Northern Ireland (Executive Formation and Exercise of Functions) Bill — House of Lords, 2018-10-30
Topic: Health
Angela Smith (Labour, Centre-left): My Lords, I rise to move Amendment 9 on the hyponatremia inquiry, which may not be something that is well known to many noble Lords, but I have to tell the House that I have special interest in this issue. As a direct rule Minister in Northern Ireland and Minster for Health, I announced the setting up of this independent public inquiry on 18 November 2004. It was to be chaired by a highly regarded QC, Mr John O’Hara, now Mr Justice O’Hara For background information, hyponatremia is a condition where the concentration of sodium in the blood falls below safe levels. It can occur for different reasons: it may be that somebody has been vomiting or has diarrhoea and needs to be rehydrated. In hospital, where patients’ fluids are monitored, it is a preventable condition The inquiry was started because five children were identified who had died in hospital. They were Adam Strain, aged four; Claire Roberts, aged nine; Raychel Ferguson, also aged nine; Lucy Crawford, aged just 17 months; and 15 year-old Conor Mitchell. The deaths of Adam and Claire, the events following Lucy’s death, Raychel’s case and the issues presented by Conor’s treatment were all investigated by this inquiry Surely, there can be no greater or more painful loss for a family than that of a child. When this happens in hospital and that child was receiving treatment, a fundamental role for any inquiry has to be to understand precisely what happened both before and after, and to give recommendations for future actions to prevent something like that ever happening again. The inquiry, announced in 2004, was originally delayed because of police investigations. For other reasons, the report of inquiry was not published until January this year, nearly 14 years after I initiated it. That report has 96 recommendations. I have just re-read large parts of the report before the debate today, and in places it makes grim and very sad reading I want to refer to two key aspects that Mr Justice O’Hara identified, and they will form the background to my explanation for bringing this amendment before us tonight. The first is the number of errors made in treating the children, which, rightly, have been very carefully and painstakingly investigated and recorded. The second is the unacceptable difficulties in getting witnesses to be open and frank. In places, Mr Justice O’Hara refers to what he calls "unsatisfactory evidence", with an attitude of deceit and defensiveness. He describes this as "frustrating and depressing". That led to his first recommendation being a "statutory duty of candour"—in other words, a legal duty to tell the truth—and there are 95 other recommendations My amendment is about the implementation of those recommendations and to ask what has happened since that report was produced in the absence of a Northern Ireland Assembly, an Executive or Ministers to consider them and take action. Paragraph 1.70 of Mr Justice O’Hara’s report said: "It is for the Department of Health to take them forward. Many will doubtless require significant detailed consideration to enable implementation. I expect the Department to indicate not only which of my recommendations it accepts but also to make clear how and when implementation is to be achieved. Further and subsequent reports should then be made detailing progress towards implementation with a final published confirmation of same" So Mr Justice O’Hara and his team took on this inquiry and made their report with every expectation that it would be properly considered and acted on, and the purpose of my amendment is ensure progress In the intervening years since 2004, I would have expected that, as problems were identified, some of those recommendations would already have been evident and acted on, with new systems and practices being put in place, but we just do not know. Also, some recommendations—particularly the statutory duty of candour—require political decisions. Others might need political direction in terms of funding and others will be purely clinical Given the difficulties faced in the 14 years before the inquiry was able to complete and publish its investigations, what is needed now is a totally transparent and open process. However, the difficulty is that, because there is no Assembly and no Ministers or Executive, we do not know what progress has been made and there is no political direction. It seems wrong that a lack of political responsibility in Northern Ireland, with no Ministers and no Assembly, should prevent action, and prevent those concerned—particularly the families of the children I have mentioned—knowing what action is being taken. Even the Lord Chief Justice of Northern Ireland, Sir Declan Morgan, has described the situation as "shocking" and "appalling". Ideally, local Ministers—I think there is also a role for a Stormont health committee here—should deal with this as a matter of urgency Therefore, my amendment provides for the Secretary of State to bring some humanity to this issue and to seek six-monthly reports with updates on progress—the amendment details the kinds of updates that we are seeking—so that the people of Northern Ireland can be confident that there is some political oversight and openness about what happens now. Whatever the political situation in Northern Ireland, this is too important a report to allow it just to fade away I am grateful to the noble Lord, Lord Bruce, for his amendment, and I know that he supports my amendment as well. I am also grateful to the Minister for the discussions that he and I have had on this issue. I know that he recognises the importance of and urgency behind it. I have had a letter from him this evening which indicates to me that, in so far as the limitations of this legislation allow, he is looking to see what can be done, and I shall be grateful if he can put that on the record tonight This matter is key. The families of these children are desperate to know what is happening and how progress will be made. In asking the Minister to respond and outline the commitments that he has been able to make to me in the letter so that they are on the record, perhaps I may press him a little further. In his letter to me, he says that he will seek that information at regular six-monthly intervals from the Department of Health. What is his expectation of the department’s responding? We need some expectation that it is going to respond and is prepared to do so. I note also that the Permanent Secretary of the Department of Health, Richard Pengelly, is prepared to meet with the noble Lord, Lord Bruce, and myself to discuss the issue. I hope the Minister can endorse the comments in his letter and explain what this House would expect. It is difficult—we understand that the Government do not want to have direct rule creep towards it, as it were—but unless there is some political responsibility, who else do the families have to turn to in order to see that justice is done and this report’s recommendations are seriously considered and implemented? I beg to move.