O’Neill Review

Jeremy Lefroy Excerpts

Tuesday 7th March 2017 Westminster Hall

[Jeremy Lefroy (Stafford) (Con)]

I declare an interest as a member of the board of the Liverpool School of Tropical Medicine. Indeed, I talked to Dr Adam Roberts who is a senior lecturer in antimicrobial chemotherapy and resistance there; he gave me some pointers to the things that he believes are extremely important in this work. I will touch on four of them.

The first thing, as others have mentioned, is to revitalise drug discovery. We are not talking about one or two drugs but 10, 20 or 30 new drugs. That is the scale of what is needed, particularly in the area of anti-Gram- negatives, because there is the least resistance to those drugs at the moment.

The second point, which has been made, is that the pharmaceutical industry as a whole should be involved. My hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake) rightly said that many treatments, such as more intense chemotherapies, rely on the availability of good antibiotics so that patients do not suffer when their resistance levels are lower. Why should those companies not contribute to the development of antibiotics, if they are not doing so already? As we said, that is challenging commercially. Perhaps we could even look at a tax on those drugs to pay for antibiotics or some other way of raising revenue from those that do not participate.

Thirdly, a public education campaign, which has been mentioned, would help people recognise that antibiotics are not to be taken at every opportunity and that we should consider who is using them, particularly in meat production. I believe that one or two major companies in the United States have already started using meat reared without antibiotics, which I welcome. The fourth area, which has also been mentioned, is regulation of the sale of antibiotics online. It is a major loophole that must be closed, and the United Kingdom can play a role.

Finally, I draw a parallel with malaria, which the hon. Member for Glasgow North (Patrick Grady) mentioned. As a result of the development of rapid diagnostic tests for malaria, the use of the very effective anti-malarials has declined, because people no longer see anti-malarials as the only treatment that can be provided when their child gets a fever. Consequently, although resistance exists, it has become less of a problem in some places. Also, initiatives such as the Medicines for Malaria Venture have created a much stronger pipeline of anti-malarial drugs through co-operation among the pharmaceutical industry, charities such as the Gates Foundation, the United Kingdom and other Governments and the Global Fund to fight malaria, HIV/AIDS and tuberculosis. Such co-operation is critical.

NHS Shared Business Services

Jeremy Lefroy Excerpts

Monday 27th February 2017 Commons Chamber

[Mr Hunt]

I would like to reflect on the hon. Gentleman’s question in a bit more detail rather than giving an instant answer, because, to date, no one has brought to my notice particular issues about staff safety, but that is always something we take extremely seriously. We are aware of the extra administrative pressure on staff caused by needing to go through records where there is a higher risk of harm to patients—indeed, we have given GP surgeries extra resources to cover that additional time—but I will look into the issue the hon. Gentleman raises.

[Jeremy Lefroy (Stafford) (Con)]

Since at least 2015, it has been a statutory requirement to use a unique and consistent identifier on health and social care records. Given that that would, as the hon. Member for Central Ayrshire (Dr Whitford) said, help with putting data electronically on health and social care systems, will the Secretary of State update the House on the issue?

[Mr Hunt]

I am very happy to do so. Clearly, when we are all able to access our health records electronically, there are potentially huge benefits for patients. In particular, people with long-term conditions who use the NHS a lot would be able to take more control of what happens and also to spot mistakes, which sometimes happen in medical records—that is one of the big findings from the US, where people have had more widespread access to electronic records for longer. The issue is the security with which people access those records online, and we are looking very closely at the systems used by banks, for example. Those are pretty robust, but we are looking at whether we can have systems that are even more robust, because it is very important that patients have confidence that only they and those they give permission to can access those records.

Oral Answers to Questions

Jeremy Lefroy Excerpts

Tuesday 20th December 2016 Commons Chamber

[Mr Hunt]

With the greatest respect, I do not think it is passing the buck to put £1.3 billion more into the NHS this year than the hon. Gentleman was proposing at the last election. A lot of actions are being taken in Cheshire and Merseyside; a local accident and emergency delivery board was set up, which is doing very important work, and the emergency care improvement programme is working very well at his local trust.

[Jeremy Lefroy (Stafford) (Con)]

There is great pressure on emergency services throughout Staffordshire at the moment. There would be even more without the accident and emergency centres in Stafford and Burton, yet the sustainability and transformation plan proposes to reduce one of them, so there will only be two left in the county. Will the Secretary of State speak to the authors of the STP to make it clear that this is totally unacceptable given the current situation?

[Mr Hunt]

No one fights harder and more eloquently than my hon. Friend for the needs of the people of Stafford. I always look with concern at proposals to change emergency services given the huge pressures that exist, so I shall happily look at the plan as he suggests.

Oral Answers to Questions

Jeremy Lefroy Excerpts

Tuesday 11th October 2016 Commons Chamber

[Mr Dunne]

We recognise, absolutely, that bills for agency staff have become unsustainable, which is why we have taken deliberate action, including by introducing price caps on hourly rates last November, which has had a significant impact on reducing agency costs. In the year to date, agency costs are some £550 million less than they were last year.

[Jeremy Lefroy (Stafford) (Con)]

I welcome last week’s announcement about the increase in the number of medical school places. What plans does the Department have to ensure that there are sufficient clinical training places for those medical students?

[Mr Dunne]

I can reassure my hon. Friend that there is considerable excess demand from UK-based students to train to become a clinician in this country—only half of those who apply to train in medical school are accepted at present—so we are confident that there will be plenty of take-up for those extra places. With regard to clinical placements, we are in discussions with universities, colleges and teaching hospitals to ensure that there are adequate numbers of places.

NHS Sustainability and Transformation Plans

Jeremy Lefroy Excerpts

Wednesday 14th September 2016 Commons Chamber

[Jeremy Lefroy (Stafford) (Con)]

First, I would like to place on record my thanks for the tremendous work of NHS staff throughout the country, in particular NHS staff in my constituency and the constituencies of other Members in Staffordshire, at the County hospital, the Royal Stoke hospital, GPs surgeries and so on. They have done a great job over the past five or six years when our health economy has been in the national spotlight.

Of course, we have had our own sustainability and transformation plan since 2012, with the trust special administration of the Mid Staffordshire NHS Foundation Trust. It was an extremely difficult and challenging time and I want to draw out two points from that. The first was eloquently made by the right hon. Member for North Norfolk (Norman Lamb)—the vital importance of consultation at every level. Do not leave people in the dark. There is nothing that my constituents like less than finding leaked reports and things that they are supposed to know about that they do not know about. Please keep as much in the public domain as possible. No doubt there will be plans that arouse anger and hostility, but it is better to deal with that properly and in public. That is what we discovered.

The second thing I want to say is: “Stick to what you agree.” What the trust special administrator for Mid Staffordshire came out with was not what we wanted. In fact, it was far short of what we wanted, although it was better than the minimum that was proposed at first, largely as a result of our local campaign. We have just had, as the hon. Member for Newcastle-under-Lyme (Paul Farrelly) mentioned, the temporary closure of our children’s emergency centre on safety grounds. That centre was specifically committed to in the trust special administrator’s proposals, and it only opened a year and two months ago. It must be brought back immediately, or as soon as possible—that means in the next few weeks—because it was a commitment. Commitments that come out of the STPs must be met.

The final point I want to make, following on from what others have said, is that we spend too little of our GDP on health. Even The Economist, as it made clear in an article last week, says that we need to spend a higher proportion of our GDP on the NHS. That means raising the money; in my view, we should do so through higher rates of national insurance in the long term. My hon. Friend the Member for Salisbury (John Glen) and I wrote an article about this a couple of years ago, in which we recommended a hypothecated tax. I believe that that is still an important way forward. As others have said, the STPs offer a good opportunity to go forward and make necessary changes, particularly around health and social care, but STPs that do not look beyond 2020 at the percentage of our GDP that we spend on health and social care will not succeed.

Carers

Jeremy Lefroy Excerpts

Thursday 9th June 2016 Commons Chamber

[Mims Davies]

I absolutely agree with my hon. Friend, and I am delighted to have secured this debate today to highlight these issues. I know that she works tirelessly in her community to support carers and the people who need them. I agree that there is a human cost and an economic cost to caring.

I thank the Backbench Business Committee for being so supportive in ensuring that this important topic gets time in the Chamber. I hope that this will be a wide-ranging debate. I am also grateful to the Government and to the Minister for Community and Social Care, who has been very supportive of my application to hold the debate this week, which is carers week.

We know the value of carers, but do we really understand what is involved? How do you become a carer? A loved one might get older or become disabled. A child might be born with challenges. Someone might experience an unexpected change in their health. There might be a car accident or an incident at work. An operation could go wrong. A mental health challenge could arise, resulting in the need for care. All of a sudden, you become someone who needs to be a carer. How do you manage it?

As my hon. Friend the Member for Cheadle (Mary Robinson) has suggested, long-term caring can have a financial and emotional effect on families. It can have an impact on relationships. You lose friends. You lose leisure time. You also lose your freedom. Relationships between husbands and wives change. You become a carer rather than a lover or a friend. The impact of the need for mum or dad or a child to come first means a big change for families. You can develop a fear of the phone. You could be at work, out shopping, doing the chores or walking the dog when you get a phone call to say that something has happened on your caring watch. It is worrying for you as a carer when the phone rings. You are mindful of what damage could be done while you are not there.

Carers week represents an important collaboration by Carers UK, Age UK, the Carers Trust, Independent Age, Macmillan Cancer Support, the Motor Neurone Disease Association and the MS Society. The focus this year is on building carer-friendly communities, and that is why I have tried in my opening remarks to remind people that someone in their lives is taking on the extra responsibility of being a carer. How many hidden carers do Members have in their constituency? Who do we know who is taking on that role? This debate gives us a chance to highlight the need to ensure that all our communities are aware of the work that unpaid carers do. Local GPs should understand the restraints a carer might face—I am aware that GPs themselves face many pressures—and employers should be spearheading flexible working and educating their own organisations to support carers.

[Jeremy Lefroy (Stafford) (Con)]

I congratulate my hon. Friend on securing this vital debate. Does she agree that some of the hidden carers are young people aged 12, 13 or 14? I have met some of them from Staffordshire and they do the most amazing work. They need our support.

[Mims Davies]

I absolutely agree with my hon. Friend. I shall go on to discuss the importance of young carers in a moment. More than 700,000 of the 6 million carers in this country are young carers who are taking on at a tender age all the burdens that I have described. This has an impact on their education and their opportunities. Our schools should show understanding and foster an environment in which young people can be carers. They should forge an appreciation of caring in our ageing society. Three in every four carers do not feel that their caring role is understood or valued by their community. It is incredible that we have so much more progress to make before we can live in a truly carer-friendly Britain. I believe that we are now at the start.

As I have said, more than 6 million people in England provide unpaid care, with 1.3 million providing more than 50 hours a week. In my constituency, there are more than 10,000 unpaid carers. We have an army of carers quietly working away looking after their loved ones across this country, and they do it for humane reasons. We do not do enough to support and recognise them. Locally, the loss of respite has been a great cause for concern. Respite offers carers freedom and time to regroup, and a lack of it can be a great concern. Alternatively, the wrong type of respite might be offered or it might be poorly managed. I have heard about such experiences in my constituency surgery feedback.

I thank the volunteers in my constituency who support our carers. The One Community brings together many groups to support each other, including the Age Concern centre, Dementia Friends, the Alzheimer’s group and all the people who help carers by driving their loved ones to hospital or to the GP.

I also want to say thank you to everyone in my constituency who runs a lunch club or a social club, all of which provide important opportunities for social contact.

A recent Carers UK report highlighted the fact that many carers are struggling. Most of us will have to care for someone at some point in our lives, and we want to be able to do that. Three in every five people become a carer at some point. Members of this House and of the other place, and our staff, are carers too.

In leading this debate, I should declare an interest. I was a carer, although I did not realise it. I was a hidden carer. We are nothing if we do not bring our own experiences to bear in our work in the House. I was a “sandwich carer”—that is, someone with small children and older, ill parents. We became so friendly with the local ambulance service that we were on first name terms, and I thank them all for the kindness they showed me and my family. My dad was affected by an incident at work and was cared for by my mother for more than 25 years. That had a massive financial impact on me as I grew up and on our family. And when dad was gone, guess what, mum needed looking after too, because when you are looking after someone you often forget to look after yourself. People can go downhill quite quickly in those circumstances.

I found myself muddling along looking after small children, going to GP surgeries and getting mum up to London, where we struggled on the escalators and on the tube to get to vital hospital appointments. I did not realise that that was an ongoing role for me. I gave up my job and threw myself into it. I remember the phone calls. One came when I was about to go on air at a radio station just before 6 o’clock in the morning. Dad was unresponsive. There had been a problem with his insulin. Luckily, mum was awake because she was going to care for my children, covering for me while I was at work. She was caring for me, I was caring for her, and we were all caring for dad. When the phone rang, I had to drop everything and get there. For me, that was a snapshot of what people are doing day in, day out, and year in, year out. There is no break. If someone is lucky to get one, that is great, but it is still your watch even when they are not with you—are they in the right place?

A particular story that comes to mind was when my dad developed glaucoma as a result of the diabetes that was brought on by the head injury. He was given respite, but at that point he had not told people that he was losing his sight. He was in a respite centre and got lost going to the loo in the middle of the night. He got in the wrong lift and was wandering around a strange place. He was over 70, frightened and concerned though he was meant to be in a safe place. That story meant that no further respite was taken, meaning no further breaks.

I want to move on from my experiences, but please remember that all of us will be doing this. There are people in the House who do it already. I hope that we can recognise and understand the issue.

Junior Doctors Contracts

Jeremy Lefroy Excerpts

Monday 25th April 2016 Commons Chamber

[Mr Hunt]

We are constantly monitoring what will happen with the new contract, and we want to make sure that we get it absolutely right. If the hon. Lady makes such a plea to me, she should also talk to the BMA and say that the way to make sure we implement this contract correctly is to sit down with the Government and talk about how to make it successful, rather than to refuse to talk to us, which is what is happening at Hull Royal infirmary and many other hospitals.

[Jeremy Lefroy (Stafford) (Con)]

I briefly attended a medical conference over the weekend, where doctors said they were hugely concerned about the impact on the vast majority of junior doctors who neither wish to strike nor believe that the contract is satisfactory, for the reason given by my hon. Friend the Member for St Albans (Mrs Main), when she was in the Chamber. They are being put in an impossible position. I really urge the BMA to withdraw the threat of strike action and the Secretary of State to make it quite clear that he will do whatever it takes in sitting down to resolve this issue for the sake of all our patients and their safety.

[Mr Hunt]

I am absolutely prepared to talk about anything that could be improved in the contract that will be introduced and, indeed, extra-contractual things such as the way in which rota gaps are filled and the training process. However, at the moment we do not have such a dialogue, and that has been the problem. The imposition of a new contract is the last thing in the world that we wanted as a Government. It followed 75 meetings—it was a totally exhaustive process—but in the end we found that our counterparty was not interested in sitting down to talk about this; it just wanted a political win. We had to make an absolutely invidious choice about doing the right thing to make patients safer. I wish we had not got to that point. We have got to it and we need to carry on, but the door is always open for further talks and discussions.

Junior Doctors: Industrial Action

Jeremy Lefroy Excerpts

Thursday 24th March 2016 Commons Chamber

[Ben Gummer]

Sir David Dalton wrote to the BMA with precisely that list. The BMA refused to reply to him. He made the judgment that there was no point in continuing negotiations because it was refusing to discuss, in any event, the remaining matters. The Government have to move ahead. We have been on this for three and a half years and it is better that we move ahead.

[Jeremy Lefroy (Stafford) (Con)]

It was with great sadness that I learned of the BMA’s decision, which is not in the interests of patients and not in the interests of its members. I urge it to withdraw the threat of action. At the same time, will the Minister consider pausing the imposition of the contract, so there can be meaningful discussions? Those discussions have to take place in the context of a withdrawal of strike action.

[Ben Gummer]

I say gently to my hon. Friend that meaningful discussions require both good faith and a will to talk from both sides. That is consistently the case on the Government side, but it has not been consistently the case for the junior doctors committee of the BMA. The fact is that this contract is better for patients, the patients he seeks to represent. It is better for doctors, the same doctors he seeks to represent. Therefore, any further delay would be bad for patients and bad for doctors. That is why we must move ahead with the implementation of this contract.

NHS: Learning from Mistakes

Jeremy Lefroy Excerpts

Wednesday 9th March 2016 Commons Chamber

[Mr Hunt]

My hon. Friend speaks very wisely. Let me say that one thing that has been a mistake of successive Governments is a short-termist approach to NHS managers. We ourselves have looked for a scapegoat when something has gone wrong—an A&E target missed or whatever—and not backed people making long-term transformations. That is something we need to think hard about.

[Jeremy Lefroy (Stafford) (Con)]

I thank the Secretary of State for his statement and for all the work he has done on this. I pay tribute to all those who have campaigned to bring patient safety to the fore, many from tragic experiences that they have had. What work is being done to ensure that medical schools and nursing schools have patient safety right there on the curriculum?

Mental Health Taskforce

Jeremy Lefroy Excerpts

Tuesday 23rd February 2016 Commons Chamber

[Alistair Burt]

The hon. Gentleman has a long-standing interest in these issues. He is absolutely right: in England, a pilot project with 27 schools is being run by the Department for Education to locate and identify a single point of contact in those schools on mental health issues for young people. Depending on the results, more projects can be rolled out. Early identification and support in school are absolutely essential, and that work is under way.

There are a number of different initiatives, sometimes inspired by people who have experienced personal tragedy in their own family. They realise that the tragedy that has befallen their young person might not have happened if their friends had been more aware of their circumstances, or if the school or college had been more aware. We look at all those different initiatives to see how best practice can be spread, but the hon. Gentleman is right to raise the issue.

[Jeremy Lefroy (Stafford) (Con)]

I congratulate the Minister and the Government on their commitment on this. He has just spoken about best practice. Last month in Stafford we held a round table on mental health. One of the issues that came up was that there were a lot of good local initiatives, both in the public and the non-governmental organisation sector, but sometimes they did not know about each other. Will he point us to best practice in the sector?