27 October 2011
George Freeman highlights some examples from the recent Care Quality Commission report and calls for greater emphasis on ‘care’.
George Freeman (Mid Norfolk) (Con): It is a pleasure to speak under your chairmanship this afternoon, Mr Betts. I will try to keep my comments brief because I know that others wish to speak.
I congratulate my hon. Friend the Member for Stourbridge (Margot James) on securing the debate and on raising such important points. It is a tribute to her and the importance of the issue that so many colleagues have stayed behind on a day when the House is otherwise empty.
This is an important subject at national and local level. Mid Norfolk is a rural constituency with a very high ratio of retired and elderly folk. The subject is also important to the families and friends of patients and, most important, to the patients themselves, who often have no voice or people to speak up for them. My hon. Friend spoke eloquently of the problems that need to be addressed, including those of nutrition, courtesy, privacy and hygiene. I was struck by one or two of the statistics that she mentioned, particularly the 9 million meals left uneaten and the shocking number of deaths from malnutrition. Although one must not overstate the problem or get it out of proportion, which the media sometimes love to do, for those who are affected it is, as the Care Quality Commission report makes clear, nothing less than cruelty and neglect. As Nigel Edwards, the chief executive of the NHS Confederation, has said:
“It is of course important to put these 10 examples”—
from the CQC report—
“into perspective. The NHS sees over a million people every 36 hours and the overwhelming majority say they receive good care. But I fully appreciate that this will be of little comfort to patients and their families when they have been on the receiving end of poor care.”
At the risk of testing colleagues’ patience, it is worth highlighting some of the examples given in the CQC report and other reports, because we have had the privilege of reading them and other people may not been able to do so. By including those examples in the report of this debate, perhaps we can help to highlight them. I was particularly struck by the following examples from the recent CQC report:
“The patient constantly called out for help and rattled the bedrail as staff passed by…25 minutes passed before this patient received attention.”
“We saw a staff member taking a female patient to the toilet. The patient’s clothing was above their knees and exposed their underwear.”
“Two members of staff who were assisting people with their meals at the time were having a conversation between themselves.”
Although in some ways the third is perhaps the least obvious example of poor care, it demonstrates what is often the source of patients’ frustration about lack of personal care when they need it.
Some other case studies were highlighted in the report of the health service ombudsman. I do not want to go through them all, but I shall mention two. The first was referred to as “Mrs H’s story”:
“When Mrs H was transferred from Heart of England NHS Foundation Trust to a care home, she arrived bruised, soaked in urine, dishevelled and wearing someone else’s clothes.”
The second case study was “Mr C’s story”:
“Mr C died two hours after undergoing heart surgery at Oxford Radcliffe Hospitals NHS Trust.”
Well, that happens, but the case study continued:
“His family was not told that his condition had worsened and staff turned off his life support, despite his family’s request to wait while they made a phone call.”
It is easy to highlight emotive examples that shock, but it is important that people’s attention is drawn to the specific nature of patients’ experiences, because it is in the details that we will begin to find the solution to the problems.
Two other issues that I have come across in my time as a parliamentary candidate and MP merit raising. The first is the difference between care and medicine. I speak as someone who has come to the House after a 15-year career in biomedicine, so I have some experience of the extraordinary advances that have been taking place in genetics, biomedical innovation, diagnostics devices and pharmaceuticals, but of course care and medicine are not the same thing. I have some sympathy with the comments made by my hon. Friend the Member for Stourbridge earlier about the occasional tendency in our modern health service to neglect, amid the busyness and professionalism involved in often extremely high-tech clinical care, some of the older skills of traditional nursing. I do not think that anybody has suggested that it is as straightforward as, “Modern nurses don’t care”, but given the specialisation and the clinical elevation of nursing we might need to consider whether we have left behind something rather more old-fashioned and traditional. In many ways, one cannot turn care into a specialism; care needs to be at the heart of everything that is done in the NHS.
The second issue is the integration of health and care. In my county of Norfolk—I dare say it is true of other colleagues’ counties too—we have an ageing population, and more and more of our constituents experience health and care needs that mean they often spend short spells in hospital before returning to the care system. That creates a number of challenging issues around the transition from health to care, and often back again, particularly relating to patient records and continuity of treatment. I know that the Government are looking at the integration of health and social care, and the commissioning reforms may provide some useful opportunities in that regard and for developing and accelerating best practice.
I will end with the observation that this topic is not one that lends itself to the creation of extreme differences between parties. It is important that today we have had a really good debate on cross-party terms and I suspect there would be wider interest in the House in taking the debate forward. I look forward to the Minister’s comments, and to reading those that I cannot hear myself as I may have to leave before the end of the debate, for which I apologise.
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George Freeman (Mid Norfolk) (Con): It is a pleasure to speak under your chairmanship this afternoon, Mr Betts. I will try to keep my comments brief because I know that others wish to speak.
I congratulate my hon. Friend the Member for Stourbridge (Margot James) on securing the debate and on raising such important points. It is a tribute to her and the importance of the issue that so many colleagues have stayed behind on a day when the House is otherwise empty.
This is an important subject at national and local level. Mid Norfolk is a rural constituency with a very high ratio of retired and elderly folk. The subject is also important to the families and friends of patients and, most important, to the patients themselves, who often have no voice or people to speak up for them. My hon. Friend spoke eloquently of the problems that need to be addressed, including those of nutrition, courtesy, privacy and hygiene. I was struck by one or two of the statistics that she mentioned, particularly the 9 million meals left uneaten and the shocking number of deaths from malnutrition. Although one must not overstate the problem or get it out of proportion, which the media sometimes love to do, for those who are affected it is, as the Care Quality Commission report makes clear, nothing less than cruelty and neglect. As Nigel Edwards, the chief executive of the NHS Confederation, has said:
“It is of course important to put these 10 examples”—
from the CQC report—
“into perspective. The NHS sees over a million people every 36 hours and the overwhelming majority say they receive good care. But I fully appreciate that this will be of little comfort to patients and their families when they have been on the receiving end of poor care.”
At the risk of testing colleagues’ patience, it is worth highlighting some of the examples given in the CQC report and other reports, because we have had the privilege of reading them and other people may not been able to do so. By including those examples in the report of this debate, perhaps we can help to highlight them. I was particularly struck by the following examples from the recent CQC report:
“The patient constantly called out for help and rattled the bedrail as staff passed by…25 minutes passed before this patient received attention.”
“We saw a staff member taking a female patient to the toilet. The patient’s clothing was above their knees and exposed their underwear.”
“Two members of staff who were assisting people with their meals at the time were having a conversation between themselves.”
Although in some ways the third is perhaps the least obvious example of poor care, it demonstrates what is often the source of patients’ frustration about lack of personal care when they need it.
Some other case studies were highlighted in the report of the health service ombudsman. I do not want to go through them all, but I shall mention two. The first was referred to as “Mrs H’s story”:
“When Mrs H was transferred from Heart of England NHS Foundation Trust to a care home, she arrived bruised, soaked in urine, dishevelled and wearing someone else’s clothes.”
The second case study was “Mr C’s story”:
“Mr C died two hours after undergoing heart surgery at Oxford Radcliffe Hospitals NHS Trust.”
Well, that happens, but the case study continued:
“His family was not told that his condition had worsened and staff turned off his life support, despite his family’s request to wait while they made a phone call.”
It is easy to highlight emotive examples that shock, but it is important that people’s attention is drawn to the specific nature of patients’ experiences, because it is in the details that we will begin to find the solution to the problems.
Two other issues that I have come across in my time as a parliamentary candidate and MP merit raising. The first is the difference between care and medicine. I speak as someone who has come to the House after a 15-year career in biomedicine, so I have some experience of the extraordinary advances that have been taking place in genetics, biomedical innovation, diagnostics devices and pharmaceuticals, but of course care and medicine are not the same thing. I have some sympathy with the comments made by my hon. Friend the Member for Stourbridge earlier about the occasional tendency in our modern health service to neglect, amid the busyness and professionalism involved in often extremely high-tech clinical care, some of the older skills of traditional nursing. I do not think that anybody has suggested that it is as straightforward as, “Modern nurses don’t care”, but given the specialisation and the clinical elevation of nursing we might need to consider whether we have left behind something rather more old-fashioned and traditional. In many ways, one cannot turn care into a specialism; care needs to be at the heart of everything that is done in the NHS.
The second issue is the integration of health and care. In my county of Norfolk—I dare say it is true of other colleagues’ counties too—we have an ageing population, and more and more of our constituents experience health and care needs that mean they often spend short spells in hospital before returning to the care system. That creates a number of challenging issues around the transition from health to care, and often back again, particularly relating to patient records and continuity of treatment. I know that the Government are looking at the integration of health and social care, and the commissioning reforms may provide some useful opportunities in that regard and for developing and accelerating best practice.
I will end with the observation that this topic is not one that lends itself to the creation of extreme differences between parties. It is important that today we have had a really good debate on cross-party terms and I suspect there would be wider interest in the House in taking the debate forward. I look forward to the Minister’s comments, and to reading those that I cannot hear myself as I may have to leave before the end of the debate, for which I apologise.
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