HC Deb 06 November 1978 vol 957 cc481-3
3. Mr. Stanbrook

asked the Secretary of State for Wales what action he has taken following the adverse criticism made of the Clwyd area health authority by the Parliamentary Commissioner for Administration in the case of Mrs. Hughes; and with what result.

The Secretary of State for Wales (Mr. John Morris)

On receipt of the Health Service Commissioner's report, I called for the then chairman of Clwyd health authority and told him of my serious concern. Since then the authority has given further guidance to junior doctors about the admission of elderly patients and it has reviewed and improved its information system and complaints procedures. All health authorities in Wales have reviewed their admission arrangements, particularly in relation to the elderly.

Mr. Stanbrook

Is the Secretary of State aware that his hon. Friend gave me an assurance earlier this year that there would be no cover-up in this case? Is he aware that the area health authority's private committee of inquiry did not take evidence from Mrs. Hughes' general practitioner? Is he aware that they considered only a letter from the hospital doctor responsible for the decision to send her home? Is he further aware that the Select Committee on the Health Service Commissioner has vindicated him and his report, which used words such as "inhuman", "a shocking case", and "misleading" and "deplorable" attitudes on the part of the area health authority? Can the position be allowed to remain there? Is it not time to set up an independent and proper committee of inquiry?

Mr. Morris

This matter, the circumstances of which caused me very great concern, has now been thoroughly investigated by the Health Service Commissioner. His report has been endorsed and vindicated by the Select Committee. It has been investigated by the area health authority. I sent for the chairman and told him of my dismay and told him to ensure that the procedures were reformed to ensure as best as one could that this situation should not recur. I have here the recommendation sent to junior doctors and others who might be responsible for decisions. We have sought to ensure all over Wales that the procedures and lessons of this extremely unhappy incident have been learnt and that it will not be repeated.

I can see no reason for continuing further with any other investigation which will reveal no new facts.

Sir A. Meyer

Is the Secretary of State aware that, in spite of these unfortunate incidents, the Royal Alexandra hospital continues to command the loyalty and devotion of a great many people in the Rhyl area?

Mr. Morris

I am grateful to the hon. Member. This was a highly regrettable and, I hope, unique incident. It is important now to reassure the public that the procedures are such that the chances of such a thing happening are minimised to the utmost. Instructions have gone out to achieve that. That in no way detracts, however, from my serious concern and my expressions of deep dismay which I made to the chairman for whom I sent on that occasion.

Mr. Hooson

Was the Ombudsman's criticism of the area health authority or of the clinical judgment of a relatively junior doctor? If it was the latter, were there any other examples of wrong judgment of this kind? Has the right hon. and learned Gentleman considered the position of the doctor concerned—whether he has ever had the chance to vindicate his clinical judgment?

Mr. Morris

I am sure that the hon. and learned Member will want to refresh his mind on the matters canvassed in the Health Commissioner's report. There were criticisms which I would have thought went beyond the matter of clinical judgment. It was a matter of common sense and humanity, of sending out an old lady aged 103 in the early hours of the morning. Whether one considers that strictly to be a matter of clinical judgment or of something much more, I should have thought that the procedure should be such that elderly people of that age are not sent home in the early hours of the morning without proper procedures and without consultation with the general practitioner, and with account taken of the availability of other resources in the hospital. All that has been done.