PARLIAMENTARY DEBATES - United Kingdom Parliament

1483 Mid Staffordshire NHS Foundation 26 MARCH 2013 Mid Staffordshire NHS Foundation 1484
Trust
Trust
[Mr Jeremy Hunt]
care and compassion that needs to be at the heart of
what the NHS does. We are putting in the safeguards
that ensure that that cannot happen.
Naomi Long (Belfast East) (Alliance): Given the mobility
of both the work force and students, what discussions
has the Secretary of State had with the devolved
Administrations regarding the proposed changes to funding
nurse places and training?
Mr Hunt: We have not had those discussions yet, but
we will be introducing them through pilot schemes to
give the devolved Administrations plenty of time to talk
to us about any knock-on impacts they may have in
their areas.
Mr Aidan Burley (Cannock Chase) (Con): Does the
Secretary of State agree that the decision to grant
foundation trust status to Mid Staffs in 2008 was
catastrophic in terms of the trust taking its eye off the
ball and focusing on targets rather than on care, and
that, now it is being abolished just five years later, never
again must a Government pressurise a trust into a
particular organisational form just to validate its ideological
policy, rather than because it improves the care of
patients?
Mr Hunt: I would also like to thank my hon. Friend
for the work that he does for his local hospital in
difficult circumstances directly involved in this terrible
scandal. I agree with him: the corporate objective to
become a foundation trust overrode everything else in
the hospital, at huge expense to patient care. We must
never allow that to happen again.
John Glen (Salisbury) (Con): What most people want
when they use the NHS is a reliable, accessible service,
and to know that when something goes wrong somebody
will be held to account and brought to book. Clearly,
that has not happened. What can the Secretary of State
say to reassure our constituents that people will be held
accountable on an individual level, and that we will not
see this happen again?
Mr Hunt: We are not saying that minimum standards
of adequate staffing levels are not needed, but we reject
the idea that they should be mandated from the centre—I
think there is cross-party agreement on that. The chief
inspector will look at and highlight the reasons for poor
care and, if they are due to inadequate staffing levels,
ensure that something is done about it.
Sir Peter Bottomley (Worthing West) (Con): On the
rare occasions when a clinician or other member of
hospital staff raises a problem and it is not taken care
of, may I suggest that employers have a box in which to
put in a note saying what the problem is? There should
be a receipt so that if there is an inquiry later, it can be
shown what the hospital should have paid attention to
right at the beginning.
Mr Hunt: That sounds like something that would
definitely encourage the duty of candour that we have
been talking about today. I am sure that different hospitals
will want to have different ways of doing that, but we
will definitely note my hon. Friend’s comments.
Andrew Percy (Brigg and Goole) (Con): Staffing levels
are important, but so are bed numbers. Many of the
41,000 beds lost under the previous Government were
in my constituency. Consequently, we have massive
pressure on beds, wards on purple alerts and very high
mortality rates. Will any inspection regime include an
assessment of safe bed levels?
Mr Hunt: The inspection regime will of course cover
such issues as part of its inspection of whether basic
standards of care are being met. Yes, of course such
issues matter, but there are challenges beyond what an
inspection regime can deliver which we will need to
address to deal with these issues. In particular, a problem
we are wrestling with at the moment is who will take
responsibility for the frail elderly when they are discharged
from hospital. One reason why they stay in hospital for
a long time is because geriatricians are nervous about
sending them back into the community. They do not
think anyone will take responsibility for them and that
is something we have to look at.
Mr Hunt: That accountability is extremely important
and happens on many different levels. In particular, we
have professional codes of conduct for doctors and nurses,
so that in the exceptional situations where those codes
are breached, we know, as members of the public, they
will be held to account. Those are done at arm’s length
from the Government by the General Medical Council
and the Nursing and Midwifery Council, but we are
talking to them about why it is that still no doctor or
nurse has been struck off following what happened at
Mid Staffs—I think that is completely wrong.
Andrew George (St Ives) (LD): I know I repeat myself,
but adequate registered nurse-to-patient ratios are often
at the heart of these failings, yet on page 68 of the
report my right hon. Friend rejects the idea of any kind
of national benchmarking or guidelines with regard to
patient ratios. Will my right hon. Friend keep an open
mind and meet me, Professor Elizabeth Robb of the
Florence Nightingale Foundation and others from
the profession so that we can explore this issue?
Jackie Doyle-Price (Thurrock) (Con): On the respective
roles of CQC and Monitor, can my right hon. Friend
indicate that he expects Monitor to use the full regulatory
tools at its disposal and give appropriate challenge to
the boards of foundation trusts and hospitals where
failure is indicated?
Mr Hunt: My hon. Friend is absolutely right. One of
the changes we are announcing today is that, in the case
of foundation trusts, CQC will be delegating its enforcement
powers to Monitor so that it has more powers to insist
on necessary changes and ensure that fundamental
standards are not being breached.
Jonathan Evans (Cardiff North) (Con): Will my right
hon. Friend note that the Patients Association and
campaigners such as the Powell family in Wales will not
be satisfied by what he has had to say about the duty of
candour until we have a full statutory duty in line with
what Robert Francis recommended?