Health

Andrew Gwynne Excerpts

Thursday 27th February 2014 Ministerial Corrections

The following is an extract given by the Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison), to the hon. Member for Denton and Reddish (Andrew Gwynne), from Oral Question number 16 on 25 February 2014.

[Andrew Gwynne (Denton and Reddish) (Lab)]

Ministers again deny that England’s A and E departments are in crisis. The Secretary of State did so in response to my right hon. Friend the Member for Leigh (Andy Burnham) earlier. It just will not wash any more. In the past two weeks, 10,743 patients waited on trolleys for up to 12 hours because no hospital beds were available and 52 patients waited for even longer. Does the Minister really think that it is acceptable that patients are experiencing the worst fortnight in A and E this winter while she is complacently sitting on her hands?

NHS Patient Data

Andrew Gwynne Excerpts

Thursday 27th February 2014 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure, as ever, to serve under your chairmanship, Mr Amess. I congratulate the hon. Member for Mid Norfolk (George Freeman) on securing this timely and important debate and on his extremely thoughtful and powerful opening contribution. I congratulate other hon. Members on their contributions, too.

I know how strongly the hon. Member for Mid Norfolk feels about this issue, and he is right. He has been instrumental in establishing the Patients4Data group. I commend also the work of the co-founder, Graham Silk, and of Patients4Data in campaigning for the opening up of data in the national health service. That group has been very good at bringing the issue of patient data to the forefront of debate on health policy across England. I was pleased to share a platform with the hon. Gentleman earlier today at the summit that he hosted in Parliament.

It goes without saying that a growing population, an ageing population, the rise of co-morbidities and the necessary drive to improve the quality of care and treatments available to patients mean that, in future, the success of the NHS will increasingly rely on the data to which it has access. Indeed, if we take as a starting point the fact that the health and social care worlds, through both desirability and financial factors, are heading towards proper and full integration, it goes without saying that in breaking down the structural silos between the NHS and social care and, within the NHS, between community services, acute services, primary care services and mental health services, we also need to break down the information silo mentality in the NHS.

Genuine “whole person” care will require “whole person” information. Let me put the current controversy over care.data to one side for the time being. The fundamental principle is to create a system designed to link together medical records from general practice with data from hospital activity and eventually extend that to cover all care settings inside and outside hospital. As even my hon. Friend the Member for Leeds East (Mr Mudie) said, no one wants to wreck that. It is a really good thing for the future of health and social care in this country.

The improvement of health care in England depends on the removal of the barriers between primary and secondary care—between the GP, the surgery and the district general hospital, and between social care providers and traditional health care providers. Integration is the key to meeting the needs of patients, and the availability of integrated data is central to shaping the services that will meet those needs. It is in that context that the need for data sharing should be seen.

Let me make it clear to the House that Labour supports the principle behind the proposal. Whole-person care must have at its heart a whole-person approach to information. It is important that key statistics drawn from that data set can be used to further clinical research or even future service planning. Let us not forget that if it were not for medical data sharing, the link between thalidomide and deformities at birth would never have been identified, and it would have taken decades longer to establish clearly and definitively the link between smoking and lung cancer, which the hon. Member for Worthing West (Sir Peter Bottomley) mentioned. Good medicine is determined by access to good data.

If we are to improve the lives of our children and reduce health inequalities, we must ensure that data are readily available to researchers. Making data at the local GP practice level available for the first time will give us an unprecedented insight into local health outcomes. Which GPs are over-prescribing antibiotics or antidepressants? What factors are causing delays to early diagnosis of cancer? If we are truly to tackle health inequalities, which are a huge issue in a constituency such as mine, we need a joined-up approach. That is simply not possible without ready access to data.

Most people readily recognise the clear benefits of a data-sharing scheme, but there is rightful concern about how the care.data initiative has been implemented so far. Mistrust of care.data is not surprising given the nature of the data involved and the typically haphazard communication about the scheme, particularly the opt-out programme for patients who do not wish to take part. Many people did not even know that the scheme was happening in the first place, at least until the recent media reports. To be fair, if the only information that someone has about care.data is what they have read in the newspapers, they will probably get on the phone to their GP to make an appointment to opt out straight away.

I do not know whether it is the result of incompetence, a reflection on how we live our lives today or a combination of both, but the conventional methods of public information campaigns simply have not worked. Every home in England should have received the leaflet entitled “Better information means better care”, which my hon. Friend the Member for Leeds East happily brought with him.

The blunt truth, however, is that most people either have not received the leaflet or have not looked at it. Questioning of Ministers during the recent Committee stage of the Care Bill, in which approval for care.data sits, revealed that even Ministers do not know whether every house has received the leaflet, what the opt-out rate is or what the regional variations are.

Although I do not get to see much TV these days—such is the nature of the job we do—the first I saw of the advert for care.data was on BBC “Newsnight” last week. That is an important point for Governments of all political persuasions. As I said at the summit earlier, if we think back to the success of some of the big public health campaigns, such as the “AIDS: don’t die of ignorance” campaign nearly 30 years ago, we remember the hard-hitting TV adverts, the big posters with the tombstone on and the powerful leaflets. Today, as my hon. Friend the Member for Leeds East pointed out, we are bombarded with so much junk mail—pizza menus, UPVC window offers, supermarket offers and, dare I say it, even the odd political leaflet—

[Mr Tobias Ellwood (Bournemouth East) (Con)]

It is a two-horse race.

[Andrew Gwynne]

It certainly is a two-horse race in my constituency; do not let the Liberals tell you otherwise. The point is that it is very easy for someone to miss the leaflet about care.data even if they received it. I received it and I read it, but I think that is probably the neurosis of politicians; when a leaflet comes through the door, we automatically think that our opponents have started the general election 16 months early.

Many of my neighbours, who I assume must have received the leaflet, claim that they did not. Likewise, we can easily skip the adverts on TV. In my home, we have Sky Plus, that wonderful technology that allows us to press fast forward as soon as the advert break starts and skip all the adverts. Conventional methods now fail to penetrate with the vast majority of the general public. We probably need to implement a more personalised approach to make the public aware of the scheme, of the benefits, of the implications and of their individual rights.

Incredibly, we have heard stories of people who want to opt out of the system and have had to make an appointment with their already overburdened GPs to do so. I do not think that that is necessarily the right approach. GPs are already struggling to use their time to deliver good quality general practice and primary care services, and perhaps an easier way to allow people to opt out using a variety of methods should be explored. As the Minister will be aware, the chief executives of Mencap, Sense, the Royal National Institute of Blind People, the National Autistic Society and Action on Hearing Loss have written to the Secretary of State expressing concerns that information about care.data is not being communicated in an accessible way to disabled people, who are consequently being deprived of the opportunity to make an informed choice about the future of their medical records.

We want care.data to work, and it is in everyone’s interests that it does, but—this is where the pause is welcome—the Government need to get a grip before the aims of the project are lost on a suspicious public anxious about what care.data is for and how their personal data will be used. That risks compromising a project that I think we all recognise to be vital. The proposal by the hon. Member for Mid Norfolk for the Government to establish a working group of campaigners and opponents—their inclusion is important—to try to resolve the differences is a sensible way forward. Consensus is the key here.

The Government must understand that the data do not belong to them or to the NHS, but to each of us individually. That should be the starting premise. The combined data that the NHS holds about me are mine and no one else’s, and that should be enshrined. Only then will the Government be able to make the case that inappropriate use of the data could never be sanctioned.

Let us be honest—if the data are mine and they are recognised to be so, that is empowering for me as an individual and a patient. “No decision about me, without me” has been the mantra of Ministers of all political parties in the Department for some years, but how about “no information about me, without me” as the next guiding principle? Our most intimate details are wrapped up in this system. The Government will be able to shore up public and institutional support only when they have convinced the public that the data will not and cannot be abused, and when they have been honest about the potential risks.

The data are owned by the patient, and all parts of the NHS must be their legal custodian. Rights and proper responsibilities must go together—the legal responsibility to use data for necessary purposes, and only for necessary purposes, with proper safeguards in place and, to agree with my hon. Friend the Member for Leeds East, tougher sanctions to underpin them. We need to convey to the public the laudable intention behind the proposals, because even professional trust in the programme is so low that a poll for the Medical Protection Society found that 80% of family doctors believed that the system could undermine public confidence in the principle of medical confidentiality.

[Sir Peter Bottomley]

I often try to look at the questions that people are asked. I am not absolutely certain that doctors were asked, “On balance, would you recommend that people stay in to contribute their information for the benefit of all?”

[Andrew Gwynne]

I entirely take the hon. Gentleman’s point, but if we are to reintroduce the element of public confidence, enshrining proper rights and responsibilities will start to build that sense of trust. As the hon. Member for Mid Norfolk suggested, it is consensus that will get us where we want and need to be.

One example of the problems that can arise lies in recent media reports, which we have heard about again in this debate, including those about the Institute and Faculty of Actuaries, which obtained at least 13 years of hospital data equating to 47 million patients. Often, media reports are not quite what they seem, but the damage is, sadly, done as a consequence. I would hate for the benefits of information sharing within the NHS, and of drawing out anonymised data sets from that system for beneficial medical research, to be jeopardised by incorrect assumptions made from media reports. There would be rightful public revulsion if identifiable or cross-identifiable information were to fall into the hands of insurers and other private interests that do not have the public good in mind, but such reports are potentially damaging to public confidence in care.data, which is already quite low.

That is why we welcome the Government’s decision to pause the scheme. I hope that they will use the opportunity wisely to reflect on how better to engage with the public about the real benefits that we have discussed in this debate, and to revolutionise patients’ rights: make the data theirs; make the NHS their custodian; put in real safeguards and, importantly, proper penalties; and have rights with responsibilities and whole-person information for the age of whole-person care. That would be genuinely transformational.

I reiterate to the Minister that we are happy to support the measures in the House, but as it stands, we fear that the security regime is woefully inadequate. There is still time to save it, and we on the Labour Front Bench have offered the Secretary of State for Health our full support if he can come up with an offer that satisfies everyone. On Tuesday, those points were put to the Health Secretary at Health questions by my right hon. Friend the Member for Leigh (Andy Burnham), the shadow Health Secretary. Maybe the desire for consensus and a way forward is sometimes lost in the theatre of the Chamber of the House of Commons, so I repeat those points to the Minister in this debate, which has been much more consensual and informative than it would ever be on the Floor of the House during Health questions. I sincerely hope that she will respond to them positively.

There are five key protections that Labour wants to introduce. First, we want tougher penalties for any misuse of data; my hon. Friend the Member for Leeds East made that point far more eloquently than I. We also want to keep the requirement for the Secretary of State to sign off on any new application to access the data, which the Government are seeking to remove in the Care Bill. Accountability to the Secretary of State, to Parliament and to us as Members of Parliament on behalf of our constituents is a fundamental requirement that would start to satisfy the need for oversight.

We want and need full transparency for all organisations granted access to the data, so there is full openness about who has access and what data they have. We need a proper targeted and personalised awareness campaign for people with a learning disability, autism or sensory impairments, so we think that GPs should be issued with clear guidance to ensure that all of their patients are informed. We want easier opt-out arrangements than those possible at present. If the Secretary of State is happy to ensure that the new provisions are in place, we are happy to lend our support to make it happen.

In closing, I should say that confidentiality has always had a tense relationship with scientific progress when it comes to clinical research, but it is only right that information is made available outside the NHS in a completely anonymised form. The hon. Member for Mid Norfolk is quite right about clinical data: their potential is enormous, they can revolutionise systems and processes and they can get to the heart of problems in certain areas far sooner. It is hugely empowering for future patients to get away not just from the silo mentalities of the structures of our health and social care system—all parties want to do that—but from the silo mentality about data that exists in parts of the health and social care system: whole-person care and whole-person information.

I commend the hon. Member for Mid Norfolk for his work on this hugely important issue and congratulate him on securing this important debate, on the summit in Parliament earlier today and on the work that he is doing alongside patients for data. Hopefully, we can get some movement on this from the Government, so that we end up with a scheme with the appropriate safeguards. I look forward to the Minister’s response.

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 25th February 2014 Commons Chamber

[Jane Ellison]

As the hon. Gentleman knows, we have often debated in this House the many reasons for the increased pressure on A and E. However, the rate of growth in the first three years of this Government has been lower than the rate of growth in the last three years of the last Government. We are responding to the pressures. That is why the Secretary of State has addressed issues such as named GPs for older patients and the integration of social care. We acknowledge that there is pressure on A and E; it is the action that the Government are taking to respond to it that really counts.

[Andrew Gwynne (Denton and Reddish) (Lab)]

Ministers again deny that England’s A and E departments are in crisis. The Secretary of State did so in response to my right hon. Friend the Member for Leigh (Andy Burnham) earlier. It just will not wash any more. In the past two weeks, 10,743 patients waited on trolleys for up to 12 hours because no hospital beds were available and 52 patients waited for even longer. Does the Minister really think that it is acceptable that patients are experiencing the worst fortnight in A and E this winter while she is complacently sitting on her hands?[Official Report, 27 February 2014, Vol. 576, c. 10MC.]

[Jane Ellison]

There is no complacency on the Government Benches, and attendances are half what they were under Labour. Week after week we have heard those on the Opposition Front Bench come to the House to talk up a crisis in our NHS, but the NHS has responded incredibly well throughout the winter. I pay huge tribute to the staff of the NHS for what they have done in responding to this. The Government are taking long-term action to reduce pressure on A and E; even the College of Emergency Medicine rebuts the Opposition line that there is a crisis in A and E this winter.

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 14th January 2014 Commons Chamber

[Mr Hunt]

We know that every year, 1.2 million of 5.2 million admissions to hospitals are avoidable if we have better alternatives in the community. The Government believe that restoring that personal link between doctors and the people on their lists—the people in their communities—who could often be much better looked after outside hospitals is the way to deal with that. That is why we are making that major change to the GP contract—it is the biggest change since named GPs were removed in 2004. That will benefit my hon. Friend’s constituents and those of all hon. Members.

[Andrew Gwynne (Denton and Reddish) (Lab)]

Before Christmas, the Secretary of State said that the A and E crisis is behind us. However, NHS data released last Friday show that patients have just experienced the worst week in A and E so far this winter. The A and E target was missed; 103 trusts failed to meet their individual target; and, shockingly, more than 5,000 patients were left waiting on trolleys for more than four hours—more than double the number in the previous week. The Secretary of State asks us to look at the facts, but those are the facts. They are apparent to all except, seemingly, him. Is he really still of the view that the crisis is behind us?

[Mr Hunt]

Let us look at those facts for last week and compare them with the facts in the identical week when the right hon. Member for Leigh (Andy Burnham), the shadow Health Secretary, was Secretary of State. When he was Secretary of State, 362,462 people were seen within four hours. Last week, we saw 365,354 people—3,000 more people—within the target. A and E is doing better under this Government than it ever did under Labour.

Health Care (London)

Andrew Gwynne Excerpts

Wednesday 8th January 2014 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Mrs Main. I congratulate my hon. Friend the Member for Westminster North (Ms Buck) on securing this very important debate about health care in London. I hope that hon. Members will forgive this Mancunian for gatecrashing the debate to respond for the Opposition.

The future of health services and especially accident and emergency services across London is an important issue of genuine concern to a great many of the constituents of hon. Members present. It is definitely an issue of real significance right across our capital city. I pay tribute to all the hon. Members who today have made contributions, long and brief, on a wide variety of matters.

Let me take this opportunity to pay tribute to the staff working in the national health service for their commitment in providing a first-class service to patients in what has been a very trying period for the NHS. As we know, there have been important changes in the provision of hospital care in London. We have had “Health for North East London”, “Shaping a healthier future”, the Barnet, Enfield and Haringey clinical strategy, the trust special administrator’s review of South London Healthcare NHS Trust and the NHS in south-east London and “Better Services, Better Value” in south London, to name a few of the reconfigurations that have taken place in the capital.

My hon. Friend the Member for Westminster North is right to point to extreme financial pressures on hospital services. North-west London hospital services must accommodate a £125 million reduction in service between 2011 and 2015. The people who use hospitals in London are rightly concerned about the changes to the services on which they rely. We have heard about the proposals that will lead to the loss of accident and emergency departments at Charing Cross, Ealing, Hammersmith and Central Middlesex hospitals.

However, it is not only my hon. Friends who are concerned about the future of A and E departments in London; local authorities are, too. Local authorities such as Ealing have voiced their concerns about the downgrading of their A and E services. As we have heard from my hon. Friend the Member for Hammersmith (Mr Slaughter), A and E facilities that both the Prime Minister and the Secretary of State had promised to save across north-west London and elsewhere in the capital will be closing. I hope very much that the meeting between the Secretary of State and the hon. Members who represent Ealing and Hammersmith can be reconvened as requested.

Of course, all this is in direct contradiction to what the Prime Minister said during the general election, when he promised to halt the closures of hospitals, accident and emergency departments and maternity units. Why does the Minister think that there is such widespread concern about the lack of leadership in the health service in London at a time when the NHS is dealing with unnecessary upheaval?

Frankly, it was a disastrous decision on the part of the Government to spend billions of pounds on an unnecessary top-down reorganisation, which has led to a loss of financial grip in the NHS. Now, more than 6,000 nursing posts have been lost, waiting lists are getting longer and we are seeing the return of patients on trolleys in corridors. Indeed, we are now seeing A and Es not just in London but across the country facing a winter crisis after an unprecedented summer A and E crisis. At the same time, local authorities are having a huge cut to their social care budgets. More and more elderly people are therefore ending up in A and E, because there is no one at home to care for them, adding even more pressure to a pressured system.

Labour Members warned Ministers repeatedly during the passage of the Bill that became the Health and Social Care Act 2012 that the legislation would lead to the break-up of the NHS. The public rightly expect to have easy access to health services, and Ministers have a heavy responsibility to show leadership and to act to prevent people’s lives being put at risk. Ministers must also tell the House today what action they propose to take to ensure that London’s growing population will continue to have good access to hospital and other health service provision in their local areas. Those points were made eloquently by a number of hon. Members, but I have to mention my hon. Friend the Member for West Ham (Lyn Brown) in relation to Newham.

Of course, Labour Members do not oppose all the changes to local health services. Surely, it is right that hospitals and services evolve and change. However, it must be change based on good clinical reasons and not just financial necessity.

[Ms Abbott]

Does my hon. Friend agree that the issue in London is not just provision for its size of population, but the extreme diversity and complexity of the population? It is a very mobile population. There are large numbers of refugees and asylum seekers, and London has the largest lesbian, gay, bisexual and transgender community in the country. That is what people have to pay attention to if they are reconfiguring services.

[Andrew Gwynne]

My hon. Friend is right. London is a global city. It has people coming in from all over the world, not just from elsewhere in the United Kingdom. It is a diverse city. It is an exciting, vibrant city—I am probably over-egging it for a Mancunian, but it is a great place. Those complexities are what makes London fantastic, but they are also what makes delivering health services a real challenge.

To make the change work, there must be clarity and partnership. Everyone must understand what is being proposed and how the decisions are to be taken. That brings me on to the issue of Lewisham and clause 118 of the Care Bill. We saw in Lewisham the power of an effective campaign in the face of unpopular change to health services and what that can achieve.

I pay tribute to the Lewisham MPs and to the campaigners, who fought tirelessly for their local hospital. The proposal to close their A and E department was rightly met by a strong local campaign, which included protest marches and a successful legal challenge to the closure. Indeed, the Court of Appeal ruled that the Health Secretary did not have the power to implement the cuts at Lewisham hospital. If only he had listened to my hon. Friends in Lewisham—they had been arguing that beforehand.

Clause 118 should give very real concern to all hon. Members in the debate, because in future it will give carte blanche to the Secretary of State and the Department of Health to reconfigure services right across the country as they sought to in Lewisham, disfranchising the communities that have spoken out very loudly across London against some of the changes. Labour Members are rightly concerned about that measure and we will be opposing it during the next stages of proceedings on the Care Bill.

In conclusion, I pay tribute to my hon. Friend the Member for Westminster North and to all my right hon. and hon. Friends who have taken part in the debate. Hospital services are very important to the capital. We must make sure that there is proper strategic planning across London, not the piecemeal approach to reconfigurations of services that we have seen, so that the complexities in health needs—including mental health, which my hon. Friend the Member for Hampstead and Kilburn (Glenda Jackson) mentioned—are taken on board fully for the betterment of people living in London.

Accident and Emergency

Andrew Gwynne Excerpts

Wednesday 18th December 2013 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

We have had a good debate, with many powerful contributions from my hon. Friends the Members for Mitcham and Morden (Siobhain McDonagh),for Wigan (Lisa Nandy), for Eltham (Clive Efford), for Stretford and Urmston (Kate Green), for Chesterfield (Toby Perkins), for Worsley and Eccles South (Barbara Keeley) and for Middlesbrough South and East Cleveland (Tom Blenkinsop).

I have to say, however, that people outside listening to some Government Members’ contributions will think that they simply do not get it. They simply do not understand how hard it is to get a GP appointment; they do not understand the real issues facing their own local A and E departments; and they do not understand the pressures hitting the NHS in England. I politely suggest that they do what the shadow Health team has done—go and spend an evening at their local A and E to see for themselves the real pressures that departments serving their constituents are under.

It would be remiss of me not to place on record my own tribute to the doctors, nurses, health care assistants and other dedicated NHS staff who—as I found out myself when I visited Tameside hospital’s A and E department last Friday night—provide such extraordinary and professional care. We have a work force who are completely dedicated and caring, but the House should be in absolutely no doubt that they are under increasing pressure, and that this is a crisis of the Secretary of State’s making. The Secretary of State may wish that Labour Members had short memories, but we remember the summer news reports of ambulances queuing outside hospitals with unacceptably long waits, and some people even having to be treated in tents erected in car parks, while the Secretary of State and his Ministers buried their heads in the sand and the Secretary of State’s “Crisis, what crisis?” strategy unravelled. Labour Members highlighted those problems, as would have been expected of us.

What we are seeing in A and E is also the culmination of three and a half years of mismanagement of our NHS, with a needless top-down reorganisation and the waste of billions of pounds that could and should have been spent on front-line care. It is little wonder that, as we discovered last week, 79 A and E departments missed the Government’s own targets.

As we have heard in the debate, the reasons for the crisis are many and complicated, but it is on the lack of access to GPs’ services that we have focused today. Surely no amount of spin can hide the fact that this Government have made it harder to obtain an appointment to see a GP. All Members will know of constituents who have had to phone their doctors only to be told that no appointments are available and that they should ring back the next day, which they do, only to experience the same problem again.

Is it not obvious to all—except, seemingly, the Secretary of State and his Ministers—that many patients who phone the surgery at 9 am and find it impossible to obtain an appointment will turn to A and E for help? That is not just my conclusion. According to an analysis carried out for the Department of Health, 42% of A and E attenders had attempted to contact their GPs beforehand, and researchers at Imperial College London found that patients who were able to see their GPs within 48 hours made fewer visits to A and E departments.

Here are some inconvenient truths that the Minister and other Government Members need to consider. First, by the time Labour left office, 98% of patients were being seen within four hours at A and E departments. Secondly, by May 2010 more than three quarters of the general practices in England offered extended opening hours at weekends and in the evenings. It is also clear that Labour’s achievement in widening access to primary care is being undone on this Government’s watch: data released by the Health and Social Care Information Centre have revealed that 854 fewer general practices now offer extended opening hours than was the case in 2009.

The truth is that now, during evenings and at weekends, many people are left with no alternative but to go to A and E because of this Government’s actions. It was this Government who cut funding for extended opening hours for GPs’ surgeries, it was this Government who scrapped Labour’s guarantee that patients would be able to obtain an appointment with a GP within 48 hours, and it is this Secretary of State who shows not one degree of regret for those actions: actions that have piled more unnecessary pressure on A and E departments and more misery on patients, at the very time when they need the NHS to help them.

No wonder things are going so wrong so quickly. To put it simply, under this Secretary of State and under this Prime Minister, it has become harder, not easier, to see a doctor, and as a result more people are heading towards A and E. What more evidence do Ministers need that A and E departments in England are under real pressure and that action is needed now to prevent them from struggling further over the winter months? Their confusion has been laid bare today for all to see. In three weeks, they have gone from “Crisis, what crisis?” to “The crisis is behind us.” It does not sound as though the Secretary of State is in control; people will struggle to take reassurance from his mixed messages. The problems in A and E have the fingerprints of the Secretary of State and the Prime Minister all over them. The components of the A and E crisis might be complex, but the real cause is very simple: you just cannot trust the Tories with the national health service.

[The Minister of State, Department of Health (Norman Lamb)]

We have heard a lot of scaremongering about the NHS today, including endless claims about a crisis. If the Opposition are thinking about new year’s resolutions, I have one for them: stop misleading and misinforming the public. Let us look at the evidence.

[Andrew Gwynne]

rose—

[Norman Lamb]

I will not give way; I do not have time.

Up until this week, A and E targets were met in the past 32 weeks in a row. Is that evidence of a crisis? The average wait for people in A and E during Labour’s last year was 77 minutes; it is now 30 minutes. Is that evidence of a crisis? Even though more people are coming through the doors, 2,000 more patients are being seen in less than four hours every day under this Government than under Labour. Evidence of a crisis? I don’t think so. The Opposition are scaremongering, plain and simple. In fact, the College of Emergency Medicine’s president, Cliff Mann, has today said that any crisis in accident and emergency is “behind us”.

[Norman Lamb]

I applaud the cross-party effort of those Members campaigning for their community, and I am very happy to engage with them further on that matter.

[Andrew Gwynne]

rose—

[Norman Lamb]

I will not give way again; I do not have time.

Last year, of the 21.7 million people who visited accident and emergency departments, almost 96% were admitted, transferred or discharged within four hours. Target achieved. So far, it is the same this year: target achieved. The right hon. Member for Leigh (Andy Burnham) missed his A and E target in two of the three quarters when he was in charge. Did he go around telling everyone that there was a crisis at that time? No, of course he did not—

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 26th November 2013 Commons Chamber

[Norman Lamb]

I have had a similar experience at the Norfolk and Norwich hospital. It is clear that the number of delays in the east of England has reduced substantially, and I pay tribute to everyone involved. Getting urgent care right requires collaboration between ambulance trusts, acute care and GPs and social care workers on the ground. Significant improvements have been made in the east of England, as well as across the rest of the country.

[Andrew Gwynne (Denton and Reddish) (Lab)]

The Minister surely knows that deteriorating ambulance handover times are just one of a growing number of signs highlighting what is going wrong with A and E on this Government’s watch. Now we see the Secretary of State and his Ministers in full panic mode after denying for months that there was a problem. The question is: why was the Health Secretary the last person in the entire NHS to realise that there was an A and E crisis?

[Norman Lamb]

It seems as if Labour is always desperately in search of a crisis, even if there is none to be found. If the hon. Gentleman had listened to the answer that I gave to the hon. Member for West Lancashire (Rosie Cooper), he would have heard me say that there had been a 38% improvement in waiting times for ambulance handovers between last November and this November. I am sure that he will welcome that.

Hepatitis C (Haemophiliacs)

Andrew Gwynne Excerpts

Tuesday 29th October 2013 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

As always, it is a pleasure to serve under your chairmanship, Mr Dobbin. I apologise on behalf of my hon. Friend the Member for Copeland (Mr Reed), who was scheduled to respond for the Opposition. Sadly, St Jude’s storm meant that he was stuck in the wilds of Cumbria yesterday and was unable to travel down in time for this morning’s debate.

I echo the thanks given to my right hon. Friend the Member for Wythenshawe and Sale East (Paul Goggins) for securing this debate on an extremely sobering and important issue that has affected many people across the country. I also welcome the new public health Minister to her post, and I wish her the best of luck.

This has been a powerful debate, with many moving contributions from Members on both sides of the House. I thank right hon. and hon. Members for contributing, including my right hon. Friend the Member for Wythenshawe and Sale East, my hon. Friends the Members for Kingston upon Hull North (Diana Johnson) and for Hammersmith (Mr Slaughter), and the hon. Members for Strangford (Jim Shannon), for North East Bedfordshire (Alistair Burt), for North Devon (Sir Nick Harvey) and for Stratford-on-Avon (Nadhim Zahawi).

We must remember that 4,500 patients contracted HIV or hepatitis C due to one of the gravest failures in modern medicine. That failure hit innocent and trusting people, and, to date, it has claimed thousands of lives. Members from both sides of the House will be well aware of how the rowdier moments in the House of Commons are perceived by our constituents, but I believe that debates such as this, conducted with great dignity while addressing serious failures and harrowing accounts, are a credit to the institution of Parliament, and I look forward to working with the Minister to help reach a speedy and satisfactory outcome for those who are campaigning for support to maintain a good quality of life.

The failures in our health system in the 1970s and 1980s, and the struggle for help and support fought by those affected, are a stark reminder of our responsibilities in this place. As we have heard today, progress has been painfully slow—that point was eloquently and powerfully put by the hon. Member for North East Bedfordshire. The previous Government and the devolved Administrations established the Skipton Fund in 2004 to make ex gratia payments to those who were infected.

In May 2009, Lord Archer published a report on NHS-supplied contaminated blood and blood products. We implemented many of his recommendations, including giving the Haemophilia Society £100,000 for haemophilia doctors and committing to phasing out prescription charges for patients with long-term conditions.

In April 2010, the then public health Minister, Gillian Merron, decided to bring forward a review of the Skipton Fund—we had previously committed to reviewing the fund in 2014. Announcing that decision, she said:

“We have listened carefully to the views of those infected, their families, carers and many in this House, who have told us that our intended review date of 2014 will be too late for many of those affected.”—[Official Report, 6 April 2010; Vol. 508, c. 133-134WS.]

I welcome this Government’s work in continuing to build on the foundations laid by the previous Government. The issue must transcend party politics. Our focus from now on must be on what we can do to support those who bear financial burdens as a result of contracting hepatitis C or HIV.

I hope that the Minister is able to give us a comprehensive account of what the Government are doing to build on the actions set out by the Leader of the House when he was Secretary of State for Health in his statement to the House on 10 January 2011. He announced changes to the financial support schemes for those infected with HIV and hepatitis C, including the introduction of an annual payment of £12,800 for those with the most serious hepatitis C-related disease as a result of NHS blood transfusions and blood products, in line with payments received by people infected with HIV. Those groups need Government support more than ever, and I want the Minister to give assurances that work on this issue will not be undermined by budget reductions.

I cannot even begin to imagine the pain and suffering inflicted on the victims who received infected blood. To those who relied on receiving blood regularly as part of their treatment for haemophilia, only to have a life-changing diagnosis thrust on them; to those still facing daily challenges; and to the dependents of those who are, sadly, no longer with us, we owe help, support and justice.

I pay tribute to the work done by the many campaigners and organisations across the country, which is a credit to the tireless efforts of those affected and their families. Their efforts could have been no better espoused than by my right hon. Friend, who set out the experiences of his constituents. It is right that such people are exempt from the Atos processes, and my right hon. Friend’s points about the financial burdens that such things put on families were extremely timely. Changes to qualifying criteria for a range of illness-related benefits will unnerve those who depend on such income to make ends meet. I am sure that the Minister will welcome this opportunity categorically to state that the Government will protect payments to those who have been affected. Leaving aside the health issues caused by the transmission of infections, the stress brought on by worrying about bills and security can have an extremely damaging impact on the lives of those concerned.

On top of dealing with financial concerns, we must provide a health care system that makes it as easy as possible for people with hepatitis C to use the services they need to maintain a good quality of life. I therefore hope that the Minister can give us an indication of the reforms that are being made to support patients.

My right hon. Friend’s proposal to unite stage 1 and stage 2 under one fund warrants serious consideration, and I would welcome a pledge from the Minister seriously to look at it and to try to bring it about. My right hon. Friend was also right when he said that the Government must take any action in conjunction with those who have been affected.

As I said, this is not a debate for political point scoring, and I assure the Minister that the Opposition want to see swift action to ensure a good outcome for those affected—something eloquently pledged by my right hon. Friend the Member for Leigh (Andy Burnham), the shadow Secretary of State for Health, in an intervention earlier. We will therefore be happy to work with the Government to introduce proposals finally to achieve a good and proper conclusion for those affected and their families and, I hope, to draw a line under one of the darkest failings seen in our country.

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 22nd October 2013 Commons Chamber

[Mr Hunt]

The figures for September, the last month of the summer, were 95.8% in England and 90.6% in Wales. It was not coalition-controlled England that had a summer A and E crisis, but Labour-controlled Wales.

[Andrew Gwynne (Denton and Reddish) (Lab)]

The Secretary of State for Health is clearly not adequately monitoring performance. If he was, he would be aware that serious problems remain across the accident and emergency departments of the trusts that were placed in special measures by Professor Sir Bruce Keogh. On his watch, the A and E performance at eight of the 11 trusts has got worse since Keogh reported, including at my hospital in Tameside. The A and E performance has got substantially worse at East Lancashire Hospitals NHS Trust, where the number of patients waiting for more than four hours has doubled since Keogh reported, and at Medway NHS Trust, where the figure has quadrupled. When will he stop all the grandstanding, cut the spin and get a grip on his A and E crisis?

[Mr Hunt]

I hope that the hon. Gentleman will be pleased that something is happening under this Government that did not happen under the Labour Government: we are putting those hospitals into special measures and sorting out the problems, including the long-term problems with A and E such as the GP contract—a disaster that was imposed on this country by the Labour Government.

Managing Risk in the NHS

Andrew Gwynne Excerpts

Wednesday 17th July 2013 Commons Chamber

[Derek Twigg]

My right hon. Friend makes an important point. That is one of the things that we explored during the Committee stage of the Health and Social Care Bill and of course we got no answers. The then Minister, now Minister of State, Department for Transport, the right hon. Member for Chelmsford (Mr Burns), said that as time goes on the NHS will be more open to the competition laws of both the EU and the UK. That is the real story here, and we will not have that transparency. That is a major part of the problem we are having to deal with.

No matter what statistics we are talking about, losing a friend or loved one is a massive human tragedy that affects everybody. We want to do all we can to reduce the number of early and preventable deaths—that is absolutely right—and put patients’ interests and those of families first. Given what we have heard in the last day or so, one would think that we somehow left an NHS in crisis—an NHS that was not delivering—yet when we left office it had the highest satisfaction rate in history. We had the lowest waiting lists in history and massive reductions in early deaths from cancer, coronary problems and so on. We also saw massive increases in doctors and nurses. We hear this Government talking about increasing the number of doctors, but when did those doctors start their training? They started under Labour.

To give an example, so that we can be a bit fairer about the situation, the Commonwealth Fund produced an international health policy survey in 2010 that looked at 11 countries—and guess what? The UK health service came out best. Just as an example, when those on above average incomes and those on below average incomes were asked whether they were confident that they would receive the most effective treatment if sick, the best results—95% and 92%—were in the UK. That was an international survey. Another question was whether people were confident that they would receive the most effective treatment if sick—and guess what again? The UK came out on top, at 92%. That is the real picture of the NHS that we left behind in 2010—although it was not without its problems and challenges, because pressures were always building up.

I also noticed that pages 4 to 5 of the Keogh report say—this is an important comment that has not been looked at much in the press—the following:

“Between 2000 and 2008, the NHS was rightly focused on rebuilding capacity and improving access after decades of neglect. The key issue was not whether people were dying in our hospitals avoidably, but that they were dying whilst waiting for treatment.”

That is where Labour made one of the biggest differences. I remember regularly having people write to me back in the late 1990s and the early 2000s about having to wait over two years for an operation. People were literally dying because of that. Addressing that was one of the biggest gains that Labour made.

The Secretary of State has now left the Chamber, but earlier I raised with him the issue of mortality. He refused to correct the record. He said that there had been a “slight” improvement by 2010, yet Professor Keogh talks about a 30% improvement in mortality in all hospitals, including those that have been under investigation. That is not to say that those hospitals should not be doing better, but he was talking about all hospitals.

[Andrew Gwynne (Denton and Reddish) (Lab)]

Professor Keogh’s report also shows that although mortality has dropped by 30% in all hospitals, it has dropped by between 30% and 50% in the 14 hospitals subject to the Keogh review. Although those hospitals are still outliers, the drop has been greater at those 14 hospitals.

[Derek Twigg]

My hon. Friend makes a strong and important point. I referred earlier to figures from the Library, but those figures are from the NHS. Just to repeat, the rate of deaths per 100,000 within 30 days of a non-elective hospital procedure in England was 4,850 in 2001-02 and 3,684 in 2010-11. That is a significant drop, so I hope the Secretary of State will correct the record, change his view that there was a “slight” improvement and confirm that it was a significant improvement, because that is what the evidence from his own Department says. Why is that important? It is important for a number of reasons. It is important to see improvements, but we should also bear in mind that the fall from 2001 took place against a massive increase—4 million additional admissions—in the number of people admitted to hospital. It is also important because people want to see continual improvements and be assured that their relatives and friends are receiving the best possible treatment.

In the short time I have available, I want to talk about a couple of local issues. Staffing plays a fundamental part in regard to risk. Many hospitals are having real difficulty with staffing at the moment, and many more will do so. I will say more about that in the context of my own hospital in a second. We need to address the problem, and the mix of staff is also a factor.

The Warrington and Halton Hospitals NHS Foundation Trust serves my constituency. We have been told by the chief executive and the chair of the board of governors that our hospital will run out of money in about 18 months’ time. It has already had to make savings in staff numbers of about 200, and implement a £7 million cut. The hospital will be unsustainable in that situation. What are the Government going to do about that? It is a foundation trust, and as far as I am aware, there are no significant performance issues. I get complaints about the different hospitals, but it is no worse than any of the others. It will run out of money, however.

My hon. Friend the Member for St Helens North (Mr Watts) has mentioned the St Helens and Knowsley NHS Trust. The Whiston hospital was rebuilt under Labour’s plan to rebuild hospitals. We replaced Victorian hospitals—and workhouses, as in the case of the Whiston—with more than 100 new hospitals. The deal on the Whiston hospital under Labour involved a private finance initiative, with the difference being paid for by the two primary care trusts. This Government have got rid of the PCTs, but they have still not put in place a way of funding the hospital on a long-term basis. The uncertainty continues, despite debates on the matter in this place and meetings with Ministers, and we still do not know what is going to happen. It is an excellent hospital with brand-new facilities, but it is facing a real challenge. We need the Government to make decisions about hospital funding, to ensure that it and others can continue; otherwise, many more hospitals will get into difficulty.