§ Mr. Raphael Tuckasked the Secretary of State for Social Services whether he is yet able to make a statement on the findings of the professional investigation at Napsbury Hospital.
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§ Sir K. JosephThe report of the investigating team has been published today and a copy has been placed in the Library of the House.
The hon. Member will be aware that I arranged in October last year for a professional investigation into medical and nursing practices on certain wards at Napsbury Hospital as a result of the number of complaints which had been received concerning patients in these wards between 1970 and 1972. The investigating team has found nothing to suggest deliberate ill-treatment of or cruelty to any patient. It is also satisfied that the methods of treatment followed in the wards investigated were, in theory, unexceptionable. The team does, however, consider that these methods were pursued in an insistent and inflexible manner, with the result that there was at times a seeming lack of compassion and of respect for the rights of patients, although it was apparent that the staff concerned genuinely felt that the end justified the means. The team says that the clinical programme on the wards in question has now been abandoned and is unlikely to be revived but it draws attention to indications at the time that a Napsbury Hospital "crisis intervention" service in the Barnet area might be marred by the same failings which in its opinion accentuated the difficulties inside the hospital in 1970 and 1971. It adds that in theory this "crisis intervention" service has many admirable features and should have a fair trial.
I entirely accept the team's view that the particular situations and conditions to which it refers in certain wards in Napsbury Hospital should not exist in a National Health Service hospital. The report raises serious issues both of ethical standards and of the role of medical administration in influencing clinical policies, and I accept the recommendations which the report makes. The main recommendations in relation to services provided by Napsbury Hospital are: first, that the medical administrative structure should be strengthened in order to provide a clearer consensus of opinion and advice on clinical policies and that this structure should include a formal ethical committee, and, secondly, that where new methods are employed, as in the northern part of Barnet, the doctors and patients in the area concerned should have more 136W choice of consultant methods than they did at the time of the investigating team's visit. The team also believes that attention should be paid to a better programme of preparation and public relations, and to greater flexibility, and in the introduction and application of new methods of treatment. The report and its recommendations have been accepted by the Chairman of the North West Metropolitan Regional Hospital Board on behalf of the board and the board will be following the recommendations up urgently with the hospital management committee and medical staff. Steps have already been taken to strengthen the medical administration structure. An additional consultant psychiatrist has already been appointed to provide an alternative service for the population of North Barnet.
The investigating team has also recommended that in view of the possibility that similar difficulties may arise in relation to other programmes of behaviour modification, my Department should consider the desirability of asking the Royal College of Psychiatrists, the Royal College of Nursing and the British Psychological Society to set up a joint working party to formulate ethical guidelines for the conduct of such programmes. I accept this recommendation and will shortly be asking these organisations for their help.
I am very grateful to Dr. Bomford and his colleagues for carrying out this difficult investigation and for their lucid report.