Bernard Jenkin MP: speeches

Speeches

• 6 Jul 2026 · Patient Safety Review · Hansard source

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  I am grateful for this opportunity to evaluate the Dash review of patient safety, and I thank the Minister for the meeting with her this afternoon. I hope that the House and Penny Dash will forgive me, but in the interests of brevity and clarity, I shall be direct. Whenever asked to justify the abolition of the Health Services Safety Investigations Body, Ministers refer to Dash, but Dash fails to make the case for what it recommends. This new clinical incident investigator was established less than three years ago. HSSIB is a new concept in healthcare, conceived to challenge the culture of denial and blame in the NHS. It is proving itself, even with its very limited budget. One early report on aortic dissection led to 300 more people receiving lifesaving treatment. The Minister now has a list of key recommendation impacts produced by HSSIB. A lot of them may seem small or piecemeal, but so far it is only a small body. After a boy suffered an avoidable death from cancer, HSSIB recommended to NHS England a new community language translation and interpreting services framework so that non-English speaking patients would get appointment letters for their children that they could read and understand. HSSIB recommended a protocol between prisons and ambulance services to avoid wasting ambulance time and new guidance for non-accidental injury of babies in emergency departments where no specific guidance had existed before. The Dash review shows no understanding of HSSIB’s purpose and no comprehension of coherent safety systems management. Dash gets facts wrong and misinterprets the law, either through a failure of understanding or because the recommendation to abolish HSSIB somehow reflected the desired outcome of the review, regardless of the facts. I will set out some specific questions, most of which the Minister has had in advance. If she does not have enough time to respond, I look forward to discussing them at a future meeting that we discussed having.

• 6 Jul 2026 · Patient Safety Review · Hansard source

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  I thank the hon. Lady for that intervention. Only an independent investigator can find the causes of the incident that may be part of the culture or practice of that provider, or of the system as a whole. It is like suggesting that airlines or aircraft manufacturers can protect passenger safety without the independent accountability provided by the AAIB. Of course, providers should have the capacity and capability of conducting patient safety investigations, but they must know that HSSIB can and will look at that work and will hold them to account. Recommendation 3 also says that HSSIB should continue as what it calls “a centre of excellence for investigations” in the CQC, but I am afraid that this is just a sop. The CQC, as was pointed out by my right hon. Friend the Member for Godalming and Ash, is a regulator and compliance enforcer, not an investigator. How can the CQC also be an independent investigator? Dash also says that the CQC internal successor should collaborate through the NQB to agree the scope of any investigations it carries out and agree the recommendations. Dash is effectively saying that CQC investigations will be overseen by the NQB. That is a direct attack on the independence of investigations. Can the Minister explain who in future will conduct independent and unconflicted investigations into safety incidents in the NHS? For example, how would an investigation under the CQC be free to find that the CQC inspections themselves were causing unintended harm to patients, or is it back to the misery of litigation through the courts and more public inquiries? The recommendation also makes no reference to the statutory safe space raised by the hon. Member for Shipley (Anna Dixon) that provides for protected disclosure by patients and their families, clinicians and others in safety investigation bodies. It is a crucial safeguard, allowing people to speak. It allows for the duty of candour. I would just point out that the duty of candour does not work if it is just imposed on people. People cannot be forced to incriminate themselves. If placed under the CQC, confidence in the safe space investigations will collapse—and back we go to public inquiries. The Health Bill does attempt to address this by replicating the 2022 Act’s safe space provisions, but that Act also provided for disclosure in certain circumstances, which is allowed on the basis that the benefits for the safety of patients outweighs any impact on current and future investigations. But under this Bill, who will decide what protected information can be disclosed? How will the CQC give the same confidence that the safe space is not being compromised as HSSIB? Finally, Dash fails to look at the comparative cost of HSSIB investigations versus the cost of public inquiries. HSSIB at the moment only costs £6.3 million per year. To save money, the Secretary of State should request that HSSIB conducts far more investigations into matters which he thinks are important, provided that he also provides the funding for the necessary capacity. HSSIB, for example, has conducted eight investigations into mental health suicides since 2023. Each was completed in a few weeks or months, costing a total of £850,000. In comparison, the Lampard inquiry into the Essex partnership university trust in my constituency—investigating the same problem—is expected to cost more than £5 million. Ockenden cost £14 million. This is very far from the best use of resources for conducting investigations. So I ask the Minister, why have Dash and the Government ignored the whole question of HSSIB’s value for money? Even if HSSIB only saves a fraction of the £3.6 billion in costs of clinical negligence, it will pay for itself many fold. I do hope that Ministers will reconsider the whole issue, reflecting on the fact that none of the Royal colleges, nor any of the patient safety organisations, nor the all-party group on patient safety support this unjustifiable policy.

• 6 Jul 2026 · Patient Safety Review · Hansard source

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  I 100% agree with my right hon. Friend. He will note that I will pick up on those points during my remarks. I come back to the questions that I want to put to the Secretary of State. First, if HSSIB’s investigations are intended to continue unaffected by the transfer to the CQC, why bother with the expense of the transfer? Are Ministers simply using Dash as the pretext for what people in the Department or elsewhere in the NHS would like to have? HSSIB was deliberately started very small, but the intention was that over time it would take over more investigations in health and replace the need for wasteful, lengthy, inexpert ad hoc public inquiries. Over the years, inquiries have proved to be a chaotic means of investigation, assembling expertise from scratch, which is then lost after the inquiry, and failing to command public confidence or to fix the system. That is why, after the 1999 Paddington rail crash, the Ladbroke Grove inquiry in 2001 established the rail accident investigation branch. Since then, despite many fatal rail accidents, there has been no public inquiry into a rail crash—nor has the public felt the need to demand one—and rail safety has improved. Given that HSSIB is expert, full time, and can conduct much cheaper and quicker investigations than public inquiries, how can Ministers accept the Dash recommendation to abolish it? Why not consider expanding HSSIB to avoid the need for so many costly public inquiries? Dash complains about there being far too many recommendations—yes, there are—but, as Dash itself enumerates, it is the 30 public inquiries that, in its language, have “cluttered” the “landscape” with some 1,400 recommendations over recent years. HSSIB is therefore not the source of those recommendations. In HSSIB’s first 34 months of operation, it has produced only 56 recommendations. How can Ministers use that reason to justify HSSIB’s abolition? Dash refers more than once to “quality (including safety) of care”. That elides quality of care with safety. In any other safety-critical industry, safety is seen as a distinct, separate and overriding priority. It is telling that in the report, the words “including safety” are added merely in parentheses, as though safety is ancillary to quality, but that becomes justification for rationalisation while actually compromising safety. Safety system management is intrinsic to safety and public confidence in other safety-critical activities, such as aviation, but this is alien to NHS culture. I therefore ask the Minister again: without HSSIB, which independent body will promote a coherent understanding of safety system management in health, and who is to hold the NHS and Government to account for safety failures?