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Patients at Southern Health NHS Foundation Trust are safe, although there is much work the trust needs to do to improve standards, Minister for Community and Social Care, Alastair Burt, has said.
Burt made this assertion in the House of Commons yesterday (May 3) in response to an urgent question on the safety of care and services provided by Southern Health, asked by Labour’s Shadow Mental Health Minister, Luciana Berger.
Berger’s question came in the wake of a report published last week by the Care Quality Commission (CQC), which revealed inspectors’ serious concerns about the safety of patients with mental health problems and learning disabilities in some locations operated by Southern Health – despite it being warned previously to improve.
“What guarantees can the Minister give to the 45,000 patients currently in the care of Southern Health, and their families, that they are safe?” Berger asked. “Secondly, where is the accountability, the culpability and the responsibility? There seems to be very little. I heard what he said about the chair, but does he agree that the chief executive’s position is now untenable, and that she should be sacked? Thirdly, will he listen to the heartfelt pleas of the victims’ families, the campaigners, and all of us who are demanding a full public inquiry into Southern Health and broader issues, such as the abject failure adequately to investigate preventable deaths?”
Burt began his reply by expressing his concern and apologies to the patients and family members “who will again have felt let down by the contents of last week’s report from the Care Quality Commission.”
Then, responding directly to Berger’s questions, he said: “There is an issue of urgency, which is really important. There are things that are discovered and things take time to get done. I am not content with that in any way, but the process is in place to do something about that. The CQC has been engaged and has ruled out no option for further action. Its options are quite extensive, including prosecution for things that it has found. The process started by the Secretary of State is not yet finished.
“I asked the same question that the hon. Lady asked about safety directly to the CQC this afternoon, and I spoke to Dr Paul Lelliott [CQC’s deputy chief inspector of hospitals and lead for mental health] who compiled the report. I asked whether people are safe at the foundation trust today. People are safe because, as we know, the CQC has powers to shut down places immediately if there is a risk to patients. It has not done so, but I am persuaded that if it had found such a risk it would have closed things down. There is therefore no risk to safety in the terms that the hon. Lady suggests.”
Several times in the debate, ministers made reference to the senior leadership of Southern Health, calling for sackings. However, Burt was careful to not echo these calls, saying that responsibility for such things lies with NHS Improvement, although he noted that 9 changes to the board since last year and the chair recently resigned.
Burt added that the CQC is considering Southern Health’s response to its warning notice, and the risks it highlighted, before deciding whether to take any further enforcement action. “The notice required significant improvements to be made by 27 April. Dr Paul Lelliott… informs me that the delivery plan required by 27 April has been received and is in the process of being evaluated,” he added.
“NHS Improvement is working closely with the CQC and the trust, and the improvement director appointed by NHS Improvement is on site regularly, so there is constant independent oversight of the progress being made as well as the formal monthly progress meetings between NHS Improvement and the trust.”
However, Burt rejected a call for an immediate independent inquiry into Southern Health along the lines of the one undertaken after failings were exposed in Mid Staffordshire in 2010, although he did not completely rule it out. “I am aware that there might be circumstances in which an inquiry would bring out more and would demonstrate the degree of concern that colleagues in the House might find appropriate and that the families and others would understand,” he said. “My first duty is to make sure that everyone is safe in the trust and to ensure the completion of the work that needs to be done to deliver what the CQC has found. Even after this very thorough work by CQC… if anything further is needed, I will give it genuine and serious consideration.”
Conservative MP Dr Sarah Wollaston asked about the learning disability mortality review, seeking assurances that a duty of candour would be more than just a box-ticking exercise.
Burt emphasised that the learning disability mortality review programme is important, and that it is already under way in a pilot in Cumbria, which will inform us how the programme operates as it is rolled out. “Plans are in place to roll out that review across all regions of England between now and 2018, with pilots commencing in other parts of the country between 2016 and 2017,” he added.