Mid Staffordshire NHS Foundation Trust (Inquiry)

Jeremy Lefroy Excerpts

Wednesday 6th February 2013 Commons Chamber

[The Prime Minister]

I thank the right hon. Gentleman for his remarks and for the tone in which he made them. I apologise for not getting my response to the report to him a little earlier this morning. That was a technical mistake rather than anything more sinister. The right hon. Gentleman is right to thank the relatives and to thank Robert Francis for his work. Let me try to answer the right hon. Gentleman’s questions.

On the issue of reorganisations, Francis says:

“The extent of the failure of the system shown in this report suggests that a fundamental culture change is needed. This does not require root and branch reorganisation—the system has had many of those—but it requires changes which can largely be implemented within the system that has now been created by the new reforms.”

I hope we can agree that the best thing to do now is to learn the lessons and put in place what needs to be done.

The right hon. Gentleman is absolutely right to raise the issue of listening to patients. As he said, we have got to make sure that whatever organisation we have—we have established HealthWatch—is independent, credible and has power. It is interesting to note what Francis finds on page 46:

“It is now quite clear that what replaced”

community health councils, and there were

“two attempts at reorganisation in 10 years, failed to produce an improved voice for patients and the public, but achieved the opposite.”

We need to learn the lessons and try to make sure that HealthWatch becomes everything we all want it to be.

As for supporting complaints, what Francis and the right hon. Gentleman said is that when there are complaints, they have got to be given a bigger voice and be taken seriously. Here, Members of Parliament have a role to play. Somewhere, buried in the report, there is a passage that is mildly critical of MPs. Like others in the community, we love our local hospitals and we always want to stand up for them, but we have to be careful to look at the results in our local hospitals and work out whether we should not sometimes give voice to some of the concerns rather than go along with a culture that says everything is all right all of the time—sometimes it is not.

On the issue of staff numbers and benchmarks, we think it important that there should be some benchmarks. We believe that because of the funding commitment we have made, there is no excuse for understaffing or for staff shortages, but that obviously requires good management.

On having a single regulator, the right hon. Gentleman made a lot of points about Monitor and the Care Quality Commission and whether there was confusion between them. When he talks of strengthening the CQC and giving it greater powers, that is in principle, as I said in my statement, the right direction to go in.

The right hon. Gentleman asked about trusts, and both sides of the House have supported the idea of foundation trusts, making sure hospitals are more accountable, more responsible and able to take more decisions. The problem is not with creating foundation trusts, but arises if the move to create them means that other things that matter more than trust status—such as patient care—are pushed to one side. We must all learn the lesson and ensure that for the next round of trust creation, they must not be rushed and they must happen only when they are ready and on the basis that patient care comes first.

The point about targets is important. I believe that there is a place for targets in our NHS, but I think that under the last Government they became too tight and too obsessive. I also think that the last Government recognised that themselves, and started to change the approach.

The public have a right to know that waiting times in A and E will not be too long and that treatments will be carried out quickly, so there is an importance in targets. I think that what Francis is saying is that it was not the targets that were to blame, but a culture in the hospital—and perhaps in other hospitals, although he does not inquire into that—in which targets and their achievement were placed ahead of patient care. Again, the two should not be alternatives.

What the right hon. Gentleman said about the ageing population and the challenge facing our NHS was absolutely right. A key part of our dementia challenge is raising the standard of, in particular, the way in which we treat elderly people in our hospitals. I also agree with the right hon. Gentleman that we need to break down the barrier between health and social care.

I hope that the report will provide not an opportunity to try to find scapegoats or to fire up some phony political debate, but a moment when everyone in the House can agree. We all love our national health service, and this afternoon’s discussion shows that we have the same ideas about patient care, about quality, about bringing health and social care together, and about ensuring that a good, rational system has patients at its heart. I hope that this can be a moment when the country comes together over our NHS, rather than seeking divisions.

[Jeremy Lefroy (Stafford) (Con)]

Today is a day on which, first of all, we think of those who suffered in Stafford and of their loved ones. I thank the Prime Minister and the Leader of the Opposition for the tone that they have adopted. I also pay tribute to Julie Bailey and Cure the NHS, to Robert Francis, to my hon. Friend the Member for Stone (Mr Cash), to my right hon. Friend the Member for South Cambridgeshire (Mr Lansley), to the Secretary of State and to the Prime Minister for the way in which they have championed the cause of this inquiry.

I know how passionate the Prime Minister is about the NHS and the work that goes on day in, day out, and I share that passion. Does he agree that the most important thing that we can do for the patients and their loved ones who have suffered is implement the recommendations that we are able to implement as quickly as possible, so that they can result in an NHS that is safe for all and is known for the highest standards of compassion and care?

[The Prime Minister]

I am sure that my hon. Friend, who has spoken up about this issue for many years, spoke for everyone in Stafford and throughout the country when he said that we should put the victims up front and centre. They are the people we should be holding in our thoughts today because of how they have suffered.

I agree with what my hon. Friend said about implementing the recommendations. There are 290 of them, so we must examine them carefully and see how we can best implement them, and the Department of Health will lead that work. Let me make two additional points. First, the recommendations are not simply for the Government or the Department; they are for every hospital, every nurse and every doctor to consider. I think it very important for that to happen. Secondly, as I tried to make clear in my statement, for all the changes in the system and all the corrections of regulatory failure that may be made, a system is only as good as the people who work in it. I think that at the heart of what Francis is saying is a cry from the heart that this is about quality, vocation and compassion, and that those are the values that we need to put back at the heart of the NHS.