Gosport Independent Panel: Publication of Report

Debate between Jonathan Ashworth and Jeremy Hunt

Wednesday 20th June 2018 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I thank the Secretary of State for the advance copy of his statement. I welcome the tone of his remarks and the apology that he has offered on behalf of the Government and the national health service.

This is a devastating, shocking and heartbreaking report. Our thoughts must be with the families of the 456 patients whose lives were shortened. I, like the Secretary of State, pay tribute to the right hon. Member for North Norfolk (Norman Lamb), whose persistence in establishing this inquiry in the face of a bureaucracy that, in his own words, attempted to close ranks, must be applauded. I know that other Members have also played an important part, including the hon. Member for Eastbourne (Stephen Lloyd), who is in his place, and the Minister for Care, who is understandably and properly in her Gosport constituency this afternoon. I also thank all those who served on the inquiry panel, and offer particular thanks for the extraordinary dedication, calm, compassionate, relentless and determined leadership—yet again—of the former Bishop of Liverpool, James Jones, in uncovering an injustice and revealing a truth about a shameful episode in our nation’s recent history.

As the Secretary of State quoted, the Right Rev. James Jones said:

“Handing over a loved one to a hospital, to doctors and nurses, is an act of trust and you take for granted that they will always do that which is best for the one you love.”

That trust was betrayed. He continued:

“whereas a large number of patients and their relatives understood that their admission to the hospital was for either rehabilitation or respite care, they were, in effect, put on a terminal care pathway.”

Others will come to their own judgment, but for me that is unforgivable.

This is a substantial, 400-page report that was only published in the last hour or so, and it will take some time for the House to fully absorb each and every detail, but let me offer a few reflections and ask a few questions of the Secretary of State. Like the Secretary of State, the question that lingers in my mind is, how could this have been allowed to go on for so long? How could so many warnings go unheeded?

The report is clear that concerns were first raised by a nurse in 1991. The hospital chose not to rectify the practice of prescribing the drugs involved. Concerns were raised at a national level, and the report runs through a complicated set of back and forths between different versions of health trusts and successor health trusts, management bodies and national bodies about what to do and what sort of inquiry would be appropriate. An inquiry was eventually conducted and it found an

“almost routine use of opiates”

that

“almost certainly shortened the lives of some patients”.

It seems that that report was left on a shelf, gathering dust.

I am sure that many of the officials and players acted in good faith but, taken as a whole, there was a systemic failure properly to investigate what went wrong and to rectify the situation. In the words of the report, serious allegations were handled

“in a way that limits the impact on the organisation and its perceived reputation.”

The consequence of that failure was devastating.

To this day, the NHS landscape understandably remains complex and is often fragmented. How confident is the Secretary of State that similar failures—if, God forbid, they were to happen again somewhere—would be more easily rectified in the future? Equally, as the Secretary of State recognises, there are questions about Hampshire constabulary. As the report says,

“the quality of the police investigations was consistently poor.”

Why is it that the police investigated the deaths of 92 patients, yet no prosecutions were brought? The report has only just been published, but what early discussions will the Secretary of State be having with the Home Secretary to ensure that police constabularies are equipped to carry out investigations of this nature, if anything so devastating were to happen anywhere else?

What about the voice of the families? Why did families who had lost loved ones have to take on such a burden and a toll to demand answers? It is clear that the concerns of families were often too readily dismissed and treated as irritants. It is shameful. No family should be put through that. I recognise that the Secretary of State has done work on this in the past and I genuinely pay tribute to him, but how can he ensure that the family voice is heard fully in future? He is right that we must be cautious in our remarks today, but can he give me the reassurance that all the relevant authorities will properly investigate and take this further? If there is a police investigation, can he guarantee that a different force will carry it out?

I also want the Secretary of State to give us some more general reassurances. Is he satisfied that the oversight of medicines in the NHS is now tight enough that incidents such as this could never be allowed to happen again? What wider lessons are there for patient safety in the NHS? Is additional legislation now required? Does he see a need for any tightening of the draft Health Service Safety Investigations Bill to reflect the learnings from this case?

The Right Rev. James Jones has provided a serious, devastating, far-reaching service in a far-reaching report. Aggrieved families have had to suffer the most terrible injustice. In the next few weeks, we will rightly acknowledge 70 years of our national health service. The Secretary of State is right to say that this must not cast a shadow over the extraordinary work done every day by health professionals in our NHS. But on this occasion, the system has let so many down. We must ask ourselves why that was allowed to happen and dedicate ourselves to ensuring that it never happens again.

[Mr Hunt]

I thank the shadow Health Secretary for the considered tone of his comments. I agree with everything he says. Members across the House will understand that we are all constrained in what we can say about the individual doctor concerned—because that is now a matter for the police and the CPS to take forward—but we are not constrained in debating what system lessons can be learned, and we should debate them fully, not just today but in the future. The big question for us is not so much, “How could this have happened once?”—because in a huge healthcare system we are, unfortunately, always occasionally going to get things that go wrong, however horrific that sometimes is—but, “How could it have been allowed to go on for so long without being stopped?”

Reflecting the hon. Gentleman’s comments, the poor treatment of whistleblowers, the ignoring of families and the closing of ranks is wrong, and we must stop it. We must go further than we have gone to date. In a way, though, it is straightforward, because we know exactly what the problem is and we just have to make sure that the culture changes. The more difficult bit is where there were process issues that happened in good faith but had a terrible outcome.

In particular, this report is a salutary lesson about the importance of transparency. Obviously I had only a couple of hours to read it—so not very long—but it looks as though the Baker report was left to gather dust for 10 years, for the perfectly straightforward and understandable reason that people said that it could not be published in the course of a police investigation or while an inquest was going on. I am speculating here, but I am pretty certain that had it been published, transparency would have prompted much more rapid action, and some of the things that we may now decide to do we would have done much, much earlier. That is an incredibly powerful argument for the transparency that has sadly been lacking.

How confident can I be that this would not happen again? I do think that the culture is changing in the NHS, that the NHS is more transparent and more open, and that interactions with families are much better than they were. However, I do not, by any means, think that we are there yet. I think that we will uncover from this a number of things that we are still not getting right.

As the hon. Gentleman will understand, it is not a decision for the Government as to which police force conducts these investigations. We have separation of powers and that has to be a matter for the police. One of the things that we have to ask about police investigations is whether forces have access to the expertise they need to decide whether they should prioritise an investigation. When the medical establishment closes ranks, it can be difficult for the police to know whether they should challenge that, and it does appear that that happened in this case.

In terms of wider lessons on the oversight of medicines and the Health Service Safety Investigations Bill, we will certainly take on board whether any changes need to be made there.

NHS Long-Term Plan

Debate between Jonathan Ashworth and Jeremy Hunt

Monday 18th June 2018 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I thank the Secretary of State for an advance copy of his statement.

Today’s announcement is the clearest admission that eight years of cuts, of the tightest financial squeeze in its history and of privatisation have pushed the NHS to the brink. Is not the announcement of new potential legislation the clearest admission that the Health and Social Care Act 2012 has been a wasteful mess and should never have been introduced in the first place?

With waiting lists at 4 million, with winters in our NHS so severe that they were branded a “humanitarian crisis” and with 26,000 cancer patients waiting more than 60 days for treatment, Tory MPs should not be boasting today but should be apologising for what they have done to the NHS.

We have long called for a sustainable funding plan for the NHS, and I note that the Secretary of State did not use the words “Brexit dividend.” Is that because he knows—I say this for the benefit of his own Back Benchers—there is no such thing as a Brexit dividend? That is why the Institute for Fiscal Studies said with respect to the Brexit dividend that

“over the period, there is literally zero available”.

If the Secretary of State disagrees with the IFS, will he confirm the Government’s own Office for Budget Responsibility forecasts that there is no Brexit dividend initially for the public finances? Is it not the truth that this package will be paid for by extra borrowing and higher taxation? The Prime Minister should level with the British public and not take them for fools.

The Secretary of State is graceful enough to concede that higher taxation is on the way, but do the British public not deserve to know how much extra tax they will be paying? Will VAT go up under the Tories? Will the basic rate of income tax go up under the Tories? It is not good enough for him to say that these are matters for the Chancellor, because they are matters for the Cabinet of which he is a member.

Given that the Secretary of State is putting up tax and borrowing, and of course every £1 should be spent wisely, can he guarantee that not a further penny piece will be siphoned off into poor-quality, poor-value privatisation? Three years ago, he told us that the NHS would find £22 billion-worth of efficiency savings. How much of those efficiency savings came to fruition?

How much will the NHS be spending on agency workers and locums in the coming years? The NHS already spends £3 billion a year. Staffing gaps have led to clinical negligence claims of £1.7 billion a year, twice the rate of 2010. How much of this new money will go to further claims? The NHS spends £389 million a year on consultancy costs. Will consultancy costs increase, or will the Secretary of State cap them? With hospital trusts in deficit by £1 billion, can he guarantee that trusts will break even next year?

Is it not the truth, as expert after expert has said, that this settlement is not good enough to deliver the needed improvements in care? Indeed that is why the Prime Minister could not even confirm, when asked a basic question today, whether this funding will deliver the NHS’s constitutional standards on treatment waits, A&E waits and cancer waits.

Can the Secretary of State tell us whether, this time next year, the waiting list for NHS treatment will be higher or lower than the 4 million it is today? This time next year, will there be more or fewer patients waiting more than 60 days for cancer treatment? This time next year, will there be more than 2.5 million people waiting beyond four hours in accident and emergency or fewer? If he cannot give us basic answers to these fundamental performance target questions, that exposes the inadequacy of this settlement.

Why does the Secretary of State not tell us what was left out of this settlement? We have a childhood obesity crisis; we have seen cuts to sexual health services and to addiction services; and health visitor numbers are falling. Yet there is no new money for public health in this announcement—instead we are told to wait until next year. We have a £5 billion repair bill facing the NHS and outdated equipment, yet there is no new money for capital in this settlement—instead we are told to wait until next year.

On social care, we have had £7 billion in cuts and we have had 400,000 people losing care support. The social care Green Paper is delayed again. Is it not a total abdication of responsibility to have left social care out of this settlement? This is not a credible long-term funding plan for our NHS; it is a standstill settlement for the NHS. The reality is that under this plan the NHS will remain understaffed, under-equipped and underfunded—it needs to be under new management.

[Mr Hunt]

It was a valiant effort, but the hon. Gentleman could not get away from the truth in British politics: when it comes to the NHS, Labour writes the speeches, Conservatives write the cheques. He gamely managed to avoid smiling when he said that this settlement was not enough. He said the same thing on “Sunday Politics” yesterday. Let me remind him that at the last election his party was promising not the 3.4% annual increases that we are offering today, but 2.2%. What today he says was not enough he said in the election was enough to

“'restore the NHS to be the envy of the world”.

His leader said that it would

“give our NHS the resources it needs”.

What we are offering today is not 10% or 20% more than that, but 50% more. In five years’ time this Conservative Government will be giving the NHS £7 billion more every year than Labour was prepared to give. [Interruption.] It is funny, isn’t it, that Labour Members talk about funding the NHS but when we talk about it they try to talk it down? They do not want to hear the fact that under a Conservative Government there will be £7 billion more funding every year—that is 225,000 more nurses’ salaries under a Conservative Government. [Interruption.]

NHS Outsourcing and Privatisation

Debate between Jonathan Ashworth and Jeremy Hunt

Wednesday 23rd May 2018 Commons Chamber

[Mr Hunt]

As Chinese Premier Zhou Enlai said about the French revolution, it is too early to tell.

As my hon. Friend the Member for Solihull (Julian Knight) alluded to, there is one ideology that we will not compromise on: our belief that the NHS should be free at the point of use and available to all. And why will we not compromise on this? It is because, contrary to Labour’s creation myth about the NHS, it was a Conservative Health Minister, Sir Henry Willink, who first proposed it in 1944. Here are his words from 1944 announcing the setting up of the NHS:

“Whatever your income, if you want to use the service…there’ll be no charge for treatment. The National Health Service will include”—

[Interruption.] I know this is difficult for Labour Members, but let me tell them what the Conservatives said when we were setting up the NHS:

“The National Health Service will include family doctors”

and will

“cover any medicines you may need, specialist advice, and of course hospital treatment whatever the illness”.

Nye Bevan deserves great credit for delivering that Conservative dream, but let us be clear today that no party has a monopoly on compassion, and no party has a monopoly on our NHS. There are some other myths—

[Jonathan Ashworth]

Will the Secretary of State give way?

[Mr Hunt]

I will give way, with great pleasure.

[Jonathan Ashworth]

I really do think the Secretary of State has some brass neck. The Tory party voted against the creation of the NHS 20-odd times. That is the reality of what happened in 1948, including on Third Reading in this House. It is a Labour creation.

[Mr Hunt]

As the shadow Health Secretary knows perfectly well, the way that this House works is that Oppositions often vote against the Government when they disagree with elements of a Bill, but that does not mean that they disagree with the principles of the Bill. I remember the hon. Gentleman’s party voting against the Care Act 2014. That does not mean that they disagreed with the principles behind it.

Oral Answers to Questions

Debate between Jonathan Ashworth and Jeremy Hunt

Tuesday 8th May 2018 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I thank the Secretary of State for his update on breast cancer screening. I welcome his letter this morning with respect to patient safety in the private sector, but is not the truth that the best quality of care is provided by a public national health service? Is it not time to legislate to ensure that private hospitals improve their patient safety standards, and if he accepts that levels of safety are not acceptable in the private sector, why is the NHS still referring patients to the unsafe private sector? Should there not be a moratorium on those referrals until these issues are sorted out?

[Mr Hunt]

The hon. Gentleman should be very careful in making generalisations about the independent sector, just as he is about the NHS sector, because the truth is that there is too much poor care in both sectors, but both sectors also have outstanding care. I have always said that there will be no special favours for the independent sector, which we will hold to the same high standard of care, through the Care Quality Commission regime, as we do with NHS hospitals. Let me just say to him that if we stopped referring people to the independent sector, 140,000 people would wait longer for their operations, and that is not good care.

[Jonathan Ashworth]

We have seen the private sector fail—the NHS is sued by Virgin Care, patient transport contracts have to come back in-house, and Carillion collapses and cleaning contracts have to come back in-house—and now we learn that the hotline for women affected by the breast cancer screening failures is provided by Serco and staffed by call handlers who, far from having medical or counselling training, have had one hour’s training. Do not the women affected deserve better than that? Will the Secretary of State provide the resources for that phone line to be brought back in-house and staffed by medical professionals?

[Mr Hunt]

I normally have so much respect for the hon. Gentleman, but I think those women deserve a lot better than that posturing. The helpline was set up at very short notice because, obviously, the call handlers could not do all their training until I had made a statement to Parliament, which I judged was the most important thing to do first. It is not the only help that the women affected will be getting—on the basis of the advice received, they will be referred back for help at their local hospital, with Macmillan Cancer Support or through specialist clinicians at Public Health England—but we thought it was right that that number was made available as quickly as possible.

Breast Cancer Screening

Debate between Jonathan Ashworth and Jeremy Hunt

Wednesday 2nd May 2018 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I thank the Secretary of State for advance sight of his statement and for his personal courtesy in directly briefing me as well. The thoughts of the whole House are with those whose screening was missed and who sadly lost their lives from breast cancer, or who have subsequently developed cancer. Anyone who has had a loved one taken by breast cancer, or indeed any cancer, will know of the great pain and anguish of that loss. I understand that the Secretary of State has referred to estimates, but when the facts are established, will he assure us that each and every case will be looked into sensitively and in a timely manner? Our thoughts also turn to the 450,000 women who were not offered the screening that they should have had, so I welcome the Secretary of State’s commitment to contact the 309,000 women who are estimated to be still alive.

Early detection and treatment are vital to reducing breast cancer mortality rates, which was why the AgeX pilots were established in 2009 and rolled out nationally from late 2010, when the Government expanded the screening programme. Given the problems that Public Health England has identified with its randomisation algorithm for those trials, will the Secretary of State tell us whether any evaluations and assessments of those pilots had been done by the Department before the national roll-out of the programme?

I welcome the Secretary of State’s candour in questioning why this problem was not picked up—eight years is a long time for an error of this magnitude to go undetected. Did the Department receive any warnings in that time? Is there any record of how many women raised concerns that they had not received the appropriate screening? Were there any missed opportunities to correct this mistake? He said graciously that oversight of the screening programme was not good enough. How does he intend to improve that oversight? What other trials are in place across the NHS and is he satisfied with their oversight?

We welcome the establishment of the national inquiry. Will it be hosted and staffed by the Department of Health or another Department? In the interests of transparency, will the Secretary of State place in the Library the Public Health England analysis from this year that identified the problem with the algorithm? Although the parallels are not exact, where the NHS offers bowel cancer screenings for women between the ages of 60 and 74 and cervical cancer screenings for women up to 64, what assurances can he give that the systems supporting those services are running properly, and what checks are being carried out to make sure that nobody misses out on screenings for other cancers?

The Secretary of State says that NHS England will take steps to expand the capacity of screening services. Will he say a little more about that? What extra resources will be made available to help the NHS provide the extra screening now needed? He will know that the NHS faces huge workforce pressures—according to Macmillan, there are more than 400 vacancies in cancer nursing, the Royal College of Radiologists has found that 25% of NHS breast screening programme units are understaffed, and there are vacancies for radiographers too. Will he assure us that the NHS will have the staff to carry out this extra work, and may I gently suggest that, if it needs extra international cancer staff, he ensures that the Home Office does not block their visas?

More broadly, does the Secretary of State share my concerns that screening rates are falling generally? The proportion of women aged 50 to 70 taking up routine breast screening invitations fell to 71.1% last year—the lowest rate in the last decade. There is also a wide regional variation in screening rates. The number of women attending breast screening in England is as low as 55.4% in some areas, and, as the all-party group on breast cancer found, there are stark inequalities in NHS services in England, with women in the worst-affected areas more than twice as likely to die from breast cancer under the age of 75. Beyond the problems identified today, what more are the Government doing to make sure that screening rates rise again so that cancer care for patients is the best it can be?

Finally, many of our constituents over whom breast cancer has cast a shadow will feel anxious and worried tonight. Members on both sides of the House want to see cancer prevented and those who have it fully supported. Transparency and clarity are vital. Will the Secretary of State undertake to keep the House fully informed of developments to offer our constituents the peace of mind they deserve?

[Mr Hunt]

I thank the hon. Gentleman for his constructive tone, and I want to reassure him that each and every case will be looked at in detail. The sad truth is that we cannot establish whether not being invited to a screen might have been critical for someone without looking at their individual case notes, and in some cases, sadly, establishing a link will mean looking at the medical case notes of someone who has died.

It is important to explain that the reason for these estimates, which are much broader than we would like, is that there is no clinical consensus about the efficacy of breast screening for older women. As I understand it, that is because the incidences of cancers among older women are higher, but a higher proportion of them are not malignant or life-threatening, which makes it particularly difficult. It is also the case that breast cancer treatment has improved dramatically in recent years and so it is less important than it was to pick up breast cancer early. None the less, we believe it will have made a difference to some women, which is why it is such a serious issue.

The evaluations of the AgeX trial, which brought this to light at the start of the year, have been continued by Oxford University throughout the trial period. I am not aware of any evaluations shared with the Department that could have brought this problem to light, but obviously the inquiry will look into that. We need to find ways to improve oversight, and modern IT systems can greatly improve safety and reliability—in fact it was during the upgrading of the IT system that this problem was brought to light.

I will share with the hon. Gentleman the advice the Department received from Public Health England in January, which was the first time we were alerted to the issue, and we will certainly provide any extra resources the NHS needs to undertake additional cancer screening. One of our biggest priorities is that women between the ages of 50 and 70, when the screens are of their highest clinical value, do not find their regular screens delayed by the extra screening we do to put this problem right. He is right that one thing that has come to light is the regional variation in how the programme is operated. It was previously operated by the old primary care trusts, under the supervision of strategic health authorities, and then brought under the remit of Public Health England, but the regional variations have continued for a long time, so this problem will be worse in some parts of the country than in others. I undertake to keep the House fully informed.

NHS Staff Pay

Debate between Jonathan Ashworth and Jeremy Hunt

Wednesday 21st March 2018 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on NHS pay.

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

The whole House will want to pay tribute to the hard work of NHS staff up and down the country during one of the most difficult winters in living memory. Today’s agreement on a new pay deal reflects public appreciation for just how much they have done and continue to do, but it is much more than that. The agreement that NHS trade unions have recommended to their members today is a something for something deal that brings in profound changes in productivity in exchange for significant rises in pay.

The deal will ensure better value for money from the £36 billion NHS pay bill, with some of the most important changes to working practices in a decade, including a commitment to work together to improve the health and wellbeing of NHS staff to bring sickness absence in line with the best in the public sector. We know that NHS sickness rates are around a third higher than the public sector average, and reducing sickness absence by just 1% in the NHS will save around £280 million. The deal will put appraisal and personal development at the heart of pay progression, with often automatic incremental pay replaced by larger, less frequent pay increases based on the achievement of agreed professional milestones. It includes a significantly higher boost to lower-paid staff, to boost recruitment in a period when we know the NHS needs a significant increase in staffing to deal with the pressures of an ageing population. Pay rises range from 6.5% to 29% over three years, with much higher rises targeted on those on the lowest and starting rates of pay.

As part of the deal, the lowest starting salary in the NHS will increase by more than £2,500, from £15,404 this year to £18,040 in 2020-21, and a newly qualified nurse will receive starting pay 12.6%—nearly £3,000—higher in 2020-21 than this year. But this deal is about retention as well as recruitment. It makes many other changes that NHS staff have been asking for—such as shared parental leave and the ability to buy extra or sell back annual leave—so they can better manage their work and family lives, work flexibly and balance caring commitments.

The additional funding that Chancellor announced in the Budget to cover this deal—an estimated £4.2 billion over three years—cements the Government’s commitment to protecting services for NHS patients, while recognising the work of NHS staff up and down the country. This is only possible because of the balanced approach we are taking—investing in our public services and helping families with the cost of living, while getting our debt falling. Rarely has a pay rise been so well deserved for NHS staff, who have never worked harder.

[Jonathan Ashworth]

The Secretary of State has finally given the lowest-paid NHS staff a pay rise. Staff, royal colleges, trade unions and the Labour party have today been vindicated in saying that a pay rise is long overdue. But when we have seen nurses, paramedics and midwives losing thousands of pounds from the value of their pay, heard stories of NHS staff turning to food banks, have 100,000 vacancies across the service, seen more nurses leaving the profession than entering and seen trusts spending billions of pounds on agency staff, this pay cap should have been scrapped years ago.

In the general election, Ministers said that scrapping the pay cap was nonsensical. When a nurse pleaded with the Prime Minister for a pay rise on national television, she was told that there was no magic money tree. Can the Secretary of State tell us how this pay rise will be paid for? Have the Prime Minister’s horticultural skills grown said magic money tree? We have heard that there will be additional money. When will trusts get the allocations, and if the money is additional, will it be paid for by extra borrowing or extra taxation? Public servants deserve reassurances that the Government will not give with one hand and take with the other.

Given the projections for inflation, can the Secretary of State guarantee that staff will not face a real-terms pay cut in any single year of the deal? We note that he has backed down on docking a day’s holiday. Will he commit to not tabling that proposal again? We also note that he will not block the transfer of hospital staff to wholly owned subsidiary companies. Will he at least guarantee that all staff employed by such companies will be covered by “Agenda for Change” terms? Can he tell us when the rest of the public sector will get a pay deal?

NHS pay has been held back for the best part of a decade. Today is a first step, but the NHS remains underfunded and understaffed. We urgently need a plan to give the NHS the funding it needs for the future.

[Mr Hunt]

If the hon. Gentleman wants a plan to give the NHS the funding it needs, can he explain why Labour in Wales has deprived the NHS of £1 billion of funding that it would have had if funding had increased at the same rate as in England? Far from Labour being vindicated, the House will remember that the pay restraint in the NHS for the past eight years was caused by the worst financial recession since the second world war, caused by a catastrophic loss of control of public finances.

The hon. Gentleman asks for some details. Today’s pay deal means that someone starting work in the NHS as a healthcare assistant will see their rate of pay over the next three years go up by 26%, nearly £4,000. A nurse with three years’ experience will see a 25% increase, which is more than £6,000 over three years. A band 6 paramedic with four years’ experience will see a £4,000 rise. On top of that, we are putting in a huge number of things that NHS staff will welcome, including, for example, statutory child bereavement leave and shared parental leave. Yes, we are asking for important productivity changes in return, but this is about the modernisation of NHS staff terms and conditions, which is good for them and good for taxpayers.

The hon. Gentleman asks where the money is coming from: it is additional funding from the Treasury for the NHS. It is not coming from extra borrowing. If he had been listening to the autumn statement, he would have heard that debt as a proportion of GDP is starting to fall this year for the first time. That is possible because we have taken very difficult decisions over the past eight years—they were opposed by the Labour party—that have meant 3 million more jobs and have transformed our economy out of recession into growth. None of that would have been possible if we did what his party is now advocating, which is to lose control of public finances by increasing borrowing by £350 billion. Let us just remind ourselves that countries that lose control of their finances do not put more money into their health services—they put less. In Portugal, the amount is down 17%, and in Greece, it is down 39%. The reason that we can announce today’s deal is very simple: this country is led by a Government who know that only a strong economy gives us a strong NHS.

Oral Answers to Questions

Debate between Jonathan Ashworth and Jeremy Hunt

Tuesday 20th March 2018 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

Thank you for your instructions, Mr Speaker. We have heard today more warnings that the winter crisis will stretch beyond Easter. We have seen the worst winter crisis for years. The Secretary of State will blame the flu and the weather, but patients are blaming years of underfunding, blaming years of social care cuts, and blaming years of cuts to acute beds, so will he now apologise for telling us that the NHS was better prepared than ever before this winter?

[Mr Hunt]

The NHS did prepare extremely thoroughly for this winter, but the hon. Gentleman is right to talk about funding because of course it matters. He will be interested in these figures, which are for the last five-year period for which we can get all the numbers: in Wales, funding for the NHS went up 7.2%; in Scotland, it went up 11.5%; and in England, it went up 17.3%.

[Jonathan Ashworth]

This Government are moving into their eighth year, not their fifth year, and yet, after eight years, life expectancy is going backwards in the poorest parts of the country and infant mortality is rising. New research shows that, in the first 49 days of 2018, an additional person died every seven minutes. That is shameful. Is it not time that we had a full national inquiry into widening health inequalities? In the 70th year of the NHS, will this Government now bring an end to the underfunding, cuts, austerity and privatisation of our health services?

[Mr Hunt]

Really, the hon. Gentleman can do better than that. The truth is that the NHS has had its most difficult winter in living memory, which is why last year, in preparation, we invested £1 billion in the social care system; invested £100 million in A&E capital; and gave the flu jab to 1 million more people. He still has not explained why, for every additional pound that we have put in per patient in the NHS in England, the Labour Government in Wales put in only 57p; that is underfunding.

Medicines and Medical Devices Safety Review

Debate between Jonathan Ashworth and Jeremy Hunt

Wednesday 21st February 2018 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I thank the Secretary of State for the advance copy of his statement. I welcome the tone of his remarks and generally welcome his commitment to a review of medical device safety, although I note that the 2017 Labour manifesto called for an inquiry into medical devices and product licensing and regulation. Today’s announcement is an acknowledgement that there are major problems, going back decades, to do with safety and lack of proper scrutiny and research.

In debate and Committee, Members in all parts of the House have offered moving testimonies about the devastating impact of mesh, Primodos and sodium valproate on the lives of thousands of women and children in our constituencies. I wish to put on the record my thanks and tribute to all the campaigners and the MPs from across the House, but especially those who have worked so hard with the all-party groups, including my hon. Friends the Members for Pontypridd (Owen Smith) and for Bolton South East (Yasmin Qureshi), and the right hon. Member for North Norfolk (Norman Lamb), who have all spent many years campaigning for justice on these issues.

We have heard how mesh implants have left women in permanent pain, unable to walk, unable to work. This is an ongoing public health scandal, and we hope the Government will do much more to support those who are affected. Mesh has been suspended in Scotland and banned in other countries around the world. I understand that mesh has been paused for use in cases of prolapse. Will the Secretary of State consider fully suspending mesh use while the review is carried out?

On Primodos, the Secretary of State indicated that the Department will drive forward and “accelerate” the recommendations of the expert working group, but does he accept that that report was met with concern on both sides of the House? Indeed, campaigners branded it a whitewash.

I am grateful to the Secretary of State for including sodium valproate. My constituent, Emma Friedmann, took sodium valproate during and after her pregnancy, leaving her son, Andrew, with severe autism along with hearing and sight problems. Andrew, who is now 18, needs round-the-clock, full-time care. Emma, like thousands of others affected, was never fully informed of the risks of taking sodium valproate during pregnancy. Last year, a charity survey found that almost one fifth of women who are taking the drug still do not know the risks that the medicine can pose during pregnancy. I welcome the Government’s efforts to raise awareness of the dangers of sodium valproate, but will the Secretary of State tell us whether the review will look at the guidelines for clinicians who prescribe it to women of childbearing age?

We offer the review our support, but note that it falls short of the calls for a full public inquiry, which campaigners have been demanding. Will the Secretary of State give the House an absolute reassurance that the review will gain access to medicine regulation files held in the National Archives, access to any valuable evidence cited in unsuccessful legal actions and access to documents and information held by pharmaceutical companies and that all such material will be made public?

Does the Secretary of State agree that those affected must have trust and confidence in the review? Who will the noble baroness report to, and who will provide the secretariat to the review? I say this with no discourtesy to the Department or the Medicines and Healthcare Products Regulatory Agency, but does he agree that the review must be independent to avoid any sense of conflict of interest that has hampered previous inquiries? I understand the steer that he has given to the noble baroness on setting the terms of reference, but I press him to ensure that victims agree with the terms of reference to maintain trust and confidence in the review.

Is the Secretary of State now ruling out a full public inquiry, or is he saying to victims that they should wait for the review’s outcome? When can we expect it to report back to the House? More broadly, can he reassure us that the inquiry will have three separate strands that will look in depth at each issue to ensure that nothing gets watered down and lost?

In the broader context of Brexit, when profound uncertainty remains about medical and device regulation as we leave the European Medicines Agency, does the Secretary of State agree that the review must inform future regulatory mechanisms and take into account how we best co-operate with other national and international regulators post Brexit? What assurances can he offer the House that the medicines and devices that women use today—especially pregnant women—will not become the tragic and desperate scandals of the future?

On the treatment of the victims involved, the Secretary of State will know that many women have been denied access to legal aid to pursue compensation claims. Does he agree that women and children deserve full compensation and support? Is that not the Government’s responsibility? Will they establish a compensation fund, and what consideration has he given to compelling the pharmaceutical industry to support a compensation fund for those affected?

Finally, mesh, sodium valproate and Primodos have devastated the lives of hundreds of thousands of women and children. Is it not time that they were given a full apology? Surely, that is the very least they deserve.

[Mr Hunt]

I thank the hon. Gentleman for his considered response and for its tone. Like him, I thank all the all-party groups who have worked incredibly hard to raise this incredibly difficult issue. Let me go through the points that he raised; he asked detailed questions, which I want to give a proper answer to.

When it comes to mesh, no EU country has banned its use. In my understanding, Australia and New Zealand have not introduced a full ban. We have taken very clear advice. We obviously have a responsibility to all patients, and the medical advice from the chief medical officer is clear that some women benefit from mesh, if it is appropriately used, so we are following that advice. However, the review will look at all the processes around mesh. We will publish NICE guidelines on persistent pain and ventral meshes—it is also important to say that meshes are used in men as well as women—and we absolutely have to get this right.

I fully accept the point that the hon. Gentleman made on the concerns of many patients and families about the findings of the expert working group. He will know that this is a very difficult, hotly contested area. We are not proposing to revisit the science, but we are giving Baroness Cumberlege full freedom to look at what the expert working group did and to come to her own views. We are not excluding her from looking at what happened, even though we think that it is important to accept throughout that we have to follow the science at every stage to get this absolutely right. We will be going forward with some important recommendations of the expert working group regardless, such as the yellow-card system.

One thing that is clear is that when people, whether clinicians or patients, have an immediate concern about a medicine, there is no easy way to raise that quickly. If women are raising these concerns all over the country, we need to find that out very quickly at the centre, so that we can take action more quickly than happened in this case. We will also be offering genetic testing to families who have suffered, or who think that they have suffered, as a result of Primodos.

On valproate, we will issue guidelines to clinicians. We also want to make sure that there is greater awareness among patients. We are changing the NICE guidelines and the labelling. When it comes to valproate, we want to push for this to be a contra-indication for women of childbearing age who are not taking effective contraception, because it is so important to get this right.

The hon. Gentleman made very important points about the public inquiry. We are asking Baroness Cumberlege to give us her considered view on the appropriate way forward in this case, and that, of course, has implications for the issue of compensation. What I would say is that we have a problem in our system, in that there is no proper process for deciding what next steps are appropriate. Is it an investigation by the Department of Health and Social Care and NHS England, or do we need a full statutory public inquiry? We particularly want her to look at whether we should have an independent process to evaluate what happened. In my time, and in the hon. Gentleman’s time, we have been approached by a lot of people who want public inquiries, but it should not simply be about the strength of lobbying. There needs to be a process, because there may be people who do not have a loud voice, who are equally worthy of a public inquiry, but who do not get considered in our system at that moment. That would not be right.

Baroness Cumberlege will report to Ministers, not to the MHRA, and there will be full consultation with the families affected by the three issues over the terms of reference. That is absolutely the right thing to do.

The hon. Gentleman made a final very important point about how we regain the trust of families deeply scarred by these issues. We can do it in two ways: first, by being open and transparent in everything we do in this process so that they can see we want to get to the bottom of it as much as they do; and secondly by recognising the fundamental issue that in the past when we have assessed these clinical medical safety issues the voice of patients has not been as strong as it should have been. We have to put that right, and I know that everyone in the NHS, as in the House, is committed to doing so.

Oral Answers to Questions

Debate between Jonathan Ashworth and Jeremy Hunt

Tuesday 19th December 2017 Commons Chamber

[Mr Hunt]

I have a great deal of sympathy with what my right hon. Friend says, and he is right that the recruitment and retention of GPs is a big issue. I have a constituency interest, in that I have a university that is also very keen to host more medical school places, so I am recusing myself from the decision. However, I wish all universities good luck, because this is a historic expansion of medical school places for the NHS.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

rose—

[Jonathan Ashworth]

May I join the Secretary of State in wishing all our NHS and social care staff a very merry Christmas, and in thanking them for their commitment this winter?

Virgin Care recently won a £100 million contract for children’s health services in Lancashire, but in the Secretary of State’s own backyard of Surrey, Virgin Care recently took legal action against the NHS, forcing it to settle out of court. This money should be going to patient care, not the coffers of Virgin Care, so why will he not step in and fix this scandal so that his Surrey constituents and the NHS do not lose out?

[Mr Hunt]

I, too, am very disappointed about the action taken by Virgin Care, but I gently point out to the hon. Gentleman that, contrary to the narrative that he and his colleagues put out, the reason why it took action was that the NHS stripped it of its contract and gave that back to the traditional NHS sector—hardly the mass privatisation that he is always talking about.

[Jonathan Ashworth]

The Secretary of State’s Surrey constituents will have heard that he will not be taking action against Virgin Care.

Our research has revealed that there are vacancies for 100,000 staff across the NHS, and there is a “national crisis in workforce”—not my words, but those of the Royal Surrey County Hospital NHS Foundation Trust in the Secretary of State’s constituency. With bed occupancy at the Royal Surrey hitting a peak of 98.7% this winter already, and 94.5% across the NHS on average, can he tell us how he expects the NHS to cope this winter when it is understaffed, overstretched and underfunded?

[Mr Hunt]

If we decide that we want more nurses following Mid Staffs, that creates vacancies. If we want to transform mental health provision, that creates vacancies. That is why we announced a workforce plan, which I notice the Welsh Government have not had time to do yet. But I will finish by wishing the hon. Gentleman a merry Christmas. If he wants to take a bit longer off and stay away for January, we are happy to hold the fort.

Maternity Safety Strategy

Debate between Jonathan Ashworth and Jeremy Hunt

Tuesday 28th November 2017 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I am grateful to the Secretary of State for the advance copy of his statement. At the outset, may I pay tribute, as he has done, to the hon. Members who have spoken out so movingly in recent months about baby loss? They include, as he has said, the hon. Members for Colchester (Will Quince), for Eddisbury (Antoinette Sandbach), for Banbury (Victoria Prentis) and for North Ayrshire and Arran (Patricia Gibson), and my hon. Friends the Members for Lewisham, Deptford (Vicky Foxcroft) and for Washington and Sunderland West (Mrs Hodgson). They are all a credit to the House.

Our national health service offers some of the best neonatal care in the world, and the progress set out by the Secretary of State today is a tribute to the extraordinary work of midwives and maternity staff across the country. We welcome his announcement that all notifiable cases of stillbirth and neonatal death in England will now receive an independent investigation by the healthcare safety investigation branch. That is an important step, which will help to bring certainty and closure to hundreds of families every year.

We also welcome the move by the Secretary of State to allow coroners to investigate stillbirths. May I assure him that the Opposition stand ready to work constructively with him to ensure the smooth and timely passage of the relevant legislation, should he and the Government choose to bring any before the House? I also pay tribute to the work carried out by the team at the University of Leicester that leads on the perinatal aspects of the maternal, newborn and infant clinical outcome review programme, which provided the evidence for today’s announcement.

The number of deaths during childbirth has halved since 1993, saving about 220 lives a year, but we welcome the Secretary of State’s ambition to bring forward to 2025 the target date for halving the rate of stillbirths, neonatal deaths, maternal deaths and brain injuries that occur during or soon after birth. If that target is to be delivered, however, it is essential that NHS units providing these services are properly resourced and properly staffed. We welcome the launch of the Atain e-learning programme, as well as the increased training for consultants on the care of pregnant women with significant health conditions. We also welcome the emphasis on smoking cessation programmes, but we should remind the Secretary of State that public health budget cuts mean that many anti-smoking programmes have been cut back across the country.

The Secretary of State will know that the heavy workload in maternity units was among the main issues identified by today’s study, which found that “service capacity” issues in maternity units affected over a fifth of the deaths reviewed. Earlier this year, our research revealed that half of maternity units had closed their doors to mothers at some point in 2016, with staffing and capacity issues being the most common reasons for doing so. The Royal College of Midwives tells us that we are about 3,500 midwives short of the number needed. A survey published by the National Childbirth Trust this year showed that 50% of women having a baby experienced what the National Institute for Health and Care Excellence describes as a red flag event, which is an indicator of dangerously low staffing levels, such as a women not receiving one-to-one care during established labour.

We therefore believe that the NHS remains underfunded and understaffed. I would be grateful to the Secretary of State if he told us what further action he intends to take to ensure that maternity services are properly funded and to address the staffing shortages as part of a full strategy to improve safety across the board. The NHS has excellent psychological and bereavement support services for women affected by baby loss, but we all know that the quality of those services remains variable across the country. Indeed, we are still a long way from full parity of esteem for mental health in neonatal care. What action does the Secretary of State intend to take to plug these gaps?

Overall, this welcome set of announcements from the Secretary of State may help the NHS to provide the best quality of care for all mothers and their babies. The Opposition look forward to working constructively with the Secretary of State and the Government, but I hope he can reassure us that they will provide the resources that NHS midwives and their colleagues need to deliver on these ambitions.

[Mr Hunt]

I thank the shadow Health Secretary for the constructive tone of his response to the statement. I think he is right to point out both the achievements that have been made over many years, but also the challenges ahead. We have about 1,700 neonatal deaths every year—that has actually fallen by 10% since 2010—but behind that figure, there is variation across the country. For example, our best trust has about three deaths in 1,000, but in other trusts the figure can be 10 in 1,000, which is more than three times as many neonatal deaths. That shows we are not as good as we need to be at spreading best practice. Today’s announcement is really about ensuring that we can confidently look every expecting mum in the eye and say, “You are getting the very highest standards of care that we are able to deliver in the NHS.”

I thank the hon. Gentleman for his offer to co-operate on any legislation needed to expand the scope of inquests to full-term stillbirths, and we will get back to him on that. I also thank him for raising the issue of bereavement services. I spoke to a bereavement midwife this morning, and I think bereavement midwives are among the most extraordinary people working in the whole NHS. We do have a programme to improve the consistency of bereavement services and to roll out the use of bereavement suites across the NHS; our best trusts have such suites, but by no means all of them do.

The hon. Gentleman was absolutely correct to raise the issues of both funding and staffing. We have seen an increase of 1,600 in the number of midwives since 2010, which is a rise of 8%, and an increase of 600 in the number of obstetricians and doctors working in maternity departments, which is a rise of about 13%, but we need more. There are lots of pressures across the NHS, and we also have to fund the extra midwives and doctors that we need. There was a welcome boost for the NHS in the Budget, with an extra £1.6 billion available for the NHS next year. However, looking forward to the next 10 years and all the pressures coming down the track for the NHS—with a growing birth rate, but also with an ageing population—I do not pretend that we will not have to revisit the issue of NHS funding and find a long-term approach. Probably the most appropriate time to do that will be when we come to the end of the five year forward view and start to think about what happens following that. If we are to put more money into the NHS, we need to have the doctors, midwives and nurses to spend that money on, which is why, in the past year, the Government have committed to a 25% increase in the number of nurse training places and a 25% increase in the number of medical school training places.

My final point for the hon. Gentleman is that, although we have lots of debates in this House in which we take different positions in relation to the NHS, one thing we can be united on is our aspiration, which is shared across the House, that the NHS should be the safest healthcare system in the world, and I very much thank him for his support on that.

Oral Answers to Questions

Debate between Jonathan Ashworth and Jeremy Hunt

Tuesday 14th November 2017 Commons Chamber

[Mr Hunt]

I do agree. I also know that, although areas such as Wealden are beautiful places in which to live, it is sometimes very difficult to recruit people to become, in particular, new partners in general practices in such areas. We are concerned about that. Nationally, we have a plan to recruit 5,000 more GPs by 2020-21, but we need to ensure that they go to rural areas such as that represented by my hon. Friend.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

The Secretary of State will know that there are huge numbers of vacancies across the NHS, particularly in nursing, partly driven by pay restraint. He has said that the pay cap will be scrapped, so does he agree with Simon Stevens, who said that it would be an “own goal” not to fully fund the scrapping of that pay cap in the Budget next week and to expect it to be paid for by productivity gains?

[Mr Hunt]

I have been clear about this: the Government are willing to be flexible in terms of funding additional pay beyond the 1% for nurses, but we want some important reforms to the contracts that they operate under. If those negotiations go well—at the moment we have been having very constructive discussions with the Royal College of Nursing—I am hopeful that we can get a deal that everyone will be happy with.

[Jonathan Ashworth]

So the Secretary of State does not agree with Simon Stevens. May I ask him about Simon Stevens’s comments last week? He warned that if the underfunding continues, waiting lists will rise from 4 million to 5 million, cancer care will deteriorate, the mental health pledges the Secretary of State has committed to will not be met, and the 18-week target will be permanently abandoned. And is it not the case that if in next week’s Budget the Chancellor does not allocate at least an extra £6 billion a year for the NHS, the right hon. Gentleman will have failed in his responsibility as Secretary of State?

[Mr Hunt]

What Simon Stevens noticed, and we all noticed, was that when he came with this plan in 2014 Labour refused to back it, and in the 2015 election they refused to fund it—to the tune of the £5.5 billion more that the Conservatives were prepared to put in, but the hon. Gentleman’s party refused to put in. He is quoting Simon Stevens, who also said that when the British economy sneezes, the NHS catches a cold—it will be far worse than a cold for the NHS if we have Labour’s run on the pound.

Oral Answers to Questions

Debate between Jonathan Ashworth and Jeremy Hunt

Tuesday 10th October 2017 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

Can the Secretary of State tell us how many elective operations he expects to be cancelled by 31 December?

[Mr Hunt]

What I can tell the hon. Gentleman is that every year over Christmas time, when we know that hospitals will be busy, we suspend elective care in particularly busy places. That is how we keep patients safe.

[Jonathan Ashworth]

I am grateful to the Secretary of State for his answer, but already more than 80,000 elective operations have been cancelled. That is an increase on the past year. A&E attendance is up on the past year, bed occupancy is higher than last year and the Care Quality Commission has today warned that the NHS is straining at the seams. Winter is coming. Last week, the Tory party made spending commitments worth £15 billion, but not 1p extra for the NHS, so will the NHS fare worse or better than last year this winter, or are we set for another winter crisis made in Downing Street?

[Mr Hunt]

What the CQC actually said this morning is that the majority of health and care systems across the NHS are providing good or outstanding quality; that the safety of care is going up; and that performance is improving. None the less, the hon. Gentleman is right that we are always concerned about winter. Let me tell him the new things that are happening this year to help prepare the NHS: £1 billion more going into the social care system in the most recent Budget; a £100 million capital programme for A&E departments; 2,400 beds being freed up; and an increasing number of clinicians at 111 call centres. A lot is happening, but, overall, let me remind him that our NHS is seeing 1,800 more people every single day within four hours—that is something to celebrate.

Oral Answers to Questions

Debate between Jonathan Ashworth and Jeremy Hunt

Tuesday 4th July 2017 Commons Chamber

[Mr Hunt]

I welcome my hon. Friend’s first question to me. I am very aware of the issues faced by the Worcestershire Acute Hospitals NHS Trust, which I visited during the difficult winter period that it has just come through. It now has a new chief executive and leadership team, who have made a very promising start. From the experience of many other hospitals that have been through difficult patches, we have found that it is usually never about the commitment of staff, but about getting the right leadership in place. I can assure her that I saw outstanding commitment from the staff of the trust.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

The number of nurses has fallen for the first time in a decade, which is why we need fair pay now. I read in the newspapers that the Health Secretary now supports the Labour party policy of scrapping the cap, although he did not vote with us last week. Given that he supports our policy, when he soon sets the remit for the NHS Pay Review Body, will he tell it to scrap the cap, and will he publish his instructions before the summer recess?

[Mr Hunt]

I did not vote for the hon. Gentleman’s amendment, because—as usual—Labour Members have told us a lot about how they want to spend the money, without having the faintest idea of where it will come from. He is ignoring an elephant in the room: if we had followed the spending plans he campaigned for in 2015, the NHS would have £2.6 billion less this year, which is the equivalent of 85,000 fewer nurses.

[Jonathan Ashworth]

I want to talk about the spending plans for 2017, in which the Secretary of State can find £1 billion for Northern Ireland, but nothing for nurses in England. Would it not be fairer not to go ahead with further cuts to corporation tax, and to put that money towards giving our doctors and nurses a fair pay rise?

[Mr Hunt]

Let me tell the hon. Gentleman what extra money is going into the NHS: three years ago, £1.8 billion, which was not asked for by Labour; two years ago, £3.8 billion, which is nearly £1 billion more than Labour was promising; and this year, £1.3 billion. That is a lot of extra money. Why is it going in? Because, under this Government, we have created nearly 3 million jobs, and that strong economy is funding an improving NHS.

Health, Social Care and Security

Debate between Jonathan Ashworth and Jeremy Hunt

Wednesday 28th June 2017 Commons Chamber

[Mr Hunt]

I am going to make some progress. The shadow Health Secretary talked about underfunding of the NHS. He did not, of course, mention the new £43 million emergency floor at Leicester Royal Infirmary, which opened in April and is benefiting his constituents. There are indeed funding pressures in the NHS as we deal, like all countries, with the pressures of an ageing population, but they would be a whole lot worse if we had followed the advice of the Labour party in 2010 and cut the NHS budget; or followed the advice of the Labour party in Wales, which did cut the NHS budget; or followed the advice of the Labour party in 2015, when it promised £5.5 billion less than the Conservatives. The difference between this side of the House—

[Jonathan Ashworth]

rose—

[Mr Hunt]

I will just make my point. The difference between this side of the House and the other side is not the desire to fund the NHS, but the ability to fund it through a strong economy, and that is exactly what we did. By 2014, we had created 2 million more jobs and the fastest growth in the G7, and what was our first priority? The NHS. Its budget has gone up by £6 billion in real terms since 2014. That is a 7% rise, and it is £2.6 billion more than the Labour party promised in 2015.

[Jonathan Ashworth]

Our advice was to put an extra £7 billion into the NHS this year, but will the Secretary of State tell me whether he thinks it fair that the people of Northern Ireland will receive an extra £1 billion—which I do not begrudge—while there is not a penny piece of extra investment for the English NHS? Is that fair?

[Mr Hunt]

Let me tell the hon. Gentleman that our manifesto was very clear: it referred to an extra £8 billion for the NHS, funded by the strong economy that Labour can never deliver.

When the hon. Gentleman talked about problems in the NHS, and problems in care in the NHS, it sounded as if all those problems had started with the Conservatives. He did not mention the most challenging and difficult problem that his party left behind: the legacy of atrocious care at Mid Staffs, Morecambe Bay and many other trusts. Unlike the last Labour Government, we did not sweep those problems under the carpet. We did the opposite: we introduced the toughest inspection regime in the world. Thirty-five trusts went into special measures, and 20 exited from those special measures. Wrexham Park, George Eliot, Hinchingbrooke, Cambridge, Morecambe Bay, Tameside and East Lancashire went from special measures to good standards. The proportion of NHS patients who say that their care is safe has never been greater.

NHS Shared Business Services

Debate between Jonathan Ashworth and Jeremy Hunt

Tuesday 27th June 2017 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

(Urgent Question): To ask the Secretary of Statement to make a statement on NHS Shared Business Services.

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

As the House knows, 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 GP surgeries—NHS Shared Business Services. The backlog arose from the primary care services’ GP mail redirection service that SBS was contracted to run. No documents were lost, and all were kept in secure storage, but my immediate concern was that patient safety had been compromised by the delay in forwarding correspondence. 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. All the documentation has now been sent on to the relevant GP surgery where it was possible to do so, following an initial clinical assessment of where any patient risk may lie. Some 200,000 pieces were temporary residence forms and a further 535,000 pieces were assessed as low risk. A first triage identified 2,508 items with a higher risk of harm, of which the vast majority have now been assessed by a GP. Of those 84% were confirmed to be of no harm to patients and 9% as needing a further clinical review. To date, no harm has been confirmed to any patients as a result of this incident.

Today’s National Audit Office report confirms that patient safety was the Department and NHS England’s primary concern, but as well as patient safety, transparency with both the public and the House has been my priority. I was advised by my 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 would 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.

A proactive statement about what had happened was again not recommended by my Department in July for the same reasons and because the process was not complete. However, as I explained to the House in February, on balance I decided that it was important for the House to know what had happened before we broke for recess, so I overruled that advice and placed a written statement on 21 July. Since then, the Public Accounts Committee has been kept regularly informed, most recently being updated by my permanent secretary in February. The Information Commissioner was updated in August.

In July 2016, I committed to keeping the House updated once the investigations were complete and more was known, and I will continue to do so.

[Jonathan Ashworth]

I welcome the Secretary of State to his place, but is it not an absolute scandal that 709,000 letters, including blood test results, cancer screening appointments and child protection notes, failed to be delivered, were left in an unknown warehouse and, in many cases, were destroyed? Does not the National Audit Office reveal today a shambolic catalogue of failure that took place on the Secretary of State’s watch?

As of four weeks ago, 1,700 cases of potential harm to patients had been identified, with this number set to rise, and a third of GPs have yet to respond on whether unprocessed items sent to them indicate potential harm for patients. Does the Health Secretary agree that this delay is unacceptable? When will all outstanding items be reviewed and processed?

The Secretary of State talks about transparency, but he came to this House in February because we summoned him here. In February, he told us that he first knew of the situation on 24 March 2016, yet the NAO report makes it clear that the Department of Health was informed of the issues on 17 March and that NHS England set up the incident team on 23 March, before he was informed, despite his implying that he set up the incident team. Will he clear up the discrepancies in the timelines between what he told the House and what the NAO reported?

The Secretary of State is a board member of Shared Business Services, and many hon. Members, not least my right hon. Friend the Member for Exeter (Mr Bradshaw), have warned him of the problems and delays with the transfer of records from SBS. Given that those warnings were on the record, why did he not insist on stronger oversight of the contract?

The cost of this debacle could be at least £6.6 million in administration fees alone, equivalent to the average annual salary of 230 nurses. Can the Health Secretary say how those costs will be met and whether he expects them to escalate?

Finally, does the right hon. Gentleman agree with the NAO that there is a conflict of interest between his role as Secretary of State and his role as a board member? Further to that, can he explain why his predecessor as Secretary of State sold one share on 1 January from the Department to Steria, leaving the Secretary of State as a minority stake owner in the company, and never informed Parliament or reported that share in the Department’s annual report—