Accountability and Transparency in the NHS

Debate between Nick de Bois and Rosie Cooper

Thursday 14th March 2013 Commons Chamber

[Rosie Cooper (West Lancashire) (Lab)]

I welcome the opportunity to speak in this debate on our national health service. I resolutely believe that we should have an open and honest debate on how we can each contribute to restoring faith in the national health service, and that we should not play politics with the findings of the Francis report.

Increasingly, there is a deeply concerning creeping veil of secrecy across the public sector—local government, education or health. The application of greater accountability and transparency is the solution, ensuring that the interests of the public remain the singular and overriding No. 1 priority in public service delivery. As a society, we display a huge and deep faith that the NHS is intrinsically good, and we want unquestioningly to believe that at all times it is acting in our best interests. The findings of the Francis report, as they should, shake that faith and belief in the NHS to its very core. Francis should be commended for his report—an extensive and comprehensive forensic examination of Mid Staffs and the structure of the NHS.

I will be as brief as I can and focus on one tiny element: listening to patients, the people who pay for the NHS, and hearing what they are saying and acting on it. We do not need to keep on looking for a black cat in a dark room. Switch the light on! It is no good the Secretary of State simply repeating that we must listen to patients and their families. What assurance does he have that, until the next crisis, they are listening? In hearing after hearing of the Health Committee, senior people associated with the NHS trot out that the regulator is responsible and that the Care Quality Commission needs to deal with it. I never, ever thought I would feel sorry for the CQC, but, when everyone else ducks, it is supposed to catch the ball. We do not need to create another bureaucracy; we simply have to make work—really work—something we already have by giving it real teeth and enough resources to make it effective.

I agree with the comments of Dame Julie Mellor, the parliamentary and health service ombudsman, when she said that she hoped that the Francis report

“will trigger a debate that will support our view that good complaint handling should be at the heart of the NHS.”

From front-line experience, I believe that to be both true and essential. During my time as chair of Liverpool Women’s hospital, a standing agenda item at the public monthly board meetings was a summary of all complaints received that provided an overview—not in minute detail, but an overview—of each complaint and the outcome: upheld or not upheld. Most importantly, there was a column that stated what action was taken. Employing this system of regular review ensured that the board had oversight, asked questions, could spot trends, be assured that action was taken and demonstrate to patients and their families that they were being listened to.

[Nick de Bois]

Does the hon. Lady accept, notwithstanding the efforts made in the hospital she mentions, that when MPs take up complaints on behalf of constituents and try to get to the truth behind them, we are faced with tremendous bureaucracy and resistance?

[Rosie Cooper]

Yes, and if MPs have problems, God help members of the public and patients.

We had to demonstrate that we were really listening to patients. The medical and managerial staff had to take ownership and responsibility for complaints. They knew that at each board meeting they could be questioned and challenged. If we accept that there are large parts of the system that work well and focus our time and resources on areas that do not, we can raise standards and tackle deep-seated problems. As chair, I sought to build in assurance and be transparent about complaints; to solve them, not hide from them, and ensure that everyone was accountable right up through the management structure. I never believed in no blame; I believed in fair blame. Each time a problem was resolved properly, we became a better hospital. We were rightly proud that on the front page of the Liverpool Echo Liverpool Women’s hospital was called an NHS gem. Sadly, the main board’s complaints report stopped after I stepped down as chair.

We do not need to reinvent the wheel or have more reorganisation in the NHS, but we must make the complaints system work. From that important but simple action, culture changes happen and become embedded in the organisation. We then have real change, real transparency, real openness and real accountability—something we can all be proud of.