The National Health Service
Neil O'Brien Excerpts(4 years, 6 months ago)
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Jonathan Ashworth
My hon. Friend is absolutely right. That is what happens when privatisation and outsourcing go wrong: workers are worse off. We should bring an end to it.
Jonathan Ashworth
I am going to make some progress.
We need clarification from the Secretary of State on whether he will exempt all NHS staff and all care staff from the shortage occupation list in the immigration Bill.
Safe care also depends on safe facilities, but after years of cuts in capital budgets, hospitals are crumbling and equipment is out of date.
Jonathan Ashworth
In a few moments.
The repair bill facing the NHS has now risen to £6.5 billion, more than half of which relates to what is considered to be serious risk. NHS capital investment has fallen by 17% per healthcare worker since 2010. Across the NHS, the estate relies on old, outdated equipment, which is having an effect on, for instance, diagnostics. The number of patients waiting longer than six weeks for diagnostic tests and scans has increased from 3,500 under Labour to more than 43,000 under this Government.
Jonathan Ashworth
I will give way in a few moments.
Even if the Secretary of State replaces all the MRI scanners that are more than 10 years old—he has adopted our policy on that—we will still be struggling with the lowest numbers of MRI and CT scanners per head of population in Europe. Is it not time for a proper strategic health review?
Jonathan Ashworth
In a few moments.
The Secretary of State will say that he has announced plans for six new hospital reconfigurations and seed funding for other acute trusts to prepare bids, but there is no guarantee that that funding is in place and that the Department will give trusts the go- ahead. “Seed funding” is a curious phrase. Can the Secretary of State confirm that there will be no role for private capital in that seed funding? In their 2017 manifesto, the Government promised £3 billion of capital funding from the private sector. Does that still hold? They claim to have abandoned the private finance initiative. We need clarity today.
Jonathan Ashworth
In a few moments.
The Tory candidate for Canterbury, one Anna Firth, helpfully explained that the Prime Minister had “clearly made a mistake”. After all,
“He can’t be on top of every little detail”.
We are talking about the £450 million rebuilding of a hospital.
Neil O’Brien
On the subject of £450 million investments, I wonder whether we could have a moment of cross-party positivity, and whether the hon. Gentleman welcomes the £450 million investment in the hospital from which both his constituents and mine will benefit. It is a transformative investment, and we are doing it without PFI. I am sure he agrees that that is wonderful news.
Jonathan Ashworth
Of course I welcome that £450 million. [Interruption.] It just shows what an effective Member of Parliament for Leicester South I am.
I know that the Secretary of State gets very excitable about this Leicester point, rather like a semi-house-trained pet rabbit. Let me tell him about Leicester. I did not see him on “Question Time” in Oadby the other evening—I do not often watch “Question Time”. I do not want to be disorderly, so I shall be careful about how I read out the transcript. The audience started shouting—well, it is unparliamentary, but essentially they started shouting that the Secretary of State was not being entirely truthful in what he was saying. I do not want to fall out with him, or to be disorderly, but according to the transcript, there were “jeers” from the audience.
One audience member said that hospitals in Leicester were “falling apart”. Another said, “It’s shameful.” A third said,
“It’s not a case of throwing money at it.”
A fourth said that the Secretary of State was
“saying you will invest loads…into Leicester Royal Infirmary, what about…the General?”
What, that audience member continued, about
“the benefit in terms of beds…as a whole?”
The Secretary of State replied:
“We will do all of those things and we’ve guaranteed the money to Leicester and it’s coming in the next couple of years.”
There was then audience “laughter”.
Jonathan Ashworth
Well, the General is essentially being downgraded and I want a sustainable future for Leicester.
Jonathan Ashworth
This will be the last intervention I take because I have to get to the end of my speech, but let me just finish this point: the Leicester General is essentially being downgraded. The only thing that remains at the Leicester General is the diabetes unit, unless the Secretary of State is moving midwifery services from St Mary’s in Melton Mowbray to Leicester and, if he is doing that, he should be clear with the right hon. Member for Rutland and Melton (Sir Alan Duncan).
Neil O’Brien
I appreciate the hon. Gentleman being generous with his time. My family used maternity services at the General just last week. We sat on a couch. My wife had not eaten for nearly 24 hours because the General does not have an all-electives list for caesarean sections. That service will be better when services come together in the new maternity hospital that is going to be built. By the way we also used St Mary’s birthing unit in Melton Mowbray. It is a brilliant midwife-led unit and we are not going to close it.
Jonathan Ashworth
There we go, but the only way the Leicester General has a sustainable future in their own plans—these are the plans the Secretary of State has signed off from the Leicester trust—is if that midwifery unit at St Mary’s moves to the Leicester General. I am sorry that the hon. Gentleman’s family got a poor service at the Leicester General. My daughter was born at the Leicester General as well and we got an excellent service.
The National Health Service
Neil O'Brien Excerpts(4 years, 6 months ago)
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Neil O’Brien (Harborough) (Con)
I thank Ministers and everybody at University Hospitals of Leicester for the role they played in securing the fantastic £450 million investment in our local hospitals that was announced the other day. I also thank Ministers for the role they have played in today’s announcement that there will be a new £46 million investment in an urgent care hub at Kettering General. That means that constituents at both ends of my constituency will benefit from huge new investments. I am incredibly grateful.
Those are not the only pieces of good news my constituency has had recently. We have the gleaming new treatment centre at St Luke’s in Market Harborough. We have had the wonderful news that we will be keeping the world-leading children’s heart unit at Glenfield—a service that is not just brilliant for everybody in this country, but through the charity Healing Little Hearts provides help for people across the entire world. We also have the futuristic new A&E at Leicester Royal Infirmary. Those things are all great, but the investment we are about to receive will be even more transformational.
The Secretary of State came to the Royal Infirmary the other day. As we walked around, we heard about both the challenges and the opportunities that we have locally. We saw the difficulty of working in maternity when it is split across two sites. When my son was born just two weeks ago, I saw how having two different sites meant that the staff had to work all day without breaks to fit us in. Their lives and patients’ lives will be much better when we have a single new maternity hospital. As we walked around with the Secretary of State, we saw the brilliance of our intensive care staff, but we also saw that they were working in fundamentally out-of-date facilities. We saw the brilliant work that the A&E team were doing, particularly in enhancing data to improve services, but we also saw the incredible growth in demand for those services.
The investment we are about to get means a new maternity hospital, a new children’s hospital, two super-intensive care units with 100 beds in total and a planned new major treatment centre at Glenfield Hospital, as well as modernised wards, new operating theatres, new imaging facilities and, brilliantly, new additional car parking. Anybody who has ever tried to park at Leicester Royal Infirmary will realise that that is a huge boon. These local improvements are part of a wider series of improvements we are making across the NHS. It is great that we now have a long-term plan for the NHS, with a long-term budget for the NHS that allows NHS managers and staff to plan for the future.
Jim Shannon
I very much welcome the Government’s commitment and the money they have set aside, but is the hon. Gentleman aware that 16 million people in England live with the pain of a musculoskeletal condition? How will the Government ensure that people with arthritis are able to access the interventions that need to be in place—from joint replacement operations to physiotherapy—in a timely fashion? I think there is an opportunity to address those issues. I have the same problems in my constituency, but it is a devolved matter. I have been made aware of this issue in England. Does he agree that it is time for that?
Neil O’Brien
The hon. Gentleman raises an important point, and I was about to come on to it. It is great that we are making record investment in services such as mental health and spending more than we did before. It is great that we are introducing new targets, such as basic standards for help with eating disorders. It is great that we have more doctors, more nurses and more money. However, we are conscious, as we speak to people in the NHS, that unless we can deal with the sources of demand, fundamentally we will never be able to spend enough on all the priorities, including musculoskeletal services.
What do we need to tackle those causes of demand? We of course need the long-term plan for social care. The Minister needs to stick to his guns on public health: the sugar tax has worked. Things like the campaign against the anti-vaxxers and their pseudo-science are incredibly important, as is action on preventive social care. We should keep going with things such as the migrant health charge, which is raising money for the NHS; we could increase it. We should keep going on technology. It is so important for Ministers to help GPs to upgrade their telephone triage facilities, which would make the experience of using primary care so much better and reduce the burden.
Some of the things in the Queen’s Speech are incredibly important to help deal with these growing burdens. We need new technologies, which is why it is important to get more clinical trials going more quickly. That is why I welcome the measures in the Queen’s Speech. This is about building on the life sciences review—the Bell review—and it is very important to build on the work that the academic health science networks are doing. The potential advantage of our NHS is that it should be one of the best places in the world to do clinical trials—we have the scale—but at the moment there are too many gatekeepers and too many things stopping them.
Last but not least, there is the wonderful improvement in the NHS safety body that we are creating. From personal experience, I can say that when my daughter was born some things went wrong. We had a wonderful junior registrar who did lots of things right, but a few things went wrong, and my wife gave birth without anaesthetic. After that, unfortunately, her placenta did not deliver and the consultant—we never found out who this was—removed the placenta manually with no anaesthetic, and it was incredibly painful for my wife.
It is important, as my hon. Friend the Member for Harwich and North Essex (Sir Bernard Jenkin) said, that we learn lessons in the NHS without attributing blame. Not attributing blame was one of the fundamental recommendations following the Mid Staffs inquiry: we have got to be able to learn lessons. When we started to complain about what happened to my wife, people closed ranks. My wife is a doctor, and we would never in a million years have sued the NHS, but they did not know that. We never even found out who the consultant was who had got things wrong, so I do not know whether the lessons were learned from that mistake; I hope they were.
Having a no-blame culture, having this new body and learning from the experiences of painful things such as the Bawa-Garba case are the ways in which we can have truth and reconciliation, with a system that learns. One of the most important things we could ever do to improve the NHS is to make it a self-improving system that is constantly learning and constantly getting better.
Oral Answers to Questions
Neil O'Brien Excerpts(4 years, 10 months ago)
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Matt Hancock
For the majority of its 71-year history, the NHS has been run under the stewardship of a Conservative Secretary of State. At this moment, it is getting the biggest funding increase and the longest funding settlement in its history, along with the reforms to make sure that everybody can get the health care that they need.
Neil O’Brien (Harborough) (Con)
The Parliamentary Under-Secretary of State for Health and Social Care (Seema Kennedy)
More than 94% of men survive prostate cancer for one year, and 86% for five years, but there is more to do. That is why last April the Prime Minister announced £75 million over five years so that 40,000 men can take part in innovative research into early diagnosis and treatment. The long-term plan sets out our commitment to speed up the path from innovation to business as usual, spreading proven new techniques and technologies faster. Safer and more precise treatments in diagnostic techniques will continue to improve prostate cancer survival.
NICE Appraisals: Rare Diseases Treatments
Neil O'Brien Excerpts(5 years, 1 month ago)
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Lyn Brown (West Ham) (Lab)
I am sure hon. Members will not be surprised to hear me talk again about baby Maryam, my seven-month-old constituent with spinal muscular atrophy type 1. Without treatment, Maryam will have only a few more months to live. She is waiting for NICE to announce a decision to allow access to Spinraza, the drug that she and other babies with the condition so desperately need.
I start by thanking my hon. Friend the Member for Blaydon (Liz Twist) for securing this important debate; the Daily Mirror, especially Pippa Crerar, for telling the stories of SMA families; the Newham Recorder, the campaigning newspaper, for its continued coverage and encouragement; and the amazing members of the local community in West Ham for their support. Councillor Mas Patel has been brilliant, as has Kevin White and many others who have taken the plight of this little baby into their hearts.
Most of all, I pay tribute to Shakil, Maryam’s father, and all Maryam’s family who have steadfastly campaigned despite knowing that, when we finally get access to Spinraza in England, it could so easily be too late for Maryam.
As we know, SMA1 is an awful disease. It is a progressive muscle-wasting condition, and for a baby it causes difficulties with breathing, swallowing and gaining weight. Babies with SMA1 may not even be able to cry aloud. Spinraza is an effective treatment for SMA. With this treatment, babies and children are living longer; they are even crawling and walking. I am told that by last August, when NICE first met to consider funding Spinraza on the NHS, none of the babies who had been treated with it in the UK had died as a direct result of their SMA. The drug was so effective that the trials stopped early, yet NICE refused to approve Spinraza at that August meeting, or at the second meeting in October or in November.
In November, the expanded access programme, which allowed treatment with Spinraza while negotiations were ongoing, was closed—Biogen, the drug company that developed Spinraza, closed it. So when Maryam was diagnosed in December last year, she had no access to this drug. Even if it could have been afforded privately and even if my community in West Ham had fundraised for it—I can tell Members that an awful lot of people have wanted to do just that—she could not have got it. We are not talking about huge numbers; we are talking about fewer than 100 babies a year. Treating this condition should not break our bank—it could not, surely.
NICE met again two weeks ago—we held a vigil while it was making its decision—but I am told it could be three or more weeks yet before that decision is known. This is callous. Making families, making Maryam and making the other babies wait this long is callous. The NICE approvals process for Spinraza has now taken 14 months. That is longer than many of the babies with SMA1 can be expected to live without the treatment. At the same time, agreements have been reached on Spinraza in the United States and in 25 European countries, including Scotland, Germany, Italy, Lithuania and Romania.
NICE has failed Maryam and all the other babies with SMA, but others are culpable, too. The closure of the access programme no doubt saved Biogen some money, but I am sure that it was closed to increase pressure on NICE as well. I cannot say that that is definitely true, but what I will say is that if it is true, the suffering of tiny babies, and the pain and suffering of their families, too, has been used in the service and pursuit of profits. I now believe that our whole system of for-profit medical research combined with public healthcare encourages this kind of brinksmanship, it encourages delaying tactics and it encourages the exploitation of sick children and their families.
Let us also consider the actions or inaction of the Government. I am sure hon. Members will recall how in the spring statement the Chancellor talked of a
“proud, successful, outward-looking nation, with no limit to our ambition and no boundaries to what we can achieve.”—[Official Report, 13 March 2019; Vol. 656, c. 352.]
He bragged about
“the single largest cash commitment ever made by a peacetime British Government”.—[Official Report, 13 March 2019; Vol. 656, c. 346.]
This was for the NHS. Surely we can afford to help these babies, too. Currently, we are the fifth richest country in the world, yet we are withholding vital medical treatment from babies. This is medicine that 25 other European countries, including some much poorer than we are, are willing to provide. What does that say about us? What does that say about our values? What kind of a country have we become?
I have asked the Prime Minister to act—twice. I have asked the Health Secretary to act. As far as I can see, nothing has happened. I hope that Conservative Members will forgive me when I say that I thought the Prime Minister’s response to me last week was cold; it was more about defending an outdated process than about understanding and empathising with the desperate plight of Maryam and her family. Let us remember that 25 European countries already have access to this drug, We do not, yet it seems to be nothing to do with the Prime Minister.
Neil O’Brien (Harborough) (Con)
The hon. Lady is making a good and powerful speech. Two of my constituents, Mark and Panna Wilson, are in a situation similar to that of her constituents: their son Aadi is only three years old and is regressing every day because he, too, has SMA, which is a terrible condition. They told me that
“without access to new treatments, each and every day is a step, not towards an exciting future, but towards a painful and dark place.”
The hon. Lady is right, and I hope that we will find a new route to the approval of Spinraza in this country. The route it is currently going through is intended for much more generic medicines and it has not been put through the route for rare medicines. We need either to put it through the route for rare medicines or to find or invent a new mechanism so that we can get treatment for these people. As she points out, this is a rich country: we must be able to save these babies and toddlers.
Lyn Brown
The hon. Gentleman is absolutely right. This is a political issue—what we are discussing today is political. It is about which of our constituents get access to which medicines, and when; who our public healthcare service helps with our public money; and who we allow to die without help.
Members on both sides of the Chamber have recently urged the Government to use their Crown use licensing powers in the case of Orkambi. Those powers can get around medicine patents when pharmaceutical companies are simply refusing to deal honestly with the NHS, and they are an option. There are always options for the Government if they wish to use them, but they seem to be content with voicing frustration. They do not do anything—they will not even threaten to do anything that might help. If the Patents Act 2004 is not working, as Ministers have said, we need to do something to replace it. Maryam’s family and others want action now. They need Spinraza now; when will they get it?
Eurotunnel: Payment
Neil O'Brien Excerpts(5 years, 2 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
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Matt Hancock
No. It is clear that we needed to ensure that there were no risks around the two contracts for the capacity that we need to bring in an unhindered supply of medicines, whatever the Brexit scenario. I do not know whether the hon. Lady thinks it would have been worth bearing the risk of a court case, which may well have struck down the capacity to make sure that people who have serious and life-threatening conditions can get the medicines that they want. She implied that she was against such assurances, and I think that would have been a mistake.
Neil O’Brien (Harborough) (Con)
I support the withdrawal agreement—it is a good deal—but I also support our being ready for no-deal eventualities. I was reassured by the Secretary of State’s answer to the question from my hon. Friend the Member for Nuneaton (Mr Jones) about stockpiling medicines that can be stockpiled, but for those that cannot be stockpiled, what action is the Secretary of State taking to be sure that they can be air-freighted rather than have to come through the tunnel?
Matt Hancock
My hon. Friend is quite right to support a deal and the action that we have taken in case there is no deal. That is the position that anybody who cares about the unhindered supply of medicines should take. When it comes to those medicines that cannot be stockpiled, we have contracts for flights to ensure that those medicines can be flown in. We have in place a flight from Birmingham to Maastricht, and the return journey, obviously, to ensure that we can get those short-term medicines in.
Budget Resolutions
Neil O'Brien Excerpts(5 years, 6 months ago)
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John McDonnell
My hon. Friend has got it exactly.
It takes something, does it not, to have headteachers marching on Downing Street? That has never been seen before. Just what did yesterday’s Budget do to tempt teachers back? What the Chancellor offered was “little extras”. It was an insult, especially when 60% of teachers are not getting a pay rise this year.
There are now 4 million children living in poverty, 500 children’s centres have closed, 500 children’s playgrounds have closed and 128,000 children are living in temporary accommodation. When children’s social care faces a funding gap of £3 billion by 2025, what did the Chancellor offer? Just £84 million for just 20 councils. That will not even scratch the surface of the problem.
John McDonnell
No.
We have a record number of children coming into care. I know what coming into care means for a child: they are scarred for life. Why are they coming into care? Because there has been a 40% cut in funding to councils for early intervention to support families. Let the Government justify that.
On young people, the YMCA reports that spending on youth services has fallen by 62% since 2010. The average graduate comes out of university with a £50,000 debt. The IFS describes home ownership among young people as having collapsed completely. Tragically, with the mounting pressure, a decades-long decline in suicide among men has been reversed since 2010.
John McDonnell
I understand the hon. Member for Croydon South (Chris Philp); he gets excited at times, but as someone who has been excited myself at times, I completely understand.
The Government have been repeatedly forced by the courts to change how they are treating disabled people. They do not seem to have learned their lesson yet, so yesterday we saw no restoration of disability premiums, no end to the cruel social security freeze, and no end to dehumanising and unreliable work capability assessments.
The Government are also putting the livelihoods of future generations at risk. A few weeks ago the world’s leading authority on climate change said that avoiding dangerous climate change would require “rapid, far-reaching and unprecedented” action. What did we get yesterday? We got no mention of climate change, no reversal of cuts to renewable energy, and no significant environmental policy.
Neil O'Brien
I am curious: the other day the Government voted through a £650 million scheme to improve energy efficiency and home insulation; why did the Labour party vote against it?
John McDonnell
Because it was not on a scale that would have had sufficient impact. I welcome interventions, but I think we should have a rule that when Members intervene they should describe their background, in this case as advisor to George Osborne, who cut back on the solar energy industry, who undermined wind power in this country, and who set us back so that we will never meet our climate change targets.
The impact—[Interruption.] Calm down, calm down—George Osborne used to say that to me, and I said “I’ll calm down when you resign,” and he did. The impact on the self-employed and small businesses has been equally stark. Some 51,000 high street stores closed last year. Wages for the self-employed have collapsed to around the same level as 20 years ago.
Matt Hancock
So many of us know just how important air ambulance services are and the countless lives they save. I am delighted that, on top of the £20.5 billion for the NHS—the biggest ever, longest ever cash settlement for any public service in history—there was £10 million for air ambulances.
Neil O'Brien
If my right hon. Friend will excuse another Leicestershire-based health intervention, I am incredibly grateful for the creation of the new Cottage Hospital in Market Harborough, the gleaming new A&E ward at Leicester Royal Infirmary and the decision to save the brilliant children’s heart unit at Glenfield Hospital. Does he agree that that is a more welcome record than the Labour party’s record of bankrupting the country, giving us the biggest recession since the second world war and putting 1 million people on the dole?
Matt Hancock
It is true that the Labour party in office has always left unemployment higher than it found it; it is true that, while Labour left the deficit higher, we are bringing it down; and it is true that inequality, too, is coming down. Page 8 of the distributional analysis shows that, contrary to what we heard in that paean of gloom from the shadow Chancellor, the biggest rises in full-time employee gross weekly real earnings over the last three years have been among the 10% least well paid in our country. That is what this Conservative Government are doing—delivering for everybody in our country.
Neil O’Brien (Harborough) (Con)
It is a pleasure to speak in favour of this Budget, which continues the important work that was begun in 2010. A lot has been achieved. We have record employment, with 3.3 million more jobs and 1,000 more people in work every single day. I am particularly proud that we have halved youth unemployment, meaning that more young people can get a good start in life. I meet them all the time in Harborough, and it is a huge pleasure.
Incomes are now rising the fastest that they have in a decade—most rapidly at the bottom end of the labour market—and the national living wage has already increased the wages of people on it by £2,750 a year. That will go up to about £5,000 a year, and combined with increases in the personal allowance, that has raised the income of someone working full time on the national living wage by 44% since 2010 alone. That is one reason why inequality is now lower than at any time under Labour.
The deficit is also down by nine tenths and debt is falling as a share of the economy—in fact, debt as a proportion of GDP is now forecast to go down by a whopping 11 percentage points. The corner has definitely been turned. In the Budget, the Chancellor has helped small businesses in my constituency. He has helped with the cost of living. He not only has debt falling but has a lot of headroom to respond to the needs of our public services. I will come back to that point in a moment, but first, let me note some of the progress we have seen in our public services in recent years, starting with schools.
The proportion of pupils in good or outstanding schools has gone up from 66% to 86% since 2010, which is a huge improvement. Thanks to the national fair funding formula, we are addressing the historical unfairness that has seen places such as Leicestershire do badly. As a result, funding in my constituency over the next two years will go up twice as fast as the national average—and, through things such as the sugar tax and the condition improvement fund, we have seen big improvements such as the new school hall in South Kilworth.
We have also seen many improvements in our schools that are not to do with just spending more money. We have ended the right of appeal against exclusions so that we protect teachers and other pupils against disruption and violence; we have introduced year one phonics screening to nip problems in the bud; we have ended grade inflation and restored rigour; we have stopped Ofsted being so overbearing, which many teachers will welcome; and we have enabled innovations such as the brilliant free schools, which are now the highest-performing type of school in our system.
The improvements go beyond schools and into further education. FE colleges in my constituency can now teach the new T-levels, a new, more rigorous qualification with 25% more funding per student and 50% more hours taught and worked.
Emma Hardy
Would these be the same T-levels that the Minister for Apprenticeships and Skills said she would not allow her own children to sit?
Neil O'Brien
The new T-levels will fix a problem that has been known about for 100 years and give us a more technical system that will be more like the German one and will be the envy of the world.
I welcome the £20 billion for the NHS—a staggering £400 million extra a week—and the fact that we have a vigorous new Health Secretary who is bringing new technology into the NHS in order that it will no longer be the place with the most fax machines and pagers in the world. If you really love something, you want it to be the best it can be and you make it the best it can be.
I welcome the fact that crime is down since 2010 and that we protected police spending in real terms in the 2015 spending review, and I welcome the £200 million a year extra in the Budget to counter serious youth violence and the money for counter-terrorism, but I hope that those are a down payment on a strong settlement for law and order in the spending review. I have been unhappy with the lenient sentences people have received in recent cases, such as the motorcyclist who repeatedly kicked a police officer in the head but was spared jail—that was a mistake; an unprovoked assault and wounding in Market Harborough that did not lead to imprisonment. Assaults on prison officers in HMP Gartree were not even prosecuted. We should be jailing more people for longer, and if we need to find additional resource to do it, it will be money well spent.
In the battle to get our terrible deficit under control, a corner has been turned. In the 2010 spending review, annual average real growth in departmental spending was minus 3%; in 2015, it was minus 1.3%; and from next year, it will be plus 1.2%—a clear difference in direction. Some people now argue that, if we exclude everything that is going up, such as health, defence and aid, other things are going down. I have two things to say about that. First, yes, absolutely the NHS has been prioritised—because it is the people’s priority. Secondly, the Chancellor has sensibly left himself some headroom. With national debt as a percentage of GDP now forecast to fall by 11 percentage points over the forecast period, compared to 7.5 percentage points before, we now have some headroom.
Only through a thorough spending review can we find out how much money we need on top of more efficiency. Once that review is complete, if the Chancellor feels he needs to use some of that headroom to invest in strong public services, he will have my full support, but while such a balanced approach has my support, the country is in no position to go on a massive spending spree. To use a diet metaphor, we have been through a difficult diet to stop the country having a heart attack and we have got the weight off, and some people say that we should get back on the burgers and the cream buns. No, we need to stay fit for the long haul and have a strong economy. That is what we will do.
Now that the partisan part of this debate is over and the real cognoscenti are here, let me finish with a couple of points we do not talk about enough in these debates. Labour sometimes says that this is an ideological choice and that we did not need to reduce spending. Why then did Labour’s last Budget propose to reduce total managed expenditure from 48% of GDP to 42% of GDP? We in practice reduced it to 41% of GDP, but the idea that the difference between 42% and 41% is the difference between a massive ideological crusade and sensible socialist cuts is ridiculous. We should be clear in the House that the differences are not so great as they are sometimes made out.
Secondly, we must be careful about promising people a huge spending splurge. We are an ageing society, and the OBR’s fiscal sustainability report forecasts that, in the absence of no policy changes, debt-to-GDP will start to rise because we are all living longer and using the NHS more, and that this will take debt to more than 250% of GDP in the second half of the century. Let us not promise people things we cannot deliver.
Thirdly, let us not be complacent about managing our debt. Sometimes people say, “Oh well, after the second world war we had huge debts that were 250% of GDP and that was fine.” I say to them that we used to have 25% inflation in this country, which cut through our debts pretty quickly, we did not have index-linked debt and we did not have an independent central bank. We must recognise in this House that if we run up big debts, it will be much more difficult than it ever was before to get them down. We must have a prudent approach.
To conclude, if Members on either side of the House say that we should use some of the headroom that we have earned to invest in strong public services, I agree with them. However, if Members want to pretend that there was an easy alternative to what has been done over the past eight years, that is just not the case. If they want to pretend that we can use magic money tree-ism to fund everything we want and not worry about the deficit ever again, that is just not true. The most sensible Opposition Members know that, and if the Opposition ever find themselves in government they will experience it. I plead for an honest debate in this House. We have to have a balanced approach and we must not promise people things that simply cannot be delivered.
Organ Donation (Deemed Consent) Bill
Neil O'Brien ExcerptsFriday 26th October 2018
(5 years, 6 months ago)
Commons ChamberRead Full debate Organ Donation (Deemed Consent) Act 2019 View all Organ Donation (Deemed Consent) Act 2019 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Public Bill Committee Amendments as at 12 September 2018 - (12 Sep 2018)
Neil O'Brien (Harborough) (Con)
It is a pleasure to support this important Bill. I grew up in Huddersfield, and Barnsley are our great rivals, but despite that it is a pleasure to congratulate the hon. Member for Barnsley Central (Dan Jarvis) on this hugely important Bill. As my hon. Friend the Member for Solihull (Julian Knight) said, it protects important rights. He made the incredibly important point that our bodies are not for the state. They belong to us, and it is essential that we have the right to say no if we have objections, but I believe that the Bill includes safeguards to achieve that.
The hon. Member for Barnsley Central mentioned the case of Max Johnson, just nine years old, whose life was saved by a heart donation from Keira Ball, who had been tragically killed. I wonder whether I might also mention the Leicestershire case of Albert Tansey, whose life was saved by a heart transplant at the amazing Glenfield Hospital when he was just four years old. The hospital is home to the now saved children’s heart unit, which we have all strongly supported in Leicestershire. Thanks to the miraculous work done at Glenfield, he is now enjoying his ninth birthday, and his family are strongly in favour of the Bill. It has already been said that this could be called the “Getting on with your life Bill”, or the “Being a Member of Parliament Bill”, but it is also the “Enjoying your ninth birthday Bill”.
Although this debate could be rather bleak, there is some good news: 50,000 people are alive today thanks to organ transplants, including the hon. Member for Birmingham, Perry Barr (Mr Mahmood), who is looking very well on it, I must say. The number of people registered as donors is rising—we thank them for that—and the numbers on the transplant waiting list have fallen steadily over the past eight years. However, the Bill is still necessary because some people are missing out. Between 2005 and 2010, some 49,000 people had to wait for an organ transplant, and 6,000 died while waiting, of whom 270 were children. We could save more lives if we had more donations. I am particularly conscious that for some groups, particularly ethnic minorities, it can be particularly difficult to find a transplant. I have seen the good work done by the NHS and visited a temple just north of my constituency to see the outreach work it is doing to try to find more donations, but none the less there is still a big problem.
In 2008, only one of the top eight countries with the greatest number of organ donors per capita had an opt-in system. All the others had opt-out systems, so there is strong evidence that such systems can increase the number of donations. In 2017, we know that 1,100 families refused to allow an organ donation because they were not sure whether their relatives would have wanted to donate. My hon. Friend the Member for Torbay (Kevin Foster) made the important point that asking people to make a proactive decision to donate at an incredibly emotional and difficult moment is harsh and unfair. I think that many families would later come to value the fact that a loved one’s organs had gone on to help someone else to live.
Julian Knight
Does my hon. Friend agree that sometimes in that situation, relatives could make a decision that they later regret, because in the emotion of the moment, they might not make the decision to say, “Let’s go ahead and make the donation.”?
Neil O'Brien
I absolutely agree.
Let us also think about the medical staff who need to have these incredibly difficult conversations. A long time ago, I was a medical student. I remember the first time I ever saw someone who had died and the medical staff’s incredibly difficult conversations with his family in the hospital. Imagine then having to ask the family to make the donation of an organ to save another life. It is almost an unbelievable thing to have to ask people to do.
We know that, since the introduction of the opt-out system in Wales, the number of deceased donors is up from 60 to 74. Those are small numbers, but none the less that is a rise of 23%. It is early days, but the opt-out system does seem to help. Obviously, we need the safeguards that my hon. Friend the Member for Solihull described, but at the end of the day, the Bill will save lives—it is as simple as that.
It is ironic that often on a Friday, when there are relatively few of us here, we talk about matters of life and death. This is one of them. This Bill will save lives. It means more careers, more lives and more ninth birthdays. If I can have a moment of poetry, it is what one poet called the
“million-petalled flower of being here”.
This Bill will save people’s lives, and it is a pleasure to support it.
Peter Heaton-Jones (North Devon) (Con)
The reason that I take a particular interest in this Bill has already been alluded to by many Members on both sides of the House, but I make no apology for rising once again to refer to the story involving my constituent.
Before doing so, may I join others across the House in wishing the hon. Member for Coventry North West (Mr Robinson) all the best in his recovery? In many ways, we would not be this far in the process were it not for him, and I pay tribute to the way he has led the Bill through the House. It has been my pleasure to speak at each stage of the Bill’s passage and to serve on the Bill Committee. I also thank the hon. Member for Barnsley Central (Dan Jarvis) for his kind words, which I will pass on to my constituents.
It is to them that I turn now and the story that has been alluded to but is worth retelling. If there is anything about this Bill that we need to keep in mind, it is that it is about people—it is about individuals, it is about saving lives and it is about the double-edged sword of a life being saved, but for that to happen, a life has to tragically be cut short. It is one such life that I wish to retell the story of.
On a Sunday morning last year on 30 July, there was a road traffic collision on the A361, otherwise known as the north Devon link road. It happened only about five minutes from my constituency home. Tragically, we had four fatalities on that short stretch of road in the space of a week. To go off slightly left-field, I am delighted to say that since then, because of persistent campaigning by many people, the Government have granted £83 million for major improvements on the road, mainly because of the safety concerns and the poor accident rate on that particular stretch.
Last summer, an accident took place involving two vehicles. Occupants of both were seriously injured. Before going any further, it is worth recognising that those who survived this accident are still living with its aftermath, and my thoughts remain with them nearly 18 months on. One of the cars involved in the accident was carrying members of the Ball family from Barnstaple. There was Keira Ball, her younger brother Brad and their mum Loanna. The paramedics, the emergency services and the NHS staff at the four different hospitals that the victims of this accident were taken to all did their best work, but sadly, young Keira Ball passed away two days later on the Tuesday afternoon. She was just nine years old.
Keira’s mother and brother were very seriously injured in the accident, and they were in hospital. They were not able to make decisions at this time, so the agonising decision came down solely to Keira’s father, Joe. He took the decision—and what a brave and courageous decision it was in these circumstances—that, in the midst of this tragedy, he wanted the life that had just been so cruelly taken away from his young daughter Keira to be given to somebody else, so he took the decision that Keira’s organs should be donated.
Following that brave decision, four people are alive today who otherwise almost certainly would not be. This is the power and the strength of organ donation, and this is why it is incredibly important that we get this Bill on to the statute book today: it is about these people. Keira donated her kidneys, her heart, her liver and her pancreas. One of her kidneys was given to a man in his 30s who had been on the waiting list for a transplant for two and a half years. The other kidney was given to a woman in her 50s, and she had been on the waiting list for nine and a half years. A young boy received Keira’s pancreas and liver.
Then we come on to Keira’s heart. It was given to a very brave and very sick 10-year-old boy, who has since very much become the figurehead of this campaign. I refer of course to Max Johnson. Max has been mentioned, quite rightly, so many times in this House and so many times during the passage of this Bill through Parliament. The media are calling it, quite rightly, Max’s law. I have a slight preference for it to be Max’s and Keira’s law, but it is actually the law for everyone who has found themselves in this situation—every parent, every relative or loved one, who has had to make the sort of agonising decision that Keira’s father made on that day—and for everyone who has benefited from the donation of an organ from a deceased person, as Max Johnson did.
It is Keira’s story; it is Max’s story; and it is a story of how a very brave and, I am sure, a very difficult decision to allow Keira’s organs to be donated has given life to other people who would otherwise almost certainly not be here today. Surely, of all of the arguments for supporting this Bill and for securing its swift passage on to the statute book, that is the strongest one—that this Bill is about saving lives. It is about giving people the gift of life just at the point when it might be taken away from them, and just at the point when it has been cruelly taken away from somebody else.
More organs are going to be available for donation as a result of this Bill, and that is crucial. We have heard some of the statistics from other Members, so I will not rehearse all of them, but I want to mention a couple of figures that I think are important. According to the latest NHS statistics, only 1% of people who die each year do so in what the NHS describes as “suitable circumstances” to allow their organs to be donated. I think we can probably guess, without going into too much detail, what lies behind that careful use of language. It means that only a very tiny proportion of people who die each year are not only suitable to have their organs donated, but have signed up voluntarily to the organ donation register.
If we cast our minds back to O-level or GCSE maths— depending on our ages—and the world of Venn diagrams, we can see that we need to have a lot of people in the middle bit where the circles intersect to ensure that enough organs will be donated to save lives. Because of the current way in which the law operates, that bit in the middle is not big enough: it does not have enough people in it. Bluntly, we do not currently have a system that allows for enough organs to be available to save enough lives. This Bill changes that, and that is why it is welcome.
Neil O’Brien
My hon. Friend is talking about the circles in a Venn diagram. I just make the point that many people would actually like to give their organs so that other people could live, but their relatives simply do not know that at present. This Bill is one way of solving that terrible problem.
Peter Heaton-Jones
My hon. Friend makes a perfect point. That is indeed the case, and another reason why the Bill is incredibly important.
NHS Long-Term Plan
Neil O'Brien Excerpts(5 years, 10 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Hunt
Today’s announcement is for NHS England’s core frontline services, but the right hon. Gentleman is right about the critical role of public health. Many of those services are delivered by the NHS, and we are very clear in what we are saying today and in a further announcement we will make in due course that there cannot be a transformation of the NHS without a proper emphasis on public health.
Neil O'Brien (Harborough) (Con)
The Secretary of State recently visited my constituency, so he will be aware of the important capital investments in my area, such as the new St Luke’s Hospital in Market Harborough, the decision to keep Glenfield Hospital’s children’s heart unit and the brand new state-of-the-art A&E at Leicester Royal Infirmary. Does the Minister agree that capital investments that improve productivity have an important part to play in the long-term plan for the NHS? Does he also agree that Leicestershire would be a very good place to make those investments?
Mr Hunt
Leicestershire would, I am sure, be a very good place to make them. Indeed, my hon. Friend will know that there has been considerable capital investment in Leicestershire. He makes an important point: one of the real benefits of a long-term plan is that we can create a stable environment for capital investment. One of the problems we have had is that when the budget is set hand to mouth, year in, year out, people do not make long-term investments in things such as IT systems. We have to put that right.