Accountability and Transparency in the NHS

Debate between Steve Barclay and Andy Burnham

Thursday 14th March 2013 Commons Chamber

[Andy Burnham (Leigh) (Lab)]

What happened at Stafford hospital was a betrayal of everything the NHS should stand for. We will face up to what went wrong and I will say more about that today. I repeat the apology to the families of people who suffered appalling abuse and neglect.

We must do more. People affected will be watching this debate and rightly wondering what it will achieve. They want to know what is going to change and when. The time has come for cross-party agreement on a way forward, and that is my hope for this debate. There must be more accountability and transparency, and that is why we support the motion.

We also support the Secretary of State’s ban on gagging clauses. It builds on statements made by the previous Government, which in turn were a response to previous scandals. That provides a crucial context for today’s debate.

In 1997 Labour inherited the job of responding to the Bristol heart scandal and the Harold Shipman murders. A series of major policy developments followed on patient safety, inspection and regulation. We passed the Public Interest Disclosure Act 1998, protecting whistleblowers. We published data that had never before seen the light of day on survival rates from heart and stroke care, and 1999 saw the first ever independent regulation of hospitals and care standards.

In 2001 we established the National Patient Safety Agency, which has sadly since been abolished and, in 2006, on the back of the public inquiry by Dame Janet Smith, the General Medical Council and the Nursing and Midwifery Council were reformed to end the professional closed shop. The truth is, however, that well-meaning as those steps were, there were places where the underlying culture of the NHS did not change and that is an important lesson for us all. When we make statements in this place and pass policies, we assume that everything changes on the ground, but it does not.

The previous Government made similar statements to that made by the Secretary of State today, yet the use of agreements persisted. Why was that? The answer is that there is a culture in the NHS—a tendency to pull down the shutters and push people and complaints away when things go wrong—that is more ingrained than we might think.

[Stephen Barclay (North East Cambridgeshire) (Con)]

On the subject of pulling down the shutters, will the right hon. Gentleman confirm that the world-leading expert, Professor Sir Brian Jarman, wrote to him in March 2010 listing concerns about 25 hospitals with high mortality rates, and that both the right hon. Gentleman and the Care Quality Commission took no action?

[Andy Burnham]

No, I will not. I was copied into an e-mail by Professor Brian Jarman in mid-March 2010 and, having asked the CQC to investigate what he had said, I wrote back to him on 31 March 2010. That was literally my last duty as Secretary of State for Health after the general election was called. I was not able to respond further to inquiries. It is important to provide some balance to the hon. Gentleman’s comments.

Changing the culture in the NHS requires vigilance and persistence. As Robert Francis says, we have all been too remote from the front line.

The foundation trust reform was a serious attempt to end the top-down culture in the NHS, bringing more accountability and transparency. If we look back, however, we will see that, when the centre stood back, there were places where an unhealthy local culture became even more firmly established. In some trusts a national top-down style was replaced with a local top-down, bullying style, which can be even worse. I can remember the shock I felt on reading the first Francis report’s finding that, on receiving FT status, one of the first things that the Mid Staffs board did was to resolve to hold more meetings in private. That was an audacious breach of the spirit of the legislation passed by this House.