Jimmy Savile (NHS Investigations)

Steve Baker Excerpts

Thursday 26th February 2015 Commons Chamber

[Mr Hunt]

The report clearly says that every trust must have a named director who is responsible for safeguarding. One can draw one’s own conclusions about whether senior management knew or not. The report was unable to find evidence that that was the case, but nor did it say that it was not the case. One comes away with the clear suspicion that senior management may not have wanted to hear the things that they were being told because of Savile’s importance in fund raising and possibly his celebrity status. That is what we must make sure never happens again.

[Steve Baker (Wycombe) (Con)]

With Stoke Mandeville serving my constituents, I was reassured to hear that in the present culture these appalling circumstances are not likely to be repeated. Can my right hon. Friend reassure me that it is now far more likely that we will see prosecutions within the lifetime of perpetrators rather than this horrific clean-up exercise after a perpetrator’s death?

[Mr Hunt]

I do believe that that is the case. I want to put it on record that Buckinghamshire Healthcare NHS Trust, which includes Stoke Mandeville, has made huge progress in turning round and improving its culture. It came out of special measures last year and the staff and management are to be congratulated. His constituents can be confident that, although things are not perfect, huge progress has been made to improve standards.

Epilepsy

Steve Baker Excerpts

Thursday 26th February 2015 Commons Chamber

[Mrs Cheryl Gillan (Chesham and Amersham) (Con)]

It is an honour to follow the hon. Member for Vauxhall (Kate Hoey), and I hope that she obtains justice for her constituent. It is also an honour to follow my hon. Friend the Member for South Thanet (Laura Sandys). As I said earlier, she will be a great loss to the House, and I am personally sorry that she is leaving this place because I think she has added a great dimension to it, particularly on the subject of epilepsy.

I declare an interest because the Epilepsy Society is based in my constituency and I am proud to be a vice-president. It has been working with and for people affected by epilepsy for 123 years. Although the detail of its aims and objectives have altered over the years, fundamentally it remains true to the vision set out by the group of philanthropists and neurologists who established it in 1892—to cure, treat and prevent epilepsy. It is unique.

At the Epilepsy Society’s Chalfont centre, groundbreaking epilepsy research laboratories are co-located with England’s only dedicated epilepsy assessment and treatment centre. Led by medical director Professor Ley Sander and head of genetics Professor Sanjay Sisodiya, some of the world’s pre-eminent epilepsy researchers and clinicians undertake research and clinical practice at the Chalfont centre. The Epilepsy Society’s researchers have been central to new scientific discoveries, in particular research that demonstrates the breadth of genetic influences in epilepsy. The society also brings together state-of-the-art diagnostic tools for epilepsy in one place, including the UK’s only dedicated epilepsy MRI scanner and a specialised epilepsy therapeutic drug monitoring service that is provided to hospitals across the UK and Europe.

The Epilepsy Society is also part of a unique three-way partnership with the NHS and with academia—the national hospital for neurology and neurosurgery at University college London—that has the benefit of translating research into clinical practice, providing access to funding, attracting top researchers and clinicians and providing the flexibility to innovate. The partnership has been recognised by the World Health Organisation.

[Steve Baker (Wycombe) (Con)]

My right hon. Friend has taught me something today—I did not know that my constituency was adjacent to such a fantastic centre. Will she confirm that it is a national centre serving a population wider than just our constituencies?

[Mrs Gillan]

That is absolutely right—it is a national centre.

Under our new chair, Helen Pernelet, and the new chief executive, Angela Geer, the Epilepsy Society has an ambitious new vision to leverage its medical research strength to revolutionise how epilepsy is diagnosed and treated. Of course, there are issues facing the society’s specialised medical and research facilities, but sadly, with only eight minutes in which to speak, I might not get through them all. For the Minister, there are co-commissioning concerns. Under the Health and Social Care Act 2012, the responsibility and budget for specialised services were brought together in NHS England as the sole national commissioner of specialised services, but since May 2014, it has U-turned on national commissioning. Instead, the new proposals for co-commissioning would see responsibility for the vast majority of specialised services shared with local clinical commissioning groups.

The Epilepsy Society is opposed to the co-commissioning of specialised epilepsy services for several reasons. NHS England asserts that national service specifications will continue to apply to co-commissioned specialised services, but it is uncertain how that will be achieved, given that CCGs are independent bodies. If CCGs are allowed to reinvest savings from specialised commissioning in other areas of their budget, it might create an incentive to underspend on specialised services, raising questions about the level of investment. There is also evidence that CCGs are not in a position to engage with specialised commissioning in areas such as neurology. For example, the Minister will know that the Neurological Alliance’s recent report, “The Invisible Patients”, found that only 26% of CCGs had assessed the prevalence of neurological conditions locally and that only 14% had assessed the cost of neurological services.

I also wish to highlight the Epilepsy Society’s opposition in principle to the introduction of a marginal rate in specialised commissioning and its concern about the lack of clarity in neuroscience specification. There is an ongoing lack of clarity over the division of responsibility between NHS England and CCGs for commissioning neurological services, and there is continued confusion about precisely which services fall under the scope of specialised commissioning arising from inconsistent statements in the manual for prescribed specialised services and the neurosciences service specification. I hope that the Minister can respond to the society’s calling on NHS England to clarify this important service specification to ensure nationally applied standards for specialised epilepsy services.

I encourage the Minister to improve access to the Government’s flagship 100,000 Genomes Project. It is an exciting development that the Epilepsy Society strongly supports, but the project’s focus is largely on cancer and rare diseases, making it unlikely that more than a handful of epilepsy genomes will be sequenced as part of the groundbreaking initiative, despite the huge potential that genome sequencing has for transforming epilepsy. I would like to see the Government continue to invest in genetics research and its translation into clinical practice and to ensure that it benefits patients with epilepsy, but I would particularly like to see the genome project embrace epilepsy.

The need to reform the current system for accessing effective medicines will become ever more important in the context of increasing the availability of personalised medicines. I have been working locally with Daiichi Sankyo on patient access to novel oral anticoagulants, and there is a gap that the Department of Health needs to address across the board.

In my remaining minutes, I would like to draw attention to the issue of laser ablation surgery. I have recently dealt with a distressing case of a constituent who sadly lost a family member to epilepsy. The constituent expressed great distress that a surgical treatment known as laser ablation therapy had not been made available to her and her child as a treatment option. Laser ablation is a relatively new surgical technique that burns away accurately targeted tissue with a surgical laser. The technique is much less invasive than traditional brain surgery, and enables surgeons to operate deeper in the brain. It is also much more accurate and carries fewer risks of complication. Laser ablation can be a good choice for patients who have few other treatment options either because medication does not control their seizures or because the lesions in their brain that cause their epilepsy are deep and hard to reach using open brain surgery.

A significant minority of epilepsy patients—approximately 12,500 in the UK—would benefit from surgical treatment, including laser-guided surgery. In around 60% of these cases, surgery can be curative. Evidence shows that it also contributes to reducing premature mortality in epilepsy. Sadly, despite these benefits, only around 300 patients a year are currently given this treatment. I think that the Department of Health should urgently review the number of patients with access to neuro-surgery each year, particularly surgery that uses the new and less invasive techniques such as laser ablation.

Finally, I mentioned the connection with autism, to which my hon. Friend the Member for South Thanet responded during her opening speech. It is obvious that although we have made great strides on epilepsy since the days when epileptics were not allowed to marry, we still have a long way to go. I hope that the Minister will respond positively to the questions raised on both sides of the House about the future of epilepsy in the hands of the NHS.

--- Later in debate ---

[Steve Baker (Wycombe) (Con)]

I ask the Government to take a close interest in the case of my constituent Jessica Monks, which I shall relate from the perspective of her parents. I am grateful to my hon. Friend the Member for South Thanet (Laura Sandys) for creating the opportunity for me to do so and for giving me the opportunity to inform myself about this important issue. I have been astonished by what I have learned.

I am glad to follow the hon. Member for Erith and Thamesmead (Teresa Pearce). As she will learn, I too will talk about issues of consent towards the end of my speech. It was shocking to hear what she set out about consent.

Jessica Monks was not just a cheerful but a positively joyful young woman. Her life and her untimely death are a case study in what can go badly wrong and what ought to be done. Jessica was born on 7 February 1996 and lived in Medmenham in my constituency. She suffered from epilepsy and was under the care of the neurology department of the John Radcliffe hospital in Oxford. I understand that she was learning to live very well with her condition.

Jessica died by suicide on Saturday 24 January 2015 as a result of a psychotic episode related to the epilepsy medication she was taking. She had been taking Zonisamide since about November 2013, but her seizures had not stopped. Her neurologist told her parents to keep an eye on her moods and to make an appointment with him immediately if her moods changed in any way.

Over Christmas 2014, Jessica, usually a joyful young woman, became noticeably low and withdrawn, very unlike her usual buoyant self. As requested, Mr and Mrs Monks attempted to make an appointment for Jessica to see her neurologist about her changing moods in early January, but despite several phone calls they did not receive a response. Her parents were concerned about her deteriorating mood so they made an appointment with her GP, who saw her on 8 January. The GP agreed that her mood had deteriorated but, crucially, felt that it was important to speak to her neurologist before prescribing any medication to help her mood improve.

On Friday 9 January, Jessica was admitted to Wexham Park hospital after taking an overdose of Zonisamide, oxcarbazepine and paracetamol. She was seen by a junior psychiatric nurse, and I am surprised that it was a nurse. I am sure that they do a wonderful job, but I would have thought that in such circumstances a consultant would have been appropriate. However, the nurse deemed her fit for discharge. Following a further attempted suicide on Monday 12 January, Jessica’s parents made another appointment to see her GP who again recommended that Jessica be prescribed an antidepressant but felt unable to do so until she had spoken to her neurologist. The GP did arrange an urgent psychiatric appointment for Jessica and, thankfully, the psychiatrist phoned that evening to make an appointment and offer out-of-hours support.

At the psychiatric appointment on 22 January, Jessica was diagnosed as suffering from a psychotic episode and was instructed to stop taking the anti-depressants immediately. The psychiatrist was concerned that the drug Jessica was taking was causing this psychotic side effect—which is, by the way, well known—and said she would speak to the neurologist that evening to discuss whether Jessica should cease taking the epilepsy drug Zonisamide.

On Saturday 24 January, Jessica died when she stepped in front of an oncoming train.

[Norman Lamb]

My hon. Friend is talking about a tragic case and I cannot begin to imagine what the family have been through. I am very happy to meet him to discuss further what lessons can be learned.

[Steve Baker]

I am extremely grateful to my right hon. Friend.

Mr and Mrs Monks feel that there was a significant breakdown in the care of their daughter, and I certainly agree with them. The speed and severity with which her mental health deteriorated due to her epilepsy medication were not considered a priority—they were not adequately prioritised—and they feel they have been badly let down by the medical professionals they saw in the days leading up to Jessica’s death.

Jessica’s death was apparently avoidable. We need to know why it was not avoided. There are a number of questions to be answered by the NHS and the investigation is ongoing, as, indeed, is the coroner’s inquest. I contacted the coroner before raising this case and they were content for me to do so. I will not run through all the questions, some of which are apparent, but I should like to ask in particular why was the consultant neurologist not more available? Why, when it is well known, as the Library brief explains, that some of this medication can cause these side effects, was more immediate, perhaps telephone, support not available in the event of an episode?

[Mrs Gillan]

Among other things, I sit on the Public Administration Committee and we are responsible for the health ombudsman. Will my hon. Friend make sure that the details of this case are passed to the Committee and to the ombudsman, because we are looking into how complaints are dealt with and how we can learn for the future from such tragic experiences?

[Steve Baker]

I am extremely grateful to my right hon. Friend. I have already passed the details to the Minister. I am aware of the inquest and the NHS investigation, but I will certainly take her advice and give those other bodies the opportunity to investigate.

That brings me on to the specific issue of consent. I have spoken to Mr and Mrs Monks today and they say that at no point was it explained to them that this medication could have these side effects. Jessica was 17 when she started taking it, and I feel that that possibility really should have been explained to her parents. They should have had the opportunity to take very strong action. Of course, they did take very strong action—they took the strongest action they could—and it seems to me, without wishing to pass judgment, that the key problem was that they could not get hold of the neurologist.

[Dr Julian Lewis (New Forest East) (Con)]

I am puzzled that the instructions that came with the medication did not include a warning that if someone had those sorts of side effects, they should cease taking it.

[Steve Baker]

I am a layman, but one of the things I have learned today is that one cannot simply cease taking medication for epilepsy, so specialist advice is required.

[Laura Sandys]

indicated assent.

[Steve Baker]

I am grateful to my hon. Friend for acknowledging that. Put simply, it seems that the epilepsy medication, which was necessary, caused psychotic side effects, which were exacerbated by anti-depressants that were prescribed with the best intentions. Jessica therefore spiralled into the situation that tragically led to her death.

I would like to finish with a few words from Jessica’s parents, who have written to me:

“The sudden and tragic death of our otherwise healthy and happy teenage daughter has caused devastation throughout our family and local community. We strongly feel that this situation could have been avoided if we were given the correct advice and prompt treatment and are committed to ensuring the same mistake does not happen to another epilepsy patient.”

Susan and Steven Monks have been robbed of their daughter and of all the future opportunities, hopes and dreams for which she stood. They deserve to know why and what will be done about it.

--- Later in debate ---

[Mr George Howarth (Knowsley) (Lab)]

I add my thanks to the hon. Member for South Thanet (Laura Sandys) for giving us the opportunity to debate this important issue. I wholeheartedly endorse hon. Members’ comments that she will be missed in the House. Her speech was not only informative but unique, because in the many years I have been in the House, I have never before heard a Member declare themselves to be both a law-maker and a law-breaker. Even more alarmingly, she declared her intention to become a repeat offender. Her speech was also unique in that it brought before the House the experience of people who suffer this condition, and she gave us the opportunity to understand more about its dimensions.

I need to say a word about the speech made by the hon. Member for Wycombe (Steve Baker), in which he described a tragic case. Anyone who has experienced the loss of a child knows exactly the depths of misery that the people concerned will have experienced. The hon. Gentleman dealt with a difficult subject in not only a suitably moving way, but with great dignity, and I, too, pass on my sincere condolences to the family.

[Steve Baker]

I am extremely grateful for the right hon. Gentleman’s kind words. I know that the family have heard him and will also be grateful.

[Mr Howarth]

The hon. Gentleman’s speech highlighted a more general point about how chronic conditions are dealt with. I have some knowledge of type 1 diabetes. When someone with that condition reaches a crisis, whether that is a psychological crisis or something that should be dealt with by a diabetologist, they cannot always get to see the right people at the right time so that they can get the right support, prescription or advice. Brilliant though our national health service is, that is one aspect that all too often breaks down, so I hope that the Minister will address that problem.

I want to concentrate on a particular issue, which I do not think has been mentioned, about which one of my constituents has contacted me: how the benefits system makes life very difficult indeed for those people who find themselves on benefits. No doubt the Minister will not be able to respond to my points, but I hope that he will pass them on to his colleagues in the relevant Department.

My constituent, who has asked to be named, Mr Adam Lane, who lives in Huyton, said:

“In regard to my DLA claim I had to go through 6 months with no money for myself, my wife and my two-year-old son. At that time we had to live on £50 a week until I went to a tribunal and won. Now I have to go through the whole process again on 13th of March for PIP. I have a letter from my epilepsy doctor stating how bad my epilepsy is. I fall and convulse without warning and have seriously damaged my knee, and have panic attacks throughout the whole experience. My seizures are occurring every week now and are very serious and now I suffer with migraines where I vomit 14 hours a day and I’m confined to bed through the process for 2 weeks at a time. I’m hoping Atos will not brush me off like last time, hoping to appease Government numbers to get people off benefits. I feel I am in need of benefits. I cannot work with my health conditions. My wife is my carer 24/7. My son has been traumatised though watching my seizures. I’m hoping my Atos interviewer sees what is in front of their eyes and not what the Government want them to see and say. Please, for others out there like me, let there be a way for people who do not abuse the system to be given a fairer crack of claiming what is deservedly theirs. Thank you.”

I thought it was worth reading that out in full because it gives a very clear picture of how this man has had to struggle to keep his family together and to support them in extremely difficult circumstances, where the benefits system seems to mount up against him to prevent him having any kind of reasonable life. I hope that such cases—there are many more of them out there—give the Government cause to think again about how people with chronic conditions are dealt with in the benefits system.

Oesophageal Cancer

Steve Baker Excerpts

Monday 23rd February 2015 Commons Chamber

[Jane Ellison]

In a recent Back-Bench debate on cancer, mention was made of the tension that we all feel as constituency Members between the desire to have services nearby and the recognition that the expertise resulting from seeing lots of cancers, particularly the rarer ones, is really important to developing clinical excellence. We have to be clear that there are areas where concentrating excellence and clinical experience will save lives, and my hon. Friend perhaps highlights one such area. We often underestimate just how few cancers of any kind the average GP sees, and that is especially true of rarer cancers.

Let me go back to the different ways of looking at earlier diagnosis. NHS England’s aim is to evaluate these innovative initiatives across more than 60 centres around England to collect evidence on approaches that could be implemented from 2016-17. In 2013, Macmillan Cancer Support, partly funded by the Department, piloted an electronic cancer decision support—CDS—tool for GPs to use in their routine practice. It covers lung, colorectal, pancreatic, oesophagus and stomach, and ovarian cancers. Following the pilot, the CDS tool has been refined and is currently installed in more than 1,000 GP practices across the UK. It is designed exactly to deal with the point about helping people who do not see certain things very often with those diagnostics. Macmillan is working with software companies to adapt the CDS for different IT systems and make it available to GPs as part of their standard software offer.

I just wish to mention the Be Clear on Cancer campaign, which I am glad my hon. Friend the Member for Hove mentioned.

[Steve Baker (Wycombe) (Con)]

The Minister has said many things that give me the impression that there is potential for a huge additional demand on consultants. One of the most striking things that my hon. Friend the Member for Hove (Mike Weatherley) said was that a consultant will get only six minutes with a patient. Will the Minister explain what the Government are going to do to make sure that consultants have enough capacity to deal with the extra demand that is likely as a result of these laudable new methods?

[Jane Ellison]

The cancer taskforce is charged with looking at all those challenges and resolving those tensions, but the NHS’s own “Five Year Forward View” considers some of the ways in which it can be innovative about the use of consultants and the interaction between primary and secondary care, and whether we can do more by looking at that differently. If my hon. Friend is interested in that, it is definitely worth looking at. That is very much the sense of direction and we are now looking to the cancer taskforce to examine all those issues. Parliamentary all-party groups have been asked by the cancer taskforce to contribute to its review, and we ascertained that before the Back-Bench debate. He highlights a fair point; all these things bring their challenges, and that is one reason why we put so much effort into testing the Be Clear on Cancer campaign.

I was delighted that the recent pilot of the Be Clear on Cancer campaign for oesophageal and stomach cancer in the north-east and north Cumbria was so successful. We carry out the pilots in order to understand what additional demand they create in the system, so we can model that and cope with it if the campaigns are rolled out. Following the pilot, a national four-week campaign ran from 26 January until yesterday, and was supported with national TV, radio, digital and out-of-home advertising and a public relations campaign. A variety of face-to-face events were held across the country in venues such as shopping centres.

The campaign aimed to raise awareness of the symptoms of oesophageal and stomach cancers and to encourage those with symptoms such as persistent heartburn to visit their GP. The campaign was targeted at men and women aged 50 and over. Of the nearly 13,000 people who are diagnosed with oesophageal or stomach cancer each year in England, more than nine out of 10 are aged 50 and over. The campaign was also aimed at friends and family, who can encourage those with symptoms to make an appointment with their doctor if they are concerned. We are all aware of those times when despite knowing what is good for us, we need a loved one to say, “It is time to go to the doctor.” The campaign takes that into account.

Let me deal with the clear and good points made about endoscopy, including by my hon. Friend the Member for Winchester (Steve Brine). We accept that there are issues to address on endoscopy capacity, which is why we have been working with NHS England and Health Education England to prioritise this area. A joint endoscopy working group, set up by the NHS England’s national clinical director on diagnostics and imaging, has been analysing the latest data, and an action plan has been developed to ensure sufficient capacity in the short and long term.

Let me briefly mention treatment. NHS England’s oesophageal and gastric cancer service specification clearly defines what it expects to be in place for providers to offer evidence-based, safe and effective oesophageal cancer services, in line with the National Institute for Health and Care Excellence’s clinical guideline, “Improving Outcomes in Upper Gastro-intestinal Cancers”.

I want to touch on research, because people should understand what we are doing to invest in understanding more about these specialist areas. The National Institute for Health Research has awarded £2 million for a research professorship with a focus on improving outcomes for oesophageal cancer through innovative screening and surveillance tests. It is also funding a £2 million trial of palliative radiotherapy in addition to self-expanding metal stents for improving outcomes of dysphagia and survival from advanced oesophageal cancer. The NIHR clinical research network is currently recruiting for 24 clinical trials and studies in oesophageal cancer.

In conclusion, I thank my hon. Friend the Member for Hove for securing this debate and congratulate him on the way he moved and delivered it. I do not underestimate the challenge of improving outcomes for people with oesophageal cancer. However, I hope that what I have briefly set out here shows that we are committed to improving cancer care through building greater awareness among the public; targeted and high-profile awareness campaigns, such as the Be Clear on Cancer; using technology and innovation to support GPs to better identify symptoms and improve the referral process; and taking action to ensure sufficient capacity in areas such as endoscopy. Things are improving, but there is much work still to be done. We are committed to improving cancer survival rates and building on the improvements we have made so far so that we have the best cancer outcomes in Europe. My hon. Friend’s speech tonight illustrated far more eloquently than I can, with all my facts, figures and statistics, why that is important to our fellow countrymen and women and why it is so important that we continue to make progress, and I thank him for highlighting that this evening.

Question put and agreed to.

Francis Report: Update and Response

Steve Baker Excerpts

Wednesday 11th February 2015 Commons Chamber

[Mr Hunt]

That is an interesting point and we should certainly reflect on it in the consultation. I am looking forward to visiting my hon. Friend’s trust in March. On many of the visits I have made to hospitals in special measures, which his hospital is not, I have met union representatives and they have an important contribution to make, because nine times out of 10 the real problem is that the people on the front line feel they are not being listened to, and when that is put right the other things start to be solved as well.

[Steve Baker (Wycombe) (Con)]

As a former airworthiness engineer, may I strongly endorse my right hon. Friend’s direction of travel? Will he confirm that Buckinghamshire Healthcare NHS Trust, having exited special measures after the Keogh review, has enjoyed a fantastic transformation, which I believe he saw when he visited Wycombe hospital?

[Mr Hunt]

I had a fantastic visit there. This was a hospital that, putting it bluntly, was one of the worst in the country, and it is now on its way to becoming one of the best. The motivation and excitement not just of the management team but also the staff there, were palpable, and I think a huge number of good things are happening. What has worked there is the sense that what we are asking of the hospital is the same thing that they want to deliver for their patients—safe, compassionate care—and that must remain the focus.

Human Fertilisation and Embryology

Steve Baker Excerpts

Tuesday 3rd February 2015 Commons Chamber

[Jane Ellison]

No, I cannot accept that description. I recognise that my hon. Friend has objections to the procedure, but I do not recognise his description. Nuclear DNA is not affected; mitochondrial DNA is different.

As well as paying tribute to the scientists at Newcastle university, I want to pay tribute to the Lily Foundation, a charity founded by families who have lost their children to serious mitochondrial disease, and who have shown us the human suffering behind this scientific advance. Many right hon. and hon. Members, like me, have constituents who are affected, and I am sure that some Members will talk about such families in their own speeches.

[Steve Baker (Wycombe) (Con)]

Does the Minister accept that a person born as a result of a mitochondrial replacement would not pass on mitochondrial disease to their successors? In other words, the germ line would have been modified so that the mitochondrial disease had stopped with their parents. It seems to me that if she accepts that the germ line has been modified, what she said a few moments ago cannot possibly be right.

[Jane Ellison]

We have made it clear that the removal of the faulty mitochondria will be passed on to the next generation. That is exactly what we have been describing, but I do not accept my hon. Friend’s description of it as genetic modification. It has to be said that there is no universally agreed definition of genetic modification, but for the purposes of these regulations, we have used a working definition and it involves not altering the nuclear DNA.

--- Later in debate ---

[Andrew Miller]

The ethical basis on which science is conducted in this country is world leading. The hon. Gentleman is right to say that we should be immensely proud of the successes—again—of our scientific community in a range of life science disciplines. This one affects a very small group of the population but does so in such a profound way. Although there are issues that need properly regulating, the regulatory structure that we have created does that properly. The Minister was asked about, and indeed mentioned, the issues associated with designer babies. Of course this House would want to impose limits, but we are considering a specific set of regulations about dealing with mitochondrial disease—they do nothing else. I, for one, would not stand here to defend the concept of designer babies and people choosing eye colour and so on. Today, we are dealing purely with those terrible illnesses.

[Steve Baker]

Will the hon. Gentleman give way?

[Andrew Miller]

No, as it would not be fair on other people. In case colleagues have not seen them, let me commend the e-mails sent to all Members by the Muscular Dystrophy Campaign; Jonathan Kingsley wrote to us all, and the Lily Foundation has written to us all in very powerful language. Those people who have sat and listened to some of the families will understand, and colleagues who have constituents affected by mitochondrial disease will understand the message.

We are in a society where people are entitled to have their beliefs, and I respect those beliefs; everyone should be entitled to express their opinion. But this is about focusing on the needs of that small part of the population that I mentioned. I urge the House, in coming to a conclusion this afternoon, to think about those families, to focus on their needs and to set aside general beliefs in the overwhelming interest of that small part of the population who have suffered immensely and who have an opportunity at their disposal because of the extraordinary science that has been advanced.

[Steve Baker (Wycombe) (Con)]

I approach this subject with a considerable degree of humility, for two reasons. First, I will never forget meeting a family in my constituency whose child suffers from mitochondrial disease; there was both a haunting sorrow in that family and the hope that if these regulations are passed they will be able to have a child without this problem. Secondly, I am very aware of my own shortcomings in relation to biological science. As a chartered engineer, I am perhaps more competent in the physical sciences, and I do not mind admitting that I had to look up at least a few of the words in the regulations in order to understand them.

As I have listened to this debate, not only today but previously, I have wondered whether we have really reflected on how science proceeds, because scientific truth is not established by authority or by democratic vote; it is established, as Karl Popper put it, through “conjecture and refutation”—trial and error. Someone who reads Thomas Kuhn’s “The Structure of Scientific Revolutions” will discover that it is possible for quite large bodies of knowledge to be developed with errors in them. When those errors are corrected, the paradigm shifts—that is a term we have all heard. That is how science proceeds, through trial and error. The reality is that there will always be uncertainty in any scientific procedure.

When the Commons Library summarised the Nuffield Council on Bioethics’ review, the second point mentioned was this:

“The knowledge about these techniques is uncertain and could remain so for several generations—their use could potentially harm future persons.”

The hon. Member for Liverpool, Wavertree (Luciana Berger), speaking from the Front Bench, made the point that, broadly, the question before us was whether there was a reason to withhold these techniques from people. If there is a reason, it is that they may do harm to future persons. I will not support the measure because this is inherently uncertain. That uncertainty is an inherent part of science, and it is no good appealing to authority to try to resolve the question, because different authorities will disagree and there is no way to resolve those disagreements apart from through empirical evidence, which we can obtain only by experimenting on humans.

[Graham Stringer (Blackley and Broughton) (Lab)]

The hon. Gentleman is making a typically thoughtful contribution to this important debate. Does he not have to balance that uncertainty, which he points out fairly, with the 100% certainty that the children of mothers with mitochondrial disease will suffer?

[Steve Baker]

The hon. Gentleman is absolutely right, which is why I began by expressing the humility I feel on this subject as a result of meeting and having had a lengthy conversation with a family who face just that issue. I remind myself, however, that we are dealing here not with a cure for those who have already been born, but with ensuring that those who are subsequently born do not suffer from that disease. If we were discussing a cure for those already living, perhaps the circumstances might be different.

[Angela Smith]

Is prevention not better than cure?

[Steve Baker]

Prevention certainly is better than cure, but the question is: at what risk? I simply accept that on the earliest stages of human life there is a space for conscience; we will have different beliefs, some of which will be religious, and it is a matter of conscience. There are noble reasons for disagreeing about that stage and about what is and is not legitimate risk taking with human beings.

The second point I wish to make is that in the course of this conversation there seems to have been what, at best, I could describe as semantic sophistry as to whether or not this process is genetic modification. As always, there is space for debate about the definition of terms, but the germ line is to be modified if these techniques go ahead. The Minister has stated that plainly—

[Jane Ellison]

indicated assent.

[Steve Baker]

She nods, and I am grateful. If the germ line is to be modified, to me this is genetic modification. I heard the hon. Member for Cambridge (Dr Huppert) give a clear explanation of the separate origins, and he understands the science better than I do. But for me the key thing is not so much where these parts of the DNA identity of a person came from, but where they are now. Each one of us has our own particular DNA identity. This procedure changes only a tiny part of it, but, having changed it, we cannot know what the consequences will be. I know that families will be affected by the decision, but I have to say, with great sorrow, that, when it comes to human beings, this degree of uncertainty cannot be borne by my conscience and I shall be voting against the regulations.

National Health Service

Steve Baker Excerpts

Wednesday 21st January 2015 Commons Chamber

[Mr Hepburn]

I am sure people in the area are extremely grateful for that statement of support and commitment and that pledge from the shadow Secretary of State. I only hope he will become Secretary of State.

The Government and the management of the NHS are not incompetent. They are acting deliberately. The 27,000 patients in Jarrow who now go to the walk-in centre will have to go to the doctors’ surgeries, where it is difficult enough already to get an appointment. That will only exacerbate the problem. When they go down to A and E, which is doing a terrific job, the situation will only get worse. The Government know exactly what they are doing. They are trying to sicken people of the NHS so that they can turn round and say, “The NHS is not working. We will bring in the private sector to help out and to take it over.” That is the policy of this Government.

[Steve Baker (Wycombe) (Con)]

Under the previous Government, my predecessor was not able to prevent the closure of A and E. If Labour is in government, I shall remember his speech today and the promise that was given to him, and I shall watch closely what happens.

[Mr Hepburn]

I can assure the hon. Gentleman that after that pledge I will certainly be watching the shadow Secretary of State when he gets in, to make sure our walk-in centre is still going.

Who gains from the present situation? Only two lots of people—the Tories, many of whom are up to their necks in involvement with private health care providers, and the profiteers, the health care providers, who are going to come in and cherry-pick the best services so that they can make profits. I welcome the shadow Secretary of State’s statement and commitment today. It will boost the morale of the people of the north-east who are so desperate to keep the service.

--- Later in debate ---

[Paul Maynard (Blackpool North and Cleveleys) (Con)]

It is intriguing to follow the hon. Member for Rochester and Strood (Mark Reckless). I will leave my intrigue at that point and focus on the debate rather than him.

It is a shame that the shadow Secretary of State has left the Chamber, as I was about to say something relatively pleasant and polite about him—he will not hear it now. When he came up to Lancaster and Fleetwood a few weeks ago he joined me in praising my local A and E department, which had seen 97% of patients within four hours, the fifth best performance in the country that week. That is a superb achievement given the complex health economy in Blackpool. It is very rare that we are at the top of a league table for the right reasons in Blackpool, whether that is for football or for health care, so I welcome that.

It was interesting to note a more hidden and nuanced message in what the shadow Secretary of State had to say. The medical director of Blackpool Victoria says that between April and September 2014, 36% of those arriving at A and E did not need to be there. They could have received their diagnosis or treatment somewhere else, and the cost to the hospital was calculated at £842,000. The message I draw from that is that we still have an immense amount of work to do to ensure that people know where to go for the right treatment at the right time. It is, of course, incumbent on us to ensure that those alternatives are resourced, that people know where to go and that people have confidence in the alternatives.

We have not spoken enough today about pharmacies. Pharmacy trade bodies and the industry put so much into lobbying Members on both sides of the House, but I think it will require another decade or so of intensive lobbying of MPs before we finally get the message that it is far better to have first recourse to the local pharmacist to see whether one needs to go further in seeking appropriate health care. I rely on regular repeat prescriptions for my epilepsy, and I have saved myself many a GP visit by asking a question at my local pharmacy. We are overlooking the most basic corner-of-our-street access point for primary health care, and we should not forget it.

I want to praise another Member of a different political party from mine, and he is sitting on the Government Front Bench: the Minister of State has already been praised today for his approach to mental health care. It is warmly welcomed, particularly in a town such as Blackpool. Our new 74-bed harbour unit is about to open on the edge of the town. It has been long-awaited, and is much-needed following some of the appalling standards of care at the Parkwood unit over the past decade.

The Minister will know that he faces great challenges. I could easily have come here today and read out a number of immensely tragic cases involving young people not getting the appropriate mental health care. He still faces a battle with the profession, because clinicians differ over their assessment of this issue. I see far too many young people with some learning disorder who are somewhere on the autistic spectrum, where the clinician refuses to accept that they can both have a learning disorder and a mental health problem. They fall into that gap and are batted backwards and forwards between different providers. There must be a battle in the medical profession over how to reconcile those two different forms of clinical diagnosis.

Another point I want to raise—I have far more than I will be able to get into my remaining four minutes—was mentioned by my right hon. Friend the Member for Chelmsford (Mr Burns). I was struck by the shadow Secretary of State’s sudden enthusiasm for the walk-in centre in Jarrow—his instant commitment that it would be saved were Labour ever to come to power. We then heard from my right hon. Friend that these things are sometimes trickier than that—that there is more nuance, perhaps. We in this Chamber often think we know it all—don’t we? We think we know everything there is to know and that we can learn nothing from anybody else about anything in our constituency—that we are the sole experts of what is right. Occasionally it would be nice to listen to the clinicians. There might actually be a clinical argument for why a particular unit has to open, close or reconfigure, but all too often debates on the reconfiguration of services become a political football—which is exactly what my right hon. Friend was saying.

A good example is the stroke unit in Blackpool. It has been a controversial addition because it was designed to serve the entire north-west. Patients were coming down the M6 from south Cumbria, past four or five other hospitals, to get higher quality treatment in Blackpool. As the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) chuntered during the Secretary of State’s speech, the important point is that it was about outcomes. People were going to have a better chance of survival if they went to the stroke unit in Blackpool rather than their local A and E. Yet when that was debated, it was very hard to tease out the medical arguments in favour of this innovation, because all too often we were more concerned about focusing on saving bricks and mortar in our own backyards rather than on what is actually best.

[Steve Baker]

Does my hon. Friend agree that the two brands in the NHS that the public really understand above all are A and E and GPs, and all the time we are talking about A and E we are getting away from the fact that sometimes care is better provided in a specialist stroke or heart centre?

[Paul Maynard]

My hon. Friend makes an important point, which is that so many different terms are used and answers given in this Chamber and elsewhere about where patients need to go. What they actually want is reassurance and confidence that when they go somewhere they will get the right treatment at the right time that solves their problem. They do not want it to be overcomplicated, and neither do we.

We have heard a lot of criticisms of this Government’s health reforms—they seem to be very unpopular on the Opposition Benches in particular—but let me highlight two that have been very good. One of them goes back to my younger days—when I had a finer figure, perhaps. My first proper job—Opposition Members will not like this—was as a health policy officer in the Conservative research department in 1999, so I listened with delight to the right hon. Member for Holborn and St Pancras (Frank Dobson) telling me all about the wonders of his time, because I scrutinised it quite carefully on a daily basis. I used to get a monthly present from the Association of Community Health Councils for England and Wales in the form of the London “Casualty Watch”, a monthly census of trolley waits in London accident and emergency departments. It was a pretty thick document. The census detailed page after page of trolley waits of more than 24 hours, and it was a shocking indictment of how Labour was running the NHS at that time.

That situation led to one of the Labour Government’s most shameful decisions: to abolish community health councils. I know that many Labour Members are embarrassed about that even now. One of the great things about our health reforms is that we have brought back Healthwatch, which has proved to be a thorn in the side of local health providers, of Members of Parliament and of the Government. We have brought back the ability of ordinary patients to affect the nature of the care in their communities. That is happening right now in Blackpool, and it is making a difference. I am delighted about that.

Another positive element involves putting public health matters into the local council. As I have said, Blackpool faces immense public health challenges, but putting Dr Rajpura, our local director of public health, into the council has been a tremendous success. It has helped to pull together all the disparate strands within the town as we face those challenges. Again, this has happened only as a result of our health reforms.

Another example that I want briefly to mention is the fact that some of our local nurses at the hospital have spun out their rehabilitation service into a community interest company called Spiral, which is now winning awards for the quality of its patient care. I am concerned that, if Labour were to reverse all these changes, the good things we have achieved would be washed away and lost, and the people who would suffer would be my constituents, including those who have turned to Spiral for their rehabilitation. That is my real concern.

--- Later in debate ---

[Steve Baker (Wycombe) (Con)]

I begin by paying tribute to the staff and leadership of Buckinghamshire Healthcare NHS Trust. The trust went through special measures as a result of the Keogh review, when it was found to have high mortality, and they have done a sterling job of turning the trust around. On my visit recently with my right hon. Friend the Secretary of State for Health, I found a renewed enthusiasm and optimism in the trust, and I am very grateful to the staff and leadership for delivering that outcome.

When the right hon. Member for Leigh (Andy Burnham) opened the debate, he asked for shared solutions, striking a markedly different tone from the usual partisan pose. I shall suggest some shared solutions later in my speech. But normal service quickly resumed. The right hon. Gentleman spoke of stories of failure. There are, of course, some stories of success, and I shall mention a few. England’s NHS has the best measured emergency care performance of any western nation, according to NHS England. Dr Sarah Pinto-Duschinsky, director of operations and delivery for NHS England, said:

“In the week ending December 28th A&E attendances were up more than 31,000 on the same period last year, meaning we successfully treated more patients in under four hours than ever before.”

I will come to why in a moment.

The Government have allocated an additional £700 million to cope with winter pressures. The College of Emergency Medicine said:

“This represents the largest annual additional funding yet seen.”

In the course of this Parliament, the NHS budget will have increased by £12.7 billion in cash terms. This additional winter pressures funding has paid for 2,500 additional beds in acute and community treatment and the equivalent of 1,000 doctors. There are almost 1,200 additional A and E doctors, including an additional 400 A and E consultants and 1,700 additional paramedics since 2010. Some 850,000 more operations are being delivered by the NHS each year compared with 2010, and numbers waiting longer than 18, 26 and 52 weeks to start treatment are lower than they were under the previous Government. It cannot reasonably be said that that is a continuous record of failure. There are considerable successes under this Government.

In an intervention on my hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard), I mentioned branding. One of the things that we could do is continue to tell patients that they should go where treatment can best be provided, but we see that patients stubbornly insist on going to hospital. The brand A and E is well understood; people know that if they have an urgent problem, they can go to A and E. It will take years of persuasion before people behave differently, and I do not think we should keep on persuading people to want something other than the preference they are clearly displaying by their behaviour, which I shall return to.

Let us not forget the legacy that the Government have had to cope with, including the grievous financial position that they inherited. Let us not forget that around the world special monetary measures are still in place to ensure that Governments can keep spending. We have had problems with patient care. I alluded earlier to the turnaround in Buckinghamshire; across the country, there have been special measures and turn- arounds. The BBC reported that a probe into whistleblowing has been swamped by people getting in touch. The Government have had to deal with an enormous range of cultural problems and turnarounds.

That brings me to solutions—first, funding. In Buckinghamshire there are pockets of real poverty. In my constituency in Micklefield, Castlefield, Oakridge, Bowerdean and Disraeli there are—by anyone’s standards —pockets of poverty and deprivation, but we suffer on funding because of how it has historically been calculated. It is time for us to look seriously at where the demands on A and E are coming from, and to reorientate funding towards the human factors producing that demand—that is, ageing. Where there are older populations, they should be properly funded. It is a simple matter of treating people humanely, decently and—dare I say it—equally.

Secondly, it is time for us to take seriously the documents of NHS England. I am talking about not just the urgent care review, which I have in my hand, but the “Five Year Forward View”. What we see emerging now is a clear vision of where places such as Wycombe should go. It is becoming increasingly obvious to me that we will never manage to achieve the return of an old-style A and E to Wycombe hospital. The clear reason for that, as set out by NHS England, is that the NHS is moving in a different direction. The urgent care review includes a clear model of future urgent care, with major emergency centres, emergency centres and urgent care centres.

I am not able to tell the hospital trust and the clinical commissioners what they should do, but if I could I would now have a clear understanding from NHS England’s own documents of what should be done in Wycombe. We have a very expensive public finance initiative hospital, and we need to make the most of it for the 20 years-plus that are left to run on it. We should have an urgent care centre, an enhancement of the current minor injuries unit, a pharmacy, GPs, social services, nurse practitioners, and a full set of services and diagnostics in Wycombe named in a way that the public can understand. We should be proud of the centre and encourage people in Wycombe to present there if it is the best thing for them to do. We should not turn off the 111 service, and we should provide the services that people need in the places where they present.

We cannot go on for ever pretending that we will re-educate the public to want something different; that is not going to happen. I am not suggesting that we have an enormous new surge in admissions—nobody wants that. What we should recognise is that the vast majority of people, when they are in difficulty, want quick reassurance. If the people of Wycombe were in charge, they would want our hospital to have a full range of diagnostic and treatment facilities available to them all year round, giving them peace of mind. They would not want poor quality care. I think most people would accept being stabilised and moved to the place that could give them the best care.

We have a heart attack and stroke unit. I do not suppose that many people in Aylesbury, where there is an A and E unit, would be very happy if they realised that in the event of a heart attack or stroke, they would be coming to Wycombe. But that is the point. A huge amount of confusion, waste and anxiety is being wholly unnecessarily created despite the fact that NHS England, through the forward view document and the review of urgent care, has set out a clear trajectory on how to give the public peace of mind and the right treatment in the right place—yes, close to home, but also making best use of the PFI hospitals, which are a millstone around the NHS’s neck. We should do the absolute best we can to get best value for money, which means a new generation of urgent care centres in places such as Wycombe.

--- Later in debate ---

[Jeremy Lefroy (Stafford) (Con)]

It is a pleasure to follow such thoughtful speeches, in general, on this subject. I thank all the staff at the accident and emergency departments that serve my constituents, whether at County hospital in Stafford, Royal Stoke University hospital, New Cross hospital in Wolverhampton, or Manor hospital in Walsall.

On many occasions in the House over the past few years, the tragic events in my constituency have been referred to. Whenever they are referred to from now on, I would like people to acknowledge the enormous progress to improve health services that has been made in Stafford at what is now County hospital and throughout my constituency. It is absolutely vital that we remember what is happening now as well as where we have come from. Let us not forget that out of the Francis report has come the tremendous emphasis on patient safety and compassionate care that is vital for all our constituents. I do not want Mid Staffs to be used just as shorthand for something that was clearly very poor care; it should also be shorthand for the huge improvements that have been made by the people working there and the NHS staff in many other hospitals throughout the country.

I would like to look in a bit more detail at what this motion proposes and the reasons we are currently suffering from the huge demand on accident and emergency services, particularly in relation to out-of-hours GP services and delayed discharges. Regarding the pressures on A and Es, it has rightly been said that there are 600,000 more attendances every year, but we are finding that there are 4,000 more admissions every week—some 200,000 a year. That indicates the seriousness of the situation, because people are not admitted to hospital unless they are in a fairly serious state or seriously unwell. It shows that we are now entering a phase in which the baby boomer generation needs more acute care. We welcome the fact that people now live a lot longer, but the fact is that when people get ill in later life, they tend to be acutely ill and to have complex needs, and that results in their admission to hospital.

The right hon. Member for Holborn and St Pancras (Frank Dobson) mentioned the ratio of beds to population in the UK. We have one of the lowest ratios in Europe—we have a very efficient health service—but the idea that we can get an even lower figure is pie in the sky. In fact, we ought to go marginally in the opposite direction. We should certainly consider increasing the number of beds. Let us not forget that our patient stays in hospital are shorter than most comparable figures across Europe.

We need to bear in mind that we will get more and more admissions, and we need to have the capacity for that. As I remember only too well, I argued a few years ago that the design for the new hospital in Stoke-on-Trent would make it too small; indeed, it is too small, and we are now increasing the number of beds there.

The King’s Fund has said that only 55.4% of patients say that they know whom to contact for out-of-hours services, and such a lack of information or lack of clarity has already been mentioned. We need something straightforward and simple, and frankly, it must be available 24/7, because emergencies happen 24/7. That is why I have pushed for my A and E to reintroduce 24/7 care, rather than its current 14/7 care. People have to look at the clock to check whether it is nearly 10 pm, and then ask themselves whether the A and E will still be open or whether they will need to go elsewhere. They avoid going to another hospital because our A and E is so good, so they delay going until 8 am, by which time they may be in a worse condition. If the facility is for emergencies, it needs to be open 24/7. I welcome the fact that we will soon get an overnight doctor service. A and E needs to return to 24/7 not only in my case, but in other centres that do not offer a full-time service.

[Steve Baker]

Does my hon. Friend agree that putting GPs into such centres provides the possibility not only of having integrated care, but of treating most people who present overnight, when an A and E consultant might not be available?

[Jeremy Lefroy]

I entirely agree, which is why I welcome the introduction of an overnight doctor-led service at the County hospital in Stafford, even though I would like such services to go further. A parent whose child is sick with a temperature may not want to be a burden on the ambulance service by calling one out but will still want to be seen at that time, rather than having to wait until morning, so being able to go to such a service gives them reassurance. If the child is particularly unwell, they can then be referred to a specialist centre, but otherwise the parent can be reassured that they can wait until the morning. Such matters are vital for our constituents.

It is, indeed, a problem to get GP appointments, and it is vital that the issue is sorted out. There are wide discrepancies. In the practice I attend, I can get an appointment the next day not just because they want the local MP to be seen, but because they are very well organised and their patient load is not huge. That is simply not the case in other practices, and some people in my constituency have to wait two or three weeks for an appointment. The problem must be sorted out, and there must be evenness across the country.

GP surgeries put an additional pressure on A and Es. The statistics show that the patients of some GP surgeries attend A and E far less often than those of other surgeries, because such GPs take the time to have longer appointments and take the trouble to go through problems and deal with them on the spot, whereas others are more inclined to say, “I haven’t got the time, so you had better go to A and E.” The statistics show that for some GP surgeries the ratio of patients attending A and E is almost twice that of others in the same area and with the same demographic.

Delayed discharges have often been referred to in this debate. The figure was relatively stable until the start of 2014-15, but since then the total number of delays has risen by 19%. The King’s Fund analysis suggests that delays attributable to NHS services have risen from 60% to 68%, whereas those attributable to social care have fallen from 35% to 26%. It states:

“This suggests that capacity and workforce issues, particularly in nursing homes and non-acute services”

—within the NHS—

“are becoming more important than social care funding”.

I find that very interesting. I do not know on what evidence it is based, but the King’s Fund is a respected institution and we must look at what it says. It implies that there is an issue with integration not just between the NHS and social care, but between acute NHS services and non-acute NHS services.

So what should we do? First, we have to recognise that there will be increasing demand for complex acute care and, hence, for accident and emergency services. A and E departments therefore need to remain open and to expand. I welcome the fact that the A and E in Stafford will double under the investment plans. Secondly, we need clear pathways for out-of-hours care, rather than complicated pathways that are difficult to understand. Thirdly, we need clear information relating to those pathways. Fourthly, we need to do much more work on access to GPs and must look much more closely at the results of GPs in avoiding A and E admissions among their patients. Finally, we need to make integration a reality, not just between health and social care, but within all NHS services and social care.

--- Later in debate ---

[Chloe Smith (Norwich North) (Con)]

It is instructive, as always, to follow the hon. Member for Dudley North (Ian Austin), and I thank him for his exposition of the positions set out around the Chamber this afternoon. I also welcome the comments of my hon. Friend the Member for Wycombe (Steve Baker) in picking up on the needs of areas that might not normally be viewed as deprived, but that need attention none the less. Norwich is one such city, because it contains wards and areas of serious deprivation. I have argued on behalf of GP surgeries that serve those wards, and there is a genuine question about the way our national structures and funding serve those areas.

[Steve Baker]

Is it not odd how people who are obsessed with inequalities take levels of aggregation that hide the real suffering of individuals and families?

[Chloe Smith]

My hon. Friend makes a wise point.

Tomorrow, I am visiting a walk-in centre and the hospital that serves my constituents. When I am there, I shall be explaining, as I have several times in the House recently, my support for the NHS in Norwich and across Britain, my thanks for what the staff are doing and my understanding of what the patients, my constituents, need from the NHS.

I want to make three points in the debate. My first point is that, as many hon. Members have said this afternoon, the NHS is under unprecedented demand. It does it no disservice to acknowledge that and bring it into the debate. I for one welcome the decisions that allow for increased numbers of doctors and nurses in urgent care—that is true in the Norfolk and Norwich University Hospitals Trust; for an increased number of operations to be carried out each year—that is true everywhere in the country; and for increased hours at GP surgeries. I recently learned to my pleasure that Norwich doctors will apply for the next round of the access fund. They have not done that before and it is very welcome. The Government have made the fund available and it could be of great benefit to patients in my area.

I am also grateful to the Government for the decisions made early—earlier than ever before—that have allowed for winter pressures to be dealt with. Again, that directly benefits the area of Norfolk that contains the Norfolk and Norwich hospital. I am particularly pleased that the use of that funding will be planned jointly with local authorities through the system resilience group. That is incredibly important. I will turn to that kind of joined-up working in my final remarks.

Let me make a point about the motion. We have heard wise contributions from Back Benchers on both sides of the Chamber. For example, my hon. Friend the Member for Stafford (Jeremy Lefroy) rightly asked us not to use the name of his area as a shorthand. He is right that we ought to look much deeper. As a further example, the hon. Member for Wirral South (Alison McGovern) rightly spoke eloquently about mental health. Unfortunately she is not in the Chamber, but I am sure she will be back before the winding-up speeches. I intervened on her to ask why the motion does not refer in its own right to mental health; it is a great shame that it does not. The motion is 10 lines of overblown and fly-blown rhetoric. It asks for an NHS that is “fit for the future”, but makes no mention of mental health being equal to physical health, which I believe strongly. Mental health and physical health should be equal in word and deed, and in budgets. Indeed, I have been discussing that with the Minister recently through parliamentary questions.

The truth is that the motion is rather sad and inadequate. It betrays even the usual standards of political football that are played on Opposition days. The right hon. Member for Leigh (Andy Burnham) said in his opening speech that it is time for honesty. To that end, we would like to know whether his party leader believes in “weaponising” the NHS. To that end, we would like an end to the shabby leaflets on the NHS that go around the country.

I would have liked mental health, which is an important topic, to replace the waste of words in the motion. The motion is a pathetic reuse of the tired and crumbling money-making policy—the mansion tax—that not even all Opposition Members agree with.

Oral Answers to Questions

Steve Baker Excerpts

Tuesday 13th January 2015 Commons Chamber

[Mr Hunt]

I do take responsibility, but I hope the hon. Gentleman will be responsible in his campaigning in Hartlepool and welcome the extra doctors, extra nurses, extra operations and extra number of people seen within four hours in his constituency. It is a record of success, of which this Government are proud.

[Steve Baker (Wycombe) (Con)]

As it becomes increasingly obvious that the public insist on receiving urgent care in a hospital setting, will the Government move to incentivise the delivery of a new generation of urgent care centre, as specified in the end of the phase 1 report on the urgent and emergency care review?

[Mr Hunt]

I have visited my hon. Friend’s local hospital. I commend him for his interest and I commend the hospital for the remarkable turnaround. From being a hospital in special measures, it has done extremely well. We want to implement the proposals in that review and we want also to make sure that for the oldest and frailest people there are alternatives that mean that they do not have to visit hospital.

Five Year Forward View

Steve Baker Excerpts

Thursday 23rd October 2014 Commons Chamber

[Mr Hunt]

I think that is the kind of rhetoric that does the whole country a massive disservice. If the Government had the kind of views about the NHS that the hon. Gentleman talks about, we would not have protected its budget during the most difficult recession we have had since the second world war. We actually increased the NHS budget over that period, because we believe in the NHS. With regard to what he says about the report, the chief executive of NHS England, a former Labour special adviser, said this, and it is a fact: “Over the past five years, despite growing pressure, the NHS has been remarkably successful.” That is what Labour people are saying.

[Steve Baker (Wycombe) (Con)]

I very much welcome the plans for urgent and emergency care set out on page 4, in paragraph 10, which ought to produce a solution that could be welcomed in Wycombe hospital and more than 20 similar hospitals across the country. When the proposals are taken forward, will my right hon. Friend ensure that they are explained to people in such a way that they can have real peace of mind that urgent and emergency care will be there for them?

[Mr Hunt]

My hon. Friend, as ever, makes an important point. I do not think that we have been as good as we should have been in the NHS about explaining changes to urgent and emergency care, and people are understandably worried if they think that there is any risk that they will not be able to see a doctor in an emergency, which is what the NHS is there to do. I think that we now have a better blueprint for urgent and emergency care, but the report also recognises that it is not sustainable to say that all urgent and emergency care will always be dealt with in A and E departments. We have to find a way to improve the capacity of primary care and make it easier for people to see their GP so that we can reduce the pressure on hard-pressed A and Es.

Oral Answers to Questions

Steve Baker Excerpts

Tuesday 21st October 2014 Commons Chamber

[Dr Poulter]

For some more specialist services, collaboration between various parts of the local NHS will always be needed. That is about good health care commissioning and ensuring that services are joined up in a collaborative way. Whereas day-to-day, bread-and-butter services will be commissioned by a local CCG, for more specialist services, clinical commissioners will of course need to work together to ensure that local centres of excellence are commissioned.

[Steve Baker (Wycombe) (Con)]

The sustainability of NHS facilities is often prejudiced by the millstone of Labour’s private finance initiative deals. What is the Government’s expectation of how CCGs should make the best of the hand that they have been dealt?

[Dr Poulter]

My hon. Friend is absolutely right that PFI deals signed by the previous Government have crippled the finances of many hospital trusts, meaning that many of them are unable to invest as much in front-line patient care as they would like. It is important that the Government support the mitigation of PFI deals, when possible, and we have a group that is doing exactly that and supporting local commissioners to deal with the worst excesses of the previous Government’s mismanagement of the NHS finances.

Hospital Car Parking Charges

Steve Baker Excerpts

Monday 1st September 2014 Commons Chamber

[Robert Halfon]

My hon. Friend highlights the problem exactly. It applies not only to the parents of premature babies but to people with cancer. Indeed, 10% of hospitals do not give people with cancer any kind of concession at all.

There is also a problem of transparency. No one knows why such huge increases in charges are taking place, and no one knows exactly what the money is being spent on. Southend hospital, in Essex, charges £2.50 for the first hour’s parking. It was highlighted on BBC Essex recently that the hospital had spent more than £7 million on a new multi-storey car park. Even Harrods and Selfridges would not spend £7 million on a car park. The hospital increased its charges in 2011 and raked in nearly £1.4 million in parking fees alone. It was never envisaged that hospital parking should become a cash cow or a tax on the vulnerable and the sick.

We should also remember that it is not only the patients, the vulnerable and those who are visiting them in hospital who face this stealth tax. It is also a tax on nurses, who are paying an average of £200 a month just to park their cars so that they can do their job. If we had to pay that amount to park our cars here at the House of Commons, I am sure that the practice would be stopped immediately. I also want to mention the concessions for people with disabilities. We often need a PhD to understand all the different rules and regulations involved. We need clear guidelines, and I welcome what the Government have said about this over the past week.

[Steve Baker (Wycombe) (Con)]

I want to set in context what my hon. Friend has just said about the scale of these charges. I have just checked the cost of parking at Chiltern Railways’ new multi-storey car park in Wycombe, and it is only £7.50 a day. I say “only” because that seems quite good value given that some people are paying £500 a week for hospital parking. Does he share my amazement that hospitals manage to provide so little parking for so much expense?

[Robert Halfon]

My hon. Friend hits the nail on the head. As I have said, this has become an easy way for hospital bosses to raise money, and there has been no dialogue with the public about it.

People say that the money could be spent elsewhere, but I believe that hospital parking is as much a front-line service as anything else. It is as important as how many nurses and doctors there are. I am glad that the Government have spent an extra £12.5 billion and that there are 3,000 extra nurses since the coalition came to power, but hospital parking is as much a front-line issue as those things and it should be put into the general pot of NHS spending. It should be taken into account in the same way as spending on nurses and doctors and on machinery. That is often forgotten.

The hon. Member for Bolton South East (Yasmin Qureshi) said that no one goes to hospital out of choice; people go because they have to, or because they have to visit relatives or friends. They should not suffer in the way that they do. They should not have to face the stress involved. Many of my constituents have contacted me to tell me of the stress they face when, having paid at the car park machine, they have to wait for a doctor’s appointment that should have been at, say, 11 but does not take place until 1 o’clock. Through no fault of their own, they have to pay extra car parking charges as a result. How can that be right? Again, I welcome what the Government have said about that.

We need to look at this as part of the front-line spending on the NHS. Estimates suggest that it would cost between £200 million and £250 million to scrap hospital parking charges. I believe that the Government should set up a special fund, possibly paid for by using more generic drugs, and I urge the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) to look at that proposal. I welcome the fact that he has listened, and that the Government have published some really tough guidelines for hospitals. I recognise that they are not the ten commandments; they are not written down on tablets of stone, and we cannot force hospitals to comply with them. They are the next best thing, however.

I put it to my hon. Friend the Minister that if hospitals do not comply with the guidelines, and that if they continue to fail to offer proper concessions to people with disabilities, to use hospital parking as a stealth tax on the vulnerable, to charge their staff for parking and to perpetuate the lack of transparency which means that no one can understand what the revenue is being spent on, we should scrap hospital parking charges completely, as Opposition Members have suggested. I hope that we are already moving in that direction.