NHS (Public Satisfaction)

Tom Clarke Excerpts

Wednesday 30th March 2011 Westminster Hall

[Mr Tom Clarke (Coatbridge, Chryston and Bellshill) (Lab)]

I congratulate my hon. Friend the Member for Leyton and Wanstead (John Cryer) on introducing a debate on such an important subject, and on the balanced way in which he opened it. I should declare that I am the co-chair with Lord Rix of the all-party group on learning disability. It is on that subject that I wish to speak in the five or six minutes that I hope to take.

I would like to make it clear that although I shall make several criticisms of aspects of the national health service, I stand second to no one in my regard for it or, as a GMB member, in my respect for those who work for the NHS, including the trade unions. They are helping to create their big society—a meaningful society—and making the NHS something of which we are all very proud.

The learning disability group has been helped considerably by Mencap. Today, I shall rely on its research and the many conclusions that it has reached. It published “Death by indifference” in 2007. Indeed, I had a debate in this Hall when the Labour Government were in power, so I hope that I will not be regarded as party political.

The report highlighted the tragic consequences of deep-rooted institutional discrimination in the NHS against people with a learning disability. In many cases, NHS staff did not know about the specific needs of people with a learning disability and did not take the time to understand and meet those needs. People with a learning disability are some of the most vulnerable members of society and have some of the most profound health care needs. Although the Government investigated the issue in the independent inquiry led by Sir Jonathan Michael, in a poll conducted on behalf of Mencap, almost one half of doctors, or 47%, and one third of nurses, or 37%, said that people with a learning disability received a poorer standard of health care than the rest of the population. In the same poll, 39% of doctors and 34% of nurses went as far as saying that people with a learning disability were discriminated against in the NHS.

I want to deal with the NHS complaints system. The unnecessary deaths—sadly, that has been the case—of people with a learning disability do nothing to increase public confidence in the ability of the NHS to give effective care to those vulnerable members of society who are most in need of it. However, that is compounded by the malfunctioning NHS complaints system which, as a result of being time-consuming, defensive and too heavily weighted in favour of health professionals, refuses to learn from previous mistakes in order to drive up standards and increase public confidence.

Following its “Death by indifference” report, Mencap has helped a number of families through the complaints system. It is revealing that not a single family has ever said they felt that justice had been achieved through the local complaints procedure. That is due to the overwhelming desire of NHS trusts to stand up for their staff, the potential conflicts of interest when NHS staff investigate complaints made about people working in the same trust, and a fundamental lack of understanding about what learning disability is.

The same issues are evident when the complaints are escalated to the parliamentary and health service ombudsman. NHS trusts have disproportionate access to support, in comparison with the families going through the complaints process. In addition, the time scales given for complaints to be dealt with are usually longer than expected and only succeed in drawing out a family’s grief.

I would like to conclude with a few comments on this theme. In light of tragic cases of misunderstanding in administering health care to vulnerable people, public confidence in the NHS understandably has been undermined. The defensive nature of the NHS complaints system, however, means that the NHS does not learn valuable lessons which could help prevent unnecessary deaths from occurring in the future. Public and patient confidence in the NHS will be improved only with greater accountability and transparency so that people can see that efforts are being made to drive up standards. The complaints process is central to that and therefore requires a fundamental overhaul to make it a more impartial and reflective system. That is necessary to drive up health outcomes across the NHS and to increase public confidence in it.