Lamb quizzes Burnham on Stafford Hospital

http://www.curethenhs.co.uk

• Norman Lamb (North Norfolk) (LD): ' . . THIS chief executive received £400,000. I have a copy of the private investigation into his actions. Surely it should be published in full-it is heavily redacted, which amounts to a cover-up of the full findings of the investigation. It points to a case for disciplinary action, yet there was a very substantial pay-off to this chief executive . . '

I thank the Secretary of State for early sight of his statement. This is an utterly shocking scandal, which is a stain on the good name of the NHS. It demonstrates again horrifying evidence of patient neglect, which should never feature in the national health service. I welcome the recognition in the statement that there are national lessons to be learned, but the focus of the inquiry was none the less on this particular trust.

It seems to me that the inquiry was not designed to ensure that the full wider lessons could be learned. It was not designed to hold anyone to account, which it specifically says, as the terms of reference did not permit investigation into the role of any of the external agencies. It was also held in private. The inquiry was not able to consider the reports of any of the individual cases through a separate process because they were not ready in time. The report itself confirms that disappointing numbers of staff came forward to give evidence. That is not good enough. It is not the fault of the inquiry, but the fault of the process created by the Government. The bottom line is that the report will not satisfy the families of those who lost their lives and it will not bring an end to demands for a full public inquiry. I also pay tribute to the work of Julie Bailey and the organisation Cure the NHS.

Do not the findings reinforce the need to learn wider lessons about the causes of the failures that took place in the hospital: the focus on process at the expense of outcomes; the failure to listen to those who receive care; staff disengaged from the process of management; insufficient attention to the maintenance of professional standards; a weak professional voice in management decisions; abuse of vulnerable elderly people; and a lack of transparency? The key point is that none of those findings can be said to be unique to this particular trust. The hon. Member for South Cambridgeshire (Mr. Lansley) highlighted other failing hospitals that the House has debated.

There is surely a need for a full public inquiry, and it should surely first consider the pay-off to the chief executive and the fact that people are too often rewarded for failure. This chief executive received £400,000. I have a copy of the private investigation into his actions. Surely it should be published in full-it is heavily redacted, which amounts to a cover-up of the full findings of the investigation. It points to a case for disciplinary action, yet there was a very substantial pay-off to this chief executive.

A public inquiry should also look at the role of targets. The statement rightly said that blaming targets in their entirety would let management off the hook, but not looking at targets lets the Government off the hook, given that targets played a part in the failures of this hospital.

It is also essential to look fully at the role of regulation. I am pleased that there will be a further inquiry into that, but it should surely be held in public and should look at the complex web of regulation that we have created. The fact that we have five different national organisations with some responsibility for patient safety has resulted in no one taking proper responsibility for it. In Basildon, for example, there were 21 visits by seven different organisations in the year before the final report emerged. We need to look at the devastating report into the role and failure of regulation that was commissioned by the NHS Confederation last summer. It showed that we have ended up with paper safety rather than real patient safety and a tick-box culture.

A public inquiry should also look at the process for securing foundation trust status, which provided a false reassurance to people that the hospital was performing to a high standard. Finally, do we not owe it to the families of those who have lost their lives to have a full examination in public of the wider lessons that need to be learned from this scandal?

Andy Burnham: I agree with the hon. Gentleman that this is a shocking report that damages the name of the national health service. He asked why the report did not allow consideration of wider national issues, but he will have seen that the report does comment on national lessons to be learned. There were four recommendations in the report, which I spelled out in my statement when I responded to those points.

I did agree with the chairman that he could comment on what he wanted to comment on. However, we wanted the inquiry to focus primarily on the trust and the voices of the patients affected by the terrible events in the trust, so that we could get to the bottom of the failings and allow the trust to move on-which is, I believe, what we must do.

I wanted to get to the bottom of events as quickly as I practically could. I was also anxious that the trust should not be debilitated by a protracted inquiry that would divert it from its main job. I believe that we have got to the bottom of what happened locally; I now want the trust to move forward, and I believe that it is moving forward under the leadership of the new chair and chief executive. However, I accept Robert Francis's recommendation that we look more closely at the bodies that have a supervisory, regulatory and commissioning role in relation to Mid Staffordshire NHS Foundation Trust. As the hon. Gentleman will know, we have already embarked on that task. David Colin-Thomé has done some work in examining the role of the primary care trust, but we must now put that work on a proper footing-knowing what we know from the first inquiry-so that we can learn the lessons at a national level, and I can assure the hon. Gentleman today that that is what we will do.

The hon. Gentleman said that the failings were not unique to this particular trust, and rightly observed that what went wrong in this instance was caused by a focus on process rather than on people. The words "focus on process" were used by Robert Francis, and they are at the heart of what went wrong. There was a failure to understand and respond to the public about what matters, and to see each patient as an individual deserving of the very highest standard of care-the care that we would all want our own families to receive.

The hon. Gentleman was right to say that the failings described in the report are not unique to the Mid Staffordshire NHS Foundation Trust, but it must also be said that the scale on which they occurred make the events in that trust unique. I sought an assurance from the Care Quality Commission that no other NHS trust exhibits problems on the scale of those found at Mid Staffordshire, and it gave me that assurance today, but let me also assure the hon. Gentleman that we remain constantly vigilant, and will ensure that every possible action is taken to deal with poor performance and poor quality in the NHS.

The hon. Gentleman asked about the Garland report on the former chief executive of the trust. I understand that he did not receive £400,000, but received his notice period and no more than his contractual entitlement.

The hon. Gentleman also asked about targets. The suggestion is that targets are there to distract people in the NHS from patient care, but they are essentially about the basic minimum that every person who arrives at the door of the NHS should be able to expect. They are fundamentally about people and the quality of care that should be given to every single person, regardless of their background or what they bring to the door of the NHS. In this case, the trust grotesquely failed to manage the pressure involved in delivering that basic standard of care to every person who arrives at the door of the NHS, which is what so many other trusts throughout the country manage to do.

Let me remind the hon. Gentleman what happened before there were targets for accident and emergency departments. The previous Government, in fact, suggested a four-hour target because there was chaos in A and E departments in the early and mid-1990s, and the present Government retained that target because basic minimum standards must be available to every patient who arrives at the door of an accident and emergency department.

The hon. Gentleman asked for a proper safety structure rather than "paper safety". I can tell him that I take my responsibilities in respect of the new registration process extremely seriously. He will know that I have expedited the introduction of that system, which I believe directly responds to the concern that he has expressed.

Finally, the hon. Gentleman asked for a full inquiry into all these events. I believe that the second inquiry that I am setting up today will meet his demands. I invite him to comment on the draft terms of reference, and if he believes that they can be strengthened, I shall listen to his comments.

What the hon. Gentleman has asked for, I will carry through. We will ensure that there is no repetition of these events in the national health service.

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