Dementia
Lord Lansley Excerpts(12 years, 1 month ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health (Mr Andrew Lansley)
Today, the Prime Minister launches his challenge on dementia to tackle one of the most important issues we face arising from an ageing population. The challenge sets out the Government’s ambition to increase diagnosis rates, raise awareness and understanding and to strengthen substantially our research efforts.
Dementia is one of the biggest challenges we face as a society and we are determined to transform the quality of dementia care for patients and their families. In England today an estimated 670,000 people are living with dementia, a number that is increasing with one in three people set to develop dementia in the future.
England was one of the first countries in the world to have a national dementia strategy and progress has been made since the launch of the strategy in 2009. But we are determined to do more to address this challenge.
The Prime Minister’s challenge sets out three key areas where we want to go further and faster, building on the progress made through the national dementia strategy. The three areas are:
driving improvements in health and care;
creating dementia-friendly communities that understand how to help; and
better research.
We know that we need to do more to raise diagnosis rates for people with dementia, with an estimated 42% of people with dementia currently having a diagnosis. Only when the condition is diagnosed can people and their families and carers get the support they need to help them. As well as when they normally see their general practitioner, the five-yearly NHS health check will be also used as an opportunity to identify risk factors for dementia such as hypertension, alcohol and obesity. Over 65 year olds will also be made aware of memory services and those at risk will be referred on.
We are also making sure that the NHS has the right incentives to identify signs of dementia when people are in hospital. From April 2012, £54 million will be made available through the dementia commissioning for quality and innovation to NHS hospitals in England for those who assess over 75 year olds admitted to hospital to check for signs of dementia. From April 2013, we will build on that incentive so that hospitals are rewarded for demonstrating good quality care for people with dementia.
The Government will also take further steps on research. The United Kingdom is world renowned for dementia research, but we still do not know enough about this devastating condition and the level of public participation in dementia research trials remains low. The funding for research into dementia and neurodegenerative disease will double to over £66 million by 2014-15 (compared to 2009-10). The Medical Research Council will be making major funding available for BioBank with a view to scanning the brains of 50,000 to 100,000 participants. This will build a world-leading resource for research into dementia and other neurodegenerative diseases. We also want to see more people with dementia taking part in research. Inviting patients to participate in research will become part of a quality marker for memory clinics.
Finally, the challenge of dementia is not one for Government alone, but for all society. We want to develop awareness and understanding, and tackle stigma, so that all parts of society can contribute. The Government will continue to fund awareness campaigns for dementia and by 2015 the aim is to have at least 20 cities, towns and villages working together as dementia-friendly communities, where local businesses, organisations and individuals come together to support people to live well with dementia, helping them remain independent for longer.
Three champion groups will be convened to bring together the leading organisations and groups with an interest in dementia to support the delivery of the Prime Minister’s challenge. The champion groups will report on progress to Department of Health Ministers who will report to the Prime Minister in September 2012.
“The Prime Minister’s challenge on dementia” has been placed in the Library. Copies are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office.
I will update the House on progress in due course.
Abortion Act 1967
Lord Lansley Excerpts(12 years, 1 month ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health (Mr Andrew Lansley)
There have recently been a number of serious allegations involving potential breaches of the Abortion Act 1967. The Metropolitan Police, Greater Manchester Police and the West Midlands Police, the Care Quality Commission (CQC), the General Medical Council (GMC) and the Nursing and Midwifery Council (NMC) are investigating the allegations into sex-selection at a number of abortion services. The chief medical officer has written to all abortion providers reminding them of their duties under the Abortion Act. The GMC interim orders panel has suspended or placed restrictions on the three doctors named in the press reports. Decisions on the registration and approval of the clinics are awaiting the investigations by the CQC and Department of Health officials into compliance with the Act and registration requirements.
Registration inspections by CQC in February also identified cases where doctors had signed the required certificate of the ground for the abortion (HSA1 forms) before the woman had been seen in the clinic. The Act requires two doctors to certify that at least one (and the same) ground for abortion exists in relation to a specific woman. The pre-signing of these forms is potentially a criminal offence and is being investigated by the CQC and the police and may lead to further referrals to the GMC or NMC.
In the light of the serious nature of these allegations, CQC are this week conducting a series of unannounced inspections of all abortion providers. Any evidence of failure to comply with the Act and registration requirements will be investigated by CQC, the police and other regulatory bodies. I will consider withdrawing an independent abortion provider’s approval to conduct abortions if the requirements of the Act are not being met. Any provider’s registration to carry out termination of pregnancy may also be suspended or cancelled by the CQC. I will provide further final details of actions taken when the initial investigations are complete.
In addition, my officials will work with the CQC and other regulatory bodies to examine compliance with the Act and relevant statutory and professional requirements in order to inform the planned revision of the Procedures for the Approval of Independent Abortion Providers for consultation later this year.
Health and Social Care Bill
Lord Lansley Excerpts(12 years, 1 month ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health (Mr Andrew Lansley)
Your generosity of spirit is legendary, Mr Speaker, and you were characteristically generous in accepting the submission of the right hon. Member for Leigh (Andy Burnham) that there was an emergency warranting this debate. I regret that he has let you down. It turns out there was no emergency, there was no argument, and there was no point.
Ostensibly, the debate is to consider the Department of Health’s transition risk register. The House considered that on 22 February, and by a majority of 53 the House decided that it did not support the publication of the risk register. We further considered that matter in the debate on 13 March. I think that the views of this House should be respected.
Yesterday, in another place, Lord Owen proposed an amendment, the purpose of which was to delay consideration of Third Reading in the House of Lords until the publication of “reasons” by the first-tier tribunal and the Government’s response. That amendment was defeated by a majority of 115. I remind the House that the Government do not command a majority in the House of Lords. That proposal was defeated by a substantial majority on the balance of the argument.
I will not repeat what I said in the debate on 22 February, but let me just add three things. First, as my noble Friend Lord Howe told the House of Lords yesterday, the risks and other impacts of the Bill were fully disclosed, not least in the impact assessments—a 200-page document—published alongside the Bill; in the NHS operating frameworks; in transition letters from the NHS chief executive and others; and in the full description of the risk headings that Lord Howe set out to the House of Lords on 28 November. I regret to say that it sounds to me that no Labour Members—with, I suspect, the exception of the right hon. Members for Wentworth and Dearne (John Healey) and for Leigh (Andy Burnham)—have taken the trouble to read the debates in the House of Lords.
Secondly, as my hon. Friend the Member for Banbury (Tony Baldry) made clear, Lord Wilson of Dinton, a former Cabinet Secretary, told the House of Lords yesterday that he has deep concerns about the Information Commissioner’s decision and its negative impact on the safe space within which officials give frank advice and act as a “devil’s advocate” to Ministers.
John Healey
The right hon. Gentleman argues that one of the principal reasons why the Government have not accepted the decision to disclose the risk register is that information about risks has been disclosed to the public already. The Information Commissioner considered that. Will the right hon. Gentleman recognise that, in his legal decision, the Information Commissioner said that he did not accept the argument that the Government advanced, and that he considers that
“disclosure would go somewhat further in helping the public to better understand the risks associated with the modernisation of the NHS than any information that has previously been published”?
Mr Lansley
The right hon. Gentleman knows perfectly well that in the debate on 22 February we made it clear that we felt that our appeal to the tribunal was justified, and indeed it was, because we won at appeal on the question of the publication of the strategic risk register. The Government’s objection and my objection to the publication of the risk register is precisely that risk registers are not written for publication. They are written in that safe space within which officials give advice to Ministers.
Mr Lansley
No.
Risk registers do not represent a balanced view. They are not a prediction of the future. They set out a worst-case scenario to challenge decision making. My hon. Friend the Member for Totnes (Dr Wollaston) captured the understanding of what a risk register is very well. The point is that we have looked precisely at the balanced view in the impact assessment, which captures where the risks and the benefits of the Bill lie. However, publication of the risk register, as my right hon. Friend the Member for Charnwood (Mr Dorrell) made perfectly clear, would prejudice the frankness and integrity of the decision-making processes of government and the Government are opposed to their publication.
As I mentioned, we won on appeal in relation to the strategic risk register, but not on the transition risk register. In the absence of the reasons for those decisions by the tribunal, and given the nature of the overlap between the strategic risk register and the transition risk register, I cannot comment further on that, or indeed on what our response will be to the tribunal’s decisions.
Duncan Hames (Chippenham) (LD)
The Secretary of State consistently makes the distinction between policy development issues and operational matters in respect of risk registers and other plans that have been published. Once this Bill has become law and the NHS becomes engaged in the operational matter of implementing his reforms to the health service, will he then encourage NHS trusts to publish, in due course, the risk mitigation plans that they might have, in order to reassure the communities they serve?
Mr Lansley
As the House has noted, risk registers designed for publication form part of the papers prepared for the boards of trusts. Of course, the legislation further strengthens the openness of foundation trust boards, for example, in respect of meeting in public and publishing their documents. But, as my right hon. Friend the Member for Charnwood rightly pointed out, there is an enormous difference between the frank expression of officials’ worse-case scenarios to Ministers in order to challenge decision making—as I say, it was anticipated that that was not intended for publication—and the preparation of risk registers by NHS bodies and trusts, which are designed for publication. Indeed, the national risk register is also designed for publication on that basis. As I said, those in the House of Lords yesterday agreed, by a substantial majority when voting on an amendment, that not only had the consideration of the Bill received unprecedented scrutiny, but that they also had the information they required.
Thirdly, let me just remind the House that the right hon. Member for Leigh, as a Minister, refused to publish the Department’s risk register. He said:
“Whilst we are conscious that there will be public interest in the contents of the Strategic Risk Register being made freely available, we have also taken into account the public interest in preserving the ability of officials to engage in the discussions of policy options and risks without apprehension that suggested courses of action may be held up to public or media scrutiny before they have been fully developed or evaluated. We also take into account the fact that ministers and their officials need space in which to develop their thinking and explore options, and that this disclosure may deter them from being as candid in the future, which will lead to poorer quality advice and poorer decision-making. Having regard to all these factors, we have determined that the balance of public interest strongly favours withholding the information.”
I could not have put it better myself, because that is precisely the point. He talks about the difference between the strategic risk register and the transition risk register, but the one requested was a risk register at the point at which policy was being formulated, and there is a substantial overlap between the strategic risk register and the transition risk register.
The right hon. Gentleman did one thing when he was a Minister and he argues the opposite now. The same thing seems to be happening in so many other fields. When he was a Minister he said that he was in favour of clinical commissioning, and practice-based commissioning was in the Labour manifesto in 2005. In 2006, he said that his ambition was to introduce
“practice-based commissioning. That change will put power in the hands of local GPs to drive improvements in their area”.—[Official Report, 16 May 2006; Vol. 446, c. 861.]
Now he wants to block a Bill whose purpose is to give clinicians—doctors and nurses across the NHS—the power to commission and design services in their area. We just do not know the position. Once more, we heard nothing positive from him about what Labour would offer the health service; all we heard was a denigration of the performance of the NHS and a determination to block the Bill. We are still hearing from him about what Labour Members are opposed to; we just do not hear about anything he is in favour of.
The curious thing is that last Tuesday, on an Opposition day debate, I said, “We are hearing from Labour Members and Labour activists all over the country about their opposition to £20 billion of cuts.” Hon. Members will remember, because this happened only a week ago, that the right hon. Gentleman was shouting at me from the Labour Front Bench, “No, no, no. We are in favour of that.” I said to him, “Look, it is in the manifesto”, because Labour’s manifesto said that
“we will deliver up to £20 billion of efficiencies in the frontline NHS”.
Yesterday, the right hon. Gentleman turned up with his hon. Friends at the Department of Health to deliver a petition from Wigan and Leigh. It said:
“We the undersigned are opposed to the Government’s Health and Social Care Bill and £20 billion of ‘unmandated’ cuts in NHS funding”.
He sat there last Tuesday saying, “No, we are in favour of £20 billion of efficiencies”, yet he is wandering all around the country with his hon. Friends saying, “No, it is £20 billion of cuts.” Frankly, Mr Speaker, if I recall correctly, that is what you would have me describe as an erroneous view.
The NHS across the country is a service that not only will use reform positively but is using reform positively now. We are seeing the reforms being implemented. On 1 April, clinical commissioning groups will take responsibility for more than £60 billion-worth of delegated responsibility for commissioning. I am tired of hearing the right hon. Gentleman denigrate NHS performance when what we have, since the election, is the lowest ever number of patients being admitted to mixed-sex wards, with numbers down 95%; the lowest ever number of patients waiting more than six months for treatment, with numbers down from 100,000-plus to 70,000; the lowest ever number of patients waiting more than a year for treatment, with numbers down from more than 18,000 to below 6,000; and the lowest ever number of patients waiting more than 18 weeks from referral to treatment. In May 2010, that figure was 209,000 but the latest figure is down to 182,000. Also, fewer people than ever are acquiring infections in hospital, with methicillin-resistant Staphylococcus aureus down 36% and clostridium difficile down 25%.
I have searched in vain for a point to this debate. I think that the only point was so that the right hon. Gentleman and his friends could put out a press release about having 24 hours to save the NHS—I think I have heard that one before. The Labour party is never knowingly over-clichéd. Only the Daily Mirror bothered to notice the press release, putting it on page 6; if it had really thought that this was about saving the NHS, it might at least have put in on page 1. No, the truth is that this is political opportunism dressed up as principle. This is a debate for no purpose and the only effect of this one and a half hour debate is to delay the consideration by this House of the amendments made in another place. Given the full and constructive character of the debate in the Lords over 25 days, I think it is a disservice to the other place that this House’s time has been wasted on having this debate. The Labour party has shown that it is interested not in what is in the Bill, but only in the political opportunity of opposing it. We are interested not only in what is in the Bill but in the opportunity it presents—not for the sake of the Opposition’s politics but for the NHS to improve and strengthen in the future.
Health and Social Care Bill
Lord Lansley Excerpts(12 years, 1 month ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health (Mr Andrew Lansley)
In commenting on the level of nursing staff, will the hon. Gentleman observe that since the election, there has been a 5% improvement in the ratio of nurses to occupied beds in general and acute wards?
Andrew George
I am not in a position to doubt that figure. The question is whether the ratio is sufficient to ensure that there is safe staffing in our hospitals now, as the RCN identified after a recent survey. I understand the argument advanced by Ministers that it comes down to the management and the management of paperwork within hospitals, and is not just about staff-to-patient ratios. I do not want to have a debate just about staff -to-patient ratios, but that issue has been raised today and I believe that it resonates with people out there in the country, who can see that nurses in particular are struggling to provide adequate services within their hospitals. Those ratios have an effect on the level of care that nurses can provide, as has been found by a variety of reports. The problem is not down to the callousness of the nurses or untrained care assistants who provide the services—where that exists, it should clearly be rooted out of the service—but to whether staff resources are sufficient to maintain safe services on our hospital wards. I think the RCN is right to raise that issue.
That concern is relevant to ensuring that we have adequate local healthwatch services because it shows that we need independent scrutiny of the health service by a body that is not in the pocket of anyone, including the local authority, but that is able to scrutinise hospitals and speak out about staffing levels in its area. We cannot be dependent on the RCN reporting such matters to the Department and on there being top-down diktats that impose mandatory staffing levels that apply in all circumstances. Rather, there should be a local healthwatch that looks at the guidance and recommendations of the professional bodies and ensures that the services in its local hospitals are adequate to provide safe nursing and hospital care. That is why it is important to ensure that the local healthwatch bodies are, as far as is possible, independent of any external influences, whether from the Department, the NHS Commissioning Board, clinical commissioning groups or the local authority. That is where I shall take my arguments.
Health and Social Care Bill
Lord Lansley Excerpts(12 years, 1 month ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Andy Burnham
No. I have been listening to the strictures from the Chair, and I want to get into my speech so that Back-Bench colleagues have a chance to contribute.
That takes us straight to the heart of the predicament in which we find ourselves. There is huge concern in the country about the Bill, but the Government and Parliament—
The Secretary of State for Health (Mr Andrew Lansley)
Will the right hon. Gentleman give way?
Andy Burnham
I will in a moment.
There is huge concern in the country about the Bill, but the Government and Parliament are seen simply not to be listening. I give way to the Secretary of State, and I hope that he might prove us wrong.
Mr Lansley
I am grateful to the right hon. Gentleman, but before we move beyond that point will he confirm that Dr Chand is an adviser to the Labour party, which inspired the petition? Further, given that Dr Chand has called on the British Medical Association to take strike action against the Bill, does the right hon. Gentleman share that view, or will he disown him?
Andy Burnham
Dr Chand is not an adviser to the Labour party, and the Secretary of State, in seeking to inject that party political note so early on in today’s debate and to claim that the petition of 170,000 people is a political petition, continues, it suggests to me, to misread the mood of this country on his unnecessary Bill.
The Secretary of State for Health (Mr Andrew Lansley)
As a learned man, Mr Deputy Speaker, you will recall that Plato said that
“empty vessels make the loudest sound”.
The right hon. Member for Leigh (Andy Burnham) has been a study in this: as his arguments have diminished, so his tone has become more strident. By the end of his speech, he was simply shouting slogans. I listened carefully to his speech, but in vain, for evidence of an argument, still less of an Opposition policy.
I ask the House to reject the motion, which is a desperate ploy from a desperate party. The House scrutinised and approved the Bill, with amendments. following a substantial and highly constructive engagement right across health and care services and with the independent NHS Future Forum. We accepted all their recommendations. The chairman of the British Medical Association Council said at the time that the recommendations
“address many of the BMA’s key concerns”.
Dr Clare Gerada, the chair of the Royal College of General Practitioners, said that
“we are reassured that things are moving in the right direction”.
Yes, things have moved in the right direction, including, apparently, Dr Gerada, encouraged by her council.
In the other place, things have moved in the right direction, too. We have had hours of constructive debate leading to further positive amendments, including amendments to put beyond doubt the Secretary of State’s responsibility and accountability with respect to a comprehensive health service, and a duty on the Secretary of State to have regard to the NHS constitution; amendments to make it clear that Monitor will have the power to require health care providers to promote integration of NHS services, enabling Monitor to use its powers to support integration and co-operation in the interests of patients; and amendments conferring new responsibilities on the NHS Commissioning Board and clinical commissioning groups to play an active role in supporting education and training, and requiring providers to co-operate with the Secretary of State when exercising his duty to secure an effective education and training system. All those amendments were positively accepted in the Lords.
Mr George Howarth
The Secretary of State quoted Plato earlier. Does he recall the advice that Cromwell gave to Members of the Long Parliament—that they had stayed in their place for too long and to no useful purpose? Is that not advice that he might take?
Mr Lansley
I do not think the right hon. Gentleman should quote Cromwell to a Cambridgeshire MP; I think I know more about Cromwell than he does. [Hon. Members: “Ooh!”] I might also tell him—
Michael Dugher (Barnsley East) (Lab)
What do you know about the health service?
Mr Lansley
What do I know about the health service? I have been at the Government and Opposition Dispatch Boxes for nearly nine years speaking on behalf of the national health service. Before that I was on the Select Committee on Health, looking out for the interests of the health service, and before that my father was working—[Interruption.]
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. Front Benchers need to be a little calmer. A lot of Members want to be called, and we want to hear the Secretary of State.
Mr Lansley
Let me just say this to the hon. Member for Barnsley East (Michael Dugher), who is sitting on the Opposition Front Bench. There may be many things that we can debate in this House, including the policies, but I deeply resent any implication that I do not care about the national health service. I believe that I have demonstrated that I do; and his hon. Friends—and, to be fair, the right hon. Member for Leigh—have made that absolutely clear, time and again. Dr Clare Gerada, on behalf of the Royal College of General Practitioners, has said clearly that she recognises the Prime Minister’s and my passion and commitment and that of the Prime Minister to support the national health service.
Stewart Hosie (Dundee East) (SNP)
The Secretary of State said some moments ago that the Bill had all been debated in this House, but of course it has not. Possibly the most damaging aspect financially to the NHS outside England is the increase in usage of the private sector in the NHS in England to 49%. That has never been debated in this House, has it?
Mr Lansley
I am afraid that the hon. Gentleman is completely wrong. The private income cap for foundation trusts was debated fully in Committee in this House, and it has been debated again in another place. The reason for the so-called 49% was simply that Members in another House said that they wanted to be absolutely clear that the principal legal purpose of foundation trusts is to provide services to the NHS, and therefore that, by definition, a foundation trust could not have more of its activity securing private income than NHS income, hence the 49%. But in truth, the safeguards that are built in make it absolutely clear that, whatever the circumstances and whatever their private income might be—from overseas activities or overseas patients coming to this country—foundation trusts must always demonstrate that they are benefiting NHS patients. That is why, I remind the House again, the foundation trust with the highest private income—27%—is the Royal Marsden, which delivers consistently excellent care for NHS patients.
Mrs Anne Main (St Albans) (Con)
Does my right hon. Friend share my absolute astonishment at Labour Members’ collective amnesia when it comes to the 13 years of mixed-sex wards and rising levels of MRSA and C. difficile that they presided over, along with a failed patient record system that has cost billions?
Mr Lansley
My hon. Friend is absolutely right, and I will come to some of those points. However, I might just say that, in the space of the last few days, we have had an opportunity to demonstrate that Labour signed up to an enormous, centralised, top-down NHS IT scheme that was never going to deliver, was failing to deliver and was costing billions.
Karl Turner (Kingston upon Hull East) (Lab)
Will the Secretary of State give way?
Mr Lansley
No.
In the space of under two years, my right hon. and hon. Friends at the Department and I have delivered a reduction approaching £2 billion in the cost of the NHS IT programme. That will enable us to empower services right across the country to be better users and deliver better IT systems.
Duncan Hames (Chippenham) (LD)
Further to the list of changes to the Bill that the Health Secretary has outlined, will he confirm that it no longer imposes reviews by the Competition Commission on the NHS, therefore ensuring that it is not treated in the same way as any private industry would be?
Mr Lansley
That is indeed true, and my hon. Friend will also be aware—the Future Forum was clear about this—that the NHS benefits from the transfer of competition powers. The Bill does not create any new competition powers in the NHS; it transfers the exercise of competition powers from the Office of Fair Trading to Monitor, as a sector-specific regulator, as we agreed in the coalition agreement. That is what the Bill does, and that is a better protection for the NHS compared with what would otherwise be the application of competition rules, and before—[Interruption.] Labour Members mutter, but it has become apparent over recent weeks that in 2006, when the right hon. Member for Leigh was a Health Minister, it was their Government who received legal advice that demonstrated that their changes had introduced the application of EU competition rules into the NHS.
Simon Hughes
Will the Health Secretary amplify his answer to our Scottish National party colleague, the hon. Member for Dundee East (Stewart Hosie), and make it quite clear that both Government policy and, now, the construction of the Bill not only prevent private sector activity from going out of the health service in terms of finance, but restrict the method of expanding private sector activity? The controls are now in the Bill, even if they were not at the beginning.
Mr Lansley
There is absolutely nothing in the Bill that promotes or permits the transfer of NHS activities to the private sector. Of course, NHS trusts are technically able to do any amount of private activity at the moment, with no constraint. The Bill will make absolutely clear the safeguard that foundation trusts’ governors must consent if trusts are to increase their private income by more than 5% in the course of one year, and that they must always demonstrate in their annual plan and their annual reporting how that private activity supports their principal legal purpose, which is to provide services to NHS patients.
Labour sought to oppose the Bill in another place, but its motion was defeated by 134 votes. We have reached a stage at which the Labour party, and the right hon. Member for Leigh in particular, having embraced opposition —for which they are well suited—now oppose everything. They even oppose the policies on which Labour stood at the election. Labour’s manifesto stated that
“to safeguard the NHS in tougher fiscal times, we need sustained reform.”
The trade unions have got hold of the Labour party in opposition, and it is now against reform. Its manifesto also stated that
“we will deliver up to £20bn of efficiencies in the frontline NHS, ensuring that every pound is reinvested in frontline care”.
I remind Labour Members, who are all wandering around their constituencies telling the public that there are to be £20 billion of cuts to the NHS, that that £20 billion was in their manifesto. Now they are talking about it as if it were cuts; it is not. We are the ones who are doing it, and they are the ones who are now opposing it. They scare people by talking of cuts—[Interruption.] They do not like to hear this. Actually, this year, the NHS has an increased budget of £3 billion compared with last year, and in the financial year starting this April there will be another increase of £3 billion compared with this year. The Labour manifesto also stated:
“Foundation Trusts will be given the freedom to expand their provision into primary and community care, and to increase their private services”.
John Pugh (Southport) (LD)
The right hon. Gentleman has just mentioned reform. In 2009, he said in this place:
“Organisational upheaval and reform do not seem to correlate well.”—[Official Report, 19 November 2009; Vol. 501, c. 225.]
What did he mean by that?
Mr Lansley
We know that it is necessary for us to reform in order to deliver the improvements that the NHS needs, as well as the sustainability that it needs. We are not even speculating about this; we can demonstrate that it is happening. This is in contrast to what the right hon. Member for Leigh said. He said that he was not scaremongering, then he got up and did just that. He scaremongered all over again. He went to a completely different set of data on the four-hour A and E provision, for example. He went to the faulty monitoring data, which are completely different from the ones that we have always used in the past—namely, the hospital episodes statistics data, which demonstrate that we are continuing to meet the 95% target.
When we look across the range of NHS performance measures, we can see that we have improved performance while maintaining financial control. The monitoring data from the NHS make that absolutely clear, and that is in contrast to what happened when the right hon. Gentleman was a Minister in the Department, when Labour increased the NHS budget and lost financial control. That happened when the hon. Member for Leicester West (Liz Kendall) was a special adviser in the Department. Now, we have financial control across the NHS and we have the NHS in financial surplus.
Let me return to the Labour manifesto—[Interruption.] Labour Members do not like to hear this. It stated:
“Patients requiring elective care will have the right, in law, to choose from any provider who meets NHS standards of quality at NHS costs.”
Yes—choice and any qualified provider are in the Labour manifesto. We are doing what Labour said should be done in its manifesto—and it is now opposing it.
Let us find out what it is that the right hon. Member for Leigh opposes in the Bill. I did not find that out in his speech; I heard generalised distortions, but I genuinely want to know. Let us take some examples. Is it the Secretary of State’s duty in clause 1 to promote a comprehensive health service free of charge, as now? No, he cannot possibly be against that. Is it that the Bill incorporates for the first time a duty on the Secretary of State to act to secure continuous improvement in quality—not just access to an NHS service, but putting quality at the heart of the NHS? Is he against that? No, surely not. Anyway, that approach began with Ara Darzi, and we have strengthened it.
Mr Lansley
Let us try this one. For the first time the Bill introduces in clause 3 a duty that embeds the need to act to reduce inequalities firmly within the health system. After 13 years of widening health inequalities under Labour, surely he cannot be against that—or is he? No. Well, what about clinically led commissioning, with doctors and nurses who are responsible for our care given the leadership role in designing services? We heard earlier about one CCG, but 75 leaders of clinical commissioning groups wrote to The Times a fortnight ago. Let me quote them, because it is instructive of what is happening. They said:
“Since the…Bill was announced, we have personally seen more collaboration, enthusiasm and accepted responsibility from our GP colleagues, engaged patients and other NHS leaders than through previous ‘NHS re-organisations’”.
They continued:
“Putting clinicians in control of commissioning has allowed us to concentrate on outcomes through improving quality, innovation and prevention”—
precisely the things that the NHS needs for the future.
Now the right hon. Gentleman says, “Oh, yes, we can do GP commissioning”, but let us recall that in 2005, practice-based commissioning was in the Labour manifesto, and that in 2006, he said he was in favour of it. He said that he was
“introducing practice-based commissioning. That change will put power in the hands of local GPs to drive improvements in their area”—[Official Report, 16 May 2006; Vol. 446, c. 861.]
Mr Lansley
I will give way in moment. The right hon. Gentleman said he was in favour of practice-based commissioning. In 2010, he was the Secretary of State and was in charge of the manifesto, yet practice-based commissioning disappeared out of the Labour manifesto —it was not there at all. After the election, he pops up and says, “Oh, we are in favour of it again”. The truth is that practice-based commissioning was always the right idea: the Labour Government did not do it; the primary care trusts suppressed it. The Bill makes it possible for clinical commissioning groups to take responsibility and for doctors and nurses to design and deliver better services. Because of this Bill, it will happen—and it will not be suppressed by a top-down bureaucracy.
Andy Burnham
I made the Secretary of State an offer in my opening remarks. I said I would work with him to introduce his vision of clinically led commissioning, but he seems strangely silent about that and is pursing a very partisan tone. Will he confirm that he could introduce GP-led commissioning without any need for legislation—and without all the upheaval that is coming with his reorganisation?
Mr Lansley
The short answer to that is no. If one wishes to arrive at a place where the clinical commissioning groups have responsibility for budgets and proper accountability—including democratic accountability for what they do—legislation is required to get there. That is why we are putting legislation in place to make it happen.
Angie Bray
I thank my right hon. Friend for that, and I thank him, too, for coming to Acton last week and spending a long evening in a room full of health professionals—doctors, dentists and pharmacists. Does he agree that there was a real desire in that room to engage constructively in discussion on the reforms rather than to turn their back on them, as the Labour party would?
Mr Lansley
I am grateful to my hon. Friend for her initiative in bringing doctors, dentists and nurses together to have that conversation. I really appreciated it, and I thought that it illustrated exactly what I have found—that, although not everybody in the room agreed with the Bill—[Laughter]—many did. Contrary to what I see on the Labour Benches, they all wanted to design better services for patients. They cared about patients and engaged in a proper debate about how to achieve that.
I am still trying to find out what it is in the Bill that the right hon. Member for Leigh is against. Is it the fact that the Bill strengthens the NHS constitution? He should be proud of that; he introduced it. For the first time, however, the Bill requires the Secretary of State to have regard to it and the NHS Commissioning Board and clinical commissioning groups to promote it. He is not against that, I presume.
What about the fact that, for the first time, the NHS Commissioning Board and commissioners will have a duty to promote integration throughout health and social care? Is the right hon. Gentleman against integrated care? I do not know. Let me try another question. What about the prohibition in clauses 146, 22 and 61 of discrimination in favour of private providers, which is in legislation for the first time? The right hon. Gentleman may be against that, because when his party was in office, that is what the Government did. They discriminated in favour of private sector providers, and we ended up with £250 million being spent on operations that never took place and the NHS being paid more for operations when it was not even allowed to bid for the work.
What about the creation of a strong statutory voice for patients through HealthWatch? The Labour Government destroyed the community health councils, they destroyed patient forums, and they left local involvement networks neutered. When they were in office, they were pretty dismissive of a strong patient voice. Well, we on the Government Benches are not, and the Bill will establish that patient voice. Is the right hon. Gentleman against all trusts becoming foundation trusts? The Bill will make that happen, and will support it—oh, no, I forgot: according to the Labour party manifesto, Labour wanted all trusts to become foundation trusts.
Let us keep moving through the Bill. Is the right hon. Gentleman against directly engaging local government in the commissioning of health services, integrating health and social care, and leading population health—public health—improvement plans? I ask the question not least because Labour local authorities throughout England are in favour of that. They want to improve the health of the people whom they represent. Is the right hon. Gentleman against local democratic accountability? The list could go on. Is he against the provision of a regulator—Monitor—whose duty is to protect the interests of patients by promoting quality, stopping anti-competitive practices that could harm patients, supporting the integration of services, and securing the continuity of services? Is he against that? It is in the coalition agreement, but I do not know whether the right hon. Gentleman is against it or not, because he does not say.
Is the right hon. Gentleman against statutory backing for the National Institute for Health and Clinical Excellence to support its work on quality? I do not know; we have not heard. Is he against developing the tariff so that it pays for quality and outcomes, not for activity? He knows that that has to happen, and he knows that it has been the right thing to do for the best part of a decade, but we have no idea whether he is against it now.
I cannot discover what the right hon. Gentleman is actually against. He sits there and says that he is against the Bill, but he is not against anything that is in the Bill. He is against the Bill because he has literally made up what he claims it says. He says that it is about privatisation—
Mr Lansley
All right, I will give way to the right hon. Gentleman one more time. Come on, then: let us find out what he is against.
Andy Burnham
I will tell the Secretary of State what I am against. I am against the rewriting of the entire legal structure of the national health service to plant market forces at the centre of the system, and to pit doctor against doctor and hospital against hospital. That is what I am against, it is what 170,000 people signed a petition against, and it is what the overwhelming consensus of health professionals is against. Would the Secretary of State not do well to listen to them for once?
Mr Lansley
So now we know, Mr Deputy Speaker. It is sheer invention. There is nothing in the Bill that creates a free-for-all. There is nothing in it that creates a market of that kind. The Bill means competition for quality, not price. It gives patients choice—and the Labour party’s manifesto was in favour of giving patients choice. Competition is not being introduced to the NHS by the Bill; it is being channelled in the interests of patients to support quality throughout the NHS.
The Opposition talk about privatisation. As I said to my right hon. Friend the Member for Bermondsey and Old Southwark (Simon Hughes), there is nothing in the Bill that allows any privatisation of NHS services. There is nothing in it that promotes such a privatisation.
The left-leaning papers talk about privatisation at Hinchingbrooke hospital because Circle is an independent mutual organisation. That is interesting, because the process for the franchising out of the management of Hinchingbrooke was started by the right hon. Gentleman when he was Secretary of State. So there we are: the only secret Tory plan that Labour can find turns out to be a Labour plan.
Paul Uppal (Wolverhampton South West) (Con)
The real issue in the debate is between long-termism and short-termism. Is not the reality that the Labour Government went aggressively down the route towards private finance initiatives, burdening so many of our foundation trust hospitals with debt that was unnecessary?
Mr Lansley
My hon. Friend makes an important point. When Labour Members talk about the private sector in the NHS, they leave out of account the fact that not only did they give the private sector a sweetheart deal to get it into the independent sector treatment centres, but they have left us with 102 hospitals that were built by the private sector and £67 billion of debt to the NHS. They wandered around the country saying, “Look how we’re spending all your money to build all these new hospitals,” but they did not spend the money to build the new hospitals. They have left the NHS to have to deal with it now, which is why I am having to support hospitals that have unsustainable private finance initiative debt that the right hon. Member for Leigh and his colleagues did not deal with.
What do we have? We have policies that the right hon. Gentleman disowns, and we have nothing to replace them with. We have political opportunism, distortions dressed up as arguments, and a shameful campaign to scare people about a Bill that, in reality, is about strengthening the NHS for the benefit of patients.
Of course, if we want to see what Labour would do, we only have to look at the situation in Wales. I have to hand a Wales Audit Office bar chart; I shall hold it up so Opposition Members can see it. One bar shows rising real-terms expenditure on the NHS in England, and the blue bar shows rising real-terms expenditure on the NHS in Scotland, while the green bar shows the rate for Northern Ireland, where the rise is lower. Another bar, however, shows a very large real-terms cut in NHS spending in Labour-run Wales. Labour in Wales did not just agree with the right hon. Gentleman that it would be “irresponsible” to increase NHS spending; Labour in Wales went further, and cut spending.
In order to see the result of that, we must look at performance. In England, 91% of patients are seen and treated within 18 weeks, compared with just 68% in Wales. In England, only 1.4% of patients waited over six weeks for diagnostic tests; in Wales, 29% waited over six weeks. In Wales, Labour says it wants to insulate the NHS against reform. It ought to adopt it, however, because all that is happening in Wales is that the Labour party is, once again, putting politics before patients.
It is patients who should be at the heart of the NHS —patients and those who care for them. This Bill is simply the support to a far more important set of changes, which make shared decision-making with patients the norm across the NHS, which bring clinical leadership to the forefront of the design and delivery of health and care services, which make local government central to planning for health and care, which strengthen the patient voice, and under which the NHS is open about the results we achieve and how to improve those results so we genuinely match the best in the world. We will continue to work with the royal colleges, and others with an interest in the future of the NHS, to implement our plans, so that we provide the best possible care for patients. The right hon. Gentleman’s motion and speech gave no credit to the NHS for what it is achieving, but I will.
We are proud of the services we deliver for patients: the lowest ever number of patients waiting over six months for treatment—[Interruption.] Labour Members do not like to listen to this, but it is the reality. Average time spent waiting for treatment is lower than at the last election. The number of patients waiting over a year for treatment has more than halved since the election. MRSA and C. difficile are at their lowest ever levels. There are more diagnostic tests—up by 300,000 over a year. There is more planned care, and there are fewer unplanned emergency admissions to hospital. Some 11,800 patients have benefited from the cancer drugs fund, and 990,000 more people have had access to NHS dentistry, while mixed-sex accommodation is down by 95%.
Mr Lansley
No, because I am going to tell the right hon. Gentleman what he did not admit. Reform is going ahead. We are delivering efficiencies across the NHS.
Mr Lansley
All right, I will give way, but the right hon. Gentleman might like to explain why in the year before the election the administration costs of the NHS rose by 23% and he added more than £320 million to the administration costs of primary care trusts and strategic health authorities, but in the year since, we have cut those costs. Absolutely contrary to what he said—because he was completely wrong—we are on track to deliver the Nicholson challenge. We delivered £2.5 billion in savings in the first six months of this year, having delivered £4.3 billion in savings during the course of the last financial year. Come on: explain that one.
Andy Burnham
I should just point out that the Secretary of State is trading on the successful legacy he inherited from Labour: the lowest ever waiting lists; the highest ever patient satisfaction. Let me leave that to one side, however. We on the Opposition Benches have noticed that he has not once mentioned his tribunal defeat on the NHS risk register, and all the achievements he just reeled off are at risk, are they not, because of this misguided reorganisation? I ask him to answer this point today: will he now comply with the ruling of the Information Tribunal, publish this risk register today, and let the public know the full truth about what he is doing to their national health service?
Mr Lansley
I was right, was I not, that the weaker the right hon. Gentleman’s argument, the stronger the tone? My noble Friend Earl Howe answered a private notice question in the other place yesterday, and the position is absolutely as he described it: we were right to go to appeal, as the appeal demonstrated, because the tribunal agreed that we should not publish the strategic risk register. The decision of the tribunal was that it took the view that we should publish the transition risk register, but it did not publish its reasons. Given the simple fact that there is considerable overlap between the strategic register and the transition risk register, I find it extremely difficult to know what the tribunal’s reasons are, so we will see what its reasons are.
Mr Lansley
I will not give way.
Let me just make it absolutely clear that reform is happening and it will be supported by the Bill: nearly £7 billion has already been saved to reinvest in front-line care; we have 15,000 fewer non-clinical staff; we have 5,800 fewer managers and 4,100 more doctors—since the election, we have had more qualified clinical staff; there are 890 more midwives since the election and a record number in training; we have 240 clinical commissioning groups covering England, leading on commissioning from April on up to £60 billion-worth of services; and the ratio of nurses to beds in hospital has gone up.
Labour’s motion is politics masquerading as principle, and it is synthetic anger. I would take the right hon. Gentleman’s campaign more seriously if his own leader could have been bothered to turn up to his NHS rally, rather than taking a Rolls-Royce to a football game. This is empty rhetoric from an empty vessel; this is no policy, only politics; and this is a leader who treats his party’s campaign with disdain. The House should have no truck with them, and I ask it to reject the Labour motion.
Valerie Vaz
I am sorry, but I have nearly finished my speech and must press on.
There was a chorus of disapproval from professionals when the White Paper was published, as they wanted more information. As Rogers and Walters say in the sixth edition of “How Parliament Works”, if there is pre-legislative scrutiny, Ministers have less political capital at stake and changes are not seen as defeats; the scrutiny of a Bill in draft gives higher quality legislation. That is not a description of the Health and Social Care Bill. The pre-legislative scrutiny was in the Secretary of State’s head, not in a draft Bill.
What about my constituent Stephen Wood, who went to his local GP’s surgery only to be told that doctors would only refer him to a consultant privately, not on the NHS, as he had apparently used up his budget?
Valerie Vaz
It is true. This has become personal. The NHS is an organisation in which miracles sometimes happen, which is why people are fighting to protect and save the very essence of its existence. Those who have paid their taxes do not want the Bill, and the health professionals do not want it. From all parties, professionals and patients in the NHS, we can say that we oppose the Bill, and when the NHS unravels, as it is now beginning to, we can say, “We told you so.” I support the motion.
NHS Pay Review Body
Lord Lansley Excerpts(12 years, 1 month ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health (Mr Andrew Lansley)
I am responding on behalf of my right hon. Friend the Prime Minister to the 26th report of the NHS Pay Review Body (NHSPRB). The report has been laid before Parliament today (Cm 8298). Copies of the report are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office. I am grateful to the chair and members of the NHSPRB for their report.
We welcome the NHS Pay Review Body’s 26th report, note its observations and accept its recommendations in full. In the light of a tough economic climate, I am pleased to confirm that lower paid NHS staff earning £21,000 or less will receive a flat rate increase of £250 from 1 April 2012. This will support continuing NHS service improvements and the position of lower paid NHS staff.
Review Body on Doctors' and Dentists' Remuneration
Lord Lansley Excerpts(12 years, 1 month ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health (Mr Andrew Lansley)
I am responding on behalf of my right hon. Friend the Prime Minister to the 40th report of the Review Body on Doctors’ and Dentists’ Remuneration (DDRB). The report has been laid before Parliament today (Cm 8301). Copies of the report are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office. I am grateful to the chair and members of the DDRB for their report.
We welcome the 40th report of the Review Body on Doctors’ and Dentists’ Remuneration and note its observations and recommendation to the Scottish Government. The Scottish Government are still considering the recommendation and expect to be in a position to make a decision by the end of the month. We will take forward the suggested actions, which will help us continue to improve our support for the DDRB’s important work.
NHS Pension Scheme (England and Wales)
Lord Lansley Excerpts(12 years, 2 months ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health (Mr Andrew Lansley)
On December 2011, I reported to the House that a heads of agreement had been reached on a new NHS Pension Scheme for England and Wales for introduction in 2015. The heads of agreement set out the Government’s final position on the main elements of scheme design.
Following this, my Department has been engaged in detailed discussions with health sector trade unions and employer representatives over the remaining details for the new NHS pension scheme. I can now report to the House that these discussions have concluded and the outcome reflected in a proposed final agreement. The headline elements of the proposed final agreement remain unchanged from those set out in my previous statement to the House concerning pension reform on 20 December 2011.
The Government have made it clear that the proposed final agreement represents our final position on scheme design. The final scheme design is conditional on acceptance by trade unions of the proposed final agreement. Trade unions have agreed to take this proposed final agreement to their Executives as the outcome of negotiations. Furthermore, the proposed final agreement includes a commitment by trade unions to seek Executives’ agreement to the cessation of any further industrial action on pension reform.
The core parameters of the new scheme are set out below:
a. a pension scheme design based on a career average revalued earnings methodology;
b. an accrual rate of l/54th of pensionable earnings each year with no limit to pensionable service;
c. revaluation of active members’ benefits in line with the consumer price index plus 1.5% per annum;
d. a normal pension age equal to the state pension age, which applies both to active members and deferred members (new scheme service only). If a member’s state pension age rises, then their normal pension age will do so too for all post-2015 service. Those within 10 years of their current normal pension age are excluded and accrued rights will also be related to current normal pension age;
e. pensions in payment to increase in line with inflation (currently consumer price index);
f. benefits to increase in any period of deferment in line with inflation (currently consumer price index);
g. member contributions on a tiered basis to produce a total yield of 9.8% of total pensionable pay in the scheme;
h. optional lump sum commutation at a rate of £12 of lump sum for every £1 per annum of pension foregone up to the maximum limit on lump sums permitted by HM Revenue and Customs;
i. the current flexibilities in the 2008 section will be included in the 2015 scheme—early/late retirement factors on an actuarially neutral basis, draw down of pension on partial retirement and being able to retire and return to the pension scheme;
j. ill-health retirement pensions to be based on the current ill-health retirement arrangements but with enhancement for higher tier awards to be at the rate of 50% of prospective service to normal pension age;
k. spouse and partner pensions to continue to be based on an accrual rate of 1/160th. For deaths in retirement, spouse and partner pensions will remain based on pre-commuted pension;
l. the current arrangements for abatement (for service accrued before and after 2015) will be retained;
m. the lump sum on death in service will remain at twice actual pensionable pay;
n. for members who in the new scheme have a normal pension age higher than 65 there will be an option in the new scheme to pay additional contributions to reduce or, in some cases, remove any early retirement reduction that would apply if they retire before their normal pension age. Only reductions that would apply in respect of years after age 65 can be bought out and the maximum reduction that can be bought out is for three years (that would apply to a member with a normal pension age of 68 or higher);
o. added years contracts in the 1995 section will continue on compulsory transfer to the 2015 scheme;
p. arrangements to purchase additional pension will continue;
q. the public sector transfer club will continue and further consideration will be given to the best way of operating it in the reformed schemes; and
r. there will be an employer contribution cap.
The Government Actuary’s Department (GAD) has confirmed that this scheme design does not exceed the cost ceiling set by the Government on 2 November 2011. The proposed final agreement and GAD verification have been placed in the Library. Copies are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office. The documents are also available at:
www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_133003.pdf
Reviewing and Strengthening the NHS Constitution
Lord Lansley Excerpts(12 years, 2 months ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health (Mr Andrew Lansley)
As Secretary of State for Health, I have a duty, under the Health Act 2009, to publish a report on how the NHS constitution has affected patients, staff, carers and the public by 5 July 2012.
The Government are committed to the common set of principles and values established by the NHS constitution, and have made a number of amendments to the Health and Social Care Bill to strengthen its influence on the NHS.
The statutory requirement for a report on the impact of the NHS constitution provides an excellent opportunity to assess the contribution it has made to reinforcing the principles and values of the NHS, supporting high quality patient care and ensuring that patients, the public and staff are aware of their rights, as well as what they can contribute. The report will help to inform efforts to fully embed the constitution in the everyday work of the NHS, including the plans of the NHS Commissioning Board (NHSCB) and clinical commissioning groups (CCGs) to fulfil their duties to promote the NHS constitution.
In order to make the most of this opportunity, I am keen to have a wide range of advice and I have therefore asked Professor Steve Field to chair an independent Future Forum working group to advise me on the NHS constitution. The Future Forum group will use a wide variety of information, including surveys, workshops, performance data, and patient experience reports to examine what effect the constitution has had on the NHS and will then advise me on how best to reflect this in my report.
Following the report, I have also asked the new Future Forum group to advise me whether there is any scope for strengthening the NHS constitution to support the fair and effective operation of the NHS. Both the group and the Government will engage with key NHS, professional and patient organisations in considering the potential for changes, before a full public consultation in autumn 2012. Any amendments to the NHS constitution would then come into effect by April 2013.
Between them, this work and the new duties on the NHS constitution contained in the Health and Social Care Bill, which will require NHS bodies to have regard to the constitution and for the NHSCB and CCGs to promote the constitution, will strengthen both the contents of the NHS constitution and the role it plays in the NHS.
Whistleblowing and the NHS Constitution
Lord Lansley Excerpts(12 years, 2 months ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health (Mr Andrew Lansley)
On 9 June 2010, I announced a full inquiry into the failings at Mid Staffordshire NHS Foundation Trust and gave a commitment to
“Reinforce the NHS constitution to make clear the rights and responsibilities of NHS staff and their employers in respect of whistleblowing”.
The Department of Health ran a full public consultation on a set of proposals for changes to the NHS constitution in respect of whistleblowing and published the Government’s response to that consultation, on 18 October 2011, setting out a commitment to making the changes in early 2012.
I have today published a revised NHS constitution which highlights the existing rights of NHS staff to raise concerns without fear of detriment and makes it clear that it is the right and duty of all NHS workers to report bad practice or any mistreatment of patients receiving care from the health service at the earliest opportunity.
Changes to the constitution add:
an expectation that staff should raise concerns at the earliest opportunity;
a pledge that NHS organisations should support staff when raising concerns by ensuring their concerns are fully investigated and that there is someone independent, outside of their team, to speak to; and
clarity around the existing legal right for staff to raise concerns about safety, malpractice or other wrongdoing without suffering any detriment.
These changes are part of a series of measures intended to highlight the importance of whistleblowing in the NHS. This Government have already issued unequivocal guidance to NHS organisations that all their contracts of employment should cover staff whistleblowing rights and amended the NHS staff terms and conditions of service handbook for those staff on Agenda for Change terms and conditions to include a contractual right to raise concerns. We have also issued guidance to the NHS on supporting and taking action on concerns raised by staff.
Enshrining whistleblowing in the constitution will contribute to further raising the profile of whistleblowing and play an important role in creating a culture where staff will be able to raise genuine concerns in good faith, without fear of reprisal.
I recently announced that the Department of Health has put in place a new and improved contract for the provision of a confidential whistleblowing helpline for NHS staff to provide them with advice on how to raise concerns and what legal protections are available to them when they do. The new contract provides for a free phone service and extends the provision of the contract to staff working in social care.
The revised NHS constitution has been placed in the Library. Copies are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office.