North Middlesex University Hospital NHS Trust

Debate between Diane Abbott and Ben Gummer

Tuesday 12th July 2016 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

I thank the right hon. and hon. Members who have given such thoughtful, considered, well-researched and knowledgeable speeches, and also the hon. Member for Hackney North and Stoke Newington (Ms Abbott) who provided such a thoughtful reflection from the shadow Front Bench. Members will be pleased to know that I agree with much of what they have said. I will come on to how I think the NHS has let Members and their constituents down and what we will do to try to fix the situation.

If Members do not mind, I will first set the issue in a bit of context. North Middlesex hospital was classed by the Care Quality Commission as requiring improvement for reasons that have been mentioned. The quality of care was not consistent enough and there were concerns about patient safety. It was not one of the worst hospitals in London, or in the country, but it was certainly not one of the best. Until July 2015, it was largely meeting its institutional standards. The 95% waiting time target for A&E was being met most months, even though the department is one of the larger ones in the capital, and in spite of the reorganisations that were discussed at length by the right hon. Member for Enfield North (Joan Ryan).

We need to be careful, therefore, with causality, and I will not give a definitive reason why the problems came about. A direct connection between the reorganisation of Chase Farm, which began under the Government before the coalition, and the problems experienced at North Middlesex over the past year, cannot be made with great surety because the hospital was dealing with the A&E caseload within the required timelines, albeit with a standard of care that was not at the level it should have been.

Nor is this about money. It is important to point out that organisations across the NHS, as the shadow Minister knows well, have reported deficits in the past year and this is one of the smaller ones. The posts that are established in the hospital are fully funded; the problem is trying to get the right people into them. I do not deny that the hospital has a staffing problem—I will come on to that in a second—but it is not connected with funding.

Let us get to the core cause of the problems that Members have noticed and brought to the attention of the House. I am afraid that I am not able to give a complete answer at this stage, but Members are entirely right to ask why this happened. We need a better explanation. This morning, I agreed with officials and NHS England that we will look in detail at the reasons within the hospital why the performance standards slipped so significantly in the middle of last year, and why the training routines and practices slipped as well. That is the first part of the review.

The second part is on why the system did not react with the speed it needed to when concerns were first expressed about a year ago. Here, I offer an apology to Members on behalf of NHS organisations. Members were not informed at the pace and the time they should have been, and for that I offer regret. Members are right to say that they should have been the first to know there were problems so that they could properly represent their constituents and hold local leaders to account.

I offer that apology within the context of a much better story across the NHS of what happens when hospitals fail. A warning notice was issued—that was the first reason that the right hon. Member for Enfield North knew something was going wrong—because of a change to the law under the coalition Government in 2014 on when the CQC was able to issue warning notices.

[Ms Abbott]

Will the Minister give way?

[Ben Gummer]

I will in a second. The whole system of CQC Ofsted-style inspection ratings, which are designed to be user-friendly so that non-clinicians can understand how well hospitals are performing, was instituted by the Secretary of State because we wanted to shine a light on the performance and quality of care in hospitals. Through two and a half years of having special measures routines and regimes for hospitals, we have a much better understanding of why things go wrong and can put them right far more quickly. Most importantly, we have a process for engaging Members of Parliament right at the beginning. That did not happen in this instance, and I will explain why after I have taken the right hon. Lady’s intervention.

[Ms Abbott]

The Minister may be coming to this, but I wanted to ask who Members should look to inform them of a catastrophic drop in standards. They should not have to wait for the CQC to issue a warning.

[Ben Gummer]

Ideally, if things are going wrong and that has been noted within the hospital, the hospital chief executive or commissioners should inform local people, but in the past—and over the two and a half to three years since we instituted the special measures regime—it has taken a Care Quality Commission investigation to highlight poor standards of care so inadequate that the hospital needs to be placed under special measures. At that point, before the public are informed, Members of Parliament are informed by the CQC and what was Monitor and the Trust Development Authority, but is now NHS Improvement.

Oral Answers to Questions

Debate between Diane Abbott and Ben Gummer

Tuesday 5th July 2016 Commons Chamber

[Ben Gummer]

The Home Secretary said she was confident we could get a deal ensuring that they could stay, but we need a new Prime Minister able to start the negotiations caused by the decision of the British people on 23 June. I say in my capacity as a Health Minister— the House has heard from other Members, including the Secretary of State—that we have full confidence in the EU nationals working in the NHS and wish to praise their contribution, which makes the NHS a better organisation.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

The head of the NHS, Simon Stevens, has strongly defended the role of immigrants in the NHS, saying that there has never been a time in its 68-year history when the NHS has not

“relied on committed employees from around the world”.

One of these employees was my own mother, who migrated from Jamaica to the UK in the 1950s to be a pupil nurse. Workers from the EU and other countries are the backbone not just of the NHS but of our social care system, which is facing many challenges. Does the Minister agree that we should be thanking these hard-working individuals for their service, not leaving them with questions about their status and job security?

[Ben Gummer]

I agree entirely with the hon. Lady that we should be thanking EU nationals working in the NHS and social care system. She herself is evidence of the enormous contribution of migrant labourers, not just in the first generation but in subsequent ones. We, as a nation and a House, should be grateful for it. This is a difficult time for many EU nationals in this country, and we should be thanking them not just for the numbers but for the special qualities they bring. In my constituency, the amazing Portuguese nurses in Ipswich hospital bring qualities and skills that some of our own nurses in our own country do not possess in our own hospitals.

NHS Success Regime

Debate between Diane Abbott and Ben Gummer

Thursday 4th June 2015 Commons Chamber

[Ben Gummer]

I thank my hon. Friend for his question and welcome him to this place. To repeat the answer I have given several times so far—[Interruption.] Those on the Opposition Front Bench say that I do not know, but I must explain to them once again that this is not about a Minister sitting in Whitehall making a decision having never visited an area. That is what the right hon. Member for Leigh (Andy Burnham) did when he tried to destroy local services in my constituency and other places in Suffolk. This is different. It is about trying to fix problems in these challenged local health economies, which in some places have been present not for months or years but for decades. We are trying to ensure that the decisions are corrected and made by the local commissioners and clinicians.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

Ministers will be aware of the plight of the Barts Health NHS Trust, which is in special measures. Part of its problem is the weight of the interest on its private finance initiative, a new Labour policy that I did not support. It is having to pay that back at £500,000 a month. Surely a success regime for Barts and other hospitals burdened with PFI debt would be a serious attempt to renegotiate those PFI agreements.

[Ben Gummer]

I am so glad that the hon. Lady welcomes the success regime and the potential it might have. I spoke to one of her colleagues the other day about the troubled hospitals that she mentioned and I was about to invite her in to have a discussion about them, as we must try to find out what the core issues are with Barts Health NHS Trust. She raises an interesting point about PFI, however. One reason we are struggling in some cases, and why we have struggled over the past five years to provide the funding within the NHS that it requires, is the enormous NHS PFI debt that was loaded on to it by the previous Government and that has cost it billions of pounds over the past 10 years.