PARLIAMENTARY DEBATES - United Kingdom Parliament

1475 Mid Staffordshire NHS Foundation 26 MARCH 2013 Mid Staffordshire NHS Foundation 1476
Trust
Trust
[Andy Burnham]
wide variations in both structure and membership. Will
the Government accept Robert Francis’s recommendation
of a consistent basic structure for healthwatch programmes
throughout the country before it is too late and they go
their separate ways?
Thirdly, on regulation and training, Robert Francis
has made a very clear case for a new system of regulation
of health care assistants to improve basic standards—a
case that we made during the passage of the Health and
Social Care Act 2012—yet it did not feature in the
Secretary of State’s statement. Have the Government
accepted in principle the regulation of health care assistants?
We support moves to rebalance nurse training and to
include more hands-on experience, but student nurses
already spend 50% of their time in clinical practice and
face significant financial barriers when completing their
training. Will the Secretary of State assure the House
that requiring a year on the ward will not increase the
financial barriers to young people entering nursing and,
if more trainees are to be on the wards, will he ensure
that there are enough staff with the time to train the
extra students?
That takes me to my fourth point and the most glaring
omission from the Secretary of State’s statement, namely
safe staffing levels. We will never get the right culture on
our wards if they are understaffed and over-stretched,
but there is evidence that things are going in the wrong
direction and the Secretary of State was silent on the
issue today.
The CQC has recently reported that one in 10 hospitals
in England do not have adequate staffing levels. Just
last week, work force figures showed that there had
been a reduction of 843 nurses between November and
December last year. Does that not sound the clearest of
alarm bells that some parts of the NHS are already in
danger of forgetting the lessons of its recent past by
cutting the front line too far? Do not communities need
a clear, objective benchmark so that they can challenge
staffing levels on wards, and would it not be a great help
to them for the Francis recommendation on staff-patient
ratios to be accepted? We learned last week that the
Department has handed £2.2 billion from last year’s
budget back to the Treasury. Surely that money would
have been better invested in the front line and in bringing
all hospitals in England back up to safe staffing levels.
Finally, I want to turn to Stafford hospital itself,
which Monitor has recommended should be placed in
administration. This doubt about the hospital’s future
will be causing real concern to the people of Stafford.
After all they have been through, I think we can all
agree that they deserve a safe and sustainable hospital,
and I hope the Secretary of State will soon set out a
plan to achieve that.
Learning the lessons of Stafford cannot be done
overnight. We all have to play our part. The Government
have made a start today, but much more needs to be
done and we will hold them to that.
Mr Hunt: The right hon. Gentleman talks about glaring
omissions in the Government’s response, but there were
glaring omissions in his response too. Where was the
apology for Labour’s targets culture that led to so many
of the problems; the apology for failing to set up a
regulatory structure that had proper safeguards; and
the apology for missing all those warning signs? This
was not just the darkest day in NHS history, but the
darkest day in Labour’s management of the NHS. It is
time the Labour party recognised the policy mistakes it
made.
Let me go through what the right hon. Gentleman
says are omissions. First, on the duty of candour, we
accept the principle of the duty of candour when it
applies to hospital boards, but we want to be absolutely
sure that there are not unintended consequences of
applying it to hospital staff, because another part of the
Francis report is on the importance of a culture of
openness and transparency, and we do not want a
culture of fear. We have therefore not ruled out criminal
sanctions for hospital employees who breach a duty of
candour—they already have a contractual duty of candour
—but, as I said in my statement, we want to wait for the
result of Don Berwick’s report on zero harm to ensure
that we do not take any measure that impedes the
openness we need in hospitals.
The inspection regime will apply to all providers. It is
important that it should, but I remind the right hon.
Gentleman, who mentioned private providers, that the
problems happened at an NHS hospital. Trying to turn
this into a debate on privatisation tells people that
Labour is missing the point in the response to Francis.
We will not introduce statutory regulation of health
care assistants, but we will introduce minimum standards
of training for them. We will not introduce statutory
regulation because we believe there is a risk that a
database of 0.5 million to 1.5 million people could end
up being a box-ticking exercise that fails to raise standards
in the way we need. We believe we have another way to
achieve the same end, which is what we will implement.
On nurse training, we believe it is important that
nurses have hands-on experience of the front line, because
nurses, when they are properly qualified, will be managing
health care assistants. It is therefore important that
nurses understand what it is like to be a health care
assistant. We will be very careful in how we implement
that to ensure that we do not create financial barriers
because, obviously, we want to attract the best people
into nursing, regardless of income.
On staffing levels and nursing numbers, I remind the
right hon. Gentleman that the problems at Mid Staffs
happened when Labour was in power, when budgets were
going up quite significantly, and when numbers were going
up. To distil the problem to one of numbers is, again, to
miss the point. This is about the values of the people on
the ward. If he wants to talk about numbers, he must
accept that, because this Government have protected
the NHS budget, which he wants to cut from its current
levels, there are 6,000 more clinical staff in the NHS
today than there were at the time of the last election.
On Stafford hospital, it is extremely important that,
when we have problems such as the ones at Mid Staffs,
we create a structure that makes it impossible not to
deal with them. That is a difficult process. We are
announcing today a time-limited process to ensure that
Ministers and the system cannot duck difficult decisions
when we have a failing hospital. Obviously, we will follow
the Monitor trust special administrators’recommendations
and look at them carefully, but it is important to address
the issues. The wrong thing to do would be to fail to do
so, because that would lead to clinical failure.