Care and Support

Debate between Lord Lansley and Dan Poulter

Wednesday 11th July 2012 Commons Chamber

[Mr Lansley]

I am not attempting to hoodwink anybody. I have made the point very clearly that in this financial year the Association of Directors of Adult Social Services is making total savings of £891 million, of which only 13%, some £113 million, is being achieved through reductions in services. We are investing in and supporting such services. In 2012-13, £930 million of extra funding will go to local authorities through formula grant to support social care. The NHS is transferring £622 million and we are doubling last year’s figure so that £300 million will be available through the NHS for re-ablement. Those are major additions to the support for care.

On the other point that the hon. Gentleman made, even the right hon. Member for Leigh did not try to return to the debate that we had before the election, and rightly so. The right hon. Gentleman eschewed party political point scoring; the hon. Member for Easington (Grahame M. Morris) did not. I think he should have done.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I warmly welcome the statement. There is clear commitment in a number of good areas, including improving the portability of services, providing greater support for carers, improving respite care and having more joined-up working between the NHS and adult social services, which will save social services and the NHS money, and improve the care that is delivered to patients. Does the Secretary of State agree that when local government commissions services, it should do so with a view to improving the quality of care and moving away from the care-by-the-minute mentality to which many local care providers seem to adhere?

[Mr Lansley]

My hon. Friend is absolutely right in all respects. I know that local government will welcome the philosophy of commissioning for quality, rather than commissioning simply on the basis of watching the clock. That will also be welcomed by older people who are in receipt of care.

Oral Answers to Questions

Debate between Lord Lansley and Dan Poulter

Tuesday 21st February 2012 Commons Chamber

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

4. What steps he is taking to address underperforming hospital management teams.

[The Secretary of State for Health (Mr Andrew Lansley)]

The performance of hospital management teams is the responsibility of their boards. Those are accountable to strategic health authorities for NHS trusts, and foundation trusts are accountable to their governors to ensure that they comply with Monitor’s framework. As part of our work to strengthen NHS trusts so that they can reach foundation trust status, we have published guidance on strengthening trust boards, their clinical leadership and management. We are further strengthening accountability through quality accounts and open reporting so that the public can see the absolute and relative performance of all NHS service providers.

[Dr Poulter]

I thank my right hon. Friend for that answer. It is absolutely right that managers take responsibility for the decisions that they take at a local level on behalf of patients and are held accountable for them. A doctor or nurse who fails in their duty can be struck off, so there is clear accountability, but there appears to be no clear accountability or traceability for the decisions of hospital managers. Who will hold those people properly to account when they have failed?

[Mr Lansley]

My hon. Friend knows that the management of trusts should be accountable directly to their boards. As I said, the management of foundation trusts are accountable, through their boards, to their governors. An important point that arose in relation to Mid Staffordshire NHS Foundation Trust is that we should ensure—we are looking at how to fulfil this—that there is also a code of practice to which managers are held accountable. He knows, as I do, that management must be accountable through their boards.

Breast Implants

Debate between Lord Lansley and Dan Poulter

Wednesday 11th January 2012 Commons Chamber

[Mr Lansley]

For reasons that I have already explained, the hon. Gentleman is simply wrong about that. It is nonsensical to attempt—as the editor of The Lancet did this morning—to compare the regulation of private providers of private care with that of private providers of NHS care. There is no comparison at all.

The CQC will inspect a sample of providers of cosmetic surgery to check that they are meeting registration requirements, and will undertake a number of unannounced inspections as part of that. We expect the inspections to be completed by the end of the month, and expect the CQC to have published its report by the end of March. It has confirmed that it has enough resources to undertake the inspections within its existing budget.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I add my support and thanks to the Secretary of State for what he is doing on this very important issue which has caused so much distress to so many women. Does he agree that this episode flags up a wider issue in the cosmetic surgery industry, in that some practitioners performing medical procedures do not have any medical qualifications or knowledge of anatomy? Does he also agree that it is a problem that there is no psychological counselling and that a holistic look at patients is not taken, as this is an on-demand industry? Finally, does he agree that there must be a proper paper trail and record system in the industry, so that we can consider what is in the best interests of patients and so that there is proper accountability for all providers?

[Mr Lansley]

My hon. Friend makes a number of important and perceptive points. It is, and will continue to be, one aspect of NHS advice that psychological assessment can form an important part in the management of patients referred for low-priority procedures, including cosmetic surgery. However, although we will look at cosmetic interventions and their regulation more widely, we must recognise that the issue in this instance related to what was a criminal act—seeking to adulterate the material in the implants. Many private providers were using what they regarded as properly certified implants for a perfectly proper procedure. To that extent, they were not engaging in any improper behaviour. However, they have legal and moral obligations to their patients, and I am asking them to discharge those obligations.

Oral Answers to Questions

Debate between Lord Lansley and Dan Poulter

Tuesday 12th July 2011 Commons Chamber

[Mr Lansley]

No, we have met the standard that patients should not wait longer than 18 weeks—a 90% standard for admitted patients and 95% for non-admitted patients. If I recall correctly, the latest data for diagnostic tests showed that there was a 1.9 week average wait for diagnostic tests, which compares with 1.8 weeks in May last year. On cancer waiting times we have achieved an improvement—up to 96%—in the number of patients who are seen by a specialist within two weeks. The hon. Lady really needs to go back and talk to her colleagues in Wales, where 26% of patients wait longer than 18 weeks, compared with less than 10% of patients here; indeed, many patients in Wales wait more than 36 weeks. We have a contrast between a coalition Government in England who are investing in the health service, with improving performance, and a Labour Government in Wales who are cutting the NHS budget and seeing performance decline.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

10. What steps his Department is taking to provide funding for healthcare infrastructure projects.

NHS Future Forum

Debate between Lord Lansley and Dan Poulter

Tuesday 14th June 2011 Commons Chamber

[Mr Lansley]

I am afraid I have to say that that was all nonsense. As the hon. Lady knows, we responded positively to the consultation last year and made changes then. However, as the details of the Bill have been emerging, people have been trying to work out how they will make it all work in the future. They have been saying, “We want to set out in the legislation precisely how it will work.” There is no better way of making that process effective than talking to people in the NHS, engaging with them, listening to them, and then implementing the changes.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I am sure the Secretary of State agrees that the single biggest challenge facing health care in the United Kingdom is the economic and human challenge of looking after an ageing population. Does he also agree that the key to that is better integration of health care services—better integration of hospital services with community and social services—and that these reforms are a good way of going about that?

[Mr Lansley]

I agree very much with that. The Future Forum’s report, particularly the part that deals with clinical advice and leadership, has given us a robust structure for engagement with the range of professions that are capable of delivering that kind of integrated, joined-up and more effective care.

Public Health White Paper

Debate between Lord Lansley and Dan Poulter

Tuesday 30th November 2010 Commons Chamber

[Mr Lansley]

We have been very clear in the spending review and subsequent announcements that we will take the ring fence off many of the grants provided to local government, because we trust local government and we expect those in local government who are responsible for such things to be accountable to their electors. Where public health is concerned—this is separate from the point the hon. Gentleman makes—NHS money will be ring-fenced in the hands of local authorities for health gain. There will be many appropriate uses, so the ring fence will in no sense, I hope, have a constraining effect.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I am sure that, like me, the Secretary of State recognises that different population groups offer and present different public health challenges; for example, the Asian community has higher rates of cardiovascular disease. Does he agree that the White Paper presents an excellent opportunity for local authorities to address specific local concerns that are relevant to their NHS populations?

[Mr Lansley]

Yes, I do. My hon. Friend is absolutely right. The structure proposed in the NHS reform White Paper in July was to bring local authorities and the NHS together to undertake joint strategic needs assessments leading to a combined strategy. Understanding the causes of ill health, and understanding where ill health is occurring and where the greatest areas of unmet need are in a community, will impact positively both on NHS commissioning and on local authorities.

NHS White Paper

Debate between Lord Lansley and Dan Poulter

Monday 12th July 2010 Commons Chamber

[Mr Lansley]

I am adopting an any-willing-provider policy that was the policy of the hon. Gentleman’s Government, until the shadow Secretary of State abandoned it in September 2009 at the behest of the trade unions. I am adopting a policy designed to achieve the best possible care for patients by giving them access to all those who will deliver NHS services within NHS prices.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

Is my right hon. Friend aware that Hartismere hospital in my constituency was closed by Suffolk PCT, while at the same time, the PCT was able to afford to spend £500,000 on opening a new car park for managers? Does he agree that community hospitals such as Hartismere are still a valuable part of health care and that the White Paper might see a return to valuing them once again?

[Mr Lansley]

I am grateful to my hon. Friend for that question. I did in fact visit Hartismere hospital with his predecessor, and I entirely sympathise with his point. At that time, the primary care trust in his part of Suffolk was regarded as “initiative central”. It had to pursue every initiative from the Department of Health, and the money just went out the door. Those initiatives lasted just a year or two and then disappeared. That is not the basis on which to design the national health service. GPs are an excellent basis for this work because they are committed to their areas, and to the patients they look after, in the long term.

Oral Answers to Questions

Debate between Lord Lansley and Dan Poulter

Tuesday 29th June 2010 Commons Chamber

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

4. What steps he plans to take to implement the Government’s proposals to end the target culture in the NHS.

[The Secretary of State for Health (Mr Andrew Lansley)]

On Monday 21 June I published a revision to the NHS operating framework in which I removed the central management of three process targets that had no clinical justification. We will carry on focusing on quality and outcomes, getting rid of top-down process targets.

[Dr Poulter]

Does my right hon. Friend agree that meeting targets does not necessarily mean improving health care, and that the last Government were far too focused on the process of health care, rather than on improving the patient experience?

[Mr Lansley]

My hon. Friend is absolutely right. I was here just a few weeks ago, announcing a public inquiry into the events at Stafford general hospital. Of course, in that hospital the adherence to ticking the box on the four-hour target was one of the things that contributed to the most appalling care of patients. We have to focus on delivering proper care for patients—the right treatment at the right time in the right place—and delivering the best outcomes for them. We will focus on that—on quality—not on top-down process targets.