National Health Service (Amended Duties and Powers) Bill

Paul Farrelly Excerpts

Friday 21st November 2014 Commons Chamber

[Andy Burnham]

It is one of the biggest scandals of recent times that people in this House who have links to private health, and many more in the other place, put through legislation that did not have a mandate from the British people and from which they would benefit financially. The story of that will one day be told in full.

The reorganisation has dragged the NHS down and left it on the brink. A reorganisation that was meant to put GPs at the heart of the NHS has left patients waiting days or even weeks to get a GP appointment. This week, there was news that the NHS has missed its cancer standard for the third quarter, leaving thousands of cancer patients waiting more than two months for treatment to start. It is a reorganisation that has systematically run down the NHS and opened the door for it to be sold off.

[Paul Farrelly (Newcastle-under-Lyme) (Lab)]

The reorganisation was unnecessary. My right hon. Friend is no doubt aware that in Staffordshire a £1 billion cancer contract has been put out to tender. The newly rebuilt local hospital is concerned that that will destabilise its finances. Does he agree that we should be very careful about going down that route without proper consideration?

[Andy Burnham]

The example that my hon. Friend quotes is the best example of the fact that the Government see no limit at all on the scale or extent of privatisation in the NHS, both in terms of the monetary value— £1 billion—and the fact that they are prepared to put cancer services out on the open market.

Francis Report

Paul Farrelly Excerpts

Wednesday 5th March 2014 Commons Chamber

[Joan Walley]

I agree, and in the many meetings that north Staffordshire MPs have had with the University Hospital of North Staffordshire, the hon. Gentleman has made that point, as we all have frequently. We have also said that it is incumbent on us to relay that to the Government, because unless there is a shift and some recognition that the funding assumptions are flawed, no matter who is on the trust board of any new hospital, they will never be able to provide the necessary genuine health care.

[Paul Farrelly (Newcastle-under-Lyme) (Lab)]

I am sorry that I could not be here at the beginning of the debate because of other commitments. Will my hon. Friend pay tribute to the willingness of the University Hospital of North Staffordshire to engage with all MPs across party to resolve the situation? Should we not recognise that in ensuring arrangements for financial stability, there is still a gap of some £15 million to be bridged to ensure that we can proceed on the basis of stability that is needed for the benefit of everyone in north Staffordshire and Stafford?

[Joan Walley]

I am conscious that many hon. Members want to speak. My hon. Friend has pre-empted two points that I want to make, so I will go straight to them.

If we accept that it is the trust special administrator’s report that is taking us forward in north Staffordshire in respect of the application by the University Hospital of North Staffordshire to take over Stafford hospital, there are two aspects to consider. The first is that there is a revenue shortfall of £4 million; and secondly, there is a capital shortfall of £29 million. I raised that matter at Prime Minister’s Question Time last week without realising that I was doing so prior to the written statement having been made available to the House of Commons. It is vital that the Government recognise that this gap must somehow be closed as the University Hospital of North Staffordshire moves forward, possibly under a new name, in taking on responsibility for this. In looking at the figures that have been put forward by the very diligent and committed directors and staff at UHNS, it is vital that the Government take account of the fact that in making a bid to take on services, those people know what they are doing, they have the expertise, and they know what changes will be needed for capital investment in Stoke and in Stafford. The gap should be closed; otherwise, Stoke-on-Trent will end up paying for the cost of bailing out Stafford hospital.

[Joan Walley]

It was suggested earlier that we might need a special debate, at length, solely on the trust special administrator, so that we can look at how this is being resolved in Staffordshire, and I would agree with that. There was also a suggestion in a previous debate that we need a debate solely on the Care Bill and its implications for changing that. Lots of different things are going on in parallel, but not in an integrated way. The real failure would be for the Government to allow the two procedures to go forward without understanding the changes made in the Health and Social Care Act 2012 which shift all the responsibility from the Secretary of State down to the commissioning bodies.

The hon. Gentleman is absolutely right. Here we are again trying to find some way of having a centralised Government system, when no matter what anybody says to the TSA or to anybody else, if the local commissioning group chooses not to go ahead and commission the services that the TSA has identified and the Government have said will be funded, those services will not be provided. I cannot understand how we are in this situation where we are not looking at all the implications of what is happening.

When the Government announced last week in a written statement that they had accepted in full the recommendations of the TSA’s report, I expected that, as a result, the UHNS would proceed quickly to implement what had been agreed in the hope that there would be a process to close the funding gap in one way or another.

The problem that I wish to give back to the Government and ask them to comment on in detail—the Secretary of State has had a detailed letter from me about this—is the uncertainty that arises as a result of the comments that were made by the Prime Minister and in a statement about obstetrics-led and consultant-led maternity provision in Stafford. On an emotional level, I absolutely agree that, as my right hon. Friend the Member for Leigh and the hon. Member for Stafford (Jeremy Lefroy) said, we need maternity services in situ that are easily accessible, and not only in Stafford but right across the country. However, my head says that the detailed financial arrangements that we currently have for maternity provision and the model that is apparently proposed do not allow for that kind of option.

We are therefore in a situation whereby people are, rightly, campaigning to have maternity services close to where they live, but the rigid procedures laid down either nationally or locally do not permit the additional funding for that. This is not just about having additional funding but about capacity in the form of trained, expert people able to deliver those services. If neither the funding nor the capacity is there, there is no point in any amount of hoping that we can have such maternity-led services in small district general hospitals, in whatever part of the country. The Government have to address that, but they cannot do so as part and parcel of the way in which they are taking forward the new configuration of health services across north Staffordshire. When the Minister replies, I want a very detailed response to the questions that I have asked the Secretary of State and given to his office, as he is aware; I am grateful for that.

The MPs concerned have met the Secretary of State and the Prime Minister to try to get some clarity on this. Until we get clarity, we cannot proceed to deal with the situation that we now have across mid-Staffordshire and in north Staffordshire. When is NHS England going to report on the further review? May we have a detailed time scale for that? To what extent will that delay the possibility of the UHNS board taking forward the new services? Already, 14 extra ambulances a day are bringing people from Stafford to Stoke-on-Trent, and staff are leaving Stafford hospital. We desperately need certainty about how this is being taken forward. When the Minister replies, the Government must set out in detail how they expect to be able to accept the TSA’s recommendations in full and then add an addendum without there being any mechanism to enable it to be implemented.

[Paul Farrelly]

Does my hon. Friend agree that the Francis report is all about patient safety? What happened at Stafford is a blot on the history of the NHS from a patient safety point of view. North Staffs hospital has reopened beds to cope with the crisis in A and E and admissions on the grounds of patient safety and therefore already has a deficit. The overriding concern of patient safety must mean that any solution for Stafford involving North Staffs has to be financially stable.

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[Paul Burstow (Sutton and Cheam) (LD)]

I will certainly watch the clock very carefully, Madam Deputy Speaker.

I want to pick up on one or two of the contributions that have already been made, particularly that by the right hon. Member for Cynon Valley (Ann Clwyd), with whom I agree about statistics. Given how much reliance we need to place on some of the absolutely key statistics about mortality, the manner and timeliness of their collection and publication, and the certainty with which we can then act, are very important.

The hon. Member for Stafford (Jeremy Lefroy) made a fantastic speech; it was very thoughtful indeed. His comments about the need to listen to individual stories and complaints, which is absolutely key, were echoed in subsequent contributions. It is also important, as he said, for chief executives to see and sign responses to letters of complaint and, indeed, for boards to be much more clearly sighted on, and open to, such issues. He also made it clear that it is absolutely key to join the dots between individual cases in order to identify, challenge and take cases forward.

The hon. Member for Stoke-on-Trent North (Joan Walley) made some very important points about the TSA process, which I think we will come back to next Monday or Tuesday. There are issues about how that system has always operated, how it is evolving and how it is being used, and we need to be clear about what should happen before a TSA process even starts. There are too many examples of the NHS not being very good at changing services and making compelling cases to the population. Too often, the case is made behind closed doors and then sold as a finished product to the public, rather than being co-designed by the public and stakeholders such as hon. Members, local councillors and many others. Until the NHS has a culture that is open to that sort of approach, we will always wind up with a crisis in administration, health care or finance that gives the pretext for triggering a TSA process. For those reasons, the hon. Lady is right to raise the issue.

[Paul Farrelly]

Will the right hon. Gentleman give way?

[Paul Burstow]

I cannot, because of what Madam Deputy Speaker has said.

My main point is about mental health. It is important that we discuss mental health in the context of Francis, because in their response the Government said:

“Whilst this poor care was in a hospital, poor care can occur anywhere across the health and social care system.”

That is absolutely right and we need to keep it in mind. I very much support the work the Government are doing to change the culture and to have more openness and compassion, and I think that an ethic of learning is part of that.

I want to focus on mental health because we could be in danger of missing it out in all this. I am convinced that there remains an institutional bias in how mental health is treated, and that needs to be tackled. We still have a long way to go to deliver the parity of esteem that this Government have put into legislation, that we have established in policy and that is now accepted, I think, as what we should all aspire to.

Francis talked about

“an engrained culture of tolerance of poor standards”,

which the issue of mental health throws into stark relief, including premature mortality figures that show a huge gap in life expectancy for those with severe mental health problems; the fact that only one in four people with mental health problems receives any treatment; and the absence until next year of waiting time targets, standards, choice and proper measurements for mental health.

The NHS has always treated mental health as a poor relation to physical health and it has a long way to go to catch up, but I welcome the fact that this Government are taking some of those steps. We need to take them as rapidly and as sensibly as we can. Another example is the routine failure to provide NICE-recommended treatments. The iniquity whereby some things are “must dos”, while others just become nice NICE things to do, cannot be right and must be changed. It is good news that my hon. Friend the Minister of State is leading work on changes to standards.

Francis talked about a failure to put patients first in everything that is done. We see that with the 7,700 people who end up in a prison cell, which they call a place of safety. The most recent figures include 41 children, which is a shocking indictment and is surely unacceptable. I just wonder whether the time has come to consider whether to attach a sunset provision to the use of powers under section 136 of the Mental Health Act 1983 so that, over the next three or four years, we work towards no children finding themselves in a prison cell because of a mental health crisis and, in due course, no adults finding themselves in a prison cell—

--- Later in debate ---

[Mr Cash]

I shall not engage in a vicarious ping-pong match with the hon. Lady. The point has been made and taken—I see that the Secretary of State is nodding—and I know that other people wish to speak, so I shall try to bring my remarks to a close.

[Paul Farrelly]

I pay tribute to the hon. Gentleman for his persistence, and to the work of the hon. Member for Stafford (Jeremy Lefroy), who was elected only in 2010; this has been the dominating subject of his time in the House.

As well as concerns about the length and cost of the administration process, the University hospital of North Staffordshire has raised concerns that it has not been able to do its own full due diligence at the same time. We cannot quite put our finger on whether that has been because of the administration process or concerns about competition. Does the hon. Gentleman agree that when such situations arise in future—and hopefully that will be rarely—we will need to speed things up in a collaborative way and that competition issues will not surface?

[Mr Cash]

I am concerned that there should be a maximum degree of co-operation and collaboration, and perceptible unity has been demonstrated across the Floor of the House on the question of achieving co-operation in the national interest. It is extremely good that that is happening. This is not just about us as MPs; this is much, much more important. This is about victims, patient care, zero harm and people having confidence in the health service. It is absolutely essential that across the Floor of the House we achieve the maximum possible amount of collaboration on this matter.

I wrote to Mr Francis in July 2009 to ask for an inquiry under the 2005 Act, and expressed my concerns regarding the Healthcare Commission investigation at that time. In fact, in that January I had submitted a list of questions, which I had put together with Cure the NHS, Ken Lownds, Julie Bailey and Deborah Hazeldine, to ask what the Healthcare Commission was going to do by way of a report. The HCC reported in March and I hope that our intervention at that point was helpful. If those questions had not been asked, I am not quite sure what the HCC would have said. I was concerned that the reviews by Dr Laker, Professor Alberti and David Colin-Thomé were not as independent as I felt they should be. That is what led me to step up my campaign for the 2005 Act inquiry, for the reasons I gave at the beginning of my remarks.

I pay tribute to all those, from all parts of the House, who have helped to address the matters with which the Francis report has so ably dealt. I remain concerned that some people who should have given evidence were not called to do so, but we now have the report. At long last, after calling for a debate on, I think, 15 occasions, we are holding it. I am absolutely delighted that we are making progress nationally to improve the national health service. Long may it continue.

Mid Staffordshire NHS Foundation Trust

Paul Farrelly Excerpts

Tuesday 7th January 2014 Westminster Hall

[Jeremy Lefroy (Stafford) (Con)]

Thank you very much, Mr Crausby, for calling me to speak. It is a pleasure to serve under your chairmanship. Given the interest of several colleagues from the Staffordshire area, with your permission I will take a number of interventions in the course of making my remarks.

On 18 December, the administrators of the Mid Staffordshire NHS Foundation Trust published their final report. It recommended the dissolution of the trust as soon as possible and the absorption of Stafford and Cannock hospitals into the University Hospital of North Staffordshire NHS Trust and the Royal Wolverhampton NHS Trust respectively. It also set out proposals for the services that would continue to be offered at both Stafford and Cannock. The total cost over three years would be £220 million, of which £63 million is revenue and £157 million capital.

Let me first address the proposal to dissolve MSFT. I believe that is the right thing to do. It will enable both Stafford and Cannock hospitals to work much more closely with larger specialist teaching hospital trusts. They will both then be able more easily to recruit clinical staff who see greater opportunities for skills development within a larger organisation working across two or more sites and overhead costs will also be reduced.

However, the administrators’ proposals do not go far enough in ensuring that the interests of those who currently use MSFT are fully taken into account. Monitor and the Secretary of State clearly need to state that the expanded trusts should immediately recruit suitable non-executive directors from the areas served by MSFT, such as Stafford, Cannock, Penkridge, Rugeley, Stone, Brewood and so on, to ensure that those areas are properly represented.

[Paul Farrelly (Newcastle-under-Lyme) (Lab)]

Under the proposals, the University hospital of North Staffordshire will take over Stafford hospital. North Staffordshire hospital has a deficit at the moment, caused by reopening beds to cope with blockages in A and E and in admissions. Does the hon. Gentleman agree that in taking over Stafford hospital, it is very important and in the interests of everybody—everybody in Stoke-on-Trent, Newcastle-under-Lyme and Stafford—that the University hospital of North Staffordshire has the prospect of attaining financial stability?

[Jeremy Lefroy]

I thank the hon. Gentleman for his intervention and I entirely agree with him. I would see the situation more as two hospitals coming together, but it is vital that the financial difficulties that UHNS is facing are sorted out. I particularly urge the Government to look at the private finance initiative cost, which is too great for that particular trust.

National Health Service

Paul Farrelly Excerpts

Wednesday 26th October 2011 Commons Chamber

[Andy Burnham]

No. Let me explain the position to the hon. Lady so that she understands it. It is correct that in the previous Parliament, not Monitor, but the chief executive of the NHS, suggested that the NHS would have to make around £20 billion of efficiency savings over the four years of this Parliament. That is called the Nicholson challenge, which I accepted. However, contrary to what the Prime Minister said at the Dispatch Box last week, it was intended that every penny of that money would go back into the NHS to help it to deal with the pressures that it faces. I am afraid that the Government are again misrepresenting my position.

My position is different from the Secretary of State’s because that challenge, on its own, would have been all-consuming for the NHS, meaning that it would have had to focus every ounce of its energy on rising to that challenge. The last thing in the world that the NHS needs is a huge reorganisation, because it will take its eye off the ball, meaning that it cannot rise to that challenge.

[Paul Farrelly (Newcastle-under-Lyme) (Lab)]

Is my right hon. Friend aware that during the so-called “pause for thought”, nothing was done to stop the NHS reorganising ahead of legislation that was yet to go through Parliament? Was that not contemptuous of both Parliament and of the genuinely held concerns of Liberal Democrat coalition partners?

[Andy Burnham]

Frankly, it is disgraceful that primary care trusts were allowed to disintegrate before Parliament had given its consent to those changes, leaving the NHS in limbo in most communities represented in the House. I have said that the Government have put the NHS in the danger zone, and I mean it. There is no capacity on the ground to help the NHS through these difficult times. It has lost the grip it would have needed to take us through the financial challenge, and I lay that charge directly at the Secretary of State’s door.

--- Later in debate ---

[Grahame M. Morris]

rose—

[Paul Farrelly]

rose—

[Bob Blackman]

rose—

[Joan Ruddock]

rose—

[Paul Farrelly]

rose—

[Barbara Keeley]

rose—

[Mr Lansley]

In this motion, there is nothing to recognise the contribution from NHS staff; it just denigrates them. It says nothing about people who rely on the NHS to care for them.

[Paul Farrelly]

rose—

[Joan Ruddock]

rose—

--- Later in debate ---

[Mr Lansley]

Thank you, Mr Deputy Speaker.

[Paul Farrelly]

Will the Secretary of State give way?

[Mr Lansley]

It is surprising that I am being embarrassed by so many interventions from the Labour Benches, because there are so few Labour Members here. I remember that before the election it was my recurrent experience that when we held Opposition day debates on the NHS, the Labour or Government Benches were nearly empty while our Benches were pretty full of Members who, because of our commitment to the NHS, were seeking to make points about it. Funnily enough, it does not seem to have happened in reverse. The Government Benches are still full while the Opposition Benches are nearly empty. [Interruption.]

[Paul Farrelly]

rose—

[Mr Lansley]

I will give way to the hon. Gentleman. [Interruption.]

[Paul Farrelly]

I thank the Secretary of State. [Interruption.]

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. There are too many side comments coming from the Front Benches. Let us carry on with the debate. I am sure that the Secretary of State does not need any help.

[Paul Farrelly]

Staff of the High Street medical practice at Newcastle-under-Lyme are dedicated and hard working, yet that practice, which has 5,000 patients, is being forced to close. The Secretary of State has written me a letter, from which it is quite clear that closing directly run GP practices with salaried doctors is NHS policy. It is also clear that the closures are pre-empting proposed legislation to abolish PCTs, which is yet to go through Parliament. If the Secretary of State believed in a patient-focused NHS, surely he would be trying to save such practices, not encouraging their closure.

[Mr Lansley]

I will not delay the House at length with further explanation of what I wrote in my letter, as the hon. Gentleman quite properly raised the matter with me at topical questions. It is our intention to move to more consistent commissioning of primary care across the country through the NHS Commissioning Board, but the driver for that is still local decisions about what GP services should be available in an area and which practices are involved. The hon. Gentleman knows from my letter that this is the view of the local primary care trust. In future, it will be for the health and wellbeing boards, not least the clinical commissioning groups, to look at whether primary medical services can be provided with or without the sort of facilities that the hon. Gentleman mentioned.

Oral Answers to Questions

Paul Farrelly Excerpts

Tuesday 18th October 2011 Commons Chamber

[Mr Burns]

My hon. Friend has asked an extremely reasonable question, and I can give him the assurance that he seeks.

[Paul Farrelly (Newcastle-under-Lyme) (Lab)]

PCTs in Staffordshire are pre-empting legislation by merging and reorganising now, which has led to plans to close the high street practice in Newcastle-under-Lyme simply because it is run by salaried GPs. Is that really NHS policy? If not, what will the Secretary of State do to help 5,000 patients rescue a much-needed surgery?

[Mr Lansley]

Nothing that is being done pre-empts legislation. What is being done in relation to primary care trust clusters is being done under existing legislation, and was necessary not least to enable us to achieve a reduction of £329 million in management costs in the first year following the election. In contrast, there was a £350 million increase in the year before the election under the hon. Gentleman’s right hon. Friend the Member for Leigh (Andy Burnham).

I do not know the circumstances of the centre to which the hon. Gentleman referred because the decision will have been made locally and will not have involved me, but I will gladly write to him about it.

Lewisham Healthcare NHS Trust

Paul Farrelly Excerpts

Friday 12th November 2010 Commons Chamber

[Jim Dowd (Lewisham West and Penge) (Lab)]

May I say in passing that I agree totally with the comments of my hon. Friend the Member for Stoke-on-Trent North (Joan Walley)? The private Member’s Bill process in this place is chaotic and we need to overhaul it.

I am grateful to Mr Speaker for giving me the opportunity to raise an important local issue. This is the first time, Mr Deputy Speaker, that I have spoken in the Chamber under your wise and sagacious chairing of our proceedings. I welcome you to the Chair.

I welcome the Minister to his place. We shared a number of experiences—I found them entertaining; I am not sure whether he did—a few years ago on the Health Committee. I suspect that if most members of the Committee had been asked whether they thought he would be occupying his current position, the view might have been that he would not. However, he has got there, and regardless of the Government arrangements, he got there completely on merit. I wish him well in the post that he holds and in his efforts to discharge his duties.

May I point out a mistake on the Order Paper which is entirely of my making? I tabled the title that appears on the Order Paper for the debate, but I have not been keeping up with developments. Lewisham Hospital NHS Trust is now Lewisham Healthcare NHS Trust. It assumed responsibility for primary care functions some 100 days ago and has now expanded to the health care trust. There was supposed to be a celebration yesterday of those first 100 days of responsibility for primary care, but that was cancelled. I am sure there were a number of reasons, but the disruption caused by the events that I am about to describe may well have played a part in that.

University hospital Lewisham has made remarkable progress over the past dozen years or so, the last eight of which have been under the stewardship of the current chair of the trust. For many years previously it was the poor relation in inner south-east London, without the kudos or connections of its much more illustrious neighbouring cathedrals of medicine in the shape of Guy’s, St Thomas’ and King’s College hospitals. In 1990, under the previous Tory Government, it was used as a pawn and a make-weight in the ill-fated attempt to set up the Guy’s and Lewisham self-governing trust. When that ploy failed, it was separated as Guy’s was linked to St Thomas’, and it has prospered ever since as an independent trust.

The notable achievements in recent times and the improvements in services over recent years have included the more than £70 million private finance initiative project at the Riverside block and improved maternity services, including one of the best birthing centres in London and therefore in the country. There have been improvements in paediatrics in the primary care centre. It has achieved some of the lowest hospital acquired infection rates in the country. During a recent stay in King’s College hospital I acquired MRSA, so that has a certain resonance with me. Just 10 days ago, work commenced on the latest stage of building there, which will run through until autumn 2011, including a new urgent care centre, upgraded and refurbished A and E facilities, new and refurbished children’s and adults’ out-patient suites, and a new main entrance and reception.

The financial management of the trust has been outstanding in recent years. Earlier in the year, as part of the Challenge Trust Board funding scheme, KPMG was asked to review the trust and measure its performance against nine domains: good business strategy, financial viability, well governed, capable board to deliver, good service performance, clinical leadership, local health economy, clinical strategy and performance. On a traffic light rating, they were all well into the green, as a net result of which the Challenge Trust Board awarded Lewisham £4 million to pay off historical cash deficits, and KPMG concluded that the

“Trust has rectified the problems that caused the trust to fall into deficit and has a platform for a medium term sustainable position”.

This organisation has not only done well; it continues to do well. It has set its ambition to become a foundation trust within two or three years. It has demonstrated the benefits of strong executive and non-executive leadership. Why then has the chair not been reappointed, or, to put it in plain language, why has he been sacked? He has been a personal acquaintance of mine, colleague and good friend for more than 30 years, and we have served variously on a number of organisations, including Lewisham borough council and Lewisham and North Southwark district health authority before it was abolished by the previous Conservative Government in 1990.

I raise this matter not at the chair’s request—he is a man of such natural modesty and charm that if it was left to him, I am sure that I would not be allowed to raise it at all—but because I want to express my outrage at the way in which he, and by extension, Lewisham Healthcare NHS Trust and the people of Lewisham have been so badly treated by the travesty of a process that has resulted in his not being reappointed. I also have to raise it because although the Appointments Commission has a complaints procedure, under item 8 on remedial action, it says that what shape such remedial action may take will vary from case to case, but in general one of the principles that will apply is that

“where an appointment has been made, this cannot be overturned.”

So clearly the die has been cast and we will have to live with the consequences.

The chair was appointed in 2002, and he was re-appointed, uncontested, in 2006, with the term ending on 31 October this year, just a few weeks ago. The process to find a new chair was implemented in August, and, under the regulations, he could serve a maximum of only two more years in the post before reaching the 10 prescribed. That was well understood by everybody involved in the health care community in Lewisham, by the chair, and by those who encouraged him to stand. Such is his reputation among the stakeholders, partners and others with knowledge of health care provision in Lewisham that many of them encouraged him to stand for those extra couple of years, including Ann Lloyd, the appointments commissioner for London, and Sir Richard Sykes, the then chair of NHS London, to get Lewisham Healthcare NHS Trust to the verge of foundation trust status.

Everybody understood the process. As the regulations said:

“At the end of an individual’s second term of office the post will automatically be the subject of an open competition. The office holder will be free to apply provided they have served less than 10 years in the same post and will be considered alongside other candidates.”

Everybody knew that to be case. However, such is the support for the current chair of the trust that, to my certain knowledge, many other candidates—including a former Member of Parliament—who would have applied had the competition been completely open, did not do so out of respect for, and trust in, the work that the existing chair of the trust had done. Either knowingly or unknowingly, the Appointments Commission and the strategic health authority have between them served to reduce the pool from which a suitable candidate to chair the trust might be found.

Most people understood that the current chair would serve for another two years, and that during that period a completely open competition would be held, in which all those who had any suitability or intention to become the chair could have stood. By skewing the process, as they have, those organisations have denied the people of Lewisham the opportunity to look at the best possible candidates.

[Paul Farrelly (Newcastle-under-Lyme) (Lab)]

My hon. Friend is certainly not alone in his concern about such issues. The west midlands regional health authority has decided not to appoint the chairman of the University hospital of North Staffordshire, Mike Brereton. Today, indeed, is Mike’s last day, yet the authority has not given any reasons either to the public or MPs. It has failed to draw up a shortlist for a successor, and I now learn that it has made a temporary appointment for one year. May I put on the record our appreciation of Mike Brereton’s long record of public service in north Staffordshire, and our deep concerns, like that of my hon. Friend in his area, about the west midlands regional health authority’s secret and unaccountable way of going about the process?

[Jim Dowd]

I am grateful to my hon. Friend. Incidentally, I gave way because, if I had not, he might have punched me and I did not want to tempt providence. I accept his point, however. The Appointments Commission will of course be abolished in a couple of years, but unreasonable, undue and improper influence has been exerted over the appointment of people to such positions, and the losers will ultimately be the local communities that they attempt to serve.

I recognise readily that there is no automaticity to reappointments, and nobody should expect there to be. That point was equally well understood by all those involved in the process, and I offer no comment on the ability or personal qualities of the chosen successor. I have met her just the once and formed a mildly favourable impression. The only reason why I met her is that my constituency boundary changed at the last election to include parts of the borough of Bromley, and she is chair of Bromley primary care trust. I have no reason to believe that she is complicit in any of the mishandling and misconduct that I believe has taken place.

At best, there has been incompetence and, at worst, improper interference. A couple of weeks ago, Professor Mike Spyer, the interim chair of NHS London, contacted the existing chair of the Lewisham Healthcare NHS trust to inform him that the Appointments Commission would not be reappointing him as he could be appointed for only two years, which was insufficient time to see the organisation through to foundation trust status. That is complete and utter nonsense. That fact was known before NHS London and the London commissioner, among others, encouraged him to stand for re-adoption as the chair of the trust.

The existing chair then received a letter from the Appointments Commission, which explained that the decision not to reappoint him

“was based on the advice of the interview panel and recommendation of the appointments commissioner and represented the overall best ‘skill mix’ for the board.”

That is complete and utter baloney. It is nothing more than an unconvincing collection of cliché and waffle to hide the fact that the board had clearly made up its mind. Why has the board not had the correct skill mix previously, I wonder? Why has it asked the existing chair to stay on until the end of the year? Because of its incompetence, the new chair cannot take up the post because of her position with Bromley PCT until the end of the year. The board has asked the existing chair to stay on for an extra couple of months, but clearly the skill mix on the board during that time will not be optimum, by definition. It speaks volumes about the character, dignity and integrity of the existing chair—and his dedication to Lewisham hospital and to health care in Lewisham—that he has said that he will stay on to facilitate the changeover to the new chair.

I contacted the Appointments Commission as soon as I heard about this outrage. I sent a letter to its chair, and she replied:

“I am sorry that you have concerns about the manner in which this campaign was conducted and hope to reassure you that it was carried out in line with best practice and in accordance with the Code of Practice issued by the Office of the Commissioner for Public Appointments.”

Well, Ms Anne Watts CBE, chair of the Appointments Commission, you have not reassured me at all. Incidentally, the letter plumbs new depths of disingenuousness by telling me that for “reasons of confidentiality” Ms Watts cannot confirm whether the existing chair was a candidate for the post—how very unco-operative. I had to make my own inquiries into the matter. She went on:

“Seven candidates applied, 3 of whom subsequently progressed to the interview stage…An excellent and experienced candidate with a sound background in NHS leadership locally was identified from among those interviewed, and an announcement regarding an appointment will be made in due course.”

Yes, that candidate was appointed—that candidate was the existing chair, but he was not appointed as the chair of the trust, though.

I received a letter from the incoming chair in her capacity as the chair of Bromley PCT. It is dated 5 November, and says:

“Thanks to the generosity of the outgoing chair…I am able to stay in Bromley until 31 December, which gives me time to ensure that appropriate transition measures are in place. However, I shall start my induction in parallel with working my notice at Bromley.”

That is fine. However, that letter is dated 5 November, and I know for a fact that until 10 November—five days after the letter was written—the existing chair in Lewisham had not made the decision to stay on until 31 December. I do not know who is trying to convince whom of what, but I suspect that there has been a degree of duplicity; as I say, I do not expect the successor chair to have been part of that, but there has been.

The whole process has been chronically mishandled. The strategic health authority, London NHS and the Appointments Commission have completely let down the institution of Lewisham hospital and the people of Lewisham by their abject failure to ensure that the best available candidate was appointed to the post. The new chair might well survive a totally open process in future, but because there has not been one, we shall never know.

Clearly, I will need to establish a working relationship with the trust and its executive and non-executive members—previously, that has been very good—and I will need to establish such a relationship with the new chair as we work for the common purpose of promoting the interests of the people of Lewisham. But that has been made extremely difficult by this astonishing catalogue of failure.