I am very proud to be part of a Government that is protecting and increasing spending on the NHS by taking difficult decisions on the other ways we use public money. But despite this financial commitment to the NHS, in the extreme – and rare – circumstances when a Trust goes into administration, we need to have a way to protect patients. It is important in such cases to give the administrator enough power to make the choices that will ensure patients get safe care. This clause of the Care Bill makes vital changes to the Trust Special Administrator regime (TSA) that will help to do just that: protect hospital services and save patients’ lives.
The TSA regime (introduced by Labour in 2009) provides a way to deal with local health services which are failing badly and it makes sure this is done transparently and in a timely way.
The process is used only as a last resort, in the most urgent cases, when all other efforts to ensure safe, effective and affordable local services have been unsuccessful and lives are potentially being put at risk. TSAs have only ever been used twice – once in Mid-Staffordshire and once in South London – where patients were suffering from dangerously poor care or vast sums of taxpayers’ money were being spent on bailing out failed hospitals.
I know from my discussions with senior managers in our local NHS that turning things around in these most severe of cases requires that the administrators can take a look at the wider health services locally, because our health system is a network, not a set of stand-alone services. That is quite clearly demonstrated in the case of Mid-Staffs, where I am sure none of you would expect changes to be made without health chiefs looking at the knock-on impact in the Moorlands.
That’s why I held a public meeting last Friday. I wanted the senior local NHS managers to explain what the reforms would mean for us and I also wanted to give you the opportunity to raise any concerns.
The Government’s view is that the original legislation was always intended to allow the administrators to look at the wider health economy, because that is the only sensible way to resolve problems for local patients.
We have a national health service, made up of hospitals that affect each other, so it cannot be right that the administrators are currently only able to look at single failing providers like Stafford Hospital in isolation. That’s why clause 119 was tabled – without it, improving patient care and making sure we preserve hospital services would be much harder.
So, I am afraid that the claims that hospitals will be closed without consultation are nothing more than irresponsible and opportunistic scaremongering.
The NHS is currently turning around a number of hospitals in special measures, many of which have had deep-seated problems for years. Clause 119 ensures that commissioners of other affected trusts would have every opportunity to make their views known. It allows administrators time to consider everyone’s views by increasing the length of time they have to produce their first report. It also extends the consultation on the recommendations, crucially giving more time for the involvement of you, the public, and everyone else.
In these extremely serious situations, lives are put at risk if the problem is not dealt with swiftly and effectively. This clause of the bill is part of a system “of last resort”: we can use it when it is absolutely needed and in the interests of patients, rather than ignoring problems or bailing out failed and unsafe services which has so unfortunately happened in the past.
I do hope this clarifies why I am happy to see the clause included – it is an important part of protecting and improving our NHS which this Government is continuing to do.