§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. MacGregor.]10.15 pm
§ Mr. John Morris (Aberavon)
; In my 20 years as a Member, no individual constituency case has caused me greater concern than that of Helenor Bye. Indeed. I have spent more time on it than on any other.
To underline my anxiety, I have tabled questions and tonight I am fortunate in having the opportunity to raise the matter on the Adjournment. It is because of the failure to obtain satisfaction on behalf of my constituents in other ways that I have had to go to this length.
It is no good the chairman of the local medical staff committee writing a hysterical letter to me. The implication that this is a political campaign leaves me baffled. I asked the area health authority as long ago as 17 July this year to set up a formal inquiry. It has not done so. I have asked the Secretary of State for Wales to set up a statutory inquiry, and he has not so far agreed.
My request about this case is not the only one. I have another constituent who also requests a statutory inquiry. I am sure that if he catches the eye of the Chair my hon. Friend the Member for Ogmore (Mr. Powell) will deal with his own anxiety. In these circumstances, whatever the differences between the complaints, however inevitable the patient's condition might have been, surely it is right to ask the Secretary of State for guidance. How many complaints where there is grave parental disquiet must there be before a section 84 inquiry is granted?
Incidentally, I have in no way opined on the medical aspects of the case. All I seek, to allay the anxiety and fears of the parents, is an independent inquiry. The AHA has not held one. Indeed, it took over two months—a delay for which it apologised—to reply to one of my letters. The Secretary of State cannot wash his hands of the affair.
As the former Minister, in addition to being the constituency Member, I have checked what has been recorded. Helenor died on 27 April 1978. In July 1978 Mr. Speaker and I saw the parents at our 1254 respective surgeries. Inquiries were made, and on 3 August my former officials summarised the position for me. On 7 August they emphasised to the Mid-Glamorgan area health authority my interest and the need for a speedy investigation On 27 September I inquired about progress, and a report was made to me on 3 October. Shortly before 26 October, a 24-page account of the events leading to Helenor's death was handed to me by the Byes at my surgery. On 27 October the Welsh Office sent it to the AHA for investigation. On 18 December another aspect of the Byes' complaint was discussed in my office. I am confident that I also inquired about progress generally.
On 7 March 1979 I had to write to Mrs. Bye in my capacity as Secretary of State and the constituency Member, explaining that it took a considerable time to investigate thoroughly such a lengthy list of complaints. On 19 March my office asked for expedition. The AHA sent the Welsh Office a copy of its reply to the Byes' solicitors regarding the 42 complaints in the Byes' 24-page document. I apparently saw that on 22 April, an election having been called in the meantime. That was six months to the day from the transmission of the complaints to where they rightly belonged, the area health authority.
On 26 June, by now an Opposition Member, an opportunity having been given me to peruse the replies. I asked the Secretary of State to set up an independent inquiry. The right hon. Gentleman rejected that request on 16 July. Since then there have been further requests and a question.
On 22 October, because another case had come to my surgery, I wrote to the Minister again asking for a section 84 inquiry. In that context I queried the number of complaints necessary for such an inquiry, knowing at the same time the anxieties of my hon. Friend the Member for Ogmore. By that time I had given up the area health authority. The Minister has returned part of the case to the area health authority and part to the family practitioners committee. The imagination boggles as to how long both bodies will take. Incidentally, the family practitioners' committee has not so far replied to the letter that I was enjoined to write by the Under-Secretary of State.
1255 There has been no inquest on Helenor's death over 19 months ago. I understand that the coroner does not wish to hold his inquest until the complaint by Mr. and Mrs. Bye has had an airing, if possible by the area health authority. That is what I was informed by the Byes' solicitor. The authority told me on 1 October that until both the inquest is held and the current exchange on Helenor's medical records to the independent medical expert appointed by Helenor's solicitor has been completed, it will be inappropriate to hold an inquiry. Leaving on one side the examination by the solicitor's experts, there is a stalemate. The coroner wants the area health authority to examine and the authority wants to have the inquest first.
The National Health Service Commissioner, although prepared to carry out a limited inquiry within his terms of reference, would prefer to await the results of the Byes' request for a section 84 inquiry. The Secretary of State in his letter of 16 July rejects an inquiry, for a number of reasons. One is that the AHA can set up an inquiry. Another is that the Health Commissioner can do likewise.
That is the tragedy that clouds the life of these loving parents. No amount of inquiries can repair their loss. It may be that Helenor's condition was incurable. However, we are left wondering whether there was a failure to recognise her complaint earlier and to make a start to ameliorate the position.
I am in no position to pass judgment. It is not my place so to do. I am aware of the care that is generally shown by hospitals and doctors throughout the land, and in the territory of the Mid-Glamorgan AHA especially. However, I regret the failure of the AHA to act in a more expeditious manner, its failure to reply promptly, its stalling tactics and, ultimately, the failure of the Secretary of State to grasp the nettle and to set up his own inquiry or grip the area health authority.
The authority is responsible to the right hon. Gentleman and is substantially appointed by the Welsh Office. He is answerable to the House for that nominated body. After 19 months, cannot these poor parents be put out of their misery and out of their anxiety by the setting up of an inquiry that will allay 1256 fears and ensure that we kill, belatedly, any increase in the loss of confidence in the area? I have put my argument in the most reasonable terms that I can.
§ Mr. Ray Powell (Ogmore)
I thank my right hon. and learned Friend the Member for Aberavon (Mr. Morris) for allowing me a few minutes briefly to tell the House of a case similar to the one that he detailed—
§ Mr. Deputy Speaker (Mr. Richard Crawshaw)
Order. We are dealing with a particular case on this Adjournment.
§ Mr. Powell
Yes, Mr. Deputy Speaker. The matter referred to is the death of Helenor Bye. I share my right hon. and learned Friend's concern, because in my own constituency of Ogmore a similar case to that of Helenor Bye has been highlighted.
§ Mr. Deputy Speaker
Order. Perhaps I can help the hon. Gentleman. If he has given notice to the Minister of another case, he will be in order.
§ The Under-Secretary of State for Wales (Mr. Wyn Roberts)
§ Mr. Powell
Thank you, Mr. Deputy Speaker. I have just sent a note to the Minister informing him of the matter that I wanted to raise, and I have previously discussed the matter with him.
The case that I want to highlight concerns the death of Deborah Girdlestone, who died on 19 October 1978, aged three years and three months. Her parents, Mr. Richard and Mrs. Susan Girdlestone, have until now not publicly disclosed their identity but feel that in the present circumstances I should disclose their names. They live at 13 Clebeland Close in Coychurch, Bridgend, which is in my constituency, as, indeed, is the Bridgend general hospital.
Briefly, the complaints and allegations were registered with the area health authority in October 1978, and the Girdle-stones received a reply in April 1979. All the relevant documents and 32 complaints went through the strict procedural channels, and when the Mid-Glamorgan area health authority replied it accepted only 1257 one complaint that it deemed needed rectifying.
My constituents decided to appeal, through their solicitor, to the Secretary of State for Wales, requesting that he exercise his powers under section 84 of the 1977 Act. He replied on 2 July 1979, refusing their appeal. They further appealed asking the Minister to review his decision, but he again refused. My right hon. and learned Friend has referred to Helenor Bye's case, in respect of which negotiations were taking place with the Secretary of State concurrently. The matter was then referred to the National Health Service Commissioner, but because of his restricted powers and the fact that he has no authority to investigate matters of clinical judgment, tonight's opportunity might help to resolve the complaints of my constituents.
I am not preparing a witch hunt against the medical staff of Bridgend hospital or against the area health authority—neither are my constituents prepared to conduct a witch hunt, as is blatantly obvious, because all along they have shown no desire for any publicity on this issue. I am sure that the House and the Minister will appreciate the compassion and understanding that these parents need. They lost a child of three years of age. They believe that they have justifiable reasons for complaint. They ask for a full and independent inquiry to investigate and report. If the Minister agrees to that, justice will not only be done but will be seen to be done.
§ The Under-Secretary of State for Wales (Mr. Wyn Roberts)
I am, of course, fully aware of the details of this very sad case. Although I realise that words can provide little consolation. I should like to express to Mr. and Mrs. Bye, constituents of the right hon. and learned Member for Aberavon (Mr. Morris), my most sincere sympathy in their continuing grief. The right hon. and learned Member has clearly been of great support to Mr. and Mrs. Bye in this distressing period, and I can appreciate the measure of his concern that the issues involved should be fully explored.
Any bereavement is, by its very nature, distressing, but it is no exaggeration to say that the death of a child touches us all much more deeply. I am sure that 1258 we all appreciate how hard it must be for those who have chosen the job of caring for sick children when a child in their care dies, but it is an unavoidable fact that very sick children taken into hospital may die there—in the same way as adults, similarly stricken, may die. The right hon. and learned Member will appreciate that the mere fact that a person dies whilst receiving treatment in hospital is not an indication of inefficiency or negligence on the part of the professional people involved. By the same token, neither can failure to diagnose a rare conditions be regarded in that way.
I would like to take this opportunity of expressing my full confidence in the Mid-Glamorgan area health authority, of which the hon. Member for Ogmore (Mr. Powell) is a member. I express my confidence in all those personally involved in the care of children at Bridgend hospital.
By the very nature of their work, doctors and nurses are particularly vulnerable to criticism. It is an understandable and natural reaction by the bereaved that they should seek a reason for their loss. Ministers must, however, consider the facts impartially and dispassionately. It is absolutely essential that the proper and objective procedures laid down for the handling of complaints against doctors, nurses and others employed in the Health Service are followed in all cases. It would otherwise be impossible for the staff concerned to carry on with their demanding work.
We all deplore wide-ranging allegations of negligence and inefficiency made on a slender basis. In this case, the criticisms of medical services in Porthcawl and at Bridgend general hospital are wide. I know from my personal contact with the chairman of the Mid-Glamorgan area health authority that he is most concerned by the many public allegations of inadequacy in his area. I, too, have taken a close personal interest in these matters and I met the chairman again today, for the fifth time in six months, to discuss a variety of issues, and today I talked to him about those now raised.
He was able to assure me that the inquiry conducted by officials of his authority had been carried out thoroughly and expeditiously, having regard to the large number of complaints made, each of which had to be examined carefully. 1259 I do not for one moment accept that there has been unreasonable delay, although I believe that there may have been some misunderstanding about the reply to a particular letter from the right hon. and learned Gentleman to the chairman, for which, as he acknowledged, the chairman has offered an explanation and an apology. The process is not yet complete. The medical consultant nominated by the complainants is still examining the medical records. The formal inquest has yet to be completed. These positive lines of action are still taking place.
The right hon. and learned Gentleman asked the health authority, in a letter dated 17 July, for an independent formal inquiry. The chairman replied on 20 July. He ended his letter by saying that if after the completion of these independent examinations there was still a demand for a formal inquiry, the authority would need to consider this. This was reiterated in a further letter dated 1 October. Thus, the authority has not closed the door on a further inquiry.
As the right hon. and learned Gentleman will recall, about six months after the death of their daughter on 27 April last year Mr. and Mrs. Bye handed him a detailed statement of their complaints in the form of a diary of events over a period of about nine or 10 months before her death.
Before any investigation could commence, it was necessary for the authority to whom that document was referred to analyse it in order to isolate what were eventually found to be 42 separate heads of complaint. The lengthy and, I stress, thorough investigations carried out by the health authority into those issues with which it was concerned of necessity took some time. The eventual response sent to Mr. and Mrs. Bye's solicitors in April this year consisted of detailed answers, point by point, to each complaint. I understand that that was within the knowledge of the right hon. and learned Gentleman when he was Secretary of State. I do not know whether at that time he found the period of six months a long period.
In addition, because it has been entirely open throughout in its handling of the case, the authority offered to provide any further information that might be 1260 of assistance to Mr. and Mrs. Bye. As soon as the solicitors provided the health authority with the name of a medical consultant, Helenor Bye's medical records were released to that nominated medical adviser.
Mr. and Mrs. Bye will obviously wish to consider, in the light of the advice that they receive following the study of those records, what further action they might take. They have been told on a number of occasions that there are several courses still open to them, such as reference to the National Health Service Commissioner or action through the courts. It must be borne in mind that the inquest adjourned by the coroner in April 1978 has not yet been resumed, having been deferred more recently at the request of the solicitors acting for Mr. and Mrs. Bye. The coroner's verdict will have a most important bearing on this case. However, it appears that Mr. and Mrs. Bye do not choose to consider these options. Instead, I understand that they have instructed the right hon. and learned Gentleman to press for an inquiry under section 84 of the National Health Service Act 1977. The conclusion of the Mid-Glamorgan area health authority, following extensive investigations, was thatall concerned had done everything within their knowledge and skills to treat Helenor".That is unacceptable to Mr. and Mrs. Bye.
The request to my right hon. Friend for an independent inquiry, made on their behalf in June by the right hon. and learned Gentleman, was carefully and thoroughly considered. My right hon. Friend concluded, on the basis of the information at present available to him, that he would not be justified in setting up such an inquiry. The right hon. and learned Gentleman pressed the case again in September and the whole matter was considered again most carefully. However, as I said in my letter to him of 15 October, in the absence of any new information we remained of the opinion that an inquiry would not be justified.
I must spend a moment or two on the question of the kinds of inquiry that might be instituted in this or any other ease. When a health authority investigates a complaint, it has the choice of a number of procedures. It may decide on an investigation conducted by officers.
1261 which is what Mid-Glamorgan did in this case. It may decide to appoint one or more members of the authority to make an investigation and report back. Alternatively, it may appoint an independent lawyer or other competent person from outside the hospital service to conduct or preside over a small committee independent of the authority and including a person or persons competent to advise on any professional or technical matter. Under both these latter procedures there is provision for parties to be present and to be heard if they wish.
I wish to stress that the choice of procedure is a matter for the authority and not for the Secretary of State. The complainants have been told that it is open to them to ask the authority for a different sort of inquiry, but, to the best of my knowledge, they have not done so.
As a lawyer and former Secretary of State for Wales, the right hon. and learned Member will know that a statutory inquiry under section 84 of the 1977 Act is quite different.
§ Mr. John Morris
Surely the hon. Gentleman is not saying that there has been no request for an inquiry to the area health authority. I have made such a request on a number of occasions.
§ Mr. Roberts
It is my understanding that there has been no request to the authority for a different sort of inquiry.
§ Mr. Roberts
I think that the right hon. and learned Gentleman is confusing his actions—which I have covered—and the actions of the parents, acting through their solicitors. I am referring specifically to a request from the parents via their solicitors. I have seen the letters to which the right hon. and learned Gentleman has referred and they are not specific in terms of the sort of inquiry requested.
It was open to the right hon. and learned Gentleman to direct that an inquiry under the 1977 Act be set up when the complaint by Mr. and Mrs. Bye came to him, as Secretary of State. He did not do so and, on the basis of presented facts, I feel sure that he was right. The facts have not changed. On the basis of evidence before us there is, in my 1262 opinion, no justification for invoking this ultimate power of the Secretary of State.
There was not a single section 84 inquiry during the term of office of the right hon. and learned Gentleman. Since the National Health Service was started in 1948, there has been only one such inquiry in Wales—the Ely hospital inquiry We learnt a great deal from that inquiry. We learnt that the procedure is costly, complex and time-consuming. We learnt that among the hazards of such an inquiry are the damage to staff morale, the loss of confidence by the community in the hospital as a whole, and the adverse effect on departments in the hospital not actually concerned with the inquiry. The committee recorded in its report some of its misgivings about the use of such an inquiry.
I am not saying that section 84 should never be used, but it must remain as a measure of last resort and it should be invoked only if the Secretary of State is very sure that the end does justify the means.
There is nothing inconsistent—as the right hon. and learned Member knows—in having the utmost sympathy with a complainant whilst, at the same time, not agreeing to the action that he seeks. I can only hope that with the passage of time the right hon. and learned Gentleman's constituents can bring themselves to accept this.
In response to the hon. Member for Ogmore, I should say that the complaint relating to Deborah Louise, the three-year-old daughter of Mr. and Mrs. Girdlestone, to whom I also extend my sympathy, was orginally made to the Welsh Office just over a year ago. The action taken—and it was taken quickly—was to ask the Mid-Glamorgan area health authority to investigate the complaint urgently and to respond directly to the complainant. I believe that that was the right thing to do.
Health authorities are responsible for the provision of services and for the investigation of complaints. The complainant was told and was also advised that if he was not satisfied with the way in which the authority handled the complaint he could ask the Health Service Commisioner to investigate.
The investigation and response of the authority was complicated by certain 1263 factors, including the threat of legal action. It would not be proper for me to comment, because the case may yet be examined by the National Health Service Commissioner and it is also open to the complainant to seek a remedy in the courts, but a full and reasoned response was sent to the complainant's solicitor by the authority on 12 April 1979.
The conclusion of the officers who made the investigation was that there had been no negligence and that all concerned did everything within their knowledge and skills to treat the little girl. She was very ill and, sadly, she died.
1264 That was a tragedy. The grief of parents at the suffering and death of a child must have the sympathy of every feeling person, but doctors and nurses are not omnipotent. Despite all their efforts, some children do die. It does not follow that somebody was to blame—
§ 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 fifteen minutes to Eleven o'clock.