Mental Health and NHS Performance

Debate between Lord Soames of Fletching and Jeremy Hunt

Monday 9th January 2017 Commons Chamber

[Sir Nicholas Soames (Mid Sussex) (Con)]

As a frequent user and admirer of the Red Cross, I regard its claims as being grossly over the top. I join the Secretary of State in his tribute to the wonderful work of the frontline staff of the NHS at a very difficult time. Does he agree that the pressures are not going to go away, and that there must be a continuing drive for reform and to do these things better? What exactly are the impediments in the NHS to the sharing of best practice, and what steps is he taking to create a more experienced and better trained leadership who are more prepared for the exceptional medical and management challenges that the NHS now faces?

[Mr Hunt]

My right hon. Friend speaks extremely wisely. I, too, think that we have to be very careful about the language we use in these situations because many vulnerable people can be frightened if we get the tone wrong. The vast majority of NHS services are performing extremely well under a great deal of pressure. His point about leadership is extremely important and one to which I have given a lot of thought. At the heart of the problem is that we do not have enough hospitals being run by doctors and nurses. Around 56% of our managers have a clinical background, compared with 76% in Canada and 96% in Sweden. To put it bluntly, doctors like to be given instructions by other doctors. Exceptional people from a non-clinical background can do it, but it is hard because doctors have many years of training and are highly experienced people. I have put in place measures to try to make it easier for more clinicians to become our managers of the future.

Junior Doctors Contracts

Debate between Lord Soames of Fletching and Jeremy Hunt

Monday 18th April 2016 Commons Chamber

[Mr Hunt]

I think that sums up the difference between the two parties. It is true that Labour would take “as long it as takes” to negotiate the changes, which is why we ended up with poor contracts in 1999, 2003 and 2004. After three years of trying to get reforms to contracts to make the NHS safer for patients and better for doctors, we need to proceed with a manifesto commitment. Ministers have to decide and act as well as talk. We did not choose this outcome and tried hard for a negotiated decision, but when the hon. Lady says that talks should go on for “as long as it takes”, she is actually saying that the other party has a veto over change. No one should have a veto over an elected Government’s manifesto commitments.

[Sir Nicholas Soames (Mid Sussex) (Con)]

One thing that the whole House can agree on is that the postponement of treatment or operations is never cost-free for patients. Every hospital has an ethics committee, so does my right hon. Friend agree that all striking doctors should consult their hospital’s ethics committee? Does he agree that the removal of emergency cover by any doctor for industrial reasons would be unlikely to meet with the approval of any medical ethic committee? Finally, does he agree that it is unacceptable for any doctor to act unethically, and that that would place him or her in serious jeopardy?

[Mr Hunt]

My right hon. Friend speaks wisely. A whole chorus of senior doctors, from Professor Sir Bruce Keogh to Dame Sally Davies to Lord Darzi, have urged doctors to think hard about the ethics involved. My right hon. Friend is absolutely right to say that consulting the ethics committee in the trust is a wise thing to do. Doctors might also take note of what the General Medical Council said about it being increasingly difficult to justify the withdrawal of emergency care and about the ethics involved. In the end, this is a personal decision for doctors, and it is about whether it is right to withdraw emergency care from patients in an industrial dispute about pay. This is a bridge that the NHS has never crossed before. It is a very big decision, not only for the NHS, but for every single doctor inside it.