Lewisham Healthcare NHS Trust
Jim Dowd (Lewisham West and Penge, Labour)
I am grateful to Mr Speaker for giving me the opportunity to raise an important local issue. This is the first time, Mr Deputy Speaker, that I have spoken in the Chamber under your wise and sagacious chairing of our proceedings. I welcome you to the Chair.
I welcome the Minister to his place. We shared a number of experiences-I found them entertaining; I am not sure whether he did-a few years ago on the Health Committee. I suspect that if most members of the Committee had been asked whether they thought he would be occupying his current position, the view might have been that he would not. However, he has got there, and regardless of the Government arrangements, he got there completely on merit. I wish him well in the post that he holds and in his efforts to discharge his duties.
May I point out a mistake on the Order Paper which is entirely of my making? I tabled the title that appears on the Order Paper for the debate, but I have not been keeping up with developments. Lewisham Hospital NHS Trust is now Lewisham Healthcare NHS Trust. It assumed responsibility for primary care functions some 100 days ago and has now expanded to the health care trust. There was supposed to be a celebration yesterday of those first 100 days of responsibility for primary care, but that was cancelled. I am sure there were a number of reasons, but the disruption caused by the events that I am about to describe may well have played a part in that.
University hospital Lewisham has made remarkable progress over the past dozen years or so, the last eight of which have been under the stewardship of the current chair of the trust. For many years previously it was the poor relation in inner south-east London, without the kudos or connections of its much more illustrious neighbouring cathedrals of medicine in the shape of Guy's, St Thomas' and King's College hospitals. In 1990, under the previous Tory Government, it was used as a pawn and a make-weight in the ill-fated attempt to set up the Guy's and Lewisham self-governing trust. When that ploy failed, it was separated as Guy's was linked to St Thomas', and it has prospered ever since as an independent trust.
The notable achievements in recent times and the improvements in services over recent years have included the more than £70 million private finance initiative project at the Riverside block and improved maternity services, including one of the best birthing centres in London and therefore in the country. There have been improvements in paediatrics in the primary care centre. It has achieved some of the lowest hospital acquired infection rates in the country. During a recent stay in King's College hospital I acquired MRSA, so that has a certain resonance with me. Just 10 days ago, work commenced on the latest stage of building there, which will run through until autumn 2011, including a new
urgent care centre, upgraded and refurbished A and E facilities, new and refurbished children's and adults' out-patient suites, and a new main entrance and reception.
The financial management of the trust has been outstanding in recent years. Earlier in the year, as part of the Challenge Trust Board funding scheme, KPMG was asked to review the trust and measure its performance against nine domains: good business strategy, financial viability, well governed, capable board to deliver, good service performance, clinical leadership, local health economy, clinical strategy and performance. On a traffic light rating, they were all well into the green, as a net result of which the Challenge Trust Board awarded Lewisham £4 million to pay off historical cash deficits, and KPMG concluded that the
"Trust has rectified the problems that caused the trust to fall into deficit and has a platform for a medium term sustainable position".
This is organisation has not only done well; it continues to do well. It has set its ambition to become a foundation trust within two or three years. It has demonstrated the benefits of strong executive and non-executive leadership. Why then has the chair not been reappointed, or, to put it in plain language, why has he been sacked? He has been a personal acquaintance of mine, colleague and good friend for more than 30 years, and we have served variously on a number of organisations, including Lewisham borough council and Lewisham and North Southwark district health authority before it was abolished by the previous Conservative Government in 1990.
I raise this matter not at the chair's request-he is a man of such natural modesty and charm that if it was left to him, I am sure that I would not be allowed to raise it at all-but because I want to express my outrage at the way in which he, and by extension, Lewisham Healthcare NHS Trust and the people of Lewisham have been so badly treated by the travesty of a process that has resulted in his not being reappointed. I also have to raise it because although the Appointments Commission has a complaints procedure, under item 8 on remedial action, it says that what shape such remedial action may take will vary from case to case, but in general one of the principles that will apply is that
"where an appointment has been made, this cannot be overturned."
So clearly the die has been cast and we will have to live with the consequences.
The chair was appointed in 2002, and he was re-appointed, uncontested, in 2006, with the term ending on
Everybody understood the process. As the regulations said:
"At the end of an individual's second term of office the post will automatically be the subject of an open competition. The office holder will be free to apply provided they have served less than 10 years in the same post and will be considered alongside other candidates."
Everybody knew that to be case. However, such is the support for the current chair of the trust that, to my certain knowledge, many other candidates-including a former Member of Parliament-who would have applied had the competition been completely open, did not do so out of respect for, and trust in, the work that the existing chair of the trust had done. Either knowingly or unknowingly, the Appointments Commission and the strategic health authority have between them served to reduce the pool from which a suitable candidate to chair the trust might be found.
Most people understood that the current chair would serve for another two years, and that during that period a completely open competition would be held, in which all those who had any suitability or intention to become the chair could have stood. By skewing the process, as they have, those organisations have denied the people of Lewisham the opportunity to look at the best possible candidates.