International Health Regulations

Suella Braverman Excerpts

Tuesday 14th May 2024 Commons Chamber

[Andrew Stephenson]

We will not be handing over any kind of control over what we do domestically; national sovereignty is a clear red line, as I made clear in my opening remarks. It is important to recognise that there are challenges with these things, which are being negotiated within the existing international health regulations. The director general of the World Health Organisation already has the ability to declare a public health event of international concern and issue temporary recommendations that provide non-binding guidance to member states. We believe that we need to stay in a situation where the World Health Organisation has an important convening role internationally to discuss issues, but the domestic response to any future pandemic is for domestic Governments to make. Anything that impinges on UK national sovereignty will therefore be unacceptable to us.

[Suella Braverman (Fareham) (Con)]

I want to put on the record my thanks to the Minister for his hard work and for taking the time last week to meet me and colleagues to discuss the terms of this treaty. He will know that I am profoundly sceptical about the World Health Organisation’s ability to manage a global pandemic, in the light of serious errors of judgment, poor leadership and, I am afraid, well-chronicled conflicts of interest that have subsequently emerged. Of course we can help poorer countries and collaborate with other nations, but under no circumstances must we surrender our sovereignty or sign up to a lockdown charter. I hear what he says about how the text currently on the table does not bind our hands, but he will know, as many of us do, that in the heat of an emergency during a real pandemic, irresistible pressure will mount on a Government to make decisions that may well turn out to be wholly harmful, as we found, and the wrong decisions for the good of the country. Will he agree that, fundamentally, to coin a phrase, no pandemic treaty is better than a bad pandemic treaty?

[Andrew Stephenson]

I 100% agree with my right hon. and learned Friend that no treaty is better than a bad treaty. However, if we scroll back to why this process was originally started, it was the former Member for Uxbridge and South Ruislip who led the international calls for this accord. The reason behind it is that we believe that commitments on stronger international collaboration and co-operation on global health are crucial to securing the UK’s health and economic security. However, domestic decisions still have to be left to sovereign nation states to take the right decisions for their countries. I think there is a lot of agreement between my right hon. and learned Friend and me, and I thank her once again for engaging in such constructive fashion and for meeting me to express her and other parliamentarians’ views.

NHS Funding Bill

Suella Braverman Excerpts

Legislative Grand Committee & 3rd reading: House of Commons & Legislative Grand Committee: House of Commons & Programme motion: House of Commons & 3rd reading & Programme motion
Tuesday 4th February 2020 Commons Chamber

[Alex Cunningham]

I am glad that he is nodding his head. Ten years ago, the Tory-Lib Dem Government cancelled the project, despite the fact that it was a priority for the country and for the national health service, so I hope that we can now have a meeting and actually start to motor on this. I am pleased to see the Minister smiling, and I hope that he can leave me smiling as well.

[Suella Braverman (Fareham) (Con)]

I rise to speak in favour of the clauses in the Bill and against the amendments. I do not think that the latter add anything material, and they ignore the vast improvements in mental health under this Government in recent years. One in four adults will experience mental health illness in their lifetime, and that is obviously a high incidence of mental health illness. It shows the growing concern around this issue as well as a growing awareness, and, I have to add, a growing commitment by today’s Government, but we cannot ignore the fact that there are many challenges in the system and many areas for improvement.

I want to talk briefly about the Government’s record. I fully support their commitment to providing funding for mental health services, which will mean that those services’ funding will increase faster than in other areas of the NHS. I hope that much of that funding will go towards the frontline in teaching and education. Perhaps the Minister will address this in his closing remarks.

I meet many education professionals in Fareham who report an increase in the incidence of mental illness among their young people and finding the cost of providing counselling and support an additional burden on their budgets.

It is important to note that by 2023-24, under the proposals in the Bill, at least an additional 345,000 children and young people under 25 will be able to access support via NHS-funded mental health services. That is a welcome aim, and I am confident that we will meet that target under this landmark funding commitment. That progress is hugely welcome, and I am glad that the Government have made children and young people’s mental health a top priority within the NHS, which is halfway through a major programme to improve access to specialist services, supported by £1.4 billion of funding. I congratulate the Front-Bench team and the Government on that work.

Health

Suella Braverman Excerpts

Tuesday 14th May 2019 Commons Chamber

[Suella Braverman (Fareham) (Con)]

I am pleased to speak in this debate about local public health, but the Opposition are seriously off target in calling for it in the first place. Of all Government budgets, the NHS has had record investment since 2010 and, although I am not going to do Labour Members’ work for them, there are stronger cases that could have been made about public funding in other Departments. When we look at public health outcomes since 2010, the Conservatives can point to a good record. The Labour party does not have a monopoly on our health service. There is this assumption that Labour somehow knows best and that the solution is simply more cash and more managers, but that is not true at all. I grew up as a proud Conservative and as a daughter of an NHS nurse—my mother worked for the NHS for 45 years. The NHS has been there for my family, for me and for my baby to be, which is due in July. I love the NHS, and just because I am on the Conservative side of the Chamber does not diminish my commitment to it whatsoever.

I want to speak about Fareham, where there are definite challenges when it comes to health services, such as with the mental health services provided by the Southern Health NHS Foundation Trust. I want to put on the record my gratitude to the Secretary of State for meeting me on behalf of some of the families who have been affected by Southern Health’s issues. When it comes to social care, I have met many relatives of elderly residents for whom the system has not worked well, a subject that I discussed in the Chamber some weeks ago.

Notwithstanding those challenges, I want to talk about a fantastic facility in my constituency called Fareham Community Hospital, and I am using my speech to launch a report that I have prepared about a future vision for how we can use the hospital better. When I was first elected in 2015, the No. 1 issue was how to make better use of Fareham Community Hospital. It is a relatively small, relatively new facility in the heart of the constituency, but it remains underutilised, according to several footfall surveys we have conducted. Rooms are frequently booked by various health trusts but still lie vacant, at considerable cost to the taxpayer. Complex lease arrangements render the release of space time-consuming and bureaucratic. There is no coherent public information system or public-facing management to signpost services for local people.

Random and sporadic services are offered. Most recently, phlebotomy and blood testing were removed, much to the disappointment of many residents and to Friends of Fareham Community Hospital, which plays a vital role in co-ordinating volunteers who want to support this asset. In short, the hospital is at risk of becoming a wasted opportunity and a wasted asset.

I set up a Fareham Community Hospital taskforce in 2015 to bring together many of the health providers: the local CCGs; Hampshire County Council; Solent NHS Trust; Southern Health NHS Foundation Trust; Friends of Fareham Community Hospital; Community Health Partnerships Ltd; Portsmouth Hospitals NHS Trust; and University Hospital Southampton NHS Foundation Trust. The sheer number of organisations reflects the complexity of how the hospital is run.

Last year, I ran a constituency-wide survey on how the community would like to see the hospital run better. I am grateful to the many hundreds of people and all the organisations that participated. I am pleased to launch the “Fareham Community Hospital Future Vision” report, which can be found on my website. The report compiles the survey, and it makes seven recommendations.

First, the report welcomes the new primary care same-day access scheme run by local GPs at the Jubilee, Whiteley and Highlands surgeries for the past 18 months, which is a reflection of the historic £4.5 billion commitment at national level for primary and community health. The scheme has been welcomed by the community, and it is working effectively. There is a call for it to be expanded to other GP surgeries. I put on record my thanks to Dr Tom Bertram for leading the initiative.

Secondly, the report recommends that more consideration be given to other clinical priorities. Scanning facilities and using the hospital as a diagnostic centre could be viable options for the future. Thirdly, public health functions should be considered at FCH. A public health hub could support patients with clinical obesity, depression, anxiety and other conditions. Lastly, accessibility is a key theme running through the responses. We need a bus stop at the hospital and a method to enable elderly and ill patients to get to it more easily.

Fareham Community Hospital is a great example of how a local asset is available to a community and how local health providers can come together to make it more responsive to local needs. I am pleased to launch the “Fareham Community Hospital Future Vision” report today, and I hope it provides a starting point for future work.

Oral Answers to Questions

Suella Braverman Excerpts

Tuesday 15th January 2019 Commons Chamber

[Suella Braverman (Fareham) (Con)]

23. Fareham Community Hospital is seeing increased usage these days, thanks to local GPs working together to provide a same-day access scheme. However, patients are disappointed about the lack of a mobile breast screening unit on site. Will my right hon. Friend join me in calling on community health partnerships and Portsmouth Hospitals NHS Trust to explore ways of providing that vital service, which could help hundreds of people every day?

[Matt Hancock]

Yes, I would love to do that. I will raise it with Mike Richards, who is running a review of the future of screening services. I am sure that the whole House will want to join me in congratulating my hon. Friend on her forthcoming use of maternity services in the NHS.

Gosport Independent Panel

Suella Braverman Excerpts

Wednesday 21st November 2018 Commons Chamber

[Matt Hancock]

Yes. I pay tribute to the right hon. Gentleman’s work, especially as a Minister in the Department, to make sure that people got to the bottom of this and that the truth was published and brought out in the way that it has been. He is right about the question of justice, but it is currently—rightly—a matter for the police, so I will go no further than that.

I strongly agree with the right hon. Gentleman that the legislative framework that we set here in Parliament leads to and underpins the culture that is critical. That is, of course, a matter for the whistleblowing legislation. There are also questions of legal liability. As the right hon. Gentleman well knows, often what patients who have been wronged—or the families of patients who have been wronged—want most of all is an apology, an explanation and a commitment that others will not be affected because the lessons will be learnt. Too often what has been offered instead is the phone number of a no-win, no-fee lawyer, and that is not the way to solve this problem.

[Suella Braverman (Fareham) (Con)]

I welcome the Secretary of State’s announcement and his plain and self-evident commitment to learning from this episode and righting the wrongs. The findings of the report are shocking and heartbreaking, and they affect some of my constituents whose families have suffered so much grief because of the life-shortening policy employed at Gosport War Memorial Hospital. Many of them still have questions many years on, about such matters as criminal investigations. I welcome the Secretary of State’s announcement that an external police team will be carrying out an investigation on whether to press charges, but can he provide some guidance on the timeline and whether the police can realistically expect justice to be done, and seen to be done, through the criminal courts?

[Matt Hancock]

My hon. Friend is right. The grief over the loss of a loved one whose life has been foreshortened is compounded if that is not acknowledged by the authorities, and we therefore acknowledge it once again today. As for the police investigation, the timings are of course a matter for the police themselves, who are rightly independent. The process currently under way is the reviewing of all the evidence to establish what and whether prosecutions should be brought forward. That will continue into the new year, and the police will then make a statement on the next stages of their investigation.

Oral Answers to Questions

Suella Braverman Excerpts

Tuesday 14th November 2017 Commons Chamber

[Mr Hunt]

What Simon Stevens noticed, and we all noticed, was that when he came with this plan in 2014 Labour refused to back it, and in the 2015 election they refused to fund it—to the tune of the £5.5 billion more that the Conservatives were prepared to put in, but the hon. Gentleman’s party refused to put in. He is quoting Simon Stevens, who also said that when the British economy sneezes, the NHS catches a cold—it will be far worse than a cold for the NHS if we have Labour’s run on the pound.

[Suella Fernandes (Fareham) (Con)]

3. What progress his Department has made on improving patient access to GPs.

[The Secretary of State for Health (Mr Jeremy Hunt)]

This Government have changed policy so that all NHS patients will be able to book routine GP appointments in the evening and at weekends. That is very important both for NHS patients and to relieve pressure on A&E departments.

[Suella Fernandes]

In September, Jubilee surgery, Whiteley surgery, Stubbington medical practice and Highlands practice launched a same-day access scheme in Fareham, based at Fareham Community Hospital, which had the honour of welcoming the Secretary of State on a visit last year. It is commission-led and supported by Fareham Community Hospital taskforce. Will my right hon. Friend join me in congratulating the GPs—including Dr Tom Bertram, who has taken the lead on this scheme—and Fareham and Gosport clinical commissioning group, and explain how patients will be able to access a GP in Fareham?

[Mr Hunt]

I was honoured to meet them, and Richard Samuel and his team have done a fantastic job in transforming services in a way that reduces pressure on local hospitals, but also improves services for local people. There was a real buzz there. I also note that neighbouring Gosport has made changes that have improved patient satisfaction to 90%, with 60% of issues being dealt with on the same day. So some really exciting things are happening.

Contaminated Blood

Suella Braverman Excerpts

Tuesday 11th July 2017 Commons Chamber

[Suella Fernandes (Fareham) (Con)]

I thank the hon. Member for Kingston upon Hull North (Diana Johnson) for calling the debate and for her indefatigable campaigning on the subject. I congratulate the hon. Member for Oxford East (Anneliese Dodds) on an excellent maiden speech; I am confident that it was the beginning of many excellent contributions in this Chamber.

Many colleagues on both sides of the House have been tireless in their advocacy for the victims of this unspeakable tragedy over many years. I am a relative newcomer to the issue, but I speak today on behalf of my constituent Jackie Britton, who lives in Portchester. Jackie has met me on many occasions, for she, too, has not given up on this fight. She contracted hepatitis C in 1982 from a blood transfusion during childbirth, but she was only diagnosed in 2011. For many years, she has been afflicted with and has suffered from a debilitating illness. Her daughter has also been very ill with various medical conditions.

I am sure that Jackie would welcome today’s news about a public inquiry into this matter. It is clear that the Government are seriously reflecting the concerns and voices of those who have been tragically affected by the incident. The inquiry is the latest in a series of actions taken by this Government over several years. The Government have increased the amount of money spent on payments to victims to record levels since 2016, with an additional £125 million in support funding for those who need it. I am pleased that the Government announced last year that they would reform the package of support measures for those affected. For the first time, almost 2,500 beneficiaries with chronic hepatitis C were eligible to receive an annual payment of £3,500 a year. That progress results from listening and action on the part of the Government.

I will conclude my comments because I am aware that other colleagues want to contribute. There is nothing that anybody can do to change the past, and this awful incident and tragedy, but I hope, for the sake of Jackie and all those victims about whom we have heard today, that the inquiry—the process of discovering the truth and bringing some justice to those affected—will provide some solace and finality to this heartbreaking tragedy.

Southern Health NHS Foundation Trust

Suella Braverman Excerpts

Wednesday 8th June 2016 Westminster Hall

[Suella Fernandes (Fareham) (Con)]

I beg to move,

That this House has considered governance of Southern Health NHS Foundation Trust.

It is a pleasure to serve under your chairmanship, Mr Hanson. I am grateful for the opportunity to open this important debate on the governance of Southern Health NHS Foundation Trust, a subject that has been the cause of mounting public concern over recent months. It has risen up the agenda as more information has come to light. It is right that we, as Members of Parliament, now have the chance to address it and to air our constituents’ concerns. For some, that is not a concern of just a few months’ standing, but a story that goes back many years.

For a number of patients under the care of Southern Health and, particularly, for the families and friends of those who have sadly died, this has been a long-running and painful saga. We will not resolve it for them today but we can ensure that the issues they care about are properly aired in public and are brought to wider attention. I pay tribute to those relatives and campaigners, some of whom have come to Westminster today. I was glad to be able to meet with them earlier and to hear from them in person before the debate. I also thank the Minister for sparing the time to join us and to hear their experiences. With the permission of the relatives, I will refer to some of their stories during my remarks and other colleagues may also want to do so, where appropriate.

As well as having a connection to the subject as a constituency MP, I have taken an interest in the wider issues through my role on the all-party parliamentary group on Hampshire and Isle of Wight, on which I lead on health issues. The area covered by Southern Health goes wider than Hampshire, of course, and we have invited colleagues from elsewhere to our meetings when the subject has been under discussion.

Since last autumn, we have had a series of meetings with representatives of Southern Health, most notably with Katrina Percy, its chief executive, and other senior directors. Those meetings have allowed us to put robust questions to them and to hear their side of the story. Although I cannot claim to have been wholly satisfied by the answers we have received, I thank Ms Percy and her team for engaging with us on our concerns. Just yesterday, we had a very useful meeting with the new interim chairman of the trust, Tim Smart, and I extend our thanks to him.

[Mrs Maria Miller (Basingstoke) (Con)]

On behalf of many other MPs from Hampshire, I commend my hon. Friend on securing this debate and on the tenacity with which she has led on the issue on our behalf. She mentioned the appointment of a new chair. Does she feel that, under the new leadership, we will see more assurance from the Care Quality Commission that Southern Health has actually understood what changes are needed for the future? Some CQC reports we have read suggest that the problems that have been raised have not been addressed in a swift manner. Does my hon. Friend share my concern or does she think we will see progress?

--- Later in debate ---

[Suella Fernandes]

I am grateful for my right hon. Friend’s point and I thank her for her work and for standing up for her constituents who have been affected by the issue. We have met with members of the CQC and with NHS Improvement, and we put those points to them directly. I share her concern, particularly on behalf of families and relatives, who would like swifter action in future. However, I am grateful to those organisations for keeping us informed and for taking the time to ensure that MPs are briefed of their actions and plans.

The facts of the issue are well known to many of those here today and to those watching beyond Westminster. However, in opening the debate, it is important for me to recount the broad sequence of events and key facts to help those who may not be familiar with them and because they deserve to be put on the record as the backdrop to the rest of the debate. Let us begin at the beginning.

The tragic starting point of the story was the death of Connor Sparrowhawk. Connor, who had autism, a learning disability and epilepsy, was 18 when he was admitted to Slade House in Oxford in March 2013. The facility was a learning disability short-term assessment and treatment unit run by Southern Health, which had taken it over from the previous provider, Ridgeway, in November the previous year.

On 4 July 2013, Connor was found submerged and unconscious in a bath at the centre. Staff tried to resuscitate him and an ambulance took him to John Radcliffe hospital but, sadly, he died the same day. The initial post mortem examination concluded that Connor drowned as the result of an epileptic seizure. Southern Health carried out a serious incident requiring investigation report and an initial management assessment, and commissioned an independent consultancy to undertake an internal investigation. That investigation concluded that Connor’s death was preventable and stated:

“The failure of staff at the unit to respond to and appropriately profile and risk assess CS’ epilepsy led to a series of poor decisions around his care…The level of observations in place at bath time was unsafe and failed to safeguard CS.”

Following the publication of that first investigation report in February 2014, Oxfordshire Safeguarding Adults Board and NHS England had ongoing concerns about the quality and safety of learning disability services provided by Southern Health in Oxfordshire, and the improvements that needed to be made. They therefore commissioned a further report in June 2014, which was charged with looking at whether the way in which learning disability services were commissioned or managed contributed to Connor’s preventable death.

The new report was published in October last year and contained a number of criticisms. It stated that there had been warnings about the standard of care in facilities including Slade House, and criticised the management processes following the transfer of services to Southern Health. It found that

“for Southern Health to only rely on its normal reporting mechanisms without addressing the…warning and ensuring that information from local managers was accurate was a serious failure.”

It also found that

“the trust did not evaluate or address the known concerns about the quality of local leadership”,

and that:

“An over reliance on a ‘business as usual’ approach to this acquisition was not appropriate.”

The report concluded:

“Southern Health should have ensured that any deterioration in the quality of services could be identified quickly and by processes that Southern Health had confidence in.”

That was the first serious criticism of the overall management of the services.

[John Howell (Henley) (Con)]

My hon. Friend described a catalogue of disasters. From the conversations she has had, what confidence does she have that the situation has been put right? I represent an Oxfordshire constituency. Can we have confidence in doing business with Southern Health?

[Suella Fernandes]

From speaking to families, relatives and patients, it is clear that they are struggling to have confidence in the services provided by Southern Health. The very reason that the debate it happening is so that we can air those concerns and, hopefully, find a pathway to restoring public trust. That is clearly the challenge facing the organisation.

[Mims Davies (Eastleigh) (Con)]

I thank my hon. Friend for securing this important debate. I also thank the Minister for the help that he is giving us across Hampshire and in the Southern Health area, and for taking the issue seriously.

Families feel concerned about their vulnerable loved ones. Despite changes in care plans and promises when things have gone wrong, families are not seeing changes. In fact, they feel that, in very vulnerable situations, it is sometimes better to be at home than in the so-called care of Southern Health. That has come up in constituency surgeries. I, like other hon. Members, feel that this debate and other investigations into Southern Health should get to the bottom of that.

[Suella Fernandes]

I thank my hon. Friend for highlighting the problems communicated to her by families, which echo and reflect the precise concerns about which the families sitting in the Public Gallery feel strongly. They emphasise that this is not an isolated issue. This is something that we all need to take seriously.

The Mazars report is the next chapter in this story. At the request of Connor’s family, NHS England commissioned an independent report into the deaths of people with learning disabilities or mental health problems while under Southern Health’s care. The report reviewed the deaths of people in receipt of care from mental health and learning disability services in the trust between April 2011 and March 2015. The report sought to establish the extent of unexpected deaths in those services and to identify issues that needed further investigation.

The report was published in December 2015, and its main findings included, first, that many investigations into deaths were of “poor quality” and took too long to complete. Secondly:

“There was a lack of leadership, focus and sufficient time spent in the Trust on carefully reporting and investigating…deaths”.

Thirdly, there was a lack of family involvement in investigations after a death and, fourthly, opportunities for the trust to learn and improve were missed.

Of the 1,454 deaths recorded at the trust during the period under investigation, 722 were categorised by the trust as unexpected. Of those, the review looked at 540 and found that only 272 unexpected deaths received a significant investigation. The report did not specify how many investigations there should have been, but it drew attention to the limited number of deaths that were investigated in different categories. The trust has questioned the use of some of those figures, but the picture painted overall was one of inconsistent standards for investigations, raising the worrying prospect that an unspecified number of deaths may not have been investigated properly. The question of whether there may have been other preventable deaths like that of Connor Sparrowhawk could not be definitively answered, which has led to a great deal of concern among the trust’s patients and something of a breakdown in confidence. Understandably, people want to know that they or their loved ones will be safe in the care of Southern Health. Those whose relatives have died while under the trust’s care need reassurance that the investigations were properly conducted and that the deaths were not also the result of avoidable errors.

My constituent Richard West is one of those relatives. His son, David, died in 2013, and he has been seeking answers from the trust ever since. At times, the handling of his case has been very poor indeed. Mr West, a former detective and policeman, says that he was ignored and was even told by a representative of the trust that the deaths of patients in its care were “like an airline losing baggage.” I know from speaking to other families that others have experienced similarly insensitive treatment.

The Mazars report contained serious and specific criticisms of the trust and its management. In particular, it levelled criticism at the board itself for the failures. It found that

“there has been a lack of leadership, focus and sufficient time spent on reporting and investigating unexpected deaths of Mental Health and Learning Disability service users at all levels of the Trust including at the Trust Board.”

[Mr Andrew Smith (Oxford East) (Lab)]

I applaud the hon. Lady on securing this debate and on her excellent speech. In just about any other organisation, such a searing indictment of the board and, by implication, its executives would have resulted in their resigning. Is she surprised that they did not simply stand down and accept responsibility, as they should have?

[Suella Fernandes]

There is a lot of pressure from the public, patients and families for people to step down, and the resignation of the chairman of the board is a reflection of the seriousness with which Southern Health takes this issue.

The report continued:

“Due to a lack of strategic focus relating to mortality and to the relatively small numbers of deaths in comparison with total reported safety incidents this has resulted in deaths having little prominence at Board level… There are a number of facets to this poor leadership…: a failure to consistently improve the quality of investigations and of the subsequent reports; a lack of Board challenge to the systems and processes around the investigation of deaths…; a lack of a consistent corporate focus on death reflected in Board reports which are inconsistent over time and which centre only on a small part of the available data; an ad hoc and inadequate approach to involving families and carers in investigations; a lack of focus on deaths amongst the health and social care services caring for people with a Learning Disability; limited information presented at Board and sub-committee level relating to deaths in these groups…; and a lack of attention to key performance indicators…indicating considerable delays in completing…investigations.”

The report also found:

“There was no effective systematic management and oversight in reporting deaths and the investigations that follow… The Trust could not demonstrate a comprehensive, systematic approach to learning from deaths”.

In what I consider one of its most damning findings, the Mazars report also found evidence of repeated warnings being ignored:

“Despite the Board being informed on a number of occasions, including in representation from Coroners, that the quality of the…reporting…and standard of investigation was inadequate no effective action was taken to improve investigations”.

The report also stated:

“Despite the Trust having comprehensive data relating to deaths of its service users it has failed to use it effectively to understand mortality and issues relating to deaths of its Mental Health or Learning Disability service users.”

By any measure, those criticisms were immensely serious and required a robust response.

Following the report’s publication, my right hon. Friend the Secretary of State for Health expressed his determination to learn the lessons of the report and set out a number of measures to address the issues raised, including a focused inspection by the Care Quality Commission looking in particular at the trust’s approach to the investigation of deaths. As part of that inspection, the CQC was asked to assess the trust’s progress on implementing the action plan required by NHS Improvement and on making the improvements required by its last inspection, published in February 2015. Separately, the CQC was also asked to undertake a wider review of the investigation of deaths in a sample of all types of NHS trusts in different parts of the country. That is particularly important because we need to know whether the problems and failings at Southern Health are exceptional outliers or whether there is a similar problem in other parts of the country.

The trust accepted the findings of the Mazars report and apologised unreservedly for the failings identified. NHS Improvement set out in January 2016 its plans to provide assistance to the trust to ensure that it delivers on plans to implement the agreed improvements, which include the appointment of a new improvement director and the taking of advice from independent experts. All those measures were agreed by the trust’s management, and in January we had a letter from the chief executive officer setting that out.

[Kit Malthouse (North West Hampshire) (Con)]

I congratulate my hon. Friend on securing this important debate. She is outlining that there is an improvement plan, that the board has agreed and that NHS Improvement is helping, but one thing that seems to be frustrating people, particularly in my constituency, is the lack of a hard date on which we can judge that the corner has been turned. Does she agree that it would be sensible for NHS Improvement, or the board itself, to set some kind of deadline by which a judgment can be made? Otherwise, improvement is purely on the never-never and we will never know publicly whether the trust has got to where it needs to be.

[Suella Fernandes]

My hon. Friend makes a sensible suggestion, which I echo. A deadline with key targets and dates would be hugely valuable, not only in motivating people and focusing minds but in restoring public trust in all the organisations involved.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I congratulate my hon. Friend on securing this debate, and on her articulate explanation of the issues involved and the tragedies that have befallen a number of patients.

Clearly there has been a failing of clinical governance in the trust on a massive scale. However, I wonder whether my hon. Friend will reflect on two points. First, it is very difficult to deliver improvements in quality in a resource-poor environment, notwithstanding the clinical governance issues, and we know that child and adolescent mental health services and learning disability services have been chronically underfunded for many years nationally.

Secondly, people with learning disabilities often have complex physical healthcare needs as well as mental healthcare needs, and improved staff training needs to be put in place nationally. That needs to be properly resourced and funded if we are to make a meaningful difference and get things right for people in the future.

[Suella Fernandes]

I totally agree with my hon. Friend’s observation. There is a challenge here. This is unfamiliar territory for the NHS, and funding will be necessary to support any new attempt to make progress following debates such as this one.

Inspectors from the Care Quality Commission visited Southern Health as part of the planned inspection during January of this year. Following that inspection, the CQC announced on 6 April that it had issued a warning notice to Southern Health, telling the trust that it must make significant improvements to protect patients at risk of harm while in the care of its mental health and learning disability services. The announcement stated that the notice required the trust to improve its governance arrangements to ensure that there was robust investigation and learning from incidents and deaths, to reduce further risks to patients.

The team of inspectors also checked on improvements that had been required in some of the trust’s mental health and learning disability services following previous inspections. They found that the trust had failed to mitigate significant risks posed by some of the physical environments from which it delivered mental health and learning disability services.

On the wider issue of reporting deaths, the inspectors found that the trust did not operate effective governance arrangements to ensure robust investigation of incidents, including deaths; did not adequately ensure that it learned from incidents, so as to reduce future risk to patients; and did not effectively respond to concerns about safety that had been raised by patients, their carers and staff, or to concerns raised by trust staff about their ability to carry out their roles effectively.

All those findings, and the serious step of issuing a warning notice, reinforce the most serious of the Mazars findings. Dr Paul Lelliott, the CQC’s deputy chief inspector of hospitals and lead for mental health, was quoted as saying that the services provided by Southern Health required “significant improvement”. He said:

“We found longstanding risks to patients, arising from the physical environment, that had not been dealt with effectively. The Trust’s internal governance arrangements to learn from serious incidents or investigations were not good enough, meaning that opportunities to minimise further risks to patients were lost.

It is only now, following our latest inspection and in response to the warning notice, that the Trust has taken action and has identified further action that it will take to improve safety at Kingsley ward, Melbury Lodge in Hampshire and Evenlode in Oxfordshire. The Trust must also continue to make improvements to its governance arrangements for reporting, monitoring, investigating and learning from incidents and deaths. CQC will be monitoring this Trust very closely and will return to check on improvements and progress in the near future.”

The CQC published the full report of its January 2016 inspection at the end of April 2016. It confirmed the concerns that had been raised in the warning notice and gave further details of specific issues. The chairman of Southern Health’s board, Mike Petter, resigned the day before the report was published.

On the same day that the CQC published its warning notice, NHS Improvement issued a statement announcing that it was seeking further powers to intervene in the trust’s governance, to ensure that the trust complies with the improvements required of it. NHS Improvement said that it intended to insert an additional condition into the trust’s licence to supply NHS services, which would allow NHS Improvement to make management changes at the trust if progress was not made on addressing the concerns that had been raised.

The additional condition was imposed on 14 April, and the statutory notice contained severe criticism of the trust and its leadership. It stated that undertakings that the trust gave in April 2014 that it would comply with enforcement notices relating to breaches of its governance conditions were yet to be delivered in full. It notes that additional undertakings were made by the trust in January 2016 in response to the Mazars report and summarises the CQC’s findings from its inspection in January, saying that the warning notice had identified “longstanding risks to patients” that had not been addressed. It then said:

“In the light of these matters, and the other available evidence, Monitor”—

that is, NHS Improvement—

“is satisfied that the Board is failing to secure compliance with the Licensee’s licence conditions and failing properly to take steps to reduce the risk of non-compliance. In those circumstances, Monitor is satisfied that the governance of the Licensee is such that the Licensee is failing and will fail to comply with the conditions of its licence.”

On that basis, NHS Improvement, or Monitor, has imposed a new condition to Southern Health’s licence, requiring that it

“has in place sufficient and effective board, management and clinical leadership capacity and capability, as well as appropriate governance systems and processes, to enable it to”

address the failures in governance

“and comply with any enforcement undertakings, or discretionary requirements, imposed by Monitor in relation to these issues.”

[Kit Malthouse]

I am grateful to my hon. Friend for giving way to me for a second time.

One of the frustrations that I think we have all had throughout this sorry saga has been about the lack of any sense of personal responsibility or line management for particular risks. A thought occurs to me. Can my hon. Friend say who at NHS Improvement will take the decision about whether the trust should be given its licence? I ask that because I have a sense that unless we know who that person is, we will not be able properly to take a view about whether their judgment is right. If the decision disappears into a bureaucratic organisation, it may well never emerge in a timely fashion. Does she have an idea of who is responsible? If she does not, perhaps the Minister could let us know what the processes are regarding the taking of the decision and who finally gets to sign on the dotted line that everything is all right, or not.

[Suella Fernandes]

I agree that there is a real risk, as my hon. Friend says so eloquently, of this issue falling into a bureaucratic abyss. It is absolutely vital that we have clear processes and that the identities of the responsible people and professionals are clear, so that there is a clear line of accountability for users and indeed for MPs.

Following the resignation of Mike Petter as chairman of Southern Health, NHS Improvement exercised its power to intervene to appoint his replacement, Tim Smart, who is now acting as interim chairman. The notice directing the trust to appoint him stated:

“These matters demonstrate that the Licensee”—

that is, Southern Health—

“does not have in place sufficient or effective board management and clinical leadership capacity and capability, as well as appropriate governance systems and processes as required by additional licence conditions. Monitor is therefore satisfied that the Licensee is breaching the additional licence condition.”

Time and again, in report after report, Southern Health has been criticised for its failures of management and leadership, and the effects that those failures have had on the care that it provides. That is why I called for this debate that focuses on the governance of the trust. We all accept that, sadly, tragic failures in care will inevitably occur from time to time, and those at the top of an organisation cannot be held responsible for every incident on the frontline.

Equally, we must pay tribute to the dedicated staff of Southern Health for the excellent care that they give day in, day out for the majority of the time. We cannot and should not tar all of them with the same brush because of the failures of others. However, when clear and systematic problems have been identified, we are entitled to ask that lessons be learned. For me, the most shocking part of the sequence of events that I have just recounted is that right up until this year—indeed, even in the last couple of months—inspectors have stated that necessary changes that have been flagged up as needing action have not been implemented.

When NHS Improvement said in its enforcement notices that the trust was failing in its obligations under its licence and did not have effective border capacity and capability, it used the present tense. That was in April. Since then, Tim Smart has been installed as chairman, and I repeat my thanks to him for meeting my parliamentary colleagues and me yesterday in Westminster. He has been conducting an initial review of governance, and I was pleased to hear that he expects to make some announcements on his findings and proposals within the next month. I am sure I speak for many when I say that we will be looking for some far-reaching changes to recognise the gravity of the situation.

That brings me on to the issue of personnel. I have been asked repeatedly whether I am calling for the resignation of Southern’s executives, and in particular that of Katrina Percy, the chief executive. I have resisted doing so because, as the Minister has said in the House, politicians and Ministers demanding that heads must roll can often cause more problems than they solve. I repeat my thanks to Ms Percy and her team for coming to meet my colleagues and me on a number of occasions to answer our questions. However, I will now say publicly what I told her at our last meeting: I find it difficult to have confidence that she has properly acknowledged the scale of the problems under her leadership or how difficult it will be for patients and families to have their faith in the organisation restored without a visible sign of a fresh start.

Resignations are a matter for individuals, and Katrina Percy has said that she believes her responsibility is to provide stability by remaining in post. I understand that position, but the sheer weight of criticism of the trust’s leadership over a prolonged period while she has been chief executive would lead many to a different conclusion. The fact that NHS Improvement has now taken the power to direct changes at board level if it considers them necessary sends its own message.

[Mims Davies]

It has been my perception that there has been a sort of bunker mentality. Perhaps people are just burying their heads, going through the process and hoping it will go away. Does my hon. Friend agree that there is perhaps a little sense of that pervading Southern Health from the top?

[Suella Fernandes]

My hon. Friend is insightful in her observation, although I do not think it takes a genius to point it out. The catalogue of criticisms and failings is not new to anyone. I can understand the frustration and anger of families and patients when they feel that no substantive and material action is being taken.

A mechanism is now in place, and I hope the new chairman and the regulators from NHS Improvement will listen to what I and others say today and consider how they can best act to restore confidence in the trust. I thank my parliamentary colleagues for showing an interest, for speaking up for their constituents and for taking the time to voice their legitimate concerns, both directly to the professionals involved and in this debate.

Before I conclude, I again pay tribute to the families and campaigners who have pursued the issue and shared their experiences with us. In particular, the courage and resilience of Sara Ryan, Connor Sparrowhawk’s mother, has been an inspiration as she has continued to demand answers and ensure that the lessons of her son’s death are learned. Since the issue first began to attract significant coverage, more people have come forward with their own stories and added to the demands for action to be taken. They want to know that their concerns are being heard and that the Government and the NHS are serious about resolving the problems. I have heard them, and so has the Minister. I hope that he will be able to give them some of the reassurance they seek in his reply. I look forward to hearing from colleagues from all parts of the House.

[Several hon. Members rose—]

--- Later in debate ---

[Suella Fernandes]

Thank you for your chairmanship this afternoon, Mr Hanson. I am also grateful to the Minister for the time he spent meeting families and relatives today. I am confident that he understands the gravity of the problem, and that is reflected in his time, dedication and personal commitment to improving mental health throughout the country. I also acknowledge his apology, which will not change anything, but—I hope—might provide some solace.

The debate is for those we have lost, those let down by the professionals, those for whom help came too late and was too little, families and relatives: more widely, it is for all those with mental illness and learning disabilities. A nation is only as humane as its treatment of its most vulnerable. We here in the Chamber have a special duty to those who depend on healthcare and support. I hope that the debate marks the beginning of a journey towards more justice and compassion.

I am grateful to right hon. and hon. Members for their contribution to the issue and to the debate this afternoon.

Question put and agreed to.

Resolved,

That this House has considered governance of Southern Health NHS Foundation Trust.

Southern Health NHS Foundation Trust

Suella Braverman Excerpts

Tuesday 3rd May 2016 Commons Chamber

[Alistair Burt]

Over the past 12 months I have met a number of families who have been victims in similar circumstances—some had children who had been placed badly in an inappropriate place, and, in one or two cases, death had been the result. My colleagues and I are determined to do whatever we can to break down those situations where people feel that they have to fight for everything, and where they find doors closed against them when they want to challenge something. All too often in mental health, when people are challenged, they respond defensively. The whole transforming care process stems from Winterbourne View and the determination of the NHS and the board that monitors and oversees that process, including those who have mental health issues themselves and their advocates. The concerns that have been expressed in the past will not go completely, but I am sure the system is better placed now to deal with them and to listen to people more seriously than was the case, tragically, in the past.

[Suella Fernandes (Fareham) (Con)]

Does the Minister agree that the resignation of the chairman is a measure of the seriousness of the issue, and that after two damning reports, serious changes in the leadership are needed? What reassurance can he provide to my constituents in Fareham, such as the family of David West, that the regulatory bodies have the powers necessary if intervention is required?

[Alistair Burt]

I know that my hon. Friend has followed these matters closely for her constituents. Since last year there have been nine changes to the board, and the chair of the board left last weekend. NHS Improvement has the powers to alter governance, and I know from speaking to NHS Improvement that it takes that power and responsibility extremely seriously. The balance is between ensuring continuity and stability so that what the trust has promised is delivered, and wholesale change, which would provide an opportunity for further delay and prevent the work going on, but I know that NHS Improvement is very aware of its responsibilities in relation to governance, as I hope is the trust itself.

Brain Tumours

Suella Braverman Excerpts

Monday 18th April 2016 Westminster Hall

[Mrs Flick Drummond (Portsmouth South) (Con)]

It is a pleasure to serve under your chairmanship, Sir Edward. I thank the hon. Member for Warrington North (Helen Jones) for her powerful start to the debate.

I want to spend a bit of time talking about the brilliant work being done in my constituency at the University of Portsmouth. The university hosts one of the largest centres of excellence for brain tumour research in the world, led by Professor Geoff Pilkington. The department collaborates with research centres around the world and Professor Pilkington is much in demand at international conferences. The centre is a flagship research body in the UK, but it is coming to the end of its core five-year funding, which will be reviewed by international scientists at the beginning of May. Although I am sure that it will come out with a top review, the next five years of funding might depend on that. It will mean £1 million a year and the ability to apply for more grants and employ more postgraduates. It is absolutely crucial to bring in new people to increase the depth of research and it is worrying that too many top research centres are continually fighting for more funds.

The research being conducted at Portsmouth is also heavily funded by the third sector. The core funding comes from the charity Brain Tumour Research, which has provided about £500,000 per year for the past four years. That money has not only funded 10 researchers, but has acted as a catalyst for donations from other charitable and third-party organisations. The centre now has between 17 and 20 researchers at any one time.

As a centre of excellence, the University of Portsmouth attracts some of the brightest students from all over Europe and beyond. Recently, the research unit has had new staff from Portugal, Italy and other places around Europe, who are contributing significantly to our understanding of this terrible disease, but extra funding is needed to enable brain tumour researchers to stay in their field. Although charities are desperately trying to bridge the gap in funding to retain the researchers, it is not enough to prevent them from moving into other fields.

[Suella Fernandes (Fareham) (Con)]

I speak on behalf of the many constituents in Fareham who have been affected by this devastating and indiscriminate disease, for example, Simon Tier, whose best friend sadly died because of a brain tumour and who is an indefatigable campaigner. Does my hon. Friend agree that current rates of funding are insufficient and that we need between £30 million and £35 million per year, in line with funding for research for other cancers?

[Mrs Drummond]

Yes, my hon. Friend is absolutely right, and I hope that those in the third sector will continue to be helped to raise funds because it has obvious implications for the progress of brain tumour research. Those currently involved are working incredibly hard.

I had the fortune of meeting Kathleen Keatley, a final year PhD student who is sponsored by a charity called Headcase Cancer Trust, and her colleagues at their labs last month. The passion, knowledge and dedication to research that the students have should be celebrated. The work the unit is doing is truly ground-breaking. Kathleen is doing research into mitochondrial mutations in glioblastoma, which is one of the most common and aggressive brain tumours. Greater understanding of glioblastoma will improve the effectiveness of treatment. We have spoken in other debates about the role that innovative treatments have in future NHS provision and research might result in personalised treatment for those with brain tumours. At Portsmouth, innovative treatments for the most serious conditions are already being worked on but we need to invest more to encourage that development.

During my visit to the University of Portsmouth, the message was clear that more funding means that we can accelerate our learning. By increasing our funding, we can continue to attract and retain the brightest people from within, and outside, the UK.