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The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): I genuinely congratulate my hon. Friend the Member for North Durham (Mr. Jones) on securing the debate. It is clear from the way in which he makes his case that he takes seriously his responsibility to represent the best interests of his constituents in the health service. I recognise and understand his concern that the North Durham Health Care NHS trust should have sound leadership. The performance of any NHS trust depends on the leadership provided by executive and non-executive directors of the board. His constituents rightly expect their local hospital to provide the best service that it can.
The new hospital, the University hospital of North Durham, which has been built on the north end of the existing Dryburn site in Durham city, is operational following a £96 million private finance initiative scheme.
We heard how Mr. Earley's personal and forthright leadership style gained him support from hospital staff and in the local community. I do not wish to say anything that would detract from his significant contribution to the trust or the community at large over the past three and a half years. However, it does not necessarily follow that his record makes him the automatic choice to lead the trust into the challenges of the next four years. The NHS Appointments Commission, in making the appointment of Angela Ballatti as chair from 1 November, has taken an independent view that North Durham Health Care NHS trust can move forward to even better performance under her experienced leadership. Before I deal with the detail of Mr. Earley's position, I will say why the NHS Appointments Commission was set up and how it operates.
In 1999 Dame Rennie Fritchie, in response to complaints from MPs and interest by the media, announced her intention to scrutinise all NHS appointments. Her report in March 2000 made 28 recommendations for improving the process. She concluded that there was a lack of transparency in the way those public appointments had been made and even that political affiliation had been more important than merit when candidates were considered. The Public Administration Committee became involved and its second report recommended that the Government should consider the possibility of an independent appointments commission.
The Secretary of State for Health took the view that an independent commission was the only way to provide complete reassurance to the public. The commission was set up with a chair, a chief executive and eight regional commissioners. The establishment of the commission means that the appointment of chairs and non-executives to NHS boards is no longer the direct responsibility of Health Ministers. In addition, the NHS Appointments Commission does not consult MPs on the identity of candidates. Instead, it writes to all Members of Parliament whenever a chair post is advertised to give them the opportunity to draw the advert to the attention of anyone who they think is suitable.
Mr. Jones: The process was clearly inefficient in my region, because even though I was elected in June the commission wrote to my predecessor, Giles Radice. I had to point out that I was now the Member of Parliament. Clearly, the commission does not keep on top of who are the Members of Parliament in the northern region.
Ms Blears: My hon. Friend makes an important point. When I met Sir Williams Wells today, I asked that the procedures connected with Members of Parliament be examined to ensure that they are efficient and effective. On occasion, not only have Members of Parliament not been notified that vacancies have occurred and that they should draw the advertisements to people's attention, but they have not been notified when an appointment has been made. I am anxious to ensure that all Members of Parliament are properly notified of appointments: they are
The NHS Appointments Commission was established as a special health authority from 1 April this year to take over responsibility for recruitment and appointment of chairs and non-executives. In taking the step of establishing an independent appointments body, my right hon. Friend the Secretary of State for Health had the support of the Public Administration Committee and the Commissioner for Public Appointments, Dame Rennie Fritchie. Sir William Wells is the first chairman of the commission.
The NHS Appointments Commission itself is subject to regular audit and scrutiny by the Commissioner for Public Appointments, who has a statutory duty to audit all public appointment files within her remit. She does that by sending in teams of auditors who trawl through the files, examine processes and report on their findings. The commission will be audited annually from 2002. I hope that that reassures my hon. Friend that the proceedings and processes of the commission will be subject to intense scrutiny.
In addition, anyone who thinks that the appointments process is flawed may draw their concerns to the attention of Sir William, who has the power to scrutinise all the papers and the process. He can request the board to re-examine the appointment, and would do so if he found evidence of flawed procedure. If the complainant remains dissatisfied, they may then take up the matter directly with Dame Rennie Fritchie, who has the power to see all the papers, audit the procedures and report back. The commission would be bound to consider her recommendations and to take appropriate action. We have built in checks and balances to ensure that the commission's activities are subject to proper audit.
Transparency is crucial if the public are to feel that proceedings have been properly conducted. One of the first actions of the commission was thoroughly to overhaul the appointments process. After a comprehensive consultation exercise involving all serving non- executives, new guidance was published that has the full support of the Commissioner for Public Appointments. I understand that copies of the entire process are available in the Library. The process is open and transparent and ensures that appointments are madeand can be seen to be madeon merit alone.
There are safeguards in the system. First, all interview panels must include an independent assessor who has the right to report directly to the Commissioner for Public Appointments if the proper procedures are not followed. Secondly, appointments are not made by any individual alone. Chair appointments are made by the full board of the commission in a collective decision. Thirdly, no chair or non-executive has an absolute right to a further term of appointment. If there is any doubt about their performance, their post will be advertised, but they are entitled to apply and be interviewed along with other candidates. That may appear harsh to my hon. Friend, but the NHS Appointments Commission believes that the process is essential to encourage openness and to ensure that the NHS always has the best leaders available to it.
Dr. Ashok Kumar (Middlesbrough, South and Cleveland, East): Those who have been rejected must be told why they were turned down. It hardly creates confidence or encourages people to come forward if they are not told.
Ms Blears: My hon. Friend makes an extremely important pointone that I raised with Sir William Wells today. All unsuccessful candidates should be entitled to proper feedback on their interview, on the process, on their perceived deficiencies, and on where they need to be stronger if they are to be appointed. I have been assured that all candidates are entitled to feedback, both orally from the members who sat on the interview panel and, if they wish it, in writing. It is an important part of the procedure that people should understand where their perceived deficiencies are.
My hon. Friend said that in relation to the process concerning Mr. Earley, a decision was made not to appoint any candidate on the first occasion. There was then a trawl or a head-hunting process. My hon. Friend has rightly said that that process of seeking applications is not in the written process that he has examined. Again, that matter needs to be remedied. Apparently, the process is acceptable to the independent commissioner, and it has been used on a number of previous occasions. My hon. Friend is correct to say that the process should be transparent and should be part of the written procedures. I will ensure that happens.
In Mr. Earley's case, there was a panel that consisted of the regional commissioner, another chair and an independent person. At the first session, Kevin Earley was interviewed in accordance with the process. Along with three other candidates, he was assessed as not having the particular skills needed by the trust for the challenges of the future. The details of that interview are in confidence between the commission and Mr. Earley. I do not have them, but he should be entitled to that feedback. I will ensure that he gets it.
Miss Ballatti was appointed by the commission at its board meeting on 12 November. She is already an experienced chair, and she will be supported in her new role by the induction and training procedures. I am delighted that my hon. Friend has said that he intends to work closely with her in the interests of his constituents to ensure that their health services continue to be of the highest possible quality.
My hon. Friend has expressed concern about the role played by Dr. John Marshall in this procedure. I have been reassured by Sir William Wells on behalf of the commission that Dr. Marshall is a man of the highest integrity who has worked in the north-east for more than 40 years in the chemical industry, the university sector and as chair of a health authority. It therefore follows that he knows many local people. It is an asset to have that