§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Tinn.]
§ 12.13 a.m.
§ Mr. Neil Macfarlane (Sutton and Cheam)
I have to tell the House that I do not approach the subject of this debate with any great relish. Unfortunately, I have no alternative but to raise this important subject because reputations are at stake and all levels of the media have produced many columns on the sentence passed at the Old Bailey, two or three weeks ago, on Mrs. Mitchell, who was the senior medical social worker at the Royal Marsden Hospital, in Sutton. In particular, about three weeks ago, there was an article in The Sunday Times by John Ball which drew attention to the serious problems surrounding this conviction.
I wish to trace the background for about 12 or 15 minutes, after which my hon. Friend the Member for St. Marylebone (Mr. Baker) hopes to catch your eye, Mr. Deputy Speaker for two or three minutes.
The Royal Marsden Cancer Hospital has a world-wide reputation and we in Sutton are proud of its massive contribution to cancer research and care. Since the trial there has been widespread anxiety and accusations about the way in which Mrs. Mitchell, who, history shows, defrauded dying patients and their relatives of £38,000 over a period of less than two years, came to be employed in the first place, when it was shown at the trial that she had previous convictions for identical offences in National Health Service hospitals—the Royal Free and the City of London Maternity Home—in the early part of this decade.
I think it can be seen that when Mrs. Mitchell was employed in April 1974 the 848 Royal Marsden committee was not rigorous enough in checking her credentials and references, because this "evil and ghoulish woman", as the judge referred to her at her trial, had told the committee that she had a degree in sociology from Leeds University, among other things. That was palpably not the truth. In April 1974, as the House will be aware, all social workers were transferred to the employing local authority. In this case the Royal Borough of Kensington and Chelsea was the employing authority, because the headquarters of the Royal Marsden group, as the Minister knows, is located there.
From then on this unhappy saga takes a different and more worrying route, and it is this that I want to consider for a few moments. If the Minister cannot acknowledge all the points that I make tonight, perhaps he can indulge in some correspondence with me and my hon. Friend the Member for St. Marylebone, because we must get to the bottom of some of the problems facing everybody involved in this case.
If firm action had been taken three years ago my constituents and others would not have been the unsuspecting victims of this wretched woman. It was evident as far back as May 1975 that Mrs. Mitchell was using her personal account to pay bills for patients convalescing at private nursing homes. One such home in my constituency is run by Councillor Stuart Walker, who, throughout the latter part of 1974 and the early part of 1975, had had a number of telephone conversations with the Royal Borough of Kensington, with a Miss Withrington, expressing his concern at what I have just said, which was that those accounts were being paid through Mrs. Mitchell's private account.
Eventually, on 5th May, in exasperation, Councillor Walker wrote to Miss Withrington at the health offices of the Kensington and Chelsea social services department, pointing out his anxiety not only that bills were late in being settled but that when they were it was from Mrs. 849 Mitchell's private account. Incredibly, Councillor Walker did not receive from the department an acknowledgement of that letter; instead, he received a dismissive letter from Mrs. Mitchell herself, and one can only conclude that the letters, of a highly confidential nature, that Councillor Walker wrote were passed on by the department at Kensington and Chelsea to Mrs. Mitchell in her office at the Royal Marsden Hospital.
So, on 20th May 1975, Councillor Walker wrote again, asking for a reply and he received one from a Mr. W. B. Utting, who was then director of social services at the Royal Borough and is now, I understand, director and chief social work officer at the Department of Health and Social Security. Mr. Utting replied to Councillor Walker saying, amongst other things, in paragraph 2 of his communication:It is the current policy of the Social Services Department that no member of staff should use their own bank account in relation to the financial affairs of a client. The social workers at Marsden Hospital are now fully aware of this.Councillor Walker, hardly surprisingly, was dissatisfied with that reply, because of the many telephone conversations that he had had over the preceding six months—between September 1974 and March 1975—before he resorted to writing letters, so he replied, on 29th May:I note, however, that your comments refer to the current policy of the Social Security Department and my discussion with Miss Withrington some three months ago also referred to the practice adopted between September, 1974 and February, 1975 and I feel that at least some explanation should be provided regarding the matters which I raised.I look forward to hearing from you.A few days later he received another letter from Mrs. Mitchell. Not surprisingly, he was angry that his letters were being sent to her by someone in that department.
Councillor Walker did not receive a reply from Mr. Utting, and so on 30th June he wrote again. This time he was more fortunate in terms of the reply, but the contents of the letter must be viewed with some anxiety, because it said:
§ "Dear Mr. Walker,
§ …At your request I am writing to confirm that the financial transactions made on behalf of certain patients of the Marsden Hospital and subsequently of Chegworth 850 Nursing Home, have been thoroughly and professionally examined. This shows that all monies which were donated from various sources over a period of about six months were all properly forwarded and correctly accounted for.
§ Yours sincerely,
§ W. B. Utting.
§ Director of Social Services."
§ That was on 7th July.
§ This correspondence is very important, and I shall see that the Minister and his Department have copies of all the letters if they require them. There are other letters from which I do not have time to read. I have them all, not only from Councillor Walker but from others involved.
§ While all this was going on, the problems of the spring and summer of 1975 were compounded by an Ombudsman's report, published on 28th October 1975. Such reports take from at least four months to six months to prepare. The investigation must have begun some time in March 1975. It resulted from a complaint by a Mrs. Hunt, a constituent of my hon. Friend the Member for St. Marylebone, who had staying with her a young French girl who, sadly, subsequently died. The girl, Mlle Francoise Gagnot required treatment at the Royal Marsden Hospital. The French social security authorities sent her a cheque for £470. The report of the Ombudsman, Sir Alan Mane goes fully into the protracted and sickening events, which demonstrate that this money, too, found its way into Mrs. Mitchell's hands. Neither the late Mlle Gagnot nor Mrs. Hunt could get the money back without an acrimonious struggle, which went on for about three months.
If they have not already read the report, I urge the Minister and his right hon. Friend the Secretary of State to do so. In paragraph 17 Sir Alan stated his conclusion:
I find Mrs. Hunt's complaint about the handling of Miss Gagnot's money and the subsequent investigation by the hospital fully justified. I consider that the treasurer, when he received her letter of 14th March made insufficient enquiries into the case and both he and the house governor were far to ready to believe Mrs. Mitchell's version of events and to think that as the money had been repaid, after an interval of seven weeks, the whole affair should be regarded as closed. The treasurer's letters to Mrs. Hunt were offhand, gave no explanation of what had happened and gave the impression that he regarded the incident as trivial and
insignificant. For my part I think any suggestion of financial irregularity should result in an urgent investigation into the handling of funds by the member of the staff concerned.
§ This sets some of the background of the sickening events that occurred throughout 1975. At the time that the investigation was going on it was well known to the authorities of the Royal Borough of Kensington and Chelsea that all was not well at the Royal Marsden Hospital in this sphere. It had known that there were other cases. It must have known that it was high time somebody sat in that office and got to the bottom of precisely what was going on. In my opinion, nobody did.
§ I want to ask the Minister four or five questions. If he does not have time to answer them all tonight, I ask him to write to me and my hon. Friend and to the Shadow Minister for Social Services, my right hon. Friend the Member for Wanstead and Woodford (Mr. Jenkin). I must warn him that the case cannot rest here.
§ First, will the hon. Gentleman guarantee that this infernal woman, Mrs. Mitchell, now in Holloway Prison, never again works in a position of authority in the health and social services? What guarantees can he give that he will acquaint all area health authorities with this woman's record when she comes out of prison? She has records going back as far as 1970. She was under suspended sentence and on probation, and nobody transmitted that information to any of the hospital authorities at the time.
§ Secondly, will the hon. Gentleman announce what steps he can take to improve vetting procedures for people working in this sensitive area of hospital work, which is an area of trust? The Royal Marsden Hospital prides itself on operating a trustworthy social services office, a matter which is of critical importance when one is dealing with terminal patients. The integrity and devotion of hospital workers are known to everyone, but this episode was disastrous. Had it not been for brilliant police work by Detective Sergeant Williams and Detective Constable Clark at Wallington Police Station it might be going on even now.
§ Thirdly, how will defrauded patients' relatives be reimbursed? The Minister must take care on this, because a letter 852 from his Department conflicts with the reply that he gave to a Written Question of mine on 31st January. He may want time to reflect further. I shall show him the correspondence that has come into my hands, because it is of critical importance.
§ I urge the Minister to hold an inquiry, endorsing the requests made by my right hon. Friend the Member for Wanstead and Woodford and my hon. Friend the Member for St. Marylebone who is hoping to catch your eye shortly, Mr. Deputy Speaker, because reputations are at stake.
§ In this context, I must ask why there was such delay before the director of social services for the Royal Borough of Kensington and Chelsea took action.
§ There have been allegations of a cover-up. My judgment is that there is a cover-up. It must be gone into very thoroughly. I ask the Minister to urge on the Secretary of State the need for a public inquiry. The Minister must allay the mood of distrust which is growing fast and may well develop and thus affect a vital and integral part of hospital life in a very sensitive area. Phrases like "tip of the iceberg" are occurring in local newspapers, and statements are being made by people who worked in this area. These fears must be allayed.
§ I wonder why neither Mr. Utting nor Miss Withington went to the Royal Marsden after Councillor Walker had written in May and the Ombudsman had investigated.
§ I have a file of documents which in my opinion highlight the bureaucratic indifference and negligence which occurred throughout this squalid business. Everyone who sat through the trial will think that this is an understatement in dealing with Mrs. Mitchell, this callous and treacherous woman.
§ I shall leave a moment for my hon. Friend the Member for St. Marylebone to make a request about this matter, which began with Mrs. Hunt, one of his constituents.
§ 12.27 a.m.
§ Mr. Kenneth Baker (St. Marylebone)
I am grateful to my hon. Friend the Member for Sutton and Cheam (Mr. Macfarlane) for allowing me a moment, and I congratulate him on raising this matter.
853 This is a deplorable case. Sick and dying people—people dying of cancer—were defrauded over months and years of considerable sums by a convicted criminal who happened to be a social worker. The sums were not trivial. They amounted to £30,000. It is disturbing that this ever occurred, and particularly that it involved someone who had two previous convictions.
The case came to me very indirectly because a constituent took up a case with the health Ombudsman, who can be approached by any citizen without going through a Member of Parliament. Only after she got the report from the Ombudsman and approached the Secretary of State's predecessor, the right hon. Member for Blackburn (Mrs. Castle) and was dissatisfied with her reply, did my constituent approach me and I became involved in the case. I was not then able to pursue it because police inquiries then started.
Mrs. Mitchell, this social worker, employed by Kensington and Chelsea Council but working in the Royal Marsden, was investigated by the Ombudsman in 1975. As a result of the inquiry, the conduct of certain members of the staff of the Marsden Hospital was criticised by the Ombudsman, but there was no attempt by him to follow up his criticism. That is a major point of principle that I wish to raise.
We do not know what cases the Ombudsman is taking up with our constituents. He can only report to the constituent and to the Health Minister. If the constituent is not a doughty person who will follow through the question and demand satisfaction, the matter usually runs into the sand. As a point of principle, the powers of the health Ombudsman should be extended to allow some powers of follow-up.
The second point of principle is that here was a social worker who had two previous convictions for cheating patients but no one seemed to know. Kensington did not know; the Royal Marsden did not know. The Department did not seem to know about it. This woman was employed in a position of trust, handling patients' money. The safety nets against a situation like this did not operate.
Only because I had a constituent who was awkward and said she was not satis- 854 fied with the replies did this case come to light, resulting in the police being called in.
I ask the Minister to answer certain specific questions arising out of the report of the Ombudsman. Did the Department know that Mrs. Mitchell had a criminal record? I have reason to believe that it did. If the Department knew, did it tell the Ombudsman? If the Ombudsman knew, did he pass that information on to the Royal Marsden, or was he not asked to pass it on?
It is clear that the Royal Marsden had no idea of the previous criminal record of Mrs. Mitchell, yet it should have been made aware of it if the Department and the Ombudsman knew. I hope that the hon. Gentleman will be able to answer these questions. I do not know whether he will be able or willing to, but I have asked, together with my right hon. Friend the Member for Wanstead and Woodford (Mr. Jenkin) and my hon. Friend the Member for Sutton and Cheam for a full independent inquiry. My hon. Friend and I will not be satisfied if the Minister says "I will set up a departmental inquiry." Something rather more than that is needed. After all, it was the silence or inaction or indifference of the Department that really led to the previous record of Mrs. Mitchell not appearing.
This case has caused deep public anxiety. How can any of us know whether there are not more Mrs. Mitchell, acting and operating in the way that she did, in other hospitals? The hon. Gentleman cannot know. The Ombudsman cannot know. The hospitals may not know. I hope that the Minister will agree to this reasonable request for a full and public inquiry. I ask him to be forthcoming on that tonight.
I stress the two points of principle. First, we have to look at the follow-up powers of the Ombudsman. Secondly, has the Minister any ideas about the need for a register of social workers, containing information that will allow the employing authorities to know about the previous activities of anyone they may employ?
§ 12.32 a.m.
§ The Minister of State, Department of Health and Social Security (Mr. Roland Moyle)
I can understand why the hon. Member for Sutton and Cheam (Mr. Macfarlane) felt that he had to raise this 855 issue. He put his points clearly. First, we should study the facts of the situation.
Mrs. Mitchell was a social worker employed in the social services department of the Royal Borough of Kensington and Chelsea, but she worked in the Sutton branch of the Royal Marsden Hospital. She was found guilty on 15 charges relating to offences between April 1974 and the early months of 1976, when she was dismissed from her employment. Some of the charges—which were described in court as sample ones—involved falsely obtaining money from the relatives of Royal Marsden patients, on the promise of obtaining private nursing care for the patients after their discharge from the hospital. She was sentenced to six years' imprisonment.
I have already expressed my deep regret to those who have suffered loss and distress as a result of Mrs. Mitchell's criminal action. It is deplorable and tragic that anyone should abuse a position of trust and care in this way, and all the more so in this case, since many patients discharged from the Royal Marsden into nursing homes are seriously ill. It is particularly terrible that they or their relatives should be victims of fraud in such circumstances.
Mrs. Mitchell's history is very complicated, and I have not yet been able to compile all the details, but the information so far available to me shows that she was first employed in the National Health Service, under a different name, in 1967 and 1968 with the North London Hospital Group, and sometime in 1968 she was declared bankrupt. In 1970, she was convicted of fraud in relation to her employment at North London and received an 18 months' suspended sentence. During 1971 and the first half of 1972 she was employed at New Cross Hospital, Wolverhampton, and then briefly at the Queen Elizabeth Hospital, Birmingham. She was dismissed from the latter employment because of her unsatisfactory methods of handling patients' money.
Between September 1972 and September 1973 Mrs. Mitchell worked, again as a social worker, at the Royal Free Hospital, and in March 1974 she was employed as a social worker at the Sutton branch of the Royal Marsden Hospital. She remained in that work until her suspension in April 1976 and dismissal in May. But since, as the hon. Gentleman will need no reminding, hospital social 856 workers were transferred to the local authority social service departments on 1st April 1974, Mrs. Mitchell became an employee of the Royal Borough of Kensington and Chelsea from that date. During the period of her employment by the borough she was convicted of fraud and put on probation. She succeeded in concealing this conviction both from her employers and from the Royal Marsden Hospital.
In 1975 the Health Service Commissioner investigated a complaint about the Royal Marsden by a friend of a patient for whom Mrs. Mitchell had undertaken to cash a cheque but who found considerable difficulty in getting her money. In October 1975 the Commissioner made a report which criticised the hospital's handling of the matter. A copy of this report was sent to the Royal Borough of Kensington and Chelsea, as Mrs. Mitchell's employer. The borough held a disciplinary hearing at which she was reprimanded. It was not of course aware of her history; neither, at that time, was the Royal Marsden.
In March 1976 the hospital received a further complaint about Mrs. Mitchell's handling of money. This led it, after consultation with the borough, to call in the police, and led the borough to suspend and subsequently dismiss Mrs. Mitchell. Police inquiries led to 19 charges, to 15 of which Mrs. Mitchell pleaded guilty and on which she was convicted.
This unhappy sequence of events clearly poses some important questions, which have been rightly pointed out this evening.
I shall first deal with the important issue of compensation. Hon. Gentlemen have expressed concern, which I entirely share, that the victims of Mrs. Mitchell's depredation should receive compensation as soon as possible, particularly as they have had to wait a considerable period while the case was sub judice. I understand that the precise legal liability in this affair may take some time to sort out. However, I am glad to be able to inform the House that arrangements have been made for claims to be examined and paid, so far as they are accepted, without waiting for the legal discussions to be concluded. I understand that the hospital has already written to claimants asking them to submit up-to-date claims.
857 However, I ought in fairness to make two points. First, I understand that a number of Mrs. Mitchell's misdemeanours, including some of those of which she was convicted, were not attributable to her employment in the health and personal social services. Clearly, the public services cannot underwrite these. Secondly, a little time will be needed to examine the claims. Payment will be made with all possible speed but it cannot happen in the immediate future. This may seem strange in view of the time which had elapsed since the offences were committed but some of the facts and figures that came to light during the trial different from those previously available to the authorities.
Returning to the main question, the first issue is how Mrs. Mitchell came to be employed by the Royal Marsden, given her history. The normal procedure is to take up references, prior to the appointment or before confirming it. Unfortunately, the Royal Marsden omitted to do this and did not do so until nearly 18 months later, after the Health Service Commissioner had begun his investigation. When they were taken up, the references proved satisfactory, as also were those taken up by the borough early in 1975 before it promoted Mrs. Mitchell to senior social worker.
It has been asked whether the Department knew at any stage of Mrs. Mitchell's previous activities and convictions, and whether it passed on any information which it had to the authorities or to the Health Service Commissioner. It has also been suggested that an independent inquiry should be established to look, in particular, at this aspect of the problem. In 1974, when the Royal Marsden first employed Mrs. Mitchell, the Department did have some evidence suggesting that she had previously committed a misdemeanour. Efforts were made to ascertain its nature, but without success. In consequence, nothing was said to the hospital.
I have not yet been able to satisfy myself as to the adequacy of the efforts made, but I am sure the House would agree that it would have been considered improper to pass on unsubstantiated suspicions. I can also tell the House that the Health Service Commissioner made 858 certain inquiries of the Department in 1975, and I shall look into this.
§ Mr. Macfarlane
Does the Minister not agree, therefore, that this makes it even more essential that there should be a public inquiry?
§ Mr. Moyle
I am looking into the matter to see whether we should take these things further.
I have asked my officials to prepare for me urgently a full account of the case, including not only all necessary information from the health and local authorities concerned but details of the information that was available to the Department at the various stages, the action that was taken, and whether this conformed with normal practice in such cases. I shall write to those hon. Gentleman who have raised the matter and let me know what conclusions I have reached, including whether or not I consider that an independent inquiry would sufficiently add to our knowledge.
That matter is still open. Of course time and cost are also involved in a decision of that sort. I can assure the hon. Gentleman that I shall go into the matter very thoroughly, and that I fully accept that we must draw all the lessons that we can from the case. There will be no cover-up.
I shall deal in a moment with one specific preventive measure which has been suggested, but I should like to make a general point first. In Mrs. Mitchell it is now clear that successive health authorities and the Royal Borough were dealing with a practised and persuasive criminal, adept at manipulating other people's financial affairs to her own profit and evading such inquiries as were made. No post of responsibility can be the subject of constant and complete supervision, and no system of checks can be entirely foolproof, but it is clearly of the greatest importance that we do all we possibly can to ensure that people such as Mrs. Mitchell are prevented from being able to worm their way into responsible positions by subterfuge.
I can assure hon. Members that I shall consider, after consultation with all the authorities concerned, what advice the Department can give, in the light of this case, to strengthen appointments procedures.
859 The hon. Member for St. Marylebone (Mr. Baker) suggested that this kind of episode might have been avoided if there were a register of social workers akin to the medical or dental registers. Unfortunately, the issue is not so clear as that. Only a proportion of the social workers at the moment held any formal qualifications of a kind on which such a register would presumably be based. I think it is about 40 per cent.
It is the Department's policy and the wish of the social work profession and 860 local authorities, that the already growing proportion of properly trained social workers should increase still further and that in due course—
§ The Question having been proposed after Ten o'clock on Thursday evening 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 seventeen minutes to One o'clock.