Orders of the Day — Wakefield Health Authority

Part of the debate – in the House of Commons at 10:20 pm on 25th October 1988.

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Photo of Mr David Hinchliffe Mr David Hinchliffe , Wakefield 10:20 pm, 25th October 1988

I propose to raise a number of issues concerning the background to the removal of Sir Jack Smart as chairman of Wakefield district health authority. I should like to make it clear at the outset that I hold no particular brief for Sir Jack. Over a year ago, I called for his resignation as chair of the Wakefield health authority because of his refusal to defend my constituents in Wakefield against the cuts in the National Health Service being pursued by the present Government. Nevertheless, I feel strongly that Sir Jack's sacking in no way solves the serious problems that have arisen in Wakefield health authority.

My specific concern relates to the introduction of cook-chill catering. The Minister will be aware that I have been pressing for an independent public inquiry on this issue since July last year, but to no avail. Lord Skelmersdale, the then joint Parliamentary Under-Secretary of State wrote to me in a letter dated 31 July 1987: Assessing the costs of the introduction of cook-chill must remain a matter for the individual health authorities concerned acting on the advice of their officers". The Minister is aware from extensive correspondence and meetings with me that Wakefield health authority has stumbled from one financial crisis to another in recent years, with numerous cuts, closures and bed reductions.

I remind the Minister that in April 1987, £1·4 million was cut from the revenue budget and in August 1987, a further £1 million package of cuts was brought before the district health authority. We have had a number of examples, of which the Minister is aware, of urgent operations being cancelled—in one instance, for lack of £140,000 revenue to pay for 13 nurses in a neurosurgical unit at Pinderfields hospital. Against that background it should be a matter of deep concern to the Government that, through the most incompetent management advice, a cook-chill system estimated to cost £1 million in capital terms in fact cost £1·5 million and that the anticipated revenue savings of £300,000 per annum from cook-chill turned out to be £400,000 per annum additional revenue expenditure to be taken from a desperately hard-pressed patient care budget.

The central responsibility for the introduction of cook-chill in the Wakefield health authority area rests with Mr. Brian Birchall, the district general manager appointed to the authority in April 1985, folowing the Griffiths management restructuring. Despite the fact that the Stanley Royd inquiry had not reported, he persuaded the Wakefield health authority in July 1985 to confirm a district management team decision to invite Tricon, a food services consultancy firm, to examine the possibility of installing a cook-chill system at Stanley Royd. Tricon's report was presented to the district health authority in February 1986. By a small majority—I was in the minority as a member at the time—approval was given to the district general manager's proposal to establish a districtwide system of cook-chill catering.

It is crucial to my point that one of the objectives outlined in Mr. Birchall's report was to create a viable unit of business as recommended by the latest guidance issued by the DHSS in respect of competitive tendering. That is important in the context of some points I shall be making later.

Since that time, Sir Jack Smart has claimed that Mr. Brian Birchall was—to use Sir Jack's words—"foisted" on to the Wakefield health authority as its district general manager and that the authority was "duped" into accepting cook-chill.

Clearly, a number of fundamental errors, which were certainly the responsibility of Mr. Birchall, were made in the introduction of cook-chill in Wakefield. I shall give three specific examples. First, the district health authority's control of infection officer and committee, its consultant microbiologist, Professor Lacey, and most of its clinical staff were not aware of the cook-chill proposals until March 1987, when the catering staff refused to operate the system, on the grounds that it was unsafe. Secondly, I believe that it is an important fact that the proposals brought forward by Mr. Birchall clearly contravened the 1980 DHSS guidelines on cook-chill, with a number of serious errors. Thirdly, numerous additional costs that should have been anticipated were not considered in Mr. Birchall's original report.

In the time available, the subsequent events are far too numerous to mention. The important matter that needs to be dealt with by the Minister is that in the constituency of my hon. Friend the Member for Normanton (Mr. O'Brien), we have a new £1 million cook-chill central production unit which has been stood doing nothing for nearly two years because of the serious errors to which I have drawn attention. I believe those errors are the responsibility primarily of the district general manager. It is important to speculate about the extent of interest charges that must have accrued during the period that this valuable building has been empty, because that will be a drain on our local National Health Service budget.

I believe that the role of the Yorkshire regional health authority has been important in this matter. I should like to ask the Minister a number of specific questions to which it is crucial that she replies this evening.

First, why did the Yorkshire regional health authority invite Mr. Brian Birchall, the general manager of the Wakefield health authority—whose record on cook-chill in that authority was, frankly, a shambles—to chair the regional health authority's catering sub-committee that pressed ahead with the introduction of cook-chill catering throughout the Yorkshire region?

Secondly, why did the regional health authority inquiry, which led to the removal of Sir Jack Smart as the chair of the Wakefield health authority, fail to look at any of the issues—especially cook-chill—that were at the root of the conflict between the Wakefield district's general manager and its chair?

Thirdly, why has the regional health authority failed to respond to or contradict any of the detailed evidence concerning costings of cook-chill in Wakefield that was presented to its inquiry by the Wakefield health authority's former consultant microbiologist, Professor Richard Lacey?

Fourthly, why, after refusing to give additional money to the Pinderfields neurosurgery unit, and saying that Wakefield health authority should spend its share of the 1987 non-recurring revenue grant on cook-chill, did the regional health authority take the unprecedented step of making a grant of £350,000 to the Wakefield health authority for the introduction of cook-chill earlier this year?

Fifthly, why, after all the grave doubts about the suitability of cook-chill for hospital catering in general, and then clear evidence of the huge cost of implementing cook-chill which would result in diversions of funds from patient care, has the regional health authority pressed ahead with the decision to implement cook-chill across the region?