Oral Answers to Questions

Debate between Jonathan Ashworth and Jeremy Hunt

Tuesday 21st March 2017 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab)]

The Government have not met the four-hour target for A&E since July 2015. In the NHS mandate, finally published yesterday, the Secretary of State is effectively telling hospitals that they do not need to meet it in 2017 and that it only needs to be met in aggregate across hospitals

“within the course of 2018”.

Is that not the clearest admission that the targets will not be met next year, because in the next 12 months the NHS will be denied the funding it needs and, as a consequence, patients will suffer?

[Mr Hunt]

Apart from observing that if the hon. Gentleman cares so much about the 95% target he might want to ask his colleagues in Wales why they are looking at scrapping it, on the money let me be very clear: in the next year, the NHS will be getting about £1.5 billion more than his party were promising at the last election and the social care system will be getting £1.5 billion more than his party were promising at the last election. We are doing our job.

[Jonathan Ashworth]

The Secretary of State says he is doing his job, so why does he not take that up with NHS Providers, which is warning that because of the underfunding, it will be “mission impossible” in the next 12 months to deliver standards of care. Returning to the NHS mandate, did you notice, Mr Speaker, that in that mandate there is no mention whatsoever of Brexit, even though the NHS relies on 140,000 NHS and care workers? I know that the Secretary of State is not a member of the Cabinet Brexit committee, but will he use his considerable influence with the Prime Minister to ensure that when she triggers article 50 next week, she will finally give an absolute guarantee of the rights of all those EU workers in our NHS?

[Mr Hunt]

First, let me first reassure you, Mr Speaker, that I will be attending the Brexit committee when it is relevant to the NHS; in fact, I shall attend it this week, because issues relating to the NHS are coming up in it. What we are not going to do in that committee, however, is to take steps that would risk the welfare of British citizens living in countries such as Spain, Ireland and France. That is why, although it is a top priority for us to negotiate the rights of EU citizens living in Britain, including those working in the NHS, it has to be part of an agreement that protects the rights of British citizens abroad.

NHS Shared Business Services

Debate between Jonathan Ashworth and Jeremy Hunt

Monday 27th February 2017 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab)]

(Urgent Question): To ask the Secretary of State for Health to make a statement on the loss of confidential NHS correspondence by NHS Shared Business Services.

[The Secretary of State for Health (Mr Jeremy Hunt)]

On 24 March 2016, I was informed of a serious incident involving a large backlog of unprocessed NHS patient correspondence by the company contracted to deliver it to general practitioners’ surgeries, NHS Shared Business Services—SBS. The backlog arose from the primary care services GP mail redirection service that SBS was contracted to run between 2011 and 2016. However, in three areas of England—the east midlands, north-east London and the south-west of England—this did not happen, affecting 708,000 items of correspondence. None of the documents was lost and all were kept in secure storage, but my immediate concern was that patient safety might have been compromised by the delay in forwarding correspondence, so a rapid process was started to identify whether anyone had been put at risk. The Department of Health and NHS England immediately established an incident team led by Jill Matthews, who heads the NHS England primary care support services team.

All the documentation has now been sent on to the relevant GP surgery, where it is possible to do so, following an initial clinical assessment of where any patient risk might lie. Some 200,000 pieces were temporary residence forms, and a further 500,000 pieces were assessed as low risk. A first triage identified a further 2,500 items that had potential risk of harm and needed further investigation, but follow-up by local GPs has already identified nearly 2,000 of those as having “no patient harm”. The remainder are still being assessed, but so far no patient harm has been identified.

As well as patient safety, transparency for both the public and this House has been my priority. I was advised by officials not to make the issue public last March until an assessment of the risks to patient safety had been completed and all relevant GP surgeries informed. I accepted that advice, for the very simple reason that publicising the issue could have meant GP surgeries being inundated with inquiries from worried patients, which would have prevented them from doing the most important work—namely, investigating the named patients who were potentially at risk.

For the same reasons, and in good faith, a proactive statement about what had happened was again not recommended by my Department in July. However, on balance I decided it was important for the House to know what had happened before we broke for recess, so I did not follow that advice and placed a written statement before the House on 21 July. Since then, the Public Accounts Committee has been kept regularly informed, most recently being updated by my permanent secretary only last Friday. The Information Commissioner was updated in August, and the National Audit Office is currently reviewing the response. I committed in July 2016 to keeping the House updated once the investigations were complete and more was known, and will continue to do so.

[Jonathan Ashworth]

Let us be under no illusions: this is a catastrophic breach of data protection. More than half a million pieces of patient data—including blood test results, cancer screening results, biopsy results, and even correspondence relating to cases of child protection—were all undelivered, languishing in a warehouse, on the Secretary of State’s watch. It is an absolute scandal.

Time and again this Health Secretary promises us transparency; today, he stands accused of a cover-up. The Department of Health knew about this in March 2016, so why did it take this self-proclaimed champion of transparency until the last day before the House rose last summer to issue a 138-word statement to Parliament? That statement said that just “some correspondence” had not reached the intended recipients. When the Secretary of State made that statement, was he aware that it amounted to more than 700,000 letters? If so, why did he not inform Parliament? If he did not know, does that not call into question his competence?

What guarantees can the Secretary of State give us that no more warehouses of letters are yet to be discovered? Was the private contractor involved paid for the delivery of the letters? If so, what steps are being taken to recover the money? How many patients were harmed because their GP did not receive information about their ongoing treatment? Do patients remain at risk? The Secretary of State talks about NHS England’s ongoing investigation into 2,500 items; when are we likely to know the outcome?

We understand that Capita now has the contract to deliver these services. What scrutiny is the Secretary of State putting Capita under so that it does not happen again? Is it not better that, rather than this relentless pursuit of privatisation, we bring services back in-house?

Two months into 2017 and the Health Secretary lurches from one crisis to another: hospitals overcrowded and waiting lists out of control. He cannot deliver the investment that our NHS needs; he cannot deliver a social care solution; he cannot deliver patient safety; and now he cannot even deliver the post. He has overseen a shambles that puts patient safety at risk. Patients deserve answers and they deserve an apology.

[Mr Hunt]

The hon. Gentleman is reasonable and sensible, but sadly those commendable sides to his character have not been on display this afternoon, not least because I answered a number of his questions before he read out his pre-prepared script. He said that there had been a catastrophic breach of data protection. Let me remind him that no patient data were lost and all patient data were kept in secure settings. I know that it is a great temptation to go on about the privatisation agenda, but may I gently tell him that, since SBS lost this account, this particular work has been taken in-house? It is being done not by Capita, but by the NHS—so much for the Government’s “relentless pursuit” of the private sector.

More seriously, the hon. Gentleman is quoted in this morning’s edition of The Guardian as saying:

“Patient safety will have been put seriously at risk.”

As he knows, patient safety is always our primary concern, but if he had listened to my response he would have heard that, as things stand, there is no evidence so far that patients’ safety has been put at risk. [Interruption.] Well, we have been through more than 700,000 documents, and so far, we can find no such evidence. We are now doing a second check, with GPs, on 2,500 documents—so a second clinical opinion is being sought—nearly 2,000 of which we believe will not show any evidence, and we are now going through the remaining ones.

Let me say that it was indeed totally incompetent of SBS to allow this incident to happen, and we take full responsibility as a Government, because we were responsible at the time. None the less, the measure of the competence of a Government is not when suppliers make mistakes—I gently remind the hon. Gentleman that that did happen a few times when Labour was running the NHS—but what we do to sort out the problem. We immediately set up a national incident team. Every single piece of correspondence has been assessed, and around 80% of the higher risk cases have been assessed by a second clinician.

The hon. Gentleman then went on to suggest that the Government have been trying to hide the matter. If he had listened to what I said, he would have heard that I did not follow the advice that I got from my officials, which was not to publicise the matter. I actually decided that the House needed to know about it. It was only a week after I was reappointed to this job last summer that I not only laid a written ministerial statement, but referred to the matter in my Department’s annual report and accounts. He said this morning that I played down the severity of what happened, but what did that annual report say? It said that a “serious incident was identified”, and it talked about

“a large backlog of unprocessed correspondence relating to patients.”

It could not have been clearer.

This Government have always cared about patient safety. We have listened to the advice of people—as the hon. Gentleman would have done had he been in office—who said that if we had gone public right away, GP surgeries could have been prevented from doing what we needed them to do, which is making detailed assessments of a small number of at-risk cases. That was why we paused, but as soon as we judged that it was possible to do so, we informed this House and the public and we stayed absolutely true to our commitment both to patient safety and to transparency.

Oral Answers to Questions

Debate between Jonathan Ashworth and Jeremy Hunt

Tuesday 7th February 2017 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. Actually, the policy is that all A&Es, where space is available, should do that. The hospitals that do it have by far the most successful results—not least Luton and Dunstable, which has pioneered that model.

[Jonathan Ashworth (Leicester South) (Lab)]

With respect to A&Es, diverts have been at twice the level of last year, 4,000 people have had urgent operations cancelled, 18,000 people a week in January were waiting on trolleys in corridors, and nine out of 10 hospitals have been overcrowded and are at unsafe levels. I have even read in the Secretary of State’s local paper that his local hospital had to put patients in the gym overnight. Does the Secretary of State agree with the Prime Minister that the crisis facing our NHS amounts to a “small number of incidents”?

[Mr Hunt]

The NHS is under a lot of pressure, but what we never get from the hon. Gentleman is any solutions. Our solution is 600 more A&E consultants since 2010, 1,500 more A&E doctors, 2,000 more paramedics, and 2,500 more people being seen within four hours every day. His solution at the last election was to cut the NHS budget by £1.3 billion.

[Jonathan Ashworth]

The Secretary of State’s solution has been to blame everybody else but never take responsibility himself.

What is the Secretary of State going to do about the crisis that we are now facing in staffing? Last week, we learned that half of junior doctors are abandoning specialist training. We have already heard that applications for nursing degrees are down by a quarter following the axing of the student bursary and we heard today that there is a shortage of midwives. I know that the right hon. Gentleman has been in the US and that he will try to give us his alternative facts, but when will he give us an alternative plan and deal with the staffing crisis—an issue that the Minister of State, the hon. Member for Ludlow (Mr Dunne), could not respond to a few moments ago?

[Mr Hunt]

Let us look at the reality, instead of the hon. Gentleman’s rhetoric. In his own local trust in Leicester, there are 246 more nurses than in 2010 and 313 more doctors. Some 185 more patients are being seen in A&E every day and next year a new £43 million emergency floor will open at the Leicester Royal Infirmary. That is because we are backing the NHS instead of wanting to cut its budget.

NHS and Social Care Funding

Debate between Jonathan Ashworth and Jeremy Hunt

Wednesday 11th January 2017 Commons Chamber

[Jonathan Ashworth]

I will give way in a moment. As the King’s Fund said, the reason there is a problem is quite simply because there is a

“mismatch between funding and activity”

affecting our hospitals. The response of Ministers, from the Prime Minister downwards, has been one of utter complacency. The Secretary of State told “Sky News” on Monday that things had only been

“falling over in a couple of places”.

When he came to the House on Monday to make his statement, he did not commit to extra emergency funding for social care and he did not promise that the financial settlements would be reassessed in the March Budget. It is worse than that, because while he was making his statement, his spin doctors were telling the Health Service Journal—this on the day when the winter crisis is leading the news and he is making a statement in the House—and letting it be known that there is “no prospect” of

“additional funding to support emergency care any time before the next election.”

So there is nothing for social care, nothing for emergency care, nothing to tackle understaffing and nothing to tackle underfunding—well thank you very much. What did we get as a response? We got a downgrade of the four-hour A&E target.

[The Secretary of State for Health (Mr Jeremy Hunt)]

indicated dissent.

[Jonathan Ashworth]

The Secretary of State shakes his head and says, “Nonsense”, but let me remind him of what he said in the House on Monday:

“we need to have an honest discussion with the public about the purpose of A&E departments.”

He began by saying he wanted to provoke a discussion. He has certainly provoked a backlash, not least by blaming the public, it seems, for turning up at A&E departments. He went on to say that the four-hour target

“is a promise to sort out all urgent health problems within four hours”,

but he added a little clarification, continuing:

“but not all health problems, however minor.”—[Official Report, 9 January 2017; Vol. 619, c. 38.]

That is what he said in the House, and now we have seen the letter from NHS Improvement to trusts a few weeks ago, which talks of

“broadening our oversight of A&E”.

On the four-hour standard, it said that it believed

“there is merit in broadening our oversight approach, beyond a single metric”.

So in the interests of that discussion the Secretary of State wants to engage in, perhaps he can answer our questions, although I know he avoided the questions on Sky yesterday. Does he recall that in 2015, when he asked Sir Bruce Keogh to review these matters on waiting times, Sir Bruce said:

“The A&E standard has been an important means of ensuring people who need it get rapid access to urgent and emergency care and we must not lose this focus”?

Mental Health and NHS Performance

Debate between Jonathan Ashworth and Jeremy Hunt

Monday 9th January 2017 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab)]

I am grateful to the Secretary of State for an advance copy of his statement. I, too, begin by paying tribute to all the NHS staff who are working day in, day out to provide the best possible care to patients during this busy period. Of course we welcome measures to improve mental health services in this country, as indeed we welcomed such announcements exactly 12 months ago, when the then Prime Minister made similar promises. But does the Secretary of State not agree that if this Prime Minister wants to shine a light on mental health provision, she should aim her torch at the Government’s record: 6,600 fewer nurses working in mental health; a reduction in mental health beds; 400 fewer doctors working in mental health; and, perhaps most disgracefully of all, the raiding of children’s local mental health budgets in order to plug funding gaps in the wider NHS? Could he therefore tell us why the Prime Minister was unable to confirm this morning that money for mental health would be ring-fenced to prevent this raiding of budgets from happening in the future? We welcome measures to improve mental health support in schools. Will the Government offer more resources to local authority education psychologists? What provision will be in place to give teachers suitable training for doing this work?

On the winter crisis, this morning the Secretary of State said that things have only been “falling over in a couple of places”. Let us look at the facts: a third of hospitals declared last month that they needed urgent help to deal with the number of patients coming through the doors; A&E departments have turned patients away more than 140 times; 15 hospitals ran out of beds in one day in December; several hospitals have warned that they cannot offer comprehensive care; and elderly patients have been left languishing on hospital trolleys in corridors, sometimes for more than 24 hours. And he says that care is only falling over in a couple of places! I know that “La La Land” did well at the Golden Globes last night, but I did not realise the Secretary of State was living there—perhaps that is where he has been all weekend. Will he confirm that the NHS is facing a winter crisis, and that the blame lies at the doors of No. 10 Downing Street?

Does the Secretary of State agree that it was a monumental error to ignore the pleas for extra support for social care to be included in the autumn statement only weeks ago? Will he support calls to bring forward now the extra £700 million that is allocated for 2019, to help social care? Will he urge the Chancellor and the Prime Minister to announce a new funding settlement for the NHS and social care in the March Budget so that a crisis like this year’s never happens again?

I press the Secretary of State further on the announcement he has just made on the four-hour A&E target. Is he really telling patients that rather than trying to hit that four-hour target, the Government are now in fact rewriting and downgrading it? If so, does NHS England support that move? What guidance has he had from the Royal College of Emergency Medicine to say that that is an appropriate change to the waiting-time standard?

The Secretary of State has made patient safety an absolute priority; in that, he has our unswerving support. I am sure he will agree that one of the most upsetting reports to come out of hospitals last week was that on the death of two patients at Worcestershire Royal hospital who had been waiting on trolleys. Will he commit to personally lead an inquiry into those deaths? Does he know whether they were isolated incidents? When does the trust intend to report back on its investigation? Will he undertake to keep the House updated on those matters?

There is no doubt that the current crisis could have been averted. Hospital bosses, council leaders, patients groups and MPs from both sides of the House urged the Chancellor to give the NHS and social care extra money in the autumn statement. Those requests fell on deaf ears and we are now seeing the dismal consequences. NHS staff deserve better. Patients deserve better. The Government need to do better. I urge the Health Secretary to get a grip.

[Mr Hunt]

I am happy to respond to the hon. Gentleman’s comments and, indeed, to the comments of all Members, but I shall first say this about the tone of what he said. He speaks as if the NHS never had any problems over winters when Labour was in power. The one thing NHS staff do not want right now is for any party to start weaponising the NHS for party political purposes. I remind him that when his party runs the NHS, the number of people on waiting lists for treatments doubles, A&E performance is 10% lower and people wait twice as long to have their hips replaced. Whatever the problems are in the NHS, Labour is not the solution.

The hon. Gentleman talked about mental health, so let me tell him what is happening on that. Thanks to the efforts of this Government and the Conservative-led coalition, we now have some of the highest dementia diagnosis rates in the world. Our talking therapies programme—one of the most popular programmes for the treatment of depression and anxiety—is treating 750,000 more people every year and is being copied in Sweden. Every day, we are treating 1,400 more people with mental health conditions and we have record numbers of psychiatrists. The hon. Gentleman mentioned mental health nurses: in this Parliament we are training 8,000 more, which is a 22% increase.

All that is backed up by what we are confirming today, which has not been done before: the Government are accepting the report of the independent taskforce review—led by Paul Farmer, the chief executive of Mind—which commits us to spending £1 billion more a year on mental health by the end of the Parliament. That would not be possible with the spending commitments that Labour was prepared to make for the NHS in the previous Parliament. It is because of this Government’s funding that we are able to make such commitments on mental health.

The hon. Gentleman talked about the NHS and gave completely the wrong impression of what I said this morning. I was completely clear that all NHS hospitals are operating under greater pressure than they ever have. He should listen to independent voices, such as that of Chris Hopson—no friend of the Government when it comes to NHS policy—who is clear that in the vast majority of trusts people are actually coping slightly better than last year. However, we have some very serious problems in a few trusts, including in Worcestershire and a number of others. I can commit to him that we will follow closely the investigations into the two reported deaths at Worcestershire and keep the House updated.

The hon. Gentleman talked about social care, which is where, I think, his politicising goes wrong. Last year, spending on social care went up by around £600 million. At the last election, he stood on a platform of not a penny more to local authorities for social care, so to stand here as a defender of social care is, frankly, an insult to vulnerable people up and down the country, particularly to those living under Labour councils such as Hounslow, Merton and Ealing, which are refusing to raise the social care precept, but complaining about social care funding.

The hon. Gentleman talked more generally about NHS funding, but in the last Parliament it was not the Conservatives who wanted to cut funding for the NHS—it was his party. It was not the Conservatives who said that funding the five-year forward view was impossible—it was his party. Labour said that the cheque would bounce. Well, it has not bounced, and we are putting in that money.

In conclusion, it is tough on the NHS frontline. The hon. Gentleman was right to raise this issue in this House, but wrong to raise it in the way that he did. Under this Government, the NHS has record numbers of doctors and nurses and record funding. Despite the pressures of winter, care is safer, of higher quality and reaching more people than ever before. It is time to support those on the frontline, and not try to use them for party political points.

Oral Answers to Questions

Debate between Jonathan Ashworth and Jeremy Hunt

Tuesday 20th December 2016 Commons Chamber

[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?

[Mr Hunt]

Let me wish the shadow Health Secretary a merry Christmas and say that despite his rhetoric I see that Santa has been quite generous to him. His local trust in Leicester has 254 more nurses and 306 more doctors than in 2010. Next year, we will have a new £43 million emergency floor at the Leicester royal infirmary. We need to ensure that there is sufficient bed capacity in our hospitals over winter—that is a very important part of winter planning—but we are also doing 5,000 more elective operations every day than when Labour was in office.

[Jonathan Ashworth]

I am delighted that the Secretary of State has done his research on Leicester, but is closing operating theatres for a month this Christmas not, in reality, a short-term fix? The truth is that when the pause ends and hospitals fill up again above the 85% occupancy recommendations, patients will be left with a simple choice: get stuck on a waiting list while hospitals try to reduce occupancy rates to safe levels, or risk going into a hospital when it is at full capacity and potentially unsafe and be exposed to higher infection risks. Which option would the Secretary of State choose?

[Mr Hunt]

May I gently urge the hon. Gentleman to be careful with his rhetoric? We are not closing operating theatres for a month over Christmas. We need to be very careful what we say in this place, because people outside are listening. The answer is to ensure that we increase capacity in the NHS, and that is why we have 11,000 more doctors and 11,000 more hospital nurses than we had six years ago. We are training 15,000 more doctors every year from 2018-19 to ensure that we can avoid these problems in the future.

CQC: NHS Deaths Review

Debate between Jonathan Ashworth and Jeremy Hunt

Tuesday 13th December 2016 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab)]

I thank the Secretary of State for advance sight of his statement, and I thank the CQC for its report.

Any death is a tragedy for families, but when that death could have been prevented, or was the fault of a system that is meant to care for our loved ones, the trauma is all the more difficult to cope with. The circumstances of Connor Sparrowhawk’s death were shocking, and I, like the Secretary of State, pay tribute to his family, who have fought so hard for justice and to ensure other families do not have to go through what they went through. Connor Sparrowhawk’s step-father, Richard, told Radio 5 live:

“When a loved one dies in care, knowing how and why they died is the very least a family should be able to expect”.

We agree.

The findings of the CQC are a wake-up call: relatives shut out of investigations; reasonable questions going unanswered; and grieving families made to feel like a “pain in the neck” or feeling they would be better dealt with at a “supermarket checkout”. This is totally unacceptable—it is shameful and it has to change. We therefore strongly welcome the recommendation of a national framework and the specific measures the Secretary of State has outlined today. I assure him we will work with him and the Care Quality Commission to support the establishment of such a framework in a timely fashion.

Families and patients should not be forgotten in this process. Will the Secretary of State pledge that families and carers will be equal partners in developing the Government’s plans for implementing the CQC’s recommendations? Does he agree that those who work in the NHS show extraordinary compassion, good will and professionalism? Does he accept that when something, sadly and tragically, goes wrong, it can often be the result of a number of interplaying systemic failures and that therefore a national framework will provide welcome standards and guidance across the service?

Does the Secretary of State recall that the National Patient Safety Agency was responsible for monitoring patient safety incidents in the NHS, including medication and prescribing errors, before it was scrapped under the Health and Social Care Act 2012? Will he perhaps acknowledge in retrospect that scrapping that agency was a mistake?

For such a national framework and the Secretary of State’s proposed measures to succeed, investment will be necessary. Will hospitals and trusts receive extra funding to carry out the additional requirements that the CQC has recommended? More generally, hospitals across England are suffering chronic staff shortages, which is leaving doctors and nurses overstretched and struggling to do basic tasks. We all recall that Sir Robert Francis called for safe nurse staffing levels to be published by the National Institute for Health and Care Excellence, but this guidance has been blocked. Will the Secretary of State now consider committing to NICE publishing safe nurse staffing levels, as recommended by the Francis report?

The Secretary of State is aware of the wider pressures on the service. Will he acknowledge that cuts to social care and the failure to provide it with extra investment in the autumn statement two weeks ago are leaving hospitals dangerously overstretched, with patients at risk of harm?

The Secretary of State will also be aware of the pressures on mental health provision. Over the weekend, we saw reports that bed shortages in England are now such that seriously ill patients with eating disorders are having to travel hundreds of miles for treatment. What does he make of this practice, and does he consider it safe and sustainable?

May I ask the Secretary of State about the heart-breaking case of the death of baby Elizabeth Dixon? I know that he has spoken of this in the past. He rightly ordered an investigation, but I understand from the family that 16 months down the line the investigation has not started. Will he provide the House with an update?

The CQC has called for the issues addressed in its report to be a national priority, and for all those involved in delivering safe care to review the findings and publish a full report. We absolutely agree. Action is needed. We welcome the recommendations and stand ready to work with the Government to ensure that these issues are no longer ignored.

[Mr Hunt]

I thank the shadow Health Secretary for the constructive nature of his comments. He is absolutely right in that, because this issue can unite people in all parts of the House. In fairness, these tragedies happen when those on either side of the House are responsible for the NHS, and we all have a responsibility to work to do better than we are doing at the moment.

I particularly agree with the hon. Gentleman that front-line doctors and nurses work incredibly hard, and we need to get away from a blame culture when these tragedies happen. That blame culture is the root cause of why we are not learning as we should from the problems that arise, because people are worried about what will happen to them personally if they speak out. We have seen this with a number of tragedies. Through the national framework, we are trying to move away from a blame culture. Of course people have to be held accountable. If there is gross negligence and people do totally irresponsible things, then there must be no hiding place and proper accountability: that is what families rightly insist on. For the vast majority of the time, however, people are just trying to do their jobs as best they can. As he rightly says, it is often a systemic problem that can be solved with systemic changes. We are now trying to implement the culture of investigation that has worked so successfully in the airline industry and other industries.

I absolutely assure the hon. Gentleman that families and carers will be equal partners as we develop the new national guidance. This area was one of the most shocking things about the CQC report. I am sure that it was a great surprise to many people in the NHS how excluded many families felt. We clearly have to do better in that respect.

The hon. Gentleman talked about the National Patient Safety Agency, and I pay credit to Sir Liam Donaldson, who was chief medical officer under the previous Labour Government and a great champion of patient safety, but we now have different structures in place. The new CQC inspection regime and the healthcare safety investigation branch are giving equal, if not greater, priority to patient safety.

We discuss on many occasions the funding issues that the hon. Gentleman raised, as I think he is acknowledging with his facial expressions. The point I would make, because we have had a good exchange and I do not want to get into the specific politics of NHS funding, is that this is a win-win, because avoidable harm and death is incredibly expensive for the NHS. The time it takes to carry out investigations when things go wrong is utterly exhausting for the doctors, nurses and managers involved, who would much rather be doing front-line care. Preventing these things from happening in future is the best possible way of freeing up time for people on the frontline.

I will take away what the hon. Gentleman said about the Elizabeth Dixon case and find out what is happening with that review.

The real lesson of today is that every family, every doctor and every nurse has a simple aim when a tragedy happens. It is not about money; it is about making sure that lessons are learned openly and transparently so that history does not repeat itself. That is really what this is about, and that is why we will continue our mission to make NHS care the safest and highest quality in the world.

National Health Service Funding

Debate between Jonathan Ashworth and Jeremy Hunt

Tuesday 22nd November 2016 Commons Chamber

[Jonathan Ashworth]

In a few moments.

We have spotted the Secretary of State’s conjuring act because we have seen this Tory trick before—robbing Peter to pay Paul. The result of this trick is cuts and underfunding, more pressures flowing through to the frontline, and, as the NAO said,

“Financial stress…harming patient care”.

In all our constituencies we see ever-lengthening queues of the elderly and the sick waiting for treatment. Across the board, we see the worst performance data since records began.

[The Secretary of State for Health (Mr Jeremy Hunt)]

Nonsense.

[Jonathan Ashworth]

What world is the Secretary of State living in? Half a million patients have waited for four hours or more in A&E in the past three months—the worst performance for this time of year for more than a decade—and he says it is nonsense. Some 350,000 of our constituents are waiting longer than the promised time for elective treatment—some have been waiting more than a year—and he says it is nonsense. Delayed discharges from hospitals are at record levels, and he says it is nonsense. The number of people waiting for 12 hours or more on trolleys has increased by over 700% since 2011-12.

Oral Answers to Questions

Debate between Jonathan Ashworth and Jeremy Hunt

Tuesday 15th November 2016 Commons Chamber

[Mr Hunt]

As ever, my hon. Friend speaks wisely. Thanks to this Government, health spending in England is up by 10.1% in cash terms—4.6% in real terms—since 2010. That is double the cash increase in Scotland and three times the cash increase in Wales. Other parties talk about funding the NHS, but Conservatives say that actions speak louder than words.

[Jonathan Ashworth (Leicester South) (Lab)]

But we have seen public health budgets cut and social care budgets cut, and I can now tell the House that the maintenance budgets have been cut. In fact, the backlog of high-risk maintenance facing the NHS has soared by 69% in the past year. In London alone, the high-risk backlog has grown by £338 million; across the country the figure is nearly £5 billion. NHS finances are so stretched that even the most urgent repairs are being left undone. Is this what the Secretary of State meant when he said that he is giving the NHS the money it asked for?

[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?

[Mr Hunt]

Unlike other parties in this House, we have been increasing funding for the NHS. Thanks to that, we are now funding the NHS in England at a 10% higher proportion of GDP than the OECD average, and we are in line with the western European average because of our commitment. These are difficult financial times and there is financial pressure, but this Government have been saying that despite that financial pressure we must make sure that the NHS continues to offer safe, high-quality care—and that is our focus.

NHS Funding

Debate between Jonathan Ashworth and Jeremy Hunt

Monday 31st October 2016 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab)]

(Urgent Question): To ask the Secretary of State if he will make a statement on NHS funding.

[The Secretary of State for Health (Mr Jeremy Hunt)]

Compared with five years ago, the NHS is responsible for 1 million more over-75s. In five years’ time, there will be another 1 million over-75s. Our determination is to look after each and every NHS patient with the highest standards of safety and care, but there is no question but that the pressures of an ageing population make this uniquely challenging.

I welcome the chance to remind the House of this Government’s repeated commitment to supporting our NHS. The NHS budget has increased in real terms every year since 2010. NHS spending has increased as a proportion of total Government spending every year since 2010, and is 10.1% higher per head in real terms than when we came to office. The OECD says that our spending is 10% higher than the OECD average for developed countries. At 9.9% of GDP, it is about the same as that in other western European countries, for which the average is 9.8%.

Given the particularly challenging current circumstances, in 2014 the NHS stepped back and for the first time put together its own plan for the future. It was an excellent plan, based on the principle that because prevention is better than cure, we need to be much better at looking after people closer to or in their homes, instead of waiting until they need expensive hospital treatment. The plan asked for a minimum increase of £8 billion in NHS funding over five years. It asked for this to be front-loaded to allow the NHS to invest in new models of care up front.

Following last year’s spending review, I can confirm to the House that the NHS will in fact receive an increase of £10 billion in real terms over the six years since the “Five Year Forward View” was published. In cash terms, that will see the NHS budget increase from £98.1 billion in 2014-15 to £119.9 billion in 2020-21. That rise is highly significant at a time when public finances are severely constrained by the deficit that this Government regrettably inherited. Because the NHS’s particular priority was to front-load the settlement, £6 billion of the £10 billion increase comes before the end of the first two years of the spending review, including a £3.8 billion real-terms increase this year alone. That £3.8 billion represents a 52% larger increase in just one year than the Labour party was promising over the lifetime of this Parliament.

[Jonathan Ashworth]

This morning the Chair of the Health Committee and her colleagues on that Committee said that the Government’s NHS spending claims were “inaccurate” and “false”. The Opposition agree with that analysis. Ministers—and the Secretary of State has just done this again—tell us that they are investing £10 billion more in the NHS, but it has now been confirmed that that figure is

“not only incorrect but risks giving a false impression that the NHS is awash with cash.”

Is not the reality that the Government have cut adult social care, the public health budget and the NHS capital budget? Now we learn that the average amount we spend on healthcare for each person in this country will fall in 2018-19. Does that not raise serious questions about the claims that Ministers, and, indeed, Prime Ministers, have been making from that Dispatch Box? In fact, the only way the Government’s figures could be further discredited is if the Secretary of State slapped them on the side of a bus and got the Foreign Secretary to drive it.

Will the Secretary of State admit that the Government have not actually given the NHS the money it needed? Will he give us an accurate account of spending plans for the NHS? Will he tell us when the Chancellor is going to respond to the Health Committee’s letter, and what representations he himself is making to the Chancellor ahead of the autumn statement?

We have also learned today from Health Service Journal that one in three local areas intend to close or downgrade A&E departments within 18 months, one in five expect to close consultant-led maternity services, and more than half plan to close or downgrade community hospitals. Will the Secretary of State confirm whether those reports are accurate? How many A&E departments, maternity units and community hospitals does the Secretary of State expect to close or be downgraded within the next year and a half? Our constituents want those answers.

Before the last election, the Secretary of State told us he was “confident” about delivering the money the NHS needed. Today that confidence has been exposed as utterly misplaced. Tory promises are completely in tatters. Rather than defending the Prime Minister’s spin on the £10 billion figure, why does the Secretary of State not stand up for patients and staff, and deliver the funding that the NHS and our social care sector desperately need?

[Mr Hunt]

I start by welcoming the hon. Gentleman to his first urgent question in his new role. As I am a relative old timer in my role, I hope he will not mind me reminding him of some of the facts about health spending.

First, the hon. Gentleman said that the Government did not give the NHS what it asked for. Let me remind him that Simon Stevens, a former Labour special adviser—I know for new Labour, but he was none the less a Labour special adviser—said at the time of the spending review settlement last year that

“our case for the NHS has been heard and actively supported”

and that the settlement

“is a clear and highly welcome acceptance of our argument for frontloaded NHS investment. It will…kick start the NHS Five Year Forward View’s fundamental redesign of care.”

I will tell the hon. Gentleman who did not give the NHS what it asked for: the Labour party. At the last election, it refused to support the NHS—[Interruption.] I know this is uncomfortable for the new shadow Health Secretary, but the reality is that the party on whose platform he stood refused to support the NHS’s own plan for the future. As his question was about money, I will add that the Labour party also refused to fund it. The NHS wanted £8 billion; Labour’s promise was for additional funding of £2.5 billion—not £6 billion or £4 billion, but £2.5 billion, or less than one third of what the NHS said it needed. Even if we accept the numbers of the Chair of the Select Committee—and, as I will go on to explain, I do not—Labour was pledging over the course of the Parliament only around half of what this Government have delivered in the first year of the spending review.

The hon. Gentleman used other choice words, one of which was “spin”. I will tell him what creates the most misleading impression: a Labour party claiming to want more funding for the NHS when, in the areas where they run it, the opposite has happened. Indeed, in the first four years of the last Parliament, Labour cut NHS funding in Wales when it went up in England—[Interruption.] Yes, it did. Those are the official figures. That is in a context in which the Barnett formula gives the Government in Wales more than £700 more per head to spend on public services, so there is more money in the pot.

The hon. Gentleman talked about social care. May I remind him of what the shadow Chancellor at the time of the last election—Ed Balls, who is now sadly no longer of this parish—said? During the election campaign, he said of funding for local councils “not a penny more”. We are giving local councils £3.5 billion more during the course of this Parliament.

The hon. Gentleman talked about other cuts that he alleges will happen in A&E departments and other hospital services. I simply say to him that we have to make efficiency savings. I do not believe they will be on the scale he talked about, but how much worse would they have to be if the NHS got a third of the money it currently gets?

If the hon. Gentleman and his party think the NHS is underfunded, they need to accept that the policies that they advocated in the past two elections were wrong —they advocated spending less than the Conservatives. Until they are serious about changing their policy, no one will be serious about listening to their criticisms.