Francis Report: Update and Response

Debate between Andrew Percy and Jeremy Hunt

Wednesday 11th February 2015 Commons Chamber

[Mr Hunt]

I will look into the issue that the hon. Gentleman raises, but let me deal now with the issue of nurse training places. The cuts began under the Labour Government, and we have been gradually reversing them. The main point, however, is that, in all parts of the House, there was a lack of understanding of the importance of safe staffing in wards before the Francis report, which is why successive Secretaries of State made mistakes in their projections of what was needed.

We have 8,000 more nurses in our hospital wards, including those at Stoke, and I hope the hon. Gentleman welcomes that.

[Andrew Percy (Brigg and Goole) (Con)]

The Secretary of State will want to congratulate North Lincolnshire and Goole NHS Foundation Trust on getting out of special measures and employing more nurses and doctors. On the issue of “freedom to speak up” guardians, will he ensure there is one in every hospital, because in my trust staff in the smaller hospital sometimes feel their voice is not heard by the two big district general hospitals, which are up to 60 miles away?

[Mr Hunt]

That is a very good point. I had a great visit to my hon. Friend’s local hospital and saw a knee operation which was quite gory but looked to me to be a very good example of safe care. He makes a good point and I will certainly feed into the consultation the idea that it should be easy to contact somebody who works in the same hospital or building, rather than someone who is a long way away.

Oral Answers to Questions

Debate between Andrew Percy and Jeremy Hunt

Tuesday 13th January 2015 Commons Chamber

[Mr Hunt]

I do recognise the pressures on the ambulance service and the hon. Lady’s local area has had £1.6 million extra to help to deal with winter pressures. We have 1,700 more paramedics in the ambulance service and they are doing 2,000 more emergency journeys every day, but none of that is any consolation to the family whom she talks about, and that is why we must always ensure that every lesson is learned.

[Andrew Percy (Brigg and Goole) (Con)]

The Secretary of State, the Department of Health and my local hospital trust inform me that there are more doctors and nurses in the local NHS and the NHS nationally than there were in 2010. This weekend, residents in north Lincolnshire received a leaflet from the Labour party saying that there were fewer doctors and nurses and less care. Who is telling the truth?

[Mr Hunt]

It is not the Labour party, because all it wants to do is to turn the NHS into a political weapon. It might just think about the impact on NHS patients and staff when it does this. It does not help anyone and it is bad for the NHS.

A and E (Major Incidents)

Debate between Andrew Percy and Jeremy Hunt

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

Of course I regret any individual incidents where people do not get the care they need promptly. The hon. Lady will know that the solutions to such problems are not always things that can be done overnight. If she looks at the record of joined-up care over the past few years, she will see that this is the first Government to encourage 150 local authority areas to sit down with their local NHS and jointly plan care for the most vulnerable people in the social care system. That is a very big step forward. We are also doing nearly 1 million more operations every year across the NHS. In accident and emergency, the number of people being seen within four hours has gone up by nearly three quarters of a million since the start of this Parliament. That is real progress, but of course there are long-term issues, and we will focus on those as well.

[Andrew Percy (Brigg and Goole) (Con)]

I congratulate Goole hospital on hitting its target 99.7% of time, and the trust as a whole on hitting its target 93% of the time. I spent my Christmas volunteering in the NHS at A and E and with the ambulance service. Staff repeatedly told me that as first responders what they see are more old and frail people needing to be admitted to hospital. That situation was not helped by 50,000 hospital beds being cut by the previous Government. One way of dealing with the problems would be to move to a community paramedicine model and to use the skills of our ambulance services more. I encourage the Secretary of State to ensure that NHS England is seriously looking at that option.

[Mr Hunt]

May I congratulate my hon. Friend on the shining example he gives to everyone in this House by being a first responder? I do agree that one thing that we could do in the next year is to integrate better what happens in the ambulance services, out-of-hours GP services and 111. Individually, they are all doing a good job, but they could do a much better job if what they did was integrated.

A and E and Ambulance Services

Debate between Andrew Percy and Jeremy Hunt

Thursday 18th December 2014 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for championing care for his constituents. Let me reassure him: I had a meeting on that very issue on Monday. It is important that the NHS community care sector plays its role alongside the social care sector in making effective discharge possible.

[Andrew Percy (Brigg and Goole) (Con)]

I thank the Secretary of State for his kind words about first responders. I will be on duty tonight, as will thousands of first responders in Yorkshire ambulance service, Lincolnshire ambulance service and throughout the country, responding to cardiac arrest, respiratory disease and so on. On the matter of community service, what are the Government doing in the light of the Royal College of Nursing saying to us at a Health Committee a few weeks ago that a failure to invest properly in community services 10 to 15 years ago is having a major impact now on our hospitals?

[Mr Hunt]

My hon. Friend is right about that. Just as this Government have taken a very robust attitude towards poor care in hospitals—we now have 6,000 more nurses on our hospital wards following the Francis report—we need to take an equally robust attitude towards what is provided in people’s homes, to make sure that we have proper care. It is a false economy to cut back on out-of-hospital care to pay for hospital care, as we need both.

Oral Answers to Questions

Debate between Andrew Percy and Jeremy Hunt

Tuesday 25th November 2014 Commons Chamber

[Mr Hunt]

We are, on the NHS, the most transparent Government in history, and I can see no reason why we would not publish that. We are very proud of what the CDF has achieved. We are very proud that the level of cancer diagnoses has increased by more than 50% compared with what it was under the previous Labour Government, and so we are finally starting to win the battle against cancer.

[Andrew Percy (Brigg and Goole) (Con)]

We all remember the horror stories before the CDF existed locally, and all Government Members certainly support its continued use. Before any drugs are delisted from the CDF, will the Secretary of State make available the scoring of those drugs? Will he also outline what the provisions will be for consultation with patients and their families?

Special Measures Regime

Debate between Andrew Percy and Jeremy Hunt

Wednesday 16th July 2014 Commons Chamber

[Mr Hunt]

I absolutely recognise that issue, which is something we will have to think about in terms of the long-term sustainability of the trust. Let me reassure my hon. Friend and the hon. Member for Barrow and Furness that the CQC chief inspector will not say that a trust can come out of special measures unless he can see a long-term sustainable future for that trust, so part of the purpose of the regime is to force everyone in the system to confront those issues so that we bite the bullet quickly.

[Andrew Percy (Brigg and Goole) (Con)]

The positive progress of the Northern Lincolnshire and Goole NHS Foundation Trust is to be welcomed and is a direct result of the work of health care assistants, nurses and doctors. On the issue of social care, may I commend North Lincolnshire to the Secretary of State and ask him perhaps to visit again? The local council has not only refused the request by the Labour opposition on the council to cut social care in the budget, but has actually increased funding for elderly and disabled people by £1 million in this year’s budget and is opening up a network of well-being centres to support older people in their own homes, as well as constructing a £3.2 million intermediate care facility, so that a lot of our residents do not have to go into hospital in the first place.

[Mr Hunt]

I thank my hon. Friend for the warm welcome he gave me when I visited the trust—including the visit to a not particularly healthy, but delicious bakery as part of the trip. I welcome what is happening in social care, and I think it is something on which we can agree at the national level across the House—that cuts in social care can be very counter-productive, leading to more pressure on the social care system and more pressure on the NHS.

Patient Safety

Debate between Andrew Percy and Jeremy Hunt

Tuesday 24th June 2014 Commons Chamber

[Mr Hunt]

I do not know the answer to that question, so I will look further into the matter and get back to the hon. Lady.

[Andrew Percy (Brigg and Goole) (Con)]

As the hon. Member for Scunthorpe (Nic Dakin) mentioned, local GPs raised concerns last week about a cluster of cases at Scunthorpe and Grimsby hospitals—not at Goole hospital, which was also revealed last week never to have breached its four-hour waiting target. There is still a lot more to be done, so does the Secretary of State share my concern at the evidence received by the Health Select Committee last week from the Care Quality Commission, which stated that all too often, members of staff who raise concerns are dealt with by the human resources department rather than in a proper way that allows their complaints to be properly aired?

[Mr Hunt]

That is a very good point, and I thank my hon. Friend for welcoming me to Goole hospital; I had a very good visit. That hospital is in special measures but it is making real progress. It was interesting to talk to staff at the front line. I do not know when the hospital will be ready to leave special measures, but the staff on the front line felt that things were changing, and they welcomed that. My hon. Friend is absolutely right that if someone raises a safety concern, it should not be viewed as an HR issue; it is a patient safety issue, and trusts need to treat it as such.

Managing Risk in the NHS

Debate between Andrew Percy and Jeremy Hunt

Wednesday 17th July 2013 Commons Chamber

[Mr Hunt]

I will give way in a moment.

The right hon. Member for Leigh talked about leadership. I want our NHS to attract the brightest and best leaders that this country has to offer. I have asked the NHS leadership academy to develop a new leadership programme to support clinicians to become clinical chief executives and to fast-track professionals from outside the NHS into leadership roles. We urgently need more talented managers in our NHS, and that will make a big difference.

[Andrew Percy]

I want to take my right hon. Friend back to the comments of the right hon. Member for Leigh, which I found shockingly complacent. I will give the example of Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, which is one of those that is in special measures. Our mortality rates started to go up in 2007 and started to fall in 2011, but our nursing numbers have been increasing over that whole period. I find it shockingly complacent for somebody to suggest that there is not an issue or to downplay those figures. In my area, that has potentially cost hundreds of lives.

[Mr Hunt]

My hon. Friend makes an important point.

I say to the shadow Secretary of State that it is a question not just of whether he responded to the warnings that he received, but of whether he received the warnings that he should have received in the first place because the inspection system might not have been up to scratch.

Hospital Mortality Rates

Debate between Andrew Percy and Jeremy Hunt

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

The same assurances I have given everyone else representing a hospital with troubles: we are totally committed to sorting out those problems—[Interruption.] Labour Front Benchers ask when, but we have said that these hospitals will be re-inspected in the next year. The structures that we are putting in place to sort them out are a million times tougher than anything that happened when they were in office.

[Andrew Percy (Brigg and Goole) (Con)]

I am proud of our local NHS, especially the examples of good practice highlighted at Goole hospital. However, as someone who works as a volunteer in the NHS every weekend, I meet patients who are frightened of going into local hospitals precisely because of the failings highlighted in the report on North Lincolnshire and Goole Hospitals Foundation NHS Trust. Will the Secretary of State visit Goole and north Lincolnshire to meet my constituents and discuss such individuals as an 88-year-old whose nails were not cut for seven months, whose toilet calls went unanswered and who ultimately died after contracting E.coli in our local hospital?

[Mr Hunt]

Of course I would be delighted to visit my hon. Friend’s local hospital. I am sure there will be a great deal that I can learn, and I hope I will be able to give encouragement to the staff there, who are working very hard in a very difficult situation. I hope today will give them encouragement that this is a Government who are determined to turn around their hospital.

Oral Answers to Questions

Debate between Andrew Percy and Jeremy Hunt

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

I do agree with Robert Francis, but as he said in Nursing Times, there is an apparent misunderstanding by many people about what his recommendations actually were. This is what he said:

“I did not recommend there should be a national minimum staffing standard for nursing. The government was criticised for not implementing one, which it is said I recommended, which I didn’t.”

[Andrew Percy (Brigg and Goole) (Con)]

As someone who worked in the public services before my election here, I well understand the pressure put on public servants to cover up bad news. I was contacted by a nurse yesterday who informed me that concerns that were raised at a training day were dismissed by a matron—people were told to put them in the bin. Can the Secretary of State assure us that he will do everything to ensure that nurses who are concerned about staffing levels feel free to speak out and will be protected?

[Mr Hunt]

What my hon. Friend says is incredibly important. We must have a culture of openness and transparency inside the NHS, which means that people at the front line feel empowered to speak up if they think there is a problem. That has not happened in the past, and we are going to put it right.

Health Services (North-West)

Debate between Andrew Percy and Jeremy Hunt

Thursday 11th July 2013 Commons Chamber

[Mr Hunt]

First, let me say to the right hon. Gentleman that 25 extra patients a day will have to be absorbed by the three neighbouring hospitals to Trafford, so it is not a large number. We want to make sure that all hospitals, including Wythenshawe, which I have visited—it is a superb hospital—are able to absorb that capacity. It is currently meeting its A and E target. The application that has been made for extra capital grant to help it to expand its A and E department will be treated as a priority.

[Andrew Percy (Brigg and Goole) (Con)]

Safety should always be paramount, but public confidence is also important. As the Secretary of State faces further tough decisions on reconfiguration in the coming years, will he assure me and other Members of this House of two things: that he will be conscious of not applying urban solutions to rural areas; and that where alternative pathways of care can be put in place, that will happen before changes take place?

[Mr Hunt]

My hon. Friend makes two important points. I explicitly said that we will not proceed with any of these changes until neighbouring hospitals have been consistently meeting their A and E standards and any necessary changes have been put in place so that we can be sure that they will improve care for patients. That is really important if we are going to maintain confidence.

On my hon. Friend’s point about urban versus rural, part of the underlying reason for these changes is that we need to get more care out of big hospitals, which are often in urban areas, and into the community—into settings near people’s homes. That is very important for rural communities where there are often large concentrations of older people. Today’s decision will mean an additional investment in those community services. As we look at the big changes we need to make in the NHS, we will need to make more decisions that allow more to be invested in out-of-hospital care if we are to prevent the illnesses that ultimately put so much pressure on our A and E departments.

Accident and Emergency Waiting Times

Debate between Andrew Percy and Jeremy Hunt

Wednesday 5th June 2013 Commons Chamber

[Mr Hunt]

I agree that A and E departments are under huge pressure, and that is why we are taking a lot of measures to deal with them, which is what I am talking about. But I am saying that we have to deal with the root causes, which were things that the shadow Secretary of State’s Government failed to deal with. [Interruption.] Labour Members need to listen. We listened to the shadow Secretary of State’s solutions, which were not really solutions; now I am telling them what we think needs to happen.

We welcome the fact that the Labour party has now seen the light and recognises the need for integration, but Labour Members need to show some humility, because it was the Labour Government who put in place many of the barriers—in particular payment by results mechanisms—that make that so hard to achieve. We are now trying to make integration a reality through the 10 pilots on removing barriers to integration announced by the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb), as part of the vulnerable older people’s plan announced to the House last month. Without integration, we will not solve the problem of bed blocking, which is at the heart of the pressures on A and E.

[Andrew Percy (Brigg and Goole) (Con)]

The Secretary of State is right to say that many of the present failures started in the Labour years, particularly the problems with integration. Does he share the concern that I and many of my constituents feel about the 50,000 beds that were lost under Labour Government? We lost the beds, but the intermediate care services and step up, step down facilities were never created to deal with the consequences. That is what is behind a lot of the A and E referrals today.

[Mr Hunt]

That is part of the problem with Labour’s approach to the NHS—a top-down approach of closing or downgrading A and E units and making the NHS sort out the problems. We are not doing that.

It is time that Labour took responsibility for the disastrous changes to the GP contract, which contributed to making it so much harder to get a GP appointment and piled further pressure on A and E departments—[Interruption.] No, they need to listen; this is important. The changes in 2004 handed responsibility for providing out-of-hours services to administrators in primary care trusts, at a stroke removing the 24/7 responsibility for patients that until then had always been a core part of being a family doctor. As we heard earlier today, even a former Labour Health Minister regretted those changes, saying before the last election:

“In many ways, GPs got the best deal they ever had from that 2004 contract and since then we have, in a sense, been recovering.”

It is important that Labour Members hear the list of independent voices all saying that we need fundamental change in primary care if we are to deal with pressures on A and E: the College of Emergency Medicine, the Royal College of Physicians, the NHS Alliance, the Family Doctor Association, the head of the Royal College of General Practitioners, who—surprisingly—said something in support of the Government in The Guardian this morning, the Foundation Trust Network and so on. All those voices were ignored by Labour as it put its head in the sand about that disastrous change to the GP contract.

Mid Staffordshire NHS Foundation Trust

Debate between Andrew Percy and Jeremy Hunt

Tuesday 26th March 2013 Commons Chamber

[Mr Hunt]

That sounds like something that would definitely encourage the duty of candour that we have been talking about today. I am sure that different hospitals will want to have different ways of doing that, but we will definitely note my hon. Friend’s comments.

[Andrew Percy (Brigg and Goole) (Con)]

Staffing levels are important, but so are bed numbers. Many of the 41,000 beds lost under the previous Government were in my constituency. Consequently, we have massive pressure on beds, wards on purple alerts and very high mortality rates. Will any inspection regime include an assessment of safe bed levels?

[Mr Hunt]

The inspection regime will of course cover such issues as part of its inspection of whether basic standards of care are being met. Yes, of course such issues matter, but there are challenges beyond what an inspection regime can deliver which we will need to address to deal with these issues. In particular, a problem we are wrestling with at the moment is who will take responsibility for the frail elderly when they are discharged from hospital. One reason why they stay in hospital for a long time is because geriatricians are nervous about sending them back into the community. They do not think anyone will take responsibility for them and that is something we have to look at.

Social Care Funding

Debate between Andrew Percy and Jeremy Hunt

Monday 11th February 2013 Commons Chamber

[Mr Hunt]

These proposals will go some way to addressing that problem. First, children who reach adulthood— the age of 18—with care costs will continue to receive the support they need without any qualification at all. Adults who become disabled during their working life will have a cap, but it will be a lower one. So we will be able to offer very important support to both those groups.

[Andrew Percy (Brigg and Goole) (Con)]

I welcome this statement as it moves the system on from where it is today. However, for a lot of communities the social care costs are so much more expensive, particularly in rural areas with very elderly populations, and they are more likely to hit that cap more quickly. So can my right hon. Friend assure us that everything will be done to ensure that the cost of care in these more expensive areas is brought down to something more in line with the rest of the country?

[Mr Hunt]

We think that these proposals will be particularly effective in such areas, because the higher the costs the sooner someone will reach the cap and the sooner they will get the support they need.

Oral Answers to Questions

Debate between Andrew Percy and Jeremy Hunt

Tuesday 15th January 2013 Commons Chamber

[Andrew Percy (Brigg and Goole) (Con)]

3. What representations he has received from clinicians in Yorkshire and the Humber on the decision to close the children’s heart surgery unit at Leeds children’s hospital.

[The Secretary of State for Health (Mr Jeremy Hunt)]

I know that some are disappointed at the decision by the Joint Committee of Primary Care Trusts and want to see children’s congenital heart surgery continue at their local hospitals. However, the Safe and Sustainable review was an NHS review, independent of Government. Under the circumstances, and given that legal proceedings and a review by the independent reconfiguration panel are under way, my hon. Friend will understand that it is not appropriate for me to comment further.

[Andrew Percy]

One hundred and seventy clinicians from across Yorkshire and northern Lincolnshire have written to express their dismay at the decision, stating that for time-critical transfers it

“exposes a number of children to the risk of death,”

largely because it will require transfers to Newcastle, where services are not co-located. Does that not prove that the decision does not enjoy clinical support in Yorkshire and north Lincolnshire and that it is simply not true that this has been a clinically led review?

[Mr Hunt]

I have seen the letter to which my hon. Friend refers and I understand that these are extremely complex issues. Let me reassure him that when I take my final decision, it will be on a clinically led basis. I will do that when I have received the IRP’s report, which I am due to receive by 28 March.

Mental Health Act 1983

Debate between Andrew Percy and Jeremy Hunt

Monday 29th October 2012 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. As a result of the new structures in the NHS, responsibility for ensuring that all patients who are threatened with detention receive the advocacy to which they are entitled under the Mental Health Act will be transferred from primary care trusts to local authorities. We will use this opportunity to review the arrangements, talk to local authorities, and do all that we can to ensure that those functions are discharged in the way my hon. Friend seeks.

[Andrew Percy (Brigg and Goole) (Con)]

Two mental health trusts that do a fantastic job in my constituency, Humber NHS Foundation Trust and Rotherham, Doncaster and South Humber NHS Foundation Trust, have been involved in this. Can the Secretary of State tell us how many patients have been affected by what has happened in trusts, so that if families approach us we can offer them the information that they require?

[Mr Hunt]

I shall try to give my hon. Friend that information later.

Academies Bill [Lords]

Debate between Andrew Percy and Jeremy Hunt

Monday 19th July 2010 Commons Chamber

[Andrew Percy]

It was not necessarily only academies that went down that route: all kinds of schools throughout the country forced children on to GNVQs and equivalent qualifications to force up their results. It was not unique to academies.

[Mr Hunt]

As the hon. Gentleman will hear later, the statistics are rather sharp on the difference between academies and the rest of the maintained sector. Moreover, the academies were unwilling to divulge the difference between academic qualifications and academic equivalent qualifications in vocational subjects.

Let us be clear that we are not debating the relative merits of academic versus vocational education. The equivalent qualifications sold as vocational are, in fact, rarely so. Many academy pupils are directed towards what might be described as semi-vocational or semi-academic subjects that do not provide the rigorous technical training that might lead to an apprenticeship but are simply weaker versions of GCSEs, such as BTEC science or OCR national certificates in information and communications technology.

[Mr Hunt]

Clearly, the hon. Lady has not discovered the new politics. This is not about party political point scoring. [Interruption.] As I said at the beginning of my speech, this is about what children learn in our schools, and Government Members would do well to remember that amid their guffawing. Although a BTEC can officially be worth two GCSEs, or an OCR national certificate worth four GCSEs, that equation is not necessarily accepted by further or higher education colleges or other academic institutions, so often the pupil is short-changed even as grade results are inflated.

[Andrew Percy]

I could not agree with the hon. Gentleman more on that point, but it is important that he understand that, very often, local authorities that controlled schools were forcing them down that route. That will not be allowed to happen if the Bill is passed.

[Mr Hunt]

Academies are going down that road to raise their league table offering.

[Andrew Percy]

rose—

[Mr Hunt]

If the hon. Gentleman will wait a moment, the statistics that might quiet him will come.

Returning to the academies offer, the important point is that pupils have true options. First, they should have the choice to pursue academic subjects, even if that is to the detriment of the school’s results. After all, whose interests are the schools serving, apart from their pupils? Secondly, pupils should not be misled into thinking that undertaking equivalent qualifications will give them the same standing as GCSEs in history, modern languages, geography or the hard sciences; they will not.

The facts are stark. A series of parliamentary questions has shown that academies succeed disproportionately in equivalent qualifications and that academic subjects are in steeper decline in academies than in maintained schools. Just 17% of pupils in academies take geography GCSE, compared with 27% in the maintained sector, and 21% of pupils in academies take history GCSE, compared with 31% in the maintained sector. Whereas only 26% of academy pupils take a modern language, some 44% of maintained pupils do so. A similar story could be told for English literature, where one learns the rudiments of grammar, and for physics, chemistry and biology.