NHS and Social Care Funding

Debate between Jeremy Hunt and Lord Walney

Wednesday 11th January 2017 Commons Chamber

[Mr Hunt]

I will give way a couple more times, and then I am going to conclude my comments.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

As the Government often point out, they want to hand decisions to local groups, but could the Secretary of State explain to worried patients in the south and west of Cumbria why local health services are suggesting the changes to A&E in the west and potentially the south? I know he has spent a lot of time looking at this area.

[Mr Hunt]

First, I would like to use this moment to congratulate the hon. Gentleman’s local trust on coming out of special measures last year and on the progress it is making. In a way, that is the answer to his point. His local trust was in special measures, and North Cumbria is still in special measures. We had some profound worries about patient care in both trusts, and we still do in the North Cumbria trust. That is why the status quo is not an option, but we understand the concerns of his constituents and many others about some of the proposals being made.

Mental Health and NHS Performance

Debate between Jeremy Hunt and Lord Walney

Monday 9th January 2017 Commons Chamber

[Mr Hunt]

With respect to the hon. Lady, who I know cares passionately about the NHS and often asks me questions about it, we now have 11,400 more doctors and 11,200 more nurses in the NHS than in 2010. We protected the NHS budget in 2010, when her party wanted to cut it, and we promised £5.5 billion more for the NHS than her party was prepared to promise at the most recent election. Her characterisation of this Government as not being prepared to back NHS staff is utterly absurd.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

The Prime Minister’s focus on mental health today is welcome, but does the Secretary of State accept that we will achieve parity of esteem only if we are prepared to accept how far we currently are from it? It is not a recent problem: the lack of recognition for mental health dates back to the inception of the national health service and is driven by our culture and choices as a country, rather than by any particular Government. Nevertheless, does the Minister accept that even the measures set out today, each of which is welcome in and of itself, will only really provide a sticking plaster for the problem? As it stands, on current progress, we are looking at having to wait decades before we achieve parity of esteem for mental health conditions.

[Mr Hunt]

I thank the hon. Gentleman for his interest in that issue. Sometimes, this is a challenging area. We legislated for parity of esteem, with cross-party support, in 2012. The danger is that such a concept can be nebulous, which is why we asked Paul Farmer, the chief executive of Mind, to look independently at what would be reasonable, fair and sensible progress towards parity of esteem by 2020. He said that he thought it would be a 10-year process, but that this was the right ambition for 2020. It was his report that the Prime Minister accepted this morning. We are making progress against benchmarks that independent people have looked at. The hon. Gentleman is right to say that we will not get there by 2020, but we must make sure that we deliver on that commitment while he and I are both MPs.

CQC: NHS Deaths Review

Debate between Jeremy Hunt and Lord Walney

Tuesday 13th December 2016 Commons Chamber

[Mr Hunt]

I absolutely do so. I know that the family of David Hinks have campaigned very strongly on this matter. The key point about families is that they are often the people who know best what happened to individuals when something went wrong, because they saw the care at every single stage. Whether the care took place in a care home, hospital or a GP surgery, families are likely to have seen the whole thing, and can really help us to understand what might have gone wrong. They are therefore a positive force in this process.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

I am so pleased that the Secretary of State took the time to praise James Titcombe and other campaigners in my constituency who have done so much to help to break down the culture of secrecy and cover-up that has afflicted too many of our trusts. The right hon. Gentleman deserves real credit for his determination, and I hope that the tone he has struck today will last and that we do not go back to the accusatory and vindictive tone that, I am afraid, too often marred discussions about this during the last Parliament. Finally—thank you for your indulgence, Mr Speaker—will the Secretary of State say more about the tension between the families’ desire for individual accountability and the need to encourage a culture of openness in which people can come forward?

[Mr Hunt]

In fairness to the hon. Gentleman, he makes two important points. I know that he worked very closely with James Titcombe, who is one of his constituents.

We are now learning the right way to deal with the tension between accountability and having a learning culture. Essentially, this boils down to an understanding that 98% of the time a mistake is made because of a systems problem—a structure or a framework that did not enable a doctor or a nurse to operate to the best of their ability—while 2%, 1% or perhaps even less of the time it is a case of genuine negligence by an individual that deserves full accountability. When we understand it in that way, we start to realise that the first thing to ask is what could be changed in the system, but if we uncover bad behaviour by individuals—there are 1.3 million people in the NHS, so it is obviously going to happen at some stage—then there of course needs to be full accountability.

On the tone of these exchanges, let me say something optimistic: I really do believe that the NHS can become the safest, highest-quality healthcare system in the world. That would be welcomed by the Labour party, as the party that was in power when the NHS was set up, and we would welcome it as part of our absolute commitment to higher standards in public services. There is no country in the world that is even considering what we have announced today, which is to ask hospitals to publish the number of their avoidable deaths on a quarterly basis. It is a very big step that can happen in a system built around public service.

Social Care

Debate between Jeremy Hunt and Lord Walney

Wednesday 16th November 2016 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. Although this afternoon’s debate is about the social care system, the sustainability and transformation plans are a critical part of the long-term solution for financial efficiency and for improving the quality of care.

I congratulate the hon. Member for Worsley and Eccles South (Barbara Keeley) on introducing this debate, which is the first Opposition day debate that she has led. I also pay tribute to the fact that she has had a long-standing interest in these issues. She has asked me questions about the social care system on many occasions. She was particularly right to focus on the impact on the NHS, which is real, and on the impact on family carers, which is also real. She talked about Susan and about the impact on people who are finding that they are giving more hours of care than they were planning or are sometimes even able to give. That is something of which we must all be aware. She asked me to answer a direct question: do I recognise the scale and seriousness of the issues faced by the social care system? The answer is, yes, I do. I want to try to address, as comprehensively as I can, some of the substantive issues faced in the social care system.

Let me start by saying that, although today’s debate and the majority of the hon. Lady’s comments were around funding, the issue is not only about funding. The hon. Member for Chesterfield (Toby Perkins) mentioned that social care is not just about older people. In 2011, we had the shock of what was uncovered at Winterbourne View by a BBC “Panorama” programme. We have had a number of examples of horrific abuse at care homes. The Ash Court Care Home case in Kentish Town was one that came to light in 2012. The abuse there was filmed by a relative on a hidden camera. Those issues were primarily not about funding, but about cruelty—a strong word—that we have tolerated in our system. We have had some very significant policy responses since then, which are making a real difference. The first is that this Government, under the coalition, introduced the toughest system of care home inspection in the world.

We often talk in this House about the work of the chief inspector of hospitals, but I wish to pay tribute today to the work done by the chief inspector of adult social care, Andrea Sutcliffe, and her team. She has completed the inspection of nearly 90% of care homes and domiciliary care services. It is encouraging that, despite the pressures that we have been talking about this afternoon, 72% of the places that she inspected were good or outstanding. More importantly, the 28% that are not are the 28% that we know about and are therefore able to do something about.

I take issue with the way the shadow Health Minister presented her findings. She said that a quarter of the inadequate places were unable to improve following re-inspection. However, the reality is that more than three quarters of places that got an inadequate inspection did improve, which is a huge step forward from where we were a few years ago when we did not know where those places were and when there was no change happening at all.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

The Secretary of State is right to highlight the need to improve standards and the need for a rigorous inspection regime, but—taking on board what his former ministerial colleague, the right hon. Member for North Norfolk (Norman Lamb), said—does he accept that even if every single care home in the country reached the appropriate standard, there would still be a care crisis? There is not sufficient funding in the system to make it work. Will he agree to work with all parties to do what we should have done many years ago—before the general election in 2010, as he will recall—and get a grip on the issue and, as a country and as a House, try to sort it out?

[Mr Hunt]

I am more than happy to work with people of all parties to come to a sensible consensus. The one thing that unites all the major parties is a commitment to the NHS and social care system. With respect to the other issues, it is not just about rooting out poor care. It is also about something that the hon. Member for Worsley and Eccles South mentioned earlier—giving a career structure to people who work in the care system and giving them recognition. That is why in April last year we introduced the care certificate, which is based on achieving 15 standards. It is a voluntary system, but the CQC inspects against it, so there is a strong incentive for care providers to get their staff enrolled for the care certificate. I pay tribute to the work done by Camilla Cavendish, who did a lot of thinking and had a long-standing interest in this issue in her time as a journalist and at No. 10, and on whose proposals we are basing our work in this area.

Junior Doctors Contracts

Debate between Jeremy Hunt and Lord Walney

Monday 25th April 2016 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for what she says about consultants in her local trust and, indeed, up and down the country, as well as nurses, paramedics and many other people who will be working to keep the public safe. I salute all of them. She is absolutely right: those leaked emails show that those on the junior doctors committee know that had they been prepared to negotiate on Saturday pay we would not have had an imposed contract, so it was completely in their hands to avoid this outcome. They chose not to do that; they wanted war. That was a totally irresponsible thing to do. They need to recognise that the way we will build a safer NHS is by sitting round and talking to a Government who want to create it.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

Why does the Secretary of State suspect the motives of his former ministerial colleague, the hon. Member for Central Suffolk and North Ipswich (Dr Poulter)? Why has he taken to Twitter to accuse him of political opportunism?

[Mr Hunt]

My hon. Friend—the one Conservative who signed up to that proposal—when he was Health Minister proposed a contract that was much tougher on junior doctors than the contract we have ended up introducing. This has been a very interesting U-turn on his part.

NHS: Learning from Mistakes

Debate between Jeremy Hunt and Lord Walney

Wednesday 9th March 2016 Commons Chamber

[Mr Hunt]

I feel prompted by my hon. Friend’s question to investigate what I am sure is excellent practice at St John of Jerusalem eye hospital. If I may, I will take away her very good point about exit interviews. We also heard a good point about agency staff. Part of the thing that inhibits a learning culture is if a large percentage of staff are in an organisation only on a provisional or temporary basis, rather than being part of regular teams and therefore not being able to transmit lessons learned. That is why we have to deal with the virus of an over-reliance on agency staff in some parts of the NHS.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

May I gently ask that the Secretary of State, if he is going to list Morecambe Bay in a litany of things to bash the previous Government over the head with, to do so while also acknowledging that the situation continued for some time under his Government and is still taking some time to turn around?

I wholeheartedly welcome the Secretary of State’s focus on patient safety and his overall approach, and I pay tribute again to the Morecambe Bay campaigners, who have done so much to trigger this improvement. However, does he share my concerns about trusts such as Morecambe Bay being forced, for a number of reasons, including for safety, to use a large number of agency staff, and about the difficulty in changing culture when that staffing situation persists?

[Mr Hunt]

Let me commend the staff at Morecambe Bay, who have been through a very difficult patch. The trust has now exited special measures, which is a very exciting step for the trust, and there has been a huge amount of work to make that possible. It feels to me that they really have turned a corner at Morecambe Bay, and we should support the staff, who have done a great job in that respect.

The hon. Gentleman raises an important point about agency staff. In particular, it is challenging to get permanent recruitment to more geographically isolated places—we find that that is a problem not just at Morecambe Bay, but across the country. However, sometimes, it can be false comfort to get in large numbers of agency staff, as not only are they extremely expensive, but they cannot offer the continuity of care that is at the heart of a safer culture, so we have to find better ways to support places such as Morecambe Bay further to improve safety.

NHS Reform

Debate between Jeremy Hunt and Lord Walney

Thursday 16th July 2015 Commons Chamber

[Mr Hunt]

The truth is that all hospitals have been moving in this direction in the past five years in different ways. My hon. Friend is absolutely right to say that, to make sure we deliver on our manifesto commitment, we will be doing a full and comprehensive audit of which people are delivering which types of services. It is partly about senior consultant cover, which we are talking about today, partly about seven-day diagnostic services, partly about handover, and partly about mental health and many other standards, but, yes, that work is being done.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

The Secretary of State was unclear before. May I say that, as far as I am concerned, Labour Members are absolutely in favour of measures that will increase safety at the weekend, and that my party will never prosper as a mouthpiece for the British Medical Association? Is he not concerned that the porters and nurses, who are being asked to swallow a decade-long real-terms pay cut, will not be able to deliver such change given the level at which they are being demoralised?

If you will permit me, Mr Speaker, may I also say that I very much welcome the full acceptance of the recommendations of the Morecambe Bay inquiry? Will the Secretary of State ensure that the families will remain fully involved in ensuring that these measures are implemented, as well as accepted, by Government?

[Mr Hunt]

Of course. The hon. Gentleman has liaised very closely with the Morecambe Bay families over the period of the inquiry. I am happy to give him the assurance that they will remain closely involved.

I am very pleased that the hon. Gentleman says he does not want his party to be the mouthpiece of the BMA, but if that is the case, it needs to get behind the proposals that the Government are making today and say it supports them. We have not heard that from his party and that is what the public want to hear.

Health and Social Care

Debate between Jeremy Hunt and Lord Walney

Tuesday 2nd June 2015 Commons Chamber

[Mr Hunt]

The hon. Lady is right. This week we saw the results of the international cancer benchmarks study, which showed that our GPs take longer than GPs in Norway, Sweden, Canada and Australia to diagnose cancers, and we still have a survival rate that lags. This needs urgent attention. The chief executive of Cancer Research UK is putting together a cancer strategy for the Government that I hope will address this issue. We will bring the results of that to the House.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

Does the Secretary of State accept that the Better Care Together report on future services in Morecambe Bay put precisely that innovative focus on primary care and prevention, but that recognition of Morecambe Bay’s unique geography and extra funding are needed to implement it? The right hon. Gentleman said that he was sympathetic to that before the election. Has he now concluded that it is the way forward?

[Mr Hunt]

I understand that geographical isolation is a particular issue and may have led to some of the problems at the trust that the hon. Gentleman and I have discussed on many occasions. We need to be sensitive to that in helping the standard of services to improve going forward.