(9 years, 11 months ago)
Commons ChamberTo pick up the last point made by the hon. Member for Bolton South East (Yasmin Qureshi) about perhaps abolishing such charges outright, later this week the King’s Fund will publish the conclusions of the Barker commission. It is looking at several questions about the future of our health and social care system, and I am sure that it will say things about charging issues and how we pay for parking. It seems to me that such questions must be looked at in the round, and in the context of the overall resources available to the NHS, by asking how to make the best use of those resources to deliver the best possible outcome for patients.
I congratulate the hon. Member for Thurrock (Jackie Doyle-Price) on bringing this matter to the House, as she is absolutely right to do. Hard-working families face difficulties because of the inconsistent way in which different NHS trusts go about applying their policies, and it is right to highlight those that chose to see car parking as another cash cow at the expense of their patients. Hon. Members have spoken about the issue of the PFI and how it further complicates the picture—indeed, it ties the hands of NHS trusts—which is an incredibly important point. The Government need to do more to deal with the mess around PFI so that these things can be sorted out.
My right hon. Friend will know that hospital parking in Wales is free, but many of my constituents go to Hereford county hospital, which is a PFI hospital. A radiotherapy facility has just been opened there, but that fact is dampened by my constituents having to pay large parking fees.
Other Members have already quite rightly intervened to point out how exceptionally high and punitive car parking charges are in that area. If this debate does nothing else, I hope that it make that trust understand that it needs to look to its laurels, review its parking policies and perhaps introduce fairer charging for the future.
That matter relates to why I wanted to talk about what has been going on in my own patch. Back in 2010, the consumer organisation Which? published a study highlighting my local trust as a particularly bad one, including as one that was quite willing to use clamping regularly as a way to enforce its charging policies. I am pleased to tell the House—this is a model of what others could and should be doing—that the work by Which? spurred my Epsom and St Helier University Hospitals NHS Trust into action: it undertook a review, which involved its patients and carers, and its policy now reflects much of the good practice that we have already heard about in this debate. There is a discounted rate of £5 a week for out-patients who visit three or more times a week, those who are going in for dialysis, cancer patients who visit two or more times a week, cardiac rehabilitation patients and immediate family members of patients receiving intensive care or high dependency coronary or neonatal care. In other words, there is an effective policy that makes it affordable for people to visit their loved ones or to get the treatment that they need. More parking for disabled people also came out of the process. There is also a recognition that some people do not want to stay for long, but want to drop someone off or pick someone up. The trust has therefore introduced more short-stay dropping-off places. If the trust delivers an appointment an hour or more late, the parking fee is refunded. Those are the sorts of policies that other trusts could copy.
It is clear from the work published by Macmillan and others that too many trusts are not even following the guidance, let alone striving to be leaders in the field or to follow best practice. As the Care Quality Commission rolls out and refines its inspection regime for hospitals, it could do more in this area. Perhaps the Minister could ask the chief inspector of hospitals to ensure that car park charging policies are examined. For hospitals that are striving not just to pass muster in inspections, but to be leaders in their field, this is another area in which they could do so.
Finally, concessions and discounts are only part of the solution. They are only as good as the publicity about them and the public awareness of their existence. It is difficult for people to access something that they do not know exists. It is therefore important to ensure that there is information at the point of use so that people do not wind up paying more than they need to. Will the Minister look at the idea that I and others have put forward recently of a carer’s passport? Some hospital trusts already have it. It is about actively identifying more carers so that they and their families can benefit from concession and discount rates, as well as other facilities to support and ease the burden on family carers.
The hon. Member for Thurrock and her colleagues who secured this debate are absolutely right that punitive car parking charges and car parking being seen as a cash cow within the NHS cannot be acceptable, as Members on both sides of the House—judging by what has been said so far—are clearly indicating. I hope that in responding to the debate, the Minister will ensure that the NHS gets that message and changes in the ways that hon. Members are suggesting.
(11 years, 11 months ago)
Commons ChamberThat goes to the heart of a number of the points made in the serious case review about the nature of the recruitment processes that were used by Castlebeck and the way in which it then carried on inadequately to train, supervise and monitor the conduct of those staff. I will come back to some of the actions that the Government are taking in that regard to make it much more difficult for that to occur again in future.
Of course, what happened at Winterbourne View came to light only as the result of the actions of the whistleblower, Terry Bryan, and the Panorama programme broadcast by the BBC. I personally thanked Terry for his actions when I spoke to him some months ago about the interim report that we published in June, and I do so again tonight. Thanks to Terry, the Care Quality Commission has changed its systems and set up a dedicated whistleblowing team. An even greater emphasis is being placed on the importance attached to the role of whistleblowers. That is why the Government have introduced a free whistleblowing helpline, not only for NHS staff but, for the first time, for social care staff, so that they can get advice on how to report concerns that they have. There has also been a strengthening of the NHS constitution to make these matters clear to their employers as well.
Terry Bryan blew the whistle on the worst excesses of a wider systemic failure. As I acknowledged in the Department of Health’s interim report in June, the problems revealed at Winterbourne View are more systemic. There has been a tendency when reporting on Winterbourne View to heap much, if not all, of the blame on the CQC. Indeed, the CQC seems to stand as the barrier to everyone else who should be in the dock being criticised, scrutinised and challenged for what went wrong. Although the CQC, rightly and properly, acknowledged its failings and apologised at the time, the issue of staffing and the freeze that this Government introduced on coming into office in May 2010 was specifically lifted for the CQC in October 2010, and there were no restrictions on staff recruitment. If there were failings of recruitment, the CQC would need to answer for them—indeed, it has—before the Health Committee.
Every part of the system—NHS and social care commissioners, providers, regulators and health and care professionals—has a part to play and, indeed, has questions to ask itself about what has passed.
The Minister rightly pays tribute to the whistleblower, but does he agree that when vulnerable people are moved away from their communities and, indeed, their families to care homes that may be many miles away, complaints are less likely to be made and, therefore, inspections less likely to be triggered?
My hon. Friend makes an important point and anticipates what I am about to say. The Department’s guidance is clear. People should be supported to live in the community, wherever possible, and only in strictly limited cases should assessment and treatment centres be used. Nowhere in policy or guidance is there justification for long-stay assessment and treatment hospitals. Indeed, the CQC found length of stay ranging from anything between six weeks and 17 years, with five to seven years not uncommon.
The hon. Member for Slough (Fiona Mactaggart) raised the issue of data during her intervention on the right hon. Member for Coatbridge, Chryston and Bellshill. I agree that we need to improve data collection so that we have a clearer picture of what is going on. The painstaking work of the serious case review, Department of Health officials and others to create a clear picture of the system begs questions about the adequacy of data collection for many years.