PARLIAMENTARY DEBATES - United Kingdom Parliament

1479 Mid Staffordshire NHS Foundation 26 MARCH 2013 Mid Staffordshire NHS Foundation 1480
Trust
Trust
[Mr Jeremy Hunt]
responsibilities of the CQC. It will no longer be involved
in putting right problems in hospitals: its job will simply
be to identify problems, so it is not compromised in its
ability to be the nation’s whistleblower-in-chief. The
responsibility for putting right problems will lie with
Monitor, the NHS Trust Development Authority, the
NHS Commissioning Board and the wider NHS system.
We want to make sure that the chief inspector is
unconstrained and unconflicted, when his or her team
goes into hospitals, from shouting loudly if there is a
problem and continuing to shout loudly until it is solved.
Sir Tony Baldry (Banbury) (Con): These changes all
come against a background of other changes in the
NHS, such as clinical commissioning groups, Healthwatch
and health and wellbeing boards, and I wonder whether
my right hon. Friend would be kind enough to put in the
Library a plain person’s guide, so that we can understand
how these new regulators, inspectors and various other
bodies fit in with each other—who is accountable to
whom—so we as constituency MPs will know whom to
approach and on what occasion. I am sure that all these
changes are very welcome, but we need to understand
how they relate to each other.
Mr Hunt: I am sure that my hon. Friend’s sentiments
are shared on both sides of the House. Indeed, I could
have done with such a guide when I started this job last
September. I am happy to do as he requests, but from
today’s announcement the most important thing that
the country should know is that when it comes to
failures in care, the buck stops in one place. It will be the
chief inspector’s job to identify such failures and shout
publicly about them, and that will be an important
clarification that the system needs.
Yasmin Qureshi (Bolton South East) (Lab): This is
not a debate about private or public, but will the Secretary
of State ensure that the duty of candour is applied
equally to private providers of NHS services?
Mr Hunt: Yes, it will be, as it will to providers in the
social care sector.
Paul Burstow (Sutton and Cheam) (LD): Can the
Secretary of State confirm that it is his intention that
the statutory duty of candour—and the introduction of
a ratings system—will apply to home care and care
homes, not just NHS providers?
Mr Hunt: Yes, I can confirm that. My hon. Friend is
right, because part of the big change that we need is to
see a big increase in provision of domiciliary care, and
an increase in the standard of that care.
John Woodcock (Barrow and Furness) (Lab/Co-op):
The Secretary of State talks about severance and follow-on
employment. Does he think it is acceptable that when
the former chief executive of Morecambe Bay hospitals
trust had to step down in February last year, because of
the problems there, he was kept on the books in secret
and paid £250,000 from local trust budgets—which
could otherwise have gone to local health care—and
was transferred to the NHS Confederation where his
responsibilities could include teaching future leaders
and helping to redesign the system?
Mr Hunt: That is the kind of shocking practice that is
totally unacceptable.
Margot James (Stourbridge) (Con): I very much welcome
the return of student nurses to the wards for a year of
their training. Project 2000 has much to answer for. On
the subject of resourcing and staff to patient ratios, may
I remind my right hon. Friend that many of the reports
we have seen in the last few years, criticising hospitals
for poor care and lack of dignity in the care of older
people in particular, have shown that wards in the same
hospitals have had very different standards of care?
How can that be about resourcing?
Mr Hunt: My hon. Friend makes an important point.
It is important that these assessments are made not just
at an organisation level, but drill down into the different
parts of a hospital, and we have taken that message on
board from the Nuffield report on ratings. She is right
that it is not just about resources, but sometimes it is
about resources. Parts of a hospital can be understaffed
when it comes to people who are required to perform
basic and important roles in terms of care. Because it is
a complex picture—and because numbers can be part
of the problem, but are certainly not the whole problem—we
want a chief inspector who will take a holistic view of
every aspect of the performance of a hospital and be
able to give proper feedback that a hospital can use to
improve its performance.
Barbara Keeley (Worsley and Eccles South) (Lab):
May I press the Health Secretary on this point? I have
raised several times the point that adequate staffing levels
are crucial to patient safety and good care, but we seem
to dodge around saying that it is a question of values,
not of numbers. Francis said clearly that one of the
issues was numbers. I have given examples of my local
hospital, which views it as crucial that it has the right
staffing mix, which it adjusts every single day, for the
patients that it has. Will he stop avoiding this question
and address it directly, because one in 10 hospitals do
not have adequate staffing levels?
Mr Hunt: I am not avoiding it. I agree that adequate
staffing levels are essential to patient care. I remind the
hon. Lady that the shadow Health Secretary said to the
Francis inquiry:
“I do not think that the Government could ever mandate a
headcount in organisations. Whilst we could recommend staff
levels, we were moving into an era when trusts were being encouraged
to work differently and cleverly, and take responsibility for delivering
safe care whilst meeting targets”.
Mr William Cash (Stone) (Con): The Secretary of
State rightly talks about a betrayal of trust of the worst
kind, and he is right. He is also right about zero harm,
and about much else that he has done. But there is one
serious omission—of accountability—and that must be
robust and include the resignation of Sir David Nicholson.
I also apportion responsibility to those former Secretaries
of State who were not called to give evidence but bear a
heavy responsibility for not having done the right thing
at the right time.
Mr Hunt: My hon. Friend knows that I have a different
view of the level of responsibility of Sir David Nicholson,
but I agree that everyone working in the system at that