§ 2.58 p.m.
§ Lord Marlesford asked Her Majesty's Government:
§ Whether they will appoint an independent inspector general of hospitals who would report to the Secretary of State for Health on cleanliness, patient handling, food standards and other non-medical and non-clinical matters relating to the administration of hospitals, such reports to be published.
§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)My Lords, we see no need for such an appointment. National standards will be set and performance managed by the Department of Health. The proposed patients' forums will also inspect premises and report on the quality of patient services in every trust.
§ Lord MarlesfordMy Lords, perhaps I may ask the Minister whether he recognises that what I propose is a good deal sharper and more focused than what he has described. I am aware of the body which has been set up. Indeed, I read the article by his right honourable friend in the Sunday Mirror of 4th February. However, is he not deeply concerned that a large number of our hospitals have overflowing lavatories and soiled tissues around the wards, and that one-third of them fail the basic hygiene checks? Does he agree that such problems are primarily a matter not of resources but of management, discipline and pride? We need a proper inspection process that will name and shame. It might use as a model the excellent performance of Sir David Ramsbotham in relation to the inspection of prisons.
§ Lord Hunt of Kings HeathMy Lords, there is no doubt that over the years the standards of some NHS trusts in relation to cleanliness and food have declined. That is why, in the NHS Plan, which was published last summer, we drew particular attention to those problems and instituted a set of procedures to put them right. One mechanism, as the noble Lord suggested, is the establishment of patient environment action teams. They are made up of people from the NHS and the private sector and of patients' representatives and they have visited every trust in the country. They have drawn attention to problems in the cleanliness area. It is absolutely clear that that has had a dramatic effect on the quality of cleanliness. I know that during the past few weeks patients have seen distinct improvements. That effort goes alongside the additional resources that we have given trusts for that purpose.
Lord Bruce of DoningtonMy Lords, is the Minister aware that most of these problems are best tackled not 99 by the appointment of higher-up administrators who operate on a large scale, but by the simple reintroduction of matrons in hospitals?
§ Lord Hunt of Kings HeathMy Lords, I could not agree more with my noble friend. That is why, in the very same NHS Plan, we advanced the proposal that modern matron figures should be appointed. It is abundantly clear that under the stewardship of the party opposite, ward sisters lost authority—they lost control over cleaning and catering and the results were clear for all to see. Our proposals and changes will reassert the authority of the sister or modern matron. I am convinced that that is the way in which to get standards back to where we all want them to be.
§ Lord Stoddart of SwindonMy Lords, I have listened to my noble friend's remarks, but I do not know whether we need an inspector. What progress is being made towards the elimination of mixed-sex wards? I am sure that they have been inspected. How is his department monitoring that and the health service generally?
§ Lord Hunt of Kings HeathMy Lords, my noble friend knows that I share his views on these issues. We conduct regular progress monitoring. In the latest returns, 93 per cent of trusts report that they will comply with our objective to eliminate mixed-sex accommodation by 2002. There are 25 that have not done so, but seven have now devised specific action plans that will be implemented by the end of 2002. That leaves 18 trusts, of which 16 will meet the target through major capital schemes which have already been approved. The remaining two are in discussion with the department about what can be done to bring forward compliance.
§ The Earl of OnslowMy Lords, what is the difference between a modern matron figure and an old matron figure?
§ Lord Hunt of Kings HeathMy Lords, as I discovered when I took up office in the Department of Health, many nurses—certainly those in the hierarchy—resisted the term, "matron", because they saw it as returning to what they may regard as the bad old days. I do not share that view. That is why we used the word. However, it does not do any harm to call them modern matrons; that enables the nursing profession to give support and ownership to what we are trying to do.
§ Baroness Thomas of WalliswoodMy Lords, will the changes that, the Minister explained to us today ensure that people in hospital, particularly the elderly, are properly fed? There are alarming stories about people—particularly older people—being less well fed during their time in hospital. While I am on my feet, will he also ensure that such patients are addressed by their names, not by a series of nicknames?
§ Lord Hunt of Kings HeathMy Lords, yes, those who address patients in hospital should do so using the 100 names that the patients wish to be addressed by. On the question of feeding, that is a matter that the visiting teams study. They watch patients being fed and ensure that if patients are unable to feed themselves they are not left alone. I make it clear that it is the responsibility of nurses to ensure that patients' individual nutritional needs are met. The chief nursing officer wrote to all nurses a few months ago to make that abundantly clear. So far as concerns the treatment of older people generally, the national service framework, which is being published today, gives clear direction to the NHS about treating older people with respect and dignity.