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  • Helen Morgan – 2022 Speech on Ambulance Response Times in Shropshire

    Helen Morgan – 2022 Speech on Ambulance Response Times in Shropshire

    The speech made by Helen Morgan, the Liberal Democrat MP for North Shropshire, in the House of Commons on 31 March 2022.

    I thank Mr Speaker for granting today’s Adjournment debate on a topic that is so important to my constituents in North Shropshire and to people across Shropshire and across the country. I start by making it clear that I am not here to criticise the hard-working NHS staff in our ambulance services and emergency departments. Indeed, I thank them for their incredibly hard and dedicated work in difficult and demotivating circumstances, but there is clearly a problem with the provision of emergency care in Shropshire, with complex causes, and I bring it before this House to urge the Government to take some action.

    It was clear throughout my election campaign, and has been clear from my inbox since then, that stories of excessive waits for an ambulance are not a rarity. I have since urged my constituents to contact me and share their experiences. Just since Monday, my office has been met with a tidal wave of correspondence, each story as saddening and frightening as the last. A care home reported a wait of 19 hours for an elderly resident with a broken hip. An elderly diabetic man fell and dislocated his shoulder. He was advised not to drink or eat anything in case surgery was required, and then waited 15 hours for an ambulance to arrive. A disabled man fell in his bathroom and waited for 21 hours for an ambulance. He was fortunately lifted from the floor after eight hours by a helpful neighbour. A man waited with a stranger experiencing heart attack symptoms on the side of the road for hours, only to give up and drive the gentleman to A&E himself.

    A man with a suspected stroke waited nine hours for an ambulance and a further five in the ambulance waiting to be transferred into hospital. A 92-year-old lady fell at 8.30 in the morning, suffering bleeding from the head and a broken leg. She was looked after by her 75-year-old neighbour for almost eight hours until the ambulance arrived, and then waited in the ambulance for transfer into the A&E department until 2.30 the next morning. She had not eaten since 6.30 the evening before her fall. An elderly woman fell down the stairs shortly after lunch. Her emergency carers—she has a red button to press for them—made her comfortable and called an ambulance, but they could not carry on waiting forever. After an 11-hour wait, she was alone with her front door open so that the ambulance crew could access her house. That was 3 o’clock in the morning.

    I could easily spend the next half hour relating heartbreaking stories, and I thank all my constituents who contacted me for taking the time to get in touch and explain the scale of the problem. One story in particular brought the issue home, and some Members may have read about it in the newspapers. It was the story of a young footballer who slipped on AstroTurf while playing football at school. He dislocated his knee and waited so long for an ambulance that by the time one finally arrived he had developed hypothermia. I do not know whether Members can imagine the distress of this young man, and the teaching staff who stayed on in the dark, long after the school day had ended, as his condition deteriorated out in the cold.

    What all these stories have in common is that they could have been much worse. I am sure everyone in the House would agree that nobody should have to suffer waiting an excessive amount of time for an ambulance, yet tragically in North Shropshire it is pretty common. I know this problem is not unique to Shropshire. I am sure that many colleagues have received similar emails describing similar events. In parts of Britain, an excessive wait for an ambulance has become normal.

    The problems surrounding this crisis are complex, and I am not here to propose a simple quick fix. However, there are consistent themes at the core of the issue. It is vital that we recognise them if we are to work out how to move on from here. The first is the problem of handing over patients at the emergency departments in Shrewsbury and Telford. West Midlands Ambulance Service has told me that, on the day the young footballer dislocated his knee, 868 hours were lost waiting to hand over patients, and that nearly 2,600 hours were lost in the month up to 29 March. Handover times in Shropshire are significantly worse than in the rest of the country, and there have been times when every ambulance based in Shropshire is waiting outside a hospital to discharge a patient.

    The hospital trust has declared a critical incident on no less than four separate occasions so far this year, and each of those incidents coincided with an increase in the number of heartbreaking stories coming into my inbox.

    Lucy Allan (Telford) (Con)

    I congratulate the hon. Lady on bringing this incredibly important issue to the House. Such heartbreaking stories are common to all Shropshire MPs. Does she agree that a combination of factors—I am sure she will go on to discuss some of them—including the transfer of patients on to wards, as well as the inaccessibility of general practitioners, is putting additional pressure on A&E?

    Helen Morgan

    I thank the hon. Lady for her intervention, and I entirely agree with her. I will stress some of those points later in my speech.

    The emergency departments of the Shrewsbury and Telford Hospital NHS Trust report that they suffer from a shortage of space and staff, along with the additional challenges of separating covid patients—on Tuesday this week, the trust had more covid patients than at any previous point in the pandemic. The trust also reports delays in discharging patients who are well enough to leave hospital because it is struggling to find care packages or care home spaces.

    A number of care homes in Shropshire are currently closed because of the pandemic. Shropshire shares the national problem of a shortage of care workers and care homes, which is probably exacerbated by our high proportion of elderly patients. The inability to discharge patients who would doubtless be better off at home or in a care home setting reduces the flow of patients through the hospital.

    The impact of all this is that, because ambulances wait so long at hospitals, the vast majority of ambulance journeys across Shropshire begin in Shrewsbury or Telford. It is not possible to reach the most seriously ill patients towards the edge of the county within the target time if the ambulance sets out from one of those two towns. This, combined with the closure of community ambulance stations, means that very few ambulances are free in places such as Oswestry and Market Drayton when people become ill and require one.

    Another factor, as the hon. Member for Telford (Lucy Allan) alluded to, is the volume of patients accessing emergency departments, or being taken to one in an ambulance, because there is no other option locally, particularly in the evening or at the weekend. Shropshire has a worsening shortage of GPs, which is leading to patients attending emergency departments for relatively minor issues because they simply have no alternative. A key reason behind the problem of staff recruitment is the chronic lack of other services in Shropshire, but that is a debate for another day.

    The Government must deliver on their promise to recruit more GPs, and they must ensure that people with non-urgent healthcare needs are provided with adequate resources in the community. I am incredibly proud that my constituents Sian Tasker and Lawrence Chappel in Oswestry and, beyond my constituency, Darren Childs in Ludlow, and other campaigners, are working tirelessly to keep this issue in the public light and are campaigning to keep their community ambulance stations open. It is partly because of their hard work that we are finally discussing this issue in Parliament.

    I am afraid to say that, so far, the Government have refused to listen to the countless warnings by campaigners and those working on the frontline. The Care Quality Commission’s “State of health care and adult social care in England” report last year, gave a stark warning that overstretched ambulance services and emergency departments are putting patients at risk. The numbers speak for themselves. The Association of Ambulance Chief Executives has found that, nationally, 160,000 people a year are coming to harm because of delayed handovers to A&E. Of those, a shocking 12,000 experience severe harm.

    I have repeatedly asked the Secretary of State for Health and Social Care to meet me and the West Midlands Ambulance Service to discuss how we can tackle local issues together. I am deeply disappointed that, so far, he has refused my request. It seems to many people in Shropshire that the Department of Health and Social Care is burying its head in the sand and refusing to acknowledge the seriousness of the issue we face. I take this opportunity to urge the Minister to meet me and my colleagues across the county to discuss the crisis and to hear some first-hand accounts of those left waiting in distress so that we can come to some sort of solution together.

    I have no doubt that all hon. Members present, including those on the Government Benches, want to ensure that people at their most vulnerable are kept safe. I welcome the recently announced additional £55 million of support for ambulance services. I fear, however, that that money may not go far enough or may not be targeted in the areas of greatest need. The hopes of the Shrewsbury and Telford Hospital NHS Trust are pinned on the Future Fit hospital transformation programme, which kicked off in 2013. It is reliant on £312 million of funding, the source of which may be an interest-bearing loan—I will happily correct the record if I am incorrect, but that is my understanding. Unfortunately, more than eight years later, a strategic outline case has still not been signed off. The estimated costs have spiralled by almost 70% and it is likely that they will not be covered by the Government.

    The initial promises of urgent care centres in more rural areas—for example, one was guaranteed for Oswestry—investment in community hospitals and local planned care centres were all quietly dropped in the summer of 2015. Promises of investment in public health and prevention, which is a good idea and would have been welcome in Shropshire, are also apparently no further forward. We are consistently told that there is no more money in the pot for faster, better-resourced ambulance services or urgent care staff, yet the Government wasted more than £10 billion on personal protective equipment that is not up to scratch. It is time that they listened to the warning signs that they have been ignoring and finally step up to provide proper support for ambulance services and accident and emergency departments.

    There are several steps that the Government could take right away to get to the bottom of the causes of the issue. The Secretary of State could commission the Care Quality Commission under powers laid out in section 48 of the Health and Social Care Act 2008 to conduct an investigation into the causes and impacts of ambulance service delays. That is a fairly simple step and the law already allows for him to commission the CQC. Once the Government have a professional assessment of the complexity of the causes of the delays to ambulance service response, they can take the correct steps, targeted at the correct causes of the problems, to make some rapid improvements to the service. As I have outlined, the causes will most likely lie in a number of areas across emergency and social care, but until they are fully understood by the right people, they cannot be resolved.

    The Government could also pass the Ambulance Waiting Times (Local Reporting) Bill of my hon. Friend the Member for St Albans (Daisy Cooper), which would require accessible, localised reports of ambulance response times to be published. Once the data was available, it would enable central and devolved Governments to accurately understand where the delays are and how best to tackle them, because we should be following the data and the facts to provide the right solutions and the right resourcing in the areas that need them most. That Bill is already written, it has had its First Reading and it is ready to go.

    I brought this debate to Parliament to ensure that the Minister and the Secretary of State understand the scale of the problem in Shropshire and, crucially, the urgency in resolving it. How many more elderly citizens will have to wait for 10 hours, with their front door open, for an ambulance? How many more people will have to wait at the roadside with a stranger who they believe might be close to death? How many more young adults will develop hypothermia when they initially have a trivial injury, such as a dislocated knee? How many more cases of serious harm, or even avoidable death, will it take?

    I thank the Minister for being here this evening and responding to my speech. I also thank Mr Speaker for granting this Adjournment debate. I take the opportunity to thank everybody in the Chamber for coming along and to wish them a happy Easter and a restful break.

  • Edward Argar – 2022 Statement on PPE Stock Management

    Edward Argar – 2022 Statement on PPE Stock Management

    The statement made by Edward Argar, the Minister for Health, in the House of Commons on 31 March 2022.

    The Government rightly prioritised saving lives throughout this pandemic. The scale of the challenge we faced should not be underestimated. We have worked tirelessly to source lifesaving PPE, delivering more than 19.1 billion items to protect frontline health and care staff.

    Global demand for PPE reached unparalleled levels at the outset of the pandemic, which resulted in huge disruption across the market for PPE.

    Our fight was against a new infection and at the outset, the data to determine what PPE the health and care sectors needed did not exist. Requirement for supplies was initially forecast on reasonable worst-case scenario modelling, and we now know less PPE was needed in practice.

    However, in a fast-moving world of tough choices too much was preferable to too little given this was about saving lives. We had to plan for the worst. As the orders were being placed during the height of the crisis, when the market was extremely volatile, we had to factor in the likely non-performance of contracts.

    We are now in a position where we have high confidence that we have sufficient stock to cover all future covid-19 related demands, even in the face of new variants of concern such as we have seen with omicron and with cases of the BA.2 lineage rising.

    Not only this, but we now have the capability to produce most of what we need here in the UK across all categories except for gloves.

    Where we have surplus stock, including stock that has turned out not to be suitable for use in the NHS, we have employed a range of measures to reduce it including selling, re-using and donating both in this country and internationally, recycling, and by pursuing return or recovery of costs through the original supplier.

    Where products have failed quality assurance, or if products were ordered that have not arrived, the Department is taking action to determine whether a breach of contract has occurred. The investigations into contracts where we have some degree of dissatisfaction due to our high standards of quality control, or due to clear contractual breach, relate to 176 contracts.

    We are working through the dispute resolution process and we are aiming to recoup significant amounts. The Department has already reduced the supply of PPE by varying and curtailing contracts. As at 18 December, the Department had negotiated the cancellation or variation of contracts to reduce the original supply of PPE by 1.21 billion items that would have cost £572 million.

    Sales

    To date we have achieved the sale of 330 million masks to two private companies, and we have other deals in the pipeline.

    We are also about to launch an online auction to sell PPE, so individuals and companies may bid for our excess stock. Details are available on Gov.UK.

    Repurposing

    There are a number of items that meet all technical requirements and are suitable for use in the NHS, but they are not the preferred option. For example, self-construct visors which take four to six minutes to build were not overly appropriate for clinical settings with high usage.

    However, the items were high quality and have been used in settings which allow for less time-pressured set up, such as by dentists.

    Similarly, flatpack aprons have been able to be distributed for use in social care settings.

    Shelf-life extension

    We are exploring shelf-life extension for items that are in demand.

    The Department has appointed a third-party medical laboratory to provide testing of certain categories of PPE products to see how viable it is to extend their shelf life without the products being compromised where this fits with our overall plans.

    Donations

    We have donated a large number of products domestically to support this country’s road to recovery underpinned by the fantastic success of our vaccination rollout. This includes 207 million masks being supplied to our schools so that pupils could get back to learning in classrooms with their peers and 38 million to transport operators to help get Britain moving once again as we begin to live with the virus. Masks have also been distributed to charities and polling stations.

    Having this stock has also allowed us to provide items across the world to support the global fight against the virus.

    So far, working with the Foreign, Commonwealth and Development Office, we have donated 500,000 items to Lebanon, Nepal and Overseas Territories and are in discussions with other countries and multilateral organisations, working to finalise agreements and logistics with over 30 countries. We have also donated to Ukraine, as part of a wider package of UK Government support.

    Recycling

    After successful trials, we have now recycled 23 million visors into plastic food trays. We are also in the process of recycling 53 thousand pallets of aprons and eye protectors; aprons are being made into bin bags, “Bags for Life” and other high-demand products.

    Disposals

    Our priorities are to sell, donate, repurpose or recycle wherever we can. Nevertheless, there are some PPE products that we cannot reuse or recycle. The majority of PPE items are designed to be single use and disposed of as medical waste and so are often made up of complex chains of polymers. These items cannot be broken down for recycling. As a result, many of the products we hold are not able to be fully recycled and around half are completely non-recyclable.

    We have awarded contracts to two expert waste service providers. These lead waste providers will review the feasibility of recycling each item across our excess and provide detailed options.

    To reduce storage costs, we must accelerate the speed of our programme, particularly for stock that is likely to become out-of-date before it is ever used and is unsuitable for recycling. For every pallet of PPE we sell, repurpose, donate and recycle, taxpayers save on average £2.75 a week for years to come.

    The amount taxpayers will save from taking this decisive action would, for example, be enough to employ around 1,850 nurses for a year.

    We will work with our lead waste providers to examine wider disposal options including through “energy from waste” processes. Environmental concerns will be key, and we will be taking into consideration the Government’s waste hierarchy, prioritising recycling, and then energy from waste for that proportion of stock which we hold that cannot be recycled.

    Our priorities are to keep selling, repurposing and donating the stock that we can but at the same time taking a realistic, pragmatic approach to managing stock and putting in place solutions that make sense economically and environmentally.

  • Edward Argar – 2022 Statement on NHS Charging Exemption for Ukrainian Residents

    Edward Argar – 2022 Statement on NHS Charging Exemption for Ukrainian Residents

    The statement made by Edward Argar, the Minister for Health, in the House of Commons on 17 March 2022.

    I want to update the House about further measures this Government are taking to step up their response to Russia’s invasion of Ukraine, which continues to see hundreds of thousands of people who ordinarily live in Ukraine forced to flee their homes and seek safety and support in other countries.

    Today I want to announce new legislative measures in England to exempt Ukrainian residents from NHS charging so that they can access the NHS on broadly the same basis as someone who is ordinarily resident in the UK. We will apply these exemptions retrospectively from 24 February 2022 to further protect people.

    Current overseas visitor NHS charging legislation requires us to recover NHS secondary care treatment costs from anyone who does not ordinarily live in the UK, unless an exemption applies to them. Primary care and A&E services and certain types of treatment—including for most infectious diseases—remain free to all, regardless of a person’s home

    We have therefore now amended the charging regulations to allow everyone who is ordinarily resident in Ukraine, and their immediate family members, who are lawfully in the UK to access NHS care in England for free, including those who transfer here under official medevac routes.

    This will cover all potential treatment needs, except for assisted conception services, to align with the existing exemption for those whose immigration health surcharge fees have been waived. Those who will benefit from this additional exemption include:

    Anyone who uses an alternative temporary (less than six months) visa route outside of the family or sponsorship routes

    Anyone who chooses to extend their visit or seasonal worker visa temporarily, without going through the IHS system

    Anyone who is in the process of switching visas (which could take some time to process).

    We have applied a six-month review clause to this policy and it is our hope that this will help not only to provide security and peace of mind for the NHS and those in need, but to remain open to further developments.

    Ukrainian residents who are in the UK unlawfully are not covered by these measures but will remain within the scope of existing provisions within the charging regulations. This means that not only treatment needed immediately, but any treatment that cannot safely wait until the overseas visitor can be reasonably expected to leave the UK, must never be withheld or delayed, even when that overseas visitor has indicated that they cannot pay. Some NHS services will remain exempt from charge for all overseas visitors, such as primary care, A&E services and treatment of infectious diseases.

    This Government continue to stand shoulder to shoulder with our Ukrainian friends and we are proud to continue to offer support for Ukrainian residents in our country.

  • Gillian Keegan – 2022 Statement on Hymenoplasty

    Gillian Keegan – 2022 Statement on Hymenoplasty

    The statement made by Gillian Keegan, the Minister for Care and Mental Health, in the House of Commons on 16 March 2022.

    On 23 December 2021, as part of the “Vision for the Women’s Health Strategy in England” publication, the Government announced its intention to ban the hymenoplasty procedure in the United Kingdom at the earliest opportunity:

    Our Vision for the Women’s Health Strategy for England – GOV.UK (www.gov.uk)

    We are already working to ban virginity testing and introduced a Government amendment to the Health and Care Bill in November to do so. Banning hymenoplasty is another important milestone in the Government’s ongoing mission to tackle violence against women and girls.

    Hymenoplasty, a procedure which involves reconstructing the hymen, is a tool of honour-based abuse and, like virginity testing, is used to oppress vulnerable women and girls.

    The Government’s decision to ban hymenoplasty followed the recommendations of an independent expert panel (the panel), that was established to look at the clinical and ethical implications of banning the procedure. The panel was made up of clinicians, ethicists, and subject matter experts and I would like to place on record my thanks to all members of the panel for their input in this process.

    The panel made a suite of recommendations in their final report: Expert panel on hymenoplasty – GOV.UK (www.gov.uk), which we are accepting in full. This includes introducing legislation to create a criminal offence of hymenoplasty alongside the prohibition of virginity testing; ensuring there are no medical exemptions including for victims of rape; issuing guidance to support healthcare professionals to carry out risk assessments when hymenoplasty is requested; and providing adequate resources for community engagement.

    Our work to ban the harmful practice of virginity testing and our commitment to banning the hymenoplasty procedure demonstrate that the safety of women and girls is at the forefront of this Government’s agenda.

    By banning both procedures this Government will ensure the United Kingdom is a safer place for women and girls.

  • Sajid Javid – 2022 Statement on Healthcare Reform

    Sajid Javid – 2022 Statement on Healthcare Reform

    The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 8 March 2022.

    I wish to update the House on my vision on health reform, “Our Health System: the Government’s reform agenda”. In today’s address, I outlined our intention to take bold action on healthcare reform, setting out our agenda for transforming the healthcare system. This agenda addresses the enduring issues facing the system, and recognises the challenges and opportunities arising from the pandemic—building on our recent elective recovery plan and the publication of the integration White Paper.

    The NHS has many strengths and is rightly regarded as a national treasure. However, it faces long-term challenges, including an ageing population and people increasingly living with multiple long-term conditions. All of these have been exacerbated by the covid-19 pandemic, which has added extra pressure on the system, highlighted existing issues, and created new challenges.

    At this critical moment, we must now seize the opportunity to put our healthcare system on a more sustainable path for the future while meeting the immediate recovery challenge we face as we emerge from the pandemic.

    The Health and Care Bill will, subject to Parliament, create the structures for the future, but we need to consider how we will work within those structures. I recognise waiting time recovery is a significant challenge. However, this is not a reason to back away from those changes, but to double down and ensure we deliver the full benefits.

    In the face of growing demand, we will focus on taking a more prevention-centred approach to healthcare, where the emphasis is on preventing needs from arising in the first place—prevention; putting people in control of their own care—personalisation; and driving up the quality of care by working smarter—performance.

    As we do this, we must build on existing progress and work with the brilliant individuals and teams in our healthcare system who are already making change happen on a daily basis—which will include continuing to invest in the workforce.

    We will build on the announcements made during my speech and set out wider Government policy in this area in due course.

  • Maria Caulfield – 2022 Statement on the Rare Diseases Action Plan

    Maria Caulfield – 2022 Statement on the Rare Diseases Action Plan

    The statement made by Maria Caulfield, the Parliamentary Under-Secretary of State for Health and Social Care, in the House of Commons on 28 February 2022.

    The Government have published the first England Rare Diseases action plan today, on international Rare Disease Day.

    This action plan is part of our continued commitment to improve the lives of those living with rare conditions, such as muscular dystrophies and Huntington’s disease. It follows the UK rare diseases framework, published in January 2021, which set out priorities for all four UK nations to speed up diagnosis, raise awareness of rare diseases among healthcare professionals, provide better co-ordination of care, and improve access to specialist care, treatment and drugs.

    England’s action plan has been developed collaboratively with our delivery partners across the health landscape and in close consultation with members of the rare disease community. Through the action plan we aim to achieve significant breakthroughs for people living with rare diseases, including:

    making it easier for more rare disease patients to access the co-ordinated care of multiple specialists without the need to travel long distances;

    developing world-class new-born screening so diagnoses can be made earlier, and patients can benefit from groundbreaking new therapies as they become available;

    ensuring all healthcare professionals are aware of rare diseases and know where to go to access further information and advice; and

    supporting rapid and affordable access to cutting-edge therapies across all regions of England.

    Building on advances in therapeutics during the covid-19 pandemic, we will also continue investing in the development of nucleic acid therapies, for example, through the world-class gene therapy innovation hubs and the nucleic acid therapy accelerator. These initiatives have the potential to allow rapid development of new therapies, transforming care for millions of patients, including those with rare and life-threatening genetic diseases.

    Under the action plan, the millions of people with rare diseases in England will see more efficient access to care and new treatments introduced. Over the course of the coming year, we will monitor the progress of these actions closely, seeking input from those living with rare diseases to ensure we are measuring the outcomes that matter most.

    Since the UK rare diseases framework runs over five years, implementation will be phased, with this first action plan focused primarily on actions taking place over the coming year. While delivery of this first action plan is underway, we will therefore also continue to explore future directions and develop new actions, informed by the needs of the diverse rare disease community.

    Through this action plan we will take the first steps in England towards achieving our overarching vision: delivering improvements in diagnosis, awareness, treatment and care, and creating lasting positive change for those living with rare diseases.

  • Sajid Javid – 2022 Comments on Visit to North East and Yorkshire

    Sajid Javid – 2022 Comments on Visit to North East and Yorkshire

    The comments made by Sajid Javid, the Secretary of State for Health and Social Care, on 15 February 2022.

    Visiting Teesside and Doncaster, I’ve seen and heard prime examples of what makes this country one of the best in the world at not only improving the lives of patients, but also developing my innovative medicines and treatments to protect us and our international partners.

    The expansion of the Fujifilm Diosynth Biotechnologies site will not only benefit the local economy through the creation of hundreds of jobs – the development of medicines and vaccines means we will be continue to be prepared for potential future health threats.

    Doncaster and Bassetlaw Teaching Hospitals are taking excellent strides to improve the lives of patients in the area – especially through expanding capacity for cancer diagnosis which is a vital part of our national war on cancer, that will be underpinned by a new 10-year-plan.

    Seeing the excellent innovations in the North East and Yorkshire, it is no wonder the UK is the envy of the world in treatments and health innovations.

  • Edith Summerskill – 1972 Speech on Whittingham Hospital

    Edith Summerskill – 1972 Speech on Whittingham Hospital

    The speech made by Edith Summerskill, the then Shadow Secretary of State for Social Services, in the House of Commons on 15 February 1972.

    The right hon. Gentleman is to be thanked for the forthright and clear way in which he has presented the report. In view of the extremely serious and shocking revelations in it, will he accept that the recommendations should be implemented as soon as possible? Will he bear in mind the deep concern of all hon. Members that the report is the latest in a succession of hospital scandals, following as it does the 1968 inquiry into the “Sans Everything” allegations, the 1969 Ely Hospital inquiry and last year’s Farleigh Hospital inquiry?

    As we are dealing with the most vulnerable in the community, who are entirely dependent on the compassion or the disciplined care of others, I would ask the right hon. Gentleman four specific questions.

    First, what immediate steps will the right hon. Gentleman take to ensure that not only in Whittingham but in similar hospitals there is from now on first-class, efficient management and co-ordination between hospital management committees, regional hospital boards and medical nursing administrators?

    Secondly, will the right hon. Gentleman take immediate steps to increase the inspection of all such hospitals by the General Nursing Council at more frequent intervals and encourage a more rapid turnover of staff, periodically bringing in new staff from outside, because in such hospitals the staff become as institutionalised as the patients?

    Thirdly, will the Secretary of State encourage the more active rehabilitation of long-stay chronic or psycho-geriatric patients, with increased transfer to community care, and will he consider giving greater powers to his proposed community health councils in the forthcoming reorganisation of the National Health Service?

    Fourthly, we note no mention in the right hon. Gentleman’s statement of the Ombudsman. Will he recognise that there is public anxiety about the lack of investigation of complaints into the National Health Service and that his Committee to investigate the role and setup of the Hospital Advisory Service is no substitute for a hospital Ombudsman, because such complaints need an independent procedure outside the National Health Service? Will he seriously consider the setting up of a hospital commissioner?

  • Keith Joseph – 1972 Statement on Whittingham Hospital

    Keith Joseph – 1972 Statement on Whittingham Hospital

    The statement made by Keith Joseph, the then Secretary of State for Social Services, in the House of Commons on 15 February 1972.

    With your permission, Mr. Speaker, and that of the House, I should like to make a statement on the Report of the Committee of Inquiry into the administration of, and conditions at, Whittingham Hospital, near Preston, Lancashire. The report has been published this afternoon in Command Paper No. 4861.

    Allegations of ill-treatment of patients, fraud and maladministration at Whittingham were made in confidence to my predecessor in 1969. These were followed by a special audit investigation and inquiries by the police. Shortly after the police inquiries were completed a nurse was tried and convicted of manslaughter of a patient. As soon as I was free to do so after these proceedings I set up the committee of inquiry, which made its report to me early in November. Publication of the report has been delayed while charges against two other nurses, on which both were acquitted. were before the courts.

    The report is very disturbing. It is highly critical of standards of medical and nursing services in some parts of the hospital, particularly for longer-stay patients, and of the management. It also criticises the Manchester Regional Hospital Board, and to some extent my Department also. With a few qualifications, which are not however central to the main issues, I accept the conclusions and recommendations.

    The report assesses Whittingham as a hospital of wide contrasts and an extreme example of a hospital which has failed to keep up with the times. Side by side with some good modern services, it found in the long-stay wards evidence of old-fashioned methods, inadequate treatment and rehabilitation, poor buildings and insufficient medical and nursing staff. The report severely criticises the medical and nursing administration, the management structure and the way these worked; it describes the result as a hospital with day-to-day tactics but no overall strategy The committee of inquiry believes that in these conditions there have been instances of ill-treatment and large-scale pilfering by some members of the staff and the further evil of suppression of complaints about such practices when made by junior staff.

    As the House knows, I have set up a Committee to review the procedures for dealing with complaints in hospitals, and I have arranged for this most distressing aspect of the Whittingham Report to be brought to its attention.

    The report apportions a share of the blame for the general state of affairs at Whittingham to the regional hospital board, which, while pioneering the establishment of psychiatric units in general hospitals, did not adequately recognise the needs of elderly long-stay patients, which led to dual standards of care. I accept that my own Department as well as others may not have been sufficiently alive to this danger in earlier years. Our present policies take full account of it.

    The report recommends that all members of the Whittingham Hospital Management Committee should be invited to resign and the committee reconstituted. It also recommends complete operational integration of the medical and nursing services at Whittingham with those of the psychiatric unit at Preston. Such integration is undoubtedly most desirable, but in my view it is doubtful whether it can be achieved satisfactorily without amalgamating under a single hospital management committee the hospitals at present in the Whittingham and in the Preston and Chorley groups. The board has already started local consultations on proposals for amalgamation. The chairman of the Whittingham committee resigned in December on grounds of ill-health, and four other members have resigned in the course of discussions of the proposed amalgamation. With my endorsement the chairman of the board is inviting the remaining member to resign so that a reconstituted committee can be appointed with amalgamation with the Preston and Chorley group of hospitals in mind at an early date. The new committee will need to consider the many detailed recommendations in the report for improvements at Whittingham itself. There have already been important staff changes.

    This report highlights two of the most important problems facing the hospital service today: the proper care and treatment of longer-stay and elderly patients in large isolated mental hospitals, and the proper planning of the transition from services based on such hospitals to services based on departments in general hospitals. I have asked all boards to review their services for longer-stay mentally ill patients, looking particularly at outmoded attitudes, at allocation of staff, and at management policies and organisation. Each board is also now working out and discussing with my Department plans for the restructuring of its services for the mentally ill; these will provide for a properly organised transition to services based in general hospitals, and improved standards in the old mental hospitals until they eventually close.

    It would be wrong to jump to general conclusions from the indictment in this report of some parts of one hospital. There have been enormous improvements in the last 20 years in nearly all psychiatric hospitals. The great majority of staff, at Whittingham as well as elsewhere, work with patience and devotion, often in difficult and unsatisfactory conditions, which we are now making great efforts to remedy.

    I have referred in this statement to the main points which arise from the report. The Command Paper includes a foreword I have written which contains similar comments and also refers in more detail to the recommendations addressed to my Department and to the regional hospital board; action on most of these has already been taken or is under way.

    The House will, I am sure, be grateful, as I am, to Sir Robert Payne and the other members of the Committee for the time and effort they devoted to their inquiry and to producing this forthright and constructive report. Ever since I have been in office I have been continuing the theme of my predecessor in concentrating on improvements in this and related fields where they are most needed. The House can be sure that the lessons of this report will not be forgotten.

  • Sajid Javid – 2022 Comments on Visit to East of England Health Facilities

    Sajid Javid – 2022 Comments on Visit to East of England Health Facilities

    The comments made by Sajid Javid, the Secretary of State for Health and Social Care, on 14 February 2022.

    It’s been incredible to see first-hand the astonishing work being carried out by health and social care staff across the East of England, and I’ve enjoyed speaking to local residents and hearing what they would like from our healthcare services as we recover from COVID-19.

    As we continue on the road to recovery, I want to thank everyone in Clacton, Romford, Rochford and the wider region who’ve shared their thoughts and experiences with me and who have given me the opportunity to talk about my mission to reform services so they better serve their needs.

    We know integrated care can help boost recovery times, reduce waiting lists and level up the health of the nation and I was proud to see local services working together in the East of England to achieve this.