North East Ambulance Service

Lord Hunt of Kings Heath Excerpts

Monday 23rd May 2022 Lords Chamber

[Lord Kamall (Con)]

Noble Lords are absolutely right to talk about the culture. Years ago, during my academic career, I looked at organisational change; one of the very difficult issues is that while you can change structures and processes, it is about how you address the culture. Quite often in organisational change, or any change, there is a cultural lag. Sometimes the lag is due to individual values and sometimes it is much more widespread than that, and there are questions about how the culture grew in the first place and how to address those roots. Sometimes it is about personnel change and sometimes it is about retraining. There are a number of issues when it comes to changing culture, which is quite often more difficult than structural change.

The Government have been clear, as has the NHS, that there are clear guidelines around the use of NDAs by the NHS, including that it should not prevent staff speaking up about concerns relating to the quality or safety of care. It will be important for us to discuss all the issues further with the trust, the CQC and others, to determine the appropriate steps to take from here, including on NDAs.

[Lord Hunt of Kings Heath (Lab)]

My Lords, the Minister makes a very interesting point about culture but does he not think that, whatever review is undertaken, it needs to look further? If this is proven to be so, what are the reasons why management would seek to take the action that it did, and to what extent is pressure on managers from higher up the system causing them to cover up because of punitive action? In other words, does he agree that the culture is set by Ministers at the top? If they deal with the health service in a punitive way, as they have often done over many years, they should not be surprised if the system responds by seeking to cover up what has been happening.

[Lord Kamall (Con)]

I recognise that the noble Lord was a Health Minister but I must say that, in my time as a Health Minister, I have never found it to be an adversarial relationship but always quite co-operative. In conversations that I have had with individuals I have met in the NHS, they have been quite clear that I have no power over them, as it were, but that we can discuss concerns—although, clearly, the Secretary of State does exercise certain powers. However, the culture goes deeper than this and the noble Lord is absolutely right to suggest that we have to understand the roots of that culture and the incentives and disincentives to certain behaviour. I am sure that this will all be looked at as we try to learn what went wrong in this case.