Francis Report: Update and Response

Debate between Jeremy Hunt and Clive Efford

Wednesday 11th February 2015 Commons Chamber

[Mr Hunt]

I thank my hon. Friend, whom I know has thought extremely hard about this issue. Indeed, we talked yesterday about getting the fit and proper persons test to work properly. It is still in the early stages, so it is difficult to assess whether it is having the impact we want. We certainly hope it will have some impact. There is an unfairness about the fact that a clinician as a chief executive of a hospital is accountable to the GMC as a doctor, whereas a chief executive who is not a doctor is not accountable. We actually want more doctors to become chief executives. On the whole, they do a really good job, and we should give further consideration to that.

[Clive Efford (Eltham) (Lab)]

It will take a great deal to change the culture. I have spoken to a senior hospital manager who would like to express his concern about the lack of qualified nurses, forcing him to advertise posts abroad. I have spoken to two A and E nurses who are concerned about the critical situations occurring at their unit every day. One of them has become an agency nurse so she can limit the number of hours she is forced to work. Then there is an ambulance worker who is concerned about the 12-hour shift and the lack of time he is given to clean his ambulance between dealing with patients. They would all like to come forward to express their concerns, but they do not feel that anyone above them would listen. What can the Secretary of State say today to reassure those people?

[Mr Hunt]

I can say that we are consulting on making a big change that would mean they would have someone independent in their organisations to whom they could talk and raise their concerns. They could say, “I want to say this, but no one is listening to me”. That is what Sir Robert Francis calls “freedom to speak up” guardians, whom he wants in every organisation. It is what Helene Donnelly is championing in her work. That is the way forward to address those concerns.

NHS Major Incidents

Debate between Jeremy Hunt and Clive Efford

Wednesday 28th January 2015 Commons Chamber

[Mr Hunt]

It was not raised by NHS England on Monday because I did not know about this local guidance, as I had absolutely nothing to do with it.

[Clive Efford (Eltham) (Lab)]

Can the Secretary of State explain why in the incident response plan from NHS England there is an entire paragraph headed “Politics” under the principles for considering an escalation response? In the House on 7 January he said:

“The decision to declare a major incident is taken locally—there is no national definition”—[Official Report, 7 January 2015; Vol. 590, c. 273.]

However, the guidance issued in the middle of January says that major incidents

“should be agreed...with the Director on call for NHS England”.

If it is not political, the Secretary of State owes the House an explanation of NHS England’s involvement and the meaning of that paragraph.

[Mr Hunt]

The hon. Gentleman has quoted selectively; he has not quoted the whole guidance. If he looks at the whole guidance, he will see that it clearly states that a responsible trust, before it declares a major incident, which is its decision, must make sure that there is not going to be a negative impact on the rest of the economy, because patients must always come first. He is also not saying what Dame Barbara Hakin said this morning —that none of this guidance was anything to do with Ministers.

A and E (Major Incidents)

Debate between Jeremy Hunt and Clive Efford

Wednesday 7th January 2015 Commons Chamber

[Clive Efford (Eltham) (Lab)]

Is it not true that this Government set out with a plan to close nine out of 31 A and Es in London, including the one at Lewisham, as directed specifically from the Secretary of State’s office? Does he regret that? What state does he think the A and E services in south-east London would be in if he had been successful, in the face of public opposition, in closing that A and E?

[Mr Hunt]

First, as the hon. Gentleman knows perfectly well, there were never any plans to close that A and E, and he should desist from scaremongering about what was happening at Lewisham hospital. He should also remember that when this Government came into office—[Interruption.] The plans—

[Clive Efford]

You idiot—it went to court!

NHS (Five Year Forward View)

Debate between Jeremy Hunt and Clive Efford

Monday 1st December 2014 Commons Chamber

[Mr Hunt]

Yes, I will. I have to say to the House that the importance of being better at tackling sepsis was brought home to me personally by two moving meetings with Scott Morrish, the father of Sam Morrish, who was from the west country—perhaps near my hon. Friend’s constituency. His son’s tragic death from sepsis was avoidable, so this is an absolute priority for me in the next couple of months.

[Clive Efford (Eltham) (Lab)]

Two weeks ago, the Secretary of State could not muster enough Conservative MPs in this House to defend the Health and Social Care Act 2012, particularly those elements of it that have allowed competition regulators into the NHS to second-guess decisions of local commissioners. If he wants to save money in the NHS, he can do away with that element of the 2012 Act and stop money being diverted from patients to pay for lawyers and accountants to oversee a tendering process that is wasting money.

[Mr Hunt]

If we stopped the NHS using the private sector, which seems to be Labour’s direction of travel, 330,000 people every year would have to wait longer to have their hips or knees replaced. We will make decisions on the basis of what is right for patients, and not of ideology.

Oral Answers to Questions

Debate between Jeremy Hunt and Clive Efford

Tuesday 25th November 2014 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for his comments. I was quite amused to see that I have a future career as an estate agent, along with the Prime Minister, when our hopefully long careers in politics are over, but the point is that this is scaremongering and it is wrong to scaremonger about something as important as the NHS. To suggest that the NHS is being privatised is fiction. What is not fiction is Labour’s legacy of poor care.

[Clive Efford (Eltham) (Lab)]

The Secretary of State’s definition of “harm” is not the definition that Labour Members have. My Bill, which was passed overwhelmingly on Friday, would require the Secretary of State to bring the matter back to this House should TTIP apply to the NHS in any way whatsoever. Will he support my Bill going into Committee without delay, so that we can discuss the detail and answer the questions he has?

[Mr Hunt]

No, I will not support the hon. Gentleman’s Bill.

Accident and Emergency

Debate between Jeremy Hunt and Clive Efford

Wednesday 18th December 2013 Commons Chamber

[Mike Gapes]

rose—

[Clive Efford (Eltham) (Lab)]

rose—

[Mr Hunt]

I am going to make some progress.

Our plans go much further than simply reversing the 2004 contract. GPs will offer the most vulnerable guaranteed same-day telephone consultations, which never happened under Labour. There will be a dedicated telephone line so that A and E doctors, ambulance paramedics and others can get advice from GPs about treatment in urgent situations. GPs will co-ordinate care for elderly patients discharged from A and E to try to ensure they get proper wrap-around care to minimise the chance of needing to go back.

We have done something else that the right hon. Member for Leigh never did to tackle long-term pressure on A and E. One of the biggest problems has been not being able to discharge people from hospital because of poor links between the health and social care systems. Through our £3.8 billion better care fund, this Government are doing something that Labour talked about a lot but never actually delivered: we are merging the health and social care systems. Gone will be people being pushed from pillar to post, because in order to access this fund, clinical commissioning groups and local authorities will have to commit to joint commissioning and joint provision.

Finally, we have looked at the long-term structure of A and E. The previous Government were battered by a succession of failed reconfigurations. We, too, have had challenges over decisions, such as those with regard to Lewisham. Sir Bruce Keogh’s recent review of urgent and emergency care has changed the terms of this debate by setting out a 21st-centruy vision of emergency care. Sir Bruce rightly said there should be more extensive services outside hospital, and this, too, will help to reduce A and E queues. He rightly said that while the number of A and Es is not expected to change, the services offered by all of them should not be identical if we are to maximise the number of lives saved. Our duty to patients is to make that a reality and we will not hesitate to drive that vision forward.

A and E and the ambulance services are performing well under unprecedented pressure. I cannot speak highly enough of the hard-working staff who are working around the clock to deliver vital services. They share our overriding commitment to putting patients first this winter. Unlike Labour Members, we do not seek to turn a tough winter into a political football. If they want to make the comparison between our record and theirs, we are happy to do so: more people being seen within four hours, shorter waiting times, and long-term problems being tackled—not posturing from the Opposition, but action from the Government, and a commitment to do what it takes to support hard-working front-line staff over Christmas. We should get behind them and not undermine their efforts.

Oral Answers to Questions

Debate between Jeremy Hunt and Clive Efford

Tuesday 22nd October 2013 Commons Chamber

[Mr Hunt]

I will tell the hon. Lady why the public can have confidence in their health service: compared with three years ago, on broadly the same budget, the NHS is doing 800,000 more operations year in, year out; MRSA rates have halved; and the number of people who wait for a year or longer for operations has gone down from 18,000 to fewer than 400.

[Clive Efford (Eltham) (Lab)]

Will the Secretary of State explain why we have had a summer crisis in A and E? We are all used to the emergency services being overwhelmed in winter. Given the crisis that we have had, what will he do to assist the NHS in averting a winter crisis this year, rather than just blaming everybody else?

Oral Answers to Questions

Debate between Jeremy Hunt and Clive Efford

Tuesday 11th June 2013 Commons Chamber

[Mr Hunt]

As ever, the Labour party is being selective in its use of information. As I have said, I visited seven A and E departments, including over the Easter period when we had some severe A and E pressures that I wanted to investigate for myself. Let me tell the hon. Gentleman about another thing that this Government have done that his Government never did: it is not just Ministers who are going out on to the front line; we have asked all our civil servants to go on to the front line for up to four weeks. I am extremely proud that my Department will be the first to connect with the front line in that way, and am even prouder of the response from my own civil servants, who embraced the scheme with great enthusiasm.

[Clive Efford (Eltham) (Lab)]

Could we have some accountability for the strategic planning of A and E services across London? Nine of them face closure and 28 ambulances were redirected to Lewisham, which the Secretary of State intends to downgrade. Without a strategic approach, how can patients be confident that their best interests are being served?

[Mr Hunt]

We do have a strategic approach, but we also have some very important safeguards that any big change in approach has to go through before it is implemented. That is why I asked for a report from the Independent Reconfiguration Panel on the plans for north-west London, and I will consider that report very carefully before I make any decision.

South London Healthcare NHS Trust

Debate between Jeremy Hunt and Clive Efford

Thursday 31st January 2013 Commons Chamber

[Mr Hunt]

I recognise how hard my hon. Friend has campaigned on behalf of his constituents and how deeply they feel about these issues. He knows that the decision has been made. We want to get the safe implementation of that decision absolutely right and I would be more than happy to meet him to discuss how we can best ensure that that happens.

[Clive Efford (Eltham) (Lab)]

The Secretary of State inherited a mess that was created by his Conservative predecessor, who abandoned the “A picture of health” process. That led to the betrayal of my constituents in respect of what they expected to come out of that process, particularly at Queen Mary’s hospital Sidcup. When he opposed “A picture of health”, the former Secretary of State said that he would decide on that closure based on what local clinicians said. In this process, it is clear that local clinicians are opposed to the closure of the A and E. Will the Secretary of State therefore say what value he places on the views of the local commissioners, who are completely opposed to what he proposes?

[Mr Hunt]

Of the six local clinical commissioning groups, five support these proposals. One group is against the proposals, but it accepts the principles behind them, including the idea that to deliver higher quality care, we must perform complex surgery at fewer sites. That will mean that more of the hon. Gentleman’s constituents have better care outcomes. I remind him that if his Government had resolved this problem when they were in office before 2010, none of us would be having this discussion today.

South London Healthcare NHS Trust

Debate between Jeremy Hunt and Clive Efford

Tuesday 8th January 2013 Commons Chamber

[Mr Hunt]

I heed absolutely the right hon. Gentleman’s warning that reorganisations are not always the panacea that they are made out to be. We need to be absolutely clear that, if we accept the proposals, they will deliver a sustainable, robust and clinically sound outcome for the right hon. Gentleman’s and neighbouring constituents, as the trust special administrator believes they will. I shall be delighted if the right hon. Gentleman attends the meeting with other MPs affected by the proposal. I shall hear what he has to say further at that meeting.

[Clive Efford (Eltham) (Lab)]

The Secretary of State has to recognise the serious contradictions between the proposals in the trust special administrator’s report and the Conservative manifesto before the last general election. If he were to accept the proposals, particularly in relation to A and E, that would be a serious betrayal of promises made to the electorate. There are also the changes expected from the “A Picture of Health” proposals for Queen Mary’s hospital in Sidcup in relation to overnight elective surgery. How much is the Secretary of State bound by the specific promises made in the Conservative manifesto before the election when it comes to making a decision on the report?

[Mr Hunt]

We were concerned in the run-up to the last election at the pace and scale of many of the reconfigurations pursued by the last Government. That is why when we came into office we paused the reconfigurations and introduced the four tests—an additional safeguard to make sure that reconfigurations were not done without local clinical support.

We wanted to avoid what had happened so often, including in my own constituency—an alliance of Health Ministers and NHS managers riding roughshod over what local people wanted. We wanted to stop that, so we put in place new systems. I hope that the hon. Gentleman will be comforted by the robustness and thoroughness of the processes that we are now going through.

NHS Funding

Debate between Jeremy Hunt and Clive Efford

Wednesday 12th December 2012 Commons Chamber

[Mr Hunt]

It is because we have protected the NHS budget that the number of clinical staff in the NHS has gone up and not down. [Interruption.] Okay, let me explain this, because there is a very important point here. Unlike Labour Front Benchers, I do not want to micro-manage every hospital in the country and tell them exactly how many doctors and how many nurses they should have. I want them to put money on the front line, and the result is that the number of clinical staff—doctors, nurses, midwives and health visitors—has gone up and not down.

[Clive Efford]

rose—

[Mr Hunt]

I am going to make some progress.

Let me move on to the accusation that the right hon. Member for Leigh made. He says that, using 2009-10 as a base year, NHS spending went down in 2010-11.

Oral Answers to Questions

Debate between Jeremy Hunt and Clive Efford

Tuesday 27th November 2012 Commons Chamber

[Mr Hunt]

I remind the right hon. Lady that the Government have not cut the NHS budget; we have protected the NHS budget. There is an ongoing consultation on the proposal that she mentions. It will finish on 13 December and I hope she will contribute to it. I will receive the recommendations of the trust special administrator at the beginning of January, and I will then make my decision.

[Clive Efford (Eltham) (Lab)]

The 2010 Conservative manifesto stated:

“We will stop the forced closure of A and E and maternity wards, so that people have better access to local services,”.

They then closed the accident and emergency department at Sidcup, having promised to save it, and they now plan to close the A and E at Lewisham hospital. Is that not a betrayal of people in south-east London and the NHS?

[Mr Hunt]

The hon. Gentleman should talk to the shadow Minister on the Opposition Front Bench, the hon. Member for Leicester West (Liz Kendall), who said yesterday that she would not automatically oppose all reconfigurations. The coalition Government have introduced four tests, which were not used by the previous Government. Those tests state that we will not impose closures of A and E and maternity units unless there is local clinical support, and evidence that it will benefit local people and improve patient choice. The tests exist to provide precisely the safeguards about which the hon. Gentleman is concerned.