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Mid Staffordshire NHS Foundation Trust

I am grateful to the Secretary of State for making an oral statement today, and for giving me advance sight of it. I want, once again, to express our deepest sympathies to the patients who suffered and to the relatives who saw them suffer. My right hon. Friend the Member for Witney (Mr. Cameron) and I have had occasion to talk to those relatives in Stafford, and the stories of their experiences were harrowing. Today's report, the second volume in particular, sets out the most compelling—indeed, horrific—character of many of the sufferings of the patients and their relatives. I pay tribute to the work of Julie Bailey and Cure the NHS, and to their determination and persistence in holding the hospital trust and the Government to account for their failures in relation to this hospital, and in securing this further investigation. The Secretary of State will recall that, when the Healthcare Commission published its first report, his predecessor instituted an internal Department of Health inquiry under Dr. Colin-Thomé and another under Professor Sir George Alberti. We told the Government then that that would not meet the need of the people of Stafford for a clear investigation in public into what had happened. When the Secretary of State announced this inquiry by Robert Francis, we told him again that it would not achieve that aim. This is the fourth report, and none of them has diminished the need for a public inquiry under the Inquiries Act 2005, in which evidence can be taken in public and under oath. We can combat a culture of secrecy and bullying only by ensuring the fullest openness and transparency in any investigation. The whole House will, none the less, be grateful to Robert Francis for fulfilling his brief in a thorough and objective manner. We find no fault with his work, but we do object to Ministers setting up report after report with constrained terms of reference that are designed more to focus on local management than to get to the full truth and the full context of the tragedy at Stafford hospital by analysing in addition the failure of national and regional scrutiny and of NHS performance management. In my evidence to Robert Francis, I urged him to recommend a further investigation into the role of the external monitoring and performance management agencies, and I am glad that he has taken this advice and made that recommendation today. Such a further investigation is essential, because many of the serious questions that we and the relatives of those who died have been asking the Government for the past year remain unanswered. Why did the primary care trust fail to ensure that standards were up to scratch when it commissioned services from the hospital? Why did the strategic health authority, which was charged with performance management of the hospital when it was an NHS trust, fail so abjectly in that task? Why did the Department of Health simply wave through the foundation trust application at the very time that clinical standards were so poor? Why did it take so long for the scrutiny by the inspectorate to establish that the high mortality rates were occurring, and to undertake an investigation into them? What are the problems with national policy and decision making on patient and public involvement that resulted in people failing to listen to patients raising their concerns in Stafford? And what are the problems with the whistleblowing procedures and practices in the national health service that prevented or inhibited front-line staff from speaking out about poor standards of care? The Francis report provides a powerful analysis of the impact of the Government's top-down targets on patient care at Stafford hospital. When the scandal was laid bare by the Healthcare Commission last March, the then Minister of State, the right hon. Member for Exeter (Mr. Bradshaw), said that""this was not a problem about targets"." However, the Francis report—on page 165—states:""This evidence satisfies me that there was an atmosphere in which front-line staff and managers were led to believe that if the targets were not met they would be in danger of losing their jobs. There was an atmosphere which led to decisions being made under pressure about patients, decisions that had nothing to do with patient welfare. As will be seen, the pressure to meet the waiting target was sometimes detrimental to good care in A&E."" Will the Secretary of State now acknowledge that Ministers were wrong to deny that targets were part of the problem at Stafford, and that they are wrong now to maintain that they are not the issue? Will he therefore move to abolish top-down political targets, so that the NHS can focus on patient safety and quality of care as an absolute priority? In this Parliament alone, I have had to stand at this Dispatch Box on four occasions to respond to issues of failing hospitals: Stoke Mandeville in 2006; Maidstone in 2007; Mid Staffordshire last March, and again today; and Basildon and Thurrock in December. Each time, Ministers have insisted that these are isolated cases and blamed local management principally, but the themes have become too frequent and too familiar for this simply to be a coincidence: waiting time targets prioritised over patient care; clinical priorities distorted by Government targets; a focus on financial issues at the expense of patient care; senior management at board and strategic health authority level putting targets and policy processes ahead of a focus on quality care for patients; primary care trusts focused on cost and volume, and not on quality; and front-line staff finding their attempts to voice concerns going unheard or, even worse, suppressed. That is not good enough. We cannot go on like this. We must be committed to establishing a full public inquiry into the tragedy at Mid Staffs. It must be an inquiry with a remit broad enough to ensure that no stone remains unturned and no lesson is overlooked. That would restore confidence among the public in and around Stafford. We will learn the lessons across the NHS, and we must do so up to and including the Department of Health. Action must be taken on the results. For our part, we would abolish top-down political targets and the pointless bureaucracy that surrounds them. Instead, we would focus relentlessly on the results for patients. We will make patient experience and outcomes central to accountability. We will ensure that the quality imperative drives NHS services so that when complaints are made, the inspectorate receives, understands and acts on them. We will make quality and safety the central drivers of NHS performance and we will see through the changes in leadership, strategy and reform in the NHS that will give the public the confidence that when they go to hospital, they are there to be cared for and to be treated—and never to be harmed.