Underperforming NHS Trusts: Government Oversight

Marie Goldman Excerpts

Wednesday 14th October 2026 Westminster Hall

[Marie Goldman (Chelmsford) (LD)]

I beg to move,

That this House has considered Government oversight of underperforming NHS trusts.

It is a pleasure to serve under your chairmanship, Mr Stuart. I am the MP for Chelmsford in Essex, and my local trust is the Mid and South Essex NHS foundation trust. A few years ago, it was decided to put three hospitals under the same trust. My local Broomfield hospital is not actually in my constituency. It is in the neighbouring North West Essex constituency, but for all intents and purposes, it is my hospital because it is the main one serving my constituents, and it fills my inbox every single day with tales of woe from both patients and staff.

I thank other Members whose constituencies are served by the same trust for coming along today. Other hon. Members from across the House, served by other NHS trusts, will probably be experiencing something similarly unfortunate. I look forward to hearing their stories, because it is incredibly important to get NHS trusts to perform properly, serve their patients and look after their staff. Looking after the most vulnerable underpins everything we do in society, and I am afraid to say that the Government are not getting it right. That is what I am here to talk about.

Earlier, somebody not too far away from me said, “I think I am in the worst trust in the country,” and I said, “I will go round for round with you on that one.” Later, I will give some details about why I believe that.

Back in March, the then Health Secretary, the right hon. Member for Ilford North (Wes Streeting), announced that the Mid and South Essex trust would be placed into an intensive recovery programme, and we waited to find out the details. The reason for the programme is that, over several years, Mid and South Essex has been massively underperforming. There have been huge issues, and I do not exaggerate when I say that they fill my inbox every single day. We are talking about long waits, delays to treatment and difficulty accessing care. When patients do access care, they are not getting the service they need and, most importantly, they are not getting the outcomes they need and deserve.

I pay tribute to the staff who work at Broomfield hospital, in the Mid and South Essex trust and in all the trusts across the country. They are working in difficult circumstances, and quite a lot of the time they are using infrastructure that is not fit for purpose and has not been properly invested in over many years. They are doing their very best, but unfortunately, they are not getting the support they need. I have met the staff, patients and leadership of Mid and South Essex foundation trust many times over a sustained period, and I know hon. Members from across the House have done the same. Unfortunately, I believe it is one of the worst trusts in the country on both patient and staff measures. We pushed for changes locally, but national support is needed.

Let me talk about the range of issues that have been raised with me. I have walked around Broomfield hospital both with the senior leadership team and with the less senior leadership, shall we say? I do not think it should be possible for me to walk around a hospital and point out things that are so obviously wrong, yet I could. There were lights outside theatres that had not been working, I was told, for 10 years. Those are things that should be relatively easy to fix, but when patients have to write to me about mould growing on the walls and windows of a children’s ward, something is going seriously wrong.

Two weekends ago, an 80-year-old gentleman told my staff that he had queued out the door of the emergency department on a Saturday for an hour. He is in his 80s and nobody even bothered to offer him a seat. Something is going drastically wrong when we have lost sight of the importance of common decency and human compassion when looking after patients. When consultants retire, they are not being replaced, and their waiting lists are just being disbanded.

People are writing to me about those sorts of things all the time. Patients have very few ways to raise their concerns. They can go to the patient advice and liaison service, but unfortunately the delays in getting responses back from PALS are enormous. MPs can raise an issue with the trust leadership and go through PALS as well, but we still do not get the responses that we need. There seems to be a lack of communication between leadership and staff, and we seem to have lost sight of what is important—the things that just make sense to keep on doing.

There was a roundtable earlier this week for the leadership of Mid and South Essex and the Essex MPs whose constituencies are in that trust. While not all the MPs could come along—I know many sent their staffers—I was certainly there. We talked about heat and the very long, hot summer we have had. We talked about how that has impacted on the running of the hospital. The chief executive told me that it meant some of the theatres had to be closed because there was too much humidity. Obviously, that has a knock-on effect on patient waiting lists, outcomes and experiences.

The chief executive said that the hospital had been gifted some air-conditioning units by a very generous national company. That sounds great, but the hospital cannot plug enough of them in because the electrical circuits cannot cope. It is a fairly new build hospital—it is a combination of PFI and some older buildings—yet we cannot plug in enough air-conditioning units to keep our theatres open. I was told that humidity is not reduced by air-conditioning units, but I am not too sure about that. I am sure there are other ways of reducing humidity.

I said to the chief executive that it was a really hot summer, and with El Niño, we are possibly expecting an even hotter summer next year. I asked the chief executive whether they are developing contingency plans to make sure that we can deal with that, because we know that long, hot summers are going to keep on happening. He said, “No, we’re not.” My mind was blown that he said that out loud. I say this as gently and courteously as possible, but it is obvious that the trust is massively struggling. It is not just the staff working day to day; it is the leadership. It is a new leadership team, and they have obviously lost sight of the importance of focusing on certain things.

[Mr Richard Holden (Basildon and Billericay) (Con)]

The hon. Lady makes some important points. We share a hospital trust. Many of my constituents in Basildon and Billericay go to Broomfield hospital. Some of them go down to Basildon hospital in the constituency of the hon. Member for South Basildon and East Thurrock (James McMurdock), as well as the Southend hospital in another neighbouring constituency.

I want to pick up on that point around contingency planning, because Basildon hospital, which is part of the trust, is particularly bad for corridor care. It is very clear to me that it is a major issue that is really hammering people. I want to make a very brief point about that care.

[Mr Holden]

Thank you for your indulgence, Mr Stuart.

A constituent came to me who was handed a second-hand book on grief, with somebody else’s notes in it, after he had just lost his wife. It really struck me that, whether it is corridor care or that almost thoughtlessness, care is actually missing in parts of the Mid and South Essex NHS foundation trust.

[Marie Goldman]

The right hon. Gentleman is right to point out that we are in the same trust, and that our constituents experience each other’s local hospitals. I want to build on what he said about the experience of patients. It is really important that we remember the patients in all this. We can talk about financial planning, keeping budgets down and sticking within the envelope of how much we are supposed to be spending, but at the end of the day, it is patients who are suffering.

One patient wrote to me in February—it was February this year, but just to give an idea of how long this has been going on, it could have been February two, three or five years ago. They said:

“I waited four hours for triage, and it was eight hours until I was admitted to a ward. I spent much of that time sitting on the cold floor, by the open doors or standing as there were not enough seats.”

It is not just about patients; it is also about the staff who work there. A nurse wrote to me just last month, in September 2026, to say:

“I have worked at the trust since 2008 and when I first joined, I was so proud to say I worked there. The next few years this feeling remained but for the last 8 years or so things have definitely taken a nosedive. The trust seems to run on broken promises and the good will of front­line staff. I am no longer proud to say where I work. I know many staff feel the same and worry for the safety of the patients, the staff and the trust.”

[Mr Mark Francois (Rayleigh and Wickford) (Con)]

The merger of Basildon, Broomfield and Southend hospitals six years ago has turned out to be an abject failure. That is not the fault of the patients, and it is certainly not the fault of the very hard-pressed staff; it is the fault of the management. We have seen endless revolving-door changes of management. Does the hon. Lady agree that it is now time for Clare Panniker, the east of England regional director of the NHS who was the first chief executive of the trust and, indeed, the cheerleader for the merger, to intervene and finally put this problem right once and for all?

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[Marie Goldman]

I think this is bigger than just one person; it needs much more attention from the Government and across the board—and I do not just mean the local trust board. It needs a lot of oversight and intervention, and really quickly. We are talking about an intensive recovery programme that was billed by the then Health Secretary as being a rapid improvement programme. I have not seen anything rapid yet, I am afraid. The programme was announced in March, and I am still waiting to see any real outcomes. It is supposed to deliver results within six months. I know they waited until the new chief exec was in place in June, so we are now a few months in, but patients—my constituents—are really suffering.

Let me give a few stats. For cancer being diagnosed or ruled out within 28 days, the national median is 78.6%. The average for Mid and South Essex is 64.3%, placing it 114th out of 117 trusts. For elective patients waiting under 18 weeks—in this case, higher is better—the median is 65.2%. In Mid and South Essex, it is 50.4%, placing it 117th out of 117. For elective patients waiting over 52 weeks—lower is better—the median is 1.5%. In Mid and South Essex, it is 8.1%, again placing it 117th out of 117. I would rather not claim the prize of having one of the worst trusts in the country, but here we are—the numbers don’t lie.

[Sarah Edwards (Tamworth) (Lab)]

The hon. Member is making an excellent speech about the importance of NHS trusts being able to meet their targets and provide care. My local trust, similarly, is not in my constituency. University Hospitals of Derby and Burton NHS foundation trust has been missing its cancer targets, with 40% of patients waiting two months, which is just not good enough. Does she agree that despite the fact there have been announcements and increased funding, we are bearing the brunt of the cut after cut that we saw under the previous Government, and it will take a long time to turn this around unless we have increased intervention from Government?

[Marie Goldman]

Yes—the hon. Member makes a really important point. I have no problem with making cuts if they are genuine efficiencies. If we look at a system and go, “Do you know what? There’s wastage over here, so we can cut it from here because we’re confident that things are going to continue to do well over there”, but that never seems to be the case. It seems to be a case of just cutting, and to hell with the consequences. I find that really frustrating.

The bottom line is that patients suffer from it, and that is never good for the economy. If we want to boil it down to money, economics and finances, that is never good for the economy, because when people have worse outcomes, they tend to need to stay in hospital for longer, which costs more money. It is ridiculous—it is a crazy way of running things.

A staff survey was done in the trust last November, and the results speak for themselves. Members can look it up, but this is the money answer that tells us pretty much everything we need to know, even if we read nothing else. Staff were asked whether they would be happy with the standard of care provided by the organisation if a friend or relative needed treatment. The national average for those agreeing is 60.83%. For Mid and South Essex, it is 38%—my word! Nearly two thirds of staff working in the trust are saying, “I wouldn’t want my friend or loved one to be treated there.” That has to be ringing enormous alarm bells. If we are not throwing everything at turning this around right here, right now, I do not understand the point of Government.

I am conscious of time and I have taken three interventions, so I will go on for just a few more minutes.

There have been six years of interventions at the trust, starting after the merger in 2020, when the Care Quality Commission rated it “Requires improvement”. In April 2024, we had a recovery support programme, which was a successor to special measures, and in March this year, as I have said, we had the intensive recovery programme. Six years and two programmes, with no CQC improvement.

We have had so many health inquiries in this country—inquiries into maternity and other services—and they have all made loads of recommendations. Can the Minister say how many of those recommendations have been implemented, across the country and in Mid and South Essex? How are we keeping track of that? Let’s not reinvent the wheel. We have had inquiries that have told us what is going wrong, so let us make sure we are implementing their recommendations.

I have written to the Minister three times, and three times I have had a response back. I have welcomed the announcement and asked questions about the detail, but I have had different details back each time. In June and July, I was told that the responsibility lies with the trust’s board, with targeted external expertise. In the July response, I was told that there was a recovery compact and a six to 18-month recovery period. In the September letter, I was told we would be getting enhanced support from NHS England regional and national teams.

It struck me when rereading those letters earlier today that there is very little reference in them to improving patient outcomes or experience. They focus a lot on money. I genuinely think that we need to get things right and then deal with the money afterwards. Sometimes we have to invest to get things to the point that they need to be, and then step back and make savings; we cannot do it all in one go—I can tell hon. Members right now that it just will not work. There is too much of a focus on financial performance right here, right now. We can get to that later, but we must first sort things out for the patients who are suffering right now.

The September response promised long-term sustainability. I just have to point out that NHS England is reportedly set to be abolished in April 2027, which is inside the recovery window I have been given. That creates a certain amount of confusion and uncertainty. Where will we be getting consistency on this?

Members will be pleased to know that I am on my last page, but I do have a list of questions for the Minister. Where is the “external expertise” coming from that will be helping Mid and South Essex? I get fed up with the merry-go-round of chief executives moving from one failing trust to another. Why on earth do we think we will get a different answer or outcome? If they did not fix it over there, why do we think they will be able to fix it over here? Where is the genuine expertise with a tried and tested track record coming from?

Who chooses the experts? Who reviews whether the support is working—or are they going to be marking their own homework? Who holds the trust to account? Do not just tell me “the board” or “MPs”—that is not the answer. What specific support is Mid and South Essex getting? If there is no improvement within the six to 18-month window, who will intervene then, and what will be the consequences? How is this long-term if NHS England is going to disappear in April 2027?

Finally, where is the commitment to making things better for the people this really matters for: the patients and the staff? I conclude by paying tribute once again to the staff who do amazing work under very difficult circumstances. Patients—my constituents—deserve better.

[Several hon. Members rose—]

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[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship, Mr Stuart. I congratulate the hon. Member for Chelmsford (Marie Goldman) on securing this debate on a subject important not only to her constituents but to all of us right across the country. The performance of the NHS is key to the health of the nation. It gives us all the best chance of good health and recovery, which is important for our social wellbeing and brings economic benefits.

The first question is this: how do we know which trusts are performing well and which are not? First, we need to decide what good performance looks like. We can look at that in a couple of ways, in particular in relation to outcome and experience, both of which are important. The outcome, for example, may be a death. That will come to us all eventually, but the experience might be one of comfort, in line with the wishes of the individual—as good as can be delivered. Conversely, one could on the face of it have a good surgical outcome from a trust but a poor experience of care during that experience.

Experience is measured in a number of different ways: individual staff, such as consultants, have patient feedback as part of their appraisal and revalidation; the friends and family test enables people to give anonymous feedback; the number of complaints or compliments can be measured; and trusts do their own surveys—but those are all to some extent internal processes.

[Marie Goldman]

I would love to hear more of what the hon. Lady is saying, but none of us can hear her well. My plea to the hon. Lady is to speak up a bit.

[Dr Johnson]

Sorry, the microphone went off, but it has just come back on again.

The processes are mostly internal. Healthwatch is an independent patient voice, which looks at people’s experience across the health service in a way that is independent of Government. As part of the Health Bill, however, the Government plan to abolish Healthwatch and to bring it inside the Department. Will the Minister comment on whether they still plan to do that?

When he was Mayor of Greater Manchester and in charge of its integrated care board, the Prime Minister wrote to the Government to suggest that they might be on the wrong path. As Prime Minister, does he still think so? What instructions has the Minister had in relation to that? People are sometimes frightened to provide feedback to trusts, but they will be more willing to do so when they have confidence in being heard independently.

Other ways in which the Government measure experience relate to waiting times—how long it takes to be seen in clinic, how long it takes to be seen in A&E, how long it takes from the decision to admit a patient to actually admitting them, or how long it takes for a procedure or an operation. The Government produce lots and lots of figures but many of them, I am afraid, go in the wrong direction.

The Government have a dashboard for the referral to treatment statistics, and the waiting lists are rising. The number reached a low point in March 2026, just after the reports of exceptional numbers of removals, but it has now risen by 222,000 in the past four months. I am afraid that the numbers waiting for a procedure or operation are higher now than at the general election. This year, many more people than in 2024 waited more than 12 hours in A&E after a decision to admit them. Staff sickness rates, mentioned earlier in the debate, are also consistently higher than they were before the general election. Statistics across the NHS are not going in the right direction.

The Government also measure outcomes through the financial management of a trust, leadership and Government metrics, the number of procedures performed, the number of “never” events, and CQC inspections. Again, the Government are planning to fold HSSIB into the CQC, which many commentators have warned against; the Liberal Democrats and we the Opposition have spoken against the abolition of HSSIB. When the Government take the Health Bill through the Lords in Committee in the next week or two, I hope that they will think again. The Government also plan to roll a number of other things into the CQC at the same time, including events management; I wonder whether they are asking an organisation that they acknowledge has been struggling to take on too much.

If poor performance is identified, who is responsible? Is it the consultant or the matron? Is it the directors’ suite—the chief executive or the chair? Ultimately, if a trust is underperforming at the moment, governors are supposed to hold the board to account. The Health Bill abolishes those. The ICBs—the commissioners—can hold the trust to account but their budgets have been halved, so will they have the capacity to do so? Many of them have merged, and some of those mergers have been paused by the Government. This is all a distraction. NHS England has a role, but it is being abolished too. Apparently, the overall headcount in the DHSC and NHS England is to be halved. How will they have the bandwidth to provide the scrutiny that the Government say they will have?

Having identified the management of poor performance, the Government chose five trusts—North Cumbria, Mid and South Essex, Hull University Teaching Hospitals, Northern Lincolnshire and Goole, and East Kent—to have a special intensive recovery programme in March 2026. However, it is not clear what has been instituted in those trusts, what outcomes that programme is developing, how long it will last or what the Government will do for those trusts that fall just outside that group of five.

How will the Government improve the variability between trusts that do not fall into the bottom cohort? How did they choose the five trusts that were chosen? As we heard earlier, there are several metrics by which some trusts could be considered in the bottom five, but they were not chosen, and some metrics by which those that were chosen may not be in the bottom five. How has the Minister chosen those trusts and how does she intend to improve those that do not fall into her chosen few?

The Government have promised a workforce plan, but the workforce is the most important thing. Right hon. and hon. Members have spoken in this debate about the really good staff in their trusts working extremely hard in very difficult conditions. The previous Conservative Government developed a long-term workforce plan. This Government decided that they wanted their own workforce plan—they won the election so they are very much entitled to make one. But they have still not written it. They promised it by the end of 2025; we are rapidly approaching the end of 2026 and it is still not with us. Can the Minister—[Interruption.]

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[Marie Goldman]

I thank all Members who have taken part in this important debate and the Minister for her response. Hon. Members from across the House have pointed out that rural constituencies are not the same as urban constituencies, and that they have very different needs. They have pointed out that we need investment in the infrastructure at our hospitals. Some hospitals are failing because their buildings have been neglected for decades. That needs to be fixed. None of us is here just to criticise. We are all listening to our constituents, to patients and to staff. It is our duty to call problems out and demand better, and that is what we have done today.

I do not like hyperbole, and often when people talk about life and death, it is hyperbole. That is not the case here. It is literally life and death for people on waiting lists. People have tragically died because they have been on a waiting list too long or because they have been mistreated or misdiagnosed, as we have heard from Members.

I make a final plea not to concentrate only on the finances. Finances will help with rural issues and infrastructure issues, but they will not help with cultural issues. The CQC did a well-led inspection of the Mid and South Essex trust recently. The stark line coming out of it was that staff are afraid to speak up for fear of reprisal. Money is not the problem with that system; it is a cultural problem, and we need to do something about it.

The Minister said that we could meet again. I gently say that we have not actually met yet, so I would love to take her up on the opportunity to meet for the very first time. I thank her for her response, and everybody who took part in the debate.

Question put and agreed to.

Resolved,

That this House has considered Government oversight of underperforming NHS trusts.