Oral Answers to Questions

Debate between Jeremy Hunt and John Bercow

Tuesday 21st March 2017 Commons Chamber

[Mr Hunt]

Let me just tell the hon. Lady what is happening to what she says is a “drastically underfunded NHS”. In her local hospital, St George’s, we have got 36 more doctors—[Interruption.]

[Mr Speaker]

Order. The hon. Lady had a question, it was rather overlong and the least courtesy she can do the House is to listen quietly and with good manners to the reply.

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[Julie Cooper (Burnley) (Lab)]

GPs around the country are facing unprecedented pressures as they work to deliver the highest possible standards of care, despite underinvestment and increasing patient demand. A record number of GP practices closed in 2016. Are the Government really serious about addressing the problem for the sake of GPs and their patients? If so, why has the promised £16 million resilience fund not been delivered in full, when it was promised by October 2016? There is very little evidence to date of the Government delivering on any of their promises in “General Practice Forward View”, no sign of the extra £2.4 billion, no sign of—

[Mr Speaker]

Order. We have got the general drift. May I gently say to the hon. Lady that the longer the Opposition Front Benchers take, the less time there is for Back Benchers on both sides? This is becoming a worsening phenomenon. It is not only the fault of the hon. Lady, but it really must stop. It is not fair to Back-Bench Members.

[Mr Hunt]

During my time as Health Secretary, the real-terms investment in general practice has gone up by £700 million or 8%, and we are planning to increase it by 14%—£2.4 billion—over this Parliament. A lot of extra money is going in, but I recognise that there are still a lot of pressures.

NHS Shared Business Services

Debate between Jeremy Hunt and John Bercow

Monday 27th February 2017 Commons Chamber

[Tracy Brabin (Batley and Spen) (Lab)]

The Secretary of State says that he has paid people—I assume that they are GPs—to clear the backlog. How much have you paid the GPs, and do you intend to recoup that money to the NHS?

[Mr Speaker]

I have made no such payment and I have no plans to recoup anything, but the Secretary of State might have.

[Mr Hunt]

I regret to say that the £2.2 million has not gone to you, Mr Speaker, but it has been paid to GPs for the extra administrative work that needs to be done. That is fair payment for the extra time that they are taking. It is, indeed, a cost to the taxpayer, but it was the right thing to do.

Oral Answers to Questions

Debate between Jeremy Hunt and John Bercow

Tuesday 7th February 2017 Commons Chamber

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

Has the Secretary of State actually been recently to a clinical commissioning group like ours in Huddersfield, where one more duty would really break the camel’s back? We have just heard that the CCG is changing its constitution, excluding GPs and totally changing the nature of the CCG. Like most of them, our CCG is under-resourced and under stress, and asking it to do something else like this, which will be complex, difficult and perhaps impossible, will kill the poor bloody animal.

[Mr Speaker]

With reference to foreign nationals, and including a question mark at the end of the hon. Gentleman’s observations.

[Mr Hunt]

I very much hope that the extra money we raise from international visitors will help all Members of this House because it will lead to more funding for the NHS, including for Huddersfield CCG.

Mental Health and NHS Performance

Debate between Jeremy Hunt and John Bercow

Monday 9th January 2017 Commons Chamber

[Mr Speaker]

Yes, but that was then, and this is now. That was when I was a badly behaved Back Bencher like the hon. Gentleman.

[Mr Hunt]

I will try to interpret the questions in what the hon. Lady said. If she was asking whether the problems in England are similar to those in Scotland, I think that we share problems, particularly across the busy winter period. She has observed that Scotland is also failing to meet the target. She is right to say that bed capacity is absolutely critical, and that is something we have not always got right in England. There have been times when beds have been decommissioned and the alternative provision that was promised has not been made, which has big knock-on effects. When it comes to what happens in Scotland and England, I think that Scotland has gone further than England in the use of community pharmacy, which is to be commended, but England has gone further in our plans to reform and increase investment into general practice. That was what the president of the Royal College of General Practitioners was talking about over Christmas when she said that she was keen for Scotland to match the package that we have in England.

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[Mr Hunt]

I actually think that broadly the hon. Gentleman makes an important point. It is not just about decisions to downgrade or close A&E departments when there is no alternative provision; it is also about community hospitals, which are very important places for A&E departments and hospitals to step people down to. He is right to say that the NHS—[Interruption.] I am getting comments from a sedentary position. With the greatest respect, this process has been going on in the NHS for decades, and I do not think that we always got it right under both parties, but I think that he is right to say that when there are changes in provision in community hospitals, we need to ensure that we have good alternative plans.

[Mr Speaker]

In wishing the hon. Members for Morley and Outwood and for Filton and Bradley Stoke all the best in the weeks and months ahead, I call Andrea Jenkyns.

[Andrea Jenkyns (Morley and Outwood) (Con)]

Thank you, Mr Speaker. First, I echo some of the points made by the Secretary of State regarding mental health support for expectant mothers. As one myself, I have to say that the midwives have been fantastic. Right from the very first appointments at grassroots level, they mention mental health, so we are feeling the support on the ground.

I welcome today’s statement, which shows the Government’s commitment to mental health by making it a centrepiece of the agenda. One in 50 young people in Yorkshire receive care for mental health. How will the new approach address the concerns of the young people and their parents, and what measures are in place to reduce the waiting list for child and adolescent mental health services?

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[Mr Hunt]

My right hon. Friend speaks extremely wisely. I, too, think that we have to be very careful about the language we use in these situations because many vulnerable people can be frightened if we get the tone wrong. The vast majority of NHS services are performing extremely well under a great deal of pressure. His point about leadership is extremely important and one to which I have given a lot of thought. At the heart of the problem is that we do not have enough hospitals being run by doctors and nurses. Around 56% of our managers have a clinical background, compared with 76% in Canada and 96% in Sweden. To put it bluntly, doctors like to be given instructions by other doctors. Exceptional people from a non-clinical background can do it, but it is hard because doctors have many years of training and are highly experienced people. I have put in place measures to try to make it easier for more clinicians to become our managers of the future.

[Mr Speaker]

In wishing the hon. Member for Liverpool, Wavertree all the best in the period ahead, I call Luciana Berger.

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

In her speech today, the Prime Minister made a number of hard-hitting observations. She said:

“there is no escaping the fact that people with mental health problems are still not treated the same as if they have a physical ailment”.

She reported on the increase in self-harm among young people, and she told us about the shocking reality that, on average, 13 people take their life every single day in England. Given that the Conservative party has been in government for almost seven years, and that the Secretary of State has been Health Secretary for almost four of those years, who does he think is responsible for the terrible failures highlighted by the Prime Minister today?

[Mr Hunt]

I just think that is a totally inappropriate question—[Interruption.]

[Mr Speaker]

Order.

[Mr Hunt]

With great respect to the hon. Lady—she campaigns tirelessly on mental health, and she deserves great credit for that—that is the same as saying that the last Labour Government should have sorted out every single problem in mental health by 2010, and I am not standing here saying that. The truth is that we have made good progress; if she thinks that it is trivial that we are treating 1,400 more people every day for mental health conditions, she should go and talk to some of her own constituents who are getting access to mental health provision, who would not have been getting that access under the policies of the last Labour Government. We have made big strides in our mental health provision, but there is much more to do, and we are determined to do what it takes.

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[Mr Hunt]

It would be cynical if we raised hopes and had no intention of doing anything about the matter. What the Prime Minister said this morning in her speech was that this was the start of a process. She pointed to those problems and said that we will have a Green Paper to look at how we deal with them in detail, which does take some time. I hope that we will get to a position when we can deal with those problems. The hon. Gentleman is lucky to have Professor Tim Kendall working in Sheffield, as he is the NHS lead mental health psychiatrist and a specialist in homelessness, and he is helping us to shape the strategy.

[Mr Speaker]

I am grateful to the Secretary of State and to colleagues across the House.

Oral Answers to Questions

Debate between Jeremy Hunt and John Bercow

Tuesday 20th December 2016 Commons Chamber

[Mr Hunt]

I thank the right hon. Lady for her question and welcome Doncaster hospital’s aspirations and ambitions. Any final decision will obviously be a matter for the NHS and Health Education England, but it is very encouraging that it is reaching for the stars in this way. Yes, we do need to train more doctors, and I hope that the hospital can make a good contribution.

[Mr Speaker]

The constituency of the hon. Member for Bassetlaw (John Mann) was just mentioned and he came in on cue. Unfortunately, he was not within the curtilage of the Chamber at the material time. No doubt we will hear from him at a later date, to which we look forward with eager anticipation.

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[Sir Edward Leigh (Gainsborough) (Con)]

We are not going to leave the EU for two and a half years, but I want the Secretary of State to grip GP services in Lincolnshire now and to start training more doctors. The Pottergate surgery in Gainsborough is closing, potentially throwing hundreds of people out without a GP, and there is a shortage of 80 GPs against a target of 915 in Lincolnshire, and only six out of 30 training places were taken up recently. Will the Secretary of State now grip the GP services in Lincolnshire for the sake of our people?

[Mr Speaker]

Order. The hon. Gentleman has rather cheekily brushed aside the part of the question that does not suit his purposes. Only to focus on half a question is very cheeky; we will allow him to get away with it on this one occasion only.

[Mr Hunt]

I hope that I can reassure my hon. Friend about this because the reality is that we increased the number of GPs by 5% in the previous Parliament, and in this Parliament we are planning an increase of another 5,000, which will be the biggest increase in GPs in the history of the NHS, and will go along with considerable extra resources.

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[Mr Hunt]

My right hon. Friend understands these matters extremely well from his time as a very distinguished Health Minister. He is absolutely right; the truth is that we want widespread availability of A&Es but we do not serve patients best by offering identical services everywhere. That is why in the past three or four years one of the things we are most proud of is the setting up of a national network of 26 trauma centres, which has had a dramatic impact on mortality rates for the most serious cases.

[Mr Speaker]

I have just been advised by a very sagacious source that in supplementary questions and answers to this question some reference to winter is desirable.

[Jonathan Ashworth (Leicester South) (Lab)]

I associate myself with the Secretary of State’s remarks about Berlin. I wish everyone in the House a merry Christmas and I extend my best wishes for a very peaceful and joyful Christmas and new year to all NHS staff, especially those working over Christmas.

Pressures on the NHS this winter are such and the underfunding is so severe that hospitals have been ordered to close operating theatres for elective surgery over Christmas. Is this what the Secretary of State means by a seven-day NHS?

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[Mr Jeremy Hunt]

First, I absolutely commend the hon. Gentleman for standing with his constituents and championing individual cases. I will happily look into the proposed changes and how they will affect people like Zac. I assure the hon. Gentleman that when we make these changes it is to improve the services of people and his constituents; that is why we are making them.

[Mr Speaker]

Alex Chalk. Where is the fella?

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[Mr Jeremy Hunt]

I add my congratulations to those of the Speaker on the hon. Gentleman’s long service, which has included campaigning for Bolsover hospital. I simply say to him that we will look very carefully at all proposals to change the services offered. I think community hospitals have an important role in the future of the NHS, but the services they provide will change as more people want to be treated at home.

[Mr Speaker]

Thank you.

Oral Answers to Questions

Debate between Jeremy Hunt and John Bercow

Tuesday 15th November 2016 Commons Chamber

[Mr Hunt]

I know that the hon. Gentleman has only been shadow Health Secretary for a while, but may I ask him to cast his mind back to 2010, when the party that wanted to cut the NHS budget was not the Conservative party but Labour? In 2015, his party turned its back on the five year forward view and said it would increase funding not by £8 billion but by just £2.5 billion. It is not enough to found the NHS—you have got to fund it.

[Mr Speaker]

Order. These exchanges, not untypically, are taking far too long, and part of the reason for that is that the Secretary of State keeps dilating on the policies of the Labour party. If he does so again, I will sit him down straight away. [Interruption.] Order. There are a lot of colleagues who want to ask questions. We want to hear about Government policy, not that of the Opposition. I have said it, it is clear— please heed it.

[Jonathan Ashworth]

Thank you, Mr Speaker.

If everything is so rosy with the NHS’s finances, why did Simon Stevens say just a couple of weeks ago that

“2018-19 will be the most pressurised year for us, where we will actually have negative per-person NHS funding growth in England”—

in other words, that NHS spending per head will be falling? The number of patients waiting longer than four hours in A&Es has increased. The number of days lost to delayed discharge has increased. The number of people waiting more than 62 days to start cancer treatment following referral has increased. Should not the Secretary of State do his job and make sure that next week’s autumn statement delivers the money that the NHS urgently needs?

NHS Funding

Debate between Jeremy Hunt and John Bercow

Monday 31st October 2016 Commons Chamber

[Mr Hunt]

I am happy to remind the House, as my hon. Friend requests, that we inherited this situation from the Labour party in 2010. Despite that toxic legacy, the people working in the Sherwood Forest hospitals have done an incredible job of turning the trust around since it was put into special measures a few years ago. I commend them on their progress, which I hope will bear fruit and allow the trust to come out of special measures soon.

[Mr Speaker]

I would like to conclude these exchanges by 4.30 pm because there is other pressing business. If people take a long time, they are preventing their colleagues from contributing. I am sorry, but it is as simple as that.

[Derek Twigg (Halton) (Lab)]

Does the Secretary of State believe that there is a need for additional funding for adult social care over and above that which has been already allocated?

Junior Doctors: Industrial Action

Debate between Jeremy Hunt and John Bercow

Monday 5th September 2016 Commons Chamber

[Mr Speaker]

We are always grateful to the hon. Member for Worthing West (Sir Peter Bottomley) for whatever counsel he might wish to proffer, even if it is done from a sedentary position.

[Mr Hunt]

Thank you, Mr Speaker.

The shadow Health Secretary needs to recognise that working people, the people her party claims to represent, need a seven-day NHS. The vulnerable people that Labour claims to represent get admitted to hospital at the weekends, and in industrial disputes patients should always matter more than politics. The next time she meets a constituent who has suffered because of not having a seven-day service or because their operation has been cancelled because of a strike, she and her colleagues should hang their heads in shame.

The hon. Lady has used some very strong words. She used words such as “vilifying” and “demonising” in relation to the junior doctor workforce, and that is a very serious thing to say. I challenge her to find a single piece of evidence that has come from me or anyone in the Government, and if she cannot do so, she needs to withdraw those comments and apologise to the House. The fact is that the single most demoralising thing for the NHS workforce is strikes, because they entrench and harden positions, which results in people getting very angry, and it becomes much harder to find consensus.

The hon. Lady also talked about the use of statistics. She does not have to listen to what I say—and I understand, given the sparring that goes on between us, that she might not want to—but we have had eight academic studies in the past five years that describe increased mortality rates for people admitted to hospitals at weekends. Her response to this, in a phrase she used in another context, was that there was “zero empirical evidence” for a weekend effect. I would caution her on this, because taking that approach to hard data is exactly what happened at Mid Staffs, where hard evidence was swept under the carpet year after year because it was politically inconvenient. This Government will not make that mistake.

Finally, the hon. Lady said that my civil servants had apparently advised me that this policy would not work. Not at all. What happens with every Government policy, as you would expect, is that smart civil servants kick the tyres of every aspect of the policy to enable us to understand the risks involved. She did not mention the fact that the same document to which she referred actually says that we are on track to deliver the four clinical seven-day standards to 20% of the country by next April. I think that her constituents will welcome that, even if she does not. These strikes are going to harm patients, damage the NHS and make it harder, not easier, to resolve the challenges facing junior doctors. Labour has chosen political opportunity today, but we will do the right thing for patients.

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[Philip Davies (Shipley) (Con)]

I was just reading an article from earlier in the year from The Guardian newspaper, which said that Saturday working is the major sticking point in the junior doctors’ dispute. Does the Secretary of State agree that any doctor who goes on strike over premium rates of pay on a Saturday, which most people in this country do not get when they work on a Saturday, should hang their heads in shame? Will he give a commitment that he will not make any further concessions, as he has already given far too many. Is it not time to look at whether we stop doctors from going on strike altogether in the NHS, as is the case with other emergency services?

[Mr Speaker]

It may be the first occasion upon which the hon. Member for Shipley (Philip Davies) has vouchsafed to the House that he is a Guardian reader.

[Mr Hunt]

I was nervous mentioning the fact that the Government have made 107 concessions when I saw that my hon. Friend might be in the Chamber because I knew that, for him, that would be 107 too many. His broader point is absolutely spot on. The working terms and conditions for Saturdays for junior doctors in this new contract are better than they are for nurses, police officers, fire officers and for those in many other parts of the economy. That is why I think it is a fair deal that everyone should recognise and welcome.

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[Mr Hunt]

I am very surprised to hear that. If my hon. Friend wants to pass me the details, I will happily look into it. On the ground, the management of hospitals are working very closely with not just junior doctors, but BMA representatives to try to do everything they can to keep patients safe if these strikes go ahead.

[Mr Speaker]

Order. I am most grateful to the Secretary of State and to colleagues.

Finance Bill (Programme) (No. 2)

Ordered,

That the following provisions shall apply to the Finance Bill for the purpose of supplementing the Order of 11 April 2016 in the last Session of Parliament (Finance (No. 2) Bill: Programme)):

1. Paragraphs (11) and (12) of the Order shall be omitted.

2. Proceedings on Consideration shall be taken on the days shown in the following Table and in the order so shown.

3. The proceedings shall (so far as not previously concluded) be brought to a conclusion at the times specified in the second column of the Table.

NHS Spending

Debate between Jeremy Hunt and John Bercow

Wednesday 6th July 2016 Commons Chamber

[Mr Hunt]

I am very happy to do so. I have visited that hospital, where the challenges very much reflect what the hon. Member for Tooting (Dr Allin-Khan) said about links to the social care system. It was clear to me that the staff in the A&E department are working incredibly hard getting people through it, but struggling to discharge people from the hospital, which is why they were not hitting their target.

I have just been handed a note by a ministerial colleague, Mr Speaker, which I hope you will indulge me and let me read out, because I have never been handed such a note before. It says: “Apparently everyone wants to go and watch Wales play, so Whips happy if you felt you wanted to shorten your remarks.” On that basis, I will conclude by thanking the shadow Health Secretary for bringing this motion to the House and for her comments in support of it.

[Mr Speaker]

The right hon. Gentleman is not only an experienced member of the Cabinet but a very seasoned parliamentarian, and I think he is well attuned to the feeling in the House, as I am sure that other colleagues will now also be—not that I am hinting or anything.

Oral Answers to Questions

Debate between Jeremy Hunt and John Bercow

Tuesday 5th July 2016 Commons Chamber

[Mr Jeremy Hunt]

Of course, and we will take every step necessary to protect the NHS throughout the country, because it remains our most important public service. I am sure that, economically, the period ahead will be difficult, but now that we have had the argument and the British people have made their decision, it is also important that we talk up the opportunities from the new relationships that we may have in the future, and the extra funding that those could generate for the NHS, and I certainly hope that that is what happens.

[Mr Speaker]

Last, I call Mhairi Black.

Junior Doctors Contracts

Debate between Jeremy Hunt and John Bercow

Monday 25th April 2016 Commons Chamber

[Mr Hunt]

All I would say is that every medical college agrees with me that doctors should not withdraw emergency care in tomorrow’s strike, because, as one of my right hon. Friends said, this is a line the medical profession has not crossed before. I do not think it should cross it tomorrow either.

[Mr Speaker]

May I say, on behalf of Members on both sides of the House, how good it is to see the hon. Member for Bristol West (Thangam Debbonaire) back in her seat and, I hope, now in very good health?

Junior Doctors Contracts

Debate between Jeremy Hunt and John Bercow

Monday 18th April 2016 Commons Chamber

[Mr Hunt]

That is a truly desperate attempt to divert attention from the single biggest question that people in this House want answered: does the Labour party support or not support a strike that will see the care of thousands of people up and down the country suffer?

Let me answer the hon. Lady’s question very directly. Yes, we are imposing a new contract, and we are doing it with the greatest of regret, because over three years—with three independent processes, 75 meetings and 73 concessions that we made in a huge effort to try to come to a negotiated settlement—the BMA refused to talk. With respect, I think Sir David Dalton, the trusted chief executive of Salford Royal, understands these things better than the hon. Lady has shown she does today. After working very hard, he concluded that a negotiated settlement was not possible. That is why I announced on 11 February that I would introduce a new contract.

As for foundation trusts, if the hon. Lady had listened to my statement she would know that it is true that foundation trusts have the freedom to introduce new contracts on pay and conditions. They can choose to exercise that freedom, but none of them has done so. She asked about non-foundation trusts. They do not have that freedom, and that is why we will be introducing a new contract for everyone.

Let me say this to the hon. Lady. There has been a lot of talk about this, but none of it as specious as the story that she planted in The Guardian this morning about the Government changing their position, which was absolute nonsense. We have not changed our position. The fact of the matter is that the Government have bent over backwards to avoid this strike. Right now, the people refusing to talk, whether it be on rota design with hospital managers or training reform with the academy, are not the Government but the BMA. Had it negotiated on Saturday pay, as it said it would, we would have had an agreement by now. Instead, we have a strike—the first ever withdrawal of emergency care in NHS history. [Interruption.]

[Mr Speaker]

Order. Opposition Members should calm themselves. The Secretary of State is responding, and everybody will be heard.

[Mr Hunt]

Rather than try to fabricate some story about the Government changing their position, which the hon. Lady knows perfectly well they are not, she might think about the words that do need to be said in this Chamber this week—about whether or not it is appropriate for the BMA to be telling people to deny life-saving care to patients.

Some people in the NHS have shown great courage in speaking out, even against their own profession: Professor Sir Bruce Keogh, the NHS England medical director, Lord Darzi, the former Labour Minister, and Dame Sally Davies, the chief medical officer. But there is one person on the public stage who has not had the courage to condemn those emergency strikes, and that is the shadow Health Secretary. I hope that, for the sake of her constituents and the reputation of the Labour party, she will say at the earliest opportunity that withdrawing emergency care in pursuance of a pay dispute is wrong, disproportionate and inappropriate, and that the right thing to do now is to show courage to reform these contracts for the benefit of patients and a seven-day NHS.

Oral Answers to Questions

Debate between Jeremy Hunt and John Bercow

Tuesday 9th February 2016 Commons Chamber

[Mr Hunt]

We have plans, as I mentioned, to have 5,000 more doctors working in general practice, and there is a big interviewing process. We need to increase the number of GPs going into general practice by 3,250 every year and I am happy to liaise with the Province to see how we can work together on these plans.

[Mr Speaker]

I call next the medal-wearing member of the team which won the parliamentary pancake race this morning, against the peers and against the press.

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[Mr Jeremy Hunt]

I am very happy to look at that.

[Mr Speaker]

Well done.

[Andrea Jenkyns (Morley and Outwood) (Con)]

By refusing to condemn the junior doctors strike, the hon. Member for Lewisham East (Heidi Alexander) has shown that she has little regard for patient safety. [Interruption.] Will my right hon. Friend repeat his condemnation of this strike, which will seriously endanger patient safety, and assure me that he will continue to press for the new contracts, which will guarantee safer patient care and a better contract for doctors?

Oral Answers to Questions

Debate between Jeremy Hunt and John Bercow

Tuesday 5th January 2016 Commons Chamber

[Mr Speaker]

Project, man, project! We wish to hear the full gist of what the hon. Gentleman has to say to the House.

[Mr Jeremy Hunt]

We absolutely will work with the medical profession to have proper seven-day services throughout the NHS in England. I hope that the hon. Gentleman and Scotland, which has the same issues with weekend mortality rates, will follow the lead of NHS England.

Junior Doctors Contract

Debate between Jeremy Hunt and John Bercow

Monday 30th November 2015 Commons Chamber

[Marie Rimmer (St Helens South and Whiston) (Lab)]

This junior doctors dispute is not just about pay. We are very fortunate to have such marvellous junior doctors. My concern, and I know that it is their concern, is about the change to the training of junior doctors in the proposed imposed contract, which will have such a negative impact on the research and development that makes our national health service the greatest in the world. Will you comment on the impact that the change in the contract will have on training and research? Will that be altered, and if not, will you please look at it again, because that is absolutely essential?

[Mr Speaker]

I will do neither of those things, but we will soon discover whether the Secretary of State wishes to do either.

[Mr Hunt]

I hope that the hon. Lady will be reassured by the Government’s November offer, which has specific protection for junior doctors doing research that the NHS needs them to do to ensure that they are not disadvantaged by doing any such research. I am happy to write to her about the plans we have outlined.

Oral Answers to Questions

Debate between Jeremy Hunt and John Bercow

Tuesday 17th November 2015 Commons Chamber

[Mr Hunt]

I gently say to the hon. Lady that we have to find efficiencies in every part of the NHS, and we are asking the public health world to find the same efficiencies as hospitals, GP surgeries and other parts of the NHS, but that should not be at the expense of services. I completely agree with her about childhood obesity, on which we will announce some important plans shortly.

[Mr Speaker]

Forgive me colleagues, but what we need at Topical Questions is short inquiries, without preamble, if we are to make progress. Let us be led in this exercise by Fiona Bruce.

NHS Reform

Debate between Jeremy Hunt and John Bercow

Thursday 16th July 2015 Commons Chamber

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

I have to declare an interest: like most doctors, I am a member of the British Medical Association.

I commend the Secretary of State for his announcement about a national officer for whistleblowers. Shona Robertson, Scotland’s Cabinet Secretary for Health, announced this in June, and we are taking action on the Francis report in the same direction. It is vital that members of staff feel they have someone to speak to if things are not going well, and that if they are not being responded to locally there is an independent voice that they can go to.

With regard to seven-day services, the excess deaths of people who are admitted at weekends is recognised and abhorred by the vast majority of doctors. I do not know anybody who gets up and works the hours we do and does not care that someone did not do well. However, I think we are blurring the lines between the elective and emergency systems. The sickest people the Secretary of State mentions—those who run the risk of dying if admitted on a Friday or a Sunday—are not part of the elective system but of the out-of-hours emergency system. It is suggested that hospitals are like the Mary Celeste and there are no doctors. In fact, any service with an emergency component runs 24/7, but there is a multi-disciplinary team. Sometimes patients will be stuck on a ward because they cannot get access to a scan or there is no physiotherapist to help them recover from their stroke.

We are already working towards solving this in Scotland. We are doing so in a more collaborative way, and that is important. There is no resistance to that, because it is recognised that we need all parts of the service. This is different from people coming in for a routine check-up on a Sunday when that does not result in a detriment to them if it is not available. The biggest shortage we have is in human resources—doctors, nurses, physios, occupational therapists and radiographers. I recommend that the Secretary of State separate these two aspects. The first is that hospital consultants did not get the option to opt out of 24/7 care for emergency patients in the contract, whereas GPs did. It is a matter of providing, funding and setting up a full service with all that is behind it to deal with ill patients seven days a week, no matter when they come in.

The other aspect is trying to get value for money. If we have invested in expensive machines and theatres, we want them to work as many days a week as possible so that we get value for money, but that must be secondary to the first priority, which is looking after sick people. I suggest that the Secretary of State starts talking about the two aspects on separate tracks and not crossing backwards and forwards, and that this should be collaborative. I echo the hon. Member for Totnes (Dr Wollaston) in saying that we require the money to be front-loaded so that we get it to start changing the service now.

[Mr Speaker]

Order. May I gently say that from now on we are going to have to enforce the time limits on Opposition responses to ministerial statements much more strictly? Otherwise they eat into the time available for other colleagues. The shadow Secretary of State has five minutes in response to a 10-minute statement and the third party spokesperson has two minutes. That really does have to be adhered to as a matter of course from now on.

[Mr Hunt]

The hon. Lady speaks with the authority of someone who works in hospitals, and I always listen to her very carefully. I do not think it is easy to make a rigid distinction between elective and emergency care. The opt-out in emergency care does apply, for example, to accident and emergency doctors. Sometimes when people are admitted to hospital because they are ill—they would not be admitted if they were not—their condition may not appear to be life-threatening on a Friday afternoon but then, over the course of the weekend, they deteriorate, and by the time they are seen by a senior consultant on a Monday or a Tuesday, it is too late. The trouble is that we have a culture in which a lot of major services are available only from Monday to Friday, and that is what is causing these avoidable deaths. The hon. Lady is right to say that this is not just about senior consultant cover; it is also about diagnostic care, handovers and many other things, and we are working at those. The Royal Edinburgh Infirmary has done a very good job of eliminating the difference between weekday and weekend mortality rates, as have Salford Royal and Northumbria hospitals in England. We need other hospitals to follow those examples.

--- Later in debate ---

[Mr Bernard Jenkin (Harwich and North Essex) (Con)]

I thank my right hon. Friend very much for his extraordinarily embracing response to the Public Administration Select Committee report on clinical incident investigation. We started less than a year ago with the germ of an idea, and it has turned into what amounts to a radical reform of safety investigation in the health service. That is a tribute to him and to the Committee’s witnesses, but it is a tribute to the health service itself that it has embraced the idea, which is a big change that I believe will be transformative.

May I pick up on the Secretary of State’s reluctance to provide special legislation for the immunity of those giving evidence to the new patient investigation body? Will he keep an open mind on the subject? If he wants that body to be truly independent and to have a special status, he should remember that the marine accident investigation branch and the air accidents investigation branch have specific legislation to provide for such immunity. Public interest disclosure protection must not be challenged by freedom of information requests, given that freedom of information has been extended into areas where we never imagined it would go. We have to be specific in legislation that that cannot happen in this instance.

[Mr Speaker]

Too long—I hope the answer will be somewhat briefer.

[Mr Hunt]

It will, Mr Speaker.

My hon. Friend’s idea is really interesting, and I am happy to take it up and explore whether we need to replicate that immunity so that we can get to the truth more quickly in a no-blame context.

I thank my hon. Friend for the work of the Public Administration Select Committee. I think it is true to say that we would not have the new patient safety investigation service, modelled on the air accidents investigation branch, which has worked so well in the airline industry, if it had not been for the work of PASC. It brought the idea to my attention and it was a good idea, and I know that he will help me make sure that it is a success in practice as well.

Oral Answers to Questions

Debate between Jeremy Hunt and John Bercow

Tuesday 7th July 2015 Commons Chamber

[Mr Jeremy Hunt]

My hon. Friend is absolutely right and has great experience in this area. We are now having a lot of transparency at an institutional level, but individual doctors and nurses in primary and secondary care are still finding it too hard to speak out if they have concerns. Getting that culture right has to be a big priority for this Parliament.

[Mr Speaker]

Emulating Strangford brevity, perhaps, I call Mr Greg Mulholland.

--- Later in debate ---

[Mr Hunt]

As I have just said, we will bring our plans to the House very shortly.

[Mr Speaker]

Last but not least, Mr Barry Sheerman.

Oral Answers to Questions

Debate between Jeremy Hunt and John Bercow

Tuesday 2nd June 2015 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for his campaigning for that hospital. The simple answer is that hospitals put into special measures end up recruiting more doctors and nurses and delivering safer care to patients, and his hospital is a shining example of that.

[Mr Speaker]

Order. I remind the House at the start of the Parliament—this might be of particular benefit to new Members—that topical questions are supposed to be significantly shorter than substantive questions: the shorter the better, and the more we will get through.

[Mr Jamie Reed (Copeland) (Lab)]

The Secretary of State has said that safe care and good finances go together, but clinical negligence claims are up by 80% since 2010, while trusts are posting huge deficits. Does he think that finances have deteriorated because care quality has deteriorated or that care quality has deteriorated because finances have deteriorated?

--- Later in debate ---

[Mr Hunt]

I think that is harsh. Let me tell the hon. Gentleman some of the progress that was made under the last Government, and that this Government will continue, to reduce the pressure on police, particularly with regard to the holding of people with mental health conditions in police cells. We are in the process of eliminating that; it has seen dramatic falls. We recognise that the NHS needs to work more closely with the police, particularly in such circumstances, and he should recognise the progress that has been made compared with what happened before.

[Mr Speaker]

Order. I am genuinely sorry that some colleagues were disappointed today; I ran things on a bit, but we need to move on. In one respect, Health questions is analogous to the national health service, under whichever Government, in that demand always exceeds supply, but I have noticed colleagues who were trying to take part today and I will seek to accommodate them on a subsequent occasion.