§ Mr. Patrick Jenkin (by Private Notice) asked the Secretary of State for Social Services whether he will make a statement on the case of Dr. Terence Lawlor of Normansfield Hospital.
§ The Secretary of State for Social Services (Mr. David Ennals)
Dr. Lawlor has been employed since 1970 as the Consultant Psychiatrist at Normansfield Hospital, a 260-bed hospital for the mentally handicapped managed by the South-West Thames Regional Health Authority and the Kingston and Richmond Area Health Authority.
The two authorities have been concerned about the situation at the hospital for some time. There is a long record of 31 difficulties at the hospital and there have been complaints from relatives of patients, from the Community Health Council and from the Richmond upon Thames branch of the National Society for Mentally Handicapped Children, both generally about standards of care in the hospital and, in one case, specifically about the attitude of Dr. Lawlor. There had also been complaints from nursing staff about Dr. Lawlor's attitude towards them. On 22nd April 1976, the Confederation of Health Service Employees, on behalf of the staff of the hospital, presented to the regional health authority a written list of complaints about Dr. Lawlor which were sent to him for his observations.
On 3rd May, Dr. Lawlor wrote to the area health authority seeking an inquiry into unexplained injuries to patients which he said had occurred during his absence. I understand that this letter was received by the area health authority on 5th May.
On the night of 4th May, virtually the entire staff of the hospital walked out saying that they would not return unless Dr. Lawlor was removed from the hospital. On 5th May the regional health authority chairman, on the advice of senior staff of the RHA and AHA, decided to suspend Dr. Lawlor on full pay pending a decision on further action. On 5th May, the Regional Administrator wrote to him telling him that he had been suspendedas a result of complaints received from the nursing staffat the hospital.
On 12th May, the regional health authority decided to set up an independent inquiry under a legally qualified chairman, with the terms of referenceto inquire into staff morale and patient care at Normansfield Hospital and in particular the circumstances leading to the withdrawal of labour by staff at the hospital on 5th May 1976".It also decided to continue Dr. Lawlor's suspension during the course of the inquiry. The inquiry was scheduled to open on 16th August. Unfortunately, it proved impossible to assemble all the evidence in time and the start was later postponed until 8th November, the earliest date at which the chairman would be available.
I received representations in August from the Hospital Consultants and 32 Specialists Association on behalf of Dr. Lawlor and in September from the BMA raising issues of principle relating to the circumstances of Dr. Lawlor's suspension. I decided that, regrettable as the delay in starting the inquiry was, to reinstate Dr. Lawlor would not help to deal with the situation at the hospital. However, in response to the representations from the BMA, which I met on 1st October, I took immediate action. I spoke to the RHA chairman, who agreed to recommend to the RHA an extension of the terms of reference of the inquiry in order that it should also look into the circumstances of the suspension of Dr. Lawlor. The BMA urged upon me the desirability of an inquiry into this matter under Section 70 of the National Health Service Act 1946, but I decided that to change the form of the inquiry would only cause confusion and further delay. On the terms of reference which I have proposed, I have every confidence that the RHA's inquiry, under Mr. Gerald Kidner, will deal fully and effectively with the matters concerned.
In the light of this, I very much regret the decision of the HCSA to ask its members to ban all routine work last Friday and hope that they will be willing to accept that the important thing now is to establish the facts and responsibilities in this case as quickly as possible and to improve the situation at Normansfield Hospital. Further industrial action will not help towards this.
I thank the right hon. Gentleman for his very long statement. Does he not recognise that there is here a very grave issue of principle? Does he think that it can ever be right for a professional man to be suspended solely as a result of industrial action by staff?
§ Mr. Ennals
It has not happened in this case solely as a result of industrial action by staff. In my statement, I made clear the reasons given by the administrator. The suspension was basically because, I would say, of the situation of patient care at Normansfield Hospital, which has been a worry for a very long time. The BMA asked me to extend the terms of reference to include the circumstances of Dr. Lawlor's suspension, and that is precisely what I did. I think that it would be unwise of me if I allowed myself to be drawn by the right hon. Gentleman into issues which are, quite 33 properly, the subject of an independent inquiry.
§ Mr. Pavitt
Will my right hon. Friend convey to the HCSA and any other organisation that, whatever the cause and whatever their feelings may be, when they take industrial action it does not act against the Government or against other members of the staff or ancillary workers but can act only against the patients? Will he do something in his Department to see that this kind of development, which has arisen not only among doctors but among other sections of National Health Service staff—they all seem to he using industrial action repeatedly as a stick with which to beat the Government—is recognised as only denial, in the end, of their own humanitarian responsibilities?
§ Mr. Ennals
I am grateful to my hon. Friend. I believe that it is the view of the whole House that it is wrong not only for consultants and junior hospital doctors to take industrial action within the National Health Service but for other workers within the service to do so. I believe that those who suffer are, as my hon. Friend says, the patients themselves, who can never be at fault on these issues, and the thought that somehow or other Government policy is influenced by this sort of action is one which I would at once say was not the case.
§ Mr. Jessel
Is the right hon. Gentleman aware that there has been widespread concern in my constituency about the standards at this hospital and that staff morale had sunk to a very low level indeed? That cannot have been good for the patients. Is he further aware that the HCSA was not made aware by its officials of the bad background to the situation and that it would be better for it to await the inquiry?
§ Mr. Ennals
I am grateful to the hon. Gentleman. This hospital is in his constituency and he knows more about the subject than others, including the right hon. Member for Wanstead and Woodford (Mr. Jenkin), who have been making statements. The decision has to be seen against a background of a very serious situation within the hospital and not simply as a question of the suspension of a consultant at a particular moment. The real issue is to get the situation right 34 within the hospital and I hope that party politics will not be made out of the issue. I am grateful to the hon. Member for Twickenham (Mr. Jessel) for his frank statement.
§ Mr. William Hamilton
As a sponsored Member of the Confederation of Health Service Employees, may I associate myself with the expression of view by my right hon. Friend that the workers should get back to work, since it can only be to the disadvantage of the patients if they do not? Can my right hon. Friend tell us whether, before he went on the radio this morning, the right hon. Member for Wanstead and Woodford (Mr. Jerkin) had contacted the Department to ascertain the facts?
§ Mr. Ennals
I do not know whether the right hon. Member for Wanstead and Woodford (Mr. Jenkin) contacted the Department to ascertain all the facts, but in the interview which he gave either he was not aware of all the facts, or, if he was, he was being very selective in his presentation to the public.
§ Mr. Cronin
Will my right hon. Friend understand that I regard it as utterly deplorable that industrial action should be used by consultants, doctors or any other health employees for the purpose of dealing with matters concerning the welfare of patients? Will he at the same time bear in mind that before Dr. Lawlor made any complaints about ill-treatment of his patients on this particular occasion, a request for an inquiry had been made by the nursing staff on account of unpleasant and unco-operative behaviour, on account of unreasonable interference with nursing administration, and also on account of attempts to intimidate members of CoHSE and to induce them to join some other union? Will my right hon. Friend not agree, bearing in mind those circumstances, that this strike or industrial action, however ill-advised, was certainly provoked?
§ Mr. Ennals
I shall not be drawn into commenting on precisely the purpose of the inquiry, but the points raised by my hon. Friends and by the right hon. Member for Twickenham show that a very wide spectrum of problems is involved here. It is not just a question of one man. I think it is best for the House 35 and the country to let the inquiry proceed in order that we can get the matters put right.
§ Mr. Anthony Grant
Is the Secretary of State aware that the HCSA requires an answer to a very simple question, namely, who is clinically responsible for the care of patients—the doctors or the members of a lay union, who seem to have met at about 2 a.m.?
§ Mr. Ennals
The problems in Normansfield Hospital—I shall not state any conclusion on this—are of a very long duration. They have lasted many months. I shall not say where the blame lies. That is precisely the purpose of the inquiry that has been established.
In relation to the responsibility now, although Dr. Lawlor has been suspended, another consultant is looking after the patients on a sessional basis. I will not answer the specific question put by the hon. Gentleman because I believe that to do so now would prejudice the inquiry which is about to start.
§ Mr. Jenkin
The Secretary of State has sought to argue that Dr. Lawlor was suspended for a variety of reasons. Is he aware that the solicitor to the regional health authority, in writing about Dr. Lawlor's suspension, made it perfectly clear that he was suspended as a result of industrial action by the staff? Will the Secretary of State now answer my question? Does he think that is right or not?
§ Mr. Ennals
I have already made clear the reason given by the regional area health authority for the suspension. I quoted it in my earlier statement, and I have a copy of the letter from the administrator to Dr. Lawlor. It is because I believe that serious principles are involved, when people can be suspended for any reason at all, that I requested that the terms of reference should be so broadened. Happily, I have the co-operation of the chairman of the regional health authority in broadening the terms of reference in order that precisely the issue raised by the right hon. Gentleman will be dealt with by the inquiry. I believe that I have properly and effectively fulfilled my responsibility in this case.