Oral Answers to Questions

Debate between Jeremy Hunt and Liz Kendall

Tuesday 24th February 2015 Commons Chamber

[Mr Hunt]

I congratulate my hon. Friend on his understanding of the importance of transparency. He will welcome the fact that we are now saving 1,000 more lives a month as a result of focusing on the five-year survival rates. But that transparency must apply to CCGs as well, and discussions are ongoing with NHS England as to the best way to do that for lots of things, including cancer.

[Liz Kendall (Leicester West) (Lab)]

Last week, we learned that the 62-day target for cancer treatment has been missed for a full 12 months:

“This isn’t just about missed targets–consecutive breaches mean thousands of patients are being failed. These targets exist to ensure swift diagnosis of cancer and access to treatment, which is vital if we’re serious about having the best survival rates in the world.”

Those are not my words; they are an exact quote from Cancer Research UK. Which bit of it does the Secretary of State disagree with?

[Mr Hunt]

I do not disagree with it, but I will tell the hon. Lady why we are missing that one target. Incidentally, we are hitting the seven other targets. We are treating and diagnosing so many more people, with 560,000 more diagnoses every year. That means that in this Parliament we are treating 700,000 more people than were treated in Labour’s last Parliament, saving 1,000 more lives a month. If the hon. Lady looks at some of the other things that Cancer Research UK says, she will see that it welcomes that strongly.

Oral Answers to Questions

Debate between Jeremy Hunt and Liz Kendall

Tuesday 25th November 2014 Commons Chamber

[Mr Hunt]

We will absolutely go through a transparent process on that. My hon. Friend is right to talk about the CDF’s success, which is why we have put its budget up by 40%. As part of the fund’s success, we want to make sure that it is allowing access to the latest drugs and to drugs that really work. Obviously, science has moved on since the fund was set up four years ago, which is why we want to make room for new drugs and take off existing drugs where there is evidence that they are not working as well as possible. However, the process must be transparent.

[Liz Kendall (Leicester West) (Lab)]

Last Wednesday, the Prime Minister denied that there is a problem with cancer care, yet the target for cancer patients to start their treatment 62 days after a general practitioner referral has been missed for nine months in a row. Cancer Research UK says that this target is vital for ensuring swift diagnosis and treatment so that we have the best survival rates in the world. Some 15,000 patients have already waited too long. This is a serious problem requiring serious action, so what is the Secretary of State going to do?

[Mr Hunt]

I think cancer patients in the hon. Lady’s constituency will welcome the fact that under this Government Leicester hospital has 194 more nurses and 120 more doctors, many of them involved in cancer care.

Let me answer the hon. Lady’s question directly. There is pressure on one of the cancer standards, and that is because every year we are now diagnosing 460,000 more people than happened under the last Labour Government, who left us with such a disappointing survival rate. When that many people are being diagnosed, it of course puts pressure on the diagnostic labs and the people doing those processes. But Cancer Research UK is also saying that we are seeing record increases in survival from cancer, and that is happening because of this Government’s policies.

Oral Answers to Questions

Debate between Jeremy Hunt and Liz Kendall

Tuesday 21st October 2014 Commons Chamber

[Mr Speaker]

Order. The hon. Member for Caerphilly (Wayne David) is normally a very calm and reserved fellow—almost statesmanlike. This curious behaviour is quite out of character. He should take some sort of sedative. The hon. Member for Cardiff South and Penarth (Stephen Doughty) can probably advise him.

[Liz Kendall (Leicester West) (Lab)]

With hospitals set to be £1 billion in the red this year, the Secretary of State should be getting a grip of NHS finances. Instead, he is starting on yet another reorganisation. First, he put NHS England in charge of commissioning primary and specialist care. Now, NHS England wants to hand this back to clinical commissioning groups. Ministers have already wasted three years and £3 billion of taxpayers’ money. How much will this Secretary of State’s second reorganisation cost?

[Mr Hunt]

It is lovely spin from the party that carried out nine reorganisations in 13 years. The difficult truth for the Labour party is that this reorganisation that they fought so hard against has been a success. We are saving this Parliament £5 billion. We have reduced the number of administrators by 19,000. We have hired 10,000 more doctors and nurses with the money, and the result is that our NHS, in very difficult circumstances, is doing nearly a million more operations every single year. That is something that we on both sides of the House should welcome and be proud of.

NHS Services (Access)

Debate between Jeremy Hunt and Liz Kendall

Wednesday 15th October 2014 Commons Chamber

[Liz Kendall]

I will not. [Interruption.] If the hon. Gentleman is going to talk about Wales, 90% of patients get their treatment within that target, compared with 84% here, so let me save him some time and bother.

The Government’s failure to keep people out of hospital and keep waiting lists under control, means the NHS is facing a looming financial crisis, too. Two-thirds of all acute hospitals are already in deficit to the tune of £500 million. They predict they will end the year £1 billion in the red, piling on the pressure for even greater service cuts and worse standards of care in future.

The tragedy is that it did not have to be this way. After 13 years of investment and reform, the previous Labour Government left the NHS with the highest ever patient satisfaction rates and the lowest ever patient treatment waits. But we were not complacent. We understood that the NHS had to face up to even bigger challenges: our ageing population, the increase in long-term conditions and huge medical advances, at a time when there is far less money around. For that reason, we had a plan in every region to reform front-line services, through Lord Ara Darzi’s NHS next stage review, by delivering some services in specialist centres so that patients got expert treatment 24/7 and by shifting other services out of hospitals and into the community. It was a move towards prevention joined up with social care to help people stay living at home. Instead of going ahead with our reforms, however, the Government scrapped them and forced through the biggest backroom reorganisation in the history of the NHS, wasting three years of time, effort and energy, and £3 billion of taxpayers’ money that should have gone on patient care.

The Health Secretary told the House today, and said on the “Today” programme, that the Government had saved £1 billion.

[Mr Jeremy Hunt]

The NAO said it.

[Liz Kendall]

I actually picked up the copy of the report he left behind, and I found his highlight. It reads:

“The estimated administration cost savings outweigh the costs of the reforms”,

but it does not mention the £1 billion figure. In fact, paragraph 4.10, on the reliability of the Department of Health, states “we found…limited assurance” in the figures. It also states that

“strategic health authority staff did not verify the figures submitted to them by primary care trusts”

and that it

“saw no evidence that the”

Government

“challenged these figures.”

Far from being independently verified, as the Health Secretary claims, they have been made up on the back of an envelope. [Interruption.]

Government Members can complain, but we have constantly argued that the NHS reorganisation has been the single biggest mistake made by the Government, and now we find out that members of the Cabinet agree. An ally of the Chancellor told The Times:

“George kicks himself for not having spotted it or stopped it”.

A former No. 10 adviser says that

“no one apart from Lansley had a clue what he was really embarking on—certainly not the prime minister”.

So we have a Chancellor, who is meant to safeguard public money, failing to stop billions of pounds of waste and a Prime Minister who claimed the NHS was his top priority, but was too confused or complacent to bother to understand his own plans. The Conservative party still does not get it. One Downing street adviser is quoted as saying:

“A lot of work had gone into persuading people that David Cameron believed in the NHS, had personal experience and cared about it. Then the Conservatives came in and forgot all about reassurance. Lansley managed to alienate all the professional people in Britain who were trusted on the NHS.”

The Government’s NHS reorganisation was not just terrible politics; it is terrible in practice for patients, taxpayers and NHS staff. I remind hon. Members that the Health and Social Care Act 2012 did not just create 221 CCGs, 152 health and wellbeing boards, NHS England, Public Health England and Health Education England; it also created four regional NHS England teams, 27 local area NHS England teams, 16 specialist commissioning units—well, there were 19, but at least two have already been merged—and 10 specialist commissioning units. That is on top of Monitor and the Care Quality Commission. It is a system so chaotic and confusing that no one knows who is responsible or accountable for leading the changes patients want and taxpayers need.

And now, just when we thought it could not get any worse, another major new reorganisation is under way. NHS England was commissioning primary care and specialist services, but in May it announced it wanted to give primary and specialist commissioning back to CCGs to try and patch up the fragmentation created by the Government's own plans. How much will this second reorganisation cost patients and staff?

Patients, staff and taxpayers cannot afford another seven months, let alone another five years, of this Government. They need a clear plan to restore care standards and restore care services so that they are fit for the future. Opposition Members would use the savings from scrapping the cost of competition in the NHS to guarantee new rights for patients to see their GP at a time that is convenient for them. We would raise £2.5 billion from a mansion tax, clamping down on tax avoidance and a levy on the tobacco companies to fund more GPs, nurses, midwives and homecare workers to transform services, particularly in the community. We will support carers with new duties on the NHS to identify family carers, a single point of contact for information and services and ring-fenced funding for carers’ breaks. Our plan for whole-person care would ensure the full integration of physical and mental health and social care services into one service with one team to meet all of a person’s needs.

At the next election, there will be a real choice on the NHS: a choice between care going backwards and money wasted under the Conservatives or Labour’s plans to fully join up services to get the best results for patients and the best value for money. It will be a choice between the Conservatives who have broken their promises to protect the NHS, throwing the system into chaos and blaming staff, or Labour who will make the real reforms we need so that people get personalised care in the right place at the right time. It will be a choice between the Conservatives’ unfunded plans to cut taxes for the wealthiest or Labour’s fully funded plans to reform the NHS and care services on which we all rely. I commend the motion to the House.

Oral Answers to Questions

Debate between Jeremy Hunt and Liz Kendall

Tuesday 10th June 2014 Commons Chamber

[Mr Hunt]

First, I thank the hon. Gentleman for the work that he does locally, in particular with people such as James Titcombe, who has campaigned extensively to improve the quality of care at Morecambe Bay. I assure the hon. Gentleman that whatever the problems are at Morecambe Bay, we will be transparent and open, and we will make sure that we deal with them promptly. That is why we have had these independent inquiries. We will look closely at what the report says and make sure that we act quickly.

[Liz Kendall (Leicester West) (Lab)]

The College of Emergency Medicine says that the use of agency doctors has become endemic in the NHS, and that hospitals are increasingly relying on more expensive agency nurses, just as Labour warned when jobs and training places were cut. It is clear that NHS finances are going backwards under this Government. Will the Minister now confirm Monitor’s latest figures, which show that annual spending on agency staff in foundation trusts has soared to £1.4 billion, a staggering 150% higher than trusts planned at the beginning of the year, and will he explain how that makes any financial sense?

[Mr Hunt]

Let us look at why the number of agency nurses has increased. It is because trusts have responded to the Francis report, published just over a year ago, and are seeking to end the shocking under-staffing of wards that was endemic under the last Labour Government. Of course we want people to recruit full-time nurses on proper contracts, and that is happening. That is why we have 3,000 more nurses—not agency nurses, but proper full-time nurses on proper NHS contracts—than when the hon. Lady’s Government were in power, and we will continue to make progress.

Oral Answers to Questions

Debate between Jeremy Hunt and Liz Kendall

Tuesday 1st April 2014 Commons Chamber

[Liz Kendall (Leicester West) (Lab)]

The Government’s damaging reorganisation has weakened the grip on NHS finances. Figures slipped out the day after the Budget show that NHS hospitals are in deficit for the first time in eight years, hospital trust deficits are three times higher than they were a year ago and twice as many foundation trusts are in the red. Will the Secretary of State now commit to publishing the final year-end figures for all hospitals in one annual account so that the House can hold him to account for his mismanagement of public money?

[Mr Jeremy Hunt]

It is financially challenging for the NHS, but we will not lose control of NHS finances, as happened under Patricia Hewitt. I remind the hon. Lady that for nine of Labour’s 13 years in office the NHS trusts sector as a whole was in deficit. We are getting a grip of those problems. We will publish the figures she wants, but the reason it has been particularly challenging this year is that hospitals have responded to the Francis report and hired 3,500 additional nurses to ensure that we have proper care on our wards.

Oral Answers to Questions

Debate between Jeremy Hunt and Liz Kendall

Tuesday 26th November 2013 Commons Chamber

[Mr Hunt]

My hon. Friend knows that the funding arrangements are decided independently of the Government, by NHS England, which will make its decision at a board meeting before Christmas. He is absolutely right to suggest that the funding formula should reflect not only social deprivation but the age profile of constituents, because the oldest people are of course the heaviest users of the NHS.

[Liz Kendall (Leicester West) (Lab)]

The Health Secretary claims that he wants the NHS to be the best in the world at looking after the elderly. Nice rhetoric, but the reality is that we now have the highest-ever number of elderly people trapped in hospitals because they cannot get the health and social care they need at home. We now have the equivalent of five hospitals full of elderly people who do not want to be there, and that is costing the taxpayer £20 million a month. Is not the truth that care of the elderly is getting worse, not better, on his watch?

[Mr Hunt]

The truth is that the previous Government had 13 years to integrate the health and social care systems, but they failed. We are doing that, and we are also providing named GPs to the most vulnerable people, so that, hopefully, they do not have to go to hospital in the first place. That is doing a lot more for older people than the hon. Lady’s Government ever did.

Managing Risk in the NHS

Debate between Jeremy Hunt and Liz Kendall

Wednesday 17th July 2013 Commons Chamber

[Mr Hunt]

My right hon. Friend makes an important point. There are many locums who work extremely hard and are very committed. However, it is true that one feature of a number of the failing hospitals in yesterday’s report was that they had a high proportion of locum staff. It is harder to build up a sense of teamwork if there is a huge turnover in the people working in NHS organisations, and I know that many will reflect on that.

[Liz Kendall (Leicester West) (Lab)]

Will the right hon. Gentleman give way?

[John Pugh (Southport) (LD)]

Will the right hon. Gentleman give way?

Oral Answers to Questions

Debate between Jeremy Hunt and Liz Kendall

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

I am pleased the 111 service worked more satisfactorily in my hon. Friend’s case. NHS England is working on the funding formula and it hopes to make any necessary changes in time for the next funding round, which starts in April 2014.

[Liz Kendall (Leicester West) (Lab)]

Ministers were repeatedly warned about problems with their 111 roll-out by the Royal College of Nursing, the British Medical Association, the Ambulance Service Network and private providers, but they ploughed on regardless. The result was patients left waiting hours for call-backs, more ambulances sent out and more pressure on already struggling A and Es. I am sure the Secretary of State is aware of the pattern of the seasons, so if he wants to avoid another A and E crisis this winter, can he explain why Bruce Keogh’s review of urgent and emergency care will not even report until next spring?

[Mr Hunt]

Actually, the hon. Lady is wrong, because Bruce Keogh’s review of urgent and emergency care with respect to vulnerable older people, and particularly with respect to the way the 111 service operates, will report this autumn, precisely so that we can make sure we learn any lessons we need to learn for this winter, and it is very important that we should do so.

Oral Answers to Questions

Debate between Jeremy Hunt and Liz Kendall

Tuesday 11th June 2013 Commons Chamber

[Mr Hunt]

My hon. Friend makes an important point. Talk to any A and E department in the country, and they will say that poor alternatives in the primary care sector are one of the things that are driving the pressures on them. It is important that we look at the structures put in place by the 2004 GP contract to see whether they are the right way to provide the care we need to give to older people.

[Liz Kendall (Leicester West) (Lab)]

Last week, the Select Committee on Health took expert evidence on the increased pressures in emergency departments and the causes of the worst A and E crisis in a decade. On Wednesday, the Chair of the Committee told this House that the 2004 GP contract

“is not why those pressures exist.”—[Official Report, 5 June 2013; Vol. 563, c. 1605.]

Will the Secretary of State tell us whether the right hon. Member for Charnwood (Mr Dorrell) is wrong?

[Mr Hunt]

I advise the hon. Lady to listen more carefully to what the Chair of the Select Committee said. He actually said that he agreed with much of what I said on the GP contract. While the Opposition are defending the status quo of the 2004 contract, independent support for reforming primary care is coming from the College of Emergency Medicine, the Royal College of Physicians, the NHS Alliance, the Family Doctor Association and even the head of the Royal College of General Practitioners.

NHS Funding

Debate between Jeremy Hunt and Liz Kendall

Wednesday 12th December 2012 Commons Chamber

[Liz Kendall (Leicester West) (Lab)]

During this debate, Ministers and the few Government Members who have spoken have either denied that the Government have broken their promise to increase NHS spending or have claimed that it does not matter, as if the Prime Minister’s clear, direct and personal pledge to voters can easily be swept to one side. They—perhaps with the exception of the hon. Member for Southport (John Pugh)—have also skated over or ignored the waste, confusion and utter distraction of their back-room NHS upheaval.

In contrast, Opposition Members have talked about the harsh reality of the double whammy of cuts and reorganisation on their constituencies. My hon. Friend the Member for Lewisham East (Heidi Alexander), my right hon. Friends the Members for Lewisham, Deptford (Dame Joan Ruddock) and for Rother Valley (Mr Barron), my hon. Friends the Members for Corby (Andy Sawford), for Bolton West (Julie Hilling) and for Easington (Grahame M. Morris), and the hon. Member for Strangford (Jim Shannon) spoke powerfully about their concern that changes to local services are being driven by money alone, not by improving patient care. I also pay tribute to my right hon. Friend the Member for Cynon Valley (Ann Clwyd), who spoke with bravery and compassion about the unacceptable standards of care in parts of the country, which must be tackled.

Perhaps the most worrying example of the combination of cuts and reorganisation that the Government are forcing through involves what is happening to cancer networks. Those groups of local specialists were set up more than a decade ago under Labour’s 2000 cancer plan to help tackle one of Britain’s biggest killers. It is widely acknowledged that cancer networks have played a central role in improving mortality rates, cancer survival rates and equality of cancer care, and they have done that on small budgets with few staff, offering good value for taxpayers’ money. Crucially, the specialist local skills of cancer networks are vital to making even greater improvements that cancer patients need and deserve in the future.

Ministers have repeatedly promised to protect budgets for cancer networks. On 31 January last year, the then Health Secretary told the House that

“cancer networks funding is guaranteed during the course of 2011-12.”—[Official Report, 31 January 2011; Vol. 522, c. 612.]

On 27 November this year in a debate on the NHS mandate, the new Health Secretary told the House:

“Cancer networks are here to stay and their budget has been protected.”—[Official Report, 27 November 2012; Vol. 554, c. 127.]

Those promises have been broken.

In response to a freedom of information survey from Labour, cancer networks report budget cuts of 13% in 2011-12 alone—[Interruption.] The Secretary of State shakes his head but he can look through all the figures, including individual examples, if he wants to see those cuts. In total, budgets have been slashed by 26%—by a quarter—since the Government came to power.

The Government’s national cancer director, Professor Mike Richards, at least has the honesty to say that

“cancer networks will have a smaller proportion of the budget in future.”

I understand that the Health Minister in the House of Lords, Earl Howe, has also been forced by an urgent question to admit that less money will be available to cancer networks.

[Mr Jeremy Hunt]

Will the hon. Lady give way?

[Liz Kendall]

I will, of course, give way to the Secretary of State.

[Mr Hunt]

First, these networks are brilliant. They are a good thing and they have done a huge amount. The Government support them and we are expanding them. That is why instead of just having cancer, cardiac and stroke networks, we will also have networks for dementia and maternity. The budget for those networks is going up by 27%.

[Liz Kendall]

The budget for cancer networks has been cut by a quarter. The Secretary of State is not expanding those networks but merging them and diluting their specialist expertise, as I will show. The cuts and the Government’s NHS upheaval mean that cancer networks have lost one fifth of their staff, withdrawn or scaled back current work, and put future projects on hold—[Interruption.] The Secretary of State is still denying that so let me tell him what the networks actually say.

The Arden cancer network in Coventry and Warwickshire says that it has lost its vital chemotherapy nurse. The Peninsula cancer network in Devon and Cornwall says it has had to turn down £150,000 from Macmillan Cancer Support to fund a programme for cancer survivors because its future is so uncertain. Essex cancer network says that posts have been removed, its staff are in a redeployment pool, and that it will have

“no presence in Essex from April 1st next year.”

Instead of supporting those vital local experts, as well as specialists in heart and stroke networks, the Government are merging them into 12 generic clinical networks that cover bigger geographical regions and far more health conditions. No one is against sharing the skills and experience of cancer and cardiac networks. However, as Maggie Wilcox, a former palliative care nurse, breast cancer patient, president of Independent Cancer Patients’ Voice and the layperson on the recent review by the Department of Health into breast screening said,

“subsuming cancer networks into generic clinical networks could be disastrous for cancer patients…you cannot be both a specialist and a generalist.”

That is especially important in an area as complex and fast-developing as cancer. Staff will not be able to make the same depth or scale of improvements if they are forced to cover a large area and more conditions with fewer members of staff.

The Secretary of State ploughs on regardless, denying that there is a problem and telling BBC Radio 5 Live that it is too early to know what will happen. How utterly complacent and out of touch. Networks are already disappearing. Their staff have left or are looking for jobs because their future is in such disarray. With their reckless NHS reorganisation, the Government have wasted not just taxpayers’ money but the knowledge and expertise of specialist staff, and patients are paying the price.

[Mr Hunt]

With respect to the hon. Lady, we have increased the budget for strategic networks by 27%. What would have happened to that budget if we had a lower NHS budget, as her party’s Front Benchers have been arguing for?

[Liz Kendall]

I do not think the Secretary of State understands that in a really complex and fast-developing area such as cancer, we need to know about individual, specific issues and concerns. If there are fewer staff covering bigger areas and more health conditions, we will not get specialist expertise.

If the Secretary of State does not believe me, perhaps he would like to comment on what Dr Mick Peake, the clinical lead for NHS cancer improvement and the national cancer intelligence network, has said. He has stated:

“With the shift towards GPs commissioning, the need for this expert…clinical advice will become ever more crucial…I am worried that in the process of reorganisation of the networks…we will lose many expert and very committed individuals, and that this could impact on the quality of commissioning and cancer services in the future.”

What will be the impact on patients, who are what the network is supposed to be about? Let us take prevention. Who has championed prevention by increasing the uptake of screening programmes? Cancer networks. Who trains GPs to spot the signs of cancer so that patients get earlier diagnosis? Cancer networks. Who has helped patients get their tests and scans done in days, not months, and slashed waits for cancer specialists to two weeks? Who has helped hospitals compare their performance, use the best drugs and treatments and transform patient information and support, and who has been central to setting up the new national cancer outcomes database, which the Government rightly say will help reduce cancer variations and drive improvements in future? Cancer networks. So why is the Secretary of State diluting—[Interruption.] Oh, now he switches to talk about the cancer drugs fund, because he knows that by stripping away vital local expertise, he is putting care at risk.

When the Secretary of State tells Radio 5 Live that he does not know why Labour is flogging this issue, calls cancer networks a mere pilot and says that his upheaval will be in patients’ best interests, cancer specialists, patients and Opposition Members know that he is wrong. We know that he cannot sustain the progress on cancer and make even more improvements in future when he is ripping away the foundations of better cancer care. As Earl Howe has just told Members of the Lords, it is “perfectly correct” that the share of the pot that cancer networks will be able to get will be smaller next year than it is this year. I rest my case.

The Prime Minister said that he would increase spending on the NHS, but NHS spending is lower in real terms today than it was when Labour left office—broken promise No. 1. Health Ministers repeatedly claim that they have protected cancer network budgets—broken promise No. 2. No top-down NHS reorganisation, mental health a priority and social care budgets protected—broken promises three, four and five. The list goes on. The Prime Minister claims that his priority can be summed up in three letters—NHS. That very same organisation is responding with its own three letters—SOS. I commend the motion to the House.

Oral Answers to Questions

Debate between Jeremy Hunt and Liz Kendall

Tuesday 27th November 2012 Commons Chamber

[Mr Hunt]

Proud as we are of the cancer drugs fund, to hear such stories is extremely distressing, and our first thoughts are with the family of my hon. Friend’s constituent. We will of course look into the issue she raises, which is a cause of great concern. I know that the Under-Secretary of State for Health, my hon. Friend the Member for Broxtowe (Anna Soubry), is a neighbouring MP and would be happy to meet her to discuss the matter.

[Liz Kendall (Leicester West) (Lab)]

The reality is that the Government are ripping away the foundations of better cancer care. The former Health Secretary made a clear promise from the Dispatch Box to protect cancer network funding, but the NHS South East London and greater midlands cancer networks both say that their budgets and staff have been slashed. The NHS medical director, Sir Bruce Keogh, says that cancer networks are an NHS success story, and Macmillan Cancer Support says it is nonsensical to cut their specialist expertise. Why do the Government not agree?

[Mr Hunt]

Cancer networks are here to stay and their budget has been protected. They are extremely important. The hon. Lady uses hyperbolic phrases such as “ripping away the foundations of better cancer care”, so perhaps she would like to talk to the 23,000 people who have benefited from the cancer drugs fund that her Government failed to introduce.