Francis Report: Update and Response — House of Commons, 2015-02-11
Topic: Health
Jeremy Richard Streynsham Hunt (Conservative, Centre-right): I welcome the broadly constructive tone that we have heard today. May I say, in that spirit, that I hope that that represents a change in substance from some of the other exchanges we have had on these topics? The right hon. Gentleman tried to vote down the legislation that set up the new chief inspectors and he opposed the holding of a public inquiry into Mid Staffs. If we are to have constructive agreement across the House, I do think we need to agree on substance as well as on tone. Let me just take the individual points he mentioned We are completely committed to death certification. That was recommended in the wake of the Shipman inquiry. The right hon. Gentleman’s Government took a very long time to do anything on this and we have been trying hard to do it. It is a complicated thing to get right. On the question of looking properly at avoidable deaths, I just want to say this. It is very difficult, when one looks at case notes, to work out whether a death was avoidable or not, but we think we have a methodology to do that. It is more difficult to relate that to individual trusts, but we want to try to achieve that as well. I was disappointed at the weekend that when we announced that, his response was that it was unambitious. Two weeks earlier, he had published Labour’s 10-year plan for the NHS, which did not actually mention reducing avoidable deaths at all. What we are proposing is the most ambitious thing that any health care system has proposed anywhere in the world, and I hope it will have his full support On the right hon. Gentleman’s comments about not generating a climate of fear, he is absolutely right; it is really important, in getting the culture right, to make sure that people are supported to speak out and that there is not, as an unintended consequence, the kind of bullying and intimidation that Sir Robert says is all too common today. I suggest to him that one of the reasons for that climate of fear has been over-dependence on top-down targets as a way of running the NHS. That is what has created the fear in managers that sometimes has led them to treat their staff in the wrong way. What would be very constructive would be a recognition from Labour that that top-down targets culture did go too far, and that we need to rely on transparency as a way of improving performance as a much better tool than endless new targets In anything we do—this is something else where I agree with the right hon. Gentleman—we must look very closely at making sure that we learn these lessons in the social care sector as well. That is particularly clear when we look at the scandal of what happened in Rotherham. That is why, when we introduced the new CQC inspection regime following the original Francis public inquiry, we did not just set up a chief inspector for hospitals but set up a chief inspector for general practice and for adult social care. We are now getting the same Ofsted-style transparent rankings of how good care is in care homes, and indeed in domiciliary care. I know that he, like me, is concerned about 15-minute care visits. I think those inspections will help to root out those problems. With respect to nurse numbers, I really do think that is something on which, if the right hon. Gentleman wants to be constructive, he should commend the Government’s efforts. We have 8,000 more nurses in our hospital wards than we had four years ago. Of course, as a short-term response a lot of hospitals are employing nurses through agencies. That must only be a short-term response. We need proper long-term commitment to institutions, which we do not get with agency staff, but I commend hospitals that have said, "While we try and get enough staff in place for the long term we are not going to wait, because we need to make sure that patients are safe today." They want to do what it takes to do that Finally, on the risk register, I simply remind the right hon. Gentleman that when he was Secretary of State he blocked the publication of the risk register. As a Minister, he said: "This would inhibit the free and frank exchange of views about significant risks and…management, and inhibit the provision of advice to Ministers."—[Official Report, 23 March 2007; Vol. 458, c. 1192W.] More broadly, I just want to say this. There are many patients and whistleblowers looking at today’s exchanges and wanting to see constructive agreement on the way forward. I think we can get a measure of that. What they say they want is not just words, but actions As we put staff and patients first in England, will Labour do the same for patients in Wales and today commit to a Keogh review of high mortality hospitals, commit to a chief inspector of Welsh hospitals and commit to protect staff who speak out in Wales, as we want to do in England? Will he commit to putting right a top-down culture that prioritised the needs of the system over the needs of individuals? Will he, as we do, recognise that that is always the danger of treating the NHS as a political possession and not as a service for patients? Patients must always come first. Staff who want to do the right thing for patients should always be heard. Our NHS deserves nothing less.