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Dr. Evan Harris (Oxford, West and Abingdon): It is a privilege to follow the right hon. Member for Holborn and St. Pancras (Mr. Dobson), who started and ended his contribution in a suitable tone, while the middle was packed with suitable content. I agree with almost everything that he said. He should also be applauded for choosing Sir Ian Kennedy to run the inquiry and for giving the Kennedy committee the freedom of a wide-ranging inquiry. He had the option of establishing a narrow inquiry, which might have limited potential damage and only implicitly criticised the direction that Governments, including that of whom he was a member, had traditionally taken. He made a brave move that has been amply rewarded, both in terms of the subjects covered in the recommendations of the Kennedy report and of the acceptance by the Government of many of the recommendations.
It is an account of people who cared greatly about human suffering, and were dedicated and well-motivated. Sadly, some lacked insight and their behaviour was flawed. Many failed to communicate with each other, and to work together effectively for the interests of their patients. There was a lack of leadership, and of teamwork.
It is an account of healthcare professionals working in Bristol who were victims of a combination of circumstances which owed as much to general failings in the NHS at the time as to any individual failing. Despite their manifest good intentions and long hours of dedicated work, there were failures on occasion in the care provided to very sick children.
It is an account of a service offering paediatric open-heart surgery which was split between two sites, and had no dedicated paediatric intensive care beds, no full-time paediatric cardiac surgeon and too few paediatrically trained nurses.
It is an account of a time when there was no agreed means of assessing the quality of care. There were no standards for evaluating performance. There was confusion throughout the NHS as to who was responsible for monitoring the quality of care.
It is an account of a hospital where there was a 'club culture'; an imbalance of power, with too much control in the hands of a few individuals.
It is an account in which vulnerable children were not a priority, either in Bristol or throughout the NHS.
And it is an account of a system of hospital care which was poorly organised. It was beset with uncertainty as to how to get things done, such that when concerns were raised, it took years for them to be taken seriously."
I am grateful to the Minister of State for the briefing that I received this morning on the Government's general approach, and for the opportunity to see this very lengthy report about an hour before the start of the debate. Making a statement, followed by questions, a few days after everyone had had the chance to read the wide-ranging proposals in the Government's report might have been a more appropriate way of dealing with this matter. Debating the matter now makes it difficult to give due credit to the Government for some of their proposalsalthough I shall tryor to give adequate scrutiny to some others.
Nevertheless, from what I understand of the Government's proposals, many of their responses to the recommendations are welcome. They will stand as a testimony to the people who campaigned for something to be done, including parents and Members of Parliament from the Bristol area who are here today, as well as my hon. Friend the Member for North Devon (Nick Harvey), who cannot be here today. He, too, pressed for an inquiry into this matter. If there is broad agreement on the Government's response, the children involved will not have died in vain, because steps will be taken to preventto the best of our abilitysuch things happening again.
The report is clear that there must be not only adequate resources but honesty about the amount of resources available, and about what can be delivered by means of those resources. Professor Kennedy sets out, in paragraph 29 of chapter 4, how one might imagine that a Government would be elected, and would put the resources in place, and that would be that. He states:
This approach would suggest that a service can never accurately be said to be underfunded since, within a relatively short timescale, its funding is regularly adjusted to reflect the prevailing political compact. On this approach also, it is idle to talk of a 'proper level of funding' or the 'necessary level of resources', since there is no absolute or proper level. There is only a political choice which, by reflecting the will of the electorate is, by that fact, the proper choice."
Of course, if governments had claimed that the service delivered by the NHS should be judged on the basis of a comparison with a moderately successful Second World country, no complaint could be raised. But the NHS was"
There is much in the Kennedy report about the culture of blame, and the Government often use such words in defence of their own policies. The right hon. Member for Holborn and St. Pancras was right to draw attention to the explicit terms in which the report talks about the culture of blame and the unwillingness to admit mistakes, both of which have arisen as a consequence partly of the club culture and partly of clinical negligence. The report states:
The lobby representing people who make a livingnot unreasonably, in their viewon the basis of clinical negligence is strong, and I hope that the Government will be strong enough to resist it. It has a point to make, but reporting errors and swift compensation for patients are important. I am not sure whether the Conservatives endorsed that system when they raised concerns about the matter. Perhaps that may be clarified from the Conservative Front Bench.