National Health Service

Alex Cunningham Excerpts

Monday 16th July 2012 Commons Chamber

[Barry Gardiner (Brent North) (Lab)]

rose—

[Alex Cunningham (Stockton North) (Lab)]

rose—

[Mr Speaker]

Order. The Front-Bench winding-up speeches will begin at 7.10 pm, so the two remaining colleagues can divide the time if they wish, but not if they do not. I call Mr Barry Gardiner.

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[Alex Cunningham (Stockton North) (Lab)]

Thank you, Mr Deputy Speaker.

Patients in my constituency of Stockton North are already feeling the pain from the Tories’ policies. The number of admitted patients who have waited longer than 18 weeks for an operation rose by a staggering 49% between May 2010 and November 2011, and I have no doubt that the figure is much higher now.

The North Tees and Hartlepool NHS Foundation Trust faces a drastic cut to its budget of £40 million over three years. Chief executive Alan Foster has said that that is the most difficult financial position that he has ever faced and has acknowledged that the cuts will undoubtedly lead to unpopular decisions to keep the trust afloat. The trust is trying very hard, and it has even resorted to car boot sales to try to balance the books. Some of those cuts could be achieved if the Government got behind the trust and did something to ensure that the two North Tees and Hartlepool university hospitals are replaced by one midway between the two communities.

My fear is that there will be no new hospital and the trust will be forced to close one of the existing hospitals if it is to have any chance at all of delivering £40 million cuts in the next few years. We could end up without any of the benefits of a new hospital, and the targets might still not be achievable. Such a cut would almost certainly cause irreparable damage to the trust’s ability to maintain the excellent range of high-quality services of which it is justly proud. It will undermine all the good work that has gone on in the trust over the past 10 years.

I know that the trust will keep patient safety, quality and performance at the top of its agenda as it goes through this difficult period, but it will not be easy to deliver services to the 350,000 people who depend on them, as they have in the past. The north-east already experiences far greater levels of poor health than the national average. It must be due to the heavy industries and resultant poor environment, as our region mined coal, built ships and made chemicals and steel. The budget cuts will only worsen this position.

The last Labour Government worked hard to reduce the kind of health inequality faced in my constituency, where men can expect to live 14.8 years less in one part of the constituency than in another. Real progress was made to close the gap, but even so, it has proved painstakingly slow, as much work requires huge resources, which are now being denied. I feel the gap growing, even though I know that Stockton borough council has recently appointed a high-calibre person to head up public health. We will not be able to make the progress everyone wants if he and the NHS are starved of resources.

Community Hospitals (North-East)

Alex Cunningham Excerpts

Wednesday 20th June 2012 Commons Chamber

[Alex Cunningham (Stockton North) (Lab)]

I congratulate my hon. Friend and fellow Teesside MP on securing this debate. I know how hard he works on behalf of his constituents to secure access to the services that they need, particularly health services. Is he surprised that there will be more cuts, particularly in the light of the £50 million that it is costing to reorganise the NHS on Teesside?

[Tom Blenkinsop]

I am not surprised, to be honest. A couple of days ago, the Newcastle Journal reported that a freedom of information request had demonstrated that even after the NHS redundancies that we have seen, which I think cost approximately £60 million, a further 1,000 nurses are set to be cut in the north-east region.

The role of community hospitals is as important as ever. Despite the apparent importance of community hospitals, I fear for the future of hospitals such as those in Brotton and Guisborough in my constituency, the five other community hospitals of the South Tees Hospitals NHS Foundation Trust, and the trust’s district general hospital, the Friarage, which is at the heart of the Foreign Secretary’s constituency. All those hospitals are seeing a reduction in services as a consequence of the Government’s health reforms and austerity package—whether the reduction of minor injuries provision, the closure of the Chaloner ward at Guisborough hospital or the downgrading of maternity and paediatric services at the Friarage, which even the Secretary of State has branded “unacceptable”.

Ultimately, communities, patients and employees recognise that only so many services can be cut before the future of the hospitals themselves is brought into question. They are concerned that the Government are failing to do anything whatever to prevent those reductions in services. [Interruption.] I give way to the hon. Member for Redcar (Ian Swales).

Oral Answers to Questions

Alex Cunningham Excerpts

Tuesday 12th June 2012 Commons Chamber

[Mr Speaker]

Order. I do not want to be unkind, but every month the Secretary of State’s answers are too long. Perhaps he can make this the first month in which he is rather more economical.

[Alex Cunningham (Stockton North) (Lab)]

2. What the cost to the public purse was of NHS staff redundancies in 2011-12.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

3. What the cost to the public purse was of NHS staff redundancies in 2011-12.

[The Minister of State, Department of Health (Mr Simon Burns)]

Audited 2011-12 figures on NHS exit packages, including redundancies, are not yet available. The data will be available in the summer, once the Department’s annual report and accounts are laid before Parliament.

[Alex Cunningham]

The latest figures from the Department show that the cost of reorganising the NHS on Teesside is more than £50 million, including £9 million in redundancy payments to hundreds of staff who have lost their jobs. At the same time the Minister is demanding massive cuts of £40 million from the local hospital trust. Will he apologise to the people of Teesside for wasting their money and confirm that none of those made redundant will be re-hired in the new structures?

[Mr Burns]

No, of course I will not. What the hon. Gentleman fails to recognise is that the NHS must continually evolve to meet challenges and that this is the best chance the NHS has to improve and drive up standards. What he fails to mention in his question is that the £1.2 billion to £1.3 billion cost of the reform will lead, between now and the next election, to £4.5 billion of savings, £1.5 billion every year thereafter until 2020, and every single penny of that money will be reinvested in front-line services.

Health Transition Risk Register

Alex Cunningham Excerpts

Thursday 10th May 2012 Commons Chamber

[Alex Cunningham (Stockton North) (Lab)]

The risk register that the Government fear publishing apparently points to potential major failures, including financial ones, in their plan for the NHS. Within weeks of coming to power, the Government ditched Labour plans for a new hospital for my constituents as it was considered too costly or financially risky, yet several hospitals could be built with the money wasted through their reorganisation. When will they recognise that and give their backing to the new financial plan for our hospital?

[Mr Lansley]

The hon. Gentleman knows perfectly well that the reason we refused that support is that his local trust is a foundation trust. It was never contemplated that foundation trusts undertaking major capital projects in excess of £400 million should simply expect the Department to supply a capital grant for that purpose. Without commenting on the merits of the proposal, I think that his trust has since developed new and improved proposals. I am not sure that they have come to me in any sense at this stage, but when they do I will certainly be willing to look at them very carefully with the Minister of State, my right hon. Friend the Member for Chelmsford (Mr Burns).

Health and Social Care Bill

Alex Cunningham Excerpts

Tuesday 20th March 2012 Commons Chamber

[Dr Poulter]

I thank my right hon. Friend for that clarification. The Government are clearly committed to the value that lay members bring to commissioning groups, and, as my right hon. Friend has said, two is the minimum. I hope the hon. Lady will accept that it is very disingenuous to suggest that lay members who are appointed to boards of hospitals or primary care trusts, or indeed to commissioning boards, show a lack of genuine care for patients in the way in which they commission services.

Given that the Opposition have tabled a bad amendment, and given the renewed focus on a commitment to integrated care for the benefit of older patients and people with mental health problems, I believe that we should support the Government this evening.

[Alex Cunningham (Stockton North) (Lab)]

I support the amendment relating to Monitor and NHS foundation trusts. The Government seek to amend the Bill to allow—[Interruption.]

[Madam Deputy Speaker (Dawn Primarolo)]

Order. I think the hon. Gentleman will find that he is referring to the wrong group of amendments. The group that we are discussing is headed “Secretary of State, NHS Commissioning Board and CCGs”. We will be discussing the amendment to which he referred later, and I presume that for that reason he will now resume his seat.

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[Dr Poulter]

I hope I reassured my hon. Friend with my earlier answer. Yes, he is right that that has happened in the past. However, there is a presumption in the Bill—particularly for rural areas such as Cornwall and in Suffolk, which I represent—that the renewed focus on integrated care that we heard about earlier is the primary focus and purpose of commissioning, over and above the use of any willing provider or private sector providers. That has given me great reassurance regarding our ability to take on and deal with the big demographic challenges of looking after older people better.

I am reassured by what the Minister has said, and I urge Government Members to support the Government.

[Alex Cunningham]

I rise to support the amendment and to speak against anything that will allow 49% of the capacity of our local hospitals to be used for private patients.

Along with other measures in the Bill, the Government have accepted various amendments that will result in lengthening waiting lists for NHS patients. The Government’s relaxation of NHS waiting times targets means that hospitals are free to devote more theatre time to private patients, and they will have a clear incentive to do so in order to maximise income, given the move towards full financial independence and a “no bail-outs” culture whereby hospitals in financial trouble are allowed to go bust with no help from the Government.

The Health and Social Care (Community Health and Standards) Act 2003 placed a cap on the level of income that a foundation trust could earn from private patients. It was based on the level of a foundation trust’s private income in 2003—the year when foundation trusts first came into being—which was typically about 2%. The Bill in effect sets trusts free to deploy as much as 49% of that capacity to generate income from private patients who can afford the fees to jump the queues, which ordinary hard-working people, and the most vulnerable in our society, cannot do. This is not what patients want, not what the professionals want, and not what the NHS needs.

The Government amendments must be changed to ensure that any increase in the proportion of patient income has the approval of Monitor. Allowing individual trusts to make the decision alone means that there is no strategic overview, which Monitor would offer, and so in theory it would be possible for all the trusts in a locality to make that increase to 49% if their individual boards approved it. I wonder what that would mean on Teesside. We have two major hospitals, so half the capacity for NHS patients could go. Labour’s amendment would set a tougher cap on private patient income. Without the amendment, the NHS will take a huge step towards privatisation and we will fail to put in safeguards to ensure that the needs of the general public are met. Rather than the NHS being free at the point of delivery, more and more people will be pushed towards insurance schemes, thereby putting money in the pockets of the insurance industry and denying the exceptionally important right to have free, high-quality health care when it is needed.

[Simon Hughes]

I am absolutely clear that I was not sent to this place to force through the privatisation of the NHS, to force people from the public sector into the private sector, or to undermine great hospitals such as Guy’s, St Thomas’s and King’s College or the other hospitals in my constituency and my borough. Like colleagues from all parts of the House, I know what a fantastic service the NHS provides, not as a matter of policy but from personal experience. It saved the life of my younger brother and looked after my mother in her last days in the most fantastic way that anybody could wish for. I am clear about the commitment of the NHS.

I am therefore clear that we have to look at what the Bill says and what it will do. I have had an exchange about that with the shadow Secretary of State for Health. This is a really important issue outside this place. Clause 161 sets out the following principle:

“The principal purpose of an NHS foundation trust is the provision of goods and services for the purposes of the health service in England.”

That was not thought to be enough, so colleagues in the other place said, “Let’s for the first time ever make it clear that private activity can never be more than a minority activity.” That is why the 49% figure appeared.

However, that is not still enough—[Interruption.] Let me deal with this point. That is why Lords amendment 148 is before us. It states that if any foundation trust hospital in England proposes to increase its private income by 5% or more from its current level, which is usually about 2% or 3% of its income, the governors have to agree to the proposal by a majority. There will not be any great vote by the governors of Guy’s and St Thomas’s, King’s College or any other hospital, with the public participation in the debate that there would be, suddenly to increase their private sector activity. That is not the real world, because that is not what the British public want. There are one or two cases—

Health and Social Care Bill

Alex Cunningham Excerpts

Tuesday 20th March 2012 Commons Chamber

[Andy Burnham]

No, because we brought down NHS waiting lists to their lowest ever levels and we left patient satisfaction at its highest ever level. Those same waiting lists are going up under the right hon. Gentleman’s Government and he should be ashamed of that. He will not publish the information about the risk to waiting times because he is frightened of putting it before the House and the public, but we will remind them of the truth.

The Government proclaimed that they were going to be the most open and transparent Government in history. Today, it still says on the Treasury website in a statement of the Government’s principles for risk management:

“Government will make available its assessments of risks that affect the public, how it has reached its decisions, and how it will handle the risk. It will also do so where the development of new policies poses a potential risk to the public.”

May I suggest that the Government take down that misleading statement of policy? Their actions have left it in tatters, together with the grand claims of openness and transparency. The tribunal, they will say today, has not given us its reasons. Ministers will try to argue that the public and Parliament’s right to know about the impact of their policy decisions is outweighed by the public interest in the preservation of a safe space for policy advice.

Those arguments were considered, first, by the Information Commissioner, and subsequently by the Information Rights Tribunal. They found the opposite to be the case: that the public interest lay in full disclosure. But it does not matter; Ministers are simply re-running the arguments of a case that they have lost. They have no leave to reopen the substance of that argument, but they are not the only arguments that they have lost.

In an attempt to rescue the Bill last year, the Prime Minister made a number of claims for it. They cover issues that we know are in the local and regional risk registers which have been published. First, he said the Bill was needed as the NHS does not

“deliver the patient-centred, responsive care we all want to see”.

He cited heart services and claimed that someone in this country is twice as likely to die from a heart attack as someone in France. That was before new research in January reported a 50% fall in heart attack deaths in the past decade.

Then the Prime Minister said that cancer services were failing people, compared with other countries. That was before new research in November 2011 which showed that the NHS in the past decade achieved the biggest drop in cancer deaths of any comparable health system in the world. Thirdly, the Prime Minister and all the Ministers on the Government Front Bench have routinely trotted out the same script for years—that NHS productivity has declined in the past decade. That was before new research on NHS productivity from Professor Nick Black published in February in The Lancet showed that, far from falling, NHS productivity increased in the past decade at the same time as the NHS achieved patient satisfaction.

One by one the Government’s arguments for the Bill have fallen apart. They have comprehensively lost the argument. They have convinced nobody and now they are running scared, resorting to the only remaining option of ramming the Bill through Parliament before they are required in law to publish the real assessment of their policies.

[Alex Cunningham (Stockton North) (Lab)]

I am sure my right hon. Friend will join me in wishing well 11-year-old Bailey Stark in my constituency as he and his family cope with his condition that means that he is unable to swallow. His mother is worried sick about the changes in the health service, which might mean that he will not get the treatment he requires in Newcastle. Does my right hon. Friend agree that that risk is all the more reason for publishing all risks, as we should know the truth about what is happening to our NHS? [Interruption.]

[Andy Burnham]

Members shout “Scaremongering” from the Government Benches, but the Government will not publish the evidence to back up their claims. We have read the local and regional risk registers which warn precisely of the case that my hon. Friend mentions—of damage to the continuity of care, risks to patient safety, longer waits for cancer patients, risks to child safeguarding. Those are the facts in the regional risk registers and they are the facts that Ministers are trying to withhold from the public.

Health and Social Care Bill

Alex Cunningham Excerpts

Tuesday 28th February 2012 Commons Chamber

[Mr Lansley]

I have to tell my hon. Friend that nothing much about the Opposition surprises me any more.

[Alex Cunningham (Stockton North) (Lab)]

Will the Secretary of State now accept that, contrary to the impression he is trying to create, the opposition to his muddled bill is not some plot by health workers or trade unions with vested interests, but is coming from many Liberal Democrats, the majority of the British public and almost the entire health community, to whom his Government promised to listen?

[Mr Lansley]

Opposition Members distort what is in the Bill and tell their constituents that it is something other than what it is, and then they come to the House and say, “Oh, it’s muddled.” It is not muddled at all; it is they who are muddled.

NHS Risk Register

Alex Cunningham Excerpts

Wednesday 22nd February 2012 Commons Chamber

[Alex Cunningham (Stockton North) (Lab)]

We have heard much hollow praise for the health service from those on the Government Benches. They say wonderful things about it, then they kick it in the teeth. The NHS is one of the best health care systems in the world, full of dedicated professionals. I am very proud of what Labour did when we were in government. We invested in health and we resuscitated the dying NHS that previous Tory Governments had left starved of resources and unable to meet people’s needs.

When I predict decline, I do not think I have got it wrong, but if the Government want to correct me on that they could publish the risk register so that the medical profession, patients and the House can know the true extent of the potential damage that their Bill will do to our national health service. Perhaps the risk register says the Bill is a great idea. I do not know. Perhaps the Government could share it with us.

Yes, something can be done to build on Labour’s legacy, but we do not need several billion pounds to change something that most people believe is an excellent service already. In November last year the Commonwealth Fund, an international foundation that supports independent research on health care issues, ranked the NHS as the best performer on a range of measures looking at how health systems deal with people with chronic and serious illness. It found that of the 11 high- income countries surveyed, Britain was among those with the fastest access to GPs and the best co-ordinated care, and suffered from among the fewest medical errors.

UK patients reported more positive health care experiences than sick adults in the other countries—they were more likely to be able to get a same-day or next-day appointment when sick and to have easy access to after-hours care. They were less likely to experience poorly co-ordinated care. All that was in spite of the fact that per capita health spend in the UK is the third lowest of the 11, at just under £2,000 per head, almost two and a half times less than in the USA.

In the light of these fantastic achievements, it is all the more baffling why the Tory-led Government are so intent on causing such havoc in our wonderful national institution and undoing all the hard work that has gone into making our health care first class. Is it not sad that they are not prepared to reveal the details of their own risk study? Again, I ask what they are afraid of. We are the envy of the world when it comes to health care, most notably leading the field in ease of access, co-ordinated care and good patient-doctor relationships. Although we must not rest on our laurels, our first priority must be to preserve and build on the strengths of general practice by producing more GPs so that even more can be done to improve the health of their patients. The excellent work done by GPs is what makes the NHS safe, fair and value for money.

Instead of looking to us for inspiration, however, the world is now looking on in astonishment that the Tory-led Government are willing to dismantle such an innovative, effective and well loved system. Patients in my constituency, Stockton North, are already feeling the pain from the Tories’ reckless policies. The number of admitted patients who have waited longer than 18 weeks for an operation rose by a staggering 49% between May 2010 and November 2011. James Cook hospital in nearby Middlesbrough serves many of them, and they tell me of mastectomies being cancelled. One patient had an operation cancelled four times owing to a lack of beds. Three patients were left on trolleys, again owing to lack of beds, and another constituent told of an out-patients department closed all afternoon because of a lack of staff. Sadly, I understand that their experiences are mirrored elsewhere in the country.

There are almost 500 fewer nurses in the north-east England strategic health authority area since the Tories came to power—500 fewer nurses who are not treating the sick, the elderly and the vulnerable at a time when health inequalities in the north-east are already unacceptably high. The gap was narrowed under Labour. Now we are seeing it widen again. In total, more than £3.5 million will be spent reorganising the NHS—an astonishing amount to spend when the economy is in such dire straits. That is all the more reason why the risk register should be published, so that we get the truth of these disastrous effects.

Oral Answers to Questions

Alex Cunningham Excerpts

Tuesday 10th January 2012 Commons Chamber

[The Minister of State, Department of Health (Paul Burstow)]

I certainly share my hon. Friend’s concerns. BBC Essex’s reports of abuse and degrading treatment in that care home are cause for concern. The CQC is due to publish a report shortly and I am certainly happy to meet my hon. Friend to discuss the matter further. The Government are determined to shine a light on abuse wherever it is found and to root it out of the system to ensure that people are treated with dignity and respect and get the care they need.

[Alex Cunningham (Stockton North) (Lab)]

T3. Does the Health Secretary agree with the Prime Minister that our nurses need greater supervision by patients’ groups on the ward to ensure that they are doing their jobs correctly, or does he recognise the tremendous job that they and their professional clinical managers are doing despite the huge cuts that the Health Secretary has forced on their numbers?

Oral Answers to Questions

Alex Cunningham Excerpts

Tuesday 22nd November 2011 Commons Chamber

[Mr Simon Burns]

The straightforward answer is no, because the Joint Committee of Primary Care Trusts has said that it intends to appeal. This is an independent review. It would be inappropriate for me or any other Minister to interfere in such a review, because we could be accused of compromising its independence.

[Alex Cunningham (Stockton North) (Lab)]

The Prime Minister promised a bare-knuckle fight to save A and E and maternity units at King George hospital, Chase Farm hospital and other hospitals that the Secretary of State now plans to close. When will that fight take place, and where can hon. Members purchase tickets for ringside seats?

[Mr Burns]

I heard what the hon. Gentleman said, and I was disappointed that we did not reach his question on the Order Paper earlier, because he has been extremely concerned about the A and E in his own area in Hartlepool. That decision was taken on safety grounds. Emergency care has been provided at the One Life centre. The decision was taken with the support of the local overview and scrutiny committee, which he will appreciate has democratic accountability. That was the right decision. Where there are clinical reasons for taking such decisions, they should be taken.