Accident and Emergency Departments

Ben Bradshaw Excerpts

Tuesday 10th September 2013 Commons Chamber

[Mr Hunt]

As so often on these matters, my right hon. Friend speaks extremely wisely. Since April, we have been working hard to deal with the underlying pressures on A and E departments while ensuring that we have cash available for short-term measures while those longer-term measures are put in place. He is absolutely right that joined-up integrated services are critical for A and E departments, because one of the biggest problems that they mention is the difficulty in discharging people from hospital, which makes it hard for them to admit patients who need to be admitted, often in very distressed circumstances. We also need to address the longer-term IT problems that mean that A and E departments cannot access people’s medical records and the question of alternatives to A and E, particularly in the community and through enhanced GP services.

[Mr Ben Bradshaw (Exeter) (Lab)]

If the Secretary of State is serious about people not attending A and E unnecessarily, why did he cut Labour’s extended GP opening hours and why is he allowing NHS walk-in centres to close up and down the country?

[Mr Hunt]

The fact is that one thing we need to do is to address why people go to A and E instead of the alternatives, such as walk-in centres. Communication about the alternatives to A and E is not as good as it needs to be. We are addressing those issues, but I must say to the right hon. Gentleman that the previous Government failed to address this problem when he was Health Minister and the difficult issue of the reconfiguration of services was never fully grasped. We are grasping it and that is why Professor Sir Bruce Keogh is undertaking his review right now.

Care Quality Commission (Morecambe Bay Hospitals)

Ben Bradshaw Excerpts

Wednesday 19th June 2013 Commons Chamber

[Mr Hunt]

I agree with much of what my hon. Friend says. He is absolutely right that accountability for what went wrong is crucial in this. I know that the CQC wanted to publish the report in full today, including the names of the individuals involved, but was given legal advice that it would be against the law to do so. However, the CQC is keen to have maximum transparency as soon as possible and is looking into how it can make sure that happens. There should be no anonymity, no hiding place, no opportunity to get off scot-free for anyone at all who was responsible for this. This is the problem we have to address in the NHS: all too often, people are not held accountable for what went wrong. However, the system also bears responsibility. This is not just about bad apples and how we root them out more quickly; it is also about creating a system that brings out the best in people—that plays to the decent instincts that got people to join the NHS in the first place, rather than making them think that targets at any cost matter more than the care and dignity of the patients in their trust.

[Mr Ben Bradshaw (Exeter) (Lab)]

The CQC’s chairman said on the radio this morning that he could not publish the names of those responsible for this scandal because of the Data Protection Act, but there are clear and explicit exemptions to the Act when it comes to

“protecting members of the public from dishonesty, malpractice, incompetence or seriously improper conduct, or in connection with health and safety”.

Will the Secretary of State please challenge the CQC’s interpretation of the Act and, if necessary, ask the Information Commissioner to rule on this flawed decision?

[Mr Hunt]

I can reassure the right hon. Gentleman that neither the chairman of the CQC nor I have any interest whatsoever in keeping these names secret. He did receive legal advice telling him that he could not publish them, but I will go back to him with what the right hon. Gentleman says. I know that the CQC chairman would like to be as transparent as possible. The choice he had, on the basis of the legal advice, was either not to publish the report or to publish it without the names. I think he took the right decision, given the advice he had, but I will ask him to consider what the right hon. Gentleman says.

Accident and Emergency Waiting Times

Ben Bradshaw Excerpts

Wednesday 5th June 2013 Commons Chamber

[Dr Wollaston]

The reality that we face is that there is a limited amount of public funding. We can spend that pot of public money only once, so we must spend it in the right place, and that often means that we need to spend more of it within social care. That is why I welcome the fact that some of the health budget has been shifted to social care, and that is very important. I also commend Torbay. My constituency covers Brixham and Paignton, and Torbay has been nationally and internationally recognised for its work on integrating health and social care. It is no coincidence that it does so well on A and E waiting times, and we should be looking at what it has achieved.

But how will we keep people out of our A and E centres? In the Health Committee, we heard evidence about the effect that paramedic crews have. If the paramedic crew in an ambulance are highly skilled, the person they treat is less likely to need to go to casualty in the first place because the expertise is there to keep them at home. There needs to be better access to records. We need to consider how we can improve IT so that the patient owns their record and every part of the system can safely access their drug and medical history—with their consent, of course.

[Mr Bradshaw]

Given the hon. Lady’s previous distinguished career as a Devon GP, does she, like me, deplore the comments made today by a Government Minister, who sought to blame the current crisis in the NHS on the growth in the number of women doctors?

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[Mr Ben Bradshaw (Exeter) (Lab)]

I associate myself absolutely with the remarks made by the hon. Member for Totnes (Dr Wollaston) about tariff reform, but given the time constraints, I will restrict my remarks to one particular issue that is putting pressure on the A and E crisis. I am talking about access to GPs.

I want to share testimony that I have recently received from people in Exeter. The first comes from a young teacher:

“Again and again, whenever I want to see a doctor there are no appointments available for as long as a week away, in addition to appointments not being made available at accessible times. Being a teacher, I am unable to easily pop out for a doctor’s appointment.”

Another constituent wrote to me last month about the A and E crisis:

“I believe one of the main reasons for this is that it has become very difficult to see your own GP unless you are prepared to wait three weeks for an appointment. I have personal experience of this, as do many of my friends and colleagues, and this is making people with minor ailments attend A and E in order to be seen.”

You will remember, Madam Deputy Speaker, that when Labour was in government, we introduced a requirement on GPs to grant appointments to their patients within 48 hours. We also introduced incentives in the GP contract for GPs to open at weekends and in the evenings, and we established GP walk-in centres in every primary care trust in England—in some areas, we established more than that. It worked. By the end of our Government, complaints from the public about GP access had declined significantly, as had pressure on A and Es that resulted from people not being able to see a GP.

By May 2010 more than 75% of GP practices in England were opening in the evenings and at weekends. Under this Government, however, 500 of those practices have reduced their opening times again. By May 2010, there were walk-in centres in every area offering quick, easy access to a GP, seven days a week and 12 hours a day. Since 2011, 25% of those centres have closed, and scrapping the requirement for GPs to offer an appointment within 48 hours has led to a return of the bad old days of people waiting days or weeks to see a GP, and therefore going to A and E instead.

[Mr Lammy]

Will my right hon. Friend give way?

[Mr Bradshaw]

I regret I will not do so because I have so little time.

When I wrote to the Health Secretary with the cases from Exeter that I referred to earlier, his colleague, Earl Howe, replied:

“It is our view that 48-hour access did not focus on outcomes, and specifying a particular model to deliver better services for patients misses the point about local needs, local services and local accountability.”

That, I am afraid, is gobbledegook. My hard-working constituents, who pay for the NHS, want to be able to see a GP when they need to and at a time convenient for them. Earl Howe’s letter went on to say that as this was a local issue, I should raise my concerns with the clinical commissioning group, which I promptly did. It replied stating:

“As this relates to GP services, the letter should be sent to NHS England.”

I await its response with interest.

Will the Minister help the House by making clear in her response who is responsible for ensuring that the public can see a GP quickly and conveniently? I was encouraged to hear the Under-Secretary of State for Health, the hon. Member for Central Suffolk and North Ipswich (Dr Poulter) tell the “World at One” yesterday that he wanted to improved GP access, including opening times, in response to the A and E crisis. Hallelujah! May I suggest, however, that he and he colleagues start by stopping the closure of walk-in centres, and reintroduce Labour’s requirements and incentives for GPs to give appointments within 48 hours and to open their surgeries at weekends and in the evenings? Without such measures, I am afraid that current pressures on A and Es will simply get worse.

Regional Pay (NHS)

Ben Bradshaw Excerpts

Wednesday 7th November 2012 Westminster Hall

[Mr Ben Bradshaw (Exeter) (Lab)]

I am pleased to see some of my west country colleagues here and to see the Minister in her place.

In May, the BBC asked the Deputy Prime Minister about regional pay, and he could not have been clearer:

“There is going to be no regional pay system. That is not going to happen.”

Yet, as we speak, plans are under way at 20 of our biggest hospitals and mental health trusts in south-west England to introduce just such a regional pay system. The organisations involved include the main hospitals in Exeter, Plymouth, Truro, Taunton, Yeovil, Poole, Bath, Bournemouth, Bristol, Gloucester and Salisbury. In total, more than 88,000 NHS staff in the south-west are affected.

Early this summer, the trusts announced their intention to form a pay cartel and to move away from the national pay negotiating process known as Agenda for Change. They committed £10,000 each to spend on business consultants to help them draw up their plans; they employed lawyers; and they set up a website. Based on the initial proposals, the trade unions, royal colleges and other organisations representing staff estimate that nurses and other NHS staff in the south-west could face a 15% pay cut, as well as changes to their holiday and other entitlements. The cartel has threatened to sack and re-employ staff to force through its plans.

I have to tell the Minister that, in my more than 17 years in this place, I have never received as many letters and e-mails expressing such anger and dismay as I have on this issue. Here is a taste of just some of them. A senior nurse in Exeter wrote to me, saying:

“My staff are at breaking point. I predict a mass exodus and patients will not receive safe high quality care.”

Another constituent wrote:

“Myself and my care workers are sick with worry over this and how I will be able to look after my family.”

Another wrote:

“I am the sole provider for a family of six and do two other jobs on top to cope. This will be the final straw.”

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

I thank the right hon. Gentleman for giving way so early in his speech. Will he undertake to share all those e-mails and letters with me so that I, too, can write to all his constituents to assure them of the Government’s plans?

[Mr Bradshaw]

I am not prepared to reveal the identities of those people without their permission. I have already written to the Secretary of State and his predecessor, and I will come in a moment to the way that they responded, which was totally unsatisfactory. However, I have given the Minister the gist, and I hope that she is not challenging the veracity of my constituents’ concerns.

Another constituent wrote:

“Myself and many nurses are planning to leave or move abroad if this happens.”

Finally, another wrote:

“I have not worked a single shift without working late or missing my break. This has sent staff morale to rock bottom.”

It is clear from the testimony of my constituents—loyal NHS staff—that even before this plan is implemented, the mere discussion of it is having a devastating impact on morale. As the Minister will know, staff morale is an invaluable and extremely precious commodity in the NHS. There is a clear correlation between high morale and safe and high-quality care. Most NHS staff go the extra mile in their jobs, but they have already had two years of pay freezes, and doing unnecessary and avoidable damage to staff morale will inevitably affect the quality and safety of patient care.

[Mr Adrian Sanders (Torbay) (LD)]

Will the right hon. Gentleman congratulate the trusts in my area—the Torbay and Southern Devon Health and Care NHS Trust and the South Devon Healthcare NHS Foundation Trust—which are not joining the pay consortium for the very reason that they think that it will damage morale and productivity and inhibit their ability to recruit the best possible people to the health care service in my constituency?

[Mr Bradshaw]

Yes, indeed I do congratulate the trusts in Torbay, which have held out against the pressure to join this cartel. I hope very much that the hon. Gentleman will put his money where his mouth is and join Labour MPs in the Division Lobby later today, when we will have a main debate on this very subject in the main Chamber.

[Kerry McCarthy (Bristol East) (Lab)]

I thank my right hon. Friend for bringing this issue before us; we have another debate on regional pay this afternoon, but it is important that we have an opportunity to focus on the south-west. Does he agree that one of the most damaging things for morale was that staff found out about the proposals only because they were leaked? There was no attempt at consultation beforehand; the consortium was set up, and the fact that those involved were trying to undermine people’s pay and conditions without talking to them gradually dribbled out.

[Mr Bradshaw]

Yes, I absolutely agree: the whole thing has been handled extremely badly by the trusts involved.

If the proposals go through, the trusts involved are likely to see an exodus of staff, not only to other regions, but, as the hon. Member for Torbay (Mr Sanders) suggested, to trusts in the south-west that are not part of the cartel.

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

The right hon. Gentleman is making a powerful case, but I am curious about one thing. There is a limited amount of money that can be spent in the national health service—the Government decided to increase it, although I seem to remember that the previous Labour Government were considering cutting it—so the choice is simple: we either go for a variation on regional pay or we make people redundant, and I am not convinced that that argument has been thought through. Would the right hon. Gentleman therefore be willing to join me in trying to convince the Government to do something about the tariff that is paid to hospitals in the south-west? We are short of money, and we need to find a way to improve that situation.

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[Mr David Crausby (in the Chair)]

Order. Interventions should be short.

[Mr Bradshaw]

The tariff is a separate issue, but that was an interesting intervention, because, for the first time, we had a Conservative MP actually speaking out in favour of regional pay in the NHS. That is not Government policy, and in all the correspondence that I have had from Ministers, they have denied that it is. At least the hon. Gentleman is one of the few MPs in the south-west who has the courage to be honest and to say that he supports it. He is almost alone; I have not spoken to a single other Conservative or Liberal Democrat Member of Parliament who supports this policy. I hope, as I said earlier, that those who do not support it will have the courage of their convictions, stand up for the west country for once and vote for the Labour motion in the main Chamber later.

As I was saying, there will be an exodus of staff to other regions and to hospitals in our region that are not part of the cartel. Between May 2010 and 2012, the south-west suffered the biggest reduction—3.54%—in qualified nurses of any region in England, and the situation is set to get worse. However, the impact will be felt not just on the health service. The south-west of England already has the biggest gap of any region in England between housing costs and wages. A reduction in public sector pay in our region of just 1%—of course, the reductions that we are talking about are much bigger—would suck £140 million out of the south-west economy, at a time when we need more, not less, demand in our economy.

I acknowledge, as do the unions and staff organisations, that there may be a case for changes to Agenda for Change. The NHS—this is partly a response to the point made by the hon. Member for Plymouth, Sutton and Devonport (Oliver Colvile)—is, after all, having to cope with the huge costs of the Government’s disastrous reorganisation of the health service, combined with its tightest-ever funding. However, the answer is to deal with these issues in national talks, in the usual way, and not to allow these parallel plans to proceed, threatening to derail national discussions and making a sensible agreement at national level less likely.

[Andrew George (St Ives) (LD)]

I would be grateful if the right hon. Gentleman clarified whether he supported the previous Government’s introduction of regional pay in the Courts Service or the freedoms that they gave foundation trusts, which enabled this very cartel to be established?

[Mr Bradshaw]

I am afraid the hon. Gentleman is wrong: the FT legislation allows FTs to pay wages that are as good as, or better than, those under Agenda for Change, so the claim often made by Liberal Democrats, who feel very uncomfortable being part of a Government who support regional pay in the NHS, is wrong. The FT legislation is quite clear: FT hospitals must pay rates as good as or higher than those under Agenda for Change. The hon. Gentleman’s point is completely irrelevant to our discussion.

In their answers to me so far, the current Health Secretary and his predecessor have tried to hide behind the very flexibility argument that the hon. Gentleman has just made—that flexibilities already exist in Agenda for Change—and they have declined to intervene. Yes, there are flexibilities in Agenda for Change to allow for local market conditions, but that is not what we are talking about. What we have here is an explicit—those involved have made it explicit—walking away from Agenda for Change, with the wholesale adoption of a regional and regionally negotiated pay structure, which, incidentally, takes no account of the different market conditions in, say, Cornwall and Wiltshire.

I know, as a former health Minister, that all it would take is a simple word from the Minister here today, and this madness could be stopped. Will she undertake to Members to intervene and make it clear to the 20 trusts involved that the Government do not support regional pay and that they should rejoin the national pay negotiation process under Agenda for Change? If she will not do that, she needs to explain why—and, please, no flannel about the NHS trusts being autonomous. She has been a Parliamentary Private Secretary and then a Minister for long enough to know that all she needs to do is speak to Sir David Nicholson, the chief executive of the NHS, or to the estimable chief executive of the southern region, Sir Ian Carruthers, and they would stop what is happening. If she will not intervene, she also needs to explain why she is prepared to continue to inflict damage on south-west NHS staff morale and destabilise the national pay negotiations.

If what is happening was thought up in the Department as a clever ruse to get the national talks kick-started, or to try to wring more concessions out of the staff side, it has backfired disastrously. There is a sensible way through, which the Minister has the power to achieve: to agree changes to Agenda for Change at the national level. The alternative is continuing uncertainty, long-term damage to staff morale and a wholly irresponsible risk to patient safety and the quality of care in the south-west of England.

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

It is a pleasure to serve under your chairmanship, Mr Crausby. I congratulate the right hon. Member for Exeter (Mr Bradshaw) on securing the debate, although it does not seem to have been much of a debate, in the sense that no one else made a speech, although I am grateful for the interventions. I noted with great care—which is why I intervened on the right hon. Gentleman—his claim that he has had more e-mails and letters on the topic than on any other topic in his 17 years in this place. That is an astonishing achievement.

[Mr Bradshaw]

The Minister is quoting me inaccurately.

[Anna Soubry]

I am so sorry.

[Mr Bradshaw]

I said I have never received so many e-mails of such strength of feeling, individually written, that were not part of a campaign such as on hunting, but were from individual, hard-working staff in the NHS writing to me about their experiences and their anger. The Minister should take note of that.

[Anna Soubry]

I am extremely grateful for that clarification and I take note. My offer remains: if the right hon. Gentleman would be so good as to contact all those people who wrote to him and seek their permission—in my experience hon. Members often do not need to seek such permission from someone who has contacted them, but simply pass messages on to the Minister—I will happily reply to every one of them, explaining the Government’s view on the matter. I very much hope that the right hon. Gentleman, too, will share my comments today with all the people who have contacted him.

First, I pay tribute to everyone who works in the national health service, for their continuing hard work and dedication to the NHS. The Government have made it clear that they support the continued option of national terms and conditions in the NHS. We expect most employers will want to continue to use them, provided that the terms remain fit for purpose and affordable. However, every pay system needs to be kept under regular review, to ensure that it remains sustainable. The responsibility for that, in respect of the Agenda for Change pay system, rests with the NHS Staff Council, a partnership of NHS employers and trade unions. The council has been considering the possibility of changes to the national terms of the Agenda for Change for about two years. Indeed, I understand that the right hon. Member for Leigh (Andy Burnham) asked them to explore the possibility of more

“flexibility, mobility and sustained pay restraint”

as long ago as 2009, when he launched “From good to great”, but there was no change then, and we are still waiting for any change.

The trade unions tell us that we should stop the south-west consortium—and the right hon. Member for Exeter makes the same point—until we can see whether a national deal is achievable. However, experience suggests that that would be a battle of hope over experience. Negotiations in the current economic climate are not easy and they are not helped when some smaller unions have already declared that they will not support any change. They prefer to stick their head in the sand and put NHS organisations and their members’ job security at risk, rather than engaging in any meaningful way. There is no point believing that the Government can wave a magic wand and make the financial pressures disappear.

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[Anna Soubry]

I hope to answer those points in my speech, in the time available to me. If I do not, I will of course write to the hon. Gentleman and answer those questions in full.

I want to talk about the financial situation in the national health service. We have already guaranteed the NHS preferential funding for the current spending review, ensuring real-terms growth every year and additional cash of more than £12 billion per annum by 2014, going into 2015. We are driving up £20 billion of quality, innovation, productivity and prevention savings, stripping out bureaucracy, cutting management costs by up to one third and shifting resources to front-line services. To be blunt, we cannot spend more on public expenditure without putting our national financial reputation at risk. We must demonstrate that we have the commitment to ensure that our economy is sustainable.

The south-west consortium faces a stern choice. It can either continue to ignore the problem, and hope that it will go away, or it can face the challenge, share it with its staff and their representatives, and work in partnership to achieve the best outcome for everyone concerned, especially patients. I used to be a shop steward and a member of the National Union of Journalists. I understand and value the role of good partnership working with staff and trade unions. I believe that the south-west consortium is taking a mature approach. It published two discussion documents in August, setting out the scale of the financial and service challenge that it faces. It has not made any decisions. It has produced a paper, setting out a wide range of options for changes to terms and conditions, and how they might help. It has included options affecting all staff, including doctors, so that every opportunity is considered, no stone is left unturned, and there are no sacred cows. I believe that that is a responsible approach.

The consortium reaffirmed its commitment to national terms and conditions and agreed not to put any proposal to its boards until December, allowing reasonable time for the conclusion of national negotiations on a possible agreement to make Agenda for Change changes sustainable. I believe that that, too, is responsible.

[Mr Bradshaw]

The Minister sounds, from what she is saying, and what she said a little earlier, as if she supports the south-west cartel, which is an interesting development in Government policy; but she also says that she wants progress at the national talks. How does she think that having a parallel negotiation going on in one region will help her to get agreement at national level?

[Anna Soubry]

I absolutely support anyone who takes a mature and sensible approach to the matters. I also understand why the south-west consortium—like many others, no doubt—is frustrated, because a two-year set of negotiations continues when it should have reached an agreement. The trade unions must take a responsible approach to ensuring that we have a national health service that is sustainable. It is in the interests of their members, and they are meant to represent their members, whose interests they should put first.

The consortium has published two discussion documents. What is our attitude and what are we to do as a Government? To be clear, we support national terms and conditions of service, but not at any cost. Individual employers must have the right to exercise the freedom, which the Labour Government gave foundation trusts in 2003, to be free of ministerial control. That is what the previous Government did.

Regional Pay (NHS)

Ben Bradshaw Excerpts

Wednesday 7th November 2012 Commons Chamber

[Andy Burnham]

I partly welcome what the hon. Gentleman has said. I have already acknowledged the flexibilities, and mentioned that only one trust in England ever sought to make use of them, because it wanted to add to the national floor that we had introduced. The flexibilities were there and I support them, but we left office with a national pay system in place. I look forward to his support later this afternoon.

We have a new Secretary of State, but those who expect a change of direction look set to be disappointed. In his first major interview, he described his mission thus:

“I would like to be the person who safeguards Andrew Lansley’s legacy”.

That must qualify as the shortest suicide note in political history. We have Lansley-lite—more of the same—but, in fact, it may be worse.

Looking at the Secretary of State’s past speeches, I could find nothing that conveyed any passion, belief or commitment to the NHS. On the contrary, I was worried when I read that he tried to remove Danny Boyle’s NHS tribute from the opening ceremony of the Olympic games. He is also one of the co-authors of a right-wing pamphlet entitled “Direct Democracy”. He may remember that pamphlet. It said:

“Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of health care in Britain.”

Is that still the Secretary of State’s view? He has gone quiet now, has he not?

You will understand, Mr. Speaker, why NHS supporters get nervous about the intentions of this Secretary of State, but today he has a chance to calm those nerves. He can come to the Dispatch Box and send the clearest of messages to NHS trusts seeking to break from national pay. What he will learn about his job is that, if he says something with sufficient force, the NHS will respond.

The developing pay crisis in the NHS is the Secretary of State’s first real test, but so far he is failing it. As we reveal today, on his watch, the 20 NHS trusts that were threatening to break away in the south-west have become 32 NHS trusts across England. That is creating real worry for thousands of NHS staff and uncertainty for businesses, which have raised their concerns with the Chancellor. But what do we get from the Government today? A “do nothing” amendment expressing no view on the south-west issue, and inviting Government Members to sit on the fence and wait for the conclusions of the pay review body’s review. That will not do.

As the Government do nothing, national pay is being unpicked and the NHS is fragmenting before our eyes, but perhaps that is all part of the plan—it is nothing to do with them; it is all due to a local decision. The idea is to hide behind a review while national pay slowly and conveniently unravels, region by region, trust by trust. Staff facing the threat of a pay cut deserve some straight answers, but rather than getting a straight answer to the question “Does the Secretary of State support regional pay in the NHS or not?”, they are hearing contradictory statements from this shambolic Government. Not for the first time, the coalition is not speaking with one voice. I understand that the Liberal Democrat conference passed a motion opposing regional pay and that the Deputy Prime Minister was captured on film voting for it—although, as we know, being photographed making pledges does not make him more likely to keep them.

The Deputy Prime Minister has also made the following unambiguous statement:

“There is going to be no regional pay system. That is not going to happen.”

The trouble is that it is happening, under the Deputy Prime Minister’s nose and by the back door. Twenty NHS trusts in the south-west are openly defying the authority of the Deputy Prime Minister. Some 88,000 NHS staff are being affected by a unilateral drive to set a new going rate of NHS pay in the regions, which would be up to 15% lower than national “Agenda for Change” rates. The trusts are proposing to end overtime payments for night, weekend and bank holiday working, and to reduce holiday leave. They are also proposing to force staff to work longer shifts, and to cut sick pay rates drastically. That is no idle threat. The silence from Ministers is clearly emboldening them. Despite concerns raised here and elsewhere, they have built a fighting fund, set up a website, and appointed lawyers to make all this happen.

[Mr Ben Bradshaw (Exeter) (Lab)]

My right hon. Friend may not have been able to catch up with this morning’s Adjournment debate in Westminster Hall, but it is more than “silence from Ministers”. The Under-Secretary of State for Health, the hon. Member for Broxtowe (Anna Soubry), who responded to the debate, admitted that the Department had known about the south-west cartel when it happened, and that she supported it. [Interruption.]

[Andy Burnham]

This debate is flushing out the Government’s position, is it not? The Under-Secretary of State keeps heckling from the Front Bench, but we now know—[Interruption.]

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[Mr Hunt]

I support the principles behind “Agenda for Change”, which were introduced in 2004 by the Labour Government of which the right hon. Member for Leigh was a member. I also support a number of other flexibilities introduced by the Government—the right hon. Gentleman supported the legislation—in respect of foundation trusts.

[Mr Bradshaw]

The south-west cartel is not about flexibilities introduced to allow hospitals to attract staff and pay them more, as they in fact did; it is about a regional pay system. The Secretary of State has to decide: is he for or against the south-west cartel? Does he say yes or no?

[Mr Hunt]

Perhaps the right hon. Gentleman will explain why he voted for the Health and Social Care (Community Health and Standards) Act 2003, which gave foundation trusts the freedom to introduce their own terms and conditions. Until he explains that, which we are simply supporting, I am afraid that his position is extremely tenuous.

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[Mr Hunt]

I support proper negotiations between NHS employers and unions to revise, reform and improve “Agenda for Change” so that it is fit for the very different financial circumstances in which the NHS now finds itself. The vast majority of NHS trusts and foundation trusts, including in the south-west, would rather negotiate on national pay scales, but that means the unions being realistic about what is sensible in this financial climate. That is why employers need to use the system more efficiently and effectively, extending the use of high-cost area supplements when they can be justified to tackle the recruitment and retention issues that affect a particular area or region.

Like the previous Government, we want to retain the flexibility that allows individual employers to use recruitment and retention premiums and, like the previous Government, we want any changes to be introduced incrementally in full partnership with NHS employers and trade unions.

[Mr Bradshaw]

Will the Secretary of State give way?

[Mr Hunt]

I have already given way to the right hon. Gentleman once.

The greatest risk to national terms and conditions is that they will become rigid, inflexible and no longer fit for purpose. If that happens, employers will be more likely to use the freedoms given to them by Labour to abandon “Agenda for Change”, which was where those freedoms came from, and introduce local terms and conditions.

The Opposition has a clear choice. They can wolf whistle to their trade union sponsors in a hollow attempt to distance themselves from legislation that they passed, or they can prioritise the interests of low-paid NHS employees by encouraging the unions to work for constructive, negotiated improvements to “Agenda for Change”. Sadly, this afternoon’s debate shows that they have made that choice—the motion is nothing more than a shameless attempt to frighten the hard-working staff of the NHS.

The debate is scandalous scaremongering from a party that did more to introduce regional pay during its time in office than any other Government in history and outrageous opportunism from a party that wanted to cut the NHS budget. Rather than singing to the tune of their trade union paymasters, the Opposition should be telling them to get around the table and negotiate seriously on “Agenda for Change”; rather than scaring NHS employees, the Opposition should be celebrating their achievements; and rather than talking down the NHS, the Opposition should, painful though it is, be celebrating the achievements of a Government who have delivered record NHS performance. I urge my colleagues to support the amendment.

[Mr Speaker]

Order. In the interests of trying to accommodate as many colleagues as possible, and many wish to speak in the debate, I have imposed an eight-minute limit on each Back-Bench contribution with immediate effect. I call Mr Ben Bradshaw.

[Mr Bradshaw]

indicated dissent.

[Mr Speaker]

The right hon. Gentleman had previously expressed an interest.

[Mr Bradshaw]

That is very kind of you, Mr Speaker, but I have had my Adjournment debate this morning and taken up enough time, so I want to let colleagues speak.

[Mr Speaker]

We are extremely grateful to the right hon. Gentleman for his selfless sacrifice. I call Kerry McCarthy.

--- Later in debate ---

[John Pugh]

Absolutely.

I was enlarging on the fact that the Minister has to keep peace between sectors of the coalition, and I do not envy him that role. To be fair, many Members from the majority party are also finding this issue uncomfortably irrelevant.

So what can the Minister do, and what can we do? I have a suggestion. The south-west trust was set up by Labour as an independent providers foundation trust with, frankly, pathetic levels of public accountability. Trusts were set up to operate within a market competing with other NHS providers and private providers, and they do not in law have to consider themselves as part of the wider NHS—as part of national bargaining or “Agenda for Change”. Apparently the trusts in the consortium do not to want to so consider themselves and want to ignore national agreements. If they see themselves as independent free agents in competition with other free independent agents, then surely they cannot all form a cartel with a huge share of the health market and conspire collectively to keep wages, and so their costs, down. That is not a free market—it is market abuse. It is not even fair trading. It is the sort of thing that in the United States would lead to a class action as wage fixing.

That is why my colleagues and I are referring this issue to Monitor and the Office of Fair Trading for investigation. This misguided lot in the south-west cannot be allowed to be freebooters when it suits them and freeloaders on the NHS when asked to play by market rules. If the Government are a bit schizophrenic on this issue, the south-west consortium appears to be even more so.

[Mr Bradshaw]

The hon. Gentleman mentions referring this to Monitor and the OFT. Does he accept from me, as a former health Minister, that all it would take is a word from the Minister to say “Stop it”, and it would stop?

[John Pugh]

I do not think that that is the case, or that the right hon. Gentleman thinks so, but he ruined my punchline, which goes like this: if the South West consortium is even more schizophrenic than the Government on this, it must be made to come to its senses.

--- Later in debate ---

[Mr Cox]

I do not believe that any party can take its hands off and claim to be not responsible for measures that allowed trusts to exploit the ability to drive down pay by forming such consortia. The Labour party cannot disavow responsibility, and neither, if it voted for it, can the Conservative party.

I want to say something about regional pay. I hope and I am sure that the Minister is listening. I have already written to my right hon. Friend the Secretary of State. In areas such as Torridge and West Devon—areas that depend on public sector pay to create the spending and buying power that puts at least some life into its economy—the concept that pay could be even lower than it is now is unconscionable and inconceivable to those of us who represent them. I hope that the Government will think again in this review. I am comforted by the Secretary of State’s words when he says that they are committed to national pay scales. I hope that those words can be counted on.

I, for one, could not support a measure that introduced regional pay as formal NHS policy, unless I was satisfied that there were sufficient safeguards for the low-wage areas I represent. People often associate rural areas such as Torridge and West Devon with prosperity, but that is a grossly inaccurate caricature. In Torridge, 26% of households are on the edge of poverty, wages are in the bottom 5% of all areas in the country, and West Devon is not far behind. It is simply inconceivable for me, as its representative, to agree to a proposition that would further depress incomes in those areas.

Having said that, it is clear that the NHS has to do something about the pay bill, which is 70% of its budget, and the only appropriate way of dealing with it is for the unions and all parties, including all political parties, to tackle it at a national level. I am disturbed that those national negotiations are apparently not taking place. I hope that the right hon. Member for Leigh will encourage the unions to take part in those discussions, because we all have to accept that there is a major national problem with the burden of the NHS pay bill.

[Mr Bradshaw]

Those discussions are taking place. Does the hon. and learned Gentleman think that a parallel process, as undertaken by the south-west cartel, is helping or hindering a successful outcome of the national negotiations?

[Mr Cox]

To be blunt, I am not happy about what I am seeing in the south-west in relation to those 20 trusts, whom I encourage to engage with staff and the unions, as my hon. Friend the Member for North Cornwall (Dan Rogerson) said, and to engage in a process that tries to reach some form of consensual agreement.

To answer the right hon. Gentleman’s question, however, I suspect that those 20 trusts have joined together only out of desperation at the static and stagnating nature of the discussions at national level. They are desperate to manage their budgets. Many are in extremely difficult financial circumstances. I see my hon. Friend the Member for North Devon (Sir Nick Harvey) in the Chamber. I will be meeting the chief executive of Northern Devon health trust shortly, and I know the budgetary pressures that it is facing. He will tell me that it cannot wait for the slow convoy of the national negotiations to take place. I urge it to do so. I hope that we can re-engage at a national level and that there are serious and mature discussions going forward. The truth is—nobody can doubt it—that the pay bill in the national health service needs to be tackled. That is why I say again to the right hon. Member for Leigh that the position adopted by the party he represents is not responsible. What he should be doing is calling for national negotiations to take place as swiftly as possible.

--- Later in debate ---

[Mr David Anderson (Blaydon) (Lab)]

I know it is unusual in this place to listen to anyone who has experience of the real world, but I will try yet again. I worked in the coal industry for many years—in fact for decades. In 1966, a national agreement was reached to bring parity to the system. It took six years for that to be applied across the industry. The main reason why that was done was that people thought it unfair that people who worked in some of the worst conditions in coalfields were historically disadvantaged because they did not produce as much coal as people who worked in coalfields where it was easier to get the coal out. It was the right thing to do. It was based on the principle that applies to this debate—that people should be paid for what they do, not for where they do it. That is the principle that should guide us today.

I had the privilege of presiding over the Unison national conference that agreed “Agenda for Change”. Unison was the last and most reluctant union to sign up to it because it saw some of the problems that it would bring in. We are now seeing those problems. People are exploiting “Agenda for Change.” They are exploiting some of the freedoms intended for families and trusts. Some employers will exploit almost anything. Seeing where we are today and some of what is going on across the country makes me believe that some of the concerns expressed were right.

Today’s debate cannot be separated from what is going on in the rest of the country. We are seeing an anti-worker attack, which is being driven to some extent by this Department but mainly by No. 11 Downing street. Let us look at what is going on. Let us reflect on the background: 750,000 jobs are to be lost in the public sector, while people are having to pay more for their pensions, work for longer and get less pension when they retire. Then there is the pay freeze.

A point was made from the Government Benches about getting the pay burden down, but health service staff will see a reduction of at least 10% in their living standards during the period of this Government. If that is not an example of the workers doing their bit—all being in this together—I do not know what is. Incremental freezes are being introduced, health and safety legislation is being watered down, job security is being weakened, and employment rights and access to industrial tribunals are being changed. There are changes to benefit rules that, officially, are about making work pay, but really mean that people have to go to work for as little pay as employers can get away with. We are back to the future—back to the low-pay, low-skill economy of the 1980s, when people were frightened to stand up for themselves because of the problems they were facing; when compulsory competitive tendering destroyed the conditions of manual workers whose roles were intrinsic to the safety of the national health service.

No one should be surprised to find out that some will be exempt from the regional pay proposals. Who are they? According to the Department of Health submission to the pay review body, the only exemption will be for highly paid managers working in the new bodies established by the Health and Social Care Act 2012. While the people being employed to privatise the health service will not be subject to the regional pay proposals, there will be an impact on the lads and lasses on the front line who look after our constituents day in, day out. That is the unfairness of the situation, and people will focus on the problems at that level in the current negotiations.

The Secretary of State said that he supported proper negotiations, but is it proper that North Tees and Hartlepool NHS Foundation Trust has served redundancy notices on people? That is no way to have proper negotiations. Is it proper that South Tees Hospitals NHS Foundation Trust is thinking about doing the same? City Hospitals Sunderland is trying to freeze increments without consultation or negotiation. Tees, Esk and Wear Valleys NHS Foundation Trust is also freezing increments, while all the trusts in Tyneside, which I represent, have said they will not introduce regional pay. That is one of the problems. Where it is easy to travel from one part of the region to the next, people will travel; people who are not getting a good deal in Hartlepool, Sunderland or Middlesbrough will travel to Gateshead, Durham or Newcastle. National terms and conditions are key, so that people are paid the same no matter where they work. Otherwise, recruitment and retention will become a huge issue.

It is clear that the majority of people who have spoken in the House and outside oppose regional pay. Ten north-east firms have urged the Government not to introduce regional pay, because reducing the spending power of public sector workers in the region will have a hugely detrimental impact on their businesses.

I raised a point with the Secretary of State about trade unions, but let me refer to the BMA, the RCN, the Royal College of Midwives and the Chartered Society of Physiotherapy. None of them is affiliated to or the paymaster of the Labour party, but all of them say, “Don’t do this.” But it is not just them saying it. The hon. and learned Member for Torridge and West Devon (Mr Cox), the hon. Members for Hexham (Guy Opperman), for Brigg and Goole (Andrew Percy), for Stafford (Jeremy Lefroy) and for Carlisle (John Stevenson)—all Conservative Members—are all against the proposal. A raft of Liberal Democrats—the hon. Members for North Cornwall (Dan Rogerson), for St Austell and Newquay (Stephen Gilbert), for Torbay (Mr Sanders), for Manchester, Withington (Mr Leech), for Southport (John Pugh), and for St Ives (Andrew George), and even the Secretary of State for Business, Innovation and Skills—are opposed to it. The Deputy Prime Minister is also opposed to regional pay, as was his party conference. How on earth can the Conservative party try to force it though?

[Mr Bradshaw]

My hon. Friend says that the Liberal Democrats have said they are opposed to it. Will not the test be how they vote in a few minutes’ time?

[Mr Anderson]

I have always appreciated my right hon. Friend’s talents, but I ask him please not to steal all my thunder.

Who wants regional pay? The Department of Health, but even more so, the Chancellor of the Exchequer, as it is part and parcel of an attempt to drive down workers’ conditions and undermine the work force for ideological reasons. He is putting the NHS at risk for the sake of party political advantage. It is a disgrace.

How will the Liberal Democrats vote tonight? I have read the amendment—I used to write amendments —and it is the easiest thing in the world to fudge your way around something, but this is a point of principle. Let us make no mistake. The people out there—the nurses, the midwives, the doctors—will read the weasel words of the amendment as exactly what they are. The basic principle is in the motion. We want the Government to tell the employers that there is a national pay bargaining agreement, and they should stick to that.

--- Later in debate ---

[Andrew George]

If the hon. Gentleman really believes that, and the motion does say that the Government should intervene, is he aware that his Government gave foundation trusts such freedoms that in fact the Government cannot intervene?

[Mr Bradshaw]

Of course they can.

[Andrew George]

They cannot.

Business of the House

Ben Bradshaw Excerpts

Thursday 6th September 2012 Commons Chamber

[Mr Lansley]

I am grateful to my hon. Friend for giving me an early opportunity to understand the encyclopaedic nature of business questions. The limits of my knowledge I have always been aware of, and it does not extend to morris dancing. I will draw the point that he raises on behalf of his constituents to the attention of my colleagues at the Department for Communities and Local Government, and ask them to respond to it.

[Mr Ben Bradshaw (Exeter) (Lab)]

May we have a clear statement from the Government on their policy on regional pay? In May the Deputy Prime Minister said:

“There is going to be no regional pay system. That is not going to happen.”

Yet 20 health trusts in south-west England have announced that they intend to abandon the NHS’s national “Agenda for Change” pay structure and adopt just such a regional pay system. This is causing great concern and anger among thousands of NHS workers and their families across the south-west.

Dementia Services (South-West)

Ben Bradshaw Excerpts

Monday 11th June 2012 Commons Chamber

[Mr Ben Bradshaw (Exeter) (Lab)]

Thank you very much, Mr Speaker—and thank you very much for granting a debate on a subject that is of great concern to my constituents in Exeter, to people throughout the south-west, and, indeed, to people throughout the country. My own mother suffered from dementia, and died very young when I was just 18. That was in the days when Alzheimer’s and other dementias were only just beginning to be recognised. Since then we have made great strides in terms of our knowledge and understanding, and the treatment that is available to sufferers and their families. I pay particular tribute to the Alzheimer’s Society for its campaigning work and the support that it provides for people.

There are currently 800,000 people with dementia in the United Kingdom, and one in three of us will have it by the end of our lives, so this is an issue that touches, or will touch, virtually every household and every family in our country. Although progress has been made, there are still big gaps and unacceptable variations in levels of service and support, and I shall focus on three issues that cause particular concern: the rates of diagnosis; the availability of drugs for sufferers; and the overall resilience of the care system, on which many dementia sufferers and their families depend.

Everybody—including, I am pleased to say, the Government—accepts that early diagnosis is absolutely vital in ensuring that people with dementia and their families receive the information, treatment and support they need. At present, however, fewer than half—43%—of dementia sufferers have a formal diagnosis, and in the south-west that rate is even lower; in fact, my region has the lowest diagnosis rate of anywhere in England at just 35.4%, with my own county, Devon, having barely a third of sufferers diagnosed and Dorset having the lowest rate in the country at just 27%. As the south-west of England has a higher than average proportion of elderly people, and therefore more dementia sufferers, that is extremely worrying. Indeed, according to the Minister’s own figures, in Devon alone there are almost 9,000 people with dementia who have not been diagnosed. In contrast, average diagnosis rates across Northern Ireland are above 60%, and in Belfast the rate is almost 70%. What is the Minister’s explanation for this huge variation in diagnosis rates across the country, and what are his Government doing to address that?

Many fear that the Government’s upheaval of the NHS might make this situation even worse, not better. Putting GPs in the driving seat means that the level of awareness and understanding of the problem among GPs will be more important than ever. GP training is therefore vital, and I welcome the progress that is being made, such as in Devon, where an education programme for GPs has reached 374 practices across our county, and there are already signs of increased diagnosis rates. But education alone is not enough. GPs need to have access to help and support, but the key to improving diagnosis rates in the south-west will be to ensure that GPs can refer patients to memory services for diagnosis. I have heard reports of people waiting over a year for an appointment at a memory clinic, however.

As the Minister will be aware, the Alzheimer’s Society recently wrote to all MPs asking us to write to our local primary care trusts in order to establish waiting times at memory services in their areas. I commend this initiative. Will the Minister say whether the Department of Health collects data on waiting times at memory services in the south-west—as well as in other regions? If not, will he arrange for NHS South of England to provide Members with this information?

The Royal College of Psychiatrists has established the memory services national accreditation programme, to ensure that services at memory clinics meet national standards. Does the Minister agree that all memory services should seek such national accreditation and that that should be a priority for local NHS managers?

As the Minister will also be aware, next month the all-party group on dementia will report on its inquiry into improving diagnosis rates. I understand that he has been invited to the launch of the report, and I hope he can confirm tonight that he will be able to attend.

The second issue I want to highlight is the variation in the availability of medicines for dementia sufferers. These medicines can make an enormous difference both to the progression of the illness and the quality of life enjoyed by the sufferer and their carers. The Minister will be aware of the massive—some reports have suggested as much as 50-fold—variation in the level of drug prescribing among PCTs in England. Again, the south-west does very poorly. We are not the lowest region in England in respect of prescribing, but we rank as the second lowest region after the west midlands. It is very worrying that our region, with its high proportion of elderly people and therefore of dementia sufferers, has the second lowest level of availability of medicines that could help them. Will the Minister explain the reasons for that, what the Government are doing about it, and how he can guarantee that this problem will not get worse under the Government’s reorganisation of the health service?

The third and final concern I wish to raise tonight is the financial hardship faced by dementia sufferers and their families because of the cost of long-term care. We know that, in some cases, that can run into hundreds of thousands of pounds; it can lead to families losing their homes or their inheritance because of the lottery of getting dementia. Many people rightly feel that that is deeply unfair. In my view, the long-awaited report by Andrew Dilnot on the future of long-term care provides a sustainable and equitable solution to that deep unfairness that some families face and to the general challenge of providing long-term care.

[Alison Seabeck (Plymouth, Moor View) (Lab)]

This is an incredibly important debate and my right hon. Friend has touched on a number of issues that affect my constituents. In a recent case, the mother of Lee Finn was in Derriford hospital with dementia; the family came in and read her chart—they had power of attorney— and saw that it said “Do not resuscitate”. The family had not been asked or consulted in any way. Does my right hon. Friend share my concern that, although there is some fantastic work going on in the field of dementia, crass errors continue to be made that cause families deep unhappiness? It is clearly not good for the dementia sufferers if the whole family is destabilised because of poor decision making.

[Mr Bradshaw]

I agree absolutely. As I said, and as I hope the Minister will endorse, training and awareness of dementia are vital not only in primary care settings but in secondary care settings, as in the case my hon. Friend raises. Some people who may seem to be extremely ill with dementia and who are in the situation she describes may in fact be physically perfectly fit and able to carry on living for some time. I hope that her local hospital will take up the case and provide a satisfactory response.

As I was saying, there is a strong feeling on both sides of the House that we need a sustainable and fair solution to the challenge of long-term care. That challenge particularly, but not solely, affects families with members who suffer from dementia because of the enormous costs imposed on them by having to pay for long-term care. I do not think it an exaggeration to say that there was great disappointment when the Queen’s Speech again failed to include a Bill to implement the Dilnot proposals. As far as it goes, the Government’s commitment to a draft Bill was welcome, but it would be helpful if the Minister told us when that draft is likely to be published and guaranteed that a Bill will be passed in this Parliament. May I boldly suggest that that would be a real legacy and worth working for?

[Julie Hilling (Bolton West) (Lab)]

Does my right hon. Friend agree that part of the reason people are not diagnosed is the great fear of what dementia means? In fact, if we provided good care in their own homes, they could stay there longer before needing to go into residential care. We should look not only at the cost of residential care, but at the cost of home care and reach a settlement on that, too.

[Mr Bradshaw]

My hon. Friend is absolutely right and makes an important point.

I would be grateful if the Minister also gave a commitment that the Bill, when it comes to the House, will address the postcode lottery in the availability and quality of services. Tower Hamlets in London, for example, spends five times as much on dementia services as Cornwall in the south-west, which is the lowest spending authority in the country. That simply cannot be right.

The urgency of meeting the challenge of long-term care is all the greater as figures uncovered by my hon. Friend the Member for Leicester West (Liz Kendall) show that pressure on local authority budgets is already leading councils to increase their charges and tighten their eligibility criteria, so that many people are losing the assistance they previously received. The situation is getting worse and will continue to do so until the Government grasp the nettle of long-term care and implement the Dilnot report.

At any one time, one in four hospital beds is taken up by people with dementia. Delayed discharges from hospital and unnecessary admissions to hospital cost every hospital in the south-west hundreds of thousands of pounds a year. As my hon. Friend the Member for Bolton West (Julie Hilling) has just said, all the evidence shows that early intervention with community services is cost-effective, it keeps people out of hospital, it is what people with dementia and their families want, and, in particular, it is what the people who have the main responsibility for caring for those sufferers want.

However, the tightening of the eligibility criteria and the cutting of local services are having the opposite effect: they are increasing the costs for the NHS. I do not know whether the Minister has any figures with him. If he does not, perhaps he could write to me, as I would be interested to know whether he has made an assessment of the impact on the NHS in the south-west of the tightening of eligibility criteria by local authorities in the area for people with dementia.

By 2021, more than a million people will be living with dementia in the UK, and this year dementia is set to cost us £23 billion. In the next 10 years, the number of people in Devon with dementia is set to increase by a third. It has been said before, but I will say it again: we face a dementia time bomb. Addressing it will require leadership and more public investment in the short term, but a successful dementia strategy will be much cheaper and equitable in the long run, and it will also reduce the strain on and suffering of patients and their families. Surely it cannot be too much to expect that someone with dementia can receive a decent level of care wherever they live in the country and that their families should no longer to be subjected to the ruinous costs of long-term care simply because they happened to have a relative who suffered from this illness.

Health and Social Care Bill

Ben Bradshaw Excerpts

Tuesday 28th February 2012 Commons Chamber

[Mr Lansley]

Yes, absolutely right.

[Mr Ben Bradshaw (Exeter) (Lab)]

Given that the right hon. Gentleman inherited an NHS with record short waiting times, record high public satisfaction and improving competitiveness, does he ever in his darkest moments wish that he had not embarked on this damaging and costly upheaval?

[Mr Lansley]

At the last election the average waiting time for in-patient treatment was 8.4 weeks. In December 2001, when the most recent data were published, it had come down to 7.7 weeks. The right hon. Gentleman might like to reflect on the fact that the number of people waiting more than a year for treatment in the NHS is now more than half what it was at the last election.

NHS Risk Register

Ben Bradshaw Excerpts

Wednesday 22nd February 2012 Commons Chamber

[Mr Ben Bradshaw (Exeter) (Lab)]

Given that this House and the other place are having to decide on the biggest upheaval in the NHS’s history, is it not absolutely essential that all the information and all the risks are in the public domain? In that context, and in the context of what my right hon. Friend has said, is it not absolutely imperative that the Francis report into the scandal at Stafford hospital is published before the Bill has completed all its stages in Parliament?

[Andy Burnham]

Of course, there are lessons to be learned for those in all parts of the House when the Francis report is published, and I can say, on behalf of Labour Members, that we will learn those lessons. However, this Bill goes to the heart of what happened in that case, because it is about autonomy in hospital services, and we know that when one makes an organisation autonomous it can sometimes fail as well as get better. I cannot understand how the Government can be legislating before they have even waited to hear the conclusions of the public inquiry that they set up. Surely that has implications for the Secretary of State’s Bill. Why has he not waited to hear what it says so that it can be properly reflected in the design of the service that he is creating?

Oral Answers to Questions

Ben Bradshaw Excerpts

Tuesday 21st February 2012 Commons Chamber

[Mr Lansley]

I will indeed ensure that that happens. We work closely with the cancer charities. We are working with them as we roll out the campaign that was piloted in the east of England to encourage the awareness of symptoms and the earlier diagnosis of bowel cancer. I hope that we will ensure that the services, such as endoscopy services, are available to support that.

[Mr Ben Bradshaw (Exeter) (Lab)]

Is the Secretary of State aware of this week’s report from the distinguished health academic at Exeter university, Dr Mike Williams, which states that his NHS upheaval is putting patient safety at risk and making a Mid Staffordshire-style hospital scandal more likely? Given that, will he assure the House that he will publish the findings of the Mid Staffordshire public inquiry in time to inform the final outcome of the Health and Social Care Bill, if it ever gets through this place?