HC Deb 17 April 1969 vol 781 cc1457-66

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Concannon.]

10. p.m.

Sir Arthur Vere Harvey (Macclesfield)

I am obliged to you, Mr. Speaker, for giving me the opportunity of raising the case of a constituent in Macclesfield, Mr. Reginald Deall, who, unfortunately, has been in hospital for several months. In debating this matter I shall refrain from mentioning the names of any doctors or officials because it is better that I do not. I should say at the outset that I have the written permission of Mr. Deall's daughter, Mrs. Harding, to disclose the facts I am about to present to the House.

Mr. Deall was admitted to Macclesfield Infirmary on 12th or 13th November last for a partial prostate operation. Things appeared to be going very well immediately afterwards, but when he went home, early in December, he still had a pain in his right leg. He was attended by his own doctor, who diagnosed sciatica. The pain became much more severe, and a specialist was called in and, according to his daughter, diagnosed disc trouble. Mr. Deall was then admitted to hospital on about 5th February and given traction treatment when weights of about seven lbs. were put on both this gentleman's legs. He became really much more ill.

He vomited daily and had a temperature of 103 or 104 degrees for most of the week. According to his relatives he was very confused in his mind. On 21st February the house doctor at the hospital admitted that he did not know what was causing the pain. I have a letter from Mrs. Harding written to the hospital in which she says, I will not say to whom: I would like another opinion on my father's condition immediately. He is a very poorly man and we feel he is being left to slip away. It is a great shock to see how ill my father was tonight, and also to learn through our own doctor that we do not know what really is the matter with my father, especially after your casual manner during the last two interviews. I feel you should have been straightforward with me. I should like the best specialist available to see him tomorrow and I would like to pay privately. By this she meant that she was quite prepared to pay any necessary expenses.

Mr. Deall then had great difficulty in moving his other leg, and complained of pains in the region of his heart. Before I saw Mrs. Harding in my constituency she telephoned my agent, who took it upon himself, after ringing me, to telephone the matron of the hospital, and then something like three or four officials saw Mr. Deall. It was not until the political note came in on this that things really began to move. He then had blood tests, two X-rays and then a more detailed X-ray after an injection of dyestuff.

On Friday, 28th February, Mrs. Harding spoke to the doctor by telephone who said that it was a kidney infection, resulting in an abcess. The doctor told her that she was making a big fuss over nothing. Mrs. Harding observed that at this time some of the injections, two daily, were not being given to Mr. Deall, by a foreign doctor. I saw Mrs. Harding on the afternoon of Friday, 7th March, in Macclesfield, and having listened to her very carefully for a long time and heard what my agent had to say, I telephoned an official at the hospital.

His reaction was: "Will you write in a letter?"

I said that this gentleman was extremely ill and that as it was Friday I should be writing on Monday, and, with the normal procedure, the man might die in the meantime. I said "No, I will telephone you again tomorrow morning before I leave for London, expecting some sort of action." I spoke to him on the Saturday morning and he said, I am sorry to say, that most of the officials were away for the weekend. I do not quarrel with that, but I should have thought that there would have been some response, to give the local Member of Parliament some satisfaction. I did not get it. I returned to London, and on Monday morning I wrote to the Under-Secretary, who, unfortunately, was ill at the time. I did not know of that, and I am sure that the whole House wishes the hon. Member for Lichfield and Tam-worth (Mr. Snow) a complete recovery. We are glad to know that he is making progress. I wrote to him, and sent the letter to the Ministry by hand to make certain that it got there as quickly as possible. I gave full details in the letter as I had been given them by Mrs. Harding, and I have all the statements signed by the daughter, which I am prepared to hand over to the Minister after this discussion.

Having written to the Minister on 10th March, I got no reply from him, in spite of several telephone calls, until 10th April. The Minister took four-and-a-half weeks to reply in relation to this, in my view, desperate matter. It is not good enough. It has been admitted in Macclesfield by the hospital officials that there was a breakdown in communication. That may well be because hospitals are undermanned and grossly over-worked. Mr. Deall is still in hospital today, but is now making a good recovery and will be out in a matter of days.

I have had a happy relationship with the Macclesfield hospital during the period of over 24 years in which I have been the Member of Parliament. It is a teaching hospital which has done exceptionally well, and previously I have had no cause to make any sort of complaint whatever. I attach some of the blame to the Ministry. I received a rather flippant letter from Baroness Serota, the Minister of State, in which she answered none of the questions which I put in the letter to the Under-Secretary in the previous month. She wrote that I was quite right to get in touch with the hospital. Of course I was right to do so. I did not need to be told that. I wanted an answer not within four-and-a-half weeks but within a week. Even a telephone call from the private secretary to my office would have allayed my fears in the matter. But the method of the Minister and his staff has been extremely dilatory, to say the least.

I raise this matter today because steps should be taken in these days when a great many doctors and nurses are leaving this country—the hospital staff are doing the best they can in most difficult circumstances—to ensure that the lines of communication between next-of-kin or near relatives are kept open to give them full data about the state of the health of the individual.

I should like to ask the Minister why it took nearly five weeks to reply to my letter. Was the case properly investigated? I should like an assurance that this sort of behaviour will not happen again. The staff of these hospitals are grossly overworked, but nevertheless they must be encouraged to try—I do not say "to be more human", for that would be the wrong word in this context—to relieve the feelings and anxieties of those who are closest to the patient.

10.8 p.m.

The Under-Secretary of State for the Department of Health and Social Security (Mr. Norman Pentland)

I have followed the speech of the hon. Member for Macclesfield (Sir A. V. Harvey) with interest and have taken careful note of the points he has made. If after I sit down this evening he is still concerned in his own mind about some of the points he has raised, I should be prepared to have a further investigation into the matter.

I appreciate that the hon. Member's motive in raising this case on the Adjournment originally was to ensure that his constituent Mr. Deall was being properly treated in hospital, and that Mr. Deall's daughter, Mrs. Harding, may be reassured of this.

I have of course obtained an up-to-date report from the specialist who is in charge of Mr. Deall's treatment, but the hon. Member will not expect me to reveal in public all the intimate details of his constituent's treatment: indeed I could not properly do so without Mr. Deall's own consent.

I will however try to deal in general terms with the complaints which the hon. Member orginally raised in his letter of 10th March addressed to my hon. Friend the Joint Under-Secretary of State and those which he has mentioned tonight. The hon. Member will appreciate that if it had not been for the unfortunate illness of my hon. Friend, he would have been dealing with this matter this evening. I am certain that my hon. Friend will be grateful for the hon. Member's good wishes.

It is correct that Mr. Deall was admitted to the infirmary branch of Macclesfield Hospital on 11th November, 1968, for an operation. Infection developed after the operation, but gradually cleared up, and he was discharged home early in December. Unfortunately he then developed severe pain in his back and right leg, and had to be readmitted to hospital early in February. This pain responded well to treatment, but the previous infection recurred and towards the end of February pain developed in the left groin and left leg. At this stage Mrs. Harding, the patient's daughter, had two successive interviews with the responsible specialist.

Sir A. V. Harvey

Would the hon. Gentleman confirm that Mr. Deall was treated for sciatica when he was admitted? Indeed, the weights were hanging on his leg. Was not the diagnosis of infection discovered afterwards?

Mr. Pentland

I am not certain what precise treatment was involved. As I explained, I am reluctant to develop that aspect of the matter. If the hon. Gentleman is still concerned about even this aspect of the treatment, I will be glad to look into the issue.

As I was saying, Mrs. Harding, the patient's daughter, had two successive interviews with the responsible specialist, but apparently these did not relieve her anxiety, for on a Saturday morning she and the hon. Gentleman's agent came to see the hospital matron asking how she could obtain a second opinion. The specialist was not available that day, but in his absence the matron did her best to ascertain was was troubling Mrs. Harding, and was left to understand that this would be put in writing. The matron therefore warned the group secretary to expect some kind of written complaint.

The next thing that happened was that the hon. Gentleman himself telephoned. As the group secretary was away, his deputy took the call. The hon. Gentleman no doubt did his best to explain his constituent's anxiety, but it was still not clear what was really troubling her. When the group secretary returned, he decided, quite rightly, in my view, that the best thing would be to invite the hon. Gentleman and his constituent to a meeting at which the responsible specialist would be present. This meeting was arranged for Thursday, 13th March, and I am sorry that the hon. Gentleman was unable to attend it.

Sir A. V. Harvey

Is the hon. Gentleman aware that I did not receive any such invitation, that there was no question of my ever seeing the doctors, that I was never invited by them or asked to see them, that I spoke to them on the telephone and that I dealt with the Ministry by letter? Will he check on these matters to clarify the position?

Mr. Pentland

The information I have, after looking into the matter, is that the hon. Gentleman was invited to attend this meeting.

Sir A. V. Harvey indicated dissent.

Mr. Pentland

I assure the hon. Gentleman that I will look into the matter.

I understand that this meeting lasted over three hours and covered the ground very fully. Mrs. Harding repeated her allegation that a nurse had admitted to her that some of Mr. Deall's injections had been missed, but the group secretary assured her that inquiries had found no substance in this allegation. She also complained that a letter addressed to the specialist which she had left on a side table was still there the next evening, although it had been opened. This minor failure of communications was admitted, with a suitable expression of regret. Mrs. Harding also questioned whether her father had been receiving any proper medical treatment and the specialist took pains to reassure her about this.

At the conclusion of this meeting on 13th March, I understand that Mrs. Harding expressed herself as fully satisfied. The group secretary explained to her the proper channels for lodging any further request or complaint, but I understand that she has not since made any use of these. The hon. Member's agent was informed of this satisfactory outcome, and my noble Friend the Minister of State wrote accordingly to the hon. Member on 10th April. I regret that the Easter Recess prevented despatch of this letter until after the hon. Member had given notice of his intention of raising the case on the Adjournment. But I would point out to the hon. Member that, if he wants a quick answer to a question about a hospital matter, he would do best to write direct to the hospital authority concerned.

We in the Department do our best to give hon. Members prompt service but inevitably an inquiry fed in at the top takes time to travel down through the regional hospital board to the hospital management committee concerned and back again. As regards the content of the letter, I am sorry the hon. Member should have found this unsatisfactory. I can assure him the aim of my noble Friend was to set out the position as we then knew it and to offer to clear up any points on which the hon. Member might feel doubt still remained.

In the absence of any further approach to the hospital since 13th March, either by Mrs. Harding or by the hon. Member, or of any reply to the letter, I have had to assume from the hon. Member's speech that he wanted to raise the general question of communication between doctors, nurses and patients.

Sir A. V. Harvey

At the end of the debate I will hand the hon. Gentleman a letter from Mrs. Harding dated 13th March, after the interview, which will make the point conclusively. The hon. Gentleman talks about the Easter Recess, but surely that was only a few days. A telephone call to Macclesfield Hospital and to my office might have saved the necessity of this debate. I contend still that there has been negligence at this Department.

Mr. Pentland

I take the point and I will look into this aspect. As I was saying, the question of communication between doctors, nurses and patients is very important. In 1963, my Department circulated a report about it to all hospital authorities for the attention of their medical and nursing staffs, and I have no doubt that most doctors and nurses are now very well aware of their obligation in this respect.

I will not attempt tonight to summarise the whole of this interesting report, which is obtainable from Her Majesty's Stationery Office. I will only draw attention to the fact that it recommends in paragraph 24 that arrangements for relatives to see the doctor should be precise and made more widely known. I am assured that, in the case we are debating, Mrs. Harding has seen the responsible specialist several times and knows now that if she has any further worries she has only to ask to see him again.

It might be more helpful if I were to explain to the hon. Member and to the House what are the proper channels for making complaints about hospitals. It not infrequently happens that a member of the public who has been aroused to complain about something that has happened in a hospital approaches an hon. Member without making any attempt to use the ordinary channels. This may well be because the ordinary channels are not sufficiently known, and if so I hope that what I say tonight may help. I am not, of course, suggesting that it is wrong for a member of the public to approach his Member of Parliament with a complaint against a hospital for which he has not been able to obtain redress through the normal channels; he is then quite right to do so. In the present case, Mrs. Harding did try to explain her worries to the responsible specialist but, not having received satisfaction, she evidently did not know what to do next. This I shall now explain.

What are these normal channels? This depends to some extent on the nature of the complaint. For example, a simple query or complaint about medical diagnosis or treatment would best be put orally in the first instance to the house surgeon or physician, or to the consultant in charge. Similarly a simple query or complaint about nursing would best be put orally to the ward sister. A more complicated complaint, or one to which an adequate answer has not been obtained at the first attempt, might be addressed either orally or in writing, to the matron or to the hospital secretary; or, in more serious cases, in writing to the secretary of the hospital management committee for full investigation. As the House will know, my right hon. Friend the former Minister of Health in 1966 issued a memorandum to all hospital authorities telling them how such complaints, however made, should be handled, and this is regularly followed up.

What is surprising is how relatively few complaints are in fact made: in 1967 there were fewer than 8,000 written complaints from all the millions of patients who had attended our hospitals during the year. I believe that this reflects the very high opinion which the public generally has of the National Health Service, and that this high opinion is generally well deserved.

Nevertheless, I and my colleagues in the Department are always willing to give our time to looking into an individual case where something may have gone wrong, and if necessary to put it right. In the case of Mr. Deall, all that was basically wrong, so far as I have been able to discover, was a temporary lack of confidence between his daughter, Mrs. Hardy, and the doctors treating him; but I am assured that this has now been put right, and moreover, in view of the hon. Gentleman's concern, I am glad to be able to tell him that Mr. Deall is now almost fit for discharge and is expected to arrive home at any time.

Question put and agreed to.

Adjourned accordingly at twenty-two minutes past Ten o'clock.