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30 Oct 2002 : Column 971continued
That the Northern Ireland Act 2000 (Modification) Order 2002 (S.I., 2002, No. 2587), dated 14th October 2002, a copy of which was laid before this House on 15th October, be approved.[Mr. Woolas.]
In the Table
Item 7, column 2, leave out from 'Office;' to end of entry;
After Item 8 insert
|'Justice and Constitutional Affairs||Lord Chancellor's 11'.|
|Department (including the work of staff provided for the administrative work of courts and tribunals, but excluding consideration of individual cases and appointments); and administration and expenditure of the Attorney General's Office, the Treasury Solicitor's Department, the Crown Prosecution Service and the Serious Fraud Office (but excluding individual cases and appointments and advice given within government by Law Officers)|
Mr. David Tredinnick (Bosworth): Before I present this petition about the threats to herbal remedies and vitamin supplements on behalf of my constituents, may I say that there are three main concerns? First, nutrients are missing from the list of permitted ingredients in the food supplements directive. Secondly, the setting of maximum levels for nutrients is unsatisfactory. There are very real worries that the products outside the scope of the traditional herbal medicinal products directive should be included. Member states need to be able to introduce their own national rules. There are also concerns about the cost of implementation.
Thirdly, the proposed ban on sales of kava kava products is based on questionable data. I draw the House's attention to early-day motion 183, in my name, which attracted 44 signatures just last night. We will all regret the fact that the proposed regulatory response is disproportionate.
The Petitioners therefore request that the House of Commons requires that the Secretary of State for Health does all in his power to protect the rights of UK consumers by ensuring that such European legislation does not unnecessarily and unacceptably restrict the availability of natural health products.
And the Petitioners remain, etc.
The petitioners therefore request that the House of Commons urges the Government to ensure that all local authorities introduce doorstep recycling schemes.
And the Petitioners remain, etc.
Dr. Vincent Cable (Twickenham): I am grateful to have the opportunity to introduce an Adjournment debate on an issue that concerns many of usthe problems associated with residential care homes for the elderly. I was in the Members' Dining Room a few moments ago, and I noticed a headline in today's Evening Standard:
The matter that I want to raise primarily concerns a home called Lynde House, in Twickenham, which is owned by Westminster Health Care. It differs significantly from the home described in the Evening Standard article, as it is owned by one of the largest groups in the country. It is a particularly luxurious home, which, none the less, has been subject to an independent investigation, which I instigated, and which has produced some damning conclusions. I want to describe to the House and the Minister the process through which we had to go to secure that inquiry and its aftermath. I also want to raise some of the wider policy issues in terms of how the National Care Standards Commission will manage its relations with very large private providers, and some of the unresolved questions about how standards will be defined and monitored under the National Care Standards Commission.
I shall start with a narrative of how this situation arose. I became a Member of Parliament in 1997, and, shortly afterwards, I was invited to another care home in my constituency called Brinsworth House, of which the Minister may have heard. It is a famous care home for the elderly, where many retired comedians, musicians and variety artists reside. Thora Hird is among its current residents, and Arthur Askey was a resident there. It is a wonderful institution. I was called in by the general manager, who pointed out a serious problem affecting his homea care nurse had abused elderly patients, and he had taken steps to have the person dismissed. He had discovered, however, that that person had been hired by another care home down the road a few days later.
The general manager called me in for two reasons. First, he wanted me to note that appalling things were happening in the unregulated private sector, that people were being hired and rehired who were well below acceptable standards, and that it was very important that the Government grasped the need to regulate the sector properly. Secondly, he wanted me to go to the local press to publicise the fact that his home had had this problem and had dealt with it. I took that to heart, as it struck me as being an exemplary way in which providers of care for the elderly in the private sector should deal with problems: in an open, transparent and public way, with nothing to hide.
Having seen that experience and good practice, I was well prepared for the events as they unfolded in relation to Lynde House. I had been made aware throughout most of last year of a growing number of complaints from relatives of residents of the home who lived in my constituency. That came to a head in November when the Catholic priest in an area of Twickenham convened a public meetingwith the local Anglican priestto draw attention to serious concerns among some of his parishioners about care in this home. I attended that meeting, at which I heard a horrifying succession of deeply felt, very emotional presentations by relatives about the experiences that their mothers and fathers had had.
There was a common thread to the reports. Despite paying extremely large feestypically, #30,000 a yearthe residents had experiences such as sitting for very long periods, being unable to attract attention after ringing bells, sitting in their own waste and being unable to attract any nursing or care attention in an understaffed environment. Perhaps most serious of all was the climate of bullying that existed. Examples were given of old people in their 80s or 90s being expelled or being threatened with expulsion because they had complained about the problems associated with care in the home.
What was worse was that the residents and their relatives told me that they had approached the local health authoritythe regulatory body in this instanceand had not been able to attract a reply. They had been reassured that everything in the home was absolutely fine. My concerns developed in the wake of the meeting even further when I was approached by a judge, who asked to meet me anonymously. Despite his senior position in public life, he was clearly a frightened man. He said that he wanted to tell me some things that had happened in the home, but did not wish his name to be used. He was afraid that, if it were, there would be retaliation against his mother who was in her mid-90s. I also spoke to the local GP who told me similar stories about what had been going on. She expressed her concerns and told me that she had approached the health authority, but had been unable to attract a response. She was assured that the home had been inspected and that everything was absolutely fine.
I then wrote a letter to the chairman of the health authority, drawing these points to her attention. Somewhat to my surprise, a few days later I was contacted by the head of Westminster Health Care, Dr. Patel, the owner of the home. Without my knowledge, the health authority had copied to him my letters of complaint, so he said that he wished to set up a meeting with me. We met over breakfast, and that was very charming at one level. However, he threatened me with legal action because I, as the Member of Parliament, had written to the health authority asking for an investigation into conditions at the home. That brought home to me strongly the type of experience to which people at the home were subjected. There were threats of intimidation and legal action if perfectly legitimate points were brought into the public domain.
I then asked the chairman of the health authority, Councillor Julie Ray, to institute a full inquiry into the home and, much to her credit, she agreed. One of the positive elements of this case is the fact that the health service is publicly accountable. She acknowledged that
Although it was far from the end of the saga, the report was completed last December and January. It did not appear. I was informed that it was stuck because of objections made by Westminster Health Care lawyers. The matter went on and the report was refined. It was officially reported to have been finished by May, but it could still not be released because of objections from lawyers. A public report instituted by the health service and of wide public interest could not be released into the public domain because the company objected to its findings.
The report was eventually released, but I shall not test the Minister's patience by going through it in excruciating detail. However, I wish to report simply for the record some of the main conclusions. They were extremely hard hitting, and half a dozen or so of the main points will capture the flavour of what was found to have happened in the home. The report said that the home:
Failed to ensure that housekeeping and cleanliness standards were maintained at all times as domestic staff only worked until 14:00 hours . . . Allowed unacceptable levels of maintenance of hoists, wheelchairs and other equipment, which put the safety of residents at risk . . . Allowed the unacceptable provision of equipment that did not meet Health and Safety Legislation . . . Allowed an Internal Complaints Management system . . . to continue that made access to . . . Senior Managers seem impossible . . . Allowed an apparent climate of fear and intimidation as perceived by some relatives and residents . . . Allowed an apparent closed organisation that did not encourage 'whistleblowing' by staff when some were very unhappy with certain situations despite a written policy and in our discussions with some staff . . . Undertook a recruitment process . . . that allowed appointed care staff to undertake tasks without fully assessing their competence in a working knowledge of English."
On the back of that, I want to pose a series of policy implications that arise from the events. How will the commission manage and supervise a system in which one of its largest private providers is in default of its obligations and refusing to accept any admission of failure? There is a distinction between a home that gives problems and a company that gives problems. The report makes that clear when it says that
Since the report was publishedit received a great deal of publicity in the national pressI have been deluged with letters from people around the country, bringing my attention to abuses in other Westminster Health Care homes. I now have a substantial dossier of cases, some of which are very serious, relating to at least seven homes owned by the company. I intend to ask the commission if it will investigate the company as a whole.
Let me cite one problem. It is not in my constituency, so I cannot follow up the individual case, but it gives a flavour of the difficulty. A former nurse who worked at one of the homes in Southgate wrote to me. She said that she
Many individual patients and their relatives and carers have written to me. One particularly distressing case concerns a former Labour MP, Michael English, who may be remembered, who was the victim of some of these difficulties. I intend to bring those cases to the attention of the commission.
How will the Government, through the commission, deal with such cases? If a company is in denial and is comprehensively mismanaging its collection of homes, the commission has only a nuclear optionit can withdraw the licence, which means that large numbers of residential care homes are taken out of use. Is it possible to have a graduated response? Are there any penalties or sanctions that can be applied to signal to a major private provider that its service is not acceptable and that it is behaving arrogantly in refusing to accept the judgments of independent inquiries appointed by the NHS? The point could then be made without closing down a share of the private sector.
Is it proposed that bigger companies, which clearly have more resources and are better able to meet standards than one-man, one-house companies, can be asked to operate at higher levels of performance? I am thinking particularly of training. The level of training in the company that I have mentioned was seriously deficient. Would not it be good practice to ask the company to have its own training institution? How can the commission advance that process?
My final question relates to staff and to a problems with staff who are unprofessional and who create serious disciplinary problems. Is there any system within the commission's approach to enable such people to be tracked, so that other homes that hire them have some cross-reference? At the moment, such staff seem to disappear into a void. Will there be a central register of staff so that issues pertaining to a lack of professional conduct can be addressed?
I want to pay tribute to those who have brought this matter to the attention of the public. Many are vulnerable people who have had a devastating personal experience, and they have been very brave. They were initially threatened with legal action and bullied, but they have come forward and made their case in public. I am bringing it to the House because it is part of the process of ensuring that they receive justice.