National Health Service

Baroness Bray of Coln Excerpts

Wednesday 21st January 2015 Commons Chamber

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

What utter, disgraceful nonsense! I will rebut every single thing that the right hon. Member for Leigh (Andy Burnham) has said.

This has been a tough winter for the NHS, and I first want to pay tribute to the hard work of staff on the front line who have been working exceptionally long hours in very challenging circumstances. What they want right now is practical help, a vision for the future and a sensible plan to get there—all of which this Government are delivering. They do not want to be turned into a political football. The public have noted that while Labour Front Benchers sometimes sound restrained in parliamentary debates, they are the opposite in the TV studios, where they do everything possible to whip up panic and a sense of crisis. That is not the behaviour of a responsible Opposition.

As NHS England and the King’s Fund have said, the NHS is coping well under real pressure and, in the words of Dr Cliff Mann, president of the College of Emergency Medicine, trying to weaponise it for political purposes is “toxic”. Indeed, Professor Chris Ham, of the King’s Fund, said this week:

“This is a long-term issue not to do with this particular government—the previous government faced many of the same challenges...patients who are really poorly will still get a very good and very quick service.”

[Angie Bray (Ealing Central and Acton) (Con)]

In contrast to what we have heard from the Opposition, will my right hon. Friend join me in welcoming the seven-day-a-week GP surgeries opening up across Ealing and Acton and the plans for the new walk-in health centre for Acton? Will he join me in condemning the Labour-led council’s decision last night to cut the public health budget?

[Mr Hunt]

That is the reality: there are new and improved services for the NHS up and down the country, but what we get from the Labour party in my hon. Friend’s constituency is scaremongering leaflets saying that hospitals are being closed when they are not. Labour should apologise for scaring very vulnerable people. It claims to stand up for them, but by scaring them it is doing the exact opposite.

A and E (Major Incidents)

Baroness Bray of Coln Excerpts

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

We have looked into that matter in huge detail. There are probably three broad factors that are behind the increase in demand. One is the ageing population. There are 350,000 more people over the age of 75 than four years ago. The point is that if someone of that age goes into A and E in the winter, there is an 80% chance they will be admitted to hospital and quite a large chance they will stay in hospital for some time. The second factor is changing consumer expectation among younger people who want faster health care—[Interruption.] That is what Professor Keith Willett, the director of emergency care at NHS England, said, and Opposition Members should listen to what our clinical leaders are saying. The third factor is a refusal by NHS trusts to do what they were pressurised to do in the past, which is to cut corners to hit targets.

[Angie Bray (Ealing Central and Acton) (Con)]

My right hon. Friend will be aware that there have been significant changes to hospital services across north-west London. There is considerable concern from some of my constituents that the closure of A and E departments at Central Middlesex and Hammersmith hospitals has led to some of the increasing pressure elsewhere. Will he tell me whether there is any evidence of that?

National Health Service (Amended Duties and Powers) Bill

Baroness Bray of Coln Excerpts

Friday 21st November 2014 Commons Chamber

[David Tredinnick]

Madam Deputy Speaker, you are kind to draw that to my attention. I simply say this: there are different regulatory bodies—not just Monitor—that we should consider. We should be taking on board the fact that osteopaths, chiropractors and homeopathic doctors are regulated by separate Acts of Parliament, yet the Health and Care Professions Council regulates clinical scientists, paramedics, physiotherapists. The Professional Standards Authority, which is another regulatory body, provides oversight of nine statutory bodies. Then there is the umbrella body, the Complementary and Natural Healthcare Council. I will leave it at that, as I do not wish to stray. On the safety aspects of those bodies, I understand from Balens, which has been insuring support services for 10 years, that there has not been a claim against a herbalist for more than 10 years.

The Bill partly addresses the issue of the transatlantic trade and investment partnership. Across the world, there is a whole mass of new thinking that could be incorporated in our health service. I am nervous that if we take out TTIP—if an exemption for the NHS is proposed—it will not be in our interests. In America there are a lot of integrated practices, in which a range of different health disciplines are brought together to reduce costs.

[Angie Bray (Ealing Central and Acton) (Con)]

Does my hon. Friend agree that the Government and the European Commission have made it clear that decisions on the provision of public services will continue to be made by the Government here in Westminster?

[David Tredinnick]

We are agreed on that. It is a case of the extent to which we derogate the powers of the Secretary of State. We have a whole lot of new bodies, including clinical commissioning groups, which have been a great success.

I congratulate the hon. Member for Eltham on securing this slot today. I wonder whether he still has 100 troops in the Tea Room waiting to come in for a closure motion, if Madam Deputy Speaker is gracious enough to grant it. I am happy to serve with him in the future on his Bill.

--- Later in debate ---

[Andy Burnham]

I will give the hon. Gentleman my message now: the Labour Government in England and in Wales have taken steps to bring down NHS waiting lists. When we left office, they were at the lowest ever level. I make no apology to him for those improvements.

The 2012 Act has put the NHS in danger, which is why it has to go. Back on that March day in 2012, I pledged that the party that created the NHS would repeal that Bill at the first opportunity, and today we honour that promise. The Bill before us, presented by my hon. Friend the Member for Eltham (Clive Efford), restores the right values at the heart of the NHS: collaboration over competition; integration over fragmentation; people before profits.

[Angie Bray]

Will the right hon. Gentleman care to comment on the letter in The Daily Telegraph today, signed by a number of doctors and led by the chairman of NHS Alliance, asking people not to support this Bill, as it would be a backward step for patients?

[Andy Burnham]

I am sure that Tory central office has been ringing around for a few days trying to find some doctors who are still in favour of the 2012 legislation, and they found 11. Well, I think that is probably about the limit for the number of people prepared to put their name to it. I can tell the hon. Lady that thousands of doctors lined up with the Opposition and pleaded with her party to call off its reorganisation, and that included the British Medical Association and the royal colleges, but it would not listen. The Government ploughed on regardless, and the NHS has gone downhill ever since.

That is why my hon. Friend the Member for Eltham gave a stirring speech of the kind this House needs to hear more, full of conviction and passion, standing up for the national health service that he believes in. He has brought before the House a Bill that reaffirms the words of Nye Bevan’s original National Health Service Act 1946 on the democratic accountability of the NHS to the Secretary of State and, by extension, to this House. The Bill abolishes the compulsory tendering of NHS services and removes market forces. It reduces the private patient income cap back down to single figures. Once and for all, it fully exempts the NHS from EU procurement and competition law, as is our right under the Lisbon treaty. It sends the Government an uncompromising message that the NHS will never be touched by any TTIP treaty.

In particular, I commend my hon. Friend for saying that it is about time this House regained full sovereignty over the national health service. They gave it away—the Eurosceptics sitting there on the Government Back Benches—when they mandated open tendering of services. By doing that, they placed the NHS in the full glare of European competition law. [Interruption.] They do not like to hear it, but that is what they did.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

I shall begin by returning to the founding moment of our NHS, when a national health service was created which remains to this day a world-class health service where care is available to all, irrespective of ability to pay and free for all at the point of delivery. These fundamental principles of our NHS have been cherished and protected by each and every Government throughout its proud history, and were in 2012, for the first time, put on to statutory footing by this Government through the Health and Social Care Act.

[Angie Bray]

Will my hon. Friend give way?

[Dr Poulter]

If my hon. Friend will bear with me, I am going to make a little more progress and then give way later on.

Those who believe that our NHS has always been run solely through public providers are of course very wrong. From its very inception, the NHS that Nye Bevan created has comprised providers in the public and the non-public sectors. In 1948, independent GPs, community pharmacists and dental practitioners contracted with our health service to provide primary medical services to patients, and they continue to do so to this day as part of the public-private partnership. It is worth reflecting on the fact that Tony Blair’s former political secretary, John McTiernan, said only this August that

“an NHS without private providers is unimaginable. For one thing, no one—even on Labour’s extreme left—is arguing that we should nationalise general practice. But GPs are private providers, acceptable to opponents of the ‘private sector’ because most encounters with the NHS are visits to your local doctor”.

We also take for granted the key role played by charities and the voluntary sector in providing NHS care to patients across the country, notably Macmillan Cancer Support and Marie Curie Cancer Care.

In opening my contribution to this debate, I reaffirm this Government’s commitment to the founding principles of our NHS, a health service free at the point of delivery, and recognise that since its creation by Nye Bevan in 1948 our NHS has always been a public-private partnership. For public services to be equitable and free at the point of use, they did not all need to be provided on a monopoly basis within the public sector, controlled in a rigid way by local bureaucracies often deeply resistant to innovation and genuine local autonomy.

“The aim should be to change fundamentally the way the NHS was run: to break up the monolith; to introduce a new relationship with the private sector; to import concepts of choice and competition”.

Those are not my words, but those of Labour Prime Minister Tony Blair about the reforms to the NHS that he introduced under the previous Labour Government.

[Angie Bray]

Does my hon. Friend agree that the most damaging thing for the NHS—patients and staff alike—is a lot of misleading scaremongering? I am afraid that we have heard more of that in the Chamber today. Will he correct the record to make sure that it is very clear that the pledge made by the Secretary of State for Health that the A and Es at Ealing and Charing Cross hospitals will both remain open for the long term still stands, and that they will allow themselves to be directed by Bruce Keogh’s report such that whatever recommendations he makes on A and E, they will make sure that they meet those requirements?

[Dr Poulter]

I am happy to confirm and to put on the record the points that my hon. Friend has made. It is important that the NHS is not used as a political football, and that services are always designed and delivered in the right way for patients. There is often too much scaremongering in these debates. I reiterate that what she said about the local A and Es is absolutely correct.

Patient Safety

Baroness Bray of Coln Excerpts

Tuesday 24th June 2014 Commons Chamber

[Mr Hunt]

We looked carefully at whether the duty of candour should apply to individuals, and we decided against that because we were worried about creating a legalistic culture in trusts. However, we are working with the regulatory bodies. The right hon. Gentleman is absolutely right to raise concerns, as they were indeed raised in the Francis report. Following on from my earlier response, one of the lessons that we learned from the airline industry is that pilots are professionally protected if they speak out, so on balance it is to their advantage to speak out rather than to shut up. As a result of that reporting of safety incidents, near misses and so on, the industry has achieved a remarkable reduction in accidents. I would like to see whether we can do the same thing in the NHS.

[Angie Bray (Ealing Central and Acton) (Con)]

One of my constituents spoke out against malpractice at the hospital where she worked and was subsequently vindicated at a tribunal, but she lost her job and has been unable to find work in the national health service ever since. Is it not time that we put an end to some kind of blacklist that stops people being re-employed when they have done the right thing?

[Mr Hunt]

I would like to thank my hon. Friend for the support that she has given to her constituent, whom I think I have also met. My hon. Friend is absolutely right: we have to stop this system of consequences for people who do the right thing and speak out. It is not right for me to comment on an individual case, because legal proceedings are often involved, but one hears of situations where people have spoken out and then been victimised by a trust, and that is wrong. We need to be better at looking after whistleblowers, but we need to go further and eliminate the need for whistleblowing by creating a culture where trusts are hungry to hear from their own staff about safety concerns because they want to put them right.

NHS

Baroness Bray of Coln Excerpts

Wednesday 5th February 2014 Commons Chamber

[Luciana Berger]

The hon. Gentleman may not have been here when we had the response from the Health Secretary. I will come on to the very points the hon. Gentleman raises in my speech, and I look forward to going through all the big issues we have with malnutrition in this country.

I echo the comments made by my right hon. Friend the shadow Secretary of State about the sneering we have heard from Government Members this afternoon regarding some very serious issues. Any case of scurvy in 21st-century Britain is shameful.

My hon. Friend the Member for Stretford and Urmston (Kate Green) talked about the catalogue of coincidences that have led to so many more people going to A and E in the first place. I refer back to the increase of 16,000 in the last three years of the Labour Government, and of 633,000 in the first three years of this Government. Why is that? A quarter of walk-in centres have closed. NHS Direct was abolished. The guarantee of a GP appointment in 48 hours was scrapped, and extended GP opening hours were cut. As my hon. Friends the Members for Easington (Grahame M. Morris) and for Worsley and Eccles South (Barbara Keeley) said, £1.8 billion has been hacked from social care budgets, with thousands of people losing their care packages.

[Angie Bray (Ealing Central and Acton) (Con)]

Is the hon. Lady prepared to admit, just a teensy bit, that some of the added numbers going to A and E, which I agree are putting a lot of pressure on the departments, are partly to do with the change in GP contracts introduced by the Labour Government? That is driving people to A and E, because no GPs are working the hours that would allow people to be seen.

[Luciana Berger]

I just do not know what to say to that because it is so ridiculous. There was an increase of 16,000 in the last three years of the Labour Government, which has rocketed to 633,000 in the first three years of this Government. The gap in those figures is tremendous. The GP contract happened in 2004. When have we seen crises in A and E? Not under the Labour Government, but under this Government—the Tory-Liberal Democrat Government.

What else has happened under this Government? We have seen the Health Secretary handing back £2.2 billion of underspend to the Treasury, 2,300 managers receiving six-figure pay outs and £1.4 billion siphoned off to pay for redundancies. My right hon. Friend the Member for Leigh also raise the issue of the amount of money NHS trusts are now having to spend on expensive legal fees as a result of competition, introduced through the Health and Social Care Act. That goes to show that when it comes to our NHS, this Government know the cost of everything but the value of nothing.

As the hon. Member for Stafford (Jeremy Lefroy) said, our elderly population is growing, but half a million fewer older people are receiving support compared to 10 years ago. That means more older people going to A and E because they cannot receive the care they need at home, and more older people stuck in hospital beds because there is no safe place to discharge them to.

Urgent and Emergency Care Review

Baroness Bray of Coln Excerpts

Tuesday 12th November 2013 Commons Chamber

[Mr Hunt]

Let me gently remind the hon. Lady that we have protected the NHS budget—we took a very difficult decision—but how the NHS budget is spent in local areas is a matter for local discretion. It is challenging for all hospitals, because if we are to address the long-term stability of the NHS we need to spend more money out of hospitals, which means finding efficiency savings in hospitals. We do not want to duck those challenges, which is why we are having the review that will be published tomorrow.

[Angie Bray (Ealing Central and Acton) (Con)]

My right hon. Friend will be aware that there are concerns about whether blue-light ambulance services will continue to define what an A and E is. Does he agree that for some years now victims of stroke, trauma and other serious problems have not necessarily gone to their local A and E but to specialist hospitals, and that that has been the reason behind the excellent improvement in outcomes?

Changes to Health Services in London

Baroness Bray of Coln Excerpts

Wednesday 30th October 2013 Commons Chamber

[Mr Hunt]

Apart from the very last sentence, I actually agree with what the hon. Lady says. It is important to carry the public with us in these reconfigurations. Governments of both parties have struggled to do that in these difficult reconfigurations, which is why the new structures that we have introduced will put doctors in the front line to argue for changes. It is not just the medical directors of trusts supporting them, but the CCG leaders, who are all local GPs, making that case. That is why there is much stronger support for these changes. All the elected representatives on the local councils, apart from Ealing, supported these changes, and that is a very big change from what we have seen previously. I agree with the hon. Lady: we need to do more work and it is very important to carry people with us.

[Angie Bray (Ealing Central and Acton) (Con)]

It is fair to say that today’s announcement leaves my constituents in a much better place than they were over a year ago when we set out to save our four local A and Es. Obviously, there is disappointment about the loss of the A and Es at Hammersmith and Central Middlesex, but huge relief that the bigger A and Es at Ealing and Charing Cross will be saved. My right hon. Friend says, rightly, that it will be for the local CCGs to take responsibility for the future of these A and Es. Can he give us a little more detail on how he sees the services being delivered and improved by the CCGs, and can he reconfirm that the A and Es at Ealing and Charing Cross will be saved as A and Es?

[Mr Hunt]

I can absolutely confirm that A and Es will remain at Charing Cross and Ealing hospitals, thanks in no small part to the remarkable campaigning that my hon. Friend has done for her constituents, both in public and in private. I commend her for that. The process that has to happen is clearly set out in what the IRP says and in my reply. There must be full consultation. There will be changes to the way in which services are provided, but they will be changes made in the interests of patients. Whatever those changes are, A and Es will remain at those two hospitals.

Accident and Emergency Departments

Baroness Bray of Coln Excerpts

Tuesday 10th September 2013 Commons Chamber

[Mr Hunt]

The pressure exists throughout the NHS. The right hon. Gentleman is absolutely right: there is real pressure in all hospitals. I commend all A and E departments for their hard work. The ones that got additional resources today were the 53 local health economies where we thought the risks were highest, and I think it was right to target that money to help those areas, but that is not to say that there is not a lot of pressure in other areas. That is why the long-term changes that we are talking about—the transformation in IT systems, the increased availability of GPs to look after frail and vulnerable older people, the integration of health and social care services—will benefit the right hon. Gentleman’s constituents and his hospital profoundly, and I am sure he will notice the difference.

[Angie Bray (Ealing Central and Acton) (Con)]

I welcome the extra money for Ealing Hospital NHS Trust and North West London Hospitals NHS Trust. It will come in very useful indeed. However, my right hon. Friend will be aware that four hospitals in North West London are still under threat of losing their A and Es. The independent review into that decision is due to report to his Department very shortly. When are we likely to get a final decision from him?

[Mr Hunt]

Let me reassure my hon. Friend. First, I thank her for her assiduous campaigning for her local hospital, which is recognised on both sides of the House. I am expecting that report on Friday, and as the House knows, when it comes to issues of hospital reconfigurations, I want to make decisions as quickly as I can. I will want to consider it very carefully, but I think everyone would like the certainty of knowing what will happen, so I will report to the House as soon as I am able to make a decision.

Accident and Emergency Waiting Times

Baroness Bray of Coln Excerpts

Wednesday 5th June 2013 Commons Chamber

[Mr Hunt]

Indeed. We were having a discussion about walk-in centres. It is true that Labour opened a lot of those, just as it closed or downgraded 12 A and E departments during its time in office. That is one of the reasons we face the problems we have today.

[Angie Bray (Ealing Central and Acton) (Con)]

My right hon. Friend should know that my constituents welcome his decision to refer to an independent review the plans to close the four A and Es closest to my constituency. Does he agree that the review will need to look carefully at whether due consideration was given to the impact of those four closures on the neighbouring hospitals and their A and E departments?

[Mr Hunt]

I absolutely agree with my hon. Friend that the impact on neighbouring A and Es in all reconfiguration decisions is extremely important, and I will not authorise any changes in service provision unless I am satisfied that they will be consistent with improved patient safety.

Oral Answers to Questions

Baroness Bray of Coln Excerpts

Tuesday 26th February 2013 Commons Chamber

The Secretary of State was asked—

[Angie Bray (Ealing Central and Acton) (Con)]

1. What assessment he has made of the benefits of comparative performance data in raising standards in the NHS.

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

Comparative performance data are essential to raise standards in the NHS. I have therefore commissioned a review from the Nuffield Trust to consider whether aggregate ratings of provider performance should be used in health and social care, and if so, how best this should be done.

[Angie Bray]

My right hon. Friend will be aware that NHS North West London has made considerable use of comparative performance data to justify closing four A and E departments in one concentrated part of its area. Charing Cross, Ealing, Hammersmith and Central Middlesex are the four A and E departments closest to my constituents, who will be wondering how their closure will raise standards of health care provision locally. Does my right hon. Friend appreciate that there will be strong support among my constituents for any calls to review the decision and the use of comparative performance data?

[Mr Hunt]

I first congratulate my hon. Friend on campaigning extremely hard on behalf of the views and concerns of her constituents throughout the process of the decision that was finally made by NHS North West London last Tuesday. Comparative performance data have a very important role to play, particularly with regard to excess mortality of people who use A and E on weekends. I am, however, aware of my hon. Friend’s concerns and will consider them carefully if, as is likely, the decision is reviewed by Ealing council.