---

Hospital Trusts (Essex)

I thank the Secretary of State for sight of the statement before he came to the House. It is important to acknowledge the fine work and standard of care across most of the NHS. Indeed, there will be many fine clinicians doing important work in the hospitals that we are discussing, so it is important not to tar everyone with the same brush. However, the revelations raise serious concerns. For example, a taskforce has been sent into Basildon, but will we get to the bottom of how the failures occurred in both hospitals so that we understand who was responsible? What about the clinicians? Each has a duty to their patients. Will they be held to account for any failures? What about the people on the board who have responsibility for patient safety? Will they be held to account? The CQC says that there is no evidence of another trust's being in the same category as Basildon and the Secretary of State repeated that assurance. Yet that is precisely what we were told in the aftermath of Mid Staffordshire—that it was an isolated incident. How can we have faith in the CQC's standards given what happened with Mid Staffordshire? Are Dr. Foster's concerns being thoroughly investigated, particularly the extraordinary statistic that 39 per cent. of hospitals have failed to investigate all unexpected deaths or cases of serious harm? Surely every case must be thoroughly investigated. There is now a series of cases in which there is an extraordinary mismatch between rating and the reality: Mid Staffordshire, baby P, Basildon; and eight of the 12 cases that Dr. Foster raised were rated good or excellent. Does not that completely undermine confidence in the system of regulation? Do not we end up with a state of paper safety, but not real patient safety? The Secretary of State will know about the NHS Confederation report, "What's it all for?", which is a damning critique of the system of regulation in this country. It highlights that more than 60 bodies inspect hospitals, with no clinical engagement in responding to all those organisations. One person would take 491 years to provide all the data to the national regulators. What has happened to that report? Are the Government ignoring it or acting on it? If they are acting on it, how are they doing that? The report highlights that several bodies nationally are responsible in some way for patient safety: the CQC, Monitor, the National Patient Safety Agency, the Health and Safety Executive. Who is ultimately responsible? Is there not a danger that no one ends up being accountable? We hear that Monitor has a list of 11 NHS foundation trusts where there has been a significant breach of standards, which it is investigating. The CQC is investigating a few hospitals. Dr. Foster has concerns about 12 hospitals. Are they all the same hospitals? Are the different bodies talking to each other? Have the local primary care trusts been informed in every case? Do not the public have a right to know which those hospitals are? Does the Secretary of State agree that ultimately openness and full information are more effective at driving up standards than tick-box self-assessment, without clinical engagement? Does he agree that it is hard to justify the increase in the pay of the chief executives at Basildon and Colchester by 15 per cent. and 11 per cent. to £150,000 when serious concerns were being raised about standards? Given the accumulation of evidence and that hundreds of people appear to have lost their lives unnecessarily, is not there a case for an independent investigation into regulation to consider its role, self-assessment, the lack of clinical engagement in providing data to the regulators, the role of targets—yes, they must be investigated—and that of financial incentives? Do we not owe it to all those who have been affected by the scandals?