Junior Doctors Contracts

Julian Lewis Excerpts

Thursday 11th February 2016 Commons Chamber

[Mr Hunt]

As someone who I fully concede may have more experience of industrial relation disputes than me, let me just say this: it is very clear that we are able to progress when there is give and take from both sides; when both sides are prepared to negotiate and come to a deal that is in the interests of the service and in the interests of the people working in the service. That was not possible. It is not me who is saying that; that is was what Sir David Dalton, a highly respected independent chief executive, said in the letter he wrote to me last night.

Some of the things that the BMA put out about the offer—for example, it put up on its website a pay calculator saying that junior doctors were going to have their pay cut by 30% to 50%—caused a huge amount of upset, anger and dismay, and were completely wrong. I do not think it would be very constructive for me to put in the House of Commons Library a list of all those things, when what I want to try to do is build trust and confidence. The differential between doctors and other workers in hospitals is what the BMA was seeking to protect. It still exists, but we have reduced it from what it was before because we think it is fairer that way and better for junior doctors.

[Dr Julian Lewis (New Forest East) (Con)]

May I add to what my long-time comrade, my hon. Friend the Member for Gainsborough (Sir Edward Leigh) said by delving into a bit of history? In 1977, I was knocked off a motorcycle by a careless driver on a Sunday. Because staff were not in the hospital, the wound could not be cleaned until it was x-rayed and because the wound could not be cleaned, I got an infection. This is not just about increased mortality rates; it is about the prolongation and exacerbation of small or routine episodes and injuries. Will the Secretary of State, in his calm and measured way, say again to the House that when we look back on this episode people will be very surprised that it took nearly 40 years—from my accident—to bring about this long-overdue reform?

Cities and Local Government Devolution Bill [Lords]

Julian Lewis Excerpts

Monday 7th December 2015 Commons Chamber

[Peter Heaton-Jones (North Devon) (Con)]

rose—

[Dr Julian Lewis (New Forest East) (Con)]

rose—

[Mr Speaker]

Ah, what a rich and delicious choice! I call Mr Robert Neill.

--- Later in debate ---

[Mr Betts]

I thank the Minister for his helpful comment. Perhaps more discussion could have been had before we reached this point; that might be something that everyone could learn from. The Minister’s intervention has been helpful to me and I thank him for it.

[Dr Julian Lewis]

rose—

[Peter Heaton-Jones]

rose—

--- Later in debate ---

I warmly welcome the new clause. It is also welcomed by the heads of Exmoor national park—I have spoken to them about this issue in great detail since Thursday. All other national park authority managers welcome it, and I know that they have been in conversation with the Minister. I warmly welcome that because the new clause will be good for Exmoor, and good for the rest of our national parks.

[Dr Julian Lewis]

I thank you, Mr Speaker, for drawing such attention to the fact that I “beetled” into the Chamber, as you put it, rather late, and I apologise for that. I also apologise for the fact that unfortunately I am going to beetle out of it again rather early, for the same reason that I was late, namely Defence Committee business. I am delighted to have the opportunity of this small window to try to reassure those on the Opposition Front Bench. I hope that they will take my reassurances seriously, as I was one of only three Conservative Members to vote against the scheme for privatising the forest estate, which the hon. Member for Heywood and Middleton (Liz McInnes) referred to in her remarks. I am not one to accept on trust everything about forests that the Government put forward.

Having said that, the Government deserve a big pat on the back for this measure. It is often said that the Government do not listen, but this is a classic case of their having listened. [Interruption.] I would be grateful if those on the Opposition Front Bench also listened for a moment, because I am directing my speech at them in an attempt to be helpful.

The chair of the New Forest national park authority, Mr Oliver Crosthwaite-Eyre, is a former official verderer of the New Forest and very highly thought of by all those who live and work in the forest and are concerned with its management and protection. He contacted me some time ago to ask if it would be possible to persuade the Government to include such a provision in the Bill in Committee. Sadly, that stage had just concluded, so it shows extraordinary flexibility and willingness to listen by the Government in general—and by the Under-Secretary in particular—to manage to include the provision.

I fully sympathise with the Opposition spokesmen, because new clause 7 is a lengthy provision, and it is their job to scrutinise measures, whether they are long or short, but particularly if they are long. I should therefore like to try to reassure them about new clause 7 by reading two brief extracts from a document supplied by National Parks England specifically for use in our debate. It says:

“National Parks England (the umbrella body for the NPAs) warmly welcomes the tabling of New Clause 7 by Ministers and hopes that you”—

meaning me—

“will be able to speak in support of it at the Report Stage debate of the Bill on Monday 07 December 2015.”

It then gives a long list of the reasons why it supports the extension of powers, which are similar, it points out, to powers given to many comparable bodies. It ends by referring specifically to the new clause:

“New Clause 7 follows the legislative format established for other public bodies. National Parks England supports this amendment and would encourage MPs to speak in support during the Report Stage debate on the Bill.”

I understand the difficulty in which Opposition spokesmen find themselves, given that a clause of such complexity has been tabled at short notice. I hope that I have been able to reassure them that national parks themselves warmly welcome the clause. I do not think that it is a conspiracy. I have had occasion in the past to point out conspiracies when they crop up, but I do not think that this is an occasion for concern about conspiracies—on the contrary, it is an opportunity to congratulate Ministers, including the Under-Secretary, on listening, being flexible and making a change at, indeed, the eleventh hour. That change deserves to be made if we are to show our trust in the judgment of the national park authorities themselves.

[James Wharton]

I do not intend to speak for long. I merely wish to record my thanks to hon. Members who have contributed to this debate. We began in a contentious place, but we have, I hope, moved towards consensus. I acknowledge the contributions of right hon. and hon. Members, including my right hon. Friend the Member for New Forest East (Dr Lewis), who has been vociferous in making the case and with whom I have exchanged a significant quantity of correspondence, for bringing this to the Government’s attention and suggesting that it be included in the Bill. The measure is welcomed by national parks and by many hon. and right hon. Members. I hope that it will be welcomed, too, by shadow Ministers and that we can move forward in a more consensual way in the rest of today’s debates. Regardless, I commend the changes to the House. They are welcome and they are important.

Question put, That the clause be read a Second time.

Contaminated Blood

Julian Lewis Excerpts

Monday 20th July 2015 Commons Chamber

[Ben Gummer]

I thank the hon. Lady. It is a good example of the new mode of working between our Governments that officials in the Department of Health have been working very closely with their counterparts in the Scottish Government. Of course, most of the events that the Penrose report refers to were pre-devolution. It is therefore entirely right that the recommendation is adopted across the United Kingdom, not just in Scotland. I expect that cross and close working will continue through the course of the settlement process.

[Dr Julian Lewis (New Forest East) (Con)]

My constituent Lesley Hughes was infected with hepatitis C 45 years ago, but the condition was discovered only relatively recently. Given that she is an older sufferer, the standard drugs do not agree with her or assist her to the extent that the new generation of drugs would. Is there a timescale that I can offer her to give her hope that she will be able to move from the less effective and less tolerable drugs to the new generation of drugs?

[Ben Gummer]

My right hon. Friend raises an important point. He may be aware that the Government have launched an accelerated review of hepatitis C drugs, and the Under-Secretary of State for Life Sciences, my hon. Friend the Member for Mid Norfolk (George Freeman), will be updating the House as soon as he has news on that. At the moment, I am afraid all I can promise is celerity rather than certainty.

Epilepsy

Julian Lewis Excerpts

Thursday 26th February 2015 Commons Chamber

[Steve Baker]

I am extremely grateful to my right hon. Friend. I have already passed the details to the Minister. I am aware of the inquest and the NHS investigation, but I will certainly take her advice and give those other bodies the opportunity to investigate.

That brings me on to the specific issue of consent. I have spoken to Mr and Mrs Monks today and they say that at no point was it explained to them that this medication could have these side effects. Jessica was 17 when she started taking it, and I feel that that possibility really should have been explained to her parents. They should have had the opportunity to take very strong action. Of course, they did take very strong action—they took the strongest action they could—and it seems to me, without wishing to pass judgment, that the key problem was that they could not get hold of the neurologist.

[Dr Julian Lewis (New Forest East) (Con)]

I am puzzled that the instructions that came with the medication did not include a warning that if someone had those sorts of side effects, they should cease taking it.

[Steve Baker]

I am a layman, but one of the things I have learned today is that one cannot simply cease taking medication for epilepsy, so specialist advice is required.

Oesophageal Cancer

Julian Lewis Excerpts

Monday 23rd February 2015 Commons Chamber

[Mike Weatherley]

My hon. Friend makes a very important point that I was not going to cover, and I thank him immensely for doing so.

Crucially, as with many other types of cancer, the outcome of oesophageal cancer depends on how advanced it is when it is diagnosed. The reason not many people can have surgery is that by the time a difficulty in swallowing is recognised, the tumour has become fairly large and has spread. As my hon. Friend pointed out, the surgeons see most people when they are already too late for curative treatment, which makes it difficult to identify survival rates for each individual stage of the disease.

What measures would I like the Minister to consider? Let me make six points. First and, I think, most important, we should make the process of seeing the doctor much easier. No one should be put off from making an appointment at the first available opportunity. Access to evening and weekend GP clinics remains patchy at best, and, as we know, that has a knock-on effect on A and E departments.

Secondly, we should make every effort to improve testing at the point of contact with GPs, and to ensure that there is rapid follow-up access to hospital diagnostic tests. Giving some GPs direct access to hospital specialist tests such as endoscopies and CT scanning would speed up the process of diagnosis.

Thirdly, we should educate patients so that they recognise the symptoms of oesophageal cancer. That will lead to earlier detection of cancer, which in turn will lead to higher survival rates. A good oesophageal awareness campaign is currently running on television.

Fourthly, 1 believe there are some “quick wins” which, if implemented, could speed up processes, remove inefficiencies and save money. For example, at the moment if someone is referred for a chest X-ray and the findings are abnormal, the results go back to the consultant or GP and the person has to have another appointment before they can be referred for an additional test, such as a CT scan. If a chest X-ray was found to be abnormal and the person was then referred straight for a CT scan, it would save on unnecessary GP or consultant appointments, and ensure that when the person is seen, their GP or consultant has all the information they need to make a diagnosis and set out next steps.

Fifthly, another factor in poor care is that it is almost invariably because of pressure on specialists due to the volume of work. When campaigns are announced by the Government, they create a surge in demand, which causes problems for medical staff because they cannot cope with the high volume of work. I would like the Minister to consider allocating extra resources for endoscopy. Targets and high outputs mean that patients are treated as statistics rather than as individuals. Take this quote, for example, from an upper-GI surgeon:

“I get lists of potential 62 day target breaches with no details of the patients themselves. We see about 20 patients in two hours in our cancer clinic on the one morning we have for these appointments—that equates to just six minutes per patient. In order to give patients dignity and respect, most doctors would need an hour per patient to talk them through their diagnosis, treatment and surgery.”

Here is a similar point direct from another specialist surgeon:

“I fully support the ‘Action Against Heartburn’ organisation emphasising the need to take seriously symptoms of persistent heartburn and dysphagia, and not having more and more medications without investigation.”

This will increase demand on endoscopy services significantly, as well as CT scanning, which of course would need extra funding to cope. However, the increased detection of early disease will enable more minimally invasive endoscopic therapy, avoiding surgery and saving money.

[Dr Julian Lewis (New Forest East) (Con)]

I recently had the advantage of an intensive briefing on oesophageal cancer from Professor Tim Underwood, a specialist at Southampton general. My hon. Friend may be interested to know that it is developing a technique that would enable the discovery of the cancer cells earlier and without an endoscopy being carried out. Research is constantly going on to try to remedy the very problem that he has identified so clearly.

[Mike Weatherley]

I thank my hon. Friend for that intervention, and my surgeons have made similar points to me. Clearly the tools are available to do that.

The sixth strategy I recommend is greater hospice care to provide end-of-life care away from hospitals that supports people and allows them to spend their final weeks and days in a place of their choice, rather than in a hospital bed.

I hope that this short Adjournment debate has two positive outcomes. The first is an increased awareness of this cancer, with many more people detecting problems earlier. If we can save lives through early detection, that has to be a good thing. The second is a commitment to additional specific resources. Of course this would mean more money being allocated, and I am well aware that there are huge conflicting demands on limited budgets, but part of this could be achieved by a quicker, more efficient diagnostic procedure. Our radiotherapy capacity is far short of what we need and access to the latest advanced techniques to spare normal tissues is limited—although I would stress again that, as my hon. Friend the Member for New Forest East (Dr Lewis) said, we do have diagnostic tools to deal with this disease and change outcomes, so it is not a huge step to save more lives.

I look forward to hearing the Minister’s comments and, hopefully, Government determination to be on the patient’s side in treating this particular cancer. We really do need to improve on just 15% of patients living longer than five years once diagnosed.

Child and Adolescent Mental Health Services

Julian Lewis Excerpts

Monday 2nd February 2015 Commons Chamber

[Norman Lamb]

I am grateful to the hon. Gentleman for his generous remarks—perhaps he ought to talk to his Front-Bench colleagues about my commitment. He is absolutely right to highlight the fact that although there is quite a mixed picture across the country, in many areas there has been disinvestment in children’s mental health services. They are local decisions, and they are not decisions that I accept. That is why I made the serious point about the absolute importance of introducing waiting time and access standards, including in children’s mental health services. We need data so that we can monitor performance against those standards, and we need a payments system that does not disadvantage mental health. I also share his view that we need to change the way services are organised and commissioned so that we focus much more on prevention.

[Dr Julian Lewis (New Forest East) (Con)]

Does the Minister accept that this is a matter not only of funding but of philosophy? Does he agree that part of the problem is that certain primary care trusts have adopted a philosophy of cutting in-patient beds generally? For example, adult beds have been cut by 35% in areas as far apart as my constituency and that of my hon. Friend the Member for Burton (Andrew Griffiths). Does he detect any rowing back from that rather extreme philosophy in the near future?

[Norman Lamb]

We want to try to ensure that when there is a crisis, a bed is available locally. With regard to the philosophy of seeking to reduce the tendency to have long periods of in-patient care—institutionalising people—it is absolutely right that we move away from that and focus far more on early intervention, community support and recovery. That is the general trend in progressive views within mental health. However, there must be a bed available when a crisis occurs.

Contaminated Blood

Julian Lewis Excerpts

Thursday 15th January 2015 Commons Chamber

[Dr Julian Lewis (New Forest East) (Con)]

Mr Deputy Speaker, having come late to the debate because of a clash with a meeting of a parliamentary Committee on which I serve, I am grateful for the indulgence of the Chair in allowing me to make a brief contribution.

I wish to focus on three points. The first is that people are still, even now, long after the event, being discovered to have been infected with contaminated blood; the second is that momentum for a settlement is in danger of being lost; and the third is that the best treatment is not always available for those who have been infected.

I was struck by what the right hon. Member for Coatbridge, Chryston and Bellshill (Mr Clarke) and others said about the debate being a chance to give a voice to individual constituents. I was also struck by the question asked on 10 December of the Deputy Prime Minister, who was standing in for the Prime Minister, by the hon. Member for Coventry North West (Mr Robinson), because he said in that question what he repeated today—that the scandal had reflected badly on successive Governments, possibly going back as far as that of Harold Wilson, if not further. In the context of momentum being lost, he said that the Prime Minister had undertaken in June to look at and rectify the situation. In fact, according to my constituent, Mrs Lesley Hughes, who only a week before he asked his question had got in touch with me about this very issue, the Prime Minister had apparently told one of his own constituents who was affected by this that he hoped to have a resolution within six months. This would have meant the end of the last calendar year.

I said that my first point was that people are still being discovered who were infected long ago, and that is Lesley Hughes’s situation. In 1970, she and her future husband were involved in a very serious road traffic accident in London, and she had to receive no fewer than 44 pints of blood. For many years she knew nothing about the fact that she had been infected, although over those years she had many visits to GPs and hospitals with numerous symptoms of illness, and considerable pain and suffering. Only last year was it finally discovered that she had been infected with hepatitis C by NHS contaminated blood. Her main concern in writing to me initially was that, given that the Prime Minister had said that he hoped to wrap the issue up himself, she was really anxious that we should not get to the general election—which is, after all, scheduled to be about five months after the deadline that the Prime Minister had set himself—without reaching a resolution.

[Mr Robinson]

I am not sure that the exact undertaking that the Prime Minister gave is recorded anywhere, but it is recorded in exactly those terms by my constituent, Joseph Peaty, as well. Does the hon. Gentleman agree, though, that the impression was left that the Prime Minister would do his very best to get a settlement by the end of the year? We are past that deadline now. Does he agree that, irrespective of the reports being compiled, we do now have the means necessary to settle the issue, and that is what the Prime Minister should try to do?

[Dr Lewis]

That is exactly my view, and for that reason I wrote to the Secretary of State for Health, drawing attention to the matter. I received a reply dated 12 January from the Minister who will reply to this debate. Of course she was sympathetic in the terms that she used, but the important part of her letter was the conclusion, which was that

“this issue is being looked at very seriously, and…an announcement will be made to affected individuals and MPs once work has been concluded.”

My simple question to the Minister is, when will that work be concluded, and will she and the Prime Minister undertake to get this work concluded, on behalf of my constituent and many others, before this Parliament comes to an end? Otherwise, we are back to square one—a cycle which I am sure has been repeated over and over again.

Finally, I said that I would mention the other point about how the best treatment is not always available. I understand from Lesley, whom I have not met yet but whom I believe to be present with her husband today, and whom I hope to meet after the debate, that there are problems with the fact that many people suffering from infection are offered the older interferon and ribavirin-based treatment, and that not everybody can tolerate that, particularly as it takes a long time to clear the system, and particularly if they are people who are at a later stage of their life.

If the Minister cannot answer today, will she perhaps write to me later about the situation of patients in that position? Kinder and more effective treatments are available, but are not always sanctioned for reasons of cost either by NICE or by individual health trusts. I wish to give others the opportunity to speak, but once again I thank my constituent for her bravery in allowing me to tell her story and attribute it to her, and I thank the House for its indulgence in allowing me to contribute to the debate at such a late stage.

Medical Records (Confidentiality)

Julian Lewis Excerpts

Tuesday 11th February 2014 Westminster Hall

[Mr George Mudie (Leeds East) (Lab)]

It is a pleasure to hold this debate under your distinguished chairmanship, Mr Hollobone.

The debate deals with one of the most accepted and appreciated relationships, which is that between patients and their doctor, with the knowledge that whatever information is recorded by the GP is confidential and kept securely in the medical records held by the practice. Next month, that will change. Under controversial legislation passed in 2012, family doctors will be required to pass to a new national database created by NHS England all the medical records of the patients in that practice.

The personal GP record may be added to by any other social care organisation that deals with the patient and with hospital records that exist for an individual. This is being done, according to NHS England, to improve the delivery of health care to benefit researchers inside and outside the national health service. I have no reason to suggest that this move will not lead to improvements in health care, and, no doubt, the Minister will deal with that matter more fully.

I have sought the debate for two main reasons. My first concern is shared by many people, including some present in the Chamber: the security dangers of bringing all such personal data together in one huge national database. The second reason is my dismay and even anger at the deliberate manner in which the public have been deprived of consultation and information on what could be, and I think will be, a significant threat to their right of privacy in respect of their medical records.

On the first threat, to security, we are assured by NHS England that the information

“will be stored…in a secure environment with the highest standards of information governance and technical expertise to protect the data.”

If patients are reassured by that statement, the US Government must have lower standards. For example, Angela Merkel, the German Chancellor, learned about the USA hacking her personal phone from sources inside the US. A young lad from Glasgow was extradited to the USA in the past 19 months to face charges, because from his Govan bedroom he had breached military systems in the US. This weekend, closer to home, Barclays bank admitted that delicate, sensitive and important financial details of 35,000 of its customers had been stolen.

[Dr Julian Lewis (New Forest East) (Con)]

Does the hon. Gentleman believe, as I do, that the single most important point, which I hope that he will elaborate for us, is whether the identities of the people whose data are being stored are also being stored? If they are being stored, I am entirely with him; if they are not and only data without identity are being stored, there might be more to be said for the scheme. I am interested to know what he has to say.

[Mr Mudie]

That is an important intervention, and I will deal with that, because it gets to the nub of the matter. Health care improved, fine, but there must be a balance with the right of individuals to have their privacy. I will deal with that.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

It is a pleasure, Mr Hollobone, to serve under your chairmanship. I congratulate the hon. Member for Leeds East (Mr Mudie) on securing this debate and all hon. Members on their contributions.

I pay particular tribute to my hon. Friend the Member for Mid Norfolk (George Freeman) for his excellent speech, in which he highlighted the importance of sharing data to improve patient care. He talked about empowering patients to take greater control over their health care. That is important and the key to it is ensuring that patients have the right data to do so. He also talked about improving research, ensuring that we can properly combat disease and linking data properly to understand exactly how to find cures for rare diseases. Importantly, he referred to the fact that we need properly to understand how good health services are, and to recognise where there is good practice. That is particularly important following the Francis inquiry and report, which outlined the importance of delivering high-quality care and transparent and properly used data to deliver that. He made those points very well.

[Dr Julian Lewis]

My hon. Friend the Member for Mid Norfolk (George Freeman) also referred to a major project involving people at the Maudsley hospital who had suffered serious mental illness. I want to hear from the Minister that there is no way under the sun that people who have suffered mental illness, for example, would find their data getting into the wrong hands. Without that guarantee, the project seems to be very dangerous.

[Dr Poulter]

In the time available, it is difficult to speak about detailed points. I apologise to my hon. Friend for that and I will write to him addressing some of the points that he raises. However, I can assure him that robust safeguards are already in place to protect patients with mental illness, and those safeguards will remain robust, if not more so under the systems that we will put in place.

It is important to recognise that the big challenge facing the health and care system is the fact that in the past we have had too much silo working, which has been to the detriment of patient care. The health system has often operated in a fragmented and siloed way. The operation of the health and care systems is not integrated and joined up. Key to driving improvements in patient care is ensuring that we join up the information that informs what good care looks like. Integration involves ensuring that a process exists to join up health and care information to improve care for patients.

We want to look after people with diabetes, dementia and long-term illnesses and to give them dignity of care in their own homes. It is important to do that and to have the right information and evidence to do so. We are well into that journey. The £3.8 billion integration fund will help with the provision of services, and the health and social care information centre will help us to get the right evidence base to drive properly joined-up, integrated care.

Mrs M. Barnes (NHS Treatment)

Julian Lewis Excerpts

Thursday 6th February 2014 Commons Chamber

[Kevin Barron (Rother Valley) (Lab)]

I thank Mr Speaker for allowing me to raise this subject in today’s Adjournment debate. I understand that he makes the decision on a Thursday afternoon.

I wish to discuss the treatment of a constituent of mine, Mrs Monica Barnes, who lives in the village of South Anston. I have been dealing with her over many years now, regarding different aspects of her health care, but my reason for wanting to speak today has to do with what has been recorded on her patient records at the Kiveton Park medical centre and the effect it may have had on her clinical treatment.

Mrs Barnes wrote to me on 5 July 2002. She said:

“Whenever I have attempted to obtain treatment some reference to litigation past or present has shown itself in my medical records and/or in letters of referral from the GP. This clearly shows there to be discrimination in my case. This time reference is made in the Patients Summary to the court case. See copy sent to me in very small print, enclosed.”

I have indeed got the patient’s summary. It is dated 18 January 2001. On the bottom, it says “await judges ruling”. My constituent contacted the Information Commissioner, and a letter was sent to the practice manager on 5 September 2002. It contained the patient’s summary and the court case entry. It said:

“In order for me to assess the practice’s compliance with the First Principle, I would be grateful if you could confirm whether individuals are made aware that personal data about them may be disclosed to other health professionals in the course of their care and treatment and the extent of such disclosures. In particular, could you please confirm whether such data as were disclosed in Mrs Barnes’ case are disclosed to other health professionals as a matter of routine, which of the conditions in the Schedules the practice is relying upon in order to make any such disclosure and whether individuals are made aware of the disclosure. Given that Mrs Barnes did not expect this, I would also welcome confirmation of these issues with regard to her case. If there is no legitimate basis for holding and disclosing the data in question when Mrs Barnes did not expect such processing, it is likely to be in contravention of the requirements of the First Principle.”

Mrs Barnes received a reply from the Information Commissioner on 6 March 2003. I have to say that the Information Commissioner had to write to the practice on 16 December to remind it of the letter it had been sent on 5 September 2002 about what was held on Mrs Barnes’s record.

Mrs Barnes received a reply from the Information Commissioner. It said:

“I understand that having considered its relevance to your patient summary records, the practice has removed the entry which states “court case”. (I have requested that the practice ensures that this does not appear elsewhere in your medical records).”

That was dated 6 March 2003. Presumably, my constituent would have been quite happy with such a positive reply. The letter went on to say:

“Consequently, on the balance of probabilities it does seem that the data in question is not relevant and is excessive for medical purposes. It is also our view that on the balance of probability it does seem that it was not necessary for the practice to disclose the details without your consent, when you did not expect this.”

That is a pretty firm statement that the Information Commissioner felt that it was wrong for the records to have been kept in such a way.

In the autumn of 2010, Mrs Barnes decided to join another practice in central Rotherham that had been built in the walk-in centre that had been opened. Her medical records were requested by the South Riding Health Services Support Agency, an organisation that I had never heard of in my 20-odd years as an MP, and they were sent on 3 November before being sent on to the new practice in Rotherham town centre. When Mrs Barnes visited her new doctor in November 2010, the practice had her medical records but on her next attendance her new GP said that he did not have them. Mrs Barnes told me that she was prompted to investigate their whereabouts.

In 2011, Mrs Barnes asked me to write to the chief executive of NHS Rotherham, who wrote back to me on 11 March saying that he had had the case investigated by his complaints officer who confirmed that the notes were sent on 3 November. The chief executive went on to say:

“However, I am informed that shortly after forwarding the medical records…the…practice received a letter from the Information Commissioners office advising them that the amendments were to be made to Mrs Barnes’…records. In order to comply with the Commissioners advice, the notes had to be retrieved from Mrs Barnes’ current GP via the SRHSSA. Whilst it is acknowledged that the Kiveton Park practice had Mrs Barnes’s medical records for several weeks, it is important to note that implementing the Commissioner’s advice was onerous.”

The chief executive wrote to me on the basis that the submission from the Information Commissioner had come in around November 2010, when my constituent was moving to another GP’s practice.

I then received a letter from NHS Rotherham on 1 June 2011, which accepted that the Information Commissioner’s advice was given in 2003 and not more recently, as mentioned in the chief executive’s letter. That was the reason for the retrieval of the records from her new GP, as it was felt “prudent” that the medical records should be reviewed for absolute accuracy. The two doctors concerned verified that the removal of information as advised by the Information Commissioner had been carried out.

Mrs Barnes referred her case to the ombudsman. She wrote to me in October 2011 setting out a number of instances in which she believed discrimination might have taken place and said in that letter:

“When I assessed my medical records at the Sheffield Northern Hospital in June 2011, I discovered that reference to court case etc, was still to be found in my patient summary.”

It seems clear to me that the advice of the Information Commissioner given in 2003 was not adhered to. The instruction was to remove that reference from her medical records in the practice and anywhere else it might appear.

I got involved with the Parliamentary and Health Service Ombudsman on Mrs Barnes’ behalf and corresponded with the office in December 2012. The ombudsman had earlier refused to investigate the case until the medical practice had the opportunity potentially to offer Mrs Barnes some compensation. That did not materialise, for whatever reason. My understanding was that the insurers might have wanted to consider the case and decide whether to take any action. In a letter to me in December 2012, the ombudsman asked Mrs Barnes for further clarification in three areas. The first was whether she had considered taking a legal remedy and why she might not have chosen to do so. The second was the level of compensation she hoped to recover. The letter said:

“The Ombudsman does not operate a tariff system and we are very much guided by what people hope to achieve. The levels of financial redress we may be able to recommend are modest when compared to sums that could be recovered by legal action and it is helpful for us to know whether we would be likely to meet the financial outcomes a complainant has expressed. This helps to ensure that they can be quickly directed to the most appropriate route to consider their concerns and helps to avoid complainants being dissatisfied at the outcomes we may be able to offer.”

The third point related to how Mrs Barnes felt that she had suffered damage as a result of the practice’s failings.

Mrs Barnes came back to me on this matter and we discussed in some detail how she should respond. In March 2013, I wrote to the assessor at the health service ombudsman saying that Mrs Barnes and I continued to be unhappy with the handling of her case. I reminded them that a letter I had received from them on 28 March 2012 stated that

“the Ombudsman will not normally consider a complaint unless the NHS organisation concerned has had a reasonable opportunity to resolve the complaint”.

I then went on to say that in relation to their letter dated 11 December, Mrs Barnes did not wish to go down the legal route because of the potentially high costs involved.

In relation to the ombudsman’s comment about the compensation that Mrs Barnes would wish to recover, as I have already pointed out, I said that

“she cannot risk going down the legal route because of the cost. Consequently, she feels the only route she has open to her is to go through the Ombudsman”.

I then said that I would appreciate it if they could be more specific about what level of financial redress they may be able to recommend if they were to settle the case for her. They told me that they had no tariff, which I quite understand.

On the third point, I reiterated that Mrs Barnes had previously provided them with information on how she felt about the damage suffered as a result of the practice’s failings. It was not just the one incident; there were many other incidents in the letter that I received from Mrs Barnes at the time.

Further correspondence took place between Mrs Barnes and the ombudsman, and in a letter to them, no doubt in her frustration, she said:

“I refuse to involve clinical negligence solicitors due to my having taken legal action against a particular hospital in the past with no outcome.”

Hence, presumably, the reference on her patient record. She went on to say:

“The only people who seem to benefit from litigation are the solicitors themselves. I refuse to further fill their pockets and barristers’ pockets with taxpayers’ money.”

That quote was used in a letter sent to me dated 18 June from the ombudsman’s office. Also in that letter it was stated:

“Mr and Mrs Barnes complaint correspondence referred to a number of other interactions with NHS Care that did not involve the practice since around 1990 and were not part of our considerations”.

That is an important point, and I agree with it. This complaint was about the issue of what was on Mrs Barnes’s medical record and how it may have been used by others if they had seen what was on that.

After further correspondence, I received a letter from the director at the ombudsman’s office in August 2013 after a review had taken place of the action/inaction of the ombudsman’s decision not to progress the complaint. That letter stated that when I wrote to the ombudsman on 24 June 2013 I had said that Mrs Barnes was unhappy with the decision because she did not have the money to take the case to court. It was said that Mrs Barnes had previously told the ombudsman that she was not prepared to put money into the pockets of solicitors and barristers, but not, so far as I can see, that she could not afford to take legal action.

The letter continued:

“However, while a person’s ability to pay legal costs is relevant in cases such as this, it cannot be the sole factor. Mrs Barnes is seeking damages for personal injury that she says she has sustained at the hands of a number of clinicians over more than 20 years and her claim arises from an action for which the law provides a specific remedy. In the circumstances we agree with our original decision that the matter is properly for the courts and is not one we should investigate.”

[Dr Julian Lewis (New Forest East) (Con)]

This is a very complicated case and I just want to be sure that I understand exactly what the ombudsman is recommending. My understanding is that the ombudsman is recommending that a lady who has had a lot of trouble because she once previously went down the legal route should, instead of pursuing a complaint about that with the ombudsman, go down the legal route all over again. Have I got that right, or am I missing something?

[Kevin Barron]

The hon. Gentleman is absolutely right. What gets me about the last two letters more than anything else is the fact that they are completely contradictory. The first states:

“Mr and Mrs Barnes’ complaint correspondence referred to a number of other interactions with NHS care that did not involve the Practice since around 1990 and were not part of our considerations”.

The last letter basically states, “No, we aren’t going to pursue any action at all. We’re not going to look at it.” It then states—I am sorry to repeat this, but I think that it is important—that

“Mrs Barnes is seeking damages for personal injury that she says she has sustained at the hands of a number of clinicians for more than 20 years”.

They are completely contradictory.

It seems to me that the parliamentary ombudsman, which is also taxpayer funded, has not only made contradictory statements, but handled Mrs Barnes’ case in a negative way. As we discussed when she and her husband visited my office, which they did on several occasions, this was not about what had or had not happened to her with the medical professional over the years; it was about what had been held on her personal records. In 2003 the Information Commissioner said that that was wrongly done and suggested it should be removed. We then found out that in 2010 the records were scooped back in again when they moved to another practice. I can only assume that the chief executive of NHS Rotherham did not know about the Information Commissioner’s decision at the time, because the second letter I received from the chief executive stated that it was more recent than he had been led to believe and that the records had been brought back from the new practice because they had just received information from the Information Commissioner that they had to change them.

I am deeply concerned about the situation. My constituent has effectively been railroaded into a situation she does not want to be in, and that she should not have to be in. Indeed, the British taxpayer has been railroaded into a situation that I do not think it should be in. My constituent said, not with my blessing—I give it my blessing now, though—that far too many people are forced into litigation in this country, at taxpayers’ expense, rather than following common sense by sitting down, looking at the problem and deciding what should be done sensibly, not feeding the law courts.

I have to tell the Minister that I am deeply disappointed that the Parliamentary and Health Service Ombudsman—I know that it is not directly a part of Government—can be run in that way and make those contradictory decisions. It seems to me that its decision is this: “We don’t have to do anything, so we’ll force her back to litigation if she does not want to go. That’s the end of the matter.” That cannot be correct, and I would like to know whether the Minister agrees.

--- Later in debate ---

[Dr Poulter]

The right hon. Gentleman is absolutely right. It is difficult, in terms of the care pathway, for any patient to draw these distinctions. However, the NHS complaints procedure relates to NHS care, and the ombudsman’s role is as a public sector ombudsman. That goes to the heart of some of the difficulties we are talking about.

If a complainant is dissatisfied with the outcome of their complaint locally, they have the right to take it to the health service ombudsman, whose office was set up under the Health Service Commissioners Act 1993. When complaints are escalated, it is important that they are investigated independently, free from the political process, to ensure that there is no question of bias. The health service ombudsman is completely independent of the Department of Health, the Government, and the NHS. It is therefore difficult for me to comment on the ombudsman’s decisions directly.

If a complainant is dissatisfied with the ombudsman’s decision, they may make use of her own complaints process. The recourse open to anyone after the ombudsman has made a final decision is to seek a judicial review. During the entire complaints process, we assume that patients would take legal advice whenever they think it necessary. That is in their best interests and, in some cases, it is often important that patients have advice from a completely independent source.

If, on the basis of the legal advice received, patients decide to commence legal action against the NHS, that is, of course, to be expected. The House will understand that I cannot comment on legal advice given to patients, including Mrs Barnes, as that is entirely a matter between the patient and her lawyer. Complaints about lawyers are not a matter for the Department of Health or the NHS, nor for this House to consider in this context. I am aware that Mrs Barnes has exhausted all the legal remedies open to her. Her case has been considered by a number of courts, including the Court of Appeal, and has on each occasion been rejected. It goes without saying that these matters will have been considered carefully by the various judges involved, and I should not and will not cast any doubt on their judgments.

[Dr Julian Lewis]

I was not familiar with this case until I heard it outlined in such detail, but as I understand it the pointed issue is not about the merits or otherwise of this lady’s original arguments with the health service. I think I am right in saying that the only pointed issue is that the Information Commissioner’s Office directed that certain data should be removed from the record. They were not and she complained to the ombudsman, who does not seem to want to say whether it was right that they were left on her record or whether they ought to have been removed.

[Dr Poulter]

My hon. Friend will be aware that patients have open access to their records and can request to see them, but it is not for a patient forcibly to remove relevant clinical information from them. I am not sure whether that was the case in these particular circumstances, but I hope to be able to reassure the right hon. Member for Rother Valley.

It is worth pointing out that, during the long line of litigation, in 2007 Mr Justice Simon said, following a hearing, that

“this is not a case of professional conspiracies by the medical or legal professions; it is a case where the balance of the evidence before the Court fell decisively and conclusively in favour of the defendant”,

meaning the NHS. There is a long history of legal rulings that make that point clearly. Indeed, I understand that the NHS Litigation Authority obtained cost orders in its favour for that case, although it was unable to recover its costs. I reassure the right hon. Gentleman, however, that I shall look into the issues he has raised about the ombudsman and the Information Commissioner and write to him about them.

Mid Staffordshire NHS Foundation Trust

Julian Lewis Excerpts

Tuesday 19th November 2013 Commons Chamber

[Mr Hunt]

Never has the hon. Lady spoken with so much support from this side of the House—I do not wish to destroy her credibility with her own party! She points to something that the public feel very strongly about and that is an issue in some parts of the nursing profession. We looked carefully at whether we should remove the requirement for graduate qualifications and decided that nurses are now asked to do a great deal more than they were 20, 30 or 40 years ago in, for example, giving people medication and the clinical procedures they are asked to be involved in. We need to make sure that there is the right culture in nursing. That is why I proposed—it was very controversial at the time, although I think it has been quite broadly accepted now—that before becoming a nurse people should spend some time, potentially up to a year, on the front line as a health care assistant to make sure that those going into nursing had the right values and recognised that giving this personal care is a fundamental part of what being a nurse should always be about.

[Dr Julian Lewis (New Forest East) (Con)]

Will the package of reforms and the greater accountability put into effect as a result of the Mid Staffs tragedy have any bearing on other areas such as the all-too-prevalent cases of people being injured or even dying as a result of hospital-acquired infections?

[Mr Hunt]

Absolutely, because this is a package designed to deal with all avoidable harm, and hospital-acquired infections are an avoidable harm. It is designed not only to have much more transparency on the levels of harm in our hospitals, but to make sure that there is a culture of openness so that when people spot things that are going wrong, it is in their interests and in those of their hospital that they speak out. The changes are likely to result in—my hon. Friend will be the first to notice this—an increase in the amount of reported harm over the next few months. That will not be a bad thing, because it will mean that hospitals will be reporting harm that up until now they have not reported. We should welcome the fact that that will then mean that this harm will be addressed.