The Scottish Government has announced it will provide additional support to a crisis-hit health board.
Jeane Freeman confirmed that NHS Greater Glasgow and Clyde (NHSGGC) had been escalated to stage four of the NHS Board Performance Escalation Framework following the deaths of two children on a ward affected by water contamination.
There have been ongoing issues relating to infection prevention, management and control at the Queen Elizabeth University Hospital (QEUH) and the Royal Hospital for Children (RHC).
A Scottish Government-led oversight board will be introduced to “strengthen current measures already in place to mitigate avoidable harms”.
In a letter from Ms Freeman to the health and sport committee, she said: “In light of the ongoing issues around the systems, processes and governance in relation to infection prevention, management and control at the QEUH and the RHC and the associated communication and public engagement issues, I have concluded that further action is necessary to support the board to ensure appropriate governance is in place to increase public confidence in these matters and therefore that for this specific issue the board will be escalated to Stage 4 of our performance framework.
“This stage is defined as ‘significant risks to delivery, quality, financial performance or safety; senior level external transformational support required’.
“The intention of the escalation would ensure appropriate governance is in place to increase public confidence and strengthen current approaches that are in place to mitigate avoidable harms.”
The oversight board will be chaired by Professor Fiona McQueen, the chief nursing officer.
Ms Freeman added: “I will keep parliament updated on the role of the oversight board and the actions that it is taking, as the work progresses.”
The country’s largest health board now joins NHS Tayside, NHS Highland and NHS Borders at stage four.
In addition, NHS Lothian and NHS Ayrshire & Arran are a level down at stage three.
Following the announcement, Ms Freeman told STV News: “So I think it is clear that what the board has not been able to do so far is clearly answer questions that patients and families, parents in this particular interest, have an absolute right to ask.
“And they have a right to get full and open answers.
“So it’s clear, I think, from everything I’ve said so far, that the board has simply not been good enough at that – and so we need to work directly with them from government to get that right.”
She added: “Level five is basically where government comes in and takes over. You can’t have that position forever. You need to be able to help a board get to where they need to be.
“So this is a mix of government intervening and making clear instructions and checking that they are followed, and so on, at the same time as we help the board to get to where they need to be, so that we can then step away when we are confident that it is working and the board can get on and do their job.
“Proper infection prevention and control, and engagement and information-giving to patients and families should be business as usual.”
‘Deepest sympathies to the families affected’
The health secretary expressed her “deepest sympathies” to the parents of ten-year-old Milly Main and a three-year-old boy who died three weeks apart at the £842m QEUH in August 2017.
Addressing MSPs at Holyrood on Wednesday, Ms Freeman said: “I want to start by offering my deepest sympathies to the families affected.
“To lose a loved one in any circumstances is hard, but I cannot begin to imagine the pain of losing a child in these circumstances – or the suffering and grief that will stay with them for the rest of their lives.
“I also want to apologise to them that they feel they have not had their questions answered.
“They are absolutely right to ask and pursue their questions, and they are entitled to have them answered and to receive the support they need.”
Whistleblower lifted the lid on child deaths
Two wards at the Royal Hospital for Children (RHC) – on the same campus as QEUH – were closed in September last year following concerns from Health Protection Scotland over incidents of water contamination.
Milly’s parents were reportedly not told about the water contamination link, which emerged following investigations into infections in children in the cancer wards at the RHC two years ago.
Milly’s mother, Kimberly Darroch, said she was “100%” certain her daughter died due to infected water at the hospital.
The children’s deaths emerged after Labour MSP Anas Sarwar was contacted by a whistleblower that claimed an internal investigation uncovered 26 cases of the infection stenotrophomonas in child cancer patients at the RHC – in addition to the 23 found by an official investigation.
Following the announcement of the oversight board, Mr Sarwar, MSP for Glasgow, said: “Jeane Freeman has taken the correct course of action.
“The Glasgow health board is not fit for purpose, and this is a necessary step following the unforgiveable failings of senior management.
“The focus now must be to tell parents, patients and the public the truth about infections at the hospital.
“I pay tribute to the brave whistleblowers who came forward to shine a light on the catastrophic failings in the hope that nothing like this can ever happen again.
“My thoughts are with Milly’s mum Kimberly and her family. She is one step closer to getting the truth.”
Scottish Liberal Democrat health spokesperson Alex Cole-Hamilton MSP added: “Increasing the level of scrutiny around the operation of NHS Greater Glasgow & Clyde is the right thing to do.
“The public would expect it following the tragic and potentially avoidable deaths of young children, and the manner in which this has been investigated.
“Families are in need of reassurance that their loved ones will be cared for in safe facilities. This has caused people with operations or hospital stays on the horizon to be more anxious.
“It is clear there is a need for continued and heightened oversight of the QEUH.”
Scottish Labour health spokesperson Monica Lennon MSP said it was a “long overdue intervention”.
She added: “When I asked Jeane Freeman in parliament if she still has full confidence in the leadership of the health board, she ducked the question.
“The Scottish Government must now confirm whether they are happy for the chief executive and the current leadership team to continue in their roles.
“The chief executive is managing a board which has badly let down many families, and this cannot be allowed to continue.”
‘Our communication has not been good enough’
Earlier this week, Ms Freeman revealed that she was yet to see the findings of the doctor-led investigation that was allegedly carried out in 2017 into possible infections at the hospital.
NHSGGC has refused to comment on the investigation raised by the whistleblower, but issued an apology to families for its poor communication.
On Wednesday, a NHSGGC spokesperson stated: “We completely understand that this has been a distressing time for families and our staff and we apologise for the anxiety caused.
“Our communication with families and parents has not been good enough and we deeply regret this.
“We continue to take steps to improve communications and to answer questions openly and truthfully.
“We are also working with professor Craig White to develop better ways of engaging with families.
“Within NHS Greater Glasgow and Clyde, we encourage staff to raise problems with their managers or with their trade union.
“We have a robust whistleblowing policy which enables staff to raise concerns and have them dealt with in full confidence. We will continue to support staff in this process.
“There are clearly lessons for this board to learn and we are committed to making the necessary improvements.”
On Friday, the health board added: “We welcome the additional support offered and are committed to working closely with the Scottish Government to implement any recommended additional changes and enhancements across infection control and associated engagement.”
‘No indication deaths are linked’
On Sunday, police confirmed they had investigated the death of the three-year-old boy and had passed a report to the procurator fiscal.
Speaking to STV News on Monday morning, Ms Freeman said there was “no indication” that the deaths of the two children were linked.
She said: “There is no indication that there is a connection between those two deaths.
“In terms of that young boy’s family, it is my understanding that his family were given full information about what happened in his case, the cause of his death and so on, and were fully informed and involved.
“But in the case of Milly Main, that was not what happened and it is not acceptable that her mum found out that at least one of the factors in her daughter’s death was an infection when she read the death certificate.
“She should have been informed of all that much earlier by the board and that is the matters that we need to get behind and we need to sort out.”