Murnaghan 23.06.13 Interview with Andy Burnham, Shadow Health Secretary

ANY QUOTES USED MUST BE ATTRIBUTED TO MURNAGHAN, SKY NEWS

DERMOT MURNAGHAN: Well the health watchdog is facing questions today over fresh allegations about a cover-up of failings at the Morecambe Bay NHS Trust. The head of the healthcare information provider told Sky News he had warned the Care Quality Commission about concerns in 2010 but the information wasn’t acted on, potentially he says causing lives to be lost. Well the Secretary of State for Health at the time was Andy Burnham and we’ll be hearing from him in just a moment. Well let’s say a very good morning to Andy Burnham and a lot of specific points to put to you about your time as Secretary of State for Health, Mr Burnham, but first the general question: do you now regret starting that culture of political pressure on the Care Quality Commission to suppress bad news about the NHS?

ANDY BURNHAM: Well I didn’t and I can point to two specific things which disprove that allegation. I was appointed Health Secretary in June 2009 and one of the very first things that I did was to appoint Robert Francis QC to conduct an independent inquiry into what happened at Stafford Hospital and that reported before the General Election but then secondly, I saw that there were problems at the CQC and at some of the hospitals and so I ordered an in-depth investigation of all hospitals in England in November 2009. Now that was designed to flush out any problems, I thought it was wrong that we had this drip-drip of problems emerging at different hospitals, we needed to clear the decks, flush out any problems, identify action to be taken so before the last election 22 organisations were registered with conditions, that meant they had to improve, and that was the very purpose of the exercise, to bring these problems into the public domain.

DM: Okay, but there is the evidence, you mentioned the Francis Commission you set up to look into problems at Mid Staffs and Baroness Young, who was Chair of the CQC a while back, said to that, named you, said to the inquiry that you did put pressure on the CQC to tone down some of its reports.

AB: Well I was asking tough questions of the CQC in that period because I had concerns about its effectiveness and that came to a head with the reports about Basildon Hospital and I said to the CQC at the time that we couldn’t have a situation where problems were arising unexpectedly, we needed to be clear about where there were problems and what action was being taken to address them so it was at that point that I made a statement to Parliament and said that I was bringing forward the new system of registration of all hospitals. Now that was designed to take a 360 degree look at each hospital in England, to give a much fuller picture than we were giving in the past. Hospitals were given a very broad label in the past as to their performance, this was designed to provide a much more detailed picture and that was done before the last election, so if I was trying to keep problems hidden from view I wouldn’t have done that would I?

DM: But you haven’t denied you said tone it down, I mean none of that would have been achieved if the CQC understood it had to tone the criticisms down. Did you say that?

AB: No, I never said to the CQC don’t say that, do say the other, that wasn’t my role. They were in an independent regulator. Obviously we had discussions about problems that were in the NHS, we had a discussion about Basildon Hospital and it was at that point that I said we needed to have a system that could provide the reassurance that people needed and also where there were problems, for them to be brought out. The allegation, the central allegation that I was in that period trying to say don’t do anything, don’t say anything, don’t bring any problems out, keep them all hidden, is fundamentally disproved by the decisions I took in relation to expediting the registration of hospitals.

DM: Are you sure? You also wrote to Baroness Young, didn’t you, in 2009 asking for the CQC to restore patient confidence. Now one way of restoring patient confidence is not telling them about the failings in parts of the NHS.

AB: No, my argument was that is precisely the way to restore confidence. What was not helping is when problems were emerging unexpectedly and I had a concern that when I asked for a list of other hospitals that had problems that they weren’t able to provide me with it, so that is why I brought forward the new system. For me it was essential that it was seen that the regulator was taking the action necessary to give in depth assurance about all hospitals and that’s why I wrote to Barbara Young to say that. At the same time, I was asking the CQC to do unannounced inspections on some hospitals that were being brought to my attention by Members of Parliament, there was a whole range of work going on and all of this was in the context of the failings at Stafford Hospital. I came in, I inherited that, immediately I brought in Robert Francis to set up a process of inquiry and when his report was made public in February 2009, I made a statement to Parliament saying all parts of the NHS now must embrace this report, there must be full openness and accountability and that’s why I’m here today, to provide those answers that families in Cumbria rightly deserve.

DM: Well that’s it, yes, and we want to talk about Morecambe. You have had this interesting exchange of letters, haven’t you, with David Morris, one of the MPs for the area, who asks you about your recollections of direct conversations about Morecambe Bay Trust back in April 2010 when it was given that first clean bill of health. You wrote back to him and you say, and I quote from your letter, “I have no immediate recollection of any specific conversations with CQC about Morecambe Bay.” No immediate recollection doesn’t mean to say there wasn’t one.

AB: Look, true, but I didn’t want to provide wrong information. I don’t hold all the paperwork from that period, when you are Secretary of State for Health many issues are being raised with you on a daily basis, lots of papers are coming across your desk. I don’t have any recollection of it, I don't think a specific concern was put to me about Morecambe Bay, that’s why I said that clearly to David Morris but I haven’t reviewed all of the paperwork held by the Department of Health. What I am clear about is that I have initiated a process which at that time was taking an in-depth look at all hospitals and, as I said earlier, 22 were identified as having problems. Now I don’t understand why Morecambe Bay wasn’t included in that list and that was obviously the subject of the deleted report that we learnt about last week.

DM: Would you encourage … I’m sure people want to hear this question, would you encourage the Department of Health to release that paperwork, to release those emails, to release the notes and minutes taken by officials, to help you jog your memory as to whether a discussion about Morecambe Bay took place in early 2010?

AB: You make it sound as though I am being evasive. I received David’s letter yesterday and I immediately replied to it and the other point I would put to you, Dermot, is we have just had a three year public inquiry into these matters, into the relationship between the Department of Health and the CQC which looked at a whole range of paperwork related to conversations between the two and I’ll remind you that that report said that Ministers were not found to have acted wrongly. Now that was the conclusion of a three year public inquiry. I am happy to come on here and answer again today and I will give David any assurances that he wants – I know that I did the right thing by acting on concerns that were put to me when I was Health Secretary and I will account for all of the decisions that I took.

DM: But it may have come up, you say in your letter, in a broader discussion. You think you did discuss it.

AB: No, I’m not saying that at all. I was answering a letter at the weekend when I don’t have access to papers, I didn’t want to say something which subsequently would be disproven. I can’t recollect every detail of every discussion that I had in that period with the CQC. I am confident that it wasn’t brought to me that there was a major problem at Morecambe and that action needed to be taken, that didn’t happen. What I am saying is I don't know whether concerns were raised as part of a more general meeting and I would have to review all the paperwork to provide that extra assurance but I am prepared to do that. What you’re not saying here is that this cover up, the deletion of the report, happened on this government’s watch and not our watch. When we were in government our regulatory system brought to the fore the problems at Stafford Hospital and as I’ve said to you, we did things then to find out what happened there. I do think that you need to be putting some of these questions to the current government. We know that the whistle blower went to the last Secretary of State with concerns, what happened, what action was taken on those concerns and the other question I would just want to be put on the record, Dermot, is this: in March 2012 when that internal CQC report was deleted, the Secretary of State for Health, Andrew Lansley, was defying the law of the land in withholding the NHS Risk Register and you will recall that I came on your programme many times to say that the government should be open about the risks it was running with the NHS by reorganising it in the way that it was so I will say to [Jeremy Hunt] today, I will agree with him that we need openness and transparency in the NHS, but if those statements that he has made are to mean anything, the government should immediately overrule the decision of Andrew Lansley, publish the NHS Risk Register, so we can all move forward with full information and we know the risks that there are to NHS services.

DM: Well that’s a point you’ve made openly for the second time on this programme but we want to get back to this issue of the Care Quality Commission and the reason why this is so important, Mr Burnham, and you’ll understand why this is, is that people want to know where this culture came from within the Care Quality Commission, that it felt it had to on several occasions suppress bad news about the National Health Service? Did it come up with it off its own bat or was it at its very birth, was that part of the reason, part of the feeling it received from politicians like you that it had to do this kind of thing? There was an election looming for goodness sake.

AB: You’ve made this allegation a few times now and I’ve said it’s disproven by the facts and by a three year public inquiry that looked in detail at all of these things, you can’t just keep on making it because you want to throw that around.

DM: It’s not me, we’ve got Roger Davidson, the former head of media at the CQC, quoted in the Telegraph today after his evidence to the Francis Inquiry, saying precisely that. He was a whistle blower, he lost his job because he spoke out and was made to sign a gagging order.

AB: I have absolutely no knowledge of that, there is no evidence to back up that I or anyone at the Department of Health requested that, I don’t believe any such evidence exists. I was quite clear to you earlier that I had asked the CQC to do the opposite, bring the problems out into the open. That is what I did as Health Secretary, I called for a process to be expedited in November 2009, an in-depth look at all hospitals in England so we could have a clear picture about each and every one of them and as a result of that process, 22 organisations were registered with conditions. Now that wouldn’t have been the action of somebody who was trying to keep these things from public view. You ask where the culture comes from, if we’re being honest there is a culture at local level in the NHS where people who bring complaints are often pushed away, the NHS pulls the shutters down, it tries to push people away from the problems and that isn’t justifiable. I said as a minister it wasn’t justifiable and we need to ensure that the NHS rids itself of that culture. Now the Francis Report that the government commissioned made some very important recommendations in this area, particularly a duty of candour on individuals and again I would say to the government today, please get on and introduce and implement the recommendations of your three year public inquiry. I would support them, we all would support them and I think the public would like to see some cross-party consensus here about culture change in the National Health Service. I don't think they want to see us point scoring. There needs to be accountability for past actions, yes, but we also need to move forward now in saying that the only way to go is openness and accountability, if the two parties commit to that let’s all move forward and that consensus across the floor of the House of Commons would send the clearest of messages to the NHS that this kind of culture and practice is simply not acceptable.

DM: Okay, Mr Burnham, thank you for your openness today. Andy Burnham there, the Shadow Health Secretary.