(9 years, 9 months ago)
Commons ChamberOn the early detection of cancer, will the Secretary of State consider putting more resources into socially deprived areas such as Halton where the incidence of cancer is higher?
We are putting more resources into Halton. In fact, we are putting more resources into the NHS across the country. We are carrying out 21,000 more diagnostic tests, including cancer tests, every year compared with four years ago, and I hope that that is something the hon. Gentleman will welcome.
(9 years, 9 months ago)
Commons ChamberIt is very important that everyone uses the right figures. What has happened at Basildon hospital is an inspiration to other trusts in special measures. In just a few months, it moved from being in special measures to being rated “good” by the CQC. The trust has an inspiring new chief executive, Clare Panniker, who really does listen to staff. I have been there and been told by staff how they feel that they are being listened to. We all have an obligation to make sure that the right information goes out to local communities, so that they understand where things really are getting better.
Most, if not all, hospitals are very concerned about next year’s proposed 3.8% efficiency saving. They fear that it will have an impact on access to and quality of services, and hence on patient safety. In the spirit of the openness and transparency that we now want to see, may I ask whether the Secretary of State was aware of those concerns, and whether, if he was not, he will find out why?
I am glad to note that this is rapidly becoming one of the most open and transparent exchanges of questions and answers we have had in the Chamber. I am, of course, aware of trusts which say that they will find it difficult to meet stretching efficiency targets, but I would say to them that if they look at some of the safest hospitals in the world—such as Salford Royal in England and Virginia Mason in Seattle—they will find that they have the lowest costs. It is not a choice between cost and safety; better safety leads to lower cost.
(9 years, 10 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
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I am aware of the problems at Addenbrooke’s. Indeed, the main issue, as my hon. Friend rightly says, is delayed discharges relating to care. The chief executive is running the command and control system and working with the local authority to facilitate the discharges that are necessary and to de-escalate the situation. The hospital has £2.2 million for its winter pressures support and 185 more doctors than four years ago.
The national health service in my constituency is under immense pressure, as are the adult services. It has been known for some months now that the number of acutely ill people coming into hospital has been growing. Has the Secretary of State investigated the reasons for that significant increase, which I am hearing about from the chief executives of the hospitals? If he has, what are those reasons? Is it to do with access to primary care, or problems with adult social services? Will he tell the House now?
We have looked into that matter in huge detail. There are probably three broad factors that are behind the increase in demand. One is the ageing population. There are 350,000 more people over the age of 75 than four years ago. The point is that if someone of that age goes into A and E in the winter, there is an 80% chance they will be admitted to hospital and quite a large chance they will stay in hospital for some time. The second factor is changing consumer expectation among younger people who want faster health care—[Interruption.] That is what Professor Keith Willett, the director of emergency care at NHS England, said, and Opposition Members should listen to what our clinical leaders are saying. The third factor is a refusal by NHS trusts to do what they were pressurised to do in the past, which is to cut corners to hit targets.
(9 years, 11 months ago)
Commons ChamberNo one campaigns more for first aid than my hon. Friend. I would certainly encourage all schools to teach first aid, as I think it is a very important skill and we should consider that as part of the prevention agenda. There is also a broader point, which is that we can do a lot with the Department for Education on this agenda.
In my constituency, people are increasingly finding it difficult to access GPs and the local hospital, Warrington and Halton, is in deficit and is missing its A and E targets. I therefore have a simple question for the Secretary of State. How many additional GPs will this money find, over and above the number of GPs who are in post today?
It takes seven years to train a GP, so the long-term solution is to train an additional 5,000 GPs, which is what the Government have decided to do and have announced. While they come on stream, this additional money will fund up to 20,000 additional posts, a number of which will be in the community.
(10 years, 1 month ago)
Commons ChamberWe have a shortage of GPs in Halton. Constituents tell me it is more difficult to get an appointment, and in recent months, two GPs have told me that there are major problems with GP services in Halton and the country as a whole. Despite what the Secretary of State says about increased numbers of GPs, that is not happening in Halton. What is he doing to address the problem, particularly in areas of great deprivation, such as Halton?
There is pressure throughout the NHS because there are nearly 1 million more over-65s than there were four years ago, which puts pressure on GPs, as it does on any department or hospital providing elective care. However, this is not just about getting an appointment; it is also about ensuring that GPs have personal responsibility for the patients on their list and are accountable for the care of some of the most vulnerable people. We have brought back named GPs with personal responsibility for over-75s, and I hope the hon. Gentleman welcomes our going further and bringing it back for everyone.
(10 years, 4 months ago)
Commons ChamberWe absolutely do need to do that. Dementia care is an area where there needs to be lots more work and innovation. There is huge variation and even some very caring places could try new ideas. There are some very interesting ideas about dementia care in Holland, too. I absolutely welcome that work.
Does the Secretary of State think that standards could be improved further by having minimum levels of staffing in care homes, and does he think that more can and should be done to improve pay and rewards for care workers?
We have recommended levels of staffing, but in the NHS we have decided not to have minimum levels of staffing. We were worried that that would be seen as a hurdle where, once achieved, nothing more would need to be done about staffing levels. The real issue about staffing levels and mandating numbers from the centre is that care needs change on a daily basis depending on how complex the needs are of the patients in a particular ward or home. That is why it is difficult to do it from the centre. We want to make sure that everywhere has the right numbers of staff. That is why I hope the hon. Gentleman welcomes the fact that we have so many more nurses.
(10 years, 5 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I would be delighted to do that. Incredible hard work by doctors, nurses and health care assistants on the front line of my hon. Friend’s local hospital has meant that the trust has come out of special measures, which the whole House should celebrate. Indeed, it was helped in that by Salford Royal, and one of the most encouraging things about the new special measures regime is that we are pairing up hospitals in difficulty with other hospitals that have a better record, and we are getting tremendous results.
Clinical commissioning groups commission services in hospitals. What discussions has the Secretary of State had with CCGs to ensure that when they commission services they particularly look to ensure transparency and that patient safety is the highest priority in their discussions?
We have a lot of discussions, and the hon. Gentleman is right: the commissioning of care is vital and we need CCGs to play their part. We have many discussions with NHS England about how to do that, and we will be considering how we can make CCGs more publicly accountable for their record in those areas.
(10 years, 7 months ago)
Commons ChamberI am happy to congratulate the trust on its excellent work. It is worth reflecting on how well the NHS did this winter. Despite constant attempts by the Opposition to talk up a crisis, we hit the target for A and E in more weeks than was the case when the right hon. Member for Leigh (Andy Burnham) was in office, and 2,000 additional people were seen within four hours every single day.
Part of the problem with people being admitted and readmitted to hospitals involves access to their GPs. What is the Secretary of State doing to ensure that elderly people across the board have access to their GP, so as to prevent their admission or readmission to hospital?
The hon. Gentleman is absolutely right. If we are going to deal with the pressures in A and E, we need to have a massive improvement in primary care access. There has been historical under-investment in primary care, going back over many years, and we need to change that. One of the ways in which we want to do that is to reintroduce GPs taking personal responsibility for the most vulnerable older people, and today’s changes will help us to move towards that.
(11 years ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I pay tribute to my hon. Friend for raising both publicly and privately his concerns about the hospital provision that his constituents face. We shall of course make sure that there is a proper review before any service changes are made. I hope that he will be reassured by the big change that happened this year with the introduction of an independent chief inspector of hospitals, who is going round the country rooting out poor care, not sweeping it under the carpet, as happened so often under the Labour Government.
Does the Secretary of State regret the loss of 6,000 nursing jobs since the last election?
(11 years, 2 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
A number of things have contributed to these changes, one of which is that we have not succeeded, as an NHS or as a Parliament, in getting the way in which we do reconfigurations right: they do not command the confidence of the public and people are not satisfied that there are alternatives that they can trust or that good alternatives will be put in place when a change is proposed. We need to learn the lessons from what happened in my hon. Friend’s constituency.
Since 2010 the new Whiston hospital has seen an increase of 25% in emergency demand, but it has not been funded for it. I met the chief executive and vice-chair of the governing board last Friday and asked them whether they would be able to guarantee a safe service if that level of activity continues with the winter pressures, and they said that they might not. Will the Secretary of State urgently look at the situation at Whiston and come up with some solutions?
I hope that when the hon. Gentleman looks at today’s announcement it will reassure him that we are addressing not just the immediate pressures in the most difficult areas, but the underlying pressures. That 25% increase at Whiston—I pay tribute to the staff in its A and E department, who will no doubt be working extremely hard to cope with it—has come about because we have not had better alternatives to A and E and because departments have often found it difficult to discharge people from hospital into the community, which has further increased the pressure on them. What we have announced in the past few months and today will make a real difference to alleviating those pressures.
(11 years, 4 months ago)
Commons ChamberIt is funny how the Labour party decided to make the NHS its main campaigning issue for the past three years, yet the moment people start to scrutinise its own record on the NHS it says the NHS is being used as a political football. What does that say about Labour’s approach to the NHS?
I want to consider the specifics of the motion before looking at the wider issue of risk. The motion mentions the Francis inquiry. One of this Government’s first acts on coming to power was to set up the full public inquiry into Mid Staffs that families had been denied by the right hon. Gentleman’s Government for too long. We are implementing it, and fast. That is why a new chief inspector of hospitals started work yesterday, just five months after the report was published. [Interruption.] The right hon. Gentleman says that a chief inspector of hospitals is not in the report, but how are we going to make sure that the report’s recommendations are implemented throughout all 266 NHS trusts? That will be done because we will have independent inspection of hospitals, which has not been done before because the situation was so undermined by the previous Government. That is how we are going to make sure that Francis actually happens.
We intend to implement the spirit of everything that Robert Francis proposed, even if the details may vary in places from his 290 recommendations. Francis himself endorsed that approach when that he said that the Government have indicated their
“determination to make positive changes to the culture of the NHS, in part by adopting some of my recommendations and in part through other initiatives.”
Francis talked about five themes, so let us look at the progress being made on them. First, on information and transparency, yesterday showed that this Government are determined to root out, once and for all, an NHS culture of solving problems behind closed doors. This is about not just the decision to hold a public inquiry into Mid Staffs, which the right hon. Member for Leigh and his colleagues rejected doing 81 times, but the Keogh review, which reported yesterday that 14 hospital trusts have excess mortality rates. This is the first time the NHS has ever conducted such a review. We have also published individual surgeon outcomes—the first country in the world to do so across an entire health system. The independent rating of hospitals will start this autumn, so for the first time people will know how good their local hospital is, just as they do for their local school.
Francis also mentioned standards. The new chief inspector of hospitals—a position that Labour still refuses to support—began work yesterday. In Professor Sir Mike Richards, we have a new whistleblower-in-chief whose sole job is to drive up standards and root out poor care. He will be supported by a team of expert inspectors, in stark contrast to the generalist inspection model set out by the right hon. Gentleman’s Government in 2009. That is plain common sense. We have put it right. The work of the inspectors will be informed by the independent review of hospital safety that is being conducted by Professor Don Berwick, who will advise on how to embed a culture of patient safety throughout the NHS. He will report back later this summer.
Yesterday, when I asked the Secretary of State whether mortality had fallen before 2010, his answer was:
“According to Professor Jarman…it has been falling slightly.”—[Official Report, 16 July 2013; Vol. 566, c. 944.]
The Keogh report states that it had fallen by 30% over 10 years. Figures from the House of Commons Library, which were sourced from the NHS, show that there has been a significant fall in deaths within 30 days of non-elective hospital procedures. Will he correct the record?
I am afraid that that intervention sums up where the spin is happening. The 14 hospitals were investigated by Professor Keogh because they had excess mortality rates. The Labour party thinks that that started in 2010, but it goes right back to 2005 in those hospitals and earlier than that in many of them. That is the ugly truth that Labour refuses to confront: 14 hospitals had high mortality rates for years and years, and Labour did nothing to sort it out.
The Francis report—
(11 years, 4 months ago)
Commons ChamberThis is the problem. [Interruption.] This is the denial we are getting from the Labour party; it is denying any responsibility for these deep-seated problems in some of our hospitals. As Health Secretary, I intend to do exactly as my hon. Friend describes. In order to try to measure the progress we are making, we will this year for the first time be asking every NHS in-patient whether they would recommend the quality of care that they received to a friend or a member of their family, because in the end that is what this is all about.
In May 2010, had mortality rates been falling in NHS hospitals?
(11 years, 4 months ago)
Commons ChamberMy hon. Friend makes two important points. I explicitly said that we will not proceed with any of these changes until neighbouring hospitals have been consistently meeting their A and E standards and any necessary changes have been put in place so that we can be sure that they will improve care for patients. That is really important if we are going to maintain confidence.
On my hon. Friend’s point about urban versus rural, part of the underlying reason for these changes is that we need to get more care out of big hospitals, which are often in urban areas, and into the community—into settings near people’s homes. That is very important for rural communities where there are often large concentrations of older people. Today’s decision will mean an additional investment in those community services. As we look at the big changes we need to make in the NHS, we will need to make more decisions that allow more to be invested in out-of-hospital care if we are to prevent the illnesses that ultimately put so much pressure on our A and E departments.
Is any consideration being given within the Secretary of State’s Department or NHS England to reconfiguring the A and E services between St Helens and Whiston hospitals and Warrington and Halton hospitals? He might not be aware that the chief executive of Warrington and Halton hospitals and the chair of its trust board recently told me and my hon. Friend the Member for Warrington North (Helen Jones) that they think they will run out of money in about 18 months’ time such are the pressures that they have at the moment. Will the Secretary of State investigate this and tell me whether any consideration of that reconfiguration is taking place?
With regard to pressures on A and E, we are working very hard with A and Es across the country to make sure that they learn the lessons from what happened last winter and are properly prepared for this winter. Those discussions will include the A and E departments that serve his constituents. He will know that any decisions about service changes or reconfigurations are a matter for the local NHS; they come to me only if they are referred to me following a formal proposal by a local health overview and scrutiny committee, and that has not happened in this case.
(12 years ago)
Commons ChamberOne way in which the Secretary of State can express his thanks is by ruling out regional pay. Will he tell us now whether he will do so, because it is a major concern for my constituents, who have written to me in their dozens over the past two or three weeks?
(12 years ago)
Commons ChamberMy understanding is exactly the same as that of my right hon. Friend. The key point is that this was a technical irregularity, but we do not believe that any patient has been sectioned, detained or hospitalised who would not have been if the correct procedures had not been followed. It is none the less very serious that this technical breach happened; that is why, as well as correcting the technical breach and providing absolute clarity, we are conducting this review to make sure that we do everything we can to avoid anything similar happening again—even under completely different structures than the SHAs.
I do not necessarily disagree with anything the Secretary of State said, but I noted that he used the term “we believe”, which means that it is not simply factual at this point that no one has been detained who should not have been. It would be worth the Secretary of State addressing the reverse position: does he believe that no one who should have been detained has been released and then gone on to commit a serious offence?
As a result of the technical irregularities that we have identified and put right, I do not believe that what the hon. Gentleman describes has happened. Let me explain that when I say “we believe”, it reflects the advice we have had that there are good arguments on why the detentions were and are lawful, but that is not to say that those arguments cannot be challenged or that a court would necessarily agree with us. That is why it is necessary to take this unusual step of introducing emergency legislation.
(12 years, 7 months ago)
Commons ChamberIt seems strange that the Secretary of State brings a special adviser into the centre of Government on a very commercially difficult contract or situation, and does not know what he is doing. But may I ask the Secretary of State a very simple question: why did the permanent secretary decide that the contact point would be a special adviser and not a civil servant?
Adam Smith was a part of the process that was authorised by the permanent secretary. But he was not the only point of contact—there were many, but he was one of the points of contact. You need to do that. [Hon. Members: “Why?”] Well, we set up a process that was approved by the permanent secretary, and we also put in place many safeguards to make sure that my decisions were taken objectively, and seen to be taken objectively. I have to say to the hon. Gentleman that there is no evidence whatsoever, looking at my actual decisions, that any of those conversations had any influence on them whatsoever.
(12 years, 11 months ago)
Commons ChamberI congratulate the Royal Liverpool golf club, and I would be delighted to attend—diary permitting. I agree with my hon. Friend that sport is a massive driver for tourism. Two million people come to this country every year to watch or play sport. I hope that sport in Liverpool will be helped by this week’s announcement of a new local TV station for Liverpool, on which I am sure my hon. Friend will be an early honoured guest.
What is the Secretary of State doing to support the tourism industry to attract more people to smaller conurbations like Halton, which has the excellent Norton Priory museum and the Catalyst science centre, which is currently struggling. What is he doing to attract more people to the, shall we say, less obvious tourist areas?
(13 years, 1 month ago)
Commons ChamberLet me first say a big thank you to my right hon. Friend the Member for Leigh (Andy Burnham). I was at the 20th anniversary commemoration service at Anfield, and I know that that was a very emotional occasion for my right hon. Friend. I think that he felt the rawness tenfold—knowing how the families, Liverpool fans and others felt about an injustice that has continued for over 22 years—and I think that he did well to get through his speech and deliver his message on that day. I want to record my thanks for what he did, along with my hon. Friend the Member for Garston and Halewood (Maria Eagle). As I have said, it was an emotional occasion. There were 30,000 people in the stadium that day. I have been going to such commemoration services for many years, but that occasion demonstrated the depth of support for the families, and for the securing of the truth and justice that we all seek.
I was present at the Hillsborough disaster. I drove to the ground that day with three friends. As was recalled by my hon. Friend the Member for Liverpool, Walton (Steve Rotheram), it was a beautiful sunny day, and we were looking forward to a good match—one of many good matches that we had seen as Liverpool supporters. One could never have imagined how the event would end. As we approached the stadium we sensed that something was wrong, and indeed the chaos had already started outside the Leppings Lane end. We witnessed mounting chaos around the turnstiles. When we eventually managed to pass through them, our tickets were not checked. There was no organisation and no policing. As I have said, it was complete chaos.
I watched the disaster. I was in the north stand, and my three friends were at the Leppings Lane end. I felt somewhat let down because I did not have a ticket for Leppings Lane. I would normally stand up in the Liverpool Kop, but for some reason I had ended up with a stand ticket, which meant sitting down, and I felt that I had lost out. Of course I did not know what was about to happen, and I did not know what had happened to my three friends in Leppings Lane until some time later.
As I have said, I watched the whole horror of the disaster unfold in front of me. It was obvious well before 3 pm that pens 3 and 4, the middle pens, were full, but on either side of them the stand was empty. I will not go into the details, because we have been through them back in 1998 and since, but it beggars belief that the police and those responsible could not see what was happening. It had to be seen to be believed. Then, of course, we saw the disaster unfold.
The horror of that day will always live with me, but I did not lose my life, and nor did anyone personally known to me. The families, however, are in a completely different position. I recognise the dignified and determined way in which they have pursued their fight for justice, in spite of the terrible slur perpetrated by the police, with the help of certain sections of the press, in blaming Liverpool supporters for the disaster. Those families have my deepest respect. It is their love for their loved ones, and their burning desire to put a wrong right, that have kept them going for 22 years. Imagine 22 years of fighting this! It is quite unbelievable—but they still have the energy and drive to see this through. One person could not be here tonight. He said that he was tired and would not be here: he wanted to save his energy, so that he could see the conclusion of the campaign and see that justice was done.
Imagine finding out that your loved one had died in that terrible disaster, or been badly injured, and reading or hearing shortly afterwards that that person and his fellow supporters were being blamed for it. It is almost unimaginable that, notwithstanding the grief and trauma that those families were going through, those reports should unfold in the next few days. As has been said, several newspapers were involved, but I think that a headline in The Sun caused the most distress and upset. It is difficult for those who were not personally affected to appreciate the impact of that headline. The fact that police officers were involved as well was disgraceful. The distress caused by all that cannot be overstated.
As my right hon. Friend the Member for Leigh said, the 3.15 pm cut-off point is crucial, because nothing that happened after that time was taken into consideration. We know that people were alive then, and, as my right hon. Friend made clear, that is an issue for some of the families. It was an unbelievable decision. Dozens of ambulances were not allowed into the stadium, and it was also unbelievable that that was allowed to happen. As my hon. Friend the Member for Liverpool, Walton pointed out, it was Liverpool supporters who led the rescue mission, if I can call it that, carrying bodies and injured people away from Leppings Lane outside the ground.
I welcomed the Home Secretary’s statement about the independent panel. There was some discussion about the establishment of the panel, and there was a good deal of mistrust among the families because of all that had happened previously, but they went along with the process and became involved in detailed negotiations with the Government. I was asked by Liverpool and Merseyside Members of Parliament to represent them in those negotiations, which required considerable hard work. The panel’s primary aim is to ensure the recording and orderly release of the documents, which—this is crucial—must be shown to the families first. However, as my right hon. Friend the Member for Leigh knows, we managed to ensure that the production of a report was included in the agreement. That report will be crucial to the process of putting the truth in the public domain, and enhancing our understanding of the events and information relating to the disaster.
I welcome the Prime Minister’s unequivocal commitment to full disclosure, but will the Minister confirm that it will include the advice on which the Director of Public Prosecutions based his decision not to prosecute any senior police officers? Will it also include the reasons for moving an experienced match commander, Chief Superintendent Mole, a few weeks before the semi-final and replacing him with Chief Superintendent David Duckenfield, who was relatively inexperienced in the policing of football matches?
I think it important for Ministers, and the Government generally, to tread carefully, because there have been some problems. I know that what the Secretary of State for Culture, Olympics, Media and Sport said about hooliganism was taken out of context, but the fact remains that it caused a great deal of distress to the families. Moreover, last week’s debacle involving the hon. Member for Christchurch (Mr Chope) almost scuppered tonight’s debate. We need careful planning and thinking about how this matter should be dealt with from now on.
As the hon. Gentleman has referred to comments that I made, may I take this opportunity to apologise to the House—as I have to the families—for those comments? What I said was sloppily worded, it caused great offence, and I hugely regret it. The families were incredibly generous in accepting the apology that I made to them.
I know that the Secretary of State did not mean his remarks in the sense in which they were portrayed. I gave that example, along with last week’s, to emphasise that all this must be dealt with sensitively. The families have been through so much, and sometimes things have been wrongly said, have not been done or have been glibly avoided.
I want to put on record my thanks to the people of Sheffield. What lives with me is the memory of queues of supporters outside residents’ houses—and I mean queues: not two or three people, but 10, 20 or 30—who were allowed to use those residents’ telephones to let their families know that they were OK, and were given cups of tea. That was tremendous. The contribution and support of the people of Sheffield should be on record, and is one of the images that live with me to this day as I recall walking back from the ground. We want justice for the 96, and we want to make sure that all this information is released and that the families can see it first; that is crucial. We also want the Government to consider very carefully the report that will be produced, and to respond in a positive way that ensures that the families know both that everything possible has been done to get the information out and that their fight has not been in vain.
(14 years, 4 months ago)
Commons ChamberMy hon. Friend makes an important point. I have already had a meeting with Lord Young to discuss how we can look at the burden of health and safety regulation on volunteering in general. A particular concern is the rule that requires two people to take children to sporting activities in minibuses. We are worried that that is putting off schools taking people to sports events in other places. My hon. Friend is absolutely right, and we are looking at that matter carefully.
I am sure that the Front-Bench team will agree that it is important to increase participation in sport at school, and that playing fields have an important role in that. During the review of capital expenditure on education, was the Secretary of State consulted on the proposal to review the regulations relating to school playing fields? If he was consulted, what did he say? If he was not consulted, why not?
We are working closely with the Department for Education on a number of projects to do with school sport. In particular, we want to ensure that proper protections are in place for school playing fields. That was a failing of the previous Conservative Government and of the previous Labour Government, and we want to put it right.