Sir Bernard Jenkin
MP for Harwich and North Essex · Conservative · United Kingdom
“Despite long and historic disagreements between successive UK Governments and Israel, it has remained a steadfast ally in counter-terrorist efforts to keep our people safe in this country. We are now embarked, it seems, on a full diplomatic dispute with Israel and tit-for-tat expulsions of diplomats.”
“I would very much have liked to have discussed the medical devices questions arising from the Bill. The Minister made an incredibly short speech about that important matter. It is quite clear that these provisions are part of the covert dynamic alignment with the EU and the covert rejoin agenda being pursued by the Government.”
“I am as keen as anybody to get on with discussing the Health Bill, but this topic is too serious an opportunity to miss, given that the hon. Member for Leeds Central and Headingley (Alex Sobel) has raised such important issues. I really commend his speech and his initiative. Everybody should read it.”
“The Minister shakes her head, but she is yet to give a good reason as to why this measure is in the Bill. When we had an Adjournment debate in July with the then Minister for patient safety, the hon.”
“The chief executive of the CQC is wantonly conflicted in terms of looking after the safe space, so he cannot be the one left in charge of that function. The real point here is that we are missing the opportunity to save so much money. Governments keep having public inquiries.”
“I asked the Minister, in a letter I sent her after the debate in July, to give us the information on how much the transfer of all this would cost. Nothing has arrived. I never had a reply to the letter. Of course, the Government have changed the Minister and the new Minister for patient safety, the right hon.”
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“(Select Committee Statement) : I am grateful to the Backbench Business Committee for providing time for me to present our 10th report of this Session, entitled “Lessons still to be learned from the Chilcot Inquiry”. The decision to invade Iraq has left an indelible scar on British politics. It continues to be as controversial today as it was at the time, not least because it became apparent after the invasion that it was to become a protracted and bloody affair, costing the lives of 179 UK servicemen and women, as well as those of our allies and of thousands of people in Iraq. The consequences of the decision to invade Iraq remain profound, not only for domestic politics but for our foreign and security policy and the stability of the region. The Chilcot inquiry was established in 2009 to provide some closure to the controversy.”
“We suggest that the House should be prepared to do that if further facts and information emerge, but Sir John Chilcot was clear that he did not hold former Prime Minister Tony Blair culpable in deliberately misleading the House, and we have to accept that view. Finally, on whether our recommendations are timid, they are limited to what we felt able to make recommendations about. However we organise our politics, I am afraid that there will always be occasions when things go wrong. I do not think that any constitutional structure can protect us from that, although we have made some recommendations that would prevent certain things from happening again.”
“I am grateful to the hon. Gentleman for his question. I voted for the Iraq invasion. I still do not know whether I would have voted the same way had we known much more about it. The salient part is the lack of preparation, and I would not have voted for it had I thought that there had been so little preparation. Having said that, I think the jury is still out on whether, in the long term, the invasion of Iraq will have been of benefit to global peace and security. On whether Parliament was deliberately misled, the Select Committee just did not feel qualified to make that judgment. We do not have the procedures and wherewithal in this House to conduct a fair trial of the facts. Were such a Committee to be established to do that, it would need to be a very different kind of Committee with a different kind of quasi-judicial procedures.”
“I will endeavour to be extremely brief. I am grateful to my right hon. Friend for her question, her participation in the Select Committee and her contribution to the report. The answer is that we are making recommendations about the conduct of inquiries, and I doubt whether the Government will like them because they would limit their control over the process. Most Governments establish public inquiries to avoid issues, not to explore them and open them up. Why did it take so long to get this inquiry? Our report is as much addressed to what the House must take control of itself in order to ensure that inquiries are better conducted in future.”
“It is just another lever for a Cabinet Secretary to use to secure their independence and the proper process set down in the Cabinet manual that Prime Ministers have agreed to in principle. On parliamentary accountability and the Prime Minister, it remains open to this House to set up a special Select Committee or privileges Committee to establish proper procedures and provide fair representation for the prosecution and for the defence, but it would be a completely new procedure. Nothing like that has been done in the era when we expect natural justice to be carried to far higher standards. We cannot have a posse of MPs, all of whom have known views on such issues, acting as some kangaroo court to arraign a former Prime Minister. That would be ridiculous and would not do this House any good.”
“I am grateful to the right hon. Gentleman. The letter of direction should not be a controversial matter, because we already have it in our procedures for financial matters, as he says. One or two former Cabinet Secretaries have bridled at that, but others are very much in support. It does not interfere with the substance of policy; it merely ensures that proper process is covered. We recommend not that the letter of the direction, which may come at a sensitive time or involve a sensitive issue, should automatically be made public, but that it should, if appropriate and at the behest of the Cabinet Secretary, be made privately available to an appropriate Select Committee, to the Intelligence and Security Committee, to members of the Privy Council or to the Leader of the Opposition.”
“As perhaps should have been done with the child sex abuse inquiry, I suggest that the Secretary of State comes to this House to ask for a Committee to be set up. Let us have an inquiry into the inquiry before we get stuck on the tramlines of legality and appointing people. She should look before she leaps and accept that Governments should not be able to establish inquiries to get themselves out of inconvenient difficulties. The House is here to assist such scrutiny, and it should be here to provide oversight so that an inquiry is properly conducted in a timely fashion.”
“The hon. Gentleman has been a trouper on the Committee for many years. I accept that this was a difficult inquiry to agree. In our draft, because we were concentrating on process and procedures rather than on the substance of the issues, we had to reflect some of the tone of the anxiety that so many people feel about this issue. I hope he felt able and comfortable to support the inquiry. He fully supports our recommendations, for which I am grateful.”
“A Select Committee would set those parameters in a motion establishing the inquiry.”
“The inquiry is an extraordinarily thorough piece of work. Sir John Chilcot should be commended for what he achieved, the detail he went into and the seriousness with which he approached the inquiry, but it was not what the public initially expected. The Crimean war was in many respects a far bigger disaster, but the inquiry into that was conducted in the space of a few months, which I think is what the public hoped for with Chilcot—there were some fairly obvious top-level things. We conduct inquiries using Salmon letters—the Maxwellisation process—and there is a tremendous sense of obligation to provide people with fairness in inquiries that perhaps did not exist after the Crimean war. We need to set down parameters for such inquiries, which is what a Select Committee would do if it studied an inquiry before it was set up.”
“I am grateful for the right hon. Lady’s kind remarks, and it is important that we make such Select Committee statements because they engage more Members in our reports. I regard our report as a serious piece of work that makes serious recommendations, and hon. and right hon. Members of all views on the original conflict can embrace it as a better way of making such decisions in government and a better way of conducting public inquiries.”
“I think that is an accurate comment, and I am grateful to the hon. Gentleman for his contribution to the Committee and this report. It cuts both ways, because the Cabinet went along with being sidelined. Chilcot was clear that plenty of Cabinet Ministers were quite content to leave it to others to make the decisions when they had the right to insist on being consulted. Our report addresses how the legal advice was taken, explored and discussed by the Cabinet, and we make recommendations about that. Our proposals make clear what Cabinet Ministers are entitled to expect. It is not a favour to ask that of the Prime Minister; it is part of the proper procedure of Cabinet government. We do not have a superannuated presidency in this country. We have a constitutional Cabinet Government, which should be reinforced by these proposals.”
“We are in a new era in which the House is consulted about such things, which never used to be the case. We used to have rather more retrospective accountability on such matters, rather than forward accountability, and I question whether such forward accountability works. I do not think the House of Commons is competent to make strategic judgments on the spur of the moment and in the heat of a crisis in the way that a Government should be.”
“I am grateful to the hon. Gentleman for his work on the Committee, and I respect that we differ on the report. I appreciate the emphasis he wants to make by declining to support the report, but it is open to the House at any time to refer any matter to the Committee of Privileges. There is a procedure for doing that, and he should try to implement it if he thinks there is a case for doing so. The difficulty, as the Chilcot inquiry said, is that there are two interpretations of all this and that there is no definitive evidence to suggest culpability or that the former Prime Minister deliberately sought to mislead the House. There are lots of lessons to be learned. As an aside, for the House to be able to make an informed decision, it relies entirely on what the Government tell it.”
“Ultimately, it is in the hands of this House, subject to whipping and all the pressures that are put on it, to decide how inquiries are conducted. If the Government are setting up an inquiry that this House does not like, this House can stop it; we are a sovereign House and that is what we should do. I agree so much with the hon. Gentleman’s comment that the length of time this took was unacceptable. Indeed, we make the point that it undermined not only the credibility of the inquiry, but the very confidence in public institutions that it was intended to try to restore. It did not serve the purpose that this House might have wanted it to serve because it took so long, and of course it was grievous torture for the families of those who had lost life and limb in this conflict.”
“I am most grateful to the hon. Gentleman for inviting us to take part in his debate, and I commend him for securing it. We are now in the throes of the so-called sustainability and transformation plans, which are being constructed on the acknowledgment, confirmed by the Boston Consulting Group, that there has been underinvestment in primary care in Essex for 20 or 30 years. If the STPs are to address the demand on the primary care units and deal with the shortage of GP facilities, there has got to be a programme, supported by Ministers, of investment in primary care in Essex so that the GPs can do far more for their patients without sending them off to hospital.”
“A moment ago the Minister mentioned some extra money for primary care. Who is responsible for investing that money? Does it come from NHS England and not from the CCG? How do we influence how that money is spent, so that there is some accountability in the process?”
“I commend my right hon. Friend for her very measured response to the provocation of the calling of a second independence referendum in Scotland: she is not ruling out a referendum in the future, but now is not the right time. Will she also point out that the Scotland Act 2016 reserves all the single market issues to the United Kingdom Government? These are matters that we should share with Scotland in the discussion, but they are matters reserved to the United Kingdom.”
“The amendment does not simply give this House the right to vote on these matters; it also gives the other place the right to vote on these matters. Will the hon. and learned Gentleman explain what would happen if this House voted to accept what the Government want to do, but the other place dug in and rejected it? What would happen then?”
“I am yet another Select Committee Chair who very much welcomes this development and the courage with which the Government are putting it forward, but there is a point to be made about what is allowed to be taught in primary schools and the fact that children’s experiences start well before they leave primary school. They are learning about these things and asking questions about them long before they leave primary school, and there is nothing in this Bill that will prevent teachers from responding to curiosity and dealing with these issues as they arise in the normal course of any other part of their education.”
“May I draw my right hon. Friend’s attention to the fact that the Public Administration and Constitutional Affairs Committee has been taking a great interest in the inter-institutional relationships within the UK, that we produced a report in December on this subject, which I commend to him, and that the main thrust of the recommendations are not about structures and institutions but about natural adversaries sitting down together and developing relationships and bonds of trust and understanding?”
“When the Government serve notice on the European Union under article 50, will they take that opportunity to frame the negotiation by making it clear that we expect to agree the framework of our future relationship, as specified in article 50? Otherwise, we will effectively be negotiating the divorce arrangements in the dark, and the European Union would not be observing the principle of sincere co-operation.”
“The purpose of complaints is not just the redress of grievances—which I must say is extremely unsatisfactory in the NHS anyway—although that is clearly important; complaints are a tool by which public services can learn and improve. When medical professionals are forced primarily to be concerned with avoiding liability and responsibility and are trapped in a culture of blame, there can be no learning. There is an acute need for the Government to follow through on their commitment to promote a culture in which staff feel able to speak out and in which the emphasis is placed on learning, not blame. I very much hope that they will implement PACAC’s recommendations as a step towards achieving that as soon as possible.”
“To ensure that the learning produced from HSIB’s investigations leads to an improvement in standards, PACAC also reiterates its previous recommendations, made in our 2016 report, “PHSO review: Quality of NHS complaints investigations”, that the Government should stipulate in the HSIB legislation: first, that HSIB has the responsibility to set the national standards by which all clinical investigations are conducted; secondly, that local NHS providers are responsible for implementing those standards according to the serious incident framework; and, thirdly, that the Care Quality Commission should continue to be responsible, as the regulator, for assessing the quality of clinical investigations at local level according to those standards.”
“Unfortunately, there is still a long way to go if the Department of Health’s aim of turning the NHS into a learning organisation is to be achieved. Most importantly, HSIB is being asked to begin operations without the legislation necessary to secure its independence and ensure that the safe space for its investigations is indeed safe. That undermines the whole purpose of HSIB. It is essential that the Government introduce the necessary legislation as soon as possible.”
“PACAC’s report also considered the potential impact of the new healthcare safety investigation branch, which is in the process of being set up. The creation of HSIB, as it is known, originates from our recommendations as the Public Administration Committee in 2015. The Government accepted our recommendation, and HSIB is due to be launched in April. It will conduct investigations into the most serious clinical incidents, and is intended to offer a safe space to allow those involved in such incidents to speak openly and frankly about what happened. In so doing, it is hoped that HSIB will play a crucial role in transforming the expectation and culture in the NHS from one that is focused on blame to one that emphasises learning. It should be a key part, albeit only a part, of the wider strategy that we want the Government to adopt.”
“To further understand the issues and what more needs to be done to tackle them, PACAC recently undertook its inquiry, which followed up on the PHSO’s “Learning from Mistakes” report. In PACAC’s report, which was published earlier this week, we conclude that if the Department of Health is to achieve its policy of turning the NHS into a learning organisation, it must integrate its various initiatives to tackle the issue and come up with a long-term and co-ordinated strategy. That strategy must include a clear plan for building up local investigative capability, as the vast majority of investigations take place locally. We will hold the Secretary of State for Health accountable for delivering the plan.”
“In its report “Learning from Mistakes”, which was published last year, the PHSO highlighted the fear of blame that is pervasive throughout the NHS. That fear drives defensive responses and inhibits open investigations, which in turn prevents NHS organisations from understanding what went wrong and why. That also undermines public trust and confidence, because the public can see that NHS organisations are failing to learn from mistakes—if they did, that would drive improvement. A combination of a reluctance on the part of citizens to express their concerns or to make complaints, and a defensiveness on the part of services to hear and address concerns, has been described by the PHSO herself, Dame Julie Mellor, as a “toxic cocktail” that is poisoning efforts to deliver excellent public services.”
“I am grateful for the opportunity to present to the House the seventh report of PACAC this Session, “Will the NHS Never Learn?”, a follow-up to the Parliamentary and Health Service Ombudsman report on the NHS in England, “Learning from Mistakes”. Over the past decade, written complaints regarding NHS services have doubled, from just over 95,000 in 2005-06 to more than 198,000 in 2015-16. Investigations into such complaints have frequently failed to identify the root causes of any mistakes that occurred. Even more frustrating is that they have failed to prevent the same mistakes from being repeated over and over again, despite multiple reports highlighting that as a critical issue from both the Parliamentary and Health Service Ombudsman and the Public Administration and Constitutional Affairs Committee, which I chair.”
“In other fields, such as aviation and marine investigations, where this kind of investigative process is already established and is designed to find the causes of accidents without blame, there is far less resort to litigation at the outset. That does not preclude litigation in the final analysis, but discovering the truth without blame is the first step towards reconciliation.”
“I confess I am not sighted on the proposal to cap litigation costs, but people resort to litigation only because they feel that their complaints are not being heard and that the problems they have identified in the service are not being addressed. People resort to litigation because they do not feel they are being told the truth. We know from our surgeries that most people who complain come in and say, “I only want to make sure this doesn’t happen to somebody else. I don’t want compensation.” Nevertheless, because that public-spirited attitude to complaining is so often rebuffed in the health service, people resort to litigation because they feel there is a cover-up.”
“I very much hope that Wales, Scotland and Northern Ireland will either set up their own equivalent of HSIB, or employ HSIB as the pinnacle of their investigation system as well. This matter is not something that necessarily needs to be devolved any more than the Air Accidents Investigation Branch of the Department for Transport.”
“I am most grateful to my Welsh hon. Friend for his question. It gives me an opportunity to highlight not only my agreement with the point that he makes, but that this is just about healthcare safety investigations in England. By pursuing this policy to set up HSIB, the Government have embarked on a very, very major and significant reform, which the health services in Scotland, Wales and Northern Ireland are certainly watching. I can assure my hon. Friend that they are being watched all over the world. Different countries in different jurisdictions have tried using various bodies to deal with this question. I do not think that any country before England has embarked on a reform of this scale and nature that has the capacity to transform safety investigation in a health system.”
“I certainly agree that the vast majority of our constituents who experience the care of hospitals or GP practices are extremely grateful for the quality of care that they receive. However, we cannot underestimate how corrosive the blame culture has been throughout our health system. Crises such as those at Mid Staffordshire and at the Morecambe Bay maternity unit arise from the defensive culture that exists in the NHS. If we are to change that into a much more open and collaborative system of learning from mistakes, we need HSIB to set the tone throughout the entire organisation. It is not just about dealing with a few complaints, but about setting a whole new standard for a whole new profession in the NHS about how complaints and clinical incidents are investigated. I am most grateful to have the opportunity to present this report.”
“I am most grateful to the hon. Gentleman for his question and for his support. I am also extremely grateful to my Committee for its work on this report. I hesitate to lose the progress that we have made. We have approved the appointment of the chief investigator of HSIB, who spent 25 years as chief investigator of the Air Accidents Investigation Branch of the Department for Transport. He brings with him that wealth of experience and perspective about how this organisation should work. The answer is, as the hon. Gentleman suggests, for the Government to bring forward the legislation as quickly as possible. I know that efforts are being made in that direction, but perhaps the Minister will have something to tell us.”
“I leave with the Minister the word “legislation” echoing in his ears, and I very much look forward to making further progress with him on these matters.”
“Perhaps something can be included in Her Majesty’s Loyal Address later this year. I must point out that it is not just about statutorily underpinning the independence of HSIB, but the safe space to which he refers and on which he thanks the Committee for its contribution. The safe space has to be legislated for. Without legislation, there is no safe space. The AAIB, the Marine Accident Investigation Branch of the Department for Transport and equivalent bodies could not possibly function unless they can provide people with protection, so that those people can come and talk openly and off the record about what has happened. That has transformed the safety culture in other areas, and it is the transformation that we need in the health service.”
“I am most grateful to the Minister for his question and for the fact that he has personally appeared at the Dispatch Box today with his opposite number from Her Majesty’s Official Opposition. I know that his presence here underlines the commitment of the Secretary of State to this programme of change. I very much welcome the shared programme of work to which my hon. Friend refers, but, in taking evidence for this particular report, we found that there was some dislocation between the various bodies involved in it. We conclude that it is only Ministers, and probably only the Secretary of State, who can draw this together to ensure that there is a coherent strategy and a plan, which is what we emphasise in this report. Finally, my hon. Friend refers to legislation in passing, but I hope that valiant efforts are being made in that regard.”
“May I ask my right hon. Friend how the Government will approach the regulations and directives that will be created and implemented between now and the date we leave the European Union? We probably have no intention of keeping those regulations or directives, such as the ban on glyphosate. The National Farmers Union is very clear that that measure will be very damaging to British agriculture. Will we have to implement it before we leave?”
“It must adapt to the way in which people in our society expect a complaints process to work, and it must better retain and engage its staff in order to do so. It must do all that while reducing costs and overheads. The scale of the challenge is significant, but I am confident that Rob Behrens possesses the strong leadership skills, the strategic vision and the judgment, as well as the experience as an ombudsman, to ensure that those challenges are met. PACAC looks forward to working with him as the PHSO continues its work.”
“She has built on the work of her predecessor with vision and commitment, and under her leadership the PHSO is much more engaged with Parliament than ever before. I thank her for staying at the helm of the PHSO while her replacement was appointed. Under her leadership the PHSO has had to face many challenges, not least a cut of more than 24% in its spending between now and 2020. It has been the target of critical public scrutiny—perhaps it is justified; some of it certainly is—which has made the role a challenging one. The PHSO is in the middle of a five-year reform plan, and it faces further reform if the Public Service Ombudsman Bill, which the Government have published in draft form, comes into effect. The PHSO must improve the quality and speed of its investigations. It must implement technological change.”
“From his time as the independent adjudicator for higher education in England and Wales and as a senior adviser to the European Network of Ombudsmen in Higher Education he has gained considerable experience of complaint handling and a detailed understanding of the role of an ombudsman. I am sure that that will enable him to make a success of his new role. I should point out that the Public Administration and Constitutional Affairs Committee and the Health Committee were unanimous in approving his appointment; we held a joint pre-appointment hearing. I would also like to take this opportunity to pay tribute to Dame Julie Mellor for all that she has done to take forward the work of the PHSO.”
“In the past few months, we have scrutinised PHSO reports such as “Driven to despair: How drivers have been let down by the Driver and Vehicle Licensing Agency”, and “Learning from mistakes: An investigation report by the Parliamentary and Health Service Ombudsman into how the NHS failed to properly investigate the death of a three-year old child”. Our report on the latter will be published on 31 January. More recently, we published our report on the PHSO report on unsafe discharge from hospital. Having been involved in the recruitment process, although I did not take part in the pre-appointment hearing, I would like to welcome Rob Behrens as the new Parliamentary and Health Service Ombudsman.”
“Our purpose is to sustain and enhance public confidence in the effectiveness of government, and, working with the PHSO, that is what we have sought to do. We not only receive the PHSO’s reports on behalf of Parliament but actively scrutinise each of them, and the public service that the report is addressing, to make sure that the PHSO’s recommendations are properly heard and followed through by whichever Department they are addressed to. We have become the accountability mechanism that makes the PHSO’s reports and work effective.”
“The Public Administration and Constitutional Affairs Committee, or PACAC, was originally established as the Public Administration Committee to receive the reports of the Parliamentary and Health Service Ombudsman and to scrutinise its performance. This was in the 1960s, long before the establishment of most of today’s departmental Select Committees. Our remit is much wider these days, but PACAC regards our work with the PHSO as one of our most important functions which exemplifies and underpins our purpose as a Committee. The PHSO exists to receive complaints about maladministration in the public service and in the NHS. “Maladministration” may be an accurate term, but it is not very appealing. However, our role and remit is clear, and our purpose is implied rather than spelled out.”
“May I commend my right hon. Friend for his reticence about getting drawn into this, and may I also commend the Prime Minister for her reticence, which was entirely appropriate given the subject at issue? Is it not rather ironic to hear right hon. and hon. Members complaining about the possible lack of credibility of the deterrent when some of them do not actually believe in the doctrine of deterrence at all? It would be unwise of the Russians or any other potential adversary to suggest that they could take the risk of invading this or that country on the basis that we might have a misfire of one of our missiles.”
“Happy birthday, Sir. May I thank my right hon. Friend for providing time quickly for the approval of the name of the candidate for the Parliamentary and Health Service Ombudsman, which was approved by the Health Committee and the Public Administration and Constitutional Affairs Committee yesterday? As we have already heard, Tuesday 24 January is the day on which the Supreme Court is delivering its judgment. May I suggest to my right hon. Friend that it would be expedient for the Government to plan to make a statement immediately on the future implications for business, even if a substantive statement on the longer-term implications of such a judgment will need to be made at a later date?”
“In the Prime Minister’s conversations with our EU partners, will she make it clear that, whatever deal we strike with the European Union, we will be offering free trade? Will she ask them why anybody is considering a reversion to protectionism and tariffs, particularly in view of the fact that paragraph 5 of article 3 of the treaty on European Union enjoins the EU to contribute to “free and fair trade”?”
“I am glad that my right hon. and learned Friend now agrees that this Parliament should be supreme. In fact, Mr Blair did take the country to war on the royal prerogative, because the vote in this House was not law, but purely advisory. Is it not rather odd that we now have a Supreme Court that sees itself as a constitutional court able to direct that this House shall have to do something, which has always previously been our right? We are a supreme Parliament; we can stop Brexit if we want to.”
“We have been in this organisation for only 43 years, which is a tiny span of our history. We debate it hotly now, but all the controversy will pass, and we will look back with much more equanimity than we feel today.”