NHS Chief Executives

Oral Answers to Questions — Health – in the House of Commons at 2:30 pm on 24th March 2009.

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Photo of David Kidney David Kidney Labour, Stafford 2:30 pm, 24th March 2009

How many chief executives of (a) all NHS trusts and (b) foundation trusts are suspended from work.

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Photo of Alan Johnson Alan Johnson The Secretary of State for Health

At the current time, I am aware of one NHS trust chief executive and one NHS foundation trust chief executive who are suspended from work. Chief executives and other executive directors are employees of their trusts, and suspension is a matter for the trust, acting in accordance with individual employment contracts and general employment law.

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Photo of David Kidney David Kidney Labour, Stafford

I am grateful to my right hon. Friend for his answer. In Stafford's case, where a thorough and damning report is already available, why has the chief executive not already been sacked? If the answer to that is that there is still due process to go through, what assurance can my right hon. Friend give me that it will be brought to an end soon, so that we can stop paying taxpayers' money—that is hospital budget money—for someone who is doing nothing?

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Photo of Alan Johnson Alan Johnson The Secretary of State for Health

I am sure my hon. Friend will accept that there is no point in acting in haste and then finding there is a tribunal decision against the Government. We have to have due process. I want everyone's case to be considered properly. I am very pleased that the trust has called in Peter Garland, a former senior official and regional director in the health service, to help it with the investigation and to look not just at the chief executive, but at the responsibility of the whole board for the dreadful events that were catalogued in the Healthcare Commission report.

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Photo of Bill Cash Bill Cash Conservative, Stone

Will the Secretary of State take account of the fact that I am repeating my call for an inquiry into this whole matter under the Inquiries Act 2005? Will he also make it clear that all those in that trust who are culpable, as set out in the Healthcare Commission report—that includes other senior management besides the chairman and the chief executive at the time—must be removed and not merely suspended on full pay?

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b

We are all fed up of seeing people in positions of power and authority being rewarded for failure. Well said, Mr Cash!

Submitted by barbara richards

Photo of Alan Johnson Alan Johnson The Secretary of State for Health

As I just said, the investigation will involve everyone who has any position of authority within that trust—the whole board and all the executive directors. It will be a proper investigation and it will be fair, and the action taken will result from that inquiry, not from any knee-jerk reaction by me or anyone else.

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Photo of Brian Jenkins Brian Jenkins Labour, Tamworth

Will my right hon. Friend assure us that there is no suspension culture in the national health service? Would he like to hazard a guess as to how long the longest-serving suspended employee in the NHS has been suspended for? If not, could he please send me a note on that?

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a

Who will ensure that the regulators/inspectors do their job?

They are as culpable for allowing this appalling standard of health care for so long.

Submitted by alan handley Read 1 more annotation

Photo of Alan Johnson Alan Johnson The Secretary of State for Health

I do not believe that there is a culture of suspension in the NHS. There are 1.3 million staff in the NHS, and I cannot give my hon. Friend an answer on how many people have been suspended or what the longest period of suspension is. However, I shall see whether somebody can answer his quiz question and then drop him a line.

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Photo of Patrick Cormack Patrick Cormack Chair, Northern Ireland Affairs Committee, Chair, Northern Ireland Affairs Committee

As I was in Northern Ireland on parliamentary business when the Secretary of State made his statement last week, may I make it plain that my constituents are acutely concerned about this report? We want to restore the confidence and trust that this hospital used to enjoy—it was a good hospital and it did have a good reputation. Would not the quickest way to do that be to have an expeditious public inquiry, so that all the facts and the reasons can come out and we can then go forward under a new regime?

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Photo of Alan Johnson Alan Johnson The Secretary of State for Health

I believe the phrase "expeditious public inquiry" is a contradiction in terms, but I accept what the hon. Gentleman said. Indeed, I was very moved by the contribution of the shadow Chief Whip, Mr. McLoughlin, at last week's business questions—he pointed out that his mother had died in that hospital, having received excellent care. We have to ensure that the hon. Gentleman's constituents and those of my hon. Friend Mr. Kidney, and other people who use that hospital are reassured that what the Healthcare Commission has said, in terms, in its report—that there has been drastic improvement, not least because of a huge increase in staff; staffing was at the core of the problems—is indeed the case. That is why I have asked Professor Alberti to make a very swift report and to report back to Parliament in five weeks' time.

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Photo of Norman Lamb Norman Lamb Shadow Secretary of State for Health, Liberal Democrat Spokesperson (Health)

Whenever the chief executive of a failing trust, such as the Mid Staffordshire NHS Foundation Trust, is suspended it raises questions about where responsibility really lies. Is not the Patients Association right to repeat the demand for an independent inquiry, looking particularly at the regulation and supervision of hospital care? Is that not particularly the case in the light of the letter in The Times today from Dr. Howard Baderman, a retired accident and emergency consultant who wrote two reports for the Department of Health? He talks of a "grave failure" by the Department to act on those reports in respect of other hospitals. Do we not owe it to NHS patients to ensure that all the lessons are learnt from this dreadful scandal?

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Photo of Alan Johnson Alan Johnson The Secretary of State for Health

We do need to learn all the lessons, but I point out to the hon. Gentleman that there was no independent regulator until we introduced one—the important word there is "independent". The Healthcare Commission report is independent. The letter in The Times this morning is strongly disputed, not just by the strategic health authority, but by people in the Department of Health who worked with the person who wrote that letter. We put patient safety first—we put it at the forefront of everything. I believe that the Patients Association will be reassured, not just with the Healthcare Commission report but with the three other reviews that are going on, and with the clear demonstrable fact that there is a very clear focus on finding out what happened at Stafford and why it happened—there is still an awful mystery to much of that—and on ensuring that we put the problems right, so that local residents can be assured that they have a safe hospital.

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Photo of Charlotte Atkins Charlotte Atkins Labour, Staffordshire Moorlands

How can my right hon. Friend ensure that any sacked chief executives, including the one at Stafford, do not receive financial benefits from their failures through some sort of golden pay-off?

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Photo of Alan Johnson Alan Johnson The Secretary of State for Health

In 2007, we issued instructions through the NHS Chief Executive, reminding trusts that if they plan to give any financial reward, payment or golden goodbye to any departing chief executive or anyone else, it requires approval from the strategic health authority and the Treasury. As far as I know, no one in those two organisations would give anything other than the statutory entitlement to individuals, because the Government—and, I think, the Opposition—do not want to see any reward for failure, which has been so apparent in other sectors of the economy, creeping into the health service.

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Photo of Andrew Lansley Andrew Lansley Shadow Secretary of State for Health

On 15 October 2007, after the terrible events at Maidstone and Tunbridge Wells NHS Trust, the Secretary of State said that

"we should be spotting these issues much earlier and getting rid of incompetent chief executives or chairpersons who, fortunately, are in the minority, rather than waiting for a report such as this, by which time, frankly, most of the damage has been done."—[ Hansard, 15 October 2007; Vol. 464, c. 571.]

The Secretary of State knew about the failings at Stafford in May 2008, so why did he not intervene then and there?

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Photo of Alan Johnson Alan Johnson The Secretary of State for Health

I ask the hon. Gentleman to look at the Healthcare Commission's report carefully. The difference between what happened in Stafford and in Maidstone and Tunbridge Wells, and the fact that the Healthcare Commission took into account those words and what others said at the time, is that as soon as commission staff went into Stafford and saw the problems—in May 2008—they immediately called the chief executive to a meeting, put their concerns to him, and started to see the process of improvement. That is the job of the Healthcare Commission while it carries out its inquiry. The staff cannot say at that stage that they have come to any conclusions, and it would be unfair, one day into an inquiry, to reach conclusions and say that heads must roll and recommendations must be made. We made that specific point to the Healthcare Commission at the time of Maidstone and Tunbridge Wells, so in Stafford staff immediately introduced measures to put things right, rather than wait for the end of the process and the report to be published—as I said they should do in that quote.

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Photo of Andrew Lansley Andrew Lansley Shadow Secretary of State for Health

I put it to the Secretary of State that he should look at the appendix to the Healthcare Commission's report and the letter of 23 May 2008 that was received by his Department. If he meant anything by saying that incompetent chief executives should be got rid of at the point at which one becomes aware of them, it should have been done then, but the Department failed to do it. The Secretary of State has to understand that there was a failure, not just within the trust, but within the agencies charged with commissioning, performance management and performance assessment, up to and including the Department itself.

The Secretary of State's proposed reviews—he now has three—do not have the scope, the powers or the independence to investigate those failures fully and, therefore, to restore public confidence. Will he agree today to institute an independent inquiry in the terms in respect of which I have written to him today?

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Photo of Alan Johnson Alan Johnson The Secretary of State for Health

We discussed this last week and there was no mention of an independent inquiry by the Opposition. The hon. Gentleman refers me to the appendix: let me refer him to the powers that the House gave to the Healthcare Commission. The commission could have immediately put that hospital into special measures. Its decision—as an independent regulator—was not to do so. It would have been quite wrong of Ministers to rush immediately to dismiss or discipline a chief executive when we did not even have any evidence from the Healthcare Commission. It had not reached any conclusion because it had spent only one day in the hospital.

Imagine a giant quango, the independent NHS board, trying to tackle these problems. The whole basis of the Opposition's policy is to try to remove politicians from these issues. That is quite wrong, and we are right to deal with these issues in the way that we have.

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Photo of Ken Purchase Ken Purchase Labour, Wolverhampton North East

Of course our thoughts and hearts are with those who have suffered because of the debacle at Stafford, but campaigners have drawn attention to many difficulties at the hospital over a very long period of time. The problem is that the board is stacked with accountants and solicitors who are not elected or responsible and who take no notice of what is going on. That is why we have ended up with what can only be called a tragedy. Will my right hon. Friend accept that the structures and targets in place for hospitals, such as looking for trust status and so on, distract them from delivering the care that they ought to be offering people?

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Photo of Alan Johnson Alan Johnson The Secretary of State for Health

I do not think that any neutral assessment of the Healthcare Commission report would conclude that the answer to the problem at Stafford would be to get rid of foundation trust status. However, my hon. Friend is right that the manager and the board at Stafford were seeking foundation trust status. To achieve that, incidentally, they had to put the trust into a proper financial position and save £4 million. They decided to save £12 million, and that is why there was one consultant and not four in the accident and emergency department, and why the hospital had three rather than 12 matrons. It is also why in the emergency assessment unit there was one nurse for every 15 patients, whereas most hospitals of that size have one for every six. Given that 85 per cent. of foundation trusts were considered to be excellent in their provision of services, it would be quite wrong to smear them with what happened in a badly managed and under-staffed hospital.

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