PARLIAMENTARY DEBATES - United Kingdom Parliament

1473 Mid Staffordshire NHS Foundation 26 MARCH 2013 Mid Staffordshire NHS Foundation 1474
Trust
Trust
and 2009, yet Ministers and managers in the wider system
failed to act on those warnings. Some were not aware of
them; others dodged responsibility. That must change.
No hospital will be rated as good or outstanding if
fundamental standards are breached, and trusts will be
given a strictly limited period of time to rectify any such
breaches. If they fail to do that, they will be put into a
failure regime that could ultimately lead to special
administration and the automatic suspension of the
board.
The fourth part of our response concerns accountability
for wrongdoers. It is important to say that what went
wrong at Mid Staffs was not typical of our NHS, and
that the vast majority of doctors and nurses give excellent
care day in, day out. We must ensure that the system
does not crush the innate sense of decency and compassion
that drives people to give their lives to the NHS.
Francis said that primary responsibility for what
went wrong at Mid Staffs lies with the board. We will,
therefore, look at new legal sanctions at corporate level
for organisations that wilfully generate misleading
information or withhold information that they are required
to provide. We will also consult on a barring scheme
to prevent managers found guilty of gross misconduct
from finding a job in another part of the system. In
addition, we intend to change the practices around
severance payments, which have caused great public
disquiet.
The General Medical Council, the Nursing and
Midwifery Council, and other professional regulators
have been asked to tighten their procedures for breaches
of professional standards. I will wait to hear how they
intend to do that, and for Don Berwick’s conclusions
on zero harm, before deciding whether it is necessary to
take further action. The chief inspector will also ensure
that hospitals are meeting their existing legal obligations
to ensure that unsuitable health care support workers
are barred.
The final part of our response will be to ensure that
NHS staff are properly led and motivated. As Francis
said,
“all who work in the system, regardless of their qualifications or
role, must recognise that they are part of a very large team who all
have but one objective, the proper care and treatment of their
patients”.
Today I am announcing some important changes in
training for nurses. I want NHS-funded student nurses
to spend up to a year working on the front line as
support workers or health care assistants as a prerequisite
for receiving funding for their degree. That will ensure
that people who become nurses have the right values
and understand their role. Health care support workers and
adult social care workers will now have a code of
conduct and minimum training standards, both of which
are being published today. I will also ask the chief
inspector to ensure that hospitals are properly recruiting,
training and supporting health care assistants, drawing
on the recommendations being produced by Camilla
Cavendish. The Department of Health will learn from
the criticisms of its own role by becoming the first
Department in which every civil servant will have real
and extensive experience of the front line.
The events at Stafford Hospital were a betrayal of the
worst kind—a betrayal of patients, families, and the
vast majority of NHS staff who do everything in their
power to give their patients the high-quality, compassionate
care they deserve. I want Mid Staffs to be not a byword
for failure but a catalyst for change, and to create an
NHS where everyone can be confident of safe, high-quality,
compassionate care, and where best practice becomes
common practice, and the way a person is made to feel
as a human being is every bit as important as the
treatment they receive. That must be our mission and I
commend this statement to the House.
12.43 pm
Andy Burnham (Leigh) (Lab): I thank the Secretary
of State for his statement and for the measured way in
which he introduced it.
The NHS is 65 this year, and if it is to be ready for the
challenges of this century, it must learn from the darkest
hours of its past. The NHS was founded on compassion
and, as the Secretary of State said, what happened at
Stafford was a betrayal of that. Rightly, apologies have
been given, but it is now time to act and make this a
moment of change.
Robert Francis delivered 290 careful recommendations
after a three-year public inquiry and, like the Secretary
of State, I pay tribute to him today. In response, the
Prime Minister promised a detailed response to each
recommendation by the end of this month. Although
the Opposition welcome much of what the Secretary of
State has said today, his statement falls short of that
promised full response and contains serious omissions
on which I would like to press him, in particular, on
four of Robert Francis’s flagship recommendations,
which I shall take in turn.
First, we welcome the move to place a duty of candour
on health-care providers and believe it could help bring
about the culture change the NHS needs. The Francis
report, however, goes further and recommends a duty
of candour on individual members of staff. Will the
Secretary of State say more about why he has only
accepted this recommendation in part and not applied
it to staff? Has he ruled that out or is he prepared to
give it further consideration?
Will the Secretary of State assure the House that the
duty will apply equally to all providers of NHS services,
including private providers? His statement was a little
vague on that point. More generally, with more private
providers coming into the NHS, is it not the case that
we will not get the transparency we need unless the
provisions of freedom of information apply fully to all
holders of NHS contracts and information cannot be
withheld under commercial confidentiality?
Secondly, on patient voice, the Government have
announced new chief inspectors of hospitals and social
care. Those were not Francis recommendations and,
while we give them a cautious welcome, I am sure that
the Secretary of State will agree that regulation alone
will not be enough to prevent another Mid Staffs.
Instead, we need a powerful patient voice in every
community that is able to sound the alarm if things are
going wrong. Rather than pulling down the shutters, as
the NHS has a tendency to do, complaints should be
embraced as opportunities to learn and improve.
It is just a matter of days until the new NHS comes
into being and the concern is that patient voice has not
been embedded at the heart of the new system. A third
of councils say that their local healthwatch will not be
up and running by the 1 April deadline, and there are