HC Deb 01 December 1977 vol 940 cc872-82

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

11.15 p.m.

Mr. William van Straubenzee (Wokingham)

I am grateful to you, Mr. Deputy Speaker, and particularly to Mr. Speaker for allowing me the opportunity to raise a matter which is of some considerable anxiety and concern to my constituents, and I am very much obliged to the Minister responsible for the disabled for his courtesy in being here at this hour to answer the debate. I know that he has the same concern for those who are caring for the mentally-handicapped as has any other Member of this House.

The hospital of which I speak is the Church Hill House Hospital at Bracknell in Berkshire. All the 270 patients in that hospital are mentally handicapped. They are all, as the saying goes, "informal" patients—I use the word in inverted commas. That is to say, none is admitted under the Mental Health Act, which means that none of them is being detained. There are 146 nursing staff who are concerned with their care.

It is not an unusual story. The basic buildings of this hospital were originally the workhouse of the area, and under successive Governments, and with care and expenditure over many years, the buildings have been greatly improved, enlarged and added to. On the several occasions when I have had the privilege to visit the hospital, like everyone else I have been very much impressed by the atmosphere. But the atmosphere is soured at the moment. The matter starts with a letter sent to the Minister by the Wokingham Constituency Labour Party, undated, but received on 1st November. It makes very serious charges indeed about the conduct of the hospital.

I do not take time to read the letter in full, but I will read an extract. It was sent by the secretary of the constituency Labour Party. It said: …we have reason to believe that there is strong evidence of victimisation of and discrimination against trade union members; that there have been cases of the fabrication of documents for the purposes of discrimination and fraud; and that there have been incidents of violence involving both staff and patients at Church Hill House hospital. These are very serious charges, and they hang over my constituents who are on the staff of the hospital and are the cause of my raising this matter.

The matter arose basically, as the letter makes clear, from an affiliated branch of the National Union of Public Employees. I understand that the chairman of the East Berkshire branch is a Mrs. Warwick, sometimes described as a nurse but in fact a nursing assistant, which is a different appointment. My first question, therefore, is whether it is a fact, as I believe to be the case, that Mrs. Warwick has recently been the subject of a disciplinary hearing carried out under the disciplinary procedures of the Berkshire Area Health Authority. I ask that question because it seems to me to be relevant when we come to judge the weight of the evidence which she seeks to put before us.

I have quoted from the letter from the constituency Labour Party. The constituency Labour candidate has wholly and absolutely associated himself with the charges in the letter. Quite rightly, the Minister of State, to whom I am also grateful, writing to the Labour Party on 16th November, said this: It is imperative that full and specific details of all allegations and incidents you refer to in your letter should be made available at once to the Berkshire Area Health Authority, so that they can carry out full investigations into them. I hope that you and the NUPE Branch will put all the information you have in the hands of the Area Health Authority. I draw the Minister's attention to the fact that that letter is now 16 days old. It is 16 days since the letter was despatched.

My second question is this. Have any details of allegations and incidents—full and specific details, to use the Minister of State's phrase—as at today's date, to the Minister's knowledge, been supplied either to the Department or to the area health authority? I repeat that it was 16 days ago.

The message that should go out from this debate, if the Minister tells us that so far no details have been supplied, is "substantiate or withdraw"—either substantiate these very grave allegation or withdraw them. If they are not substantiated or if the complaints prove to be so trivial as not to justify the allegations, then the candidate concerned will stand discredited.

But I do not make my major case to be that. I have in front of me the full-scale spread of the Wokingham Times of 3rd November. The Wokingham Times is a member of the Thomson Group of newspapers. It spreads across the whole front page, Why this hospital must be probed". I quote from the leader, known in that newspaper as "Adam McKinlay's Column": All is not well at Church Hill House Hospital for the mentally handicapped in Bracknell, and there is urgent need for a public inquiry. For weeks a team of reporters from this office has been investigating allegations of violence and other serious acts concerning patients and nursing staff. Their findings worry me. Further on it says, the main issue…is the allegations of acts of violence of a most unpleasant nature against mentally handicapped patients. They are very serious charges indeed to be made in a public newspaper, as you, Mr. Deputy Speaker, will agree.

A little later, the editor writes, I have gone through every line of the investigation carried out by my team of reporters and if only one of the serious allegations of acts of violence against the patients is true, it is one to many. This is no time for mincing words. I have read all the allegations which were brought to Alan Furley and I share his anxiety. He has read all the allegations, so they must exist; they have been read.

I ask my third question of the Minister. Has there been any contribution from the editor of this newspaper? Has he made statements available to the area health authority or to the Minister's Department? Has any of this evidence been made available?

I say with some reluctance that the truth about this newspaper is that it is a local newspaper dominated by its editor, and, in turn, he is a man with a passion for self-advertisement. Journalistically, he is without principle. He cares only for the circulation of his newspaper and his own ego. Perhaps I may give a small example. It would, I think, be a surprise to the readers of The Times of London if Mr. William Rees-Mogg's photograph—pleasant as it is—were to appear regularly on the front page of that newspaper. But that is what regularly happens with this paper. For example, in the issues both of 20th October and of 17th November there was the editor's photograph on the front page.

I believe that this editor has used his position as editor to bring maximum discredit upon the entire staff of this hospital who are devotedly caring for the mentally handicapped, without having made public, unless we hear to the contrary tonight, to the Minister or to the AHA a shred of evidence in support of his cruel allegations.

Fourthly, I do not know whether the Minister will feel able to do this, but I ask him to warn hospitals in the immediate area of what might happen in the columns of the newspapers in the same way as it has in respect of Church Hill House. For example, the editor was recently a patient at Heatherwood Hospital. He wrote honeyed words about his treatment there from the nurses, but heaven knows what revelations he might yet be prepared to make and write leaders about.

I believe that the borderline between restraint and ill-treatment is a very thin one. There may well be guidelines, but they cannot cover all situations. In the care of the mentally handicapped there can be violent aggression by one patient leading to some use of physical force and restraint, but others caring for such a patient may do it by only a word or a gesture, and restraint may sometimes be necessary by an experienced nurse who has seen danger signals.

I sum up my views in this way. I want it to be clearly understood—and I hope that the Minister will understand—that I think that any person who abuses his care of the mentally handicapped should ruthlessly be the subject of inquiry. I want the Minister to appreciate, as I am sure he does, that nothing that I am saying tonight would seek to sweep under the carpet matters which should be the subject of inquiry.

I certainly assert firmly, even in regard to a profession which I respect greatly and which is doing work that I think is demanding and difficult, that any case of violence or any alleged case of violence should certainly be referred to the Director of Public Prosecutions. Mine tonight is not a case of trying to whitewash. What I am saying to the Minister is this. I think there is a responsibility, too, upon those who make these accusations. The responsibility is not to make the accusations publicly as was done in this case—that has endangered everybody's reputation and cast a cloud over the whole of the hospital and all the work within it—until investigations have been carried out privately.

For example, I assert firmly that if proper allegations, substantiated allegations, had been brought to me, as to any other hon. Member I feel sure, I should certainly have done all I could to have them very thoroughly investigated first.

The alternative is not to make public allegations unless one is simultaneously prepared to produce the evidence on which those public allegations are based. Those seem to me to be the two criteria which it is reasonable to ask of anyone who is making such grave accusations as this. For the truth is that in a situation like this the staff of a hospital—all of them, nursing, medical, administrative—against whom such allegations as these have been made have no redress once the allegations are made public. They must all suffer the stigma of an unproven allegation. They have no redress, with one exception. That exception is being demonstrated tonight.

Not only is Mr. Speaker the guardian of the rights of minorities in this House, for which we are very grateful, but he is the guardian of the rights of minorities among those whom we represent here. It was he who enabled me to raise this matter tonight with the Minister, and enabled him, as I trust, with due regard to his overall responsibilities for all the things that I have said, if he feels so inclined, to come to the defence of the staff whose predicament I have raised.

11.30 p.m.

The Under-Secretary of State for Health and Social Security (Mr. Alfred Morris)

The hon. Member for Woking-ham (Mr. van Straubenzee) has brought before the House a matter of very considerable importance to people living in and around his constituency. I am grateful for the manner of his speech. He dealt with Press allegations which have not been supported by facts. They are allegations that could seriously undermine public confidence in an important service for mentally handicapped patients and the highly skilled staff who look after them. I welcome the opportunity provided by the hon. Gentleman to show that the allegations have not been supported by any statements of fact. I shall also seek to answer the pointed questions he has posed and comment on recent events which gave rise to this debate.

Church Hill House Hospital is near Bracknell, and has about 270 beds for mentally handicapped patients. Over the years, it has rightly earned a good reputation for the services it provides. The hospital is held in high regard locally, where many families rely on it for support which is essential to them in the care of their mentally handicapped relatives.

Early in November, my right hon. Friend the Secretary of State for Social Services was asked by the Wokingham constituency Labour Party to set up an independent inquiry into allegations about Church Hill House Hospital. He was told that the executive committee had received representations from an affiliated branch of the National Union of Public Employees, which led it to believe that there was evidence of victimisation of, and discrimination against, trade union employees at the hospital, of fraud, and of violence involving both patients and staff. In view of the representations the constituency Labour Party had received it was, of course, both understandable and proper for it to raise the matter with my Department.

Moreover, when suggestions of misconduct of this kind are made there is a recognised procedure for dealing with them. In keeping with this procedure, my hon. Friend the Minister of State replied to the Secretary of the Woking-ham constituency Labour Party stressing that it was imperative that full and specific details of all allegations and incidents should be made available to the area health authority at once so that the authority could carry out a full investigation into them. My hon. Friend asked that any information in the hands either of the local party or the NUPE branch concerned should be passed to the AHA. In the meantime, the Press carried reports of the allegations that were being made. These reports, however, con- tained no specific factual information upon which investigations could be based.

The Berkshire Area Health Authority is responsible for provision of services at Church Hill House Hospital. It is concerned that the hospital should be managed efficiently and well, and that patients should receive the highest possible standards of care. It is its policy to investigate complaints and allegations about management and about services to patients, both thoroughly and impartially, and also to take any necessary action to ensure that these objectives are met. The authority was, therefore, understandably very concerned about the allegations that were being made about the hospital. At the same time, it was rightly anxious that it should have the full facts so that it could start investigations without any delay. But I understand that it has not received any facts supporting the general allegations that have been made.

Clearly, the area health authority cannot carry out any meaningful investigation without some factual information. Its officers have made wide-reaching inquiries within the hospital, but I am told that they have discovered nothing to indicate that the allegaions are in any way warranted.

The authority is, of course, in an invidious position. The public will expect of it that it either refutes the allegations or shows what action it has taken to put right what it has found to be wrong. Yet its first duty is to investigate, and it cannot do this without factual information in support of the allegations. This it has not been given. As a responsible body, it must exercise caution before issuing any public statement implying that it has come to final conclusions about the management of the hospital and services to patients while there remains any possibility of someone coming forward with hard facts that can be investigated.

The rumours and allegations about Church Hill House Hospital have had a serious impact on morale among the staff there. I am told that at all levels they find themselves under a cloud of suspicion. The staff have emphasised to the area health authority their confidence that the care they give their patients will stand up to examination by anyone wishing to go to the hospital and look at their work in detail. Naturally they want to have the allegations about the hospital refuted. They are impatient for those responsible for the Press allegations to come forward with factual statements which can be properly investigated.

It is not surprising that this affair should have had its effect on morale in the hospital. As the House well appreciates, good morale is essential to good services to hospital patients. If the allegations that we have seen in the Press have been made without just cause, the burden of responsibility on those who made them is a heavy one indeed.

The allegations have also had their impact on public confidence in the hospital. There have been requests for full inquiries. The hon. Member for Woking-ham has written to my hon. Friend expressing his appreciation of the dedicated and devoted work of the staff at Church Hill House Hospital. Moreover, he is by no means alone in having done so. The area health authority has received communications from a great many people, including relatives of patients and the hospital's League of Friends, expressing their confidence in the staff and in the care they give their patients.

I am sure that all this is very encouraging to the staff at the hospital. While they feel under attack, they must have found some solace in the knowledge that they have the admiration and trust of so many people who are qualified by their experience of the hospital to express an informed opinion. I think it important that the people of Berkshire should know that many who have intimate knowledge and experience of the hospital just do not believe that the allegations have any substance.

In his speech, the hon. Member asked some specific questions. I should now like to deal with them. One of his questions was whether the area health authority has yet received statements of facts in support of the allegations. The short answer is "No". From no source has the authority received any statement of fact throwing light on the allegations and which might make detailed investigation possible. For my part, I sincerely hope that, if anyone has any information that should be made available to the area health authority, he will make it available to the authority without delay. Mis- management, fraud and ill-treatment of patients are gravely serious matters which must be dealt with responsibly. These are not words to be bandied about lightly and without just cause. The hon. Member and his constituents have my word that I shall have any factual information very rigorously examined.

This brings me to the hon. Member's suggestion that the area health authority should be cautious in its dealings with the Press. I shall certainly draw the authority's attention to what he said. I am, of course, fully conscious of the very important rôle played by the Press in drawing attention to matters of public concern. The hon. Gentleman's point to me is that this affair highlights the need for the Press to check out stories as far as possible before going to print on matters which are certain to give rise to public disquiet. Credibility is the journalist's stock-in-trade, and credibility suffers irreparable harm when readers are asked to give credence to reports of smoke without showing at least some clear evidence of fire.

The hon. Member also referred to disciplinary proceedings held at the hospital recently. I understand that in October there was a disciplinary inquiry at the hospital involving an unqualified nursing assistant, and that she was subsequently given a formal warning about her conduct. I understand that this was the employee referred to in the first of the questions put by the hon. Member.

It has been suggested that this nursing assistant and other members of the staff have been subjected to victimisation. The area health authority would not accept that the disciplinary action could be regarded in any way as victimisation. It has not, however, been given specific details of alleged acts of victimisation but, as in the case of the other allegations which have been made about the hospital, it is prepared to investigate, given the facts.

It is a matter for deep regret that those who have made allegations have not come forward with facts for the area health authority to investigate. If there are no facts available, I find it a cause for particular concern that the allegations were made in the first place. Without factual support the allegations can be regarded as nothing more than rumours.

While I do not doubt that the people involved passed on the rumours that they had heard in good faith, this whole affair seems to emphasise the very great dangers of rumour-mongering. As I have said, real harm has been done to the morale of a group of people who have the often very demanding job of looking after mentally handicapped people.

I am sure that their dedication to the needs of their patients is fully recognised by the area health authority and by the relatives of the handicapped people in their care. That knowledge at least should hearten the staff. I cannot stress strongly enough the importance I attach to the need for anyone who has factual information bearing on the general allegations that have been made to come forward so that a thorough investigation can be carried out.

What it comes down to is this. It is all very well to demand an inquiry. We are very ready to investigate any specific allegations of improper behaviour. But I must again emphasis that we must first know what the allegations are before we can invesigate them.

I should like now to pay tribute to the responsibility with which the area health authority has acted. It has made it clear that it will thoroughly investigate any facts laid before it. Its officers have made inquiries to discover anything that might be going wrong in the hospital, but this has brought nothing untoward to light. It has also invited the police to carry out their own investigations and I understand that these are still continuing.

It is not possible for me to say whether the police inquiries have led or may lead to any action in the courts: I can go no further than to say that the area health authority has heard nothing so far that leads it to believe that formal police proceedings are likely. The area health authority has made it clear by its actions that it exercises proper vigilance in managing services at the hospital.

I cannot let this opportunity pass without also paying tribute to the men and women who provide the health services for mentally handicapped people. They are dedicated people who undertake a difficult task and do their work to a very high standard. I endorse entirely what the hon. Member said about the dedication of people who spend their lives helping the mentally handicapped.

Development and enhancement of services for the mentally handicapped is one of the Government's top priorities in the health services. We want to ensure that mentally handicapped people have a satisfying environment, as far as possible in the general community, that they have education, stimulation and employment so as to develop and exercise all the skills they can acquire so that they can achieve their full potential in society. In developing services in this way we rely heavily on the experience and expertise of the existing staff, who can show what success their past efforts have brought in these directions.

I emphasise the importance of what was said—

The Question having been proposed after Ten o'clock and the debate having continued for half an hour, Mr. DEPUTY SPEAKER adjourned the House without Question put, pursuant to the Standing Order.

Adjourned at fourteen minutes to Twelve o'clock.