Business of the House

Debate between Lord Lansley and John Baron

Thursday 11th July 2013 Commons Chamber

[Mr Lansley]

Given that the hon. Gentleman’s question is occasioned by the front page of today’s Guardian, I hope he will be pleased to hear that the Government have not commissioned contingency plans for Faslane. Ideas of the kind described have not come to the Defence Secretary or the Prime Minister and they would not support them if they did.

[Mr John Baron (Basildon and Billericay) (Con)]

The Leader of the House is well aware of the phenomenal success of the cancer drugs fund since it was introduced in 2010, but there is growing concern among charities, clinicians and patients about the lack of clarity about its replacement. In a well-attended meeting in March, the Secretary of State for Health said that he would make a statement about this before the summer recess. Will the Leader of the House update us on progress with regard to that statement?

[Mr Lansley]

I repeat that my right hon. Friend the Health Secretary will be here to answer questions next Tuesday. I know that my hon. Friend the Member for Basildon and Billericay (Mr Baron) is assiduous in taking up these issues and I absolutely agree with him: the cancer drugs fund is tremendously important. It was always clear that it would enable us to meet the needs of patients in accessing new and innovative medicines and it has done so in about 27,000 cases, which is tremendous news. It is expected, however, that from January 2014 we will have a system that will enable patients right across the NHS to access the latest innovative medicines at a price that represents value for money for the NHS.

Business of the House

Debate between Lord Lansley and John Baron

Thursday 6th June 2013 Commons Chamber

[Mr Lansley]

I am grateful to my hon. Friend. I am sure that many Members will share with him a sense of the importance of the Science Museum Group, including, in particular, the Museum of Science and Industry in Manchester. The group receives over 5 million visitors a year, so it is very important. It received a real-terms reduction in its overall funding in the previous funding review and, obviously, I am not in a position to talk about any future spending review. The distribution of funding within the Science Museum Group is an operational matter for the group itself, but I will bring the point raised by my hon. Friend to the attention of my right hon. Friend the Secretary of State for Culture, Media and Sport.

[Mr John Baron (Basildon and Billericay) (Con)]

May I seek absolute clarity on what the Leader of the House kindly said about a debate on arming the Syrian rebels? Are the Government committed to having a substantive debate and vote before any decision is made on whether to arm the Syrian rebels, even if Parliament is in recess at the time? Will we get that debate before any policy is implemented?

[Mr Lansley]

Let me be clear: as the Prime Minister made perfectly clear yesterday, that question has not yet arisen because no such decision has been made. The Prime Minister was clear, as he was in relation to Libya, that he will seek to secure an opportunity for the House to debate and express its view through a vote on these matters. It is, of course, a hypothetical question at present. The Prime Minister is determined, as is the Foreign Secretary, that the House should have the opportunity, as was the case with Libya, to express its view.

Business of the House

Debate between Lord Lansley and John Baron

Thursday 13th December 2012 Commons Chamber

[Mr Lansley]

I am sure that you, Mr Speaker, and the House will be aware of the evidence from the Backbench Business Committee of the progress it is making in being able to accommodate requests. I have seen, by sitting with the Committee at its sessions, just how an increasing number of Members from right across the House appreciate that and take advantage of it. The hon. Lady asks for flexible debates if the business of the House concludes early. We took that approach for the autism debate, which I thought was very successful and delivered precisely what the Committee was seeking.

[Mr John Baron (Basildon and Billericay) (Con)]

The Government are about to announce a key decision on whether one-year and five-year cancer survival rates will be included in the 2013-14 commissioning outcomes framework. Given the importance of this decision to cancer patients and the cancer community at large, may we have an appropriate statement in this House?

[Mr Lansley]

My hon. Friend and I have discussed this on many occasions. He will understand that one thing we have set out to do is hold the NHS to account, through the Commissioning Board, for the outcomes it achieves in the national outcomes—the NHS outcomes framework. The way in which the board then holds clinical commissioning groups to account in greater detail—I am pleased to say that the first 34 have now been authorised by the board—is a matter for it to decide under the NHS commissioning outcomes framework. It is for the board to make these announcements, rather than for Ministers to do so.

Business of the House

Debate between Lord Lansley and John Baron

Thursday 6th December 2012 Commons Chamber

[Mr Lansley]

I cannot immediately offer the prospect of time for debate. If I recall correctly, such issues were touched upon on Tuesday during Foreign and Commonwealth Office questions. Other Members will share the hon. Gentleman’s concern about this matter, and he and others may look to secure an Adjournment debate, or something of that kind, to enable their views to be aired.

[Mr John Baron (Basildon and Billericay) (Con)]

Many hon. Members are concerned about the extent of cuts to the regular battalions under Army 2020, including the 2nd Battalion, Royal Regiment of Fusiliers, and the ability of the Territorial Army to fill the gap. Will the Leader of the House arrange for a statement so that the House can be updated on the progress of the TA plans?

[Mr Lansley]

My hon. Friend will recall that the Secretary of State for Defence recently made a statement on the reserve forces. There is a debate this afternoon on defence personnel, in which I encourage my hon. Friend further to pursue those questions. He will know from our exchanges that Ministers have completely understood the points that he and my hon. Friends have made on the 2nd Battalion, Royal Regiment of Fusiliers. Ministers are approaching Army 2020 in a positive way, despite the necessity to make many difficult decisions.

Business of the House

Debate between Lord Lansley and John Baron

Thursday 6th September 2012 Commons Chamber

[Mr Lansley]

In terms of business, the hon. Lady is right. The House had an opportunity to debate Atos Healthcare, and I think that she may have received replies from the then Minister of State, my right hon. Friend the Member for Epsom and Ewell (Chris Grayling). I personally know that the work done as a consequence of the Harrington reviews, and what we announced in July about the recording of tribunal judges’ reasons for overturning decisions on appeal, will enable us continuously to improve the process.

[Mr John Baron (Basildon and Billericay) (Con)]

I welcome the Leader of the House to his new post. May I ask him to consider one further fact relating to the 2nd Battalion the Royal Regiment of Fusiliers? It is the only infantry battalion that is being axed for political rather than military reasons, in order to save the more poorly recruited Scottish battalions ahead of the referendum. In fact, no Scottish battalions are being axed. I am married to a Scot and I believe in the Union, but discriminating against the English is not the way for us to achieve our goal.

[Mr Lansley]

My hon. Friend had an opportunity to raise that with the Prime Minister at Prime Minister’s Question Time, and I hope that he will take the opportunity that the Prime Minister gave him to make his points at a meeting. However, I do not recognise his description of the way in which decisions were made. They were made on the basis of an assessment of how the armed services could be sustainable for the future, and could secure representation and maintain recruitment throughout the United Kingdom.

Health and Social Care Bill

Debate between Lord Lansley and John Baron

Tuesday 28th February 2012 Commons Chamber

[Mr Lansley]

I believe that I answered that question. The point of the letter was to reflect the discussions that we have been having.

[Mr John Baron (Basildon and Billericay) (Con)]

Does my right hon. Friend accept that the debate so far risks ignoring the importance of the Bill’s renewed outcomes? In cancer, for example, such focus is instrumental in driving forward earlier diagnosis, which in itself could save quite literally thousands of lives.

[Mr Lansley]

My hon. Friend is absolutely right, and I am sure that in that context he shares with me the appreciation of the benefit that will come from campaigns to promote the early awareness of cancer, such as, following piloting, the roll-out of the national campaign for the awareness of bowel cancer symptoms.

Oral Answers to Questions

Debate between Lord Lansley and John Baron

Tuesday 12th July 2011 Commons Chamber

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

The first NHS outcomes framework includes a number of outcomes relevant to people with cancer. For example, domain 1, on preventing people from dying prematurely, includes progress in improving one-year and five-year survival rates for breast, lung and colorectal cancers. A number of indicators will also be relevant to patients with cancer, such as health-related quality of life for people with long-term conditions, and improving the experience of care for people at the end of their lives. Clinical commissioning groups will be held to account for their contributions to improving those national outcomes through the commissioning outcomes framework.

[Mr Baron]

The all-party group on cancer and others lobbied for a greater focus on outcomes, but the one-year and five-year cancer survival rates may now be less statistically robust, as CCGs cover smaller population sizes than primary care trusts. Will the Government therefore give added priority to the excellent work of the National Cancer Intelligence Network in producing a set of evidence-based process measures to complement, not replace, other evidence so that CCGs can be held accountable?

[Mr Lansley]

The House will know of my hon. Friend’s consistent support, through the all-party group, for patients with cancer. I entirely agree that a number of proxy measures and process measures will be relevant in the context of the commissioning outcomes framework. There may be measures that are attributable to CCGs individually in some respects. For example, the quality of life of people living with long-term conditions, to which I referred, would be relevant to a small population. For other measures, however, it may be appropriate for the CCGs to be held to account at the level of, for example, a cancer network, using cancer registry data.

NHS Future Forum

Debate between Lord Lansley and John Baron

Tuesday 14th June 2011 Commons Chamber

[Mr Lansley]

I reiterate that the clinical commissioning groups will be statutory bodies with a statutory responsibility for commissioning, so it would not be legal for them to delegate that to another body that was not subject to the same obligations. As far as access to private patients is concerned, we have made it clear—I do not believe that the Future Forum makes any recommendations on this—that foundation trusts, which often have arbitrary rules relating to limits on their income from private patients, should have that cap lifted, but we propose to put additional safeguards in place to make it clear that, if they do so, not only must that income be separately accounted for so that there is no subsidisation from NHS facilities, but the trusts must demonstrate how that will support their continuing primary purpose of providing services to the NHS in England.

[Mr John Baron (Basildon and Billericay) (Con)]

Having very much supported the listening exercise, I know that for many of us the most important aspect of these reforms has always been the new focus on outcomes, as illustrated by the inclusion of the one and five-year cancer survival rates in the outcomes framework. Will the Secretary of State assure me that the Future Forum’s suggestions will in no way detract from that new focus on the quality of care?

[Mr Lansley]

I can give my hon. Friend that assurance. Indeed, I can go further and say that one of the reasons the Future Forum has made no recommendations on the outcomes framework is that it found enthusiasm across the NHS for focusing on quality and outcomes and nothing but approval for the framework. Of course, the Labour party ignores the fact that, as stated in the White Paper we published last year, that is one of the central aspects of what we are setting out to do. He is right that the focus on outcomes, which enables people to see how this country performs in health, relative to other countries, and continuous improvement in health outcomes, rather than just a small number of focused targets, is instrumental in continuous improvement.

Oral Answers to Questions

Debate between Lord Lansley and John Baron

Tuesday 7th June 2011 Commons Chamber

[Mr Lansley]

My right hon. Friend the Prime Minister has made it very clear that we will not let waiting times rise and that we will improve performance in the NHS right across the board, which was what I was illustrating. I remind the right hon. Gentleman again that waiting times in hospitals are down from 8.4 weeks to 7.9 weeks for in-patients and from 4.3 weeks to 3.7 weeks for out-patients. That is what we are committed to. Chris Ham of the Kings Fund was on the “Today” programme this morning and said on waiting times, “There hasn’t been a great deal of change since the election.” What has changed since the election is that we are improving performance, driving down the number of breaches of the single-sex rules, increasing access to dentistry, cutting the number of managers and increasing the number of doctors. Those are the things we are doing in the NHS, and it is to the benefit of patients that we do.

[Mr John Baron (Basildon and Billericay) (Con)]

3. What steps he is taking to enable GP consortia to commission integrated cancer services.

Future of the NHS

Debate between Lord Lansley and John Baron

Monday 9th May 2011 Commons Chamber

[Mr Lansley]

I do not want to correct the hon. Lady, but everything I have been saying up until now has been about defending the NHS and defending our focus on delivering better results by giving the NHS greater front-line devolved responsibility. That is not a matter of debate and disagreement between the coalition parties; we are all in favour of that. The point is this: how can the Bill best support the principles on which we are agreed? I thought the right hon. Member for Wentworth and Dearne and the Labour party were agreed on those principles; that seemed to come out from his interview last week. Indeed, at the end of his speech today I was not quite sure whether or not he agreed with us.

[Mr Baron]

Given that our cancer outcomes are well below the European average, the need for NHS reform is well established. However, as my right hon. Friend the Secretary of State will know from my having raised the issue with him previously, the entire cancer community will breathe a sigh of relief if the guaranteed funding for cancer networks can be extended to 2014 when the transition period for GP commissioning comes to an end, as we would risk losing a lot of expertise if we were to end it in 2012. Will he address that point?

[Mr Lansley]

The support for cancer networks will continue during the course of this year and the start of next year, but when the NHS commissioning board takes responsibility for commissioning, including the relationship with consortia, it will need to decide how to manage its commissioning responsibilities. However, as I have told my hon. Friend in the House previously, it is now looking—we will look at this over the coming months—at how it can use networks as a basis for having precisely the kind of commissioning structures we want, and it is my expectation that that would include cancer networks that are not only helpful for providers, but that tie together commissioners and providers in understanding the future strategy for cancer.

NHS Reorganisation

Debate between Lord Lansley and John Baron

Wednesday 16th March 2011 Commons Chamber

[Mr Lansley]

Yes, that is one possibility. Another is that Labour Members are paid for by the trade unions.

Our changes are driving real improvement. Our investment means that more than 1,300 patients are now getting the life-extending cancer drugs they need; that is investment in cancer drugs that the Labour party opposed.

[Mr John Baron (Basildon and Billericay) (Con)]

My right hon. Friend is absolutely right to make no apology about the need for reform when cancer outcomes in this country remain well below the European average. The all-party group on cancer and, most recently, the Public Accounts Committee have made the case for recording staging data, which provide an insight into early diagnosis. Will he assure the House that, under these reforms, the importance of this issue will be pursued by the Government?

[Mr Lansley]

Yes. I am grateful to my hon. Friend and pay tribute to his work in this area, which is much respected. He is absolutely right—we will be doing that. Indeed, we can see the benefit already. A few weeks ago, I launched the bowel cancer awareness campaign in the east of England. The reason we were able to start that awareness campaign in that region is that we had good staging data arising out of the cancer networks in the area, which means that we will be able to make valid comparisons between the past and the future in terms of the stage at which patients are presenting for diagnosis of cancer.

Health and Social Care Bill

Debate between Lord Lansley and John Baron

Monday 31st January 2011 Commons Chamber

[Mr John Baron (Basildon and Billericay) (Con)]

rose—

[Mr Lansley]

Let me complete this point, then I will give way to my hon. Friend the Member for Basildon and Billericay (Mr Baron). On the point of allowing the independent sector to be a provider to the NHS, I should say that it was the right hon. Member for Leigh (Andy Burnham), the shadow Secretary of State’s predecessor, who said that

“the private sector puts its capacity into the NHS for the benefit of NHS patients, which I think most people in this country would celebrate.”—[Official Report, 15 May 2007; Vol. 460, c. 250WH.]

Well, Labour Members are not celebrating it now; they have reverted to type.

[Mr Baron]

The Government’s increased focus on improving outcomes is long overdue and very welcome, but will the Secretary of State address the issue of cancer networks and the concern that some of the expertise may be lost because of the funding gap between the end of funding for the cancer networks themselves and GP commissioning fully taking effect? Can the Government do anything to bridge that gap so that we allow GP consortia to be better informed in making decisions about what services to commission?

[Mr Lansley]

My hon. Friend rightly takes a close interest in these matters. When I was with him and other colleagues at the Britain against cancer conference, I made it clear—and he made it equally clear—that the cancer networks funding is guaranteed during the course of 2011-12. There is not a gap, because from April 2012 onwards the NHS commissioning board will take up its responsibilities. There will then be decisions by the commissioning board about how it will structure that.

Let me come back to what the last Labour Government did. They introduced the concept of payment by results. Unfortunately, however, payment tended to be by activity and not by results. We will now make it payment by results and really make that happen.

To complete the picture, I should say that throughout the Bill there are elements of policy that we are taking forward, such as foundation trusts. The Bill follows the brainchild of Alan Milburn and Tony Blair back in 2002. In 2005, the Labour Government said that every NHS trust should become a foundation trust by December 2008. That just did not happen. Again, it will be our task to make modernisation in the NHS consistent and comprehensive.

NHS Reorganisation

Debate between Lord Lansley and John Baron

Wednesday 17th November 2010 Commons Chamber

[Mr Lansley]

No, I will not do those things, because what I said was accurate. The specialist children’s hospitals and ourselves are engaged in a constructive process of discussion about the future of the tariff for those hospitals and the top-up. Until a proposal is made there is no purpose in informing the House. We will inform the House as soon as we are in a position to say what the tariff for next year looks like.

[Mr Baron]

I totally commend the Government for their focus on cancer reform and improving outcomes. I accept that this is in the melting pot at the moment, but does my right hon. Friend agree that it is important that the one-year and five-year cancer survival rate figures are presented not as a league table but as a performance table, to ensure that all primary care trusts and GP consortiums are tasked with improving performance, irrespective of how they compare with others?

[Mr Lansley]

Yes, my hon. Friend makes a good point. What we are looking for is not a league table at all, as health care should not be regarded in that way; we are looking for proper benchmarking to take place. We are going to benchmark this country’s performance against that of the best health care systems around the world—the Labour party never did that—and we are going to ensure that there is a culture of continuous improvement in the NHS in respect of both the one-year and the five-year cancer survival rates, which my hon. Friend rightly mentioned.

The reforms that I was talking about are not a radical departure from the past. The principles of the White Paper should be what the NHS has always been about, but it has been distracted too often by the bureaucratic processes that the Labour party was always supporting. Let me make it clear that many of the things that we are doing were championed by former Labour Ministers. When John Reid was Health Secretary he championed patient choice, and we know why. His view was, rightly, that in the NHS, in a bureaucratic system, the articulate middle classes get access to the best health care, and it is only through institutionalising and embedding patient choice—shared decision making for every patient—that we will ensure that the most disadvantaged in society get the right access to health care.

As for GP-led commissioning, the Labour party was supposed to have introduced practice-based commissioning.

Oral Answers to Questions

Debate between Lord Lansley and John Baron

Tuesday 7th September 2010 Commons Chamber

[Mr John Baron (Basildon and Billericay) (Con)]

T8. Is any flexibility available to allow the interim cancer drug fund to review earlier and more speedily adverse National Institute for Health and Clinical Excellence decisions—because in certain cases, as we know with Avastin for late-stage bowel cancer, a few months, or even a few weeks, can make a big difference to patients.

[Mr Lansley]

My hon. Friend will be aware that we have proceeded as rapidly as we possibly can in finding savings this year, so that from 1 October the regional panels of expert clinicians can look at individual cases. It is not a matter of their reviewing NICE decisions; it is a matter of their looking at individual cases that cannot be funded under existing guidance or local decisions, but being able to apply clinical criteria to individual cases using an additional fund.

NHS White Paper

Debate between Lord Lansley and John Baron

Monday 12th July 2010 Commons Chamber

[Mr Lansley]

I do not recognise the hon. Lady’s latter point. Some 7% of the population in London are not registered with a GP, which is one reason why commissioning consortiums of GPs will take responsibility for their locality, not just their registered patient population.

In relation to hospitals such as the Royal Free, one reason why the hon. Lady, I and other Members were campaigning against her Government before the election was that we recognised that we cannot shut down accident and emergency departments when patients are coming in the door by the tens of thousands because there is no alternative provision. The best way to design services in the community that better meet the needs of patients is through general practitioners designing them around the needs of their patients.

[Mr John Baron (Basildon and Billericay) (Con)]

I very much welcome the White Paper’s increased focus on improving outcomes, and particularly my right hon. Friend’s comments about the introduction of one-year and five-year cancer survival rates, for which the all-party group on cancer has been pushing. How does he envisage GP commissioning of cancer services improving with the White Paper, given that part of the problem is that a typical GP will see only eight new cancer presentations a year?

[Mr Lansley]

I pay tribute to my hon. Friend’s work. He will have noted that I deliberately said both one-year and five-year cancer survival rates—he made an important point about that. Clearly, there are many specialist commissioning services, which will become the NHS commissioning board’s responsibility. To that extent, GPs should not be expected to commission specialised services—they have little experience of that. However, GPs as commissioning consortiums, like primary care trusts at the moment, are capable of having a relationship with their cancer networks to establish the services that they need for their patients. Indeed, that applies more to GPs because many of the patients and those who work in cancer services to whom I speak are critical of the lack of awareness on the part of PCT commissioners of the available services. Those who work in cancer services do not believe that PCT commissioners understand the service that they provide. Not every GP understands every aspect of cancer care, but they are much better placed to work with cancer specialists to design the services.

Oral Answers to Questions

Debate between Lord Lansley and John Baron

Tuesday 29th June 2010 Commons Chamber

[Mr Lansley]

I am grateful to the hon. Lady for that question, and I have had the privilege of twice visiting the national bowel cancer screening programme at St Cross hospital in Rugby—it looks after people in parts of the midlands and the north-west—and indeed, I have visited the Preston royal infirmary, which deals with bowel cancer screening follow-up. As I said in my first reply, one of the things we aim to do is to increase awareness of the signs and symptoms of cancer. It is unfortunate that, as a recent study established, only 30% of the public had real awareness of what the symptoms of cancer would be, beyond a lump or a swelling. We have very high rates of bowel cancer, so it will be part of our future cancer strategy to increase awareness of those symptoms and to encourage men in particular to follow up on them.

[Mr John Baron (Basildon and Billericay) (Con)]

The recent inquiry of the all-party parliamentary cancer group into cancer and equalities heard expert evidence to suggest that if people can survive the first year of cancer, their chances of surviving for five years are almost identical to the chances in the rest of Europe. Does the Secretary of State therefore believe that a one-year survival indicator is a good idea both for encouraging early diagnosis and for matching the survival rates of the best in Europe?

[Mr Lansley]

My hon. Friend makes an extremely good point. When we set out proposals for an outcomes framework, I hope that he and others will respond, because that is one of the ways in which we can best identify how late detection of cancer is leading to very poor levels of survival to one year. I hope that we can think about that as one of the quality indicators that we shall establish.