significant additional pay through “Agenda for Change”. As my right hon. Friend the Member for Harlow (Robert Halfon) said, we are also creating new routes so that those who come into the NHS through other routes, such as by joining as a healthcare assistant, are not trapped in those roles but are able to progress, because the Conservative party backs people who want to progress in their careers. Healthcare assistants who want to progress into nursing should have that opportunity.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

When defending the decision to scrap bursaries, the Secretary of State said that, if done right, it could provide up to 20,000 extra nursing posts by 2020. Well, that figure now looks wildly optimistic, with applications down two years in a row. Is it not time that Ministers admitted they have got this one wrong and joined the Opposition in the Lobby tomorrow to vote against any further extensions to this failed policy?

[Stephen Barclay]

If Members vote against the policy tomorrow, the reality is that they will be voting for a cap on the number of postgraduate nurses going into the system, and therefore they will be saying that more people should be rejected—more people should lose the opportunity to become nurses—because they want to have a cap that restricts the supply of teaching places.

Oral Answers to Questions

Debate between Justin Madders and Steve Barclay

Tuesday 20th March 2018 Commons Chamber

[Stephen Barclay]

Had the hon. Lady been able to attend the recent Westminster Hall debate on this issue, she would have heard that in the trust under discussion the staff survey showed an improvement in responses as a result of the subsidiary because many staff valued the flexibilities in the new contracts that the subsidiary could offer.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

The Minister may be in denial about privatisation, but is it not the case that the question-and-answer document from North Tees and Hartlepool Hospitals NHS Foundation Trust said that its subsidiary organisation could be taken over by a private company in the future? If the Minister wants to put these privatisation stories to bed, will he rule out the possibility of any of the subsidiary companies’ being taken over by private organisations in the future?

[Stephen Barclay]

The party that is in denial is the Labour party, which, in 2006, passed the legislation through which subsidiaries could be offered. If the hon. Gentleman does not believe me, perhaps he should listen to NHS Providers, which says:

“It is…inaccurate and misleading to say that the establishment of wholly owned subsidiaries is a new phenomenon or being pursued to avoid VAT, privatise the NHS, or to reduce terms and conditions for NHS staff.”

Labour Members should stop scaremongering over legislation that their party actually passed.

Acute and Community Health

Debate between Justin Madders and Steve Barclay

Thursday 8th February 2018 Commons Chamber

[Justin Madders (Ellesmere Port and Neston) (Lab)]

May I start by adding my appreciation for the tenacity my hon. Friend the Member for West Lancashire (Rosie Cooper) has shown in pursuing this matter over a number of years? She has led the way in tackling this injustice fearlessly and relentlessly. In that respect, she is an example to all right hon. and hon. Members in this place. I agree with the Minister that the report is a vindication of her courage, but is it not shameful that this scandal only came to light because a Member of Parliament was prepared to give a voice to those who were afraid to speak out?

Today’s independent report on the Liverpool Community Health Trust lays bare a catalogue of failure that caused harm to patients across Merseyside between 2010 and 2014. It is a grim example of a repeat of the regulatory pressures and board management failures at Mid Staffs. What is of huge concern is that some of the failures came after the final publication of the Francis report. As we have heard, incidents identified in the report include the deaths of inmates at HMP Liverpool, patients having the wrong tooth extracted by trust dentists, and patients on intermediate care wards suffering repeated falls and broken bones or ending up with pressure ulcers. We have to make sure that the pain experienced by so many patients and their families is properly detailed and recognised. We must make sure the NHS is able to learn from these events and that systems are put in place to ensure they never happen again.

I put on record our thanks from the Labour Benches to Dr Bill Kirkup and his team for the work they have done in carrying out this investigation and helping us to understand what has gone wrong. Today’s report says that patients of community services suffered unnecessary harm because the senior leadership team was “out of its depth”. Let us be clear what lies at the heart of this: unrealistic cost-cutting by the trust without regard to the consequences that led directly to patients being harmed. The report exposes serious problems around the scale of cost-cutting being imposed on NHS trusts. In the case of Liverpool Community Health, the motivation was the drive to achieve foundation trust status. The trust disciplined and suspended staff who blew the whistle about poor care and its controversial plans to slash staff to save money. What guarantee can the Minister offer that trusts are no longer being allowed to prioritise financial savings over patient care? What protections have been put in place for staff who raise concerns about cost-cutting?

Today’s report notes the irony of staff reductions being agreed at the same board meeting that had earlier considered the implications of the Francis report. That alone should have raised alarm bells about the capacity of board members to challenge the trust. The NHS still faces huge workforce shortages, so what update can the Minister give us on how the 10-year workforce strategy has been received? What additional measures will the strategy include to guarantee safe levels of staffing in all areas of the country, in community as well as acute services?

I am pleased that the Minister recognises concerns that managers responsible for these extreme failures can often go into leadership roles in other parts of the health service, or indeed for private providers to the NHS in another capacity. Will he advise the House how many people who refused to co-operate with the investigation are still employed in some part of the NHS? Is there anything in the existing terms and conditions or structures that can be used to require future co-operation? Is there any redress in existing policies and procedures that we can use against these people?

The report said that regulators were distracted by higher-profile services such as acute care. The Health Service Journal said today that oversight failures were partly attributable to organisational changes that were taking place under the Health and Social Care Act 2012, so what will the Government do to ensure that national priorities are not allowed to interfere with local oversight?

Finally, the report raises serious concerns about the quality of healthcare in prisons. HMP Liverpool still has significant challenges, and the new provider of the prison’s health service—the Lancashire Care NHS Foundation Trust—has just said that it cannot continue with the contract on the level of funding currently available. The Ministry of Justice will investigate these matters more generally, but will the Minister assure us that prison healthcare is properly supported and resourced in Merseyside and elsewhere across the country?

Paragraph 1 of the review’s findings sums up the devastating impact of these multiple failings:

“Staff were overstretched, demoralised and—in some instances—bullied. Significant unnecessary harm occurred to patients.”

In the unprecedented financial squeeze that the NHS currently faces, we need assurances from the Minister that patients and staff will come before finance and that today will be the last time we hear such a damning message about what is going on in our NHS.

[Stephen Barclay]

I thank the shadow Minister for his questions and the manner in which he put them before the House. His first key question was to what extent measures are in place to address this sort of issue, should it arise again. Post Francis, and following Sir Bruce Keogh’s review of 14 trusts with high mortality rates, a new regime has been put in place. There is a new chief inspector of hospitals, Professor Ted Baker, and a specific regime involving NHS Improvement, which commissioned this report. NHS Improvement has a new chair, Dido Harding, a very senior figure from the business community.

That regime has put 37 hospitals into special measures so far. The methodology that is used to alert regulators to areas of concern has also been revised. For example, far more importance is now placed on staff and patient surveys. However, it remains to be explained why a trust could pay so many compromise agreements, for example, in response to so many staff disciplinary issues. I assume that many concerns were raised by trade unions locally, as no doubt the hon. Gentleman is aware. We must also consider the extent to which earlier reports, such as the Capsticks report, raised concerns that should have been addressed. That is why, in my statement, I signalled my desire to look at those issues and ensure that they are addressed by the fit and proper person test in particular. As he will be aware, though, that test pertains only to board-level appointments in the NHS, not to all roles. We will need to look at that scope, at the effectiveness of the investigation and particularly at the revolving door element of the problem, which he recognised.

Turning to the other issues that the shadow Minister raised, we clearly need to ensure that due process is followed. I do not need to remind the House of the difficulties of any enforcement against for instance, Fred Goodwin in financial services or Sharon Shoesmith in child services. People rightly expect due process, and all hon. Members would ask for that. The victims will rightly ask, “How can the chief executive, with this catalogue of issues, move within the NHS rather than be fired?” I know that the hon. Member for West Lancashire (Rosie Cooper) has many concerns about that, as do the Health Committee and many other Members.

I look forward to working with the hon. Member for Ellesmere Port and Neston (Justin Madders) in the spirit in which he raised these issues. We share concerns, and I know the House as a whole wants us to get to the heart of them.