Oral Answers to Questions

David Crausby Excerpts

Tuesday 24th February 2015 Commons Chamber

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

No, I do not regard that as satisfactory and I am happy to talk to the local commissioners. We have ensured that there will be real-terms increases in mental health funding for 2015-16, and that should be regarded locally as a matter of urgency.

[Mr David Crausby (Bolton North East) (Lab)]

T6. Bolton’s accident and emergency department has been in crisis recently, partly because the clinical commissioning group closed the town’s walk-in centre. Will the Secretary of State support my petition calling for its reinstatement, or will he say, more predictably, “It’s not me, guv; I’m just the Secretary of State for Health”?

[Mr Jeremy Hunt]

I am accountable for what happens in the NHS, so let me tell the hon. Gentleman what is actually happening in Bolton: compared with four years ago, 2,756 more people are being seen at A and E within four hours. That is a record of investment and success.

A and E (Major Incidents)

David Crausby Excerpts

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

The main reason is that Labour in Wales chose to cut the NHS budget, whereas in England we chose to protect and increase it.

[Mr David Crausby (Bolton North East) (Lab)]

Before a major incident was declared yesterday morning, 76 patients were awaiting transfer to social care in the Royal Bolton hospital—nearly four wards-full—so when is the Secretary of State going to do something effective about the crisis in social care that is causing mayhem in our accident and emergency department?

[Mr Hunt]

I recognise the pressures that the hon. Gentleman is talking about, but last year, for the first time, the local NHS and the local authority in Bolton sat down together to plan social care for the most vulnerable people—his constituents—who need such joined-up care and have wanted but not had it for so many years. With the better care programme from this April, we will start to see some real improvements.

Oral Answers to Questions

David Crausby Excerpts

Tuesday 25th November 2014 Commons Chamber

[George Freeman]

As I said in the debate, we absolutely support the Bill’s intention, which is to promote the greater use of off-label and off-patent drugs, but that must remain a decision for clinicians exercising their judgment about what is best for their patients. We do not think it right that the Government should be put in the position of effectively sponsoring new drug licence applications to the Medicines and Healthcare Products Regulatory Agency. I have convened a round table working group with all the stakeholders to try to look at how we can maximise information to clinicians to promote the use of off-label and off-patent drugs.

[Mr David Crausby (Bolton North East) (Lab)]

10. How many (a) NHS trusts and (b) foundation trusts are forecasting a deficit.

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

Thirty-three NHS trusts and 60 foundation trusts are forecasting an end-of-year financial deficit, with the remaining 65 NHS trusts and 87 foundation trusts forecasting an end-of-year surplus.

[Mr Crausby]

Earlier this year, Monitor announced that the number of trusts in financial breach had nearly doubled over the previous 12 months. How confident is the Minister that the number will not double again next year?

[Dr Poulter]

I am very confident that the measures already in place to drive efficiencies in the NHS are on course to save £20 billion during this Parliament. Many of those efficiencies are being delivered by improved procurement practice at a trust level. The Government have also invested £15 billion during this Parliament, which is a real-terms increase of £5 billion in NHS funding to support trusts.

Ambulance Resources and Response Times

David Crausby Excerpts

Wednesday 14th May 2014 Westminster Hall

On resuming—

[Mr David Crausby (in the Chair)]

I will adjourn the sitting at 5.15 pm. I call the Minister.

[Jane Ellison]

Thank you, Mr Crausby. Welcome back to the hon. Member for Hartlepool—I think some colleagues may not have been able to rejoin us.

As I was saying, NEAS tells me that in 2013-14, 74.8% of calls categorised as green 2, meaning serious but not life-threatening, received a response within 30 minutes, and 71.2% of calls categorised as green 3, meaning non-emergency, received a response within 60 minutes. Although that does not in any way diminish the tragedy of cases such as Mr Gouldburn’s, which are never acceptable, it is important that we recognise the generally excellent service provided by the trust and its staff.

[Jane Ellison]

I think we can all agree that those are circumstances that we want to minimise.

I want to turn briefly to one or two specific local points, and then to one or two wider points. Most recently, the Government recognised the importance of investment in front-line services with £14 million provided to ambulance services last December. Obviously, it is for local commissioners and trusts to decide how that money is used. I recognise that in the hon. Gentleman’s region, local commissioners see that more investment is needed for ambulance services, and we recognise that the trusts are working with local commissioners on that, making sure that they get that commissioning piece right.

More generally, there is also an issue about staffing in the ambulance service. Since 2010, the NHS has recruited 16% more paramedics, but we know that in some areas of the country, there is insufficient academic capacity, for example, to produce paramedics in the numbers required. Again, the Association of Ambulance Chief Executives is working with Health Education England to address that issue in the medium term.

The hon. Gentleman also alluded to ambulance handover delays. We absolutely recognise the role that they can play in making the job of the ambulance service more difficult. I believe there has been an ongoing issue, to which he alluded, for NEAS at County Durham and Darlington NHS Foundation Trust hospitals. Local commissioners have advised that there has been recent improvement, helped by winter initiatives supported by the urgent care working group. That has included support from the fire and police service, but I know there is more to be done.

Indeed, my colleague from the east of England, my hon. Friend the Member for Suffolk Coastal (Dr Coffey), who has not been able to rejoin us, was talking as we went to the vote about work that had been done specifically in her area to look at some particular issues that affect handover delay. As she said in her intervention on the hon. Gentleman, it is well worth local Members exploring some of that detail with their board as well to see whether lessons can be learnt from other parts of the country.

The urgent and emergency care review is being led by Sir Bruce Keogh, the national medical director of NHS England. He was asked to undertake a review of urgent and emergency care, looking at all aspects of the sustainability of the urgent and emergency care system. That does not exclude ambulance services. The review proposes the development of 999 ambulances; they would become more like mobile treatment services, not just urgent transport vehicles. There is a lot of fresh thinking in all sorts of areas of delivering excellence in emergency health care, and it is right that we look at new ways of delivering that health care with regard to ambulances as well, rather than just looking at the old model.

I want briefly to put a point on the record in the 30 seconds left to me. Let us not minimise the importance of people being asked about a rash as a symptom on the phone. It is one of the signs of meningitis and the royal colleges have advised that that should be asked as a question, so it is not an insignificant point.

With regard to private ambulances, that provision was brought in by the right hon. Member for Leigh (Andy Burnham), when he was in office—

[Mr David Crausby (in the Chair)]

Order.

Oral Answers to Questions

David Crausby Excerpts

Tuesday 1st April 2014 Commons Chamber

[Mr David Crausby (Bolton North East) (Lab)]

2. What his most recent estimate is of the cost to the public purse of reorganisation in the NHS.

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

According to official figures, the new structure set up by the Health and Social Care Act 2012 will save £5.5 billion in this Parliament and £1.5 billion every year after that, all of which will be reinvested in front-line care.

[Mr Crausby]

Given that he promised in 2010 that there would be no top-down reorganisation of the NHS, how can the Secretary of State justify spending billions of pounds on top-down reorganisation on the day on which Simon Stevens, the new chief executive of NHS England, has warned that the NHS is facing the biggest

“budget crunch in its 66-year history”?

[Mr Hunt]

As Simon Stevens is starting today, I think that this is a good moment to welcome him to his post. He is an outstanding individual, and I know that we all wish him well in what will be a challenging but incredibly important job.

As for the reorganisation, the official figures make it clear that it is saving more than £1 billion every year during the present Parliament—money that is being reinvested in the provision of 1,600 more nurses, 1,700 more midwives, 1,800 more health visitors and nearly 8,000 more doctors than we had under Labour. I am afraid that that shows that Labour has not learned the lessons of Mid Staffs. Labour Members still want to turn the clock back and spend all that money on administration.

Oral Answers to Questions

David Crausby Excerpts

Tuesday 25th February 2014 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right to raise that issue and I am happy to give that assurance. That incident is one of the reasons why we set up the Health and Social Care Information Centre through the Health and Social Care Act 2012, in the teeth of opposition from the Labour party. Following the establishment of the centre, the guidelines in place mean that such a thing could not happen. She is also right that it is important that we reassure the public because, let us not forget, it was this important programme that identified the link between thalidomide and birth defects, that identified that there was no link between MMR and autism, and that helped to identify the link between smoking and cancer, so it is vital that we get this right.

[Mr David Crausby (Bolton North East) (Lab)]

20. Virtually everyone wants to improve patient care in the NHS, so why not scrap the underhand way in which the care.data programme has progressed so far, and instead provide a diverse choice of ways to opt in, limit the use of medical data to the NHS and keep the public’s personal information out of the hands of the private sector?

Diabetes

David Crausby Excerpts

Wednesday 9th January 2013 Westminster Hall

[Several hon. Members]

rose—

[Mr David Crausby (in the Chair)]

I will not impose a time limit on speeches, but four Members wish to speak and I would appreciate it if they could keep their contributions to around 10 minutes, or less, so that I can call all four of them.

--- Later in debate ---

[Keith Vaz]

rose—

[Mr David Crausby (in the Chair)]

John Pugh.

Regional Pay (NHS)

David Crausby Excerpts

Wednesday 7th November 2012 Westminster Hall

[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.

Induced Abortion

David Crausby Excerpts

Wednesday 31st October 2012 Westminster Hall

[Mr David Crausby (in the Chair)]

As a result of the number of Members who wish to speak in this debate, with the authority of the Chairman of Ways and Means I am imposing a five-minute time limit on Back-Bench speeches after the first speaker has finished. The rules are exactly as in the House. Each of the first two interventions accepted will stop the clock and give the Member who gives way an extra minute. Unlike in the Chamber, the mechanisms here do not yet enable a speaking Member to see a countdown clock on the displays around the room, so to assist Members I will cause a bell to be rung when a Member has one minute left. If an intervention is made during the last minute that entitles a Member to added time, the bell will be rung again when there is one minute left.

--- Later in debate ---

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

I have listened with great interest to the debate and the points made by hon. Members from all parties. I recognise, as I am sure all hon. Members do, the difficulty and sensitivity of this debate. I am sure we would all prefer a world in which there are fewer abortions; in which men and women have access to sex education, support and advice to make the right decisions for themselves; in which, should partners choose to engage in sexual relations, there is safe and confidential access to contraceptives; in which there is no rape or incest; and in which, if a woman becomes pregnant, she is not so afraid of family and community that she is unable to seek early advice and support. But we do not live in such a world. In making judgments as politicians and as a society, we must use the best available evidence and the right balance of arguments and interests. At the heart of our debate, there must be evidence and facts.

Recent debates in the House have ruled out lowering the time limit, and for good reasons. First, there has been no new medical evidence to suggest any scientific or medical reason for a reduction in the abortion time limit since the subject was last debated in the House of Commons in 2008, during the passage of the Human Fertilisation and Embryology Bill. Amendments to lower the time limit to 22, 20, 16 or 12 weeks were voted on, and all were rejected by MPs. The major professional medical bodies in the UK support the 24-week abortion time limit, including the British Medical Association, the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives and the British Association of Perinatal Medicine.

There has been no significant change in survival rates. Many of those who currently advocate a reduction in the time limit argue that there have been major clinical developments in the care of pre-term infants which have led to a reduction in the gestational age at which a foetus can survive and that, therefore, the 24-week limit should be reduced. That is not the view of the main medical bodies, and there are no calls from them to reduce abortion time limits. For example, the BMA debated the issue at its annual representatives meeting—the ARM—in 2005 and in 2001. On both occasions it rejected a call for any reduction in the 24-week time limit.

It is important to keep a focus on the facts. No statistics make the case for reducing the limit. The majority of abortions in the UK take place at an early stage of pregnancy: 91% are carried out before 12 weeks of gestation; and only 1% of abortions take place after 20 weeks—that number has continued to fall year on year. We have heard some survival rates of zero at 20 weeks, 1% at 22 weeks and about 10% at 23 weeks, but the viability in terms of quality of life remains a great concern.

There is no support for reducing the limit among health groups. Indeed, following the call by the Secretary of State for Culture, Media and Sport, in early October, for the abortion limit to be reduced to 20 weeks, the BMA said:

“The BMA does not believe there is any scientific justification to reduce the abortion limit from 24 to 20 weeks. We will not be lobbying for any reduction.”

When the Secretary of State for Health later offered his support for a reduction to 12 weeks, the Royal College of Obstetricians and Gynaecologists called the suggestion “insulting to women”, stating that his comments

“politicise the debate around the abortion time limit and do not put women at the centre of their care.”

Different arguments are made, on the right of life of the baby and on the question of the woman’s well-being and her right to choose. Furthermore, the right to choose is related to a woman’s well-being, given that she has to carry a baby to term and does so knowing that she will have the responsibility afterwards—

[Mr David Crausby (in the Chair)]

Order. The hon. Lady’s speaking time is up.

--- Later in debate ---

[Mr Leigh]

We can certainly debate that point. I should have thought that the law is that we have abortion on demand, but if the hon. Lady believes that some women feel they are under pressure not to have abortions before 12 weeks, we can discuss that matter. I thought, however, that we were focusing on late abortions today, which I should have thought we regret all around the Chamber.

A lot of European countries that are viewed as much more liberal than we are have time limits on abortions that are many weeks less than in Great Britain. The UK’s 24-week upper limit is double that of most European countries. Sixteen of 27 EU countries have a gestational limit of 12 weeks or lower; thus attempts to stir a reduction of the upper time limit as controversial have very little ground to stand on when we compare our laws with those of our European neighbours, as we often do in many other areas. A 2005 survey revealed that more than three quarters of women in the United Kingdom are in favour of reducing the time limit on abortions. A 2007 survey, commissioned by Marie Stopes International, found that 65% of GPs would welcome a reduction.

The number of abortions performed in Britain is now four times higher than in 1969, the first full year that abortion was available under the 1967 Act. G.K. Chesterton wrote:

“Men do not differ much about what things they will call evils; they differ enormously about what evils they will call excusable”.

For those of us who are abortion opponents, like my hon. Friends, our views are known, and they can be dismissed. I hope, however, that even the most fervent supporters of legal abortion recognise that abortion is not desirable, even if they find it excusable. Anything that we can do to prevent late abortions is surely desirable for our country.

Regardless of the obvious moral debate, there is a compelling medical case for wanting to reduce the number of abortions. The Royal College of Psychiatrists has recognised that abortion can damage a woman’s mental health. Studies have discovered that women who have had abortions are almost twice as likely to suffer from mental health problems, three times as likely to have major depression, and six times as likely to commit suicide as mothers who do not have an abortion—

[Mr David Crausby (in the Chair)]

Order.

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[Mr Robertson]

I find that intervention rather confusing, because if the babies are surviving, surely that is proof of the science. If the hon. Lady will forgive me, I cannot understand the point of the intervention.

The hon. Member for Sunderland Central (Julie Elliott) asked why we were having the debate now, when we considered the issue four years ago. I have to say that Parliament does not always get things right. On very many issues, public opinion and the evidence are way ahead of where Parliament is. Examples include welfare reform, immigration and the European Union. Parliament has not caught up with what everyone else in the country is saying on those issues. This is one such issue that certainly needs to be revisited. My hon. Friend the Member for Mid Bedfordshire is right: we should not shy away from this subject or any other, because if we—

[Mr David Crausby (in the Chair)]

Order. May I ask the hon. Gentleman to wind up his remarks soon, please? I know that he has not had his full time, but I want to bring in the Front Benchers.

[Mr Robertson]

Certainly. I shall make one final point, then. We sometimes hear that it is only vulnerable teenagers who get pregnant and need an abortion. That simply is not true: 29% of abortions are carried out on women over the age of 30, entirely for social reasons. The number of repeat abortions is in the thousands. In the past year, 76 women had had seven abortions before the one that they were then having; there are very many issues there. I shall certainly respect your request for me to wind up my remarks, Mr Crausby, but this is a very serious issue, and I hope that Parliament revisits it very soon.

--- Later in debate ---

[Hon. Members]

Give way!

[Mr David Crausby (in the Chair)]

Order.

[Ms Abbott]

We have heard the concerns about high levels of abortions and repeat abortions. Let me say from the Opposition side of the Chamber that we all share those concerns. Every abortion is a tragedy. I think that we would all in this Chamber want levels of abortions to come down, but we do not fairly bring down levels of abortions by restricting women’s right to choose. As the royal colleges have pointed out, the way to bring down levels of abortions is to recognise that abortions are largely about unintended pregnancy. What is needed is better work on access to contraception and better sexual health education in schools, and, if I may say so—this is a personal view—more needs to be done to fight the objectification and sexualisation of women in society. Of course we want to bring down abortion levels and levels of unintended pregnancy, but that is done through working in schools and working with young women, through sexual health care, and by fighting, as I said, the sexualisation of women, of which we see far too much.

As I said, of course we respect people’s consciences on this issue, but we do not want, and there is no evidence that British women want, the importing of the American politicisation of abortion to this country. We have only to look across the Atlantic to see politicians trying to outbid one another in the ferocity of their opposition to women’s right to choose, to see the attacks on doctors who work in these clinics, and to see candidates for office claiming that abortion as a consequence of women being raped is not an issue because there are things about a woman’s body that kick in and prevent her from getting pregnant as a result of rape—American politicians revealing their complete ignorance of women’s reproductive health.

Sadly, that is inching into this country. There are prayer vigils outside abortion clinics. There are leaflets claiming that abortion leads to breast cancer and infertility. There is work on college campuses. British women do not want to go down the route of politicians seeking to gain a political edge by sensationalising and politicising the issue of abortion. Let us rest on the medical evidence.

The hon. Member for Mid Bedfordshire said that the 1967 Act was a joke. I say to her that the 1967 Act was not a joke; it was a huge advance for the lives of women in this country. She talked about women marching in leafy suburbs. I have opportunities in my lifetime that my grandmother could never have dreamt of, and she was not brought up in a leafy suburb. As a result of political, social and educational advances, there are opportunities for women in my generation that our grandmothers could never have dreamt of, and the bedrock of those advances is women’s control of their own bodies and their reproductive health.

I am happy to debate this as often as Members want to bring it forward, but the debate must rest on the evidence, and we should debate the subject without denigrating our medical profession, and with respect for often very vulnerable women who have to make a difficult decision and do not welcome politicians sensationalising and politicising.

Oral Answers to Questions

David Crausby Excerpts

Tuesday 27th March 2012 Commons Chamber

[Mr Lansley]

On the contrary, the Chancellor set out very clearly his intention that a White Paper on the reform of social care would be published in the spring. The hon. Lady may wish to know that we are in direct discussions with the Opposition to seek consensus about the long-term reform of social care funding.

[Mr David Crausby (Bolton North East) (Lab)]

2. What his most recent estimate is of the cost of NHS reorganisation.

[Gavin Shuker (Luton South) (Lab/Co-op)]

7. What his most recent estimate is of the cost of NHS reorganisation.

[The Minister of State, Department of Health (Mr Simon Burns)]

The cost of the NHS modernisation is estimated to be between £1.2 billion and £1.3 billion. It will save £4.5 billion over the rest of this Parliament and £1.5 billion a year to 2020. We will reinvest every penny saved in the NHS in front-line services.

[Mr Crausby]

The Bolton clinical commissioning group estimates that its budget will be about £25 per Bolton resident, or £100 for a couple with two children. Is that not too much, considering that they will get no medical treatment at all from that money, just administration money paid to doctors who should really be treating patients and not sat in the back office?

[Mr Burns]

No, I do not believe it is. The administration figure that has been announced for CCGs throughout the country is £25 a patient, but if a CCG is more effective and efficient in providing administration and bureaucracy and makes savings, those savings can be transferred and reinvested in funding the care of their patients. That is an incentive for them to be streamlined and to ensure that that happens.