Defending Public Services

Debate between Jeremy Hunt and Nicholas Dakin

Monday 23rd May 2016 Commons Chamber

[Mr Hunt]

We need extra legislation to expedite the process. I point out to my right hon. Friend that that is another policy which has been opposed by the Labour party. All the time it says we should be doing more to get a grip on NHS finances and yet it opposes every policy we put forward in order to do precisely that. The answer to his question is that the issue with the NHS is primarily that we are not very good at collecting the money to which we are entitled from other European countries, because we are not very good at measuring when European citizens are using the NHS. This legislation will help us to put those measurement systems in place so that we can get back what we hope will be about half a billion pounds a year by the end of this Parliament.

We will no doubt hear later this afternoon the charge that the Government have lost control of NHS finances, but we strongly reject that charge. The House may want to ask about the credibility of that accusation from a party that is at the same time proposing a funding cut for the NHS and criticising the difficult decisions we need to take to sort out NHS finances.

[Nic Dakin (Scunthorpe) (Lab)]

Two months into this financial year, can the Secretary of State say whether or not the Department of Health broke its budget for last year?

[Mr Hunt]

We will find out those figures when the full audit is complete. I just say to the hon. Gentleman that efficiency savings are never easy, but a party with the true interests of NHS patients at heart should support those efficiency savings, because every pound saved by avoiding waste is one we can spend improving patient care.

Let me therefore outline to the House what we are doing to deliver those efficiencies, as well as to support NHS trusts to return to financial balance. First, we are taking tough measures to reduce the cost of agency staff, including putting caps on total agency spend and limits on the rates paid to those working for agencies. So far, that has saved £290 million, with the market rate for agency nurses down 10% since October and with two thirds of trusts saying that they have benefited. Our plan is to reduce agency spend by £1.2 billion during this financial year. Secondly, we are introducing centralised procurement under the Carter reforms. Already 92 trusts are sharing, for the first time, information on the top 100 products they purchase in real time, and we expect savings of more than £700 million a year during this Parliament as a result. Thirdly, given that the pay bill is about two thirds of a typical hospital’s costs base, we are supporting trusts to improve on the gross inefficiency of the largely paper-based rostering systems used at present. This should also significantly increase flexibility and the work-life balance for staff, as we announced last week. Finally, and perhaps most critically, we will reduce demand for hospital services by a dramatic transformation of out-of-hospital care, as outlined in the five-year forward view. If we meet our ambitions, we will reduce demand by more than £4 billion a year through prevention, improved GP provision, mental health access and integrated health and social care.

Junior Doctors Contract

Debate between Jeremy Hunt and Nicholas Dakin

Thursday 19th May 2016 Commons Chamber

[Mr Hunt]

Yes, I am happy to do that, and I thank my hon. Friend for a lot of his correspondence. The principle here is that junior doctors want to know that there is someone independent they can appeal to if they think they are being asked to work hours that are unsafe and which mean that they cannot look after patients in the way that they would want to because they are physically or mentally too exhausted. We would all want to make that possible, but it means that they need to have someone who is not their line manager. They will go to their line manager in the first instance, but they need to have someone independent and separate. One area where we have made the most progress during the past few months, even before the past 10 days of talks, is on establishing how these guardians can work in a way that has the trust of both the hospitals and the doctors working in them.

[Nic Dakin (Scunthorpe) (Lab)]

The Secretary of State is absolutely right that we can always get further if we get round the table, so why, in response to the cross-party initiative back in February to get everybody around the table, did he not do exactly that and save us all this trouble, rather than trying to impose the contract?

[Mr Hunt]

The cross-party initiative was not to have a new contract, but to abandon plans for a new contract and to have pilots in a few limited places. If we had followed that advice, we would not now have agreed with the BMA the biggest changes in the junior doctors contract for 17 years. Our goal was to get the agreement that we secured yesterday—safer care for the NHS and a better deal for doctors. That was what we achieved, and we would not have got there if we had listened to that advice.

Junior Doctors Contracts

Debate between Jeremy Hunt and Nicholas Dakin

Monday 25th April 2016 Commons Chamber

[Mr Hunt]

I think many people inside and outside the medical profession are deeply upset that that is happening. I really enjoyed my visit to my hon. Friend’s constituency, and we will continue to invest in his local health services. I think that his constituents will be upset by the fact that the pay and conditions many of them have for working at weekends go nowhere near what is being offered to junior doctors under the new contract. In that sense, it is totally disproportionate to withdraw emergency care, which is such an extreme measure and has never happened before.

[Nic Dakin (Scunthorpe) (Lab)]

I welcome the Secretary of State’s recognition that junior doctors are the backbone of the NHS and his expression of willingness to talk about the implementation of the contract. Those words are great, but I urge him to take actions to match them and take the opportunity of the cross-party initiative to pilot this contract. If he does not do that and ploughs on regardless, he will jeopardise patient safety.

[Mr Hunt]

I welcome any genuine attempt to try to resolve this issue, but Health Education England has said that it does not believe that that cross-party approach is workable. As I have said to the hon. Gentleman before, having pilots of seven-day care and new junior doctor contracts would mean that we took too long to deliver a key manifesto promise.

Junior Doctors Contracts

Debate between Jeremy Hunt and Nicholas Dakin

Monday 18th April 2016 Commons Chamber

[Mr Hunt]

We do have that power by law. The letter we put out in defence against the legal action that has been taken against the Government explains very clearly why and how we have that power. It is all written there for the hon. Gentleman to see. I assure him that, on something as contentious and difficult as this, we take every care to make sure that we are acting within the law.

[Nic Dakin (Scunthorpe) (Lab)]

If I were Secretary of State for Health, I would feel personally responsible for this unprecedented action taking place on my watch, and I would do everything I could to build bridges to make sure it did not happen and that patients were not threatened in the way we all fear. What is the Secretary of State doing to build trust between himself and the NHS workforce?

[Mr Hunt]

I will tell the hon. Gentleman one of the things we are doing, which is turning around the hospital in his own constituency, which is no longer in special measures because the quality of care has improved dramatically. What else are we doing? Over three years, there have been 75 meetings, 73 concessions and three different independent processes. We have tried everything to get a negotiated outcome, but in the end we have to do the thing that is right for patients.

William Mead: 111 Helpline

Debate between Jeremy Hunt and Nicholas Dakin

Tuesday 26th January 2016 Commons Chamber

[Mr Hunt]

I do agree that we need more clinicians in primary care. We also need to invest in secondary care, which is why the hon. Lady has a new A&E centre opening in Hull, which I am sure she welcomes. We need more clinicians in primary care so that we can deal with these issues more quickly, before people need hospital care and to spot conditions such as sepsis. This Government are investing £10 billion in the NHS annually in real terms in order to step up the improvement in the services that we offer.

[Nic Dakin (Scunthorpe) (Lab)]

So will the Secretary of State put a higher proportion of clinicians in 111?

[Mr Hunt]

We will certainly look at whether we need to have more clinicians in 111. We do have clinicians available in 111. My own view is that it is the separation of the out-of-hours services and the 111 service that is at the heart of the problem that we are looking to deal with, but as part of the review we will look at the availability of clinicians in 111.