Cystic Fibrosis Drugs: Orkambi

Lord Spellar Excerpts

Monday 10th June 2019 Westminster Hall

[Paul Scully]

There are clearly two sides to the negotiations. The NHS has to understand that CF sufferers are not just names on a spreadsheet; they are real people. We are all here as politicians to represent our constituents, but we are humans first and politicians second. We have to remember the humanity. On the other side of the negotiations, Vertex needs to make sure that these patients—the people living with CF—are not just names on a shareholder report.

[John Spellar (Warley) (Lab)]

I thank the hon. Gentleman for his comprehensive introduction. The fundamental core of the problem is the greed of Vertex and its unreasonableness in the discussions. Should the Government not play a much stronger role in dealing with the issue of generics? That is the demand of those who are suffering, such as my constituent Nicola Johnson and her son George, whose capacity is steadily reducing. The Government need to get a move on with that alternative route.

[Paul Scully]

The right hon. Gentleman is right to say that Vertex has to be reasonable, because the UK is effectively the biggest market for a pharma company that comes in to tackle CF, for the reasons that I have mentioned. It has to understand that the issue is not all about its share price in the long term. As a free-market liberal economist, I recognise that private companies must be allowed to deliver fair profits for their shareholders, which will further research and future investment, but they are sailing close to the wind if they are profiteering from human suffering.

Nursing: Higher Education Investment

Lord Spellar Excerpts

Wednesday 21st November 2018 Westminster Hall

[Eleanor Smith]

That is definitely so. My hon. Friend is completely right, and with the way Brexit is going, that is understandable. People working in the NHS understand that.

Without policies and funding intervention, as I have said, the shortfall will grow to almost 43,000 by 2023, and that number is on the low side. It does not account for the one third of nurses who are due to retire in the next 10 years. It does not include nursing shortages in social care or public health. Students are being forced to plug the gaps. They should be learning, but instead they are providing care before qualification, without supervision and before they are ready—all because we do not have enough nurses. That is deeply unfair to students. It is risky for qualified nurses and it is unsafe for patients, and all because no one wants to pay for the solution.

Poor workforce planning in health and care is not new. Even in my time, policy makers pursued a boom-to-bust approach, rather than ensuring that supply was available to meet demand. Six years on from the Health and Social Care Act 2012, it is fundamentally unclear who is accountable for workforce strategy. As a result, it is not being done by anyone. Earlier this year, Health Education England held a consultation, but Professor Ian Cumming has failed to deliver a workforce strategy. We are told that it will be dealt with in the new 10-year plan. Mr Simon Stevens, the chief executive of the NHS, has been handed an additional £20.5 billion a year for the NHS by 2023-24, and it is widely understood that his long-term plan must address the extreme gaps in our nursing workforce by fixing the supply issue and providing funding.

[John Spellar (Warley) (Lab)]

I congratulate my hon. Friend on securing this important debate. I do not think it should focus only on the bursary, as some of the letters have—important though that is—but on the Government’s lamentable failure to bring in nursing apprenticeships, which provide such an important route for many youngsters from working-class areas in the Black Country, including areas in her constituency and mine.

[Eleanor Smith]

My right hon. Friend covers a point about apprenticeships that I will address in my speech, because what we are saying is that it is one of the routes, but not the only route.

NHS Trusts: Accountability

Lord Spellar Excerpts

Tuesday 10th July 2018 Commons Chamber

[Sir Mike Penning (Hemel Hempstead) (Con)]

It is a privilege to have so long for this Adjournment debate on such an important subject. I know that when other colleagues realise that the debate has started, they will scamper to the Chamber. When I put down the title for this debate, I did not intend it to be a general debate, but when I have raised this issue in the House, many colleagues and those on the Front Bench have acknowledged it, particularly when I have raised it with the Leader of the House at business questions.

The NHS is not owned by politicians. It is not owned by doctors and nurses, and it certainly is not run by the bureaucrats in charge of the NHS. It is owned by the people. The people’s NHS was founded 70 years ago, which we are celebrating today. I would never advocate that we go back to the time when politicians and Ministers ran the NHS, but we are in a situation now where the bureaucrats who run the NHS have very little accountability. Time and again, my constituents say to me, “Why are they not listening to us? Why are they not listening to you, my MP? At the end of the day, you represent us in the House of Commons—you are there to represent our money.” That is the principle of our democracy today and has been the founding principle ever since we first elected people to this House over 900 years ago.

I find it amazing when we question the clinical commissioning group or one of the numerous trusts in my constituency. I never understand why, in a small county like mine, we have so many NHS trusts, acute trusts, mental health trusts and community trusts. The people do not understand it. They just see an NHS. They do not realise or want to know how many chief executives, finance directors or directors of nursing there are. They just want to be looked after by the NHS, which was the promise when the NHS was founded.

There are a couple of examples from my constituency that might resonate with colleagues around the House, as it may have happened in their constituencies as well. A few years ago in my constituency, we lost the NHS trust’s chief executive. The chief executive had been involved in the downgrading and closure of the acute hospital in my part of the world, and once he had done that, he decided to go to pastures new at very short notice. The then regional health authority seconded a new chief executive on what we thought was a temporary basis, but we noticed some time down the line that the role of chief executive of the West Hertfordshire Hospitals NHS Trust had not been advertised, and there did not appear to be anybody saying that we should have people applying for such a senior position in the trust.

The gentleman’s name was Jan Filochowski. I know Hansard will ask me to spell that name later, and I will attempt to help them as much as I can, but anybody in my part of the world will know who that gentleman is. I did not have any particular gripe with Jan. I completely disagreed with the running down that he continued to do, but I did have one specific gripe, as did the hospital action group in my part of the world. In particular, Mr Ron Glatter picked up the argument, and I fired off several really important questions to the NHS regional health authority: “Hold up a second, has this person got this job now? Has he been appointed, and if he has, when was it advertised, and when was he interviewed?”

Sometime down the line—hidden with lots of mirrors in lots of different parts of the NHS—it was revealed that the gentleman had got the job without it being advertised and without being interviewed for it. However, because he had been given a contract, it would have been too expensive to remove him and to start again from scratch. We eventually found out that his remuneration package was in excess of £300,000, which is well over twice what the Prime Minister of this country earns. I accept that someone does not become the Prime Minister to earn a lot of money—clearly, there are other reasons why someone becomes Prime Minister—but surely, within the NHS of all places, that sort of remuneration package is not only excessive, but actually sick. The money that person was earning! I am sure there are others who are earning close to that, perhaps more or perhaps slightly less.

[John Spellar (Warley) (Lab)]

Does it not get even worse, in that individuals who fail in such jobs are given pay-offs to get them out of the hospital, but in a fairly short space of time the magic circle again fits them up with an appointment in another hospital, where they again fail and again cost huge sums of money?

[Sir Mike Penning]

The right hon. Gentleman is absolutely right. The gentleman did not stay very long, but he caused carnage in our NHS trust and morale went through the floor. I am sure some of the books might have looked a bit better, but certainly acute care was really struggling. The gentleman left after two years, or something like that, and he went to Great Ormond Street Hospital as the chief executive. I am sure he went on a huge pay cut—no, I am being cynical: I doubt it. He has now retired.

On the right hon. Gentleman’s point, before that gentleman there was another chief executive involved in investing in our health, who went off under a cloud. I managed to get him summoned to the Health Committee, when I was a member of it, to find out the truth about what was happening with the closure programmes. The right hon. Gentleman is absolutely right because, a few years later, he appeared back in my constituency as the chief executive of the community trust. He then had the audacity to ask, “Can we put all that behind us, as this is a new job and a different project for me?” Yes, it goes full circle: just as the right hon. Gentleman said in the previous debate, it is jobs for the boys, and they come back round again.

Privatisation of NHS Services

Lord Spellar Excerpts

Monday 23rd April 2018 Westminster Hall

[Mike Hill]

I certainly do share my hon. Friend’s concern. Ironically, in my patch, sexual health services are delivered by Virgin doctors.

[John Spellar (Warley) (Lab)]

Is it not the case, as the two previous examples show, that we are not comparing like with like? The supposed savings are actually achieved by an immediate reduction in service or by the service becoming unviable, which means that the Government have to pick up the pieces. If anything goes wrong with a private healthcare operation, the patient has to go into the national health service, which has to bear the burden.

[Mike Hill]

I entirely agree. The forecasts for the next three years indicate that £10 billion-worth of NHS work will go to the private sector.

A settlement reported to be in the region of £330,000 was paid to Virgin Care in December 2017, following a procurement process in which an alliance between a foundation trust and local social enterprises won a contract to provide children’s services across Surrey. Such interventions and the ability of private companies to challenge NHS procurement provisions are precisely why there are fears about the transatlantic trade and investment partnership—a proposed trade agreement between the European Union and the United States. Many fear that our separate post-Brexit trade agreements with the United States will mean that NHS services will be exposed to the competition and might of the American private care market.

--- Later in debate ---

[Mike Hill]

I agree. As I said, it is estimated that, over the next three years, up to £10 billion-worth of NHS contracts will go to the private sector, including the provider that my hon. Friend mentions.

Are such fears irrational or are people right to be concerned about the privatisation of NHS services, given the fact that the influence of private healthcare providers has risen sharply in recent decades? The use of the private sector has been progressed by successive Governments over many years. The present Government blame Labour for introducing private finance initiatives, which they say have burdened the NHS with eye-watering debts, but the Government compounded the problem through PF2. They also blame Labour for opening up the NHS to marketisation by splitting primary care trusts into commissioning and provider arms, and introducing the concept of “any preferred provider” in its transforming community services programme, even though the Secretary of State at the time, Andy Burnham, expressly stated that the NHS would always be the preferred provider of services. Yet from 2010 onwards this Government extended that model, creating clinical commissioning groups and pursuing competition and commercialisation with renewed vigour. Today, therefore, many traditional public health services are run by private providers such as Virgin Care and GP consortiums in their own right—services such as out-of-hours urgent care, sexual health and mental health residential care.

The Health and Social Care Act 2012 was designed to bring in a far greater private sector element to the NHS through expansion of the internal market. Since then, the privatisation picture has been more mixed than had been feared, not only as a result of campaigns by Unison, the GMB and others, but because various Government initiatives to boost privatisation fell flat. However, there is still significant evidence of increasing privatisation, with companies such as Virgin, Serco and Spire continuing to prosper.

[John Spellar]

My hon. Friend mentioned the care sector. Is there not a fundamental flaw in that sector, because it is based on offshore location of ownership of the assets and on heavy leveraging and gearing of the companies? That has meant that many of them are on the brink of bankruptcy, and they seek either to be bailed out or to throw many thousands of very vulnerable and elderly people straight back to the Department of Health and Social Care. The Government have no real plan, as far as we can see, to deal with such a contingency.

[Mike Hill]

My right hon. Friend makes an important point about social care. In fact, some private providers have drifted away from healthcare contracts because of the losses that they might make on them.

 Orkambi and Cystic Fibrosis

Lord Spellar Excerpts

Monday 19th March 2018 Westminster Hall

[Paul Scully]

It is exactly the case—there is no doubt about that. There are many people in the Public Gallery whose children are sufferers from cystic fibrosis. When I was at the Cystic Fibrosis Trust last week, I could not meet many sufferers, because they cannot be in the same room due to the risk of infection. As my hon. Friend says, cystic fibrosis can escalate quickly, and the more we can treat the underlying causes, which Orkambi and subsequent drugs will allow us to do, the better.

[John Spellar (Warley) (Lab)]

Can we not see, during the week in which Stephen Hawking died in his 70s from a condition that was anticipated to kill him in his 20s or early 30s, that in fact conditions can allow for a much longer life? Is it not therefore incumbent on the Government to put pressure on both NHS England and the manufacturer to get an acceptable solution that will enable younger patients in particular to have the same opportunity that Stephen Hawking had?

[Paul Scully]

That is very much the point. Half the people who die of cystic fibrosis are under the age of 31. The average life expectancy for someone born now with cystic fibrosis is 47, so we see how it is starting to extend. When I was at the Cystic Fibrosis Trust just last week, I thought that the two people I was able to meet were just staff of the trust and did not realise they were sufferers. Why was I able to meet them, and why did I not notice? Because they had had lung transplants. In effect, they had pressed the reset button on their suffering. They had fresh pairs of lungs and Orkambi would not necessarily be right or necessary for them. The right hon. Gentleman is absolutely right in identifying that it is for the next generation coming through.

Agenda for Change: NHS Pay Restraint

Lord Spellar Excerpts

Monday 30th January 2017 Westminster Hall

[Catherine McKinnell]

I very much share the right hon. Gentleman’s concerns. He anticipates some of the points that I would really like to get across.

My view of the importance of those who work in our NHS is shared not only by Opposition Members. The Department of Health stated in its response to the e-petition:

“Agenda for Change staff are vital. They work incredibly hard for patients and deserve to be fairly rewarded. We are committed to ensuring trusts can afford to employ the staff the NHS needs.

NHS staff are our greatest asset. Despite the pressures on the NHS driven by an increasingly aged and frail population, nurses, and all our hard working NHS staff continue to put patients first, keeping them safe whilst providing the high quality care patients and their families expect.”

How have we found ourselves in a situation in which hard-working, dedicated, exhausted nurses, midwives and other healthcare professionals are genuinely struggling to make ends meet?

[Mr John Spellar (Warley) (Lab)]

Are we not in danger of getting into a downward spiral? Staff feel stretched, undervalued and underpaid, and many are looking to move abroad, or possibly even into other professions— I have had emails to that effect. Many are also going to agencies, and we know how much money agencies make. That costs extra, especially at a time when the retail prices index is moving inexorably up as a result of currency effects.

[Catherine McKinnell]

My right hon. Friend puts his point very succinctly and absolutely correctly.

Dementia and Alzheimer’s Disease

Lord Spellar Excerpts

Tuesday 12th April 2016 Westminster Hall

[Jim Shannon]

The hon. Lady speaks with knowledge. I thank her for that contribution.

There are ten key indicators of the quality of life of people with dementia: communication difficulties; relationships; environment and surroundings; physical health; a sense of humour; independence; a sense of personal identity; the ability to engage in activities and the opportunity to do so; difficulties with eating, drinking and swallowing; and, of course, their experience of stigma. All of those things are important.

[Mr John Spellar (Warley) (Lab)]

I congratulate the hon. Gentleman on securing this debate. As he draws these strands together, there is one problem that we should focus on. Local authorities have many statutory responsibilities, but as a result of the significant cuts to their budgets, these areas—they are not statutory responsibilities but, as a number of colleagues identified, they play a huge role in enabling people to manage their condition, stay active for longer and provide respite for their carers—are being cut back, which will ultimately have a long-term cost for the health service.

Community Pharmacies

Lord Spellar Excerpts

Tuesday 23rd February 2016 Westminster Hall

[Derek Thomas]

I welcome that intervention. That is exactly the point that I hope to make, particularly for independent pharmacists in rural areas, where it is much more difficult to access acute services and GP practices.

[Mr John Spellar (Warley) (Lab)]

The hon. Gentleman ought to see that that is true across the whole country. In urban areas, people are finding it more and more difficult to get appointments with their GPs and are going to accident and emergency. The best way to relieve that pressure is to encourage more people to go to our well-resourced local community pharmacies, maybe even rather than chain pharmacies.

[Derek Thomas]

That is absolutely right. The community pharmacist is part of the solution, not part of the problem, in what we want to do for the NHS. I hope to make the point in my speech that we need to do all we can to support the development of community pharmacists rather than take away money that they need.

Oral Answers to Questions

Lord Spellar Excerpts

Tuesday 1st April 2014 Commons Chamber

[Mr Hunt]

I will tell the right hon. Gentleman what is not an April fool—the appalling care at Mid Staffs on his watch. If he is talking about how the NHS is doing, perhaps, for once, Labour Members should look at what patients are saying. I know that it is difficult, but if we look at what patients say, we see that since the election, there has been a 5% increase in those who think that their NHS care is safe, and a 10% increase in those who think that they will be treated with dignity and respect in the NHS under the coalition. We are proud of that, because we are putting patients before politics, which the right hon. Gentleman never does.

[Mr John Spellar (Warley) (Lab)]

3. How many staff have been made redundant and subsequently re-employed by NHS organisations since May 2010.

[Pat Glass (North West Durham) (Lab)]

10. How many staff have been made redundant and subsequently re-employed by NHS organisations since May 2010.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

Since May 2010 and up to December 2013, 4,050 staff across the whole NHS have been re-employed in the NHS following redundancy. This covers all staff grades, not just managers, and is a tiny proportion of the total NHS work force of currently around 1.2 million.

[Mr Spellar]

May I thank the Minister for that utterly complacent answer? Is it not outrageous that, while front-line health service staff are having their salaries frozen, the fat cats at the top are getting monstrous pay-outs and then being re-employed straight away elsewhere in the NHS?

[Dr Poulter]

The Opposition will have to do better than these prepared questions. We have been lumbered with their redundancy terms, which were negotiated when the right hon. Member for Leigh (Andy Burnham) was a Minister in the Department of Health.

On NHS pay, we believe in having enough front-line staff to care for patients. That is the lesson of Mid Staffs. What the previous Government would have done—and the Opposition would have us do—is give some staff in the NHS two pay rises, not just one. That is unacceptable. We need to have enough staff to ensure that we can look after patients. All staff in the NHS will receive a pay rise of at least 1%, but unfortunately, because of the terms that the previous Government set, some managers are still treated better than patients. We will change that.

Business of the House

Lord Spellar Excerpts

Thursday 6th September 2012 Commons Chamber

[Mr Lansley]

I am grateful to my hon. Friend, and I will raise that issue. I know that people feel strongly that service personnel who serve this country should be treated with the greatest respect and honoured as a consequence. My colleagues at the Ministry of Defence will want to reply to him on that matter.

[Mr John Spellar (Warley) (Lab)]

May I also welcome the Leader of the House to his new position? I should like to take him back to his previous incarnation as Health Secretary. Is he as shocked as I was to find out how much typing work is now being outsourced abroad by hospitals? My freedom of information request has revealed that West Middlesex outsourced 230,000 letters in one year, that Whittington outsourced 90,000, that Epsom outsourced 11,000 in a quarter, and that Kingston outsourced 17,000 in a pilot. Medical secretaries are being laid off as a result. May we have a debate so that the Secretary of State for Health can justify taking away British jobs from British workers?

[Mr Lansley]

I will of course raise that issue with the Department of Health on the right hon. Gentleman’s behalf, but he might also like to raise it himself in the pre-recess Adjournment debate, which will give Members the opportunity to mention issues of that kind. I was interested to see, in my own constituency a few years ago, that Addenbrooke’s—a major hospital—had outsourced activities of that kind, but that it brought them back to this country as a consequence of seeing the quality of service that could be delivered here.