Burnley Health Care Trust (Hansard, 28 November 1994)

§ Mr. Peter L. Pike (Burnley)
I want to refer to the problems experienced in the Burnley national health service trust. That trust serves not only Burnley but Pendle and parts of the borough of Rossendale.
In the past few months, major problems have arisen in the trust. It is clear that those problems will become all too common in other trusts because they have been caused by the NHS reforms forced through by the Government. Because of the introduction of the concepts of market forces and the purchaser-provider role to the health service and the fact that the NHS is now judged according to financial criteria as opposed to the quality of service offered and various statistics—all too often the wrong ones—what has happened to the Burnley health care trust will be repeated in many other trusts.
I want to make it clear that the problems experienced by the trust have nothing to do with its staff, who, despite those problems, have got on with their work and provided a first-class service to the people served by that trust. In September, I was an in-patient at the hospital, so I can speak from experience about the standard of service offered and the dedication of the trust staff.
The call for a debate on the problems of the trust has not only come from me and my hon. Friends the Members for Pendle (Mr. Prentice) and for Rossendale and Darwen (Ms Anderson), but has been loudly echoed by the people served by that trust. They believe that the problems encountered need to debated in the House, because they want answers to many of the questions that we have been asking on their behalf for some time. Indeed, on the day that it was announced that I had been fortunate enough to secure this Adjournment debate, 18 November, the Burnley Express and News said: At last, we might get some answers to the questions surrounding the current shenanigans at Burnley Health Care Trust. By securing a parliamentary debate on the management of the trust, there's just a chance that the people of this borough will get some answers. We don't want to know for political gain. We don't want to score political points. We just feel we have a right to know what's been paid out and for what reason? The central characters are not beyond reproach—they are accountable to us all and we have a democratic right to be given the facts, figures and reasons behind this whole sorry saga. In the same newspaper, the chairman of the East Lancashire health authority was quoted as saying, at a meeting held that week, that there was an urgent need for a new style of management at Burnley with the emphasis on co-operation not confrontation. The Minister must have seen the many headlines and quotations of the papers in the past few weeks, and I shall refer to a few of them. One was in the Lancashire Evening Telegraph of Tuesday 25 October: Scapegoat: 'Health chairman asked me to resign to save his own neck.' The chairman and chief executive of the troubled Burnley Health Care Trust each called for the other's resignation today in an astonishing bust-up. 1052 On 4 November, the Burnley Express and News said: Consultants at Burnley General Hospital yesterday welcomed the resignation of their colleague Dr Sam Pickens as medical director—but said they hadn't won a victory. That is under the heading: Medical director quits board job. As recently as Friday 25 November, the Lancashire Evening Telegraph said: Health boss No 3 resigns. Pay-out probe urged as Chairman Rawson follows Aikman and Pickens. That type of thing has been going on for many weeks and we need the answers to those questions.
On 15 September, I heard on Radio Lancashire that Mr. Ian Mahady had been made redundant. Radio Lancashire telephoned me for an interview about that, and I said that I had no information, other than what I had heard on the radio. However, I said that I was very anxious about what I had heard on the radio, because Mr. Mahady had been given three hours' notice to clear his desk and leave the hospital, after which he might not enter the hospital again.
Whether he should have been made redundant or not, that was an appalling way to behave towards Mr. Mahady. I know that he is pursuing his appeal, and that he had the right of appeal. That appeal is being dealt with, and the British Medical Association is representing him in that respect. Nevertheless, that behaviour shows the false way in which those matters have been handled.
The BMA issued a statement on 15 September, saying: This is the first compulsory consultant redundancy in the North West Region to take place directly as a result of the internal market, and the British Medical Association, which is representing Mr. Mahady, is very concerned at the implications for consultants in future. The BMA will be appealing against the decision on the grounds of failure on the part of the Trust—which admits to having no procedures to deal with staff redundancies". I find it incredible that a trust employing such a large number of people has no procedure to deal with such matters.
On 19 September, 21 consultants sent a letter to the chairman of the health care trust, Mr. Rawson, which said: We can find no justification for the removal of Mr. Mahady at such short notice and cannot see any reason why he should not have been allowed to continue with the care of his patients for the three months of his 'notice', irrespective of any arguments regarding the redundancy. That is the type of argument that many constituents have raised with me and my two hon. Friends who are here for the debate.
On 27 September, I attended a public meeting of the Burnley, Pendle and Rossendale community health council, at Rawtenstall, and during that meeting I mentioned the situation there. I spoke to the chairman and the chief executive of the trust, who were present at the meeting. I was given a copy of a press statement, which said that, earlier that day, two leading consultants, a Mr. Robert Atlay and Dr. David Warrell, had been appointed by the trust to inquire into the situation at the unit, and that that had been with the approval of the North West regional health authority.
1053 I made it clear that, in my opinion, we needed an independent inquiry. Any body that acts in a way that is criticised is certainly incapable of appointing another body to conduct an inquiry into its actions.
I then wrote to the Secretary of State, asking her to appoint an independent inquiry to look at the way in which this has been handled by the Trust …the functioning and working of, that unit and …the way in which all staffing matters are dealt with at Burnley General Hospital. In a reply dated 18 October, the Minister who will reply tonight stated that this was an entirely local matter between the Trust and one of its employees. He wrote to me again on 27 October, saying that Mr. Mahady was exercising his right of appeal". I accept that, and do not wish to become involved in any specific appeal; but the Minister also said: Individual Trusts are, of course, responsible for making their own staffing arrangements, having due regard to employment legislation and ensuring that the health needs of their local community are met in the best possible way. On 7 October, the trust issued another statement saying that it had "every confidence" in Dr. Pickens, and that it was a credit to him that over the past year he has been fulfilling the dual role of Consultant Physician with a full clinical workload and that of Medical Director. On 12 October, at their request, I met the chairman and chief executive—Mr. Rawson and Mrs. Aikman—privately. At that meeting, I was assured that Mrs. Aikman had the full backing of both the chairman and the board; they were confident that, at any appeal or tribunal resulting from Mr. Mahady's redundancy or dismissal, their position would be supported. Yet on 24 October, Mr. Rawson asked Mrs. Aikman to resign. The following day she asked him to resign. At the end of the week, she resigned.
At that meeting, Mr. Rawson gave me a copy of a letter that he had sent to one of my constituents, who has written to me about the same issue. The letter said: These reports have not altogether reflected the full facts of the situation and have led to considerable concern within the local community. With this in mind I have invited two …independent clinicians to review the circumstances and facilitate a resolution to the situation. I intend to make both public and to act on their recommendations". When will the report of that inquiry be available? Will the recommendations still be implemented when it is finally published?
I must tell the Minister that the overwhelming view—my view, that of my constituents and that of my hon. Friends the Members for Pendle and for Rossendale and Darwen—is that the matter will not be resolved until an independent inquiry takes place. What has been done so far has not resolved the position at all. On 1 November I wrote to the Secretary of State again, asking for such an inquiry and forwarding a petition with 7,000 signatures calling for Mr. Mahady's reinstatement. I wrote: The Trust is clearly in crisis and you have the responsibility and power to act and you should do so now in the interests of the N.H.S. and patient care. 1054 I wrote to the Secretary of State again on 4 November, saying: It now appears Mrs. Aikman has been paid over £250,000 to go on condition of silence. We have a right to know what that payment was.
It was also rumoured that, if Dr. Sam Pickens had left as both consultant and medical director, he would have asked for £1 million. I know that he did not get that in the end, because he continued as a consultant. If no payment was made to him, we have a right to know.
In a letter dated 10 November, the Minister said: The responsibility for any settlement lies ultimately with the Trust chairman who is personally accountable for a termination payment to the chief executive. If the chairman, who resigned last Friday, is found to have paid out a sum in excess of what he should have done, who will meet that amount? The cash payment has been made and it has implications for the pension and other matters. We have a right to know that.
On 1 November, I wrote to Mr. Rawson to ask how much the chief executive had been paid to go and on what terms. I said that the public had a right to know. I asked him why, when we met on 12 October, he said that it was clear that she had the full backing of the board. If that is so, what changed? Was what I was told on 12 October true?
On Friday of last week, Mr. Rawson finally went. An acting chief executive is now in place. Up until today, an acting chairman was in place but there is no medical director. Today, the Minister announced the appointment of a new chairman—Dr. James Archer. Obviously, I hope that he is able to overcome the problems. He said that his role was to end uncertainty and to heal any remaining wounds. I hope that he succeeds in that objective, which will be a hard task. People want answers to the questions that I have put.
Yet again, there has been a change in the chief executive. A few weeks ago, after the chief executive Mrs. Aikman went, Mr. David Meakin, a financial officer, was appointed to fill her position in an acting capacity. This morning, David Chew was appointed. He is an employee not of the trust but of East Lancashire health authority. It is strange that he has been switched from one job to another.
It is known that Mr. David Meakin was strongly opposed to any merger with the Blackburn, Hyndburn and Ribble Valley Health Care NHS trust. Mr. Chew, however, has been heavily involved in planning for federation. I, the press and the public are opposed to any merger or federation. I hope that the Minister will assure us that Mr. Chew's appointment does not mean that there is to be a merger between Burnley Health Care NHS trust and the Blackburn, Hyndburn and Ribble Valley trust, which is what the press is saying. That will not be acceptable. We must ensure that there is a lot of consultation before any federation takes place.
I hope that the Minister will respond to those points and assure us that problems will not be allowed to arise. I know that my hon. Friend the Member for Pendle wants to say a few words on these important matters.

§ Mr. Gordon Prentice (Pendle)
I shall be brief. I share the concerns of my hon. Friend the Member for Burnley (Mr. Pike). The annual report of the NHS executive, which has just been published, states: The NHS is accountable through Parliament for the effective and efficient use of taxpayers' money. I want to concentrate- on that in the two minutes available to me.
I want to know a bit more about the pay-off to the former chief executive Maggie Aikman and to ask the Minister the simple question: why did she go? Who decided that she should go? Was the rest of the board involved? The code of conduct and the code of accountability for NHS boards suggests that they should have been involved. If they were, should they not take collective responsibility and resign, like the former chairman James Rawson?
What reasons did Mr. James Rawson give to Maggie Aikman for requesting her resignation in the first place? Is it true that the pay-off amounted to £250,000? What about her pension arrangements? If the £250,000 figure is accurate, how can that possibly be justified? If Mrs. Aikman's performance was lamentable, why did she receive such largesse? I asked Mr. Rawson those very questions and he refused to answer. Will the Minister answer them?
Astonishingly, the Minister for Health told me last week that the Department keeps no records of trust chief executives who resigned or who were dismissed, or of the reasons for their dismissal. Will the Department do so in future? Did the Secretary of State ask the chairman, James Rawson, to consider his position? If the right hon. Lady did so, why?
I do not want to rake over the coals but it is as plain as a pikestaff that the community is mortified by what has occurred. An independent inquiry is needed so that lessons can be learnt for the future. We must avoid a repeat of the astonishing, tragic farce that is Burnley health care trust.

§ The Parliamentary Under-Secretary of State for Health (Mr. Tom Sackville)
I congratulate the hon. Member for Burnley (Mr. Pike) on securing this Adjournment debate and on the assiduous way in which he has followed the regrettable events of the past few weeks. I cannot say other than that I deeply regret that they occurred. I assure the hon. Gentleman that they are not typical of the national health service or of trusts, and such a series of events is probably unique in modern times.
I join the hon. Member for Burnley in paying tribute to the staff, management and everyone else involved at the hospital for continuing to offer a fine health service to the hon. Gentleman's constituents.
Patients must come first, and I am glad to report that there is no evidence that patient care suffered as a result of the events in question. The district health authority is closely monitoring the quality of care in the hospital. The events must not detract from the trust's record and its achievements. They include increasing the number of in-patients and out-patients treated; achievements in the learning disability field, for which it won a prestigious award; a reduction in waiting lists and waiting times; new 1056 consultant appointments; and new facilities in general surgery, gynaecology and other specialties. The trust has achieved an overall improvement in health facilities for the people of Burnley, Pendle and Rossendale.
The course of events is approximately as the hon. Member for Burnley described them; I shall comment briefly on one or two of his specific questions. He asked when the inquiry will report and whether its recommendations will be implemented. I can only answer as soon as possible, and that the trust will take close account of the inquiry's findings.
I cannot agree that an independent inquiry would achieve anything now. I have no reason to doubt the independence and objectivity of the two consultants who are investigating the matter of Dr. Mahady. Neither do I agree that the issue will not be resolved until there is an inquiry. It will be resolved in a period of calm and stability under the new chairman and chief executive, to allow the scars that may remain from the events to heal and to allow everything to get back to normal. That is always needed in the health service.

§ Mr. Pike
If the Minister will not take it from me that an independent inquiry is required, he should ask for the views of the community health council. It will point out that a range of staffing issues have arisen from the old-style management. We hope that that will change, but only one aspect of the trust has been considered.

§ Mr. Sackville
I hope very much, as I hope the hon. Gentleman does, that the new chairman and chief executive will address any such problems.
On the matter of the payment to the former chief executive, I can confirm that she received a net sum of £135,750 and that that represented a gross cost to the trust of £245,000. Those are very large figures, but I have no reason to suppose that they were not the negotiated settlement that represented her contractual entitlement. Her contract had been renewed quite recently and, with her basic salary grossed up to her total package over a period of just over two years, that is the figure that was negotiated. I can confirm that the former medical director received no payment, although he is, of course, still a valued member of the hospital.
I should also like to comment briefly on what was said about the new acting chief executive, Mr. Chew. No sub-agenda should be assumed, as a result of his appointment, connected with the future configuration of the trust. He was appointed because he is an experienced manager who, it is believed—I have no reason to doubt it—will bring experience and a much-needed period of stability to the trust.
I should like to reiterate that, regrettable though the matter is, for it to continue to occupy the press and the minds of people locally can only cause worries for the staff, patients and everybody else, and a great deal of further noise about it cannot help.

§ Ms Janet Anderson (Rossendale and Darwen)
Will the Minister give way?

§ Mr. Sackville
No, because I have only a few minutes left.
So those who are friends of the hospital, as the hon. Member for Burnley is—and he has just been in the hospital—will agree that there is nothing to be achieved 1057 down that route. What we need for calm is mature consideration of how those events can be avoided. I have no indication that such matters within the trust are likely to recur. As I have said, it is quite unique in the recent history of the health service that such events should occur in a hospital.
I should like once again to congratulate the trust on the standard of care that it has achieved. I congratulate it on the fact that it has maintained that care during the past two months. I deeply deplore any attempt to exploit it for any political or other reason. I heard what the hon. Member for Burnley said about not wishing to seek any political gain by raising those matters. I am sure that he 1058 agrees that they are regrettable, but they need to be put behind us so that things at the hospital can return to normal.
I shall quote once again, as the hon. Gentleman touched on it himself. As he knows, Dr. Archer is an eminent microbiologist who has served the interests of patients in Burnley for many years. He is respected by clinicians and management alike. His role is to end uncertainty, heal any remaining wounds, and to have everyone working together to restore public confidence in this excellent hospital. Question put and agreed to.
Adjourned accordingly at three minutes past Midnight.