ST. MARY'S HOSPITAL, HARROW ROAD (Hansard, 12 December 1969)

§ The Minister of State, Department of Health and Social Security (Mr. David Ennals)
Hon. Members will already have seen the report of the committee of Inquiry which was set up by my right hon. Friend to enquire into the organisation of medical and nursing care of children at Paddington General Hospital—now renamed St. Mary's, Harrow Road—with particular reference to the case of David Tomlinson, who was admitted to and died in that hospital in July 1967. Copies of the report were placed in the Library of the House at the beginning of this week.
I would also refer to the reply given by my right hon. Friend to a Question from my hon. Friend the Member for Willesden, West (Mr. Pavitt), on 9th December, stating that he had told the board of governors that he had accepted the recommendations in the report and would be discussing with the board what action should be taken on them.
I understand that it was decided yesterday by the board that there should be no further admissions to the children's unit for the present. Ministers will be discussing the future of the unit with the board of governors urgently.

§ Lord Balniel
I thank the Minister for that statement. The report, which was published before it had been considered by the governors, recommended that the children's ward should be closed. Is it not absolutely essential to reach a deci- 788 sion about the future of this children's ward immediately, as otherwise the position of the nursing staff is quite impossible?
Is it not also very important that parents should be encouraged to cooperate to the full with the nursing staff? If these nurses are typical of their profession, as I suspect they are, they are absolutely dedicated to helping the best interests of the patients, and they deserve our wholehearted support.
Further, does the Minister appreciate that the morale of medical and nursing staff in some of our hospitals is now under tremendous strain? They are overworked and understaffed, and work in very difficult conditions. Will the hon. Gentleman take more seriously and urgently our recommendation that there should be an independent inspectorate, covering the whole of the Health Service, which can ensure proper standards, and give advice and help; and also a parliamentary commissioner to whom patients and staff with complaints could turn for an objective inquiry?

§ Mr. Ennals
I entirely agree with the noble Lord about the importance of parents co-operating with the staff in the unit. As is known, there has been a suspension of new admissions. In most cases, and this is not casting any particular aspersion on any of the staff who were there at the time of the death, the staff is almost entirely different, and there have been improvements not only in staff complement but in the redecoration of the ward, which was one of the complaints touched on in the report. It is of the greatest importance for the morale both of the staff in that particular unit and elsewhere that parents should recognise that they should co-operate; and that there is a very good service provided for them.
I also entirely agree with the noble Lord on the importance of taking a decision. As he knows, there was a meeting of the board yesterday, at which it was decided to suspend further admissions. It is recognised that there is a considerable number of other pediatric beds in the group so that no problem arises with regard to children being admitted to hospitals within the group as a result of the suspension of admissions to this ward.
789 My noble Friend the Joint Minister of State, after consultation with my right hon. Friend the Secretary of State, hopes to have a very early meeting with the chairman of the board so that decisions can be taken as to exactly what the future of the ward should be.
The noble Lord spoke of an inspectorate, He will already know of one step that was taken by my right hon. Friend following the Ely Report. He will also know that very serious consideration is being given to some sort of new procedure for those parents who feel dissatisfied and want to register a complaint. Whether it should be in the form of some kind of health commissioner, I am not at present prepared to say, but this is one of the matters which will be dealt with in the Green Paper which my right hon. Friend will be bringing to the House some time next year.

§ Mr. Scott
May I put three points to the Minister? The first is on the suggestion of the tribunal that, in general, children's beds should be grouped together. What view do the Government take on that? It seems that one of the characteristics of a general hospital ought to be that it has provision for the treatment of children within that general hospital. One does not have to think very hard to envisage circumstances in which urgent treatment of children in a general hospital would be absolutely essential.
Secondly, on the question of nursing, the nursing establishment was 100 under par at the time of this incident and is still well under par. How are we to get nursing establishments to the proper level with discontent over nurses' pay growing as it is at the moment?

§ Mr. Speaker
Order. I know the hon. Member has a special interest in this problem, but questions must be reasonably brief.

§ Mr. Scott
Finally, can the Minister confirm that there was nothing that could have been done in the present state of medical science to save the life of this child?

§ Mr. Ennals
The answer to the last question would, I think, require a doctor to say, but I think that all the evidence showed that the death of David Tomlinson could not have been averted by any- 790 thing that could have been done. Even if everything had gone according to plan, it is extremely unlikely that the very severe infection from which the child was suffering could have led otherwise than to death.
In answer to the hon. Member's first question, the Secretary of State entirely agrees with the general principle that children's units should come under the overall care of a consultant paediatrician, as recommended by the Platt Committee on the welfare of Children in Hospital in 1959 and commended to hospital authorities by the then Minister of Health. They were reminded in 1967, and again in 1969, of the importance of the Platt Committee recommendations and asked to review their arrangements for child patients. Even where existing buildings prevented the grouping of children in one place units should still be linked together under the general care of a consultant paediatrician and his team.
Further guidance is to be issued to hospital authorities on their service for the care and treatment of children in hospitals. It is, of course, true, as the report showed, that there was a substantial understaffing of this particular unit, but it should be recognised that there has been an improvement in the staffing position there since the time of the accident, which was over two years ago.

§ Sir Robert Grant-Ferris
As chairman of a London hospital which is intimately concerned with the recruiting of nurses, may I ask the hon. Gentleman whether he will pay particular attention to seeing, if possible, that nothing is done to affect the morale of the nursing service, because our problem in getting nurses today is very grave indeed? We owe an enormous amount to this great service and the work which it does. I hope that it will be possible to see that the finest possible construction will be put on the work of these devoted people.

§ Mr. Ennals
I endorse every word that the hon. Member has said. Parents, children and all who find themselves in hospital, owe an enormous debt of gratitude to the care, ability, dedication and devotion to duty of the nursing and medical staff at every level. It is of great importance that in every way we can we should help to sustain and raise the morale of the profession to which the country owes a very great debt.

§ Sir B. Rhys Williams
Does the hon. Gentleman recognise that the concern in the House and the country is not just about a particular case, but affects the entire hospital service? Improving the facilities for making complaints will not necessarily improve the morale of people in the hospital service. What action is the hon. Gentleman taking to improve the morale of people dedicating their lives to the service of the public?

§ Mr. Ennals
The House must get this matter in proportion. From time to time we hear, as in this and other reports, of very tragic events usually affecting one person or a few persons. While none of us would underestimate the significance of these single events, it should be recognised that the quality of care that is received in our hospitals is of a very high standard. Of course, I agree that while making better provision for complaints is only one quite small part of the problem, the much more important problem is to see that we can improve the staffing and provision of equipment of hospital in so that not only may we obtain the standards we have now, but may continue to gain a higher standard of care in our hospitals.