Francis Report

Kate Green Excerpts

Wednesday 5th March 2014 Commons Chamber

[Jeremy Lefroy]

I thank my hon. Friend for that intervention and for all the work he has done on this issue. It is salutary for all of us to remember that when we get such a letter it often represents probably another 10 people who did not write to complain because they do not want to affect the NHS. We should treat each letter of complaint as being of immense importance.

I said that I am less confident about accountability, so let me say why. This is not just a question of the resignation of executives within a trust or the NHS when things go badly wrong, although it remains astonishing to me that no one has had the courage to do this given that the failings in Stafford were so clearly systemic; it also concerns the approach of the professional bodies representing nursing and clinical staff. The Francis inquiry saw evidence of poor co-operation with the General Medical Council from other organisations, including royal colleges, even though serious matters of fitness to practise and patient safety were involved; they almost put the practitioners above the patients. Those representing the medical and nursing professions are accountable to the public first and foremost. The best way of maintaining public confidence in their professions is to ensure that they treat their members who are not fit to practise in a firm, fair and swift way; cases of doctors or others being suspended for months or even years are too frequent.

Before I discuss Stafford specifically, may I just make a few remarks about hospital standardised mortality ratios? The Francis report states that Professor Jarman

“made it clear that it is not possible to calculate the exact number of deaths that would have been avoidable, nor to identify avoidable incidents…The statistics can only be signposts to areas for further inquiry.”

I urge all those who handle HSMRs to do so with care. They are extremely important as guidelines, and it was absolutely right that they were the first statistics that showed up the need for the Healthcare Commission inquiry, but to extrapolate numbers from them can be difficult and the evidence does not necessarily bear it. We have seen examples of that happen.

[Kate Green (Stretford and Urmston) (Lab)]

I am grateful to the hon. Gentleman for mentioning that point. Does he agree that an important task of public education needs to accompany the transparency around such statistics, because they are complicated and, as he says, they are a signal but not a whole story in and of themselves? Has he any suggestions as to how we could enlarge that public education and understanding.

[Jeremy Lefroy]

I thank the hon. Lady for her intervention, but that task is probably beyond my competence. I agree that we should use HSMRs and respond to their signals, but we should not say that they are the final judgment on specific numbers. Any HSMR that looks difficult and looks as though it needs to be investigated must be investigated—it is much better to do so than not to do so.

I will now discuss my own constituency, which, along with those of my hon. Friends the Members for Cannock Chase (Mr Burley), for Stone (Mr Cash) and for South Staffordshire (Gavin Williamson), has probably been the most affected. The spotlight has been on Stafford hospital for several years now, and it has been an extremely difficult time for those who raised their concerns, such as Julie Bailey and Cure the NHS, which were dismissed in a very offhand way by the NHS system and for which they endured abuse; it has also been extraordinarily testing for the many people working at that hospital and the one in Cannock, who have tried to carry out exemplary care at a time when the spotlight has been on them. They have, by and large, brought excellent care to patients, despite what has been going on around them. Understandably and rightly, the Care Quality Commission carried out an unannounced visit on the very day last week when it was announced that the Mid Staffs trust would be dissolved, so hon. Members can understand the sort of pressures that staff have faced. The great improvement that has been made has been recognised by the CQC and, most importantly, by patients and their loved ones. There is no complacency; there are still instances that should not happen, and the hospital and the trust are determined to ensure that they learn from all those. For Stafford and Cannock, however, it has also been a time of coming together and putting aside differences, as tens of thousands of people have worked together to save our hospitals and their services.

I will not dwell at length now on the process, the administration and the dissolution of the trust announced last week, but I will seek a debate on it, because some of the points made by the Opposition spokesman, the right hon. Member for Leigh (Andy Burnham), are fair in respect of the way the process works—or does not work. I have been critical of it and will continue to be so. I will, however, dwell on the unity. I have marched twice, not only with people who have had wonderful care at Stafford, but with some who have told me that they, too, experienced very poor care at Stafford but wish, for the sake of everyone, to see both patient safety and care improved, and services protected. Last week, the trust’s dissolution was announced, and although most services will continue, I continue to oppose decisions that mean the potential loss of consultant-led maternity services, consultant-led paediatrics and in-patient paediatrics. I will continue to fight for those services, because I believe they are essential in a hospital and a place that is at least 30 km away from the nearest other possibilities for patients. I urge NHS England, in particular, to take the consultant-led maternity review very seriously indeed.