Oral Answers to Questions

Debate between Lord Lansley and Rosie Cooper

Tuesday 12th June 2012 Commons Chamber

[Rosie Cooper (West Lancashire) (Lab)]

In written responses to questions about clinical commissioning groups, the Minister of State, Department of Health, the right hon. Member for Chelmsford (Mr Burns) incessantly replies—most recently on 18 April—that CCGs do not yet exist, so how can he offer assurances, as he has done today, that any real progress is being made by the CCGs, when they are currently being supported by PCTs? And will he explain his “now you see them, now you don’t” response?

[Mr Lansley]

I will tell the hon. Lady how we can talk about the progress made by CCGs—because we actually go and talk to them. I recall visiting the Blue Coat school in Merseyside a few weeks ago and speaking to the leaders of clinical commissioning groups—from Liverpool, Lancashire, Manchester, Warrington, Knowsley and St Helens—and many of them had 100% delegated responsibility for budgets this year. They explained to me the opportunities they were taking to improve the care of their patients by using that responsibility.

Oral Answers to Questions

Debate between Lord Lansley and Rosie Cooper

Tuesday 27th March 2012 Commons Chamber

[Rosie Cooper (West Lancashire) (Lab)]

T4. At a time of major upheaval in the national health service, the people of west Lancashire and other areas of Lancashire are being failed by the chief executive of the Lancashire primary care trust cluster. Living in Yorkshire and working from Lancaster, Janet Soo-Chung has failed to meet with me or other colleagues, including my hon. Friend the Member for Chorley (Mr Hoyle). Can the Secretary of State assure me that the necessary time and development is being invested in health services in west Lancashire to ensure that authorisation takes place in a timely way without conditions and that the health services provided to my constituents are good?

[Mr Lansley]

I will, of course, ask Janet if she will meet the hon. Lady and her colleagues, but I think the hon. Lady might have noted that the NHS is performing magnificently. The quarter document published just this morning gives details of 14 performance measures across the NHS, in five of which performance has been maintained and in nine of which there has been improvement, so there has been no deterioration in performance. When the hon. Lady gets to her feet she should say to the NHS, “Well done for improving performance.”

Oral Answers to Questions

Debate between Lord Lansley and Rosie Cooper

Tuesday 21st February 2012 Commons Chamber

[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.

[Rosie Cooper (West Lancashire) (Lab)]

The Secretary of State has part-begun to answer this question, as he recently threatened to sack NHS boards that do not meet their financial and waiting time targets. The question is this: why is he abolishing those powers in the Health and Social Care Bill? Is he really saying that governors of foundation trust hospitals have the power and wherewithal to sack a board?

[Mr Lansley]

The hon. Lady should know that we intend to enhance the powers of foundation trust governors, but I am simply taking what was her Government’s policy before the election—that all NHS trusts should become foundation trusts, with the freedoms that go with that, and the responsibilities and accountability. We are putting that into place where her Government failed.

National Health Service

Debate between Lord Lansley and Rosie Cooper

Wednesday 26th October 2011 Commons Chamber

[Mr Lansley]

I entirely agree with my right hon. Friend. That is not only the case in hospitals, where people can sometimes ask, “Under whose care is my husband?” It is also especially true in community care. I hope that there will be more integrated services in the community, but although there may be a range of providers, there must be an integrated service with a clear line of accountability.

[Rosie Cooper]

Will the Secretary of State give way?

[Mr Lansley]

No, as I need to conclude my speech. [Interruption.] I am sure what the hon. Lady says is true.

The NHS in Wales is not cutting its budget because everything is going well. Labour Members are fond of citing waiting times, but the latest figures on waiting times show that in England 90.4% of admitted patients and 97.3% of non-admitted patients were referred to treatment within 18 weeks, whereas the figures for Wales are 67.6% and only 74% respectively.

Let me tell the House about infection rates. In 2007, the clostridium difficile mortality rates in England and Wales were similar—in fact, the rate was slightly higher in England. However, in the latest year for which figures are available there were 23.4 deaths per million for men and 23.5 deaths per million for women in England, whereas the figures for Wales were 54.9 deaths per million for men and 59.5 deaths per million for women, so the level in Wales is more than twice that in England. In four years, the gap has widened to the point where Wales has double the number of deaths from C. diff infections relative to England. Less money, less innovation and less good care is what has been happening in Wales under a Labour Government.

I must make it clear that we are going to put patients at the heart of the NHS. We are going to focus on the NHS delivering excellent care every time. Labour focused on the targets and the averages, and never got to the place of really caring about the specifics. A patient about to go into hospital for knee replacement surgery does not want to know about the national figure; they want to know about their hospital, their ward and what will happen to them. The same is true for mixed-sex accommodation. Labour turned a blind eye to variation in performance. We are going to open it up to clinical and public scrutiny, so that we can reward and celebrate achievement and excellence across the service, and shine a light on poor performance.

Health and Social Care (Re-committed) Bill

Debate between Lord Lansley and Rosie Cooper

Tuesday 6th September 2011 Commons Chamber

[Mr Lansley]

I said that I would come on to the continuing role of the OFT in relation to mergers, and I will.

Returning to this substantial group of Government new clauses and amendments, the purpose of which is to set out the regime for the continuity of services, our new proposals focus on five particular changes. Together, the proposed changes significantly improve upon the existing situation. First, the Bill puts clinically led commissioning at the heart of securing high-quality services for local populations. It is therefore right that commissioners should have a leading role when continuing access to services is threatened. Our amendments therefore strengthen the role of commissioners. For the first time, commissioners will have an explicit role in working with Monitor to agree plans to secure continuity of services.

There will also be an oversight role for the NHS commissioning board. Where issues involve more than one clinical commissioning group, it will be the board’s role to co-ordinate agreement so that a joint plan is agreed. Secondly, commissioners will need to be supported in acting with providers to ensure that they have access to the scope, quality and choice of services they need. It is about promoting high-quality, effective and integrated services, as set out in clause 58. This will be the task of Monitor.

If need be, when continued access to services is threatened because of failure occurring in a particular provider, Monitor will have a range of actions it can take. For example, it could take action to secure sustainability of essential services by adjusting prices. This would be necessary where a provider is otherwise unable to cover the costs of essential services—for example, because of lower patient volumes in more remote areas of the country. That was included in the Bill from the outset, and our amendments strengthen the provisions by ensuring that Monitor must agree the methodology with the NHS commissioning board.

[Rosie Cooper (West Lancashire) (Lab)]

Will the Secretary of State be clear on this issue? Can the enhanced tariff that I think he is suggesting Monitor can use to save a provider apply to private companies as well as the NHS?

[Mr Lansley]

It would apply in any circumstances where it was necessary in order to secure continued access to essential services for patients, so a methodology would be in place. As I have described, the intention is to have a regime through which, although specific mechanisms will be applied to foundation trusts and to other providers—of course, the overwhelming majority of activity is in the hands of foundation trusts—the principles of intervention will be the same between the two sets of providers. We want to arrive, wherever possible, at a consistent application of failure rules. Why? Our concern is to make sure that we deal with this, which has not been the case in the past. Under Labour’s regime, if a private sector or independent sector provider failed financially, there was no appropriate mechanism for intervention and continuity of services.

NHS Future Forum

Debate between Lord Lansley and Rosie Cooper

Tuesday 14th June 2011 Commons Chamber

[Mr Lansley]

The hon. Gentleman must know that the money available to the NHS in Wales is available to the NHS in Wales, and that it is separate from England. The Labour Welsh Assembly Government have made their own decisions about the priority that they attach to the national health service in Wales, and the result is, as the King’s Fund says, that they plan to reduce its budget by 8.3% in real terms. We are going to increase the NHS budget in real terms. The result can be seen in waiting times, which we were talking about. In England, the proportion of patients admitted to hospital who are seen within 18 weeks, according to the latest data, is 89.6%. He might like to reflect on the fact that the figure for Wales is 64.5%.

[Rosie Cooper (West Lancashire) (Lab)]

Although it has been difficult to hear during this debate, I would like to address my comments to the statement made by the Secretary of State.

[Rosie Cooper]

Question, sorry. [Interruption.] Let us get to the point and stop playing around. The Secretary of State said in the statement that consortia will now have one nurse and one secondary care doctor and that:

“To avoid any potential conflict of interest, neither should be employed by a local health provider.”

How will the Secretary of State apply that rule to GPs? Would not the Secretary of State and his reforms be best described as like Schrodinger’s cat—in a state of uncertainty and both alive and dead at the same time?

[Mr Lansley]

The hon. Lady misses the point. If GPs were providers as well as providing primary medical services, they would be unable to make decisions about those responsibilities because of a conflict of interest. Of course, as primary medical services providers in their area, they are not commissioned by the clinical commissioning groups—if the hon. Lady is listening to the answer at all—because the commissioning of primary medical services is undertaken by the NHS commissioning board, not by the local groups.

NHS Reorganisation

Debate between Lord Lansley and Rosie Cooper

Wednesday 17th November 2010 Commons Chamber

[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.

[Rosie Cooper]

rose—

[Mr Lansley]

I am not giving way, so the hon. Lady must sit down. [Interruption.]

--- Later in debate ---

[Rosie Cooper]

Absolutely. I am sure the Secretary of State will give due cognisance to the comments being made, especially about putting resources right there on the front line, delivering for the very people who are paying the wages.

In his evidence to the Select Committee on 20 July, the Health Secretary set out five aims of the White Paper, and he went through them here today. I shall review some of those in the light of the dribbles of information that we have received, and see how they stand up. The first aim was creating a patient-led NHS. Let us start with the Secretary of State’s glib catch-phrase, “No decision about me without me”—

[Mr Lansley]

Glib?

[Rosie Cooper]

Yes, glib. Where is the substance? Will it make any difference if the GP consortiums do not agree with the Secretary of State? Will those consortiums meet in private or in public? Will he listen to those patient voices? Will he be able to hear them?