William Mead: 111 Helpline

Debate between Baroness Stuart of Edgbaston and Jeremy Hunt

Tuesday 26th January 2016 Commons Chamber

[Mr Hunt]

All 111 services have clinicians present at call centres, so it is about not the availability of clinicians, but the speed with which they are involved in cases where they can make a difference. It is also about the training of those clinicians so that they can recognise horrible infections such as sepsis quickly. It is a combination of things. The important thing here is that if we are to give the public confidence in a simpler system where they have a single point of contact—albeit a phone line or a website—they need to be confident that if they are not immediately speaking to someone who is clinically trained they will be put through to such a person if it is necessary. We have not earned that confidence yet, which is why it is so important that we learn lessons from what happened in this tragic case.

[Ms Gisela Stuart (Birmingham, Edgbaston) (Lab)]

I was the Minister who set up NHS Direct, and one of the first cases that caused us to review the algorithms was a meningitis case. May I therefore say to the Secretary of State that just looking at the algorithms used by call-handlers will not be sufficient? It is clinically exceptionally difficult, and his review is too limited to address the problem.

[Mr Hunt]

I understand what the right hon. Lady is saying, and of course I would listen to her because of her experience, but I reassure her that that is not the only thing that we are doing; we are doing lots of other things. The report makes many recommendations, one of which is to look at the algorithms that the call-handlers use to make sure that they are more sensitive to some of the red-flag signs of sepsis, meningitis and other conditions. There are lots of other recommendations. They include earlier access to clinicians where appropriate, and recommendations on the training of clinicians in the out-of-hours service, the training of GPs and the training of people in hospitals. So we will be undertaking a much bigger body of work as a result of this review.

Junior Doctors Contract

Debate between Baroness Stuart of Edgbaston and Jeremy Hunt

Monday 30th November 2015 Commons Chamber

[Ms Gisela Stuart (Birmingham, Edgbaston) (Lab)]

When the Secretary of State chaired his three contingency meetings, did he take account of the fact that last year we had about 43,900 excess winter deaths, which were avoidable and largely caused by almost toxic overcrowding of emergency departments? What provisions has he made to avoid the excess deaths that we had last year and to make sure that that is not made even worse by the present situation?

[Mr Hunt]

The hon. Lady is right to be concerned by the much higher than normal excess winter deaths that we had, but I would not characterise the reason for those excess deaths as she did. We think they were largely caused by the ineffectiveness of the flu vaccine that was recommended by the World Health Organisation last year but proved not to be as effective as it normally is. The early signs are that this year’s flu vaccine will be more effective. Those excess deaths are deaths at home and throughout the system, not just in hospitals, but of course we are doing everything this winter, as we did last winter, to make sure that we minimise the possibility of excess deaths.

Junior Doctors’ Contracts

Debate between Baroness Stuart of Edgbaston and Jeremy Hunt

Wednesday 28th October 2015 Commons Chamber

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

I beg to move an amendment, to leave out from “House” to the end of the Question and add:

“welcomes the Government’s commitment to delivering seven-day hospital services and saving lives by combating the weekend effect; notes the British Medical Association’s (BMA) decision to walk away from negotiations to reform a contract which all sides acknowledge is not fit for purpose; further notes the Government’s proposed introduction of new contractual limits which protect staff from working unsafe hours and the commitment that average junior doctors’ pay will not fall; and calls on the BMA to put patient care first, to choose talks over strikes, and to return to negotiations.”.

I warmly welcome the hon. Member for Lewisham East (Heidi Alexander) to her post at her first Opposition day debate.

One Saturday in April 2006 a 20-year-old man called John Moore-Robinson was out mountain biking with his friends in Cannock Chase when he fell off his bike and the handlebars hit his stomach. His friends dialled 999 and he was rushed to hospital. Although the paramedic who took him to hospital thought he had life-threatening internal bleeding, instead of being treated he was left for 50 minutes, apart from a brief examination. Then he was told he had bruised ribs and sent home. In fact, he had a ruptured spleen and tragically died later that Saturday night.

Tragedies happen in any healthcare system, and despite such stories I am fiercely proud of our NHS and the brilliant care given by our doctors and nurses seven days a week. The hon. Lady was right to thank each and every one of them. Anyone who uses such stories to denigrate the NHS should remember that last year the Commonwealth fund rated us the best healthcare system of 11 major countries—better than France, Germany, Australia or the US—and rated our A and E departments —[Interruption.] It was the Opposition who called this debate, so they might want to listen to some of the arguments. This is a very important issue about the lives of NHS patients, and I am saying that the tragedies and the problems we have should not be used to denigrate the NHS or our A and E departments.

Part of being the best in the world is being honest about where we need to improve, and the fact remains that in our hospitals today we have around three times less medical cover at weekends. In our manifesto in May this Government committed to a truly seven-day NHS so that we prevent a repeat of the tragedy that happened to John Moore-Robinson.

[Ms Gisela Stuart]

The Secretary of State is absolutely right that we need to address the fact that there seems to be less cover at the weekends. He is trying to circle that square without expanding the number of doctors and the services. He is thinning the service on Monday to Friday to bring more cover to the weekends. That does not solve the problem.

[Mr Hunt]

I am happy to deal with that. We went into the election in May saying that on the back of a strong economy we were prepared to commit £10 billion extra to the NHS in real terms over the course of this Parliament. That was £5.5 billion more than the hon. Lady’s party was prepared to commit. In the last Parliament, when the increase in NHS spend was half that amount, we increased the number of doctors by 9,000, so we are increasing the number of doctors, but as we do so we need to ensure that we give the right care to patients.

I want to give a word of caution to the shadow Secretary of State. The tragedy of John Moore-Robinson, the gentleman I have mentioned, happened not only on a Saturday, but at Mid Staffs. The last time the House discussed the difference between excess and avoidable deaths was under a Labour Government, when they tried to brush the problems at Mid Staffs under the carpet, saying that we should not take the figures on excess deaths too seriously because they were a statistical construct and different from avoidable deaths. I would have hoped that the Labour party learned the lessons of Mid Staffs and would not make the same mistakes again. [Interruption.]

NHS Major Incidents

Debate between Baroness Stuart of Edgbaston and Jeremy Hunt

Wednesday 28th January 2015 Commons Chamber

[Mr Hunt]

I totally agree with the right hon. Gentleman. I am sure, too, that he will agree with me that the best way to give the NHS certainty over funding in the future and the increase in funding that it needs to implement the five-year forward view is a strong economy, and it is only this Government who are able to deliver that.

[Ms Gisela Stuart (Birmingham, Edgbaston) (Lab)]

According to some statistics, I have more medics per square mile in my constituency than any other MP. I also have the University Hospitals Birmingham NHS Foundation Trust on my patch and a lot of people who work across the west midlands and in Birmingham. The Secretary of State’s operational guidance, as he has interpreted it, is not perceived in the way that he thinks it is. A and E consultants tell me that they are not just overworked and overstretched, but unsafe. If he thinks the guidance is purely operational without any political interference, will he follow the call of the shadow Secretary of State and say that he will issue a new set of guidance that makes that clear, because it is not how it is seen on the ground?

[Mr Hunt]

I have great respect for the hon. Lady, so I hope she will understand this: when people are worried about political influence over operational guidance, I do not then issue some political guidance. The only thing that I, as Health Secretary, say in respect of instructions going out is that patient safety must always be the priority, and that is what I have said time after time. But then the actual decision about whether to declare a major incident must be taken by people locally. Julie Moore, the chief executive of UHB, is fantastic and absolutely able to make those decisions, and those decisions should not be second-guessed by politicians.

A and E (Major Incidents)

Debate between Baroness Stuart of Edgbaston and Jeremy Hunt

Wednesday 7th January 2015 Commons Chamber

[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.

[Ms Gisela Stuart (Birmingham, Edgbaston) (Lab)]

Facts are important in this debate. There is now good evidence to show that overcrowding in emergency departments increases mortality and length of stay. Will the Secretary of State ensure that the figures for hospitals are available in the House of Commons on a monthly basis, so that we can correlate spikes following emergencies with what happens to mortality rates? If mortalities increase, the problem is even more serious than we think it is.

[Mr Hunt]

I agree with the hon. Lady. It is critical that we look at the data carefully. I will see whether the data on mortality rates are available on a monthly basis. I will be as interested as she is to see it.

UK Ebola Preparedness

Debate between Baroness Stuart of Edgbaston and Jeremy Hunt

Monday 5th January 2015 Commons Chamber

[Mr Hunt]

I can reassure my hon. Friend that my right hon. Friend the International Development Secretary has spoken to the President of Sierra Leone about that very issue. One of the big learning points from the relative success of Nigeria, which we discussed earlier, in combating Ebola compared with Sierra Leone has been about the strength of the local health system. One particular challenge is that the entire health system in Sierra Leone is now focused on Ebola, raising the risk of other diseases, such as malaria, tuberculosis and HIV, killing more people even than Ebola. Strong local health care systems are an important long-term insurance policy to ensure that countries can deal with infectious diseases.

[Ms Gisela Stuart (Birmingham, Edgbaston) (Lab)]

We are still learning about Ebola and the efficacy of the screening processes. What discussions has the Secretary of State had with other European countries, particularly European Health Ministers, to share best practice, exchange what we have learned and ensure a comprehensive approach?

[Mr Hunt]

I have spoken to several European Health Ministers, and the Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison), who has responsibility for public health, is in regular touch with them about the international effort. The hon. Lady is right that no one country can solve this on its own, and we collaborate well with others—perhaps most closely with the French, who have taken responsibility for the fight against Ebola in Guinea.

Ebola

Debate between Baroness Stuart of Edgbaston and Jeremy Hunt

Monday 13th October 2014 Commons Chamber

[Mr Hunt]

My hon. Friend makes an important point. I am sure that those arrangements are already in place, but I will ensure that they are. Yes, we are in touch with colleagues in other countries. It is important to say that there are only a very few direct flights to Europe from the affected region, and indeed there are none to the UK. At the moment, it is possible to be fairly confident that we will reach the vast majority of people who come from those affected areas. But part of what I am trying to convey in this afternoon’s statement is that the risk level could change—for example, there could be a breakdown in public order in the affected countries—which is why we need to be prepared for a much more porous situation, with people coming from many different points of entry.

[Ms Gisela Stuart (Birmingham, Edgbaston) (Lab)]

Is the Secretary of State talking to our universities, as a number of them must have overseas students from west Africa returning for their studies in October? Is he focusing on them in particular, and what provisions are we making to cater for them?

[Mr Hunt]

The hon. Lady makes a very important point. Clearly, it is important that anyone who comes from those countries, whether a student or a visitor, is treated with the same screening and monitoring process. Screening and monitoring people simply on the basis of their passport would not work. There will be people who have indefinite leave to remain in the UK but who have a Sierra Leonean passport, and it would not be appropriate to put them through that process. It is most important that we have a system in place in which we can check and find out who has been to the Ebola-affected areas in the past three weeks, so that we can give them help if they need it.

NHS Investigations (Jimmy Savile)

Debate between Baroness Stuart of Edgbaston and Jeremy Hunt

Thursday 26th June 2014 Commons Chamber

[Mr Hunt]

I am absolutely happy to do that. I wholeheartedly agree with my hon. Friend’s comments. The NHS needs to move to a system where it is the norm rather than the exception to report, and where NHS staff feel comfortable that reporting any concerns is an absolutely normal part of their job. She is right to say that one of the most disturbing things in the reports is the clear evidence that some people helped Savile in what he did—for example, that people were escorted to his private room in Broadmoor—which is very shocking. That is why it is very important that everyone is vigilant. I totally agree with what she said.

[Ms Gisela Stuart (Birmingham, Edgbaston) (Lab)]

The only people who emerge with any credit are the victims, and we need to support them. However, I was slightly stung by the Secretary of State’s comment about the right hon. and learned Member for Rushcliffe (Mr Clarke). If the right hon. and learned Gentleman thought that the actions of the Minister—it was Edwina Currie, if I remember rightly—were inappropriate then, as they would be now, will he apologise for his stewardship of the Department at the time, or will the Secretary of State look at the Minister’s conduct and come back to the House to explain how it was possible?

[Mr Hunt]

I hope that I have gone some way to meet the hon. Lady’s concerns because, on behalf of the Government and the NHS, I have offered a full apology to all the victims for what happened, and I have accepted that there were failures at many levels. It is very important to say that the reports show that there was no evidence that Ministers or officials were aware of any sexual abuse by Savile. I pointed to the comments by my right hon. and learned Friend the Member for Rushcliffe because I wanted to make it clear that this Government are not defending actions which, as he has said, were indefensible then and would be indefensible now.

Hospital Mortality Rates

Debate between Baroness Stuart of Edgbaston and Jeremy Hunt

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

My hon. Friend’s hospital had excess mortality rates for five of the nine years leading up to 2010 and not enough action was taken, and that is what today is all about. I hope that what his constituents will take from today is that this Government are committed to turning around failing hospitals and putting in place the right leadership, and the reassurance that when their loved ones go to Queen’s hospital or anywhere else in the country, they can get the kind of care they would want for themselves.

[Ms Gisela Stuart (Birmingham, Edgbaston) (Lab)]

May I say to the Secretary of State that there is a tone and a language that we should choose to employ for candid conversations about failure and it saddens me that he did not find that language today, because it will not do us any good? The Francis report recommended a duty of candour. Will he update the House as to just how much progress he has made on that?

[Mr Hunt]

Yes, I can. We have accepted the recommendation that there should be a duty of candour on the boards of hospitals, with criminal sanctions if they fail to tell members of the public that they or their loved ones have been harmed by the hospital, and if they fail to tell the system that those incidents have happened. We have commissioned a review of safety by Sir Don Berwick, one of the greatest experts in the world, and we shall ask him whether we should extend that duty of candour to below board level. We shall wait to hear what he says. We understand the reasons why people might want to do that, but we are also aware that others have expressed the concern that it might destroy an atmosphere of trust in a hospital if people were worried about criminal consequences if they did not talk about any failures they saw in their daily work.

Mid Staffordshire NHS Foundation Trust

Debate between Baroness Stuart of Edgbaston and Jeremy Hunt

Tuesday 26th March 2013 Commons Chamber

[Mr Hunt]

My right hon. Friend makes an important point. The thing about complaints procedures is that we must have a system that is not about process and whether there is a response to a complaint in three days. The question is whether a hospital looks at and learns from a complaints procedure and changes its behaviour. That is what the right hon. Member for Cynon Valley (Ann Clwyd) and Professor Tricia Hart are looking into. Hospitals will be inspected against best practice to try to encourage as many of them as possible to adopt the very best complaints procedures.

[Ms Gisela Stuart (Birmingham, Edgbaston) (Lab)]

The Secretary of State has announced that he will consult on a barring scheme to prevent managers who are found guilty of gross misconduct from finding a job in another part of the system. To how many managers of Mid Staffordshire would he expect that to apply?

[Mr Hunt]

The hon. Lady will know that, when it comes to individuals—appalled as I am, and as appalled as all hon. Members are, by what happened at Mid Staffs—I must try not to prejudge due process. If we are to bar people from employment, we must have a fair process and system and a right of appeal, which is required under our law anyway. However, I would not expect any manager responsible for the kind of things that happened at Mid Staffs to be able to get a job in the health service ever again.