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The National Health Service

Part of the debate – in the House of Commons at 3:51 pm on 23rd October 2019.

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Photo of Bernard Jenkin Bernard Jenkin Chair, Public Administration and Constitutional Affairs Committee 3:51 pm, 23rd October 2019

I join Dr Wollaston on that last point. We pay tribute to all those who are serving in the NHS and our emergency services. In particular, if I may, I pay tribute to those serving in North East Essex.

Recent years have seen a significant turnaround in the health service in my constituency. Colchester General Hospital was for years in some considerable difficulties, but it is now commanding the confidence of the Care Quality Commission. It has newly merged with Ipswich Hospital in the East Suffolk and North Essex NHS Foundation Trust. It exemplifies the importance of the inspirational and strong leadership that we have in Nick Hulme, who is the chief executive of that trust.

I also commend the strategic transformation plan, which was greeted with great suspicion when such plans were first talked about. It is looking strategically at things such as GP capacity—for example, we need a new surgery on Mersea island—and at providing more services locally, such as at the Fryatt Hospital in Harwich, where we are maintaining and developing the excellent minor injuries unit and developing local access to other satellite services that would otherwise have to be at Colchester General Hospital.

All this underlines the importance of leadership, and I do hope the Secretary of State and his Ministers will continue emphasising the importance of leadership and staff engagement. I have to say to the colleague who served with me on the Joint Committee, Dr Whitford, that all this is much harder to achieve in Essex on 40% less funding per head than is available to the NHS in Scotland.

I want to concentrate on the Health Service Safety Investigations Bill, which originates from a report that my Committee—the Public Administration and Constitutional Affairs Committee—produced in 2015. We were dealing with the aftermath of all the problems of Mid Staffordshire, with 80% of the complaints coming through from the Parliamentary and Health Service Ombudsman, in an atmosphere where we were asking how complaints could be better handled and how incidents could be better investigated.

People such as Martin Bromiley, whose wife died on the operating table in 2005 and who set up the Clinical Human Factors Group, inspired me, as did papers by people such as Carl Macrae and Charles Vincent—they published a paper in the Journal of the Royal Society of Medicine in 2014, called “Learning from failure: the need for independent safety investigation in healthcare”—and that led my Committee to establishing our inquiry.

In a context of the then Secretary of State telling us there were 12,000 avoidable hospital deaths, 10,000 serious incidents, 338 “never” incidents and 170,000 written complaints about healthcare in the NHS every year, and with the NHS Litigation Authority reporting a potential liability for clinical negligence of £26 billion—the figure today is much larger—we were determined to find a better way to investigate clinical incidents so that there could be learning and no blame. The fundamental conclusion we published was that there is

“a need for a new, permanent, simplified, functioning, trusted system for swift and effective local clinical incident investigation conducted by trained staff, so that facts and evidence are established early, without the need to find blame, and regardless of whether a complaint has been raised.”

With the Bill that the Government introduced in the House of Lords last week, we are now progressing towards legislation for a safe space, so that the conversations can happen, without fear of litigation, through a properly independent body that is not a regulator, is not part of the political apparatus and is not beholden to the spending and politics of the NHS, much like safety bodies in other industries such as the air accidents investigation branch.

The Joint Committee considered the legislation last week, and the Select Committee produced another report in August 2018, “Draft Health Service Safety Investigations Bill: A new capability for investigating patient safety incidents.” I look forward to its being one of the Government’s most important achievements when they set up this body under statutory authority.