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Labour launches bid to end NHS ‘culture of secrecy’ and improve safety following care scandals

Exclusive: Ashworth reveals plan for patient safety

Shaun Lintern
Health Correspondent
Saturday 25 September 2021 21:13 EDT
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Labour wants the health secretary to have a duty to maintain safe staffing levels in the NHS
Labour wants the health secretary to have a duty to maintain safe staffing levels in the NHS (PA)

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Labour is to push for key changes to the government’s NHS reforms, with new laws on transparency in the NHS and a demand for safe staffing levels on hospital wards, following a series of scandals relating to failures in patient care.

Amendments to the government’s Health and Care Bill will also include plans for the investigation of stillbirths by medical examiners, and for limits on the power of the health secretary to interfere in investigations.

Labour’s shadow health secretary Jonathan Ashworth believes the changes – which also include giving local NHS regions the ability to object to some spending limits if they consider them to pose a risk to patient safety – will attract the support of Conservative MPs.

In an exclusive interview with The Independent ahead of the Labour Party conference in Brighton, Mr Ashworth said it was vital that the NHS learned from mistakes and improved its record on safety, which he said could only be achieved through greater transparency.

“Patient safety has been forgotten in this bill. The patient voice has been ignored. Patients are like the ghosts in the machine,” he said.

“The bill is going through parliament, and we are putting down amendments to improve it as best we can. We want to put in the bill a framework to deliver greater patient safety, because after all, it should be the golden thread running through every aspect of healthcare delivery.

“We can be outvoted because of the arithmetic of parliament, but I hope Tory MPs will look seriously at supporting these amendments.”

The shadow health secretary will deliver a speech to the Labour conference on Tuesday, in which he will set out the wider reforms to health that Labour wants to see delivered, which will include a broader focus and funding for public health measures.

He will also reveal concerns over the creeping use of private hospital providers in mental health services in the light of questions over their safety, with their CQC rating almost half that of independent mental health services.

The Labour Party will put forward the amendments on patient safety to the Health and Care Bill during its committee stage, and hopes to push the changes to a vote.

Among the changes include a new requirement for NHS trusts to publish reports by royal colleges following investigations into clinical services.

The lack of action by the NHS following royal college reports that were not made public has been a feature in several patient safety scandals, including the maternity disaster at the Shrewsbury and Telford Hospitals Trust and the deaths of babies at the East Kent Hospitals University Trust.

In May, the BBC’s Panorama programme revealed that the results of only 16 out of 111 reviews by royal colleges had been made public.

Mr Ashworth said that transparency in the NHS after mistakes have been made was vital to making necessary improvements.

“I cannot understand why we would not want transparency. It is a key ingredient when we are trying to improve patient safety and learn from mistakes, to make sure errors don’t happen again. There are times when mistakes will happen, and it is unimaginable, and I can’t put into words the grief that someone must feel when mistakes have been made.

“What is important is that the system learns from these mistakes, and reviews what has gone wrong, and puts in place reforms. The best way to do that is transparency with these reviews.”

Separately, the party wants to extend the role of medical examiners, who currently review all deaths in the NHS that are not referred to a coroner, to include a requirement that they also review stillbirths.

Parents who have experienced a stillbirth, and have concerns about the care they or their child received, are at present unable to have these concerns addressed by a coroner or an inquest.

Labour will also seek a new duty for the health secretary to produce an annual report on measures to address inequality in maternity services. Currently, black women are four times more likely to die than white women when giving birth.

Mr Ashworth said: “I think it is a scandal that black mothers are four times more likely to die and Asian mothers are twice as likely to die. It shames this country.”

Mr Ashworth also wants changes to be made to planned rules on capital spending in the NHS. This is spending related to the upkeep of buildings and equipment in the service, which is currently subject to a £9bn backlog. NHS England will have the power to impose spending limits on local areas, but Labour want the NHS to have the power to object to any limit if it risks patient safety.

The Leicester South MP said: “We are really worried about this £9bn backlog. Several hospitals have reported roof collapses, sewage pipes leaking, and so on. This is a great threat to patient safety, and countless NHS trusts need investment because their hospitals are crumbling. If we want to provide safe care, we need a framework around capital spending.”

Concern over widespread workforce shortages in the NHS, and their impact on the ability of NHS trusts to provide safe care, has prompted the party to table a further series of amendments to demand an annual report on workforce staffing in the NHS, which it says should include an assessment of safe staffing levels and whether they are being met within the NHS.

Labour will also press for the health secretary to have a duty to “maintain safe staffing levels” in the NHS in England.

Within the Health Bill are plans to give safety watchdog the Healthcare Safety Investigations Branch (HSIB) full independence from the NHS and the government, although the legislation provides for the secretary of state to direct the body to carry out an investigation.

Labour wants to give HSIB the power to decline such a direction from the health secretary, and to be able to request more funding for an investigation as well as to prevent the health secretary from having any involvement in an investigation.

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