NHS Risk Register

Frank Dobson Excerpts

Wednesday 22nd February 2012 Commons Chamber

[Mike Freer]

I will give way later. I want to make a little progress first.

I do not believe that the Opposition’s call for publication is remotely to do with transparency. If it were, they would themselves have published risk registers in the past. The right hon. Member for Leigh (Andy Burnham) said earlier that the present was not the same as the past, and that the past had not involved major reorganisations. Let me refresh his memory. In 2008 and 2009, in London, there was a major reorganisation of hyper-acute stroke units and a major reorganisation of major trauma centres. When the clinicians and the public opposed that action, what did NHS London do? It did not make the risk register public; it did not make details of all the risks fully available so that we could make an informed judgment, as the Opposition are trying to persuade us to do. It simply rewrote the consultation results, and what did it say? “The consultation results from the people of Barnet were inconvenient, and we are therefore inserting a new chapter so that we can ignore the clinicians and the patients.” That is the track record of the Labour party.

The Opposition may come to regret—

[Frank Dobson (Holborn and St Pancras) (Lab)]

Will the hon. Gentleman give way?

[Mike Freer]

I said earlier that I would give way to the hon. Member for Birmingham, Erdington (Jack Dromey).

--- Later in debate ---

[Frank Dobson (Holborn and St Pancras) (Lab)]

I think the Government will conclude that it is foolish of them not to publish the register, because everybody assumes that they must have something to hide—something to do with policy development.

In the absence of publication, we can only speculate on what the register contains. I should like to know, for instance, whether there is any reference to the risk that is being taken by inviting American health corporations to bid for services in this country. After all, all the leading American health corporations have, at one time or another, been indicted for defrauding patients, doctors or taxpayers. I asked the Secretary of State whether he would ensure that no contracts are given to any American corporation that has been indicted for fraud. He refused to ban them, so we can expect them to come in.

There is also the question of marketisation and of putting things out to tender. We have an example in my constituency. The Camden road practice was put out to tender in 2008 and the existing practice doctors put in a bid that met all the requirements. According even to the stuff that was published, they did better than the private sector bidder in respect of the requirements, but the private sector firm bid to provide the services at a lower cost to the NHS and got the contract.

When I asked for details of all the bids and considerations, I was told that they could not be disclosed because they were commercial and confidential. I warn all hon. Members who think they will get the details of what happens in their areas—we can safely bet that the words, “No you can’t have the information. It is commercial and confidential”, will come up time and again.

As it happens, a US company, UnitedHealth primary care, got the contract. I admit to having a touch of cynicism in my make-up and rather assumed it would do a rattling good job to demonstrate what a wonderful outfit it is, but it was not so. It did not even bother to act as a loss leader. It reduced the amount of time patients had with doctors and at one time suggested that patients could raise only one topic with their GP. Opening hours were changed. It closed a baby clinic, but because there was a great row, it reopened it. The PCT contemplated taking legal action to enforce compliance with the contract but was advised by its lawyers that the contract was not enforceable.

Last year, that triumphant outfit suddenly sold all its GP contracts, including the one at the Camden road practice, and said it would concentrate on offering support to GP commissioning boards because that is easier and more profitable than supplying a GP service. It sold the Camden road surgery contract to an outfit called The Practice plc. The contract was not put out to tender and nobody was consulted about the transaction—not the NHS or the staff, or least of all patients.

Patients—my constituents—were chattels in that transaction, but they might have been reassured when they saw the publicity for The Practice plc, which states:

“At The Practice we offer clinical services to NHS patients who need to be sure of the very highest standards. But it’s how we do what we do that makes the difference. We aim to deliver genuinely caring and thoughtful patient centered services, minimise waiting times and make the whole experience one to remember with satisfaction. From first referral through diagnosis to effective treatment we promise true professionalism…At The Practice, patients come first.”

Not any more they don’t. It has been announced that the practice in both centres is closing down because the lease has run out. The patients have been left bereft and bewildered. It is not a question of integrated care between primary care and social services. There will be no integrated care at the practice because people will be spread around half a dozen neighbouring practices. And why? It is because this commercial organisation, dedicated to profit and lining the pockets and handbags of its shareholders—the sacred shareholders, whose interests must always come first—has decided that it cannot find alternative premises. What is the risk of that happening when the Government spread this practice right across the country? Is the risk of that happening mentioned in this famous risk assessment? I doubt it very much.

A constituent of mine wrote to me:

“Before United Health took over…we had an excellent surgery with excellent…doctors. They knew their patients’ medical histories and the patients trusted them…. What are we left with? A Surgery which started to deteriorate almost as soon as the original doctors left/were forced to leave, one which continued to deteriorate… So much unnecessary disruption and upset… Totally ridiculous and unprofessional and with no sensitive consideration or understanding being afforded to patients.”

We hear a lot about patients from Government Members. They need to consider what will happen to their patients when this is all marketised.