Andy Burnham’s open letter to David Morris MP

After coming under repeated attack by Morecombe MP David Morris – including an open letter on ConHome today – as part of the on-going debate around the failings of the care regulator, Andy Burham has responded with an open letter of his own. You can read it below:

Dear David

Thank you for your letter this morning.

You have raised a number of serious points and I wanted you to have a full and immediate response.

First, you ask me whether pressure was applied in the pre-Election period to minimise hospital failings.

You have made this allegation a number of times over recent days and I am glad to be able to set the record straight. The real position is the precise opposite of what you claim. Let me explain.

When I was appointed in June 2009, one of my first decisions was to appoint Robert Francis QC to conduct an independent inquiry into what went wrong at Stafford. Separately, the Department raised concerns with me about the effectiveness of CQC and I began taking steps to deal with it.

In late 2009, when problems emerged unexpectedly at Basildon and Thurrock Hospital, it became clear to me that an in-depth look at all hospitals in England was needed so that all problems could be flushed out, action taken and reassurance given to the public.

On 30 November 2009, days after the emergence of the problems at Basildon, I made a statement to Parliament to explain my decision to expedite the new system of registration of hospitals. This 360 degree process was intended to provide a full picture of each individual hospital rather than the more blunt tool of the old Annual Health Check it replaced.

I asked the CQC to get on and complete this work before the end of the last Parliament. The very purpose of this process was publicly to identify organisations with weaknesses. At the end of it, 22 separate organisations were registered with conditions.

So, far from covering up any problems at hospitals in the pre-Election period, I hope you can now see how was actively working to identify them.

Second, you ask me for details of any conversations I had with CQC about your trust and to publish information relating to this period.

All the information you mention is held by the Department, not me, so I am unable to give you a definitive answer without reviewing it. However, I have no immediate recollection of any specific conversations with CQC about Morecombe Bay in this period, though it is always possible that it might have come up in a broader discussion.

But it is important for me to make clear that, as with the inspection and registration of all individual trusts, decisions were solely a matter for the independent regulator. The process the CQC followed in reaching its flawed decision is covered by the deleted internal CQC report and I believe we need to know more about it. That is why I called on Jeremy Hunt to publish it.

More broadly, you ask me to publish all my papers from that period. I wish to remind you that the Francis Inquiry had access to Department of Health papers. It found no evidence of any inappropriate behaviour by Ministers, a finding echoed by this week’s Grant Thornton.

Third, you ask me if I stand by my criticism of Government policy on regulation.

I remain very concerned about the Government’s failure to accept and implement the recommendations of the Francis Report. Instead, in its response, it presented its own proposals for three new Chief Inspector roles which, as you will know, did not form part of Robert Francis’ recommendations.

I have no objection in principle to the new roles proposed. I am prepared to work with the Government to get them right. But I do have a concern about an emerging over-emphasis on new forms of top-down inspection and regulation, and a neglect of the other important changes Francis suggests. With the best will in the world, regulators can’t be everywhere. Culture change is needed at local level and that is why a duty of candour on individuals is important.

Fourth, you ask me if I stand by a generalist model of inspection, as opposed to a specialist model favoured by the Government.

As you know, it was the last Labour Government which first introduced independent regulation to the NHS following previous scandals. Methods or regulation have been evolving ever since.

I have to say I do not see the choice as an either/or between generalist and specialist. Instead, we need a mix of the two.

If we were to have a purely specialist system where GP inspects GP, or dentist inspects dentist, there is a risk that it would not carry public confidence. Good regulation should always have a place for outside eyes.

I trust this letter answers your points in full.

Your constituents have been badly let down and they deserve full answers to their questions.

Given that your own Government also has questions that your constituents want answered, I trust you will now be challenging Andrew Lansley and Jeremy Hunt in the same way.

Yours Sincerely,

Andy Burnham MP