§ 6.20 p.m.
§ Mr. Kenneth Robinson (St. Pancras, North)
It is characteristic of our proceedings that we are apt to switch abruptly from considering the constitutional future of a nation to the personal problems of an individual, but the House never rates the latter type of debate any less important on that account. I am raising today the Rubery Hill inquiry, and doing so not only as a personal case. I am concerned with the injustice suffered, as I believe, by Mr. David Rhydderch, the central figure in the controversy, but I am no less concerned with the wider implications for the hospital service and beyond.
I believe that profound issues of public policy are involved in this matter, and the purpose of the debate is to ensure that never again should a layman, who has devoted himself voluntarily, and totally without reward, to the public service, and against whom no malpractice is alleged, be subject to the kind of prolonged ordeal, the financial hazards and the public humiliation that Mr. Rhydderch has undergone. This is a complex story, and we have not a great deal of time. I shall therefore compress my remarks as much as possible.
The bald facts are that last September the medical committee—all the doctors working in the hospitals concerned—of Birmingham No. 6 Group, comprising two mental hospitals—Rubery Hill and Holly Moor—passed a vote of no confidence in the chairman of the hospital management committee, Mr. Rhydderch, who happens also to be vice-chairman of the hospital board. 95 This resolution was communicated to the right hon. Gentleman, and in January of this year he ordered a public inquiry under Section 70 of the National Health Service Act into the differences between the parties leading up to the medical committee's vote of no confidence.
This inquiry lasted for fourteen days. It is estimated to have cost about £12,000, and its findings led to the drastic action of breaking up the hospital group concerned and its management committee with it, to the Chairman's resignation, and to the right hon. Gentleman's refusal to reappoint him to the regional board.
I want the House to consider, first, the Minister's actions in setting up an inquiry, then the nature of the inquiry itself and the findings embodied in the report and then, perhaps, the wider and more general implications of the matter. First, I take the right hon. Gentleman's actions. If a voluntary member of a hospital board or management committee is unsuitable for his appointment, either from excessive zeal or the lack of it, or for any other reason, his term of office is three years only, and it would be quite appropriate not to reappoint him at the expiry of that term. This is the normal, quiet, decent way of getting rid of such people. It is done every year in every region, in hundreds of cases.
Mr. Rhydderoh served on the Birmingham Regional Hospital Board and as chairman of its hospital management committee for fourteen years. During that time his achievements, not least in getting his hospital modernised—and everybody agrees that they sorely needed it at the appointed day—were very considerable. If the differences to which this inquiry related were so long-standing; if the tensions between Mr. Rhydderch and his medical staff were so serious and, indeed, if the chairman possesses all the failings of character that the report alleges, how did he come to be appointed no less than four times by successive Ministers of Health to the regional board and no less than four times by the regional board to the chairmanship of the management committee? On the assumption—which I do not necessarily accept—that the com- 96 mittee of inquiry was fair in its assessment of Mr. Rhydderoh's character and actions over the past ten years, then the Ministers concerned and the Regional Board are guilty of grave errors of judgment in reappointing him four times each. If, on the other hand, the committee's assessment is unfair, Mr. Rhydderch has suffered the grossest injustice.
The right hon. Gentleman may ask how he was to know what was going on in the Birmingham Region. I would reply by saying that he has ample facilities for knowing what goes on in any hospital region, and if there is something going seriously wrong it is his duty to know. He has his regional officers, who are quite entitled to attend any board meetings or management committee meetings in the areas to which they are assigned, and they, at any rate, should have had an inkling of the situation. The regional board should have had more than an inkling. Yet Mr. Rhydderch received continuously, over all these years, what were, in effect, renewals of confidence on the part of all concerned.
I believe that it was widely known that Mr. Rhydderch was apt to tread on a few toes here and there, but that this was regarded as a small price to pay for the dynamic energy and enthusiasm which he brought to his job as chairman. Those qualities, at least, are not in dispute. The committee of inquiry itself— counsel on both sides, and the doctors— paid generous tribute to his energy and the hard work that he put into his job.
Therefore, if, and to the extent that, Mr. Rhydderch was responsible for the situation that ultimately blew up in the Minister's face last autumn, I say that that situation could and should have been avoided. But it was not avoided, and the Minister was faced with the demand by a cabal of doctors for some action by him. The resolution of no confidence was sent to the regional board and communicated to the Minister. But, in addition, Dr. Mathers, medical superintendent of Rubery Hill Hospital and the leader of this group of doctors, wrote a personal letter to the Minister which contained at least one very serious allegation—that of the irre-sponsible use of public funds.
97 Clearly, at this point something had to be done: I grant the Minister that. The next step taken seems to have been not an unreasonable one in the circumstances. The regional hospital board —almost certainly after full consultation with the Ministry—agreed to institute an inquiry. That would be quite a normal procedure in a situation of this kind. It would be a private inquiry. Three members of the board were chosen to constitute this inquiry—the then Chairman, Sir Edward Thompson; the present chairman, Sir Arthur Thomson, and the Lord Bishop of Lichfield.
Mr. Rhydderch was quite agreeable to this course of action, but the doctors were not. They are apparently unwilling to trust the impartiality of this trio of board members, which seems to be a little odd, in view of their eminence and distinction. But by this time the whole matter was in the hands of the Medical Defence Union, and, acting on their solicitors' advice, the doctors refused to accept the regional board inquiry. What they wanted was a public showdown.
It was at this point that the right hon. Gentleman took a fatally wrong stop. He gave way to the doctors. I want to know why he did not stand firm. He had already agreed to a perfectly reasonable inquiry into the differences that had arisen. Why was not he prepared to stand firm on that? Why did he have to give way? I hope that he will tell us.
He did order, under the vary wide powers conferred on the Minister of Health by Section 70 of the National Health Service Act an outside inquiry into the differences which had arisen between the chairman and the medical committee leading up to the passing of the no confidence resolution and any matters subsequently connected therewith, and a committee of three was duly appointed presided over by a Queen's Counsel.
After a time the statement of case was produced on behalf of the doctors. It comprised a list of 41 charges, going back nearly ten years in time. By fax the greater part of these charges ware incredibly petty and trivial. There were allegations of discourtesy and rudeness. A few of them alleged dictatorial conduct on the part of the chairman, failure to consult the doctors and interference 98 in matters which were allegedly within the medical sphere. There was nothing whatever about the misuse, or irresponsible use, of public money. I believe that the right hon. Gentleman, even at that stage of seeing the statement of case, would have been perfectly justified in rescinding his decision to hold a Section 70 inquiry. But he did not do so.
I wish now to turn to the inquiry itself. The first question I wish to ask is how it was that despite the most specific disclaimers by all concerned that it was to be anything of the kind, this inquiry degenerated very quickly into the trial of Mr. Rhydderch. I think that this was largely due to the procedure that was adopted. I hasten to add that within that procedure I have heard no criticism of the actual conduct of the hearing. I have reason to believe that the members of the committee were scrupulously fair to all concerned, but two decisions were taken which loaded the scales still more heavily against Mr. Rhydderch. The first was to hold the inquiry in public and the second to dispense with the normal rules of evidence. It seems that the Minister—perhaps he will be able to confirm this—instructed Chat the inquiry should be private if both parties wish it to be private, but that if either parties wanted the inquiry in public then it must be held in public. We know that the doctors did want a public inquiry and so it was held in public.
The report takes a rather different view of this. It deals with it as a matter of principle and I should like to quote from paragraph 189 dealing with the decision to hold the inquiry in public.As we see it, an inquiry must be held in public unless the object of it is to be limited to conciliation. If it is plain that an accommodation must be secured, in the public interest, between two parties who are at issue, and the sole question is to find terms which are ultimately acceptable to both sides, then the bargaining is better done in private since otherwise parties may take up attitudes from which it is difficult for them to resile in public. But if more drastic action rather than conciliation could even possibly come into the picture, we think that the inquiry must necessarily be in public since there may have to be a decision against one party and that should not be done where the public do not see the process.I feel that that is a dubious principle, anyhow. It is certainly different from the Minister's point of view. It seems 99 to me that conciliation must have been ruled out from the start and certainly it was ruled out the moment the decision was made to hold the inquiry in public.
As to my second objection, the dispensing with the rules of evidence, the House may think that inevitable in an inquiry of this nature. But I should like hon. Members to consider another Section 70 inquiry in the same hospital region only two years ago. It was an inquiry into the conduct of a consultant surgeon. At the outset of that hearing, the chairman, another Queen's Counsel, made it absolutely clear the ordinary rules of evidence must apply throughout the hearing as the reputation of a distinguished man was at stake. Furthermore, he went on to say that only criminal standards of proof would be accepted and that the charges against the consultant concerned would be dismissed unless they were proved beyond all reasonable doubt.
Why were safeguards which were freely given to a distinguished surgeon denied to a distinguished public servant? In his case there was no question of the rules of evidence being applied or of proof beyond reasonable doubt. There was hearsay evidence and malicious gossip recounted day after day, and the more sensational bits presented in the newspapers both local and national. In effect, what we have here is an accused man without any of the protection which an accused man quite properly receives in a court of law. I ask the right hon. Gentleman, whether, on reflection he feels that this was an appropriate procedure for investigating charges of this nature.
I should like the House to compare the risks which were assumed by the two sides to this dispute. First, the financial risk. In this case the costs of Mr. Rhydderch, who had to employ a Queen's Counsel and a junior, as the other side bad done so, amounted to more than £3,000. He is a salaried employee. He is not a man of wealth. Why could not the right hon. Gentleman at the outset have undertaken to reimburse all reasonable legal expenses incurred? I should have thought that the least he could have done, as he had placed in jeopardy a man who had given to him and to his predecessors 100 fourteen years of hard unpaid work in the National Health Service. In foot, the night hon. Gentleman offered £100 and then, under pressure, increased the sum to £250 plus the cost of one copy of the transcript of evidence. He did say that the matter could be subject to re-examination and I am very glad indeed that as recently as last Friday he agreed to meet substantially the whole of Mr. Rhydderch's costs. It occurs to me to wonder how much Mr. Rhydderch would have got had he not decided to debate this matter.
The fact is that for nearly six months Mr. Rhydderch has been faced with financial anxiety, on top of everything else, initiated by his somehow having to find more than £3,000. Compare the position with the doctors who initiated this whole affair. They, of course, had no anxiety at all on this score. They had nothing to lose because, automatically, their case was handled by the Medical Defence Union Which would meet all legal expenses and costs. The name "Medical Defence Union" strikes a rather curious note in this connection. I should have thought that it was a medical prosecuting union in this instance.
That is not the only type of risk incurred by someone in the case such as this. There is the other type of risk, the risk to reputation and to position. Here, too, for Mr. Rhydderch everything was at risk and in the event he found that his public reputation was systematically undermined in the full gaze of the public. His character was largely destroyed by the report and his career as a distinguished voluntary public servant was brought to an ignominious end. Mr. Rhydderch lived for the hospital service and to that extent he lost all.
Had the doctors no fears for their position or career, had the case gone against them? Certainly, I think that they had little cause to fear. It is well-nigh impossible for a consultant to be removed from his post in the National Health Service whatever the circumstances. On the few occasions when it has been attempted, the Regional Board concerned had usually been instructed by the Minister at the time to reinstate the consultant. Of course, it is perfectly right that consultants and other doctors in the hospital service should have job security. But there are those who think 101 that the degree of security which they enjoy is quite fantastic. Perhaps the House would consider this matter when we come to the happenings after the report was published.
I now come to the report itself. I do not want to make any bones about it, Mr. Rhydderch gets a mauling from the committee of inquiry. After recognising the fine work that he has done for the hospital—it could hardly do less than that—the committee devotes pages to his alleged character failings, to his unconstitutional methods, his domination of the hospital management committee and of those around him. It concluded that the group must be broken up and that he should not continue as oh airman. In fact, the day that the report was published, Mr. Rhydderch resigned his chairmanship without being asked to do so. The Minister has not reappointed him to the regional hospital board.
The doctors received somewhat different handling from the committee of inquiry. True, the report says that there wore faults on both sides. But it then goes on to devote precious little space by comparison to the faults of the doctors, no reference at all to the undoubted fact that it was a deliberate conspiracy laid by Dr. Mathers to get rid of the chairman and destroy him in full public view. There is, it is true, a sharp rebuke about the conduct of the annual meeting at which the vote of no confidence was passed, but that is about all, at least until we come to the supplementary report. I deal with that now.
After the main hearing was completed, Dr. Mathers decided to deal with the one colleague who had stepped out of line. This is Dr. Orwin, who had originally voted and then saw the statement of case and immediately withdrew his support from the vote of no confidence to give evidence during the hearing on behalf of Mr. Rhydderch. When the hearing was over, Dr. Mathers wrote a most extraordinary letter to Dr. Orwin asking him to resign from the medical committee on which all the doctors served and threatening to move his expulsion from the committee if he refused to resign.
This letter was brought to the right hon. Gentleman's notice and very correctly since it came within the terms of 102 reference, he referred the matter to the committee of inquiry. The committee was reconvened and issued a supplementary report, dated 31st June, a fortnight after the main report. After, I think, gratuitously questioning the motives of those who very properly brought this attempt at victimisation to the right hon. Gentleman's notice, the report condemns Dr. Mathers in the roundest terms. It states, in paragraph 26:We are of the opinion that Dr. Mathers' action was wholly unjustified, was uncharitable, showed vindictiveness towards a colleague, and was motivated by the desire to have him removed from the committee. We find that he acted irresponsibly, failed to realise what was due from anyone in his position as Medical Superintendent or to have due regard to the consequences of his action. We are particularly perturbed about this because we think that, with Dr. Mathers' background and responsibility his action was all the more reprehensible.In paragraph 29 the report stated:There is nothing whatever in our previous report from which we wish to retract in any way.Is it conceivable that a man who could act in such a manner was as relatively free from responsibility for the tensions and differences with the chairman as the main report suggests? Indeed, could anyone but a weak and passive chairman have co-operated satisfactorily with such a man?
Make no mistake, Dr. Mathers was the ringleader in this conspiracy and he dominated the medical committee just as surely as Mr. Rhydderch dominated the management committee. How did this belated revelation of his character and motivations fail to modify one iota the committee's assessment of blame for the situation that it was inquiring into? It is at this point that one feels that the objectivity of the committee might be called in question. What happened to Dr. Mathers following this scathing condemnation?
He has been very understandably asked to resign the post of medical superintendent by the regional hospital board. He has refused. I understand that the board as either unable or unwilling to press the matter further or to do anything about it. So we have a man who is "vindictive, uncharitable, irresponsible", I use the committee's words, "left entrusted with the care of 900 mentally sick people." Is that a 103 situation which the right hon. Gentleman feels happy about, and if he does not what does he propose to do about it?
I return to Mr. Rhydderch. I should make it dear that I have never met Mr. Rhydderch, although I am a member of a regional hospital board and inevitably I have heard of him from time to time. I know of the good work which he has done for the mental hospitals under his care. I have read most, although not all, of the 600,000 words of the transcript of this hearing. It is clear to me that Mr. Rhydderch is a man of great energy, drive and imagination, absolutely devoted to the hospitals that he served. We do not have too many people in the hospital service with these qualities. But, also, I think that it is clear that in some respects he had the defects of these qualities.
I must accept that sometimes he was impatient, intolerant, perhaps overbearing. Probably tact was not his outstanding virtue, but if these weaknesses unfit him for the offices that he held, surely something better was due to him for the fourteen years unrewarded sweat and toil which he put in, than this. I do not believe that he should have been dragged by the right hon. Gentleman through the travesty of a judicial process, defending himself against hearsay evidence and malicious gossip in the full hearing of the public Press.
What I am chiefly concerned about now is the effect of this unhappy affair on the whole hospital service and the even wider repercussion on voluntary service generally. Anyone who has served on a regional hospital board must know how hard it is to find suitable people for hospital management committees, who are interested in hospitals and who are willing and able to give the very considerable amount of time necessary for no reward at all. We need some 5,000 of them at any one time.
Does the Minister think that this has made it any easier to get these people in the future? Why should people undertake voluntary duties if they see as their reward at the end of the road a public trial of their character and their possible humiliation? Another unhappy repercussion of this will be the effect on the 104 relations between doctors and voluntary management. This relationship is always a delicate one. I would have thought that it should be simple and straightforward; but it is not. The line between clinical and administrative responsibility is a fairly clear one, although not always in absolute terms even here. I think that if Mr. Rhydderch transgressed seriously over that line he was at fault. Particularly in mental hospitals, the line between medical and non-medical responsibility is far less sharply drawn. There is a great area where inevitably responsibilities overlap.
For example, a hospital management committee is empowered to discharge a patient against the advice of the medical superintendent or the responsible consultant. It says very much for the good sense and mutual tolerance of both voluntary members of committees and the medical profession that serious difficulties arise so seldom, but here and there there are doctors who resent the existence of these committees and the serious situation which we have been discussing this evening has happened before.
Indeed, this is not the first time that a no-confidence note on the chairman has been passed by doctors. I remember a very similar case, but that ended in some doctors resigning from a hospital management committee. It is the sort of situation which is most likely to arise if there is a particularly active and vigorous chairman of the management committee or where there are particularly inert and ineffectual medical staff. This is not the first time that a group of doctors set out to get rid of the chairman of a management committee, but it is, so far as I am aware, the first time that they have succeeded and I think that it was a black day for the hospital service.
I do not regard the voluntary element in hospital administration as something extraneous, something that perhaps impedes progress like the fifth wheel of a coach. I see it as something essential and integral, and I believe it was always intended so to be. It is one of of the two democratic safeguards of the National Health Service, the other being the right hon. Gentleman's answerability to the House of Commons. It is something to be cherished by any Minister of Health and its authority reinforced 105 wherever possible. In cases of doubt, in all but clinical matters the voluntary element must prevail, or we open the doors to syndicalism.
Our complaint against the Minister is that he has dealt a damaging blow at the principle of democratic voluntary control for hospital services by demonstrating for all to see that a determined cabal of professional men can secure the removal of a lay chairman that they dislike. I hope that the right hon. Gentleman has learned the right lesson and drawn the right moral from this miserable story and that neither he nor his successors will ever again deal with such a situation in this way.
§ 6.52 p.m.
§ Mr. Leslie Seymour (Birmingham, Sparkbrook)
I am a member of the Birmingham Regional Hospital Board. I have also been chairman of the management committee of a hospital concerned with mental deficiency. Therefore, I have some knowledge of the running of a hospital and the connection between members of the committee and the medical staff. It can be truly said that in all committees from time to time there must be differences of opinion— differences of opinion between the members of the committee and the chairman, differences of opinion between the committee and the staff. These differences of opinion, if properly ventilated and discussed and settled amicably, can lead only to progress in the hospital.
However, in the case of Rubery and Hollymoor these were not differences of opinion. They were differences between persons, a difference in personalities, where those on one side could not synchronise with those on the other. Harmony in a mental hospital is particularly important, because the staff and all the workers have to work in close confines. The differences between the chairman of the committee and the members of the hospital staff have gradually grown during the last ten years. They started in a small way and gradually increased to such an extent that the members of the general medical staff, together with the secretary of the hospital group, decided that it was necessary for them to submit a report to the committee.
106 There are two sides to every question. I listened with great sympathy to the speech of the hon. Member for St. Pancras, North (Mr. K. Robinson). It is true that three members of the Birmingham Regional Hospital Board, after a complaint by Dr. Mathers and the secretary that Mr. Rhydderch refused to accept their report and had it expunged from the minutes at one of their meetings, took a very serious view about this. Three members of the regional hospital board who are colleagues of mine on the board offered to assist in coming to a settlement. It is true that Dr. Mathers, acting on behalf of the G.M.C., said, "No, we do not wish the chairman and his colleagues to sit in judgment on one of their colleagues, and in particular the deputy-chairman of the board".
It was for that reason that they wrote to the Minister and asked for an inquiry to be set up. Unfortunately, all the grievances were made public. However, if there are grievances of a serious nature in a nationalised service surely it is batter for the benefit of the public itself that it should know the true facts. I was very pleased to see that at least the facts would be made public and this smouldering bonfire which had been going on at Rubery and Hollymoor for nearly ten years would be brought out into the open.
§ Mr. Donald Chapman (Birmingham, Northfield)
The hon. Member says that there was a smouldering bonfire going on for nearly ten years. He has also told us that he is a member of the regional hospital board. Does he honestly come to the House and say Chat he knew that this bonfire had been going on for nearly ten years but as a member of the board the had done nothing about it?
§ Mr. Seymour
As a general rule, one does not tackle a fire until it bursts into flame. If it is smouldering, it starts at a very small point and gradually spreads. It is not the right of a regional board to interfere in the details of a hospital management committee in differences of opinion. It is the hope of the board that at least the members will have sufficient sense to settle it themselves.
The inquiry has been held and the reports have been made public. One Chang which is rather outstanding is the 107 final conclusion on Mr. Rhydderch and the methods which were operated. The trouble with Mr. Rhydderch was not that he was inefficient in any way. I agree that he gave up considerable tame. He was enthusiastic. He did a lot for the Service. His trouble was that he wanted to do too much. He wanted to do the job of everybody else in the hospital and refused to let them do it.
Paragraph 87 of the Report says this of Mr. Rhydderch:(1) that he acted as a manager-chairman instead of as chairman,(ii) that he assumed direction of all activities, including some which were clinical,(iii) that he failed to establish adequate communications between the professional staff, the administrative staff and the H.M.C.,(iv) that he prevented certain of the Group officials, that is, the medical superintendent and the Group secretary, from performing their allotted functions. …What dearer evidence could there be of a man who was doing too much?
The most important conclusions reached in the report are, first, that there was no conspiracy by the doctors against Mr. Rhydderch. The passing of the resolution of no confidence was the culmination of a series of incidents which had caused the doctors disquiet. Also practically all the allegations made by the doctors were found to be substantiated. The committee of inquiry, in paragraph 136, clearly regarded the attempt by Mr. Rhydderch to alter the administrative machinery and his resistance to any ventilation of complaints about this matter as one of the most important parts of the inquiry.
The hon. Member for St. Pancras, North said that Mr. Rhydderch trod on the toes of some of the staff. I think those were the words he used. Let us see what he did and whether hon. Members consider that he was treading on the toes of the staff. In September, 1961, the chairman caused or permitted a supply sub-committee to be formed. This committee was for the purchasing of commodities for the hospital, including the supply of drugs. Yet no member of the G.M.C. was appointed to that committee.
In 1957 he caused or permitted a new dormitory to be constructed at Rubery 108 without consultation with the G.M.C. or even taking the medical superintendent of Rubery into consultation concerning it. He caused two villas to be built at Hollymoor without consultation with the medical committee. Finally he caused or permitted the deputy matron's office at Hollymoor to be scheduled for conversion to a chiropody department without prior consultation with the committee or the medical superintendent.
§ Mr. Seymour
That may be so, but the chairman of the committee should at least act in the orthodox manner, and the proper manner is to consult the medical superintendent of the hospital where these improvements, desirable as they may be, were to take place.
§ Mr. Hale
The hon. Member talks about the orthodox manner. The National Health Service was introduced only a year or two before the incidents of which he is speaking occurred. There is no orthodox manner. There is evidence that the people who asked to be consulted about plans admitted that they did not understand plans. There was a desperate need for improvement of the services in Birmingham. The chairman got them. He never missed a meeting. He had unanimous support from the board year after year. What was the hon. Member doing all this time? What did he do to help? How many meetings did he attend? How often did he express dissent about these urgent steps?
§ Mr. Seymour
These improvements were made at Rubery and I was one, as chairman of the finance committee, who voted against the increase for modernisation and improvements for which Mr. Rhydderch was asking, because he was having more than his share of the "mental millions".
§ Mr. Denis Howell (Birmingham, Small Heath)
He was too big for the hon. Gentleman and for the committee.
§ Mr. Seymour
That may be the opinion of the hon. Member for Birmingham, Small Heath (Mr. Denis Howell).
Here are some of the other things which he tried to do and which are 109 really the responsibility of other members of the department He gave instructions to the heads of departments to write direct to him, as chairman, on staff matters such as promotions and appointments of staff. Was that his duty or the duty of the medical superintendent? All requests for facilities at the hospital for outside bodies were to be addressed to him personally. Surely they should have been addressed to the secretary. On the appointment of the nurses' home warden by the chairman, the lady was told that she would be responsible direct to the chairman. Are those duties which he should have undertaken? Surely this is ample proof of what I have already said, that Mr. Rhydderch's trouble was that he tried to do too much and took responsibility from other people.
The finance officer, another important officer, was unable to carry out his functions properly. He was unable to carry out some of his duties and, in fact, neither he nor the finance committee ever saw tenders until after one of them had been accepted. No one ever made any recommendation or comment to the H.M.C.
This is the other side of the story. The report of the committee points out quite cleanly that as the committee was satisfied with Dr. Mathers, it was also satisfied with Mr. Hurst, the group secretary. The committee decided that Dr. Mathers was justified in going beyond normal constitutional procedure in asking the Minister to hold an inquiry. The committee said in the supplementary report that Dr. Mathers' action towards Dr. Orwin was Wholly unjustified, but it went on to say something which the hon. Member did not say. It said that if Dr. Mathers was to continue to hold the post of medical superintendent he must develop a greater sense of responsibility or restraint in his conduct towards others. That is proof that not only Mr. Rhydderch but Dr. Mathers was also criticised. He has not been there ten years.
§ Mr. Seymour
The previous medical superintendent of that hospital resigned before it was necessary for him so to do because he could not agree with the chairman.
§ Mr. Hale
The hon. Member is deliberately misleading the House. I regret having to use those words. He knows there were two hospitals. Dr. Mathers was at all relevant times on the staff of one or the other. In 1952 he was deputy medical officer at Hollymoor. The events which concern this inquiry raised charges at Hollymoor and Rubery and a whole continuous series of events in every one of Which Dr. Mathers in one capacity ox another was involved. The hon. Member should not say things like that.
§ Mr. Seymour
I stand corrected. It is true that Dr. Mathers was deputy director at Hollymoor before he came to Rubery. With regard to Mr. Rhydderch, as I have said, he was too energetic. He did not permit other people to do their work properly, and as a result he clashed with most people who were employed there. But he is a man of many good points.
§ Mr. Seymour
I am not being patronising. I am making a statement. He is a man of great energy and determination and spares no personal effort in all that he undertakes. Knowing him and the hard work he has done, I would also pay my tribute to him for the work he did at Rubery. He has never done this work for his own profit but always for the good of the hospital. He has resigned, but I hope that in the future some other position will be found for him where his unlimited energy may be used to the benefit of the community.
I was also pleased to read in the newspapers last Friday that the Minister was contributing a sum of £3,000 towards Mr. Rhydderch's expenses, but I am of opinion that the Minister had this in mind all the time. [Interruption.] How could he say how much he would pay until he knew what it cost? How could he say "Yes" until Mr. Rhydderch made application?
As to the future of this hospital management committee, I emphasise that these two hospitals, Rubery and Hollymoor, are adjacent and they care for the same sort of patients and they have many common services. Because of this, and because I do not want to 111 see the group split up, I hope that the Minister will accept the second recommendation of the committee of inquiry and join both hospitals to another group. The committee suggested either splitting them and putting them in two other groups or joining them both to another group. Knowing the hospitals as I do, and knowing that one major physical hospital will in the future be located in the grounds of Rubery, I hope that the Minister will consider putting both these hospitals with another to form another group.
§ Mr. Charles A. Howell (Birmingham, Perry Barr)
Will the hon. Gentleman risk his reputation by becoming chairman of the committee to take over these hospitals?
§ Mr. Seymour
I have already offered my services as chairman. [HON. MEMBERS: "Oh."] I have been chairman of a mental hospital committee for many more years than Mr. Rhydderch, and I can honestly say that the officers worked in complete harmony with me, to their great credit.
If this hospital management committee is disbanded, two consequences will follow. The senior officers will lose their jobs. Why should the finance officer and the secretary lose their jobs when they were prevented from doing the work which they ought to have done? Secondly, the members of the hospital management committee will be dispersed. I hope, therefore, that these two hospitals will stay together and that other hospitals will be joined to them in order to make them a reasonable group.
Under the guidance of a new chairman, with the help of the members of the management committee who have given many years of voluntary service to hospitals, and with the co-operation of the doctors, the lay staff and all the nurses—I am sure that they will work together if they have a chance—these two hospitals can function to the credit of the National Health Service.
§ 7.12 p.m.
§ Mr. Denis Howell (Birmingham, Small Heath)
I am glad to have the opportunity to speak in this debate. First, I think that I ought to declare my interest, 112 though it is not a financial one. Mr. David Rhydderch has been a personal friend of mine for very many years. He is the treasurer of my union. Like the committee of inquiry, I have had ample opportunity to judge his character. Perhaps the House will make allowance for some of the things which I may say. It will have to judge me, and I shall not mind if the House does not, perhaps, accept all my judgments of the situation.
The hon. Member for Birmingham, Sparkbrook (Mr. Seymour) made one of the most contemptible speeches which it has been my Jot to hear in the House for a long time. Before I come to him, I ought to congratulate my hon. Friend the Member for St. Pancras, North (Mr. K. Robinson) on his magnificent statement of the case. I am sorry that my anxiety to get at the hon. Member for Sparkbrook caused me for a moment to overlook that. My hon. Friend made a very fine speech. Much of it I should have liked to have said myself. No doubt, the House will be delighted to learn that what my hon. Friend said will enable me to shorten my own speech considerably.
To return to the hon. Member for Sparkbrook, throughout all the years he has been a member of the regional hospital board he has had one of the worst attendance records of any member, yet now he has the effrontery to suggest that he ought to assume chairmanship of the new hospital group. Perhaps we need not worry too much about the hon. Gentleman; but I will put this point to him. My Rhydderch is accused of not carrying out the form of democracy in his committee. There is a form of democracy in the regional hospital board. What did the hon. Member for Spark-brook do to ensure that the trappings of democracy were anything more than a matter of lip-service on the regional hospital board? He has already admitted, in answer to a most penetrating interjection, that during the ten years while the fire was smouldering he did nothing at all about it.
The members of the regional hospital board never adequately discussed this matter, yet they are in law the employers of the doctors. The doctors contemptuously ignored the regional hospital board. The committee of three appointed by the regional hospital board was 113 not composed of nincompoops, not people like the hon. Member for Spark-brook, but was composed of elevated persons, Professor Sir Arthur Thomson, Sir Edward Thompson the previous chairman, and the Lord Bishop of Lichfield. If one had gone to every regional hospital board in the country one could hardly have found such a galaxy of talent. When these three members of the board attempted to intervene in the matter, they were contemptuously swept aside by the doctors, and the Minister condoned it. What the Minister did in condoning this was to say that, even though the doctors are employed by the regional hospital board they, the doctors, should decide whether or not they should treat with their employers. That is one of the serious aspects of the matter which we have to consider.
The hon. Member for Sparkbrook said that the committee of inquiry came down against Mr. Rhydderch and found most of the charges proved. It said no such thing. In paragraph 8, page 3, of its main report, the committee said:For reasons which we shall give later, we do not regard the incidents set out in the formal Case and Answer to be the real difficulty in this matter".Those were the 41 charges.They are symptoms of the basic trouble which lay below the surface. We think it best to deal with these symptoms first, which will take up a considerable section of the report since there were originally 41 of them, and then deal with the root difficulty which, in our opinion, they reveal.The committee then says:But first we think it right to say something of the characters "—the House will note that it is "characters", in the plural—as revealed before us, of the principal persons involved.My intervention during the hon. Gentleman's speech was closely relevant. I said that Mr. Rhydderch was too big for the people with whom he had to deal, certainly far too big for the doctors who did not like the great speed of change. I can give personal testimony, as a member of a hospital management committee and someone who has been in every mental hospital in the West Midlands in the course of an investigation into mental health services, that there has been greater change, greater modernisation and more dramatic im- 114 provement in these two hospitals under Mr. Rhydderch's control than there has been in any other hospital in the Midlands. Whatever anyone may say in this debate or at any inquiry, those achievements stand for all time and cannot be denied.
After saying that it would deal with the principal characters, the committee fell into the same error as did the regional hospital board and the members of the hospital management committee because it devoted five foolscap pages of its report to dealing with the character of Mr. Rhydderch but did no more. The members of the committee of inquiry were so overwhelmed by his character that they forgot to deal with anyone else's character. Although they began by referring to "characters" in the plural, it was only with "character" in the singular that they dealt in their report. They were as overwhelmed and as captivated by Mr. Rhydderch as most people who have known or worked with him have been.
I apologise to the House if my speech becomes somewhat jumbled. I have a good deal to say and I had it all ordered, but so much has been said that I want to avoid repetition. If I have one or two natural breaks, I hope that the House will forgive me.
As my hon. Friend the Member for Oldham, West (Mr. Hale) says, this matter goes back a long time. There was the Hollymoor case. I know that my hon. Friend the Member for Oldham, East is very interested in this case, and I do not wish to say too much about it because I hope that he will have the opportunity of saying a few words. This girl of tender years, fourteen or fifteen years of age, should never have been in this mental hospital. Mr. Rhydderch came along one day and said, "What on earth is this girl doing here? This is the last place in which she should be. She should be moved to a more suitable place" The doctors, led by Dr. Mathers—at least Dr. Mathers, together with Dr. Ross, was involved in this—hummed and hawed, and three months later Mr. Rhydderch was amazed to find this unfortunate girl still at the hospital.
Mr. Rhydderch, to his great and eternal credit, became rather annoyed about this. At that stage, when the 115 matter had come before this House, the doctors wanted to have her certified as a mental defective, a moral defective. Mr. Rhydderch, to his credit, refused to have anything to do with that. He said that it was monstrous and, in his experience, wrong for a girl of that age to be where she was. Under the law, as it was then—I am not sure what it is now —hospital management committees decided questions of certification, and Mr. Rhydderch and his committee decided that this girl should not be certified. In a very few days, after the case had been raised publicly at the instance of Mr. Rhydderch, the girl was taken out of that hospital and moved to a more suitable place.
The end of the story is this. The girl is now married and she has children. Mr. David Rhydderch has been proved right and the doctors of Hollymoor proved wrong. The whole of this business goes back to the Hollymoor girl's case. Here are some doctors who never forgave a lay chairman for being right on a matter which, at that time anyway, was their responsibility.
We in the Midlands know something about this matter. We were staggered when these doctors passed their "no confidence" motion. This gives a clue to the sort of men with whom we are dealing. Not once during the ten years that, according to the hon. Member for Sparkbrook, this matter was smouldering did these doctors raise this matter on the hospital management committee on which they sat. The hon. Member for Sparkbrook says that things were done about which they were not consulted, but what were these doctors doing on the hospital management committee? Why did they not open their mouths? Perhaps they did not have a thought in their heads. Perhaps their attitude was completely negative. But what sort of men sit for ten years on a committee and then say, "Although the fire has been smouldering for ten years, we have not said a word about this during the whole of that time"?—and the hon. Member for Sparkbrook asks us to take this matter seriously! I have never heard such arrogant nonsense in all my experience in this House, although I admit that I have not been here as long as some.
116 These doctors pass a vote of "no confidence", yet never say a word about it to the members of their committee or to the regional hospital board. Instead, they send straight to the Minister and say, "We want a public inquiry and nothing less." They treated with contempt the three illustrious members of the committee set up to deal with the matter.
§ Mr. Seymour
Surely it is true that the doctors did present a report. It went to the committee and Mr. Rhydderch would not accept it. He had the representation expunged from the minutes. Had it gone to the committee in the proper manner, it would have been sent on to the regional board.
§ Mr. Howell
I do not know how to deal with the hon. Gentleman. Very often he does not listen. When he does listen there is obviously so little intellectual content present that it is difficult to get things through. The point is that these doctors sent the report to their committee after they had asked the Minister for a public inquiry. Mr. Rhydderch took what I should have thought was a sensible view. At that stage, at the eleventh hour, he said, "As these men have gone directly over my head and over the regional board to the Minister asking for a public inquiry, it would be improper for this committee to consider the matter until we know what the Minister is going to say." That was a sensible attitude to adopt. It might have been argued that he was in contempt of court if he had allowed his committee to discuss the matter at that time. If I had been Mr. Rhydderch I would have told these doctors a few home-truths; but that is another matter. Where was I before that ridiculous interruption?
The most contemptible thing of all was that the Minister set up a public inquiry, as my hon. Friend the Member for St. Pancras, North said, on three very specific charges. The most important was that concerning the irresponsible use of public funds. The second charge, made in a letter to the Minister, was that Mr. Rhydderch interfered with the appointment of a consultant. The third charge, which was much the minor charge, was that there had been some rudeness to a senior nursing officer.
117 When the Minister is told, "There is a chairman irresponsibly using public funds", something must be done about it. But what the Minister should have done at that stage was to ask these doctors to state a case. If a charge is made against a doctor in the Health Service, it first must be established that there is a prima facie case before anything further is done. That did not happen in this case. What did the doctors do? As soon as they got their public inquiry, they dropped every one of these three charges. Not a word was heard of the charge of irresponsible use of public funds from the day that the Minister set up the inquiry, and I cannot use strong enough words to describe that sort of activity. It is quite wrong to make the grossest libel on a distinguished public man, to get a public inquiry on the basis of it and then run away and proceed to produce 41 more charges. If the hon. Member for Sparkbrook had been doing anything on his regional hospital board, he would have realised what was happening and would have said, "This is monstrous. The three original charges have gone and now 41 other charges are being brought, all of which are a tarradiddle of nonsense, tittle-tattle gossip". The Minister should never have allowed this nonsense to continue in the way that he did.
At that stage I wrote to the Minister and said, "This is getting out of hand." I have had some talks with Mr. Rhydderch's legal advisers. The Minister had offered Mr. Rhydderch £100 towards his costs. That was an indication of the fact that the right hon. Gentleman thought that this would be a small inquiry which would be completed in a day or two. But when it came to the doctor's case, 41 charges were made, going back over ten years and involving people who had retired from the Health Service and who had to be interviewed up and down the country. What an impossible financial burden this was putting on Mr. Rhydderch. Solicitors told me that it was impossible for them to meet these charges and carry on their normal duties because they were told that they had to give a reply in a very short time.
For the first time in my experience in this House the Minister refused, not only to see me—he may not have liked the 118 tone of my letters which probably accounts for his not seeing me—but to see the official Opposition spokesman on Health Service matters, my hon. Friend the Member for St. Pancras, North. The right hon. Gentleman refused point blank to see us in order to discuss the principles involved, the question of an adjournment and the question of costs. That was extremely lamentable.
When the chairman of the committee was written to, the secretary to the committee at the Ministry of Health wrote a letter, dated 7th February, which I wish to put on record. I know that the Minister corrected it afterwards, but I want hon. Members to judge and evaluate this for themselves. It was addressed to Messrs. Rowley, Ashworth and Co., the solicitors acting for Mr. Rhydderch, and it reads:Dear Sirs. Birmingham Inquiry.Thank you for your letter of 5th February "—that is a letter by Mr. Rhydderch's solicitors saying that they could not possibly reply to the charges in time in view of their nature and extent—which I have put before my Chairman. I am instructed to say that in the light of the effect on the administration of the hospitals concerned, the inquiry should be held with the least possible delay. As a result of this view, which is shared by the Minister, my Committee are not prepared to postpone the date fixed for the hearing, but, if it should transpire that either your client or the Group Medical Committee has to meet allegations not fully disclosed by that time, the matter could be considered further by the Committee at the hearing.I drew the Minister's attention to this and said that it was a terrible thing. I am not a lawyer, but the solicitors acting for Mr. Rhydderch got a letter from the Ministry, with the Minister's connivance at the lowest and his agreement at the highest, that the Commission must hold the inquiry when it suited him and not the parties to it. I do not make too much of that point.
The Minister got the committee to write and say that that was a mistake and that the phrase should never have been put in the letter. I bet it was a mistake and never should have been put in the letter, but it was. We are entitled to know more about it and to know exactly what are the relationships with the committee.
119 I want to quote an extract from a memorandum sent to me by the solicitors on behalf of Mr. Rhydderch so that when deciding these proceedings in future, the House will know the difficulties in which solicitors find themselves. I quote:On 16th January, 1962, a letter from the Secretary to the Committee suggested the week beginning 12th March as the appropriate date. At that time, no one had any idea of the extent of the inquiry or how big a job it would be and, indeed, on 30th January it was hoped by the Ministry that the matter could be dealt with over a period of four days.The statement of case from the other side, which by itself ran to ten foolscap pages and included about 35 separate charges, was not received until 2nd February. When it became apparent how big a job this was every effort was made to try and get an adjournment. The only result, as can be seen from the correspondence, was that permission was given to delay the formal reply. But every effort to get the actual date of hearing postponed failed.In the end, instructing solicitors had one solicitor, one managing clerk, one articled clerk and three or four typists engaged almost full time attempting to get the case ready in time. It was not ready, indeed it could not be ready, at the time the inquiry opened.The matter was further complicated by further allegations being received from the group medical committee only two or three days before the inquiry began.As a result of all this, the inquiry began with permission from the Committee that any witnesses who were subject to recall at our request … Witnesses for Mr. Rhydderch were still being interviewed a week after the inquiry actually opened and further statements were then still being taken. In the result, the burden put upon Mr. Rhydderch and his solicitors was probably unfair".The letter goes on clearly to say, however, thatno actual harm was done so far as the refusal to adjourn was concerned and it is difficult now to think what could have been done which was not, in fact, done, but this was only because the inquiry went on for so long that it was possible to work on Mr. Rhydderch's defence after it had opened.I mention all this because time and again, the report states that the inquiry was surprised from time to time that such and such a line was not followed up by Mr. Rhydderch's legal advisers. They could not possibly follow up every line that was being chucked in night after night. I am not a lawyer. If that is the way we conduct our affairs, something is 120 seriously wrong. I am told by my legal friends, however, that it is not the way that affairs are conducted; there are matters of discovery, and so on. The way that the matter developed meant that Mr. Rhydderch was put on trial and had to answer these questions. The Committee had to answer them. There were about 41 or 51 charges. The effect of all this was to put Mr. Rhydderch on trial, whatever the Minister may say.
I come next to the point raised by my hon. Friend the Member for St. Pancras, North about the Shrewsbury case, which involved a doctor and which also was a matter in which I was concerned. I was not a member of the House at the time. The charge briefly was that a surgeon was getting people into a maternity hospital by charging them fees when there were no private beds and he had no right to charge them fees. Certainly, that was a serious allegation. The same Minister quite rightly agreed to set up a committee if inquiry.
That was a farce if ever there was one. The particulars had been investigated by the local C.I.D. and the regional hospital board, including Mr. Rhydderch and, so far as I know, the hon. Member for Birmingham, Sparkbrook, said that it was a question of fraud and not a matter for them; if money was being taken from patients for letting them into hospital when there was no right to take the money, that was false pretences. The papers went to the Director of Public Prosecutions.
After the Director of Public Prosecutions considered the matter, he said that there was not enough evidence to justify a prosecution, by which, presumably, he meant that there was not sufficient proof of guilt to justify a criminal charge, but that it was a proper case to be dealt with by an inquiry under Section 70. The Minister appointed the inquiry, which then proceeded to say that it must have proof beyond any reasonable doubt. In other words, from the moment of its being set up, the inquiry laid down criteria for onus of proof which the Director of Public Prosecutions had already said could not be satisfied. If that did not make the whole thing farcical, I do not know what did.
My purpose in raising the Shrewsbury case tonight is to quote what was said in 121 the report. I quote from The Times of 30th September, 1960, in amplification of what my hon. Friend the Member for St. Pancras, North said:The Committee says: … ' We had been well aware that the allegations are grave and could if established have the most serious consequences for the person against whom the allegations were made… Consequently we have throughout considered the facts and reached our conclusions not on a balance of probabilities but on the basis that such allegations ought to be proved with certainty and beyond reasonable doubt. We consider that the adoption of this approach is not only our duty but is vital in order that justice may be done'".I do not complain about that, but if it is true for the doctor at Shrewsbury why is it not true for Mr. David Rhydderch? The Minister has a serious point to answer. This is double talk and a double standard in the Health Service. It is applying one set of standards to doctors and another standard under the same Minister and under Section 70 to voluntary lay people. I consider it a shocking business.
My hon. Friend has read paragraph 189 of the report and I will not repeat it. Right from the start, however, the inquiry took certain predispositions. It decided that if it was likely that it would have to deal severely with the party the inquiry should be in public and everything would be admitted. Indeed, the committee admitted everything. Mr. Rhydderch was treated in a shameful manner when we compare what happened in a similar inquiry at Shrewsbury. I ask the Minister to think about this double standard and this difference of treatment of two responsible men in the Health Service.
I now pass rapidly to the Hollymoor and Rubery Hospital Management Committee, from whom I have today received a letter. The hon. Member for Sparkbrook made great play of reading from the committee's findings that it regarded the management committee as a miserable, inefficient committee dominated by this terrible ogre of a man Mr. David Rhydderch.
The management committee asked at the outset to be legally represented, but the Minister refused this. Now, the committee is to be pilloried although it had no opportunity to defend itself. I want to put on record what the committee has said. It feels strongly about 122 the matter, as it is entitled to do. I have been sent this copy of a letter which has been written to Mr. Newstead, Secretary of the regional hospital board.The strictures and intemperate language in the report of the Committee of Inquiry involving the Hospital Management Committee are deplored. The H.M.C. were not informed officially that an Inquiry was to be held; nevertheless, when they became aware of the setting up of a Committee of Inquiry, legal representation was requested by them for their Vice-Chairman"—who was then acting on behalf of the committee—but this was refused. The terms of reference before the Committee of Inquiry specifically referred to the differences between the Chairman of the H.M.C. and the Group Medical Committee and made no reference to the H.M.C.The second point of the statement was:The H.M.C. resents the statement contained in the report that its 'control had been culpably weak…' This statement does not conform to the facts.They were never asked about this. They had no legal representation.The H.M.C. feel very strongly that it is entitled to be consulted before the Regional Hospital Board arrived at conclusions on the future of the Hospital Group….I want to put that on record in fairness to some distinguished men and women, and there are members in the party opposite who know them. They know they are not stooges. They are sensible men. These are sensible and honourable men, and they were not properly treated. They were treated disgracefully and I do not think that the hon. Member should have come to the House today and read out that this was a weak committee when most members of the committee were never seen by the committee of inquiry.
§ Mr. John Hollingworth (Birmingham, All Saints)
Was the letter signed by all the members of the hospital management committee?
§ Mr. Howell
This is a resolution of the hospital management committee— its considered views. There is no minority report attached to it. It is the committee's considered opinion and I put it before the House. In this country minority rule in these matters usually carries little weight, and people who find themselves in disagreement from time to time do not go round for ever letting people know they were in the minority. 123 I suppose that in the normal process of democracy this was the considered view of the committee.
I come to the tribunal's dilemma. I have read out already what the tribunal said about specific facts. It was quite dear to some of us that this tribunal was in this dilemma. There was nothing to show any of these Changes. They probably reasoned like this. We cannot allow it to go on as though we have not determined a balance between the voluntary chairman on the one side and sixteen doctors on the other, and the balance is a balance of convenience. Some of the sixteen doctors had only just arrived at the hospital, and some were foreigners and could not speak a word of English, but nevertheless there they were on the one side against Mr. Rhydderch, and Mr. Rhydderch had to be sacrificed to the balance of convenience. One can imagine that this tribunal took a long time over its findings, saying to itself, "How can we get out of this impasse?"
I want to make this point very dear. The doctors in their dosing speech to the tribunal said specifically through their learned counsel, "We shall refuse to work any longer with Mr. Rhydderch". This was a dictatorial ultimatum of the worst kind. This was what they said. Therefore the tribunal found itself in this position, that on balance it had better get rid of Mr. Rhydderch and keep Dr. Mathers. Unfortunately for the tribunal, in this long and sorry story—which, though the House may find it hard to believe, I am trying to keep short—the end was not to be. In fact the most interesting part was only just starting, because this wretched Dr. Mathers had a way of dealing with people he did not like and who disagreed with him. We had the case of Dr. Nicol. Dr. Nicol must have worried the inquiry because he is the Deputy Medical Officer of Birmingham, not a man of straw but a man of substance, a man of integrity. Dr. Nicol objected very strongly to what the committee was to do about Mr. Rhydderch. The committee and Dr. Mathers and the cabal said to Dr. Nicol, "Out you go". They said, "We have got to get rid of him". And Nicol went.
§ Mr. Howell
When Nicol had gone and the committee was finishing after sixteen long, weary days, and when everybody was fed up, and everybody was saying, "Thank goodness, it is all over, What can we do? We must have a balance of convenience "Dr. Mathers got busy. His character was not analysed by the committee but he has analysed it himself, for he wrote to Dr. Orwin. This was the man the committee preferred to Mr. Rhydderch. It said, "We have to prefer one to the other. Right, we prefer Mathers." This is what he wrote to Dr. Orwin, the one medical man who gave evidence for Mr. Rhydderch:Dear Dr. Orwin, This is to let you know that unless I hear you have resigned your membership before then I propose to move a resolution at the next meeting of the Group Medical Committee that you be no longer admitted to membership. I hope you will appreciate that I will only take this step with reluctance, and in what I consider to be the. interests of the medical staff of the Group as a whole. Yours sincerely, James Mathers.I had to bring that to the attention of the Minister. I pay a tribute to him. He very properly sent it back to the inquiry and said they should look at this. They castigated Dr. Mathers as a vindictive man, but this was not the end of the story because the Regional Board said that something would have to be done about it and so they asked him to resign.
But Mathers, what does he do? He does what he has done all along—cocks a snook at the regional hospital board. And the horn. Member opposite cocks a snook at the board. He tells them to go jump into the canal—or do any of the less polite things people sometimes tell other people to do. The regional board decided what they must do and that was to ask him to resign, but he is still there, having been asked to resign.
What is the Minister going to do about it? Justice demands that something be done about it. He is a man who has grossly intimidated all of his medical colleagues, and then he says, "I am not going to resign," and the board says it can do no more about it.
But that is not the end of the story because one opinion which the main report shows is that these doctors are to beware of the grave danger of discussing in their medical committee affairs which 125 are not medical matters. They hope that never again will this medical group committee or any other go into politics. That is what they mean in simple language.
This is one of the cardinal principles we ought to be discussing—the control of the Health Service; and the lay should predominate over the other interests in the name of democracy. The Minister has to answer that point.
The regional hospital board solemnly decided last week, after paying the most handsome tribute to Mr. Rhydderch—I will not read it out; it is all on the record in the Birmingham Post —that in future it would ask its senior administrative medical officer to sit in at all meetings of the group medical committee. Next day there were banner headlines in the Press about further local difficulties and references to the Medical Defence Union again. What has the committee decided now? It has decided that it will not accept this man, and has said that if he comes, it is not sure that there will be a meeting. That is treating the regional board, the Minister and the country with the grossest contempt. Those people are prepared to hold up the Health Service to that sort of contempt.
§ Mr. Chapman
I do not want to stop my hon. Friend's flow, but has he forgotten the best gem of all, which is the letter which has now been sent to all of us? After having been told in no uncertain terms to keep out of politics, they then draft a manifesto to Members of Parliament in which, with absolute arrogance, they complain about the amount of time that they have had to spend to establish the unsuitability of a certain individual, Mr. Rhydderch, already in post. If that is not arrogance in the course of the removal of that gentleman, I should like to know what is.
§ Mr. Howell
I assure my hon. Friend that I had not forgotten that. It was to be my great peroration. Unfortunately, he has torpedoed it.
The committee is still playing politics. The hon. Member opposite says that he wants it to carry on as a group—presumably with its little intrigues behind closed doors, and with him as chairman.
§ Mr. Seymour
Let us stick to the facts. I said that other hospitals should be 126 added, and I instanced a hospital which at some future time is to be built in the grounds of Rubery.
§ Mr. Howell
The hon. Member has disproved something for me today. I told some of my friends that now that the committee had got rid of David Rhydderch, I did not know who would take over as chairman and that no man in his senses would ever dream of taking on the committee with those persons in control. But the hon. Member cannot be in complete possession of his senses, because he has volunteered for the job.
We must contrast the treatment meted out here to a distinguished public servant with that meted out to the doctors, who are still there. Every day that has gone on since the inquiry finished has proved that Mr. Rhydderch was right. Day in and day out the doctors are doing their best to underline the fact that he was right. They are still playing politics, and we are entitled to know what the Minister proposes to do about it.
The tribunal says that Mr. Rhydderch is a man of absolute honesty and integrity and of tremendous achievement. Sir Arthur Thompson, chairman of the regional board, has said it. Dr. Whittaker, chairman of the regional consultative services, has paid tribute to him in glowing terms. The Minister has done his bit by agreeing, belatedly, that £3,000 of the £3,100 costs should be paid to Mr. Rhydderch. But Mr. David Rhydderch, after fourteen years' service, has had no letter to explain why he is not on the management committee. He has been got rid of, in a very unfortunate manner.
The decencies of life demand that the Minister shall take the first opportunity of putting Mr. Rhydderch back on the regional hospital board. Indeed, there is nothing in the whole story to justify taking Mr. Rhydderch off it, whatever was done about the hospital management committee. He ought never to have been taken off it. After the crucifixion—it has been a public crucifixion —there has to come the resurrection, and I hope that the resurrection of Mr. Rhydderch to his proper place in our society, irrespective of party feelings, will take place as soon as possible.
Lastly, it was said time and time again in the report that Mr. Rhydderch could 127 not handle men. Apparently, he could not handle Dr. Mathers. Neither can the regional hospital board. Neither can his own colleagues. Neither can the Minister. Dr. Mathers is still there in spite of all his arrogance and impertinences. If justice is to be seen to be done, it can be done only when Mr. Rhydderch is put back on the regional hospital board. I predict that as long as Dr. Mathers stays where he is there will be no peace on that committee, or on any other committee, because he is that sort of man. Mr. Rhydderch has gone and will not be there to disprove the lie that it was he who caused the trouble. There will be more trouble— there is more trouble—now that Mr. Rhydderch is not there, and it is for the Minister to face up to this point.
§ 7.55 p.m.
§ Mr. Leonard Cleaver (Birmingham, Yardley)
I do not propose to keep the House quite as long as the hon. Member for Birmingham, Small Heath (Mr. Denis Howell) has done. Unlike the hon. Member and my hon. Friend the Member for Birmingham, Sparkbrook (Mr. Seymour), I have no interest in this matter to disclose.
I hope the hon. Member for Small Heath will not object to my saying that he has been putting the point of view of Mr. David Rhydderch, as he quite properly disclosed that he is his friend. One would not, of course, expect him to take a disinterested view of the matter and try to see something of the other side in those circumstances.
I believe that the House is agreed that the matter has been going on far longer than the six or twelve months to which the report has referred. I am told that it started in 1953. We may at some time discuss why the matter did not come to the fore earlier, but that is not what I wish to discuss. But it certainly has been going on for some time, and I ask the House to appreciate that, whether we like it or not, the fact that it has been going on so long is one of the reasons why it has become so urgent today and why it has become such a tragic matter.
I would point out to the hon. Member for Small Heath that in no way is Mr. Rhydderch's integrity called into question. There is no reference to his 128 having a good or a bad character, and I should not like anyone to think that his character was in question. There has been no question of the committee reporting on his character. He has been reported on only in regard to his right to act as chairman of these hospitals.
The hon. Member for St. Pancras, North (Mr. K. Robinson) referred, quite rightly, to whether or not the inquiry should have been held in public. The point he started with was quite right. If there had been a possibility that some reconciliation could have been effected, it would have been far better to have held it in private. The hon. Gentleman went to the trouble of reading out from the report observations made upon this point and arguments put forward. But he stopped his quotation at a vital point. The very point that he wanted considered was considered by the inquiry. The last words of the report sum this up:In our view this was a case where it was clear from the outset that something more than conciliation could possibly be necessary.
§ Mr. Deputy-Speaker (Sir Robert Grimston)
We cannot have two hon. Members on their feet at the same time.
§ Mr. Cleaver
It had been going on a long time whether hon. Members opposite like it or not and whether they consider Mr. Rhydderch right or wrong. In the circumstances of these disputes arising at the hospital, it was right that something should be done, that some inquiry should be made and that the public should know that the matter was being looked into.
No one denies that these are two most important hospitals and that the treatment of the patients in them should be of the highest order. But one cannot get the right sort of treatment in a mental hospital if the conditions are such as described in the report. Whether the hon. Member for Small Heath likes it or not, this report comes down adversely to Mr. Rhydderch practically the whole way through. In making their defence, the hon. Gentleman and 129 his hon. Friend the Member for St. Pancras, North clutched like drowning men at the supplementary report. This, I agree, contains condemnation of Dr. Mathers—it is the only one—and says, quite rightly, that he should not have dome what he did.
But this trouble had gone on for a long time—far too long for a man holding his responsibility. Whether he was right or wrong he was under great stain. He was at odds with his chairman. He was harried by accusations and he was the obstacle to the chairman's power. He was subjected to great discourtesy—I will not say frightened— from time to time in the committee. Naturally, he wrote that unfortunate letter. Perhaps he should not have done so.
In this respect the hon. Member for Small Heath should have gone a little further. He should have referred to the passage in the report describing how that particular incident arose. There was another letter written to the Press and also to the Minister. The report commented:in the circumstances, while we have no doubt at all about the soundness as principles of the principles set out in the letter of Miss Walker and to Alderman Bowen"—to the Minister—nor of those set out by Mr. Rhydderch in his evidence, we do not find ourselves able to accept it that these were the sole considerations behind Mr. Rhydderch's actions in informing Miss Walker and Alderman Bowen of what he had found, nor theirs in writing to you. We think that they had strongly in mind the advantage to Mr. Rhydderch's case in the main inquiry of this chance piece of very prejudicial evidence against a principal member of the party who had opposed Mr. Rhydderch in the main inquiry.That passage should be emphasised, for hon. Members opposite have made the points put in that letter very forcefully.
§ Mr. K. Robinson
I am trying to follow the hon. Gentleman. Is he suggesting that it would have been better and more in the public interest if this letter of Dr. Mathers had been suppressed and not brought to the Minister's attention or to the attention of the inquiry committee? Otherwise what is the point of the hon. Gentleman's intervention?
§ Mr. Cleaver
Not at all. I think it was quite right that it was published, since it had been written. But only one 130 side has been put in all the accusations which have been made by Members opposite. It is only right that the House should know the other arguments in the report.
What has been going on? What has been the basis of the troubles in the hospitals for years? Mr. Rhydderch may be an enthusiast for building hospitals and spending money on them, when he can get it granted by the regional board. But he is not the only man in Birmingham to want to do that. The whole time, however, he wished to establish his place as dictator of this particular management committee. And when he was chairman, he was well able to do it.
Mr. Rhydderch appointed ad hoc committees to settle important questions of spending public money on extensions. That was very suitable for his purpose. If one has an ad hoc committee one does not have to refer a matter to the main committee, which does not meet very frequently. He interfered with the ordinary conduct of the staff. He wanted references made direct to him instead of through the normal channels. It is remarkable that hon. Members opposite have not mentioned that point.
Wherever there are personnel relationships involved, whether in works, office or hospital, surely the right way to make complaints and objections is to one's immediate superior. One does not call in the district organiser of one's trade union just because something is wrong with the tea. One goes to the foreman. Exactly the same principles apply to a hospital—even more so. This sort of situation has been going on for years. Medical people, like everyone else, object to it. One can understand their feelings. These men are very sensitive about such matters.
It is the same with the general policy and conduct of a hospital. No one says that some of the things should not be done but it is only right that they should be considered by the management committee. If decisions are made they should be communicated either through the proper lay member of the staff or through the medical member of the staff and so filtered down through the organisation in the proper way. That was not done in these hospitals and it suited this chairman that it should not be done.
§ Mr. Howell
Would the hon. Gentleman deal with the fact that the committee has said that it was consulted and refuses to be described in these terms by the inquiry? Why denigrate these other public servants in Birmingham?
§ Mr. Cleaver
The hon. Member need not make a second speech, if he does not mind, in an intervention. I will deal with that in a moment. Now I am trying to put the point that the whole trouble in these hospitals was that the chairman wanted to be autocratic, to be dictator, while at the same time he was discourteous with the people working there. This discourteous handling of various members of the staff lay at the root of a lot of the trouble over the years.
At the same time, Mr. Rhydderch had certain support on the committee. It is no good trying to avoid that conclusion. Let us take the one instance of the letter which has been so much discussed. The committee members were equally divided and the chairman decided to suppress it on his casting vote. Thus a body of people wanted to take active management of the hospital. They did their best, but they were not allowed to do so. It is not easy to restore democracy after a long period of autocratic behaviour.
The hon. Member for Birmingham, Small Heath did not mention another factor of the report which was far worse than the technicalities and legalities he spoke about. This referred to the fear among some members of the staff. That can only mean that people were afraid to put their views before the chairman because they thought that he had the power either to remove them from their posts or to prevent them from getting promotion. That sort of atmosphere would not be allowed in any other organisation. One would not get it in a factory, for the trade union would protect the staff. But not in this case. With that background, one can understand why there has been trouble in these hospitals.
We must have team work in the National Health Service in order to 132 make our hospitals work. Whether it be the regiment, or the trade union, or the club, in all of them there must be leadership and co-operation. That is even more vital in the medical services, because when what one might call the "end product"—the patient—sees a staff which is not confident, cheerful, happy and co-operative, he very soon senses the atmosphere and loses faith, very often, in his medical advisers.
I very much regret to say that the degree of tension in the atmosphere in this psychiatric unit more than anywhere else was liable to affect the behaviour of mental patients, who are more affected by atmosphere in hospital than anyone else. The whole time the doctors and staff are trying to create a calming, therapeutic atmosphere. But in this case, as the report says,… this is well nigh impossible under conditions created by the chairman's behaviour".The lesson is that these valuable professional men in a hospital, whatever their job, must be relieved as far as possible of the ordinary drudgeries of administration. The committee should do its job in the proper way, be properly consulted and know that its advice is wanted. That advice should be considered, but this was not the case in this hospital, and that is the reason for the whole of the trouble.
§ Mr. Cleaver
An hon. Member asks me what I know about it. I am trying to make out, whether he likes it or not, that this is all due to the behaviour of the chairman.
I think that the generalisations of condemnation which have been made about the committee are a little unfortunate. Some members of the committee tried to do their duty as they saw it, but, whether we like it or not, there was a faction supporting the chairman. The only thing wrong about the chairman is that he has been condemned outright in the report and has been held very largely responsible for the trouble that has been going on.
§ Mr. Sidney Silverman (Nelson and Colne) rose—
§ Mr. Cleaver
I am sorry, I cannot give way. I do not want to take too 133 long, and the last speech was a very long one. It is dictatorship in this hospital which is the whole trouble, and had there not been that dictatorship, and had the hospital been conducted on normal lines, there would not have been this inquiry. The committee felt that it had not been informed. It felt that it should have had legal representation when the inquiry came, and that the chairman should have been able to take part in it. I hope that my right hon. Friend can give some reason why that was not the case.
With regard to the other problem— and it is a very big problem which comes out not only in Birmingham but in the whole country—which is the cost of an inquiry Like this, I say that, by all means, public people who voluntarily undertake work of the nature such as happened in this committee, and which may well happen in the case of other committees in the country, should be entitled to some protection, even money protection, when they have to defend themselves. At the same time, I do not think that we should be so open-handed that it should be automatic and give the impression that one can do as one Likes when one is chairman of a board, without consideration of the results at all or of the cost to the taxpayer. I was very glad to see that my right hon. Friend said that this was to be an ex-gratia payment, and I hope that means that all other cases will be considered on their merits.
Finally, with regard to the position of Dr. Mathers, I think it would be very unfair if he was compelled to retire, or even if he was removed, unless the removal meant promotion. We cannot alter the fact that the inquiry came out in his favour, and very strongly in his favour, except for the minority report. [Interruption.] I know that hon. Gentlemen opposite do not like it, but the minority report was not a majority report.
§ Mr. Cleaver
I have got my facts right.
It would be most unfair if a man who has been faced with all this discouragement and trouble for years in the running of a hospital should now find his 134 position jeopardised after an inquiry which has justified him, and find that he is being compelled to retire. It would be absolutely wrong, and I think it would prevent people who try to do what they think is right and who are even prepared to go before an inquiry, from doing so in the future. I think that we have a very important task to see that he has protection in this matter.
I have spoken for quite long enough, but, to summarise the whole position, I would add that it may well be that the still waters of the Avon run deep, but the troubled waters of this mental hospital run deeper still, and sticky mud lies at the bottom.
§ 8.16 p.m.
§ Mr. Leslie Hale (Oldham, West)
The hon. Member for Birmingham, Yardley (Mr. Cleaver) finished a speech which, I hope, when he reads it tomorrow he will be ashamed of, by expressing the hope that some amendment will be made or some measures taken when inquiries of this kind are held again. I hope inquiries of this kind never will be held again. I do not want to be tempted by the inconsequences and inaccuracies of the last speech into saying anything which is not objective, because I had intended to deal with one considerable and important section of the report only.
My hon. Friend the Member for St. Pancras, North (Mr. K. Robinson), in a magnificent opening speech, paid a perfectly fair tribute to the members of the tribunal. They listened with patience, conducted themselves with dignity and tried to be considerate to all the people, but the whole inquiry was misconceived, as almost inevitably it had to be misconceived, and I shall refer to that later. I happened to be reading yesterday a case prepared by the democratic lawyers of Brussels on the Nazi trials and the re-emergence of Nazi judges in Germany. It is surprising how these little bits of evidence, these collections of scraps of evidence, these accumulation of bits of suspicion and bits of hearsay here and bits of something there were used to send some one to the firing squad, just as Mr. Rhydderch was sent to his dismissal—to what one hon. Member opposite has said was an ignominious dismissal. I think there never was a dismissal which did a man more credit, and, indeed, the method nowadays of 135 making a man a Companion of Honour might have been adopted.
A night or two ago, I went to the pictures, where I usually go to get some quiet sleep. A few moments later, as I was dozing, my attention was attracted by the sort of motion that gives one notice that something is going to happen. The screen was recording that the right hon. and learned Gentleman the Member for Wirral (Mr. Selwyn Lloyd) had taken a penny lick off all the ice cream cornets about to be sold, and the ladies who had torn up my ticket were now dressed in white coats like umpires, posed like the statue of General Smuts, and endeavouring to sell those extraordinary confections of glucose on chopsticks, which intimated to the intelligent members of the audience that the big film was about to commence. It started, as films usually do, with a long and interminable time list of the persons who have been responsible for the montage, the maquillage and the mucilage which was to follow. Then the screen was focussed on a very moving scene. We had the motor traffic going in different directions at enormous speed, while a little girl stood terrified and helpless, with no one seeking to help her at all. There was that little girl, and her face was focussed in my mind when I was reading this too long report, quite unconsciously.
We have been treated recently to some propaganda on behalf of the right hon. Gentleman. We are told that beneath that stern exterior and that neat waistcoat there beats a heart of gold, that he is the sort of man who would like to be kind to the nurses if economic circumstances would permit. We are told that, even though he may be reading Euripides at Cabinet meetings, at home he plays "Happy Families" cheerfully and chuckles over "Miss Bung, the brewer's daughter" like an ordinary individual. No one had played with the little girl except old men with their trousers down. She was not a girl of 14 and 15, but a child of 13 years and three months who went into Holly-moor. She was later described as a voluntary patient, who had been having full sexual experience for five years in this Christian country of ours. That was the little girl in whom the"blustering 136 Napoleonic, bouncing, brassy" chair-roan of the regional hospital board— according to his enemies—took an interest, and it was time that somebody did.
A man of 64, among others, was awaiting trial at the assizes in connection with the little girl. The News of the World, with that infinite delicacy which distinguishes its reports, would have said that he was "alleged to have committed a serious offence against her," and the little girl was found to be in need of care and protection, as indeed she was. She was sent to the child psychiatrist in Birmingham, Louise Eickhoff, who seems to have done her utmost to help. Nearly everybody tried to help. There are no villains particularly in this story. The little girl was sent to this adult mental hospital, Hollymoor.
We are told that she was not put in with the very old geriatric cases. But this little girl was sent to what in our less intelligent days we used to call a lunatic asylum and what we now call an adult mental hospital. Dr. Mathers was the deputy medical superintendent and Dr. Ross was the superintendent. All the report says—and there is nothing controversial about this—is that on the whole Dr. Ross is a rather genial figure while Dr. Mathers is a rather dominating figure. I am not trying to introduce into this story anything which is not already there, but it is a story which Dostoievsky might have conceived.
When one is going back to something that happened a long time ago, there is much to be said for relying on documentary evidence and much to be said for relying on the records of what people said at the time. The girl came to Hollymoor on 24th October when she was still being treated as an out-patient by Dr. Louise Eickhoff. Dr. Ross said that he thought that she was a psychopathic personality, which is probably quite true—so am I for that matter—and that is about all that was said.
The next communication came from the Shropshire County Council, which wrote to see if she could give evidence against this great big man who had committed serious offences against her. It asked whether she would be fit mentally and physically to attend the assizes and face what is always a terrible ordeal. Dr. J. R. Mathers signed a report to say that 137 this little girl was mentally and physically fit to give evidence at the assizes— that is my certificate, J. R. Mathers. That was on 12th November, so far as I remember. The little girl gave evidence at the assizes and things went on and Christmas came and we had carols at the mental hospitals and hymns were sung about little children and the Kingdom of God. Then, early in January, Dr. Louise Eickhoff wrote to the Home Office and asked what was to be done with the little girl. Dr. Mathers had written to say that they "were achieving nothing with her here." That was fair enough, for this was not a juvenile mental hospital and it had no suitable accommodation and there was nothing to be done. So Dr. Louise Eickhoff wrote to the Home Office early in January, and although there was no reply it seems that the letter never turned up and there may have been a misunderstanding.
To be fair, in February, Dr. Mathers wrote and said that the weeks were going by and that the little girl was not getting any education. She was getting precious little treatment and she was exposed in a mental hospital to conditions in which not only was her education retarded, not only was she in the formative part of her life, but she was exposed to all the difficulties and all the problems associated with older people who are metnally ill.
The Home Office did not reply and Dr. Mathers wrote again and by now it was March. The sun was beginning to come out and spring had come, and in the spring a young man's thoughts lightly turn to thoughts of Paris, or even a trip to Birmingham, and, we are told, "A livelier iris gleams upon the burnished dove."
By now it was April. Dr. Mathers wrote to the Home Office and said that there was some evidence of schizophrenia or a psychopathic personality— it is always schizophrenia or psychopathic personality in these days. He told the Home Office that the girl must go to some institution where skilful treatment would be available. He said that the Home Office authorities could make it an approved school if they liked. He said that she needed care and protection and that a juvenile psychiatrist could give her constant treatment and care.
138 The Home Office wrote back to say that there was no such institution anywhere. It did not have one. It did not say that the money had been spent on the hydrogen bomb. Not only was there no room at the inn, but there was no room for the little girl in any psychiatric institution. There was no room and no treatment for her anywhere. The Children's Department at the Home Office wrote to the Shropshire County Council to say that if the girl could be certified as a mental defective under Section 5 of the Mental Health Act, 1913, they could lock her up as a mental defective.
Dr. Ross wrote to say that she was not a mental defective whatever else she was and Chat she had an I.Q. of 80. I can Chink of a number of hon. Members whom I would not credit with an I.Q. of 80. In the girl's exercise books there were charming little essays, pages of highly complicated sums with every answer right, and some drawings which showed genuine talent. But this little girl was left in an adult mental hospital. When asked to say that she was mentally defective, Dr. Ross said that it was very difficult to say that, but it was then said that she might be said to be a moral defective.
Section 5 of the 1913 Act deals with idiots and imbeciles which are defined. Idiots are persons so lacking in mental ability that they may be a physical danger to themselves, but a moral defective is something different and is a person whose tendencies are so vicious and so criminal that he might be a danger to other people. The little girl was to be locked up as a moral defective because she might be a danger to the concupiscence of some randy old man of 64 with his trousers down. That was the case against the little girl and that was the ground for saying that she was a moral defective.
Mr. Rhydderch said this was monstrous. He said that he knew the girl and that this could not be done to her. This was the blustering, bouncing, interfering Napoleon who was pushing the doctors all over the place and running everything himself but who found time to be nice to a little girl and to get to like her. He said, "You cannot do this to this little girl". He said that he thought he said that in March but most 139 of the evidence shows that he probably said it rather later.
I hope that hon. Members will not think that I am criticising Birmingham, for this could have happened in Oldham or in Manchester. But one knows that there are generous homes with doors open for these people. One knows that doors would not have been closed and that even if there was no room in the inn at that time, there were still decent people with kindly hearts who would have taken that little girl.
David Rhydderch asked about sending her to her own home and said that she had a father and a mother. But the social worker's report said that that was hopeless and that there were other children at home which was where the trouble had started. This little girl had been going about with men, or rather they with her, since she was eight years old.
So they thought again. What about some sort of approved school—it might be possible to get her into one at Warrington. But before that was done David Rhydderch wrote to the Home Office. It was a perfectly reasonable and sensible letter, with not a word of criticism of anyone. All he said was that it would not be fair to certify this bright little girl—perhaps a little backward— as a mental defective, and that to lock her up with imbeciles and idiots would spoil her life and cripple her mind.
The evidence of Dr. Mathers is clear. He knew that David Rhydderch was going to Write this letter, and Dr. Rhydderch put the letter on the girl's file where Dr. Mathers could see it. Then when Dr. Mathers saw it he manifested the commencement of what is really a story by Dostoievsky, if not by Strindberg. We quote Juvenal lightly and talk of Quis custodiat ipsos custodes. We are apt to crack jokes about psychiatrists and say that they are sexual maniacs who have failed the practical, but we need a Strindberg to paint a picture of the mental specialist who sees developing in his mind the very things that he is there to cure. It needs a Dostoievsky to show the jealousy and the anger of the man who begins to see in his own mind, in the mirror of his own phychiatric knowledge, the development of the 140 very qualities, the vices, the passions that he is trying to cure in other people, and watches them fester and grow for ten years.
The hon. Member for Yardley, with that felicity of phrase which he does not often display, said that the bonfire was smouldering for years, and indeed that is fair. Dr. Mathers wrote to the Home Office, using (that little feline insidious phrase:You might not have understood what the Chairman meant because he is only a layman.That did not satisfy his jealously, so he wrote to the medical secretary of the board and said that if this sort of thing happened again the whole confidence of the public in our medical integrity would be lost, all this because someone tried to stop the little girl from going to a home for moral defectives after one of his colleagues was prepared to say that she was a moral defective. It is not a medical matter anyhow. David Rhydderch was a magistrate, and in the old days would have been called on to certify people for medical treatment after examination. He had examined this little girl. She liked him. He brought to the little girl a little interest which she had never had before. One of the reports says that all she needs is a little affection, not from old gentlemen, but from some decent trained personality so that she can focus her betrayed affection on somebody.
Louise Eickhoff comes out of this extremely well. She said that this little girl was suffering from subdued suicidal impulses. This was the case that excited Dr. Mathers' antipathy and animosity and his desire for revenge to such an extent that he wrote to the Home Office and to the hospital committee and said that the whole of public confidence was lost. It is true that there were statements in the Press, but they were not very exciting statements.
My hon. Friend the Member for Birmingham, Small Heath (Mr. Denis Howell) said that the story ended with this little girl's soul and body being saved. Thank God nobody knew her name. It ended with her getting married and becoming a decent and respected personality after that unpromising beginning. The hon. Member for Yardley, who left the Chamber after making his 141 speech, gave a very inaccurate account of the end of the story.
The little girl went to Hollymoor on 24th October, 1952. That is when it started. It was in 1961 when Dr. Mathers managed to persuade the medical committee to pass this vote of no confidence in the chairman of the hospital management committee.
We talk ofone who always marched breast forward, never doubting clouds would break, never dreamed, though right were worsted, wrong would triumph, held we fall to rise are baffled to fight better, sleep to wake.The tribunal would call that a naive egocentric who never consulted anyone, not even a barometer.
David Rhydderch fills the picture very well. There is something comic but also macabre about this hard-working generous man who easily forgives and always wants to shake hands the next morning after having a row the night before. There is something almost comic, in a macabre sort of way, in thinking of them wandering around that hospital for ten years while psychiatrists began to need the services of fellow psychiatrists and, while jealousy and the bitterness that comes from jealousy, were developing and being fermented.
Dr. Orwin is obviously a nice young man, but not a man with a strong personality. He had not been there very long and had no great experience of what was happening. He went to a meeting of the doctors and wa,s told that they had passed a resolution of no confidence in the chairman. All that he did was to say,"All right." He did not know much about it. He did not know what the other doctors had agreed.
Weeks afterwards came the announcement that the right hon. Gentleman was to start an investigation, incidentally, an investigation into charges that ought never to have been formulated. Dr. Orwin realised that he might be asked to go into the witness box to support the resolution. He knew very little of what had happened. All he said was that he did not know anything about it. He did not know who was right or wrong, because all these things happened before he went there anyway. He wrote to the tribunal and said that he had agreed to the resolution, but frankly 142 did not know about all these things. He did not know about the charges against the chairman. It was a perfectly ordinary letter, and then he went before the tribunal. He gave evidence on subpoena.
The clock tells me that I have been talking for some time, but perhaps I may say one or two other things. The tribunal was misconceived. From the very first the tribunal put Mr. Rhydderch in the dock. It asked the doctors to write what was in fact a formal document on the lines of the French act d'Accusation. It said, "Chuck in everything. Say that he was rude to his teacher at school and say that he raped someone when he was 99. Put everything in." It is usually said that things start that way when they develop into murder.
The tribunal said,"We will have the witnesses for the prosecution first." The prosecuting counsel appeared for the doctors and doctors and my distinguished hon, and learned Friend the Member for Liverpool, Edge Hill (Mr. A. J. Irvine) led for the defence for Mr. Rhydderch. That is how it began. Then the tribunal found itself in a miserable difficulty. It did not say that the case against Mr. Rhydderch was proved. It said that a lot of the charges were nonsense and were not true, and that even where something was proved there was not much in it. God bless my soul! They were talking about losing a free church chaplain after a post-luncheon row ten years before, and arguing whether Mr. Rhydderch voted for him or against him.
They were deciding whether Mr. Rhydderch was an extrovert or an introvert, whatever those words mean. Nobody really seems to know. We are told by the Jung section that a man uses introversion to cover his extroversion. All this was being discussed at the trial of a distinguished public man—a man who, everyone agrees, took over some of the worst mental hospitals in the country. Everyone agrees that they were a disgrace to civilisation, and that they were altered to the extent that all the women's newspapers published photographs of them—alongside pictures of strip-teasers in the Bahamas—showing the windows, the beds and the settees, 143 and referring to them as a new conception of the mental hospital. Everyone said that this was due to Mr. Rhydderch. Nobody denied it. The tribunal did not. Nobody even mentioned the hon. Member for Birmingham, Yardley until he got up and mentioned himself.
All the time the tribunal was concerned with this sort of miserable scandalous and pettifogging matter, which somebody had fitted altogether. In charge of the prosecution was Dr. Mathers, this powerful personality whose sore was still festering and whose fires were still smouldering—who was reaching the time of real tragedy. I sympathise with him over this, because Dr. Mathers was an able medical man, and he must have known what folly it was to write the letter he did write. He must have known that he was betraying himself to the enemy. But his mind had got so possessed with hate that he could not stop himself doing something stupid. He had to finish the course. So he wrote that terrible letter to Dr. Orwin, saying, in effect, You crossed me. I shall smash you like a fly. You crossed me. Although as a mental specialist he knew it was a foolish letter which put him in the wrong, so strong had these passions become he could not do anything about it. He had to let it go.
So we come to the final document, which I do not want to read. Dr. Orwin, who had committed no crime except to say that he did not know anything about the matter, and who had given evidence under subpoena and had said one or two nice things about the chairman— nothing very much, and not very contradictory—found that on Monday that this meeting was being held on Tuesday. He thanked Dr. Mathers for being so kind as to let him know he was going to smash him, and for being so generous-hearted as to say that he was only doing it in the public interest and not from his own personal venom, and, half an hour before the meeting was held, handed in his resignation. Dr. Orwin is a man against whom no one has said a word except that he is not a Napoleonic figure. That is presumably the end of Dr. Orwin. That is the picture, and it is a macabre picture.
144 I have not said much about Mr. Rhydderch; practically everything has been said. Honourable dismissal is the sort of thing that happens these days. Hon. Members opposite may feel some sympathy for the victims of the recent political disturbances. We have heard a great deal about the right hon. and learned Gentleman for Wirral. Most of us have been inculcated with the first law of plutodynamics, that if there is a slump it is Wall Street and if there is a boom it is Selwyn. If a man is sacked and then made a Companion of Honour; if he is given a testimonial and offered another job, there is not much more that can be done for him. In Old-ham six mills have been closed this week but no one has said that they propose to do anything for the operatives from those mills. The friends of the right hon. and learned Member for Wirral come forward and say something which is metaphorically and literally true—that a bit of ribbon on the breast does not cover a bruise on the backside. That is incontrovertible.
What would be the position had we had an inquiry regarding the right hon. and learned Member for Wirral? What would be the position if witnesses came from the junior bench of the Treasury and said,"When he became Chancellor he could not do his decimals?" What would be the position if someone from the Foreign Office said. "I never trusted him since the day I learned that he could not spell Reykjavik and could not recall the new name for Nijni-Novgorod"? What would be the position if one of the waitresses from the restaurant said, "The right hon. and learned Gentleman was always dictatorial. He would go to the cold table and select his own ham"? What would the position be if some hon. Member said,"I saw him in the corridors at the time of Suez and he was not looking worried at all?"
We smile sometimes about these things, but here there is not much to smile about. What has happened is that £12,000 of public money has been spent in legal costs, about £1,000 of it in deciding whether Rhydderch was an introvert or an extrovert though we are told that introversion is adopted by extroverts as a new version and Birmingham has lost an outstanding public servant who has devoted himself selflessly and profitlesaly 145 without thought of gain not only to the services of mental hospitals but to the cause of mental health throughout the country. His papers on mental health and upon mental hospital design are widely respected.
We must strike a balance. We might have acquired the hon. Member opposite as the new chairman. But which scale of the balance one would put that imponderable I do not know. There is left the festering sore in the hospital with the doctors at loggerheads; with the nurses victimised—there was evidence that the nurses were told that if they did not support the doctors they would not last for long. That evidence, supported by letters, came from the matron. That is a sorry state of affairs. I do not envy the right hon. Gentleman his task of trying to put things right. But I think that he might at least do a little more in justice to David Rhydderch.
§ 8.46 p.m.
§ Mr. E. Partridge (Battersea, South)
I have listened to all the debate but for the opening speech by the hon. Member for St. Panoras, North (Mr. K. Robinson), and I am surprised and somewhat disgusted at the histrionic effort of the hon. Member for Oldham, West (Mr. Hale), who made fun of things about which he should not have made fun and who turned round to is hon. Friends behind him and got laughs about things which are no cause for laughter. The one think that appears to be lacking is any thought about the great service to which hon. Members opposite pay lip-service but very little else, the service of public health.
It is the service which ought to stand above all, above the individual, and any claim for one man on account of what he has done, or in accounting for the effect of what he has done to make the bitterness to which the hon. Member for Oldham, West referred and which he did not deny had been created. He said that there was bitterness everywhere, and yet he thought that no inquiry was necessary and that nothing could be done to get rid of this festering sore of which he spoke so often.
I think that it would have been far better if hon. Members opposite had thought about how best to remove the evil which had been caused, because evil 146 there was. It is no use trying to find a scapegoat. We should be directing our minds, with all humility, to how best we may improve the service and get rid of personalities. They do not count if we are working unselfishly for the cause. Then personalities do not count. For myself—I think this should apply to hon. Gentlemen opposite as well—if I thought that my presence was a disturbing influence in a committee on a matter of this kind, I would rather resign than go on to try to prove that justice should be done. I think that the greatest possible injustice—
§ Mr. Partridge
If I do cause such bitterness in the circles in which I try to do public service and could be told about it, I would try to remedy it or get out.
§ Mr. Silverman
I did not mean to be rude to the hon. Member in any way. Will he try to bear in mind that this inquiry was about persons and a great many people think that the inquiry came to the wrong conclusion? Therefore, if we are trying to prove that it came to the wrong conclusion, we have to talk about the persons. We cannot affect the issue by mealy-mouthing about personalities, and the hon. Member ought to know that.
§ Mr. Partridge
I can be accused of being mealy-mouthed or what one will, but I would very much rather that the circumstances had never arisen which caused an inquiry to be made. There was more than one person concerned in that.
§ Mr. Partridge
A lot of quotations have been made this evening, but the one that I would remember is:Who steals my purse steals trash … But he that filches from me my good name"—I forget the rest.
Dr. Mathers has been dragged in the mud this evening here if in no other 147 place. I would have thought that it would have been far better for us to try to think how we could avoid these things happening in the future and not to try to see that a man who may be good or who may not—I do not seek to judge in this matter—should go back to a place where he had caused bitterness and friction. I would not have thought that that was in the best interests of the service. I hope that the Minister will find a way out of this matter but not in the way suggested to him by hon. Members opposite.
§ 8.53 p.m.
§ Mr. Donald Chapman (Birmingham, Northfield)
What the hon. Member for Battersea, South (Mr. Partridge) does not realise is that while we all want to look to the future of the great service that is involved in this debate and see a good future for these hospitals, we are not prepared to do so by simply turning our backs on an injustice that is being perpetrated on one person who has given us so much voluntary service.
We cannot run away from an issue when injustice is being dome, and say, "Let us forget it and look only at the future". If we did that no one would learn anything from mistakes. I want to say several things to the Minister about the lessons that we have learned from this. The biggest lesson—and I hope that the Minister will give us an assurance about this—is that no tribunal of this kind should ever be held again. It makes one's blood boil to read what is British justice as set out in the pages of that report. The tittle-tattle about what Mrs. Ross said at the hairdressers and the tittle-tattle as to who was invited into the house on Christmas day. All kinds of judgments have been made on evidence that would never be accepted in a court of law in this country. On the basis of that, on the basis of a whole lot of half-truths, and on the basis of a lot of partly unsupported evidence, a man's reputation has been dragged in the mud. I am not prepared with the hon. Member for Batter-sea, South to forget all that and say that we must look only to the future.
I will try to be temperate, Strongly though I feel about this case. I hope that the Minister will confirm that, if any tribunal of this kind is set up again, 148 he will issue the strictest possible instructions about how it is to be run. We cannot have this happen again in the name of British justice. I want the Minister to confirm also that, if the misfortune arises and he has to appoint another tribunal of this kind, he will ensure that the people who are to be called in question before it are properly represented. The chairman was represented by his own Q.C. What about the hospital management committee? The committee is condemned in the report without any evidence being called on its behalf, without any of its members being called to testify about the precise charges against it, and without any legal representation, which the Minister himself refused to grant. Is this British justice? One begins to wonder whether it can be when one reads the report.
A second assurance I want from the Minister is that the lessons of this lamentable fiasco which was called an inquiry will be learned and that in future people involved will be properly represented according to the rules of what I am proud to call British justice.
This tribunal became a fiasco partly because the rules of justice were not followed and because the rules of evidence were not used properly. Right from the beginning Mr. Rhydderch was put on trial. The whole report is to this effect, "Mr. Rhydderch said or did this. Was it true?" That happens in paragraph after paragraph. The tribunal became so bemused with this that it itself began to do injustice to Mr. Rhydderch. It forgot to look at the characters of the other people. However, it did come through at one point. This is where the whole thing becomes lop-sided. It is a quotation which has not been made so far. Paragraph 18 of the main report says:It has appeared to us that the psychiatrists have been, in their inter-personal relationships, too sensitive, too critical of others and too inclined to misinterpret motives.The tribunal at one point did begin to see that perhaps somebody else ought to have been a little on trial as well as Mr. Rhydderch. It began to see that one ought to begin to look at the other people involved. Unfortunately, the tribunal became so involved in all this turmoil about Mr. Rhydderch and Mrs. Ross at the hairdressers and all this rubbishy tittle-tattle that is a disgrace in 149 the pages of the report that it forgot to do this. It forgot to look any further at the other people involved in the case.
It becomes a little clearer from the supplementary report. As my hon. Friend the Member for Oldham, West (Mr. Hade) has said, it then emerges that this largely turns on the history of Dr. Mathers and not on the history of Mr. Rhydderch. According to the supplementary report the fight started with the argument about Dr. Orwin and Dr. Mathers kicking him off the medical committee. Two other little facts crept into the supplementary report which nobody seams to have noticed. The first is in paragraph 19, which says, without even pondering on the significance of it—The two doctors had not spoken together for some months.Secondly, paragraph 24 says:… we feel it necessary to add that Dr. Mathers had opposed Dr. Orwin's appointment as a consultant and it appears that this antipathy has persisted.We see what the situation is when we come to the supplementary report. There are chinks where the light has got through and one begins to see that other people should have been on trial before this tribunal. The first one should have been Dr. Mathers to ascertain whether a fair share, and perhaps an equal share, of the blame for responsibility for this lamentable breakdown in personal relationships should have gone to Dr. Mathers as well as to other lay members, including Mr. Rhydderch. It started with the "Hollymoor girl case", as it has been called. It went on through disagreement after disagreement. It became clear that Dr. Mathers was an unsuitable person for the position he held in view of the way in which he exercised his powers, which has been so violently condemned in the supplementary report.
It becomes clear that this was not only a travesty of British justice from the point of view of the manner in which the inquiry was conducted, but a travesty also in the findings, because not all the right people were properly questioned and put on trial. It was lopsided. If the tribunal had only been able to see the wood for the trees and had been able to dissociate itself from all the tittle-tattle about Mr. Rhydderch, it would have realised that it takes two people to make 150 a breakdown in personal relationships in a hospital like that.
The second point I wish to impress upon the right hon. Gentleman is that he must not accept these findings in toto as they stand. It is clear that the tribunal was conducted wrongly and became lost in a maze of intricacies about Mr. Rhydderch, and never examined whether other people were to blame. The few paragraphs which give a hint of this fact were never followed up in the final judgment.
I come to my third point, and this came out so brilliantly during the speech of the hon. Member for Birmingham, Sparkbrook (Mr. Seymour). If anybody ought to be on trial in this lamentable case it ought to be the regional hospital board. It was the job of the regional hospital board to solve this 'problem once it arose. The fact that the doctors turned it down and did not want the board to conduct the investigation and pronounce judgment should not have been sufficient to deter a proper regional hospital board from carrying on its job. If it is true, as it may be for all I know, that the board is not strong enough to carry out these functions, let us be told and let something be done about it. I should not have thought that the proper way to start off the proceedings was to kick off the chairman or the vice-chairman who had been a tower of strength on it. But that is by the way.
Moreover, I was ashamed at the haste with which the night hon. Gentleman rushed in to appoint two members immediately after the tribunal's findings. We had known for some time that this tribunal's findings were awaited. We had known 'that Mr. Rhydderch's re-appointment to the board was under discussion. Within two days of the findings being published in answer to a Question in this House, without waiting for any of us to put representations to him and to suggest ways in which the Board might be strengthened, the right hon. Gentleman rushes in with two names—names that I do not know and, therefore, I pass no judgment about them, but certainly without waiting for anybody to make suggestions about the lamentable failure of the board as well as of anybody else in this unfortunate case. I am very sorry that the right hon. Gentleman 151 would not even listen to us when we wanted to make 'those representations.
I now come to my fourth point. I want to be brief, because I (think that we have had a long enough debate, but I would say that in addition to the strictures on Dr. Mathers we now have to bear in mind that this story has not ended. We now have the situation in which Dr. Mathers and the G.M.C. apparently are unwilling to allow a medical representative of the regional hospital board to sit in at its future meetings. If this is so, we are entitled to ask the Minister what he intends to do about it. We cannot have a regional hospital board saddled with the job, under the Minister's direction, of sorting out the tangle of this report and being flouted by a set of doctors who say that, no matter what the board want to do to clear up the mess, they will not have its medical representative sitting in at meetings. The right hon. Gentleman must lay down the law and tell these medical men that what the board wants must stand and it must be obeyed. If they are not willing to do so, the Minister must remove them or discipline them in some other way.
The contrast between the behaviour of Mr. Rhydderch and Dr. Mathers after publication of the committee's report is quite extraordinary. Dr. Mathers is oondemned by the committee of inquiry in round terms—"wholly unjustified", "uncharitable", "vindictive towards a colleague", "motivated by a desire to have him removed", "acted irresponsibly", "failed to realise what was due from anyone in his position". Those are the terms used. This was a violent condemnation of a man in charge of a team of people. One would have expected that he would immediately put pan to paper and say that it was his duty to got out. He has done no such thing. More extraordinary still, when asked to do so by the regional hospital board, he has now refused a second time to resign. Apparently the board is saddled with him, and nobody can do anything. Will the Minister stand by and see this happen? The board cannot even get this man to resign in the best interests of the hospital. It is an extraordinary situation.
The same comments apply, unhappily, to some of the members of the medical 152 team. I speak with restraint here because they are all my constituents. I know some of them, and I do not want to pick on personalities any more than I wish to pick on the person I think is most to blame, namely, Dr. Mathers; but I suggest that it is in the interests of the hospital service that this medical team should be broken up.
§ The Minister of Health (Mr. J. Enoch Powell) indicated assent.
§ Mr. Chapman
They should be moved to other jobs, to other hospitals where they can create new paths of activity for themselves and where this sense of conspiracy can be dispelled. I was glad to see the Minister nodding. I hope that he will say that something can be done to move these gentlemen to fresh hospitals where there can be less chance of this sort of trouble continuing.
I come now to my final point. I am sorry to "pinch" the peroration of my hon. Friend the Member for Small Heath (Mr. Denis Howell). He had so many pieces of paper with him. I kept watching him picking them up and putting them down and I thought that this was one document which had escaped his notice. I refer to the letter which we have all had from this group of doctors. In my view, this is one of the most scandalous aspects of the whole matter. The group medical committee was told by the committee of inquiry that it must stop meddling in affairs which did not concern it. I do not want to exaggerate. The words in the report were:The Group Medical Committee … should revert to, and not again trespass outside of, its proper function.There is a further recommendation that the regional hospital board should maintain close supervision on the administration of the group. After being told to keep out, these doctors sent us this letter. In it, they have the effrontery and arrogance to say:We, however, are somewhat dismayed at the amount of time we have had to spend and the amount of trouble we have had to contend with"—how frightful for them, apparently—in order to establish the unsuitability of a particular individual already in post.By that, of course, they mean Mr. Rhydderch.
153 How much more are we to stand from these gentlemen? This is a quite intolerable way to treat Members of Parliament and to treat the findings of the committee of Inquiry. It gives added point to my remark that they ought to be removed to other jobs as soon as possible.
In contrast with what Dr. Mathers did, I would simply read the tribute which the chairman of the regional hospital board. Sir Arthur Thomson, paid to Mr. Rhydderch for the way that he behaved after the findings of the tribunal. He had the decency immediately to resign in the best interests of the service. Sir Arthur said:No one knew better than Mr. Rhydderch that the recommendations of the committee of inquiry and their acceptance by the Minister confronted this board with problems of great difficulty, and as he realised that his chairmanship of Group 6 Management Committee would be a source of embarrassment to us he surrendered that office because he felt by so doing he would contribute to the best interests of the hospitals.That should be written on a plain sheet of notepaper and sent to Dr. Mathers and he should be asked whether he has sentiments like that which we can then all praise.
§ Mr. Cleaver
The hon. Gentleman should inform the House that the chairman of the trades council has opposed the chairman throughout.
§ Mr. Chapman
This is typical. This is the sort of tittle-tattle which some people think is bound up in the report of a tribunal of this kind.
§ Mr. Chapman
I can tell the hon. Gentleman many things which are the truth, but I have my doubts about whether they are relevant to what is said in this place. Like his hon. Friend the Member for Sparkbrook, the hon. Gentleman does not do the causes which he is trying to advocate any good by talking silly tittle-tattle, as I call it, of that kind.
I say to the Minister that this report is a scandal in the sense that true British justice does not emerge from its pages. I hope that we shall never have another one like it and that no person who has given such valiant service at such great cost to himself as Mr. Rhydderch has 154 given to the Birmingham hospitals will find himself exposed to this kind of Gestapo-like inquiry; it is very little else.
If the Minister wishes to see standing tribute to Mr. Rhydderch, he should see Hollymoor today and contrast it with the Hollymoor which I knew ten years ago. I saw it when I first became Member of Parliament for the constituency in which it is situated. I have seen step by step what that man has done for that hospital. He may have trodden on many people's toes—I am sure that he has— in the rough and tumble of Birmingham politics. When a Welshman is in charge who is very much like our late friend Aneurin Bevan in the way in which he often approaches people, people frequently get hurt. In Birmingham, one has to learn that this kind of robust. vigorous politics is the way in which public affairs are often conducted. I do not think that Mr. Rhydderch is to be blamed for that. He is to be praised for what he has created out of the chaos that there was at the hospital ten years ago.
The Minister must bear his share of the blame in this. I am sorry to say this, but he has been party to a form of inquiry which, no doubt, he instituted with the best motives but which in the end has proved to be the worst, un-British kind of tribunal which I personally could ever have imagined.
§ 9.14 p.m.
§ Mr. Charles A. Howell (Birmingham, Perry Barr)
One thing which has intrigued me in this debate is the fact that we have been honoured throughout by the presence of the hon. Member for Battersea, South (Mr. Partridge), who has even intervened in the discussion. I listened very carefully to hear what his interest was in this matter, but I did not discover it. However, I agreed with some of the things which he said. He said that if he ware on a committee and came to the conclusion that he was not getting on well with people or was not working properly for the benefit of the service he would get out. If one man has come out of this inquiry with honours it is Mr. Rhydderch, because he did exactly what the hon. Gentleman said he would have done. Why on earth the hon. Member for Battersea, South did not go on and say that the doctor who 155 instigated all this should have done the same and set the same high example, I do not know.
§ Mr. Partridge
I was objecting to the blame being put upon the Minister for instituting an inquiry when one was so obviously necessary to find what were the difficulties. I withheld judgment on Mr. Rhydderch or Dr. Mathers. The only thing I said was that if it be thought that Dr. Mathers had come out of this unscathed, tonight had disproved it, because his name has been mentioned in every second sentence by hon. Members opposite, and not in terms of praise. I was not judging between Dr. Mathers and Mr. Rhydderch. I was saying that my right hon. Friend the Minister had done the best in the circumstances to get rid of the friction.
§ Mr. Howell
We have recently been through the turmoil of resignations, but none of them was as honourable as the resignation of David Rhydderch. I thank God that in the reshuffle the Minister of Health did not become Home Secretary. If anything is a travesty of justice, it is what the Minister of Health is responsible for here.
The Minister set up an inquiry with indecent haste at the request of some people without ascertaining the facts behind the demand. He had a plain statement of fact that they disagreed with and objected to the chairman. He did not get any facts. Eventually, we have heard, three charges were put forward. I ask hon. Members, on either side, to imagine what would happen if any of them, after passing a traffic light showing red received a summons for driving without lights. That is exactly the kind of thing that has happened here. The inquiry began on three charges. Each of the three was dropped immediately the Minister put it up. I hope that when he replies, he will tell us how many similar inquiries have been held since 1948.
This is where I part company with the hon. Member for Birmingham, Spark-brook (Mr. Seymour), who I am sorry is no longer present. The regional board obviously has come out of this badly. As a member of that board, the hon. Member told us that this matter has been festering for ten years. That is a clear indication that it started with the 156 girl at Hollymoor. If the sore has been festering for ten years, the regional board has been lacking.
I want to get clear the conditions under which the Minister has done all this. Obviously, he did not make inquiries of the regional board and ask whether it was satisfied with the complaint that had been received from its employees. These medical people are appointed by the regional board, not by the hospital management committee, so the responsibility is that of the board. Having received a communication from the Board, the first thing that the Minister should do is to write to the Secretary of the Board asking for the request for an inquiry to go before the board. That was not what the Minister did.
I am making no imputations about why the Minister did this, but imputations are being made and will be made. It is up to the Minister tonight to make plain why he ordered the inquiry without, for example, sending people from his Department. Did he not receive legal advice from his Department about the terms of the inquiry? When the three original charges were withdrawn and forty-two more were put in, did he not feel any grounds for suspicion? If his original inquiry was based on three charges, why on earth did he allow it to go on when the three were withdrawn? That is a question which the Minister must answer.
Let us look at the regional board and the hospital management committee. My hon. Friend the Member for Oldham, West (Mr. Hale) said that the two hon. Gentlemen opposite, the hoe. Gentleman the Member for Yardley and the hon. Gentleman the Member for Sparkbrook would be ashamed if they read their speeches tomorrow in HANSARD. I will not go as far as that, because it was obvious from the whole of their speeches that, just as my colleagues were intent on clearing the character of David Rhydderch, the chairman who has been arraigned, they were intent on looking after the medical advisory committee. But can anyone trust any member of the advisory committee from now on? Do not they stand condemned as weak? One could not speak English; another had been in the hospital service only 157 about six months; but they all subscribed to a unanimous decision against their Chairman. And they did not even know what it was about. They could not possibly have known what it was about. Are they weak?
The hon. Member for Yardley referred to the chairman setting up ad hoc committees. He nods his head. I thought I was right. He said that he set up ad hoc committees, apparently to cut out red tape and to get something done. Is he trying to tell this House that those ad hoc committees were secret and reported to the chairman only? Did they not report to the management committee? Did the management committee approve of what they were doing? Did they not report at all? Were they secret committees?
§ Mr. Cleaver
The management committee did not meet often enough and the device of holding ad hoc committees suited the chairman very well indeed.
§ Mr. Howell
If the management committee is not meeting often enough I claim that that is the responsibility of the committee. There can be no question about it. What the hon. Gentleman has said and what his hon. Friend the Member for Sparkbrook has said amounts to this, that they have condemned out of hand every member of that committee.
§ Mr. Howell
There can be no denial of it. I do not know what the hon. Gentleman wants. Do we normally appoint the weakest member of a committee to be the chairman? When I was a voluntary tutor of the National Council of Labour Colleges I told the Council that the chairman had to be a strong man. In this case, apparently, we had two strong men who meant their job to go without red tape.
But surely to goodness they are not going to tell me that here again the regional board is to blame? Is it responsible for picking the weakest people in the Birmingham district? I cannot accept that for a moment—not even of the members of the Tory Party on that committee. I think they have, every one of them, done a good job of work. I would not recognise it as being composed of weak men or women.
158 Are we asked to believe that this chairman so dominated them that not one of them—not one—had the courage to write to the secretary of the regional board and, as the hon. Gentleman the Member for Battersea, South said, perhaps resign from this management committee, because "It is a one-man bank and I cannot do my job"? No one has done that. No one on the committee has complained about the chairman, only the hospital superintendent.
§ Mr. Cleaver
The ad hoc committee itself made decisions and dictated them to the committee and that suited the chairman when that happened. The secretary to the committee could call a meeting of the committee.
§ Mr. Howell
The hon. Member is getting deeper into the mire. I am coming to the conclusion that he will be ashamed of what he has told the House now. He says the management committee did not in fact meet regularly or did not meet often enough. I think the Minister and his Department would have had something to say if the management committee had met to deal with every little item instead of having sub-committees, which every hospital management committee does.
There is no question that the committee of inquiry went outside its terms of reference and broke every ethic of British justice. It arraigned, judged and eventually condemned members of the committee who had had no right to come before it. I do not know whether the Minister had the right to delete from the report certain paragraphs which were irrelevant, but at no time, as far as I am aware, did the management committee come into this. We have all had a letter saying that the management committee has protested to the board about this —why is the Minister laughing?
§ Mr. Powell
Since the hon. Member has referred to me, I will say straight away that nothing whatever was deleted from the report. It was published as I received it. The hon. Gentleman is under a misapprehension.
§ Mr. Howell
I am sorry, but the right hon. Gentleman was not only laughing but not giving attention to what I was saying. I said that I did not know whether he had the right to do it. Here 159 we have a complaint by a management committee that it has been condemned out of hand without having had an opportunity to answer any questions.
The hon. Member for Birmingham, Yardley (Mr. Cleaver) does not seem to agree with me, but I can tell him that every layman who reads the report will consider that not one of the members of the committee ought to have been there in the first place. The report says that they are too weak to do the job and that they have allowed themselves to be dominated by the chairman.
I am not interested in individuals in this case. One man has acted like a British gentleman and resigned, and it is now up to the others to do the same thing to allow the Health Service to function properly in Rubery and Holly-moor. I hope that some pressure will be applied if the Minister does not exercise his powers in this regard.
I plead on the behalf of the chairman. I am not the chairman of a hospital management committee, but I am the chairman of a hospital committee, and it may well be that I tread on corns going round the hospitals every Saturday morning trying to put right things that I see wrong instead of waiting a month for a hospital committee meeting. There are not many laymen of the working class who are chairmen of hospitals. They cannot afford to be, because it is expensive and one must sacrifice a lot of time. The Minister and others on the Government Front Bench pay tribute to the work of laymen, and I subscribe to that also, but is it British justice that if a medical committee makes accusations against a chairman and he cannot afford to present his case with legal advice, he must accept everything that is said against him and resign?
I make no bone-? about this. If the accusation had been made against me, I should have had to resign straight away and allow it to go by default because I could not have afforded to defend myself as David Rhydderch was forced to. He must have placed his home, his family and his whole life in jeopardy to defend himself. The Minister gave him no assistance at all, not even moral assistance by saying originally that he would make a donation of £100 or, subsequently, £250.
160 It is not fair that when a doctor who has made accusations against a layman can get the whole of his expenses covered by his profession, the layman is in jeopardy because he may not be able to afford to defend himself. If the right hon. Gentleman intends to run the regional boards and hospital management committees with layman, he must give some consideration to how he can protect these people against charges and accusations arising from their work so that none will be in danger of losing his character, as Mr. Rhydderch was in danger of doing, for financial reasons. That is not British justice.
Furthermore, if the Minister has the misfortune to have to order another inquiry, I hope that he will see that the charges contained in the original accusation are those for which the terms of reference are given, and will not change the terms of reference later in order to bring in what my hon. Friend the Member for Birmingham, Northfield (Mr. Chapman) called "a lot of tittle-tattle". It is the Minister and the administration of justice who are on trial, not Mr. Rhydderch. I hope that the right hon. Gentleman will give us some of the explanations we have been seeking.
§ 9.31 p.m.
§ The Minister of Health (Mr. Enoch Powell)
There are essentially two, and only two, questions which have been at issue throughout this debate. The first is whether I should have set up this inquiry under Section 70 of the National Health Service Act. The second is whether, the committee of inquiry having reported, its report should have been acted upon. There are other matters which I will deal with as I go on, but these are the two essential points at issue.
On the 27th September last year, the medical committee of this group passed a resolution of no confidence in the chairman. That resolution it forwarded to the regional hospital board, its employer, sending a copy to me to which was presently added the representation on the part of the chairman of the committee that I should hold an inquiry into the matter.
Now the holding of an inquiry under Section 70 is not a first resort in a matter 161 of difficulty in the National Health Service. It is essentially the last resort. It is a power, as I understand it, which is given to the Minister to enable him to inquire, for the benefit of the Service, into the facts of a situation which cannot otherwise properly be dealt with.
There was no doubt that the first instance in this case was the regional hospital board itself, the employer of these men, and whose agent for the administration of these hospitals the hospital management committee is. As the House has been reminded, on receipt of the resolution the regional board appointed three of its members, the late chairman, Sir Edward Thompson, the present chairman, Sir Arthur Thomson, and the Bishop of Lichfield to attempt to reconcile the differences. The committee of inquiry's report in paragraph 189 said,The ministrations of this ad hoc committee were rejected and the rejection was quite definitely on the G.M.C. side and not on that of the Chairman.So there was no question but that this matter could not be resolved by the regional board itself. Indeed, the chairman of the board wrote to me following the activities of the subcommittee and said,I regret to have to inform you that our attempts to reconcile the difference were unavailing. In these circumstances there is no other course open to me but so to inform you and to suggest that you now make arrangements for an independent inquiry.Thus, after attempting to reconcile the differences, the regional board reached the conclusion that there was no course open to deal with this situation except the appointment of an inquiry by me.
Now, these were the people—the chairman, the present chairman, and the Bishop of Lichfield—who had been charged by the board with the duty of reconciling the differences, and this was their conclusion. This was the result of their attempt. No hon. Member of this House can argue that, confronted with a resolution of the medical committee of these hospitals saying that they had no confidence in the chairman, confronted by the fact that 'the regional hospital board was unable to resolve the differences, and confronted by the recommendation of the chairman of that board that an inquiry should be ordered, he would have done anything else but 162 use the powers of last resort which are entrusted to me by the Act to ascertain the facts by an impartial inquiry.
§ Mr. K. Robinson
What the right hon. Gentleman is saying seems to be very curious. He is, in effect, saying that if there is a dispute in the Health Service, and if one of the parties refuses to accept the jurisdiction of the court set up, then, automatically, the case will go to him for an independent public inquiry, and that under Section 70, he will grant it.
§ Mr. Powell
No court had been set up. I was confronted with a situation in which the medical committee had passed a resolution of no confidence in the chairman, in which the regional hospital board, their employers, and responsible directly for the hospital management committee administering the hospitals, had failed to resolve the differences, and in which the regional hospital board itself considered that an inquiry was the only available action. I do not believe that any hon. Member of this House in my position would have done other than order an inquiry in these circumstances.
§ Mr. Powell
Of course it does not, and the hon. Member perfectly well knows it, but it does mean that where a situation arises in which the management of a group of hospitals and the welfare of the patients in them are jeopardised by a dispute which the regional board itself cannot resolve, it is the duty of the Minister to act, and that no hon. Member of this House in my position would have acted otherwise. That is what it means.
§ Mr. R. T. Paget (Northampton)
Does the right hon. Gentleman mean that where one of the parties summoned by the employer refuses to go to the employer and refuses to state their case to the employer, it follows from that that the employer is incapable of resolving a problem in which one of the complainants refuses to appear before him, and that he can have a public inquiry? It is extraordinary.
§ Mr. Powell
Not necessarily, but, in the situation which existed, there was no practical alternative to the course which I took, and there was no other course which would have safeguarded the future of the patients and of the hospitals in question.
I had to decide whether I should direct the holding of this inquiry in private or in public. I begin with a prejudice in favour of holding an inquiry in public, because if the situation is such that it is necessary, as I judged it to be necessary, for the Minister to resort to these powers under Section 70, there needs to be strong reason why the inquiry should be held otherwise than in public.
Reference has been made to a previous inquiry set up by my right hon. and learned Friend the Member for Hertfordshire, East (Sir D. Walker-Smith), my predecessor, into a matter at Shrewsbury Hospital. The reason which led my predecessor in those circumstances to decide that the inquiry should be in private was the fact that the material evidence would be evidence given by women patients about maternity. He held that in those circumstances that was a reason which counterbalanced the general presumption in favour of a public holding of the inquiry.
But there was another consideration in this matter. If there had been a likelihood that this could have been resolved without publicity and these hospitals could have got back on an even keel and the matter been resolved, that would have been a justification for the inquiry being held in private. It was for that reason that I indicated that if both the parties to the inquiry wished that it should be held in private, it might be so held.
Unfortunately, that was not the position. It is important that the House should bear in mind the view of this matter which was formed by the committee of inquiry itself. The hon. Member for Oldham, West (Mr. Hale) was under a misapprehension, for it was not a view which the committee farmed before holding the inquiry, because it was not the committee but I who had to take the responsibility of deciding whether the inquiry should be in public. But at the end of its work, it decided that this was a case in which "it was 164 clear from the outset that something more than conciliation could possibly be necessary", and it made it clear in paragraph 139 of its report that in its view it was right—this was after the event —that the inquiry should have been held in public.
§ Mr. Hale
I know that the right hon. Gentleman is trying to be fair. My intervention was to make two points. The first was the statement quoted by the right hon. Gentleman after the tribunal in relation to its expression of view before it had heard any evidence. It had no facts to go on. If it had been an impartial tribunal, it would not have known what it was about—and it was only two days since the charges had been formulated. If the tribunal is saying that before it started it had come to a conclusion, then it had got some information from somewhere and we should like to know the source.
The second point was that the whole of Mr. Rhydderch's case was that these were misunderstandings, that he did not know how they happened, that they had been festering for years. He kept saying that he believed he could put it right by shaking hands. That may sound foolish, but he meant it. How could the tribunal decide, before meeting Mr. Rhydderch, before hearing the charges and before knowing the facts?
§ Mr. Powell
I am glad that I made it clear that the expressions of opinion were reached by the committee not before it had begun its work but afterwards, when it was looking back on the inquiry and deciding on the wisdom or otherwise of holding it in public.
Another point in connection with the inquiry was the representation of the hospital management committee. There is no question of my having taken any action to exclude the hospital management committee from representation. The regional hospital board sent me a copy of the resolution of the hospital management committee asking for steps to be taken to obtain legal representation for the chairman and vice-chairman at public expense. The question of the representation of the chairman has been dealt with and is not in issue here. As regards the representation of the vice-chairman; I noted that the vice-chairman was not named as a 165 party in the terms of reference of the committee, but that if it should transpire that matters were raised at the inquiry affecting the vice-chairman, the committee of inquiry would be able to consider whether she should be regarded as a party entitled legal representation, in which case the question of any contribution to legal expenses would be on the same basis as in the case of the chairman. There is, therefore, no question of the hospital management committee having been excluded from representation at the enquiry as it took place.
§ Mr. Denis Howell
I hesitate to interrupt the right hon. Gentleman, but surely this is ludicrous. The committee said that the chairman had to defend himself, but wanted the vice-chairman to be represented by counsel. It was not until this report came out castigating the whole committee that we got to know that this was to happen without the committee being represented.
§ Mr. Powell
I pointed out that the representation from the hospital management committee was in regard to the representation of the chairman and the vice-chairman, and I dealt with that.
As the House knows, the committee reported and immediately on the report being issued the chairman of the hospital management committee, Mr. David Rhydderch, resigned.
§ Mr. Ede (South Shields)
In the whole of this debate we have not heard the terms of the tribunal. I have been waiting to hear them, and I hope that the Minister will tell us what they were.
§ Mr. Powell
They are quoted in the first paragraph of the committee's report. I do not know whether I need trouble the House by reading them, but they are set out in full in the paragraph.
The House is now concerned with the question whether, that report having been issued by the committee of inquiry, Which was followed by the resignation of Mr. Rhydderch, the hospital management committee chairman, I should have accepted the report and it should have been acted on, or whether I should have declined to do so, for that is the practical issue.
The hon. Member for Birmingham, Northfield (Mr. Chapman) was the only hon. Member who was clear and candid 166 in his answer to that question. He said that I ought to have rejected it. No other hon. Member suggested that. The hon. Member for St. Pancras, North (Mr. K. Robinson) used the expression that "the objectivity of the committee might be called in question", but I do not think that anyone, except perhaps the hon. Member for Northfield, seriously suggested that after I had set up a committee of inquiry under Section 70, and after it had reported as a result of a full and careful hearing and consideration, I, as the responsible Minister, should have rejected that advice and sought to prevent action being taken on it.
I cannot conceive an action which would have been a greater dereliction of my duty, which was to resolve this situation in the interests of the hospitals and the patients. I cannot conceive that it could have been right for me, when an impartial committee after all those proceedings had come to its conclusion on the matters submitted to it, and had given its advice, to turn it down and leave the hospitals in exactly the same deadlock as that from which the whole inquiry had originated.
That is an absolutely inconceivable course, but I will not rest on that. As it was my duty to do, I applied my mind to the report which the committee made to me. I cannot transfer this responsibility to anyone else, and I therefore say that after a careful study of that report I was satisfied that its conclusions and recommendations were right, that it was right for me to accept them, and that action upon them should follow.
§ Mr. Hale
I do not want to use a discourteous word to the right hon. Gentleman but I am afraid that I am going to. In my view this is mere histrionics. He appointed a committee to investigate an allegation of misappropriation of public funds. The charge was that he improperly used public funds supplied for supervision and audit. He asked the committee to investigate that. The charge was withdrawn. He should then have cancelled the proceedings and not allowed the committee to go on discussing whether Mrs. Ross should have had her sink or not.
§ Mr. Powell
I am obliged to the hon. Member for enabling me to rebut this 167 as a complete travesty of the facts. The committee was to inquireinto differences which had arisen between the Chairman of the Hospital Management Committee … and the Medical Committee of that Group leading up to the passing by the Medical Committee of a resolution set out in a letter … on 27th September and any matters occurring subsequently connected therewith",and to report to me on the facts found. Following the setting up of this committee the medical committee was invited to put forward the grounds on which its resolution of no confidence was founded.
§ Mr. Powell
I have explained the reasons for setting it up. They had nothing to do with particular allegations in one letter concerning public funds. I have explained that it was the situation which arose out of the resolution of no confidence which ultimately made the setting up of this committee inevitable, and that the grounds for the resolution of no confidence which were placed before the committee of inquiry—and which, as the hon. Member says, did not include that item—were grounds which it was invited to put forward when the committee was set up.
I believe that hon. Members on both sides recognise that, in practice, there is no real alternative in these circumstances, if we want to secure the future of these hospitals—the differences and the history having been examined by an impartial body—to action upon the lines recommended by that body.
§ Mr. Chapman
The right hon. Gentleman has been good enough to mention that I alone suggested that he should have rejected the report. May I make my view clear? My point was that if one reads this report it becomes clear that the whole proceeding was a travesty of British justice as we know it. No matter whether its conclusions were useful, in a practical way, in helping to resolve the dilemma, the method used was a travesty of justice. My second point was that not all the right people had been put "in the dock", and for that second reason the report should have been rejected. I meant to make it quite clear that I was not disagreeing 168 with the general idea that the practical way out might be the right one.
§ Mr. Powell
I appreciate the reasons for which the hon. Member for Northfield, and he alone, said that he would have rejected the report, although in my opinion that course would have been clearly impracticable. The chairman had resigned. Such a course would have been totally against the interests of the Service, the hospitals and the patients. It would also have been contrary to my own judgment of the conclusions arrived at after a study of the report.
My hon. Friend the Member for Battersea, South (Mr. Partridge) said, rightly, that what matters—and this has been my consideration from the beginning of this affair—is a better future for the running of these hospitals, since I believe that we all recognise that the situation which existed and which led to these events could not but have the most harmful repercussions upon the hospitals and patients. Therefore, perhaps the most important conclusion of the committee, and one upon which the Board has taken action, is that these hospitals should be regrouped. I have assented to the proposals put to me by the Birmingham Regional Hospital Board for the regrouping of these hospitals.
I regard that action as the key to the solution of this problem and to a better future for these hospitals and the atmosphere in them. It will give a new start to all concerned. It will give a new grouping of the medical officers, and it will give a new structure of hospital management committees. Indeed, I believe, out of all the conclusions at which the committee of inquiry arrived, that was the most important.
§ Mr. Powell
That depends on the regional board. It is a matter for the board to decide.
The hon. Member for St. Pancras, North said that these events had demonstrated that a cabal of doctors could remove a chairman whom they disliked, and it has been repeatedly suggested that what has happened in this case will weaken the inducement to lay people to 169 serve and the confidence in lay administration in the hospital service. I totally disagree. A cabal of doctors will not remove a chairman or anyone else, unless what that expression means is that an impartial committee of inquiry can come to a conclusion which results in the chairman, or the lay administrator, deciding that it is in his duty, in the light of those conclusions, to resign.
Those are the facts and the statement by the hon. Member for St. Pancras, North is a travesty of the facts. I believe that the effect of it being seen that there is a determination in circumsances of this kind to bring resolution to a situation which had become intolerable for all concerned is not something which will deter people from voluntarily giving of their time to the hospital service. It is a precondition of a healthy lay administration in the hospital service that there should be the fullest determination to resolve a situation of this kind if it arises.
Consequently, what has happened, painful and regrettable though At is in its personal repercussions and the events surrounding it, will not only mean that this hospital will have a better future but that the service itself will be stronger.