Essex Mental Health Independent Inquiry

Neil O'Brien Excerpts

Tuesday 31st January 2023 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)]

It is a pleasure to serve under your chairmanship, Mr Davies. I thank my right hon. Friend the Member for Chelmsford (Vicky Ford) for securing this important debate, and I thank her and all the local MPs—my right hon. Friend the Member for Witham (Priti Patel), my hon. Friend the Member for Rochford and Southend East (Sir James Duddridge) and my right hon. Friend the Member for Maldon (Sir John Whittingdale)—for their dogged work over a long period in trying to get justice both for those in the Public Gallery and for all the others who are unable to be present this morning.

I know that Members have raised a lot of concerns about the progress of the inquiry, and I want to take this opportunity to make clear our strong commitment to this absolutely vital work. The speech made by my right hon. Friend the Member for Chelmsford was stark, and I know that some of the victims, survivors, and friends and families of people who have been affected are in the Public Gallery. It is a powerful reminder of why the inquiry is so important: it has to get to the truth.

The Government are committed to improving mental health services across the country, which is why we launched the independent inquiry in January 2021, covering a 20-year period from 2000 to 2020. Obviously, it is a complex inquiry. Like Members present, I am pleased with the hard work of Dr Geraldine Strathdee, the inquiry chair, since the inquiry started its work. However, I am concerned about the level of co-operation that the inquiry has received, which was set out clearly by my right hon. Friend the Member for Chelmsford. It is not good enough, and Dr Strathdee has recently raised concerns about this. She met the Secretary of State and has since published an open letter in which she stated that

“in the event that staff engagement remains very poor, it is my view that the inquiry will not be able to meets its terms of reference with a non-statutory status.”

We take those concerns very seriously.

Dr Strathdee has raised two particular concerns. The first is about the participation of current and former staff, and the second is about the availability of documents for the inquiry. As a result of Dr Strathdee’s concerns, the Secretary of State met Paul Scott, the chief executive of Essex Partnership University NHS Foundation Trust, to better understand how the trust will support the inquiry. The Secretary of State sought assurance on two key issues. The first is what actions the trust will take to encourage more staff engagement with the inquiry, and the second is assurance that the trust will provide all the evidence and information requested by the inquiry, to enable it to fulfil its terms of reference. I know that Mr Scott has also written to local MPs setting out the steps that he thinks necessary to improve engagement, and he feels confident that progress can be made.

On staff participation, I remind the House that it is incumbent on all holders of public office and all health professionals to demonstrate their fitness for office by voluntarily co-operating with independent inquiries. In their guidance on the duty of candour, professional regulators advise that health and care professionals must be open and honest with their colleagues, employers and relevant organisations, and take part in reviews and investigations when requested. Similarly, they must support and encourage each other to be open and honest. I therefore hope that anybody who is asked to contribute evidence will co-operate fully with the inquiry in the public interest and in fulfilment of their professional obligations. The Department is also working closely with the inquiry and NHS England to look at what more can be done.

Dr Strathdee has expressed her concern that an additional 600 cases were recently sent to the inquiry. The trust has advised that they were identified during a validation process. I appreciate that this is not ideal, but I understand that the trust has allocated appropriate staffing and resource to ensure the thoroughness of the searches requested by the inquiry.

As Members have mentioned, the participation of families is equally important to the work of the inquiry, and I am grateful to all who have provided evidence to date. I am disappointed that a number of families who have tragically lost loved ones have chosen not to participate and get their voices heard. I urge them to reconsider, so that the inquiry can be as thorough as possible.

Our view is that a non-statutory inquiry, if it is possible, remains the most effective way to get to the truth of what happens. It is quicker, and potentially involves not having to drag clinicians through the public processes of a statutory inquiry. When my right hon. Friend the Member for Witham was Home Secretary, she used the non-statutory process to protect those who did not want to be named and dragged through a statutory process. It is faster and more flexible, which is why it was chosen in the first place. Although statutory inquiries can compel witnesses to give evidence under oath, that does not necessarily mean that it will be easier to obtain the evidence we want. However, all that turns on people co-operating with a non-statutory inquiry, and we now need to see a quantum leap in the level of co-operation. We will not hesitate to move to a statutory inquiry if we do not see a dramatic increase in the level of co-operation. Given how long this has gone on, we cannot wait for a long period for a transformation in the level of engagement. While the approach remains non-statutory for now, we will not hesitate to change that approach if we do not see the change we need rapidly.

[Sir James Duddridge]

I have visited Essex Partnership University NHS Foundation Trust in Rochford a number of times and have been incredibly impressed with its work, notwithstanding its very real problems. What I cannot get over is why people have not come forward to give evidence in a non-statutory environment, because these are caring individuals who want to improve the service. I do not understand why only 11 people have come forward.

[Neil O’Brien]

That is a vital question. There is an excellent chair, and many publicly spirited individuals are already co-operating to get to the truth and improve services for the long-term. We are currently in this environment of the non-statutory inquiry, which allows an informal approach. People do not have to give evidence in the way they would if we went to a statutory approach. There is an opportunity for people to co-operate more with the inquiry, exactly as my hon. Friend says.

[Vicky Ford]

I understand that the Minister is asking for a quantum leap—that is a good phrase to describe the massive change we need—rapidly. Does he agree that rapidly should mean no more than one month?

[Neil O’Brien]

It is not for me to put a date on that in this setting. I have had conversations with a number of the hon. Members here, but my hon. Friend can rest assured from the tone of what I am saying that this will not be a long period of time. We are not kicking this into the long grass; we urgently need this change because, as numerous Members have pointed out, this has been going on for a long time and families who have been through the mill are waiting for justice.

[Sir John Whittingdale]

One of the problems with a non-statutory inquiry is people’s reluctance to come forward. If it becomes statutory, certain consequences obviously follow, including the publication of the names of those who are summoned to appear. Will my hon. Friend the Minister think about making his requirement that the co-operation be achieved in a short space of time more public, so that people understand exactly what will follow if they continue to fail to co-operate?

[Neil O'Brien]

This debate goes some way to achieving exactly that. My right hon. Friend is exactly right that the current non-statutory approach has the benefit that those who give evidence do not have to be named. That is why it would clearly be more desirable if we could make the non-statutory approach work, but that has not been the case to date and, unless that changes, something else will have to change too.

To continue making progress in how we address issues with mental health services, Members will be aware that we have recently announced a rapid review into patient safety in mental health settings across England. The review will focus on what data and evidence is available to healthcare services. I am pleased that Dr Strathdee will be leading the rapid review over the next couple of weeks, given her knowledge and experience. However, I assure hon. Members that the work of the inquiry in Essex will continue at the same time.

I firmly believe in the importance of transparency and accountability to improve patient safety, and I wish to take all action necessary to assist the inquiry in its work. This is absolutely the last chance to make progress. If staff engagement and access to documents remain unsatisfactory despite these actions, we will consider whether the inquiry should remain on a non-statutory footing. We simply cannot go on as we have, with inadequate co-ordination and documents not being forthcoming. Everyone in the inquiry knows the situation and that there is not a long period of time for things to change.

I thank hon. Members for bringing forward the debate, because it allows us to set out the situation clearly for the public. I thank all who are here today, all who have co-operated with the inquiry, and all who have lost loved ones or been personally affected by this matter and have had the bravery and grit to come forward and talk about their experiences. We are extremely grateful to them.

Question put and agreed to.