27/02/2017 House of Commons

to see what ever my department can do to work across and help all

regions of the United Kingdom including Northern Ireland.

Thank you. Order. Wilbur member wishing to take his seat please come

to the table. -- would the member wishing to take his seat.

I, Gareth Craig is now do solemnly sincerely and truly declare and

affirm I will be faithful and paid for allegiance to Her Majesty Queen

Elizabeth, her heirs and successors, according to law. -- Gareth Snell.

Gareth Snell, member for Stoke-on-Trent Central.

Order. Urgent question, Jonathan Ashworth. Thank you Mr Speaker. To

ask the Secretary of State to make a statement on the loss of

confidential NHS correspondence by NHS shared business services.

The Secretary of State for Health, secretary Jeremy Hunt.

Thank you Mr Speaker. On the 24th of March last year I was informed of

the serious incident involving a large backlog of unprocessed NHS

patient correspondence, by the company contracted to deliver it to

GP surgeries, NHS shared business services. The backlog arose from the

primary care services GP mailed redirection service that SBS was

contracted to do in 2016. However, in three areas of England, the East

Midlands, north-east London and the south-west England, this did not

happen, affecting 708,000 items of correspondence. None of the

documents were lost, and all were kept in secure storage but my

immediate concern was patient safety might have been compromised by the

delay in forwarding correspondence. This is a rapid process was started,

to identify whether anyone had been put at risk. The Department of

Health and NHS England immediately established an incident team led by

Mr Matthews, who heads the NHS single primary care services team.

All the documentation has been sent on to the relative relevant GP

services, where it is possible to do so, following initial clinical

assessment of where any patient risk my life.

200,000 pieces were temporary residence forms and a further

500,000 pieces were assessed as low risk. A first for a large identified

2500 items that had potential risk of harm and needed further

investigation, but followed up by local GPs has already identified

nearly 2000 of these as having no patient harm. The remainder are

still being assessed, but so far no patient harm has been identified.

As well as patient safety, transparency both for the public and

this house has been my priority. I was advised by officials not to make

the issue public last March, until an assessment of the risks to

patient safety had been completed, and all relevant GP surgeries

informed. I accepted that advice for the very simple reason that

publicising the issue could have meant GP surgeries being inundated

with enquiries from worried patients, which would have prevented

them doing the most important work, namely investigating the named

patients who word is potentially at risk. For the same reasons and in

good faith, a proactive statement about what had happened was again

not recommended by my department in July. However, on balance, I decided

it was important for the House to know what had happened before we

broke for recess, so I did not follow that advice and placed a

written statement before the House on the 21st of July.

Since then the PAC has been kept regularly informed. Most recently

been updated by my permanent secretary only last Friday. The

information Commissioner was updated in August and the National Audit

Office is currently monitoring the response. I committed in July 2016

to keeping the House updated once the investigations are complete and

more was known and will continue to do so.

Let's be under no illusions Mr Speaker, this is a catastrophic

breach of data protection. Over half a million patients data, including

blood test results, cancer screening results, biopsy results, even

correspondence relating to cases of child protection all undelivered.

They were languishing in a warehouse on the Secretary of State's watch.

It's an absolute scandal, Mr Speaker. Time and time again this

Health Secretary promises us transparency. Well, today he stands

accused of a cover up. The Department of Health knew about this

in March, 2016, so why did it take this self-proclaimed champion of

transparency until the last day before the House rose last summer to

issue 138 words statement in Parliament? That's statement said

"Just some correspondence had not reached the intended recipients"

Foster when he made that statement was he therefore aware that it

amounted to over 700,000 letters? If so, why did he not inform

Parliament? If he didn't know, does that not call into question his

competence? Now, what guarantees can he give us

that no further warehouses of letters are yet to be discovered?

Was the private contractor involved paid for the delivery of these

letters and if so, what steps are being taken to recover the money?

How many patients were harmed because their GP did not receive

information about their ongoing treatment? Do patients remain at

risk? Is talked about the ongoing investigation into 2500 by NHS

England. When are we likely to know the outcome of that investigation?

We understand capita now has the contractor delivering these

services. What he putting Capita under so it doesn't happen again and

is it not better that rather than this relentless pursuit of

privatisation that we bring services back in-house? Mr Speaker, two

months into 2017 and the health service lurches from one crisis to

another. Hospitals overcrowded, waiting lists out of control. He

can't deliver the investment our NHS needs. He can't deliver a social

care solution. He can't deliver patient safety and now he can't even

deliver the post, Mr Speaker! He has overseen a shambles that puts

patient safety at risk. Patients deserve answers and they deserve an

apology. The right honourable gentleman is

reasonable and sensible but these commendable sides to his character

have not read on display, not least because I answered a number of the

questions in his preprepared questions. He said there had been a

catastrophic breach of data protection. Nope patient data was

lost and all data was kept in secure settings. I know it's a great

temptation to go on about privatisation but what happened

since SBS lost this account was that this work was taken in-house. It is

not being done by Capita at by the NHS, so much for his relentless

pursuit of the private sector that he thinks we are pursuing. This

morning he told the Guardian that patient safety will have been put

seriously at risk. Patient safety, as he knows, is our primary concern

but as things stand, he will have heard there is no evidence so far

that any patient safety has been put at risk. We have been through over

700,000 documents and so far we can find no evidence but there are 2500

we are doing a second check with GPs so that a second clinical opinion is

sought and of those so far, nearly 2000 cases, we do not think there is

evidence and are going through the remaining ones, but it was totally

incompetent for SBS to allow this and we take full responsibility as a

government because we were responsible at that time but the

measure of the competence of the Government isn't when suppliers make

mistakes, it happened a few times when Labour were running the NHS,

the measure is what you do to sort out the problem and immediately we

set up an instant team, every piece of correspondence has been assessed,

around 80% of the higher risk cases have been assessed by a second

clinician, and then he suggested the Government had tried to hide the

matter. If he listened, I did not follow my advice from officials

which was not to publicise the matter, I decided that the House

needed to know and it was only a week after I was reappointed to this

job but I didn't just lay a written statement, I also referred to which

in my department's annual report and he said I had played down the

severity of what happened. The report said the serious incident was

identified and talked about a large backlog of unprocessed

correspondence relating to patients. It couldn't have been clearer. For

this Government has always been about patient safety, we have

listened, as I know he would have done if we were in office, to the

advice of people who said if we went public right of way, GP surgeries

could be prevented from making detailed assessments of a small

number of at risk cases and that was quite report, but as soon as we

judged it possible, we informed this House and the public and stayed true

to our commitment to patient safety and transparency. This is

undoubtedly a serious incident but I welcome the detailed and thorough

steps the Secretary of State has taken to protect patient safety. He

will know there are ongoing problems with the transfer of patient records

and GPs and hospitals spend hours chasing up results and letters on a

daily basis. Isn't it time that patients were given direct control

of their own records and will he update the House on this? I would

like to thank my honourable friend for her contribution and she is

right that although the process of sending on these documents has been

taken in-house, other parts of the contract were taken on by Capita

and... No. He cannot stop, campy? Left me rip eight that this work has

been taken in-house but other work by Capita has had teething problems

which we are aware of and we know it has caused doubles for GPs, and the

minister has been meeting Capita and people relating to that contract of

a fortnightly basis. In the long run the issue is to give patients

control of their records. We have become the first country in the

world to give every patient access to their records online and from

September you will be able to do that without having to do to your

GP. I'm sure everyone across the House is glad that this 750,000

incidents have not so far resulted in patients suffering but that is

like rather than plan for which we should be grateful. This is yet

another situation similar to concentric 's and others we have

seen, so when we are outsourcing and taking on these companies, what is

the basis and governments of the contract? The Secretary of State

mentioned other incidences of transferring data when a patient

moves surgery, so when will data in England become more digital so

things are not sent by the post-? We haven't used that for several years

in Scotland and it is holding back the primary care system here, so

when will his vision for that come about? She's good at selling their

house things that Scotland does better than the NHS in England but

is more coy about things that Scotland does less well than

England, and if you put aside those issues, we can both agree that the

sooner the NHS across the whole UK goes electronic the better. We have

made progress so far, more than two thirds of A departments can access

a summary of GP records and we go further every month. As these

patients could have moved anywhere in the country, can my right

honourable friend assure me whether any of my gift achievements in Bury

North would be affected, either today or in the future? I don't have

the information about Bury North patients immediately to hand but I

will write and tell him if it has affected any of his constituents. I

raised my concerns about the contracting out of patient records

service to SBS in 2011 and was told by his predecessor that this was

about saving money, so can he tell us how much money has been saved and

how many of the 708,000 patients affected are in the South West? The

south-west was one of the regions affected and I can write to him with

exactly how many patients I think were affected, but it was when his

government was in office and when he was a Health Minister that the use

of the private sector was championed. I know it's not

fashionable in his party now but we think if we want the NHS to be the

safest in the world... Water. The honourable gentleman is shouting

from a sedentary position. I cannot imagine it is the offence I would

have committed. I do not know what has happened to standards. Objection

to the manner and content of a ministerial response is not a novel

phenomenon in the House of Commons. Victoria Atkins. There have been

cries opposite of privatisation but isn't the truth that in 2007 HMRC

lost the entire collection of child benefit records affecting 25 million

people and isn't the point that old data holders, whether in the private

or public sector, must hold our private information securely? That

is absolutely the point and what people will wonder was, when we were

faced with this issue, which was a serious issue, did we react as

quickly as we could to keep patients safe, and I believe the answer is

yes, and did that happen under the last laboured government? The

Secretary of State just stated with great authority that no patient data

was lost. I would be interested to know how he can be so certain, given

all this data was missing for a long time without anyone noticing. What

controls are in place now that were not in place then that meant he can

make that statement? I don't know if she has done a health question with

me before but we are assured that the data was not lost, it was kept

in secure setting which means it was safe, it wasn't breached or accessed

by anyone else. What didn't happen but should have happened is that it

wasn't passed on to the right GP surgery, which is why we have taken

steps to make sure patients are kept safe. My honourable friend miracle

times when we found ourselves in opposition and hope we had found a

success on our hands and the image that springs to mind is foxes and

shooting them. Will he agree with me that the department he expertly

guides need to draw attention to the use of electronic data for all

patients rather than spurious opposition problems? As ever he is

thinking intelligently about the problems we really face, and the

question was asked by the Liberal Democrat member for Richmond Park

about the security of the data files, but the security of

electronic files is the issue we have to think about more serious

states as we give everyone access to their records and because of issues

around hacking, it is an issue we are taking seriously and working on.

I wrote to the Secretary of State on behalf of a medical centre in my

constituency in January but haven't yet had a reply, perhaps he could

respond to my point about staff safety. We had an issue of patient

safety but what about danger to staff of these records are not being

available about patient? I would like to reflect on his question in

more detail rather than giving an instant answer because to date no

one has brought to my notice issues about staff safety but it is

something we take seriously. We are aware of the extra administrative

pressure on staff caught by leading to go through the records where

there is a high risk of harm and we paid GP surgeries extra resources to

cover that extra time but I will look into the issues he raises.

Since 2015 it's been a statutory requirement to use a unique and

consistent identifier on health and social care records, since this

would help with putting date it electronically in the health and

social care system, so could the Secretary of State update the House

on that? I am happy to do so, when we can all access our health records

there are potentially huge benefits to patients, in particular people

with long-term conditions being able to take more control of what happens

and spot mistakes that sometimes happen in records, this is a big

finding from the US where people had more widespread access to records

for longer, the issue is the security with which people accessed

those records and we are looking at the systems used by banks, which are

pretty robust, but whether we can have systems even more robust than

those used by banks because it is important that patients have

confidence that only they can access those records. Can he tell us which

areas in the Midlands have been affected and given that I is an fine

structures we have in the NHS, can he tell the House which of his

ministerial team have the job of keeping watch on NHS Shared Business

Service? The minister who was responsible for these areas is my

honourable friend the minister for Oxford and West Abingdon, but in

this case, this happened before she was in post and I took personal

responsibility myself because it was such an important issue and I will

write to him with more details about how the East Midlands was affected.

Does the Minister agree it is vitally important we move toward a

paperless NHS and it will be very difficult to do that for as long as

National Health Service trusts can't talk to each other electronically.

Meaning for example, images of radiological images are very often

not available when patients see doctors, meaning patients after the

test again, which is contrary to all the precepts of good practice. He's

absolutely right. This is a very big part of our translation plans for

the NHS. As much on summation plans. When the NHS does well

internationally, are GP records are among the best of any country, and

the GPs have done a fantastic job in the last 50 15 years. Where we are

less good is in our hospital records, where you can still find

paper records in widespread use. He's quite right, that's not just

very, very expensive but also an safe at times.

I used to work in a pathology lab and absolutely pains me to think of

those results that are generated by the hard work of pathology staff,

languishing in a warehouse somewhere, unseen by anybody. I know

what GPs will do if they don't get those results, they will bring the

laboratory and ask for them. Has the Secretary of State made any estimate

to the time wasted in phone calls from GP services to pathology labs?

Regrettably I'm sure that because of what happened extra work was created

for GPs. But what I would say to the honourable lady is, it's because of

GPs commitment to their impatience that it appears that in the vast of

cases patient harm is avoided, because when results don't come

through that GP is expecting, the GP chases those results and makes sure

the right thing is done for patients. As you rightly says, at

the cost of work. Would my right honourable friend

agree with me that had the Labour government not made such a

catastrophe of implementing the NHS computer system, that record such as

these that have been digitalised many years ago and problems with

storage of paper records would not have impacted the patients that are

currently suffering? He does speak wisely, and I think

that's why many members of the public will be faintly amused to

hear the party opposite saying how important it is we move to

electronic health records. It was an absolute catastrophe, the NHS IT

project, costing billions of pounds. The intention was right that the

delivery was wrong, and that's what we're trying to sort out.

I understand that large numbers of patients in north-east London were

affected by this failure of the service. Can the Secretary of State

tell me how many of my constituents were affected? Can he tell me how

many of those were cancer patients? Can he tell me how many would have

been subjected to an inordinate delay in receiving referrals for

treatment? Can he give that itemised breakdown to all members of

Parliament who are in constituencies where we will have constituents

affected by this? I'm very happy to write to

honourable members in the areas affected with any extra information

that we are able to provide. But what I'd reassure him is that to to

date we have not been able to identify any patients in any part of

the country that has come to harm as a result of what happened.

It's a shame that the synthetic layout in the Labour Party was

apparent when they were talking for a public inquiry into deaths in mid

Staffordshire or the worst IT White elephant disaster, ?12 billion in

2013. Isn't it the case that my right honourable friend, isn't it

the case he's observed the appropriate Parliamentary

accountability protocols in that he has not only employed clinical

expertise but been to the House in July and his officials have updated

the official accounts committee in September and come here today

question that there is no cover up. I'm grateful to my honourable

friend. As he rightly points out, this was a judgment call, because

going public on what happened at a very early stage risked overwhelming

GP surgeries, which would have meant GPs were not able to investigate the

most serious cases as quickly as we needed. That's why I received very

sensible advice to hold back. But I did decide that the House needed to

know this before the summer break and that is why I made the effort

that I did. A number of GP practices in Wirral

West have made clear to me that concerns about capita's handling of

confidential records. There are cases of records being delayed, in

some instances records haven't arrived at all. As my colleague, the

member for West Derby said, there also been the concern that where

there is a patient that may be at risk because of some mental health

issue, that is in flag to our medical staff. That's a very serious

risk to put our staff under. Would my honourable friend shared the view

of the chair of the BMA's GPs committee was that this is an

example of what happens when the NHS tries to cut costs by inviting

private companies to do work they then don't do properly?

She does make very important points about the need for rapid transfer of

records when people move GP surgeries. Can I just gently point

out to her as well... I'm sure it's a question she was asked to say but

the reality is, because of the failures of this contract, we have

taken this work in-house. It is not about the Government is pressing on

with privatisation irresponsibly or whatever is, this work is now done

in-house. It seems to me, first of all we have

an excellent Secretary of State, and the Government seems to have taken

the appropriate action. My concern is what the Secretary of State said

about his members saying that how should not be informed. I remember

under Gordon Brown and Tony Blair on the last day of term we would have

80 odd written statements. It would be better of the written statement

was made earlier in the week so members could have considered

whether an urgent question was appropriate.

I think... Inordinate circumstances he makes a reasonable point. -- in

ordinary circumstances. He may remember there were other things

happening at that time last year. As I say, I had only been reappointed

for a week so there were other things. My priority was to make sure

we didn't go away for the summer without the House being informed of

the situation. The Minister says he has paid people

to clear this backdrop. I'm assuming they are GPs. How much have you paid

the GPs and are you intending to re-coop that money back to the NHS?

I have no plans to recoup anything but the Secretary of State might

have. I regret to say the ?2.2 million

that was paid to GPs has gone to GPs for the extra work that needs to be

done and that is fair payment for the extra time that they have taken.

It is indeed a cost to the taxpayer, but it was the right thing to do.

The question... ?2.2 million, for the second time.

Could the Secretary of State reassure the House that throughout

appropriate staffing resources have been made available to deal with

these backlogs, not just nationally but also in the East Midlands?

We have always been concerned to make sure, because of the extra

administrative work involved, going through more than 700,000 records,

other patients using the NHS to find their care is delayed. That is why

we made extra resources available for GP practices, so that they could

get the resources in to do that without interrupting the ordinary

work they have to do for their patients.

Surely the Secretary of State would agree with me that if everything was

going swimmingly in the NHS, if we were investing like our European

neighbours in the NHS, if we had people who were confident that their

A were safe, that their trusts were safe, that they, that the whole

health service wasn't in trouble, the privatisation was by chewing

into the NHS, this could be put into proportion. But the NHS under his

watch is in chaos. That's why we are so worried about these items.

Let me gently remind the honourable gentleman that because of decisions

this government has taken we're actually now investing more than the

European average in the NHS. Something that would have been much

more difficult to do if we'd followed his own party's plans.

He tries to characterise our approach, suggesting that the NHS

doesn't have a problem. We think the NHS has got some very big problems.

It's working hard to tackle them but we are providing more doctors, more

nurses, more funding and more operations than ever before in its

history. I commend the Secretary of State for

his response to the situation once he was told about it. Welcome his

pledge to provide constituency why data to the House. My constituents

in Kettering will be amazed that for five years no one spotted that

700,000 records had gone missing. Can I ask him, how was it

discovered, and why is it that in these three areas such a large

amount of data effectively disappeared from public view?

Well, I wish I could give him the answer to that question! LAUGHTER

I do think it is, I do think it is completely extraordinary that for

such a long period of time it wasn't noticed that this data had gone

missing. I think it was discovered towards

the end of the SPS contract, and I think there are lessons in the NHS

which relate very closely to what other honourable members have said,

about the dangers of overreliance on paper rather than electronic

systems, where it is much, much easier to keep track of what's

happening. And let me say to the honourable

gentleman opposite, who continues to make comments from the sedentary

position, that when it comes to making the NHS electronic, I think

people will compare his government's record and hours and say which is

better. I'm sure our members across this

house will be able to identify with the anxiety caused while waiting for

test results or diagnoses, I certainly can. Does he concur with

me it will be of scant consolation to those 700 and odd thousand people

who were told their letters weren't lost but were residing in a

warehouse somewhere? It is completely an acceptable in

the supply is no longer performing that job for the NHS. Of course, it

causes frustration for many people when their information they are

waiting for doesn't reach their GP surgery. I think the most important

thing she and I would agree with is the safety of patients, and that's

why our biggest priority in this has not been about the administrative

inconvenience, frustrating though it is, but to understand of any

patients have actually been put at risk.

This morning I was very pleased to tour the new clinical assessment

unit that was opened last month at Crawley Hospital, partly made

possible because that space used to store paper records and now they

have moved to an electronic records. Can I commend the Secretary of State

for increasing that drive to electronic records rather than using

paper? And can I urge him to redouble his efforts in that

respect? I'm very happy to follow my

honourable friend's advice in this respect. I think we all know that

proper use of electronic records creates huge opportunities, but we

have to carry the public with us and we have to make sure we have that

confidence that that data is going to be held securely, which is why we

have introduced a new Guardian, the patients watchdog in this area.

NHS shared business services Limited exists for one reason only and that

is to deliver ?1 billion in savings by 2020. The results of this

government's ideological obsession with savings and austerity is surely

now laid bare for all to see. We are quite lucky, quite literally that we

didn't kill anyone. Wilbur Secretary of State agreed to meet with the

Chancellor urgently to discuss increased funding for our health

service that is being starved of resources it needs to run

effectively? -- will the Secretary of State?

The ideological obsession with savings and austerity as we have

increased the NHS twice as much as they have in Scotland.

As the Secretary of State is aware, patient safety is absolutely

paramount. For the benefit of my constituents can you confirm that

patient safety was, throughout this process, and remained his primary

concern? She is absolutely right. That has

been our primary concern. I think it also needs to be our primary concern

as we examine the lessons that need to be learned as a result of this.

Both in terms of the setting of contracts with the private sector

and also the monitoring of those contracts, both of which were

clearly deficient in this case. The Secretary of State was

responsible for nearly the entirety of this contract but has told us he

doesn't know how it came to light to NHS England. Do you think he should

have been better prepared and what assurances can he give us that he

now has controls in place for future contracts? If she listened to the

facts I told her, what happened over 700,000 records have been shut, 2500

high-risk ones are being checked by two clinicians and 80% have been

shut, a huge amount of work has been done to clear up the situation. I

agree it was unacceptable that it happened but we are not the first

government where suppliers have let us down. Resign! A few moments ago

the Secretary of State added to do what he called teething problems

with Capita had GP practices in my constituency have told me those

problems are worsening. How much longer will he give Capita to

perform under their contract with thick Capita -- the Department of

Health and if they cannot, how quickly will he decide to take that

work back in-house? If they do not perform we will take all necessary

measures including ending the contract, but she is right there

have been problems with that contract in its early days. We

believe this situation is improving but there still to be made. Order.

Point of order, Mr Speaker. A plethora of points of order. Last

Friday after debates on Private Members' Bills, the honourable

member for Redcar left the chamber and briefed to the media at large

that my speech on the Istanbul convention had stopped her bill from

being debated and had in effect blocked it, despite me saying I

supported her bill. This has led to my office receiving some widespread

and unjustified abuse that they should not be subjected to. The

honourable lady for Redcar's bill was the eighth to be considered on

Friday.