Mitochondrial Replacement (Public Safety)

Steve Baker Excerpts

Monday 1st September 2014 Commons Chamber

[Sir Paul Beresford (Mole Valley) (Con)]

Perhaps I could turn the last comment the other way round. I do not want to be standing here, or sitting at home in my dotage, saying, “Why didn’t we do something when we could have?” That is what we are looking at. We have the same problems with many issues relating to human fertilisation and embryos. We have heard these arguments in the House before. We have heard the speculation and the unsupported fears. Although I congratulate my hon. Friend the Member for Congleton (Fiona Bruce) on raising this debate, the scares that she raised are as unsupported as anything we have ever heard. I also congratulate my right hon. Friend the Member for Havant (Mr Willetts) on his contribution. He saved us an enormous amount of time because he covered the key points and nailed them to the floor. The right hon. Member for Holborn and St Pancras (Frank Dobson) reminded us just how long we have been examining this issue. Action is now overdue. I will now completely ruin the political career of the hon. Member for Cambridge (Dr Huppert) and say that I support him.

Today, we are talking about a real opportunity to help thousands of children by taking out of the system, over time, an inherited condition. We are talking about a gene transfer through nuclei, and the 0.1% that was mentioned is motor functional; it is not inherited genes. It is an opportunity to have two parents and not, as the media would have it, three parents.

The media has to take some of the blame. We have discussed these complex issues of fertilisation and embryos and so on, and the scaremongering has been appalling. There is scaremongering not only by individuals—I am not necessarily talking about the ones who write in green ink—but by the media. I was shocked to hear this nonsense about three-parent babies, on which the hon. Member for Cambridge touched. We are not talking about three-parent babies. This is an opportunity to put through these regulations. We are a bit early because we have not yet seen them or the results of the consultation. We have not even seen the Government’s reaction to them. None of us here—not even the hon. Member for Heywood and Middleton (Jim Dobbin) who spoke about the American situation—knows what will happen or is an expert on the matter. None the less there are experts who are reviewing this and coming forward with recommendations. They know and understand the subject a lot better than we do. We have to take their guidance and expertise. By the way, a comment was made about the Americans putting this matter on the backburner, but that was a different situation from what is under discussion now.

[Steve Baker (Wycombe) (Con)]

My hon. Friend is making his argument with characteristic force. I am just mindful that in the Library brief there was a particular insight from an evolutionary biologist suggesting that there was a real danger of DNA mismatching between the mitochondrial DNA and the nuclear DNA. Is he satisfied that the insights of evolutionary biology have been fully and adequately taken into account in this area?

[Sir Paul Beresford]

If my hon. Friend looks at the research, I think he will find that that will have been looked at. From my limited knowledge—my knowledge is limited but it may be slightly greater than that of my hon. Friend—I suspect that such a mismatch would mean that the nucleus and the cytoplasm with the mitochondria would fail and an ovum would not be produced from it, but I could be wrong. I am speculating in the same way as my hon. Friend did. At the end of the day, we have an opportunity to change the rules to allow this research to progress. We must recognise that we have some of the best teams in this field in the world. We lead the field, and this provides us with an opportunity to continue to lead for the benefit of those many children. It will enable us carefully to continue with the research with the appropriate safety factors built in, so I am adamantly opposed to the motion.

Patient Safety

Steve Baker Excerpts

Tuesday 24th June 2014 Commons Chamber

[Mr Hunt]

Again, I am surprised that we do not have more agreement. If the hon. Lady looks at the figures, she will see that in the past year there have been 5,900 more nurses on our wards. Why does she not welcome that? We are using Salford Royal—a brilliant hospital that she knows well—to lead a safety campaign across the whole country to learn from the brilliant things that it is doing. I put a written statement before Parliament, and nothing I said this morning is not in the public domain. I would be delighted to come to the House any time to make an oral statement, and I notice that far more coalition MPs want to ask questions about safety and compassionate care than do Labour MPs.

[Steve Baker (Wycombe) (Con)]

My right hon. Friend will remember some of the issues that I raised in the House about patient safety, and the Francis report, the Keogh review, and the new Care Quality Commission regime have made a material improvement. On Friday last week, Buckingham Healthcare NHS Trust was the second trust to emerge—at last—from special measures. Will the Secretary of State join me in congratulating that trust, and express the hope that that marks a new beginning about which we can be optimistic?

[Mr Hunt]

I would be delighted to do that. Incredible hard work by doctors, nurses and health care assistants on the front line of my hon. Friend’s local hospital has meant that the trust has come out of special measures, which the whole House should celebrate. Indeed, it was helped in that by Salford Royal, and one of the most encouraging things about the new special measures regime is that we are pairing up hospitals in difficulty with other hospitals that have a better record, and we are getting tremendous results.

Care Bill [Lords]

Steve Baker Excerpts

Tuesday 11th March 2014 Commons Chamber

[Steve Baker (Wycombe) (Con)]

Will the right hon. Gentleman give way?

[Andy Burnham]

I will make some progress but I will give way to the hon. Gentleman before the end of my speech.

Let me set out more of the background, because the Minister raised it a moment ago. In 2009 I took proposals through the House to create a process that could be used in extremis to deal with a trust that had got into serious financial problems. That was a financial and administrative vehicle, not a vehicle for widespread service change across the health economy. That is why the High Court was quite correct in upholding Parliament’s original intention when it accepted the case of the people of Lewisham against the Secretary of State, and threw out his plan to downgrade a much-loved and successful hospital. At that point, common decency would have suggested that the right response to the reverse in court would have been to listen to the court and bow down gracefully. Instead, it appears for all the world as if in a fit of pique, the Secretary of State is changing the law to get his way because he can. Imagine the outcry if someone caught breaking the law could simply come along and change it to their satisfaction. We would not accept that for burglars, and we should not accept it for politicians.

--- Later in debate ---

[Andy Burnham]

I will come on to that point, but the CQC had existing powers on care failure, and powers to move more quickly than clause 119 provides for. Adequate powers were in place to deal with the point the hon. Gentleman has just made.

In truth, it is arrogance in the extreme for the Government to be coming along today—and worse, it seriously risks damaging public trust in how change in the NHS is made. That will be the real loss if the clause is accepted. It threatens to destroy any public faith in a sense of fair process governing these crucial decisions, and any prospect of cross-party consensus on a way to make changes to hospital services.

Making changes to those services is about the most difficult decision that politicians have to make, but the fact is that hospitals need to change if we are to make services safer and respond to the pressures of an ageing society. We did not shy away from that in government, and we do not say something different now. However, there is a right way and a wrong way of going about such things.

The Government’s answer—to use a brutal administration process to take decisions above the heads of local people—is a spectacularly wrong response to a very real problem, and precisely because those decisions arouse such strong emotions, we must find better ways of involving people, not shutting them out. If people suspect a stitch-up, and see solutions imposed from on high, they will understandably fight back hard. Does the spectacle of tens of thousands of people marching in Stafford or on the streets of Lewisham not give Ministers pause for thought that this new approach might seriously set back the goal of better public engagement in the NHS?

[Steve Baker]

rose—

[Andy Burnham]

I will give way one final time, but I hope the hon. Gentleman will take on board the point that public engagement is essential if we are to have trust in the NHS.

[Steve Baker]

I am most grateful to the right hon. Gentleman and I have listened extremely carefully to what he has said. Wycombe lost its A and E under his Government. Does he seriously suggest that that change was not imposed on the people of Wycombe, or that they were listened to, engaged and approved of the change?

[Andy Burnham]

I am saying to the hon. Gentleman that the previous Government had a process at the end of which was an independent panel—the Independent Reconfiguration Panel—to take a decision on whether a proposal was right or wrong in the interests of patient safety, which was the driving principle. I will defend the changes we made to improve services. I have given him the example of stroke services in London. The Opposition are not against making change in the NHS, but we are emphatically in favour of local people in areas such as his having the ability to have their say in the process. Clause 119 seeks to drop solutions on local people from on high.

Our policy was set out in the Carruthers review, commissioned by Patricia Hewitt in 2006, which concludes:

“Reasons for change should be built on a clear evidence base of clinical and patient benefits.”

That principle guided the Darzi review towards the end of the previous Government, which put quality centre stage. The Darzi review influenced the plans for stroke services in London and others, and the difficult changes we planned to make in south-east London before the last election. A detailed consultation, “A Picture of Health”, had brought together a case for change to how services were delivered across the area. It was given formal approval before the election, but was subject to the Government’s moratorium after it.

In the space of a few years, Ministers have gone from campaigning outside hospitals to save services to campaigning for extra powers to close them down without debate. That will leave the NHS more top-down than ever before, with the patient and public voice utterly marginalised.

--- Later in debate ---

[Grahame M. Morris]

I am absolutely amazed. I share my right hon. Friend’s incredulity that the Secretary of State is not here. In my view, clause 119 is one power too many for a Secretary of State who apparently believes the NHS to be a 60-year-old mistake. [Interruption.] That is a direct quotation from the Secretary of State before he took office.

The Secretary of State’s increased power and Monitor’s expanded role directly contradict the Government’s earlier promise that local commissioners would no longer be subject to central diktat. That represents a reversal of the vision that was presented during the consideration of the Health and Social Care Act 2012. Clause 119 supports none of the preconditions for a legitimate reorganisation of a local health economy and will allow trust special administrators to overrule any concerned parties.

If clause 119 becomes law, the Secretary of State will be granted the power to issue directions to require foundation trusts and clinical commissioning groups to take steps that they do not want to take. Any Member who wants to prevent the Secretary of State’s axe from falling arbitrarily on their own hospitals without clinical justification should seek to remove the clause from the Bill. I therefore urge right hon. and hon. Members to support Labour’s amendment 30 and new clause 16, which is a compromise measure to ameliorate the worst aspects of clause 119.

[Steve Baker]

I have listened with quiet astonishment as Opposition Members have suggested that the NHS previously offered meaningful accountability and public control.

In the manner in which the right hon. Member for Leigh (Andy Burnham) spoke to amendment 30, he viciously punched a raw and delicate bruise in Wycombe. As I indicated in my intervention, it was under the last Government that we lost A and E services, maternity services and paediatrics. Years later, all that people want is to have those services back. They want an emergency unit that is capable of accepting whoever turns up. To use the jargon, they want the treatment of undifferentiated emergency patients. The NHS should not be offering constant excuses for why that cannot be provided. God knows, we pay enough in tax and in salaries that people ought to be creative enough to figure out how to offer the treatment of undifferentiated emergency patients at local hospitals like the one in Wycombe. There is a proposal to do so, which I will return to another day,

I have found myself listening to some sort of exposition of a democratic utopia that has never existed. When considering how this has been positioned—the idea that it is about reconfiguration rather than urgent procedures when a trust is in extreme difficulty—will the Minister reassure me that the Government did not establish clinical commissioning groups and health and wellbeing boards, and the rest, just so that they could use this clause and power to override everything else they have put in place?

[Dr Poulter]

I am happy to give my hon. Friend that reassurance. We believe in locally led commissioning and in listening to patients locally. That is what devising services locally is about. This clause is not to be conflated with normal procedures for designing and arranging local hospital services. I hope that that reassures my hon. Friend and other hon. Members.

[Steve Baker]

I am extremely grateful to the Minister for that reassurance because in my constituency there is really only one story: the loss of services, and, because of the way the clause has been presented by Labour Members, people are worried about that.

It has been said that these hospitals are categorically different because they exist in a broader health economy, but that is not why they are different. Any business exists as part of a wider economy with dependencies and so on—the hon. Member for Lewisham West and Penge (Jim Dowd) suggested the example of Comet versus Currys. In private enterprise, if the administrator turned up and shut down our competitors when we failed, it would obviously be absurd, but the truth is that both sides of the House have made a positive decision to use the techniques of state socialism to provide health care. That choice has consequences, one of which is this clause.

[Mrs Emma Lewell-Buck (South Shields) (Lab)]

It will come as no surprise that I support the proposal to remove clause 119 from the Bill. Of all reforms in the Bill, this clause has attracted the most attention from my constituents. They recognise it for what it is—a frightening power grab by central Government that will put services across the whole country at risk from the Secretary of State. It is a cynical move from the Government, who in their wildly unpopular top-down reorganisation of our beloved NHS claimed that they wanted to put more power in the hands of doctors. Now they seek to give sweeping new powers to the Secretary of State.

It is of course true that some NHS trusts and foundation trusts find themselves in tough financial situations, and in those difficult situations decisions will have to be made so that services continue to operate. That is what the TSA regime was set up to do, and it is an appropriate process for dealing with the difficulties within a trust. It is true that trusts do not operate in complete isolation, but the TSA is already required to act with the interests of the wider health service in mind.

--- Later in debate ---

[Nick de Bois (Enfield North) (Con)]

I am grateful for the opportunity to discuss amendment 30 and new clause 16. I realise that it will come as a disappointment to Government Members but I will support amendment 30 and new clause 16. Let me explain why, and I hope that I can avoid drifting into the scaremongering that has been associated with this issue.

For me, the concern has always been about public trust in reconfigurations. As many hon. Members will know, I have been through 10 years of discussions and consultations on reconfigurations. That first started under the then Labour Government, and I agree with my hon. Friend the Member for Wycombe (Steve Baker), who suggested that there was a wonderful alliance of faith and trust professed by the Opposition in the effectiveness of consultations. For the record, we had the most shameful consultations at the beginning of the process on Chase Farm, and not much changed after the change of Government in 2010.

[Steve Baker]

To be clear, I think these consultations are a fiction and sham that do not make any difference to the progress of events in the NHS. In fact, they cruelly mislead the public into thinking that they have any say at all.

[Nick de Bois]

I am grateful for my hon. Friend’s intervention and I understand where he is coming from. Certainly in the early days under the tenure of the predecessor of the shadow Health Secretary, we were presented with consultations that listed 10 options for the reconfiguration of Chase Farm, one of which included retaining the A and E services. It disappeared from the list before anyone had had a chance to consult. A selected group of stakeholders was then invited to a meeting that, funnily enough, was not held in Enfield or Barnet. It was held in central London during working hours, meaning that very few people could attend—certainly not the public. I share the shadow Health Secretary’s view that that consultation was utterly flawed and it led to the decision to downgrade my hospital being made by his predecessor in 2008. Hopes were raised with the moratorium that was introduced by the coalition Government, but they were then sorely dashed. I have described my displeasure and the distress of my constituents who had their hopes raised in that shameful episode, the likes of which litter the history of Chase Farm over the past 10 years.

--- Later in debate ---

[John McDonnell]

I entirely agree. There are still members of the community who, like me, deeply regret the fact that we lost two cottage hospitals in my constituency and another in the constituency of the right hon. Member for Uxbridge and South Ruislip (Sir John Randall). We lost a whole network of cottage hospitals. I do not remember who was Secretary of State in the 1980s under the Thatcher Government, but that Secretary of State was obsessed with closing them down, and they were closed down as a result of central diktat rather than listening to people.

As other Members have said, there were consultations, and, in every case, nearly 100% of local people wanted to keep the local cottage hospital. The hon. Member for Wycombe (Steve Baker) said that we were running a socialist health service. Well, my socialism is grass-roots socialism—community socialism—which means listening to local people and respecting their wishes. Local people often know intuitively what is right, and that is why I am so anxious about any further powers being put in the hands of the Secretary of State.

[Steve Baker]

Not for the first time, I find myself gently agreeing with the hon. Gentleman. I think that he has advanced a magnificently Conservative argument, and I look forward to his eventually matching the colour of his tie with the colour of his rosette.

[John McDonnell]

I will send the hon. Gentleman a few books about council socialism and the socialism of the grass roots.

Today’s debate is about trust, about listening to local people, and about not allowing any further powers to accrete in the Secretary of State’s hands and override local wishes. People do not trust central Government. That is not a party-political point; I think that people have been ill used over a long period by not being listened to at local level, which is why I urge Members to support the new clauses and the amendment.

Let us not denigrate organisations such as 38 Degrees which are merely expressing a view. Others may not agree with that view, but it has been expressed to me not just by 38 Degrees, but in e-mail after e-mail and letter after letter from people whose views I respect because they have gone through the same local experience as me. All that those people want is long-term stability and investment in a publicly funded and democratically accountable health service.

Oral Answers to Questions

Steve Baker Excerpts

Tuesday 25th February 2014 Commons Chamber

[Mr Hunt]

The difference between donors to the Conservative party and donors to the Labour party is that our donors do not write our policies. While we are talking about private sector health care providers, I remind the hon. Gentleman of what an unnamed shadow Cabinet Minister told The Independent last week:

“We all remember when Andy was Health Secretary and happily contracting out bits of the NHS to the private sector… You have to ask yourself what’s changed.”

[Steve Baker (Wycombe) (Con)]

The NHS diagnostic centre in Wycombe, which is operated by the private sector, does a fantastic job. Will the Secretary of State join me in congratulating and thanking Opposition Members for all that they did to extend private and independent provision in the NHS?

[Mr Hunt]

I am happy to do that. My hon. Friend may be interested to know that in the last four years of the last Government, private sector contracts in the NHS doubled—something that this Government have not been able to match. It is important to look at the facts before we start any hares running with respect to privatisation.

Oral Answers to Questions

Steve Baker Excerpts

Tuesday 26th November 2013 Commons Chamber

[Mr Hunt]

I wish the hon. Lady had been as diligent in asking that question of Labour Ministers, who also handed back underspends to the Treasury when they were in power.

[Steve Baker (Wycombe) (Con)]

Along with county colleagues, I wrote to the Secretary of State on this subject, because Buckinghamshire Healthcare NHS Trust is relatively underfunded compared with the rest of the country and it is in special measures following the Keogh review. Further to the answer that he gave to the earlier question, when can we expect the NHS England funding settlement to reflect more equitably the age of the public?

[Mr Hunt]

I commend my hon. Friend for the campaigning he does for high standards in his local trust. That has not been easy because, as he says, there have been a lot of problems there, although I hope he thinks that we are beginning to turn a corner. The decision on the funding allocations will be made by NHS England before Christmas, and the things that he says will, of course, be taken into account.

Pharmacies and the NHS

Steve Baker Excerpts

Wednesday 20th November 2013 Westminster Hall

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

It is a pleasure to serve under your chairmanship this morning, Dr McCrea. I congratulate my hon. Friend the Member for Ipswich (Ben Gummer) on securing the debate. I have tried on one or two occasions to get a debate on pharmacy, and he has beaten me to it and introduced the debate very successfully. No doubt he has more pull with the Speaker’s Office than I do. I thank the Minister for attending, too.

I got involved in the pharmacy story when in the 1990s resale price maintenance on non-prescription medicines became a big issue. The chief executive of Asda—I do not think that he was a Member at the time—was very keen to get rid of RPM on non-prescription medicines because he felt the market should be much more open. Quite a debate has taken place over the years on how to liberalise the pharmacy market in a big way.

At that time, community pharmacists were concerned about whether their trade would be reduced and the effect on their livelihoods. We must recognise that community pharmacies play a significant role in the high street economy. People are regularly drawn into town and city centres to spend money and visit the community pharmacy at the same time. I have followed developments with interest. I congratulate and support pharmacists, who do an incredible job. As the right hon. Member for Rother Valley (Mr Barron) pointed out, they are the first point of contact for people who need help.

I understand the concern of my hon. Friend the Member for Ipswich about the lack of liberalisation in the market and the need for transparency. I am always one for a lot of transparency—more sunlight normally produces it. During the 1980s and 1990s, the Conservative Government made sure that town centre retail developments and new supermarkets were assessed, to find out the implications for other supermarkets and food retailers. Regulation of town centres has been going on for a while. That was also to do with the sequential test.

[Steve Baker (Wycombe) (Con)]

My hon. Friend reminds me that we often complain that our town centres are in decline; he may have given us the reason.

[Oliver Colvile]

I agree that supermarkets have had an impact, but my point is about trying to protect small businesses in town and city centres.

[Steve Baker]

That is not quite what I meant. I pointed out that our town centres have been regulated for a long time, and that they are now in decline. Perhaps we should liberalise more consistently, and should have done so for a long time.

[Oliver Colvile]

The bigger issue, frankly, is car parking in town centres. Outside town centres people do not pay charges for car parking, but they do in town centres: so where do they go? In my constituency, I suspect that they end up at the Marsh Mills Sainsbury’s or elsewhere.

Two other big issues affect the pharmacy profession, one of which is the criminalisation of dispensing errors. If pharmacists make a mistake, they can be prosecuted and potentially sent to prison, whereas GPs, for whom I have a great deal of time, do not suffer the same prospect. The Department of Health is looking at that, and I hope that it will come to a conclusion on how we can equalise the situation and ensure a more level playing field.

The other issue is the sharing of data between pharmacists and GPs. I raised the matter during a recent statement from the Secretary of State for Health on the whole business of how pharmacists could play a part in helping to relieve accident and emergency units. The Government are keen to ensure that more and better data sharing takes place. I have a slight concern in that my understanding is that the process would be run by the Department of Health, but I recently read in an article that the Department was suggesting that the responsibility would lie much more with the local commissioning boards. If the Minister can respond to that confusion, that will be helpful.

We need to ensure that pharmacies play a much better role. They need to be the first point of call for people seeking help from professionals, as that would help to relieve GPs. During the summer recess, I visited the Keyham healthy living pharmacy, which is a brilliant organisation in a deprived community. Life expectancy differs by 11 years between the suburbs of Plymouth and Devonport, which is where the Keyham pharmacy is located. The pharmacy offers not only flu vaccinations, but also smoking cessation services and other such things. It is a service that certainly needs to be available.

Finally, there is concern about how we can improve how people feel about pharmacies to ensure that they are used in a much better way. If pharmacies were used to deliver flu vaccinations, that would take some pressure off our accident and emergency units over the winter. We have discussed an important issue this morning, and I am delighted that you, Dr McCrea, have been in the Chair to ensure that we get some positive comments.

--- Later in debate ---

[Steve Baker (Wycombe) (Con)]

I congratulate my hon. Friend the Member for Ipswich (Ben Gummer) on provoking a stimulating debate, and one in which I have learned a great deal. In particular, he emphasised the local impact that pharmacies can have, while the right hon. Member for Rother Valley (Mr Barron) clearly explained some of the opportunities that can be seized through pharmacies.

In Lane End in my constituency, a pharmacy opened alongside a dispensing GP practice, but if I remember the circumstances correctly, the practice was forbidden from serving local people; we had an absurd situation in which the purpose of the regulation made my constituents’ lives less convenient and less easy, in the interests of somehow distributing profit fairly. The debate has brought in some of the wider aspects for society and some of the things that a heavily regulatory state has messed up.

The purpose of prices, profit and loss in a market society is to guide individuals and voluntary associations into best serving society. If pharmacists wish to open a pharmacy, they should simply be able to do so, if they can find a place to do it, can do so within the law and are selling lawful products. They should be able to get on with it and serve whomever comes through the door. Instead, we have the situation described by my hon. Friend—people have to fill in a 200-page application form and might subsequently find themselves subject to particular restrictions on whom they may or may not supply.

One of the issues with a market system is that business men are profit-maximising, which is both a problem and a benefit. The problem is that business men do not like competition much, because that is what drives down prices and therefore profit. That is the crux of the matter. The purpose of the Government is not to entrench in law and regulation the tendency of business men to seek rent—excess income through capturing the state—but that is just what is happening when competition is inhibited by restrictions placed on a dispensing practice simply because a neighbour has opened a pharmacy. Certainly, on the siting of pharmacies, the Minister should seek to abolish rules and controls wherever he can, because they are getting in the way.

[Ben Gummer]

In my address, I omitted to mention the whole range of practice payments paid to pharmacists simply for, in effect, being open. The problem is that the opening of a new pharmacy creates a liability for the NHS to pay those practice payments, no matter who does or does not go through its doors. That shows the rather extraordinary situation that we have ended up with in respect of how pharmacies are remunerated.

[Steve Baker]

My hon. Friend is absolutely right and I am extremely grateful to him for bringing that up. We pretend that we live in a capitalist society—I have said this in the House before—but if our system is capitalism, I am not a capitalist. We have an absurd hybrid system, in which the state constantly intervenes in order to give people rents. It is peculiar that we call it a free market society.

The purpose of our all being here, of course, is to improve our constituents’ lives. When I say such things, my intention is to ensure that my constituents—all our constituents—have better access to pharmacies. In the House, we have a real consensus about an increase in the services offered by pharmacists being of benefit to all our constituents. What I want is for the Government to get out of the way, not to use taxpayers’ money to provide the payments that my hon. Friend mentioned and to allow pharmacists to get on and best serve the public in a way that is in the public’s best interests—a way that can be discovered only through experimentation and entrepreneurship.

On pricing, I want to make the point that in this country we are not good at haggling. We should haggle over prices and drive them down. The hon. Member for Strangford (Jim Shannon) talked about the scandal of some simple and inexpensive medicines that ought to cost pennies, but cost very much more. What I see at work there could be something that I witnessed when I was a contractor working with Government: Departments are not good at driving down prices. They tend to accept the price that they are given—“Oh, that must be the market price.” No—they should set the market price by demanding that they are charged less and, if suppliers do not provide the goods at a lower price, they should go elsewhere.

That brings me to generics and parallel imports, a subject touched on earlier. We ought to be making sure that the big pharmaceutical firms do not hold the NHS over a barrel. I have heard some of their arguments, and of course producing a new drug is an expensive business, but we should not be held over a barrel. In a market society, people should be held to account to drive down costs and drive up quality.

Johnson & Johnson, based in my constituency, has a wonderful credo, which was written when the basis of a free society was under threat in an earlier time. That credo sets out the principles on which the industry should be founded, and one such should be: no legal privileges, wherever possible.

[Oliver Colvile]

During the all-party group inquiry, we looked at that issue. One suggestion for easy identification of who was exporting and importing pharmaceutical products in this country was to look at VAT returns—when I ran a small business and was VAT registered, I had to fill in a piece of paper that recorded what level of EU trade I had ended up doing. I approached the Treasury on the matter, but it was not willing to participate and help, but that seems to me to be a way in which we could identify who the offenders are. We had some difficulty in identifying the offenders.

[Steve Baker]

My hon. Friend has identified what might be a missed opportunity because an enormous effort is going into preventing that fraud. With the opportunities that electronic communication offers today, it should be possible to use some of that information in other contexts. With that in mind, I will turn to the internet.

Clearly, everyone wants to ensure that prescribing takes place properly, but when people have been prescribed medicines it should be possible for them to buy over the internet in appropriate circumstances. I am particularly aware that homeopaths have had great difficulty with the internet because of the need for people to present physically to buy a medicine.

We cannot have it both ways on homeopathy—either the medicines are relatively harmless and can be treated with scorn by the medical profession, in which case they should be freely available on the internet, or they are dangerous and should be tightly regulated. Homeopaths’ experience suggests that people can take responsibility for themselves and buy products on the internet.

[Ben Gummer]

My hon. Friend touches on an interesting issue. Given the fact that the Government are going to great lengths to try to get GPs to do more consultations on the internet and Skype—great news for many of my constituents, especially those in busy jobs with difficult hours—it seems obvious to extend such innovation to the dispensing of pharmaceuticals.

[Steve Baker]

My hon. Friend is right. In the 21st century, we should be waking up to the opportunities to use technology to drive down costs and drive up service. People are so busy today, so why can they not have consultations in their offices with Skype, and why can pharmacists not prescribe to offices with Skype? The solution to these problems is for the Government to abolish whatever rules and controls they can and wherever they can, and to liberalise when abolition is not possible.

[Mr Barron]

The majority of patented goods that the national health service buys are a recognition not just of cost, but of the pharmaceutical industry’s worth to the British economy—including exports, manufacturing base and so on. We export around £7 billion of pharmaceutical goods a year. Might a free market endanger that?

[Steve Baker]

We may be in danger of straying into philosophically deep water about what free markets do and do not do. Clearly, because of the moral imperatives of health care, we cannot have an unimpeded market. We have made political decisions to ensure that no one goes without health care. That has consequences, and we should accept them.

The way to deploy scarce resources in the service of the public is to allow the price system, as well as profit and loss, to run as freely as possible. When we talk about something’s worth, price is too often ascribed to things that are not subject to market transactions. Only through exchange can it be established how people value things. I do not want to go on for too long, so I will leave that to another debate, perhaps the one on the Budget.

I want to encourage the Government to liberalise and to look more closely at what can be done to enable pharmacists to set up wherever they need to in order to serve the public best.

Oral Answers to Questions

Steve Baker Excerpts

Tuesday 22nd October 2013 Commons Chamber

[Jane Ellison]

If my hon. Friend will allow me, we will perhaps need a separate conversation. I am happy to meet her afterwards to discuss the matter she has raised.

[Steve Baker (Wycombe) (Con)]

16. What steps he is taking to ensure that the NHS becomes a more patient-led organisation.

[The Secretary of State for Health (Mr Jeremy Hunt)]

The big shift we need to make is to turn the NHS into a patient-led organisation. Two measures that will help that are: independent inspections by a new chief inspector that put the patient experience at their heart; and asking every NHS in-patient if they would recommend their treatment to a friend or member of their family.

[Steve Baker]

I am encouraged by that answer. Long ago, the medical establishment was held to account by what were essentially patient-led co-operatives, and today more and more voices are asking for more patient engagement. Will the Secretary of State consider a paper brought forward by Civitas and Anton Howes calling for the incremental implementation of patient-led commissioning to close this gap?

[Mr Hunt]

No one campaigns harder than my hon. Friend on the issue of putting patients first in his constituency and throughout the NHS. CCGs have a legal obligation to involve patients in decisions about services and about them personally. The ideas in the paper he mentions are interesting, and I respect them, but given that we have brand-new commissioners and inspectors going out this year, I think we should see how the current reforms work first.

Accident and Emergency Departments

Steve Baker Excerpts

Tuesday 10th September 2013 Commons Chamber

[Mr Hunt]

I thank the right hon. Gentleman for the interest and support that he shows for his local hospital. Of course, Mid Staffs has an extremely troubled history and it would be a derogation of my duties if I did not try to sort out the problems there once and for all, but we will not make any changes that have knock-on effects on neighbouring trusts without proper assessment and making sure that provisions are in place so that they can cope with any additional pressures. The final decision about what is going to be done has not been made, but I reassure the right hon. Gentleman on that point.

[Steve Baker (Wycombe) (Con)]

The A and E crisis in Wycombe results from the closure of the department under the previous Government. Although I would love to lay the blame squarely on Labour, is not the truth that, over the life of the NHS, clinical practice and management have changed substantially? Will my right hon. Friend consider producing a White Paper that takes a holistic view of emergency and out-of-hours care so that we can have an A and E service that is fit for the 21st century?

Hospital Mortality Rates

Steve Baker Excerpts

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

Perhaps the hon. Gentleman would like to acknowledge that more money has gone to the front line as a result of the reorganisation that this Government have introduced. We have 8,000 more clinical staff now than when the Labour Government were in office.

[Steve Baker (Wycombe) (Con)]

Walter Coles died because he was forgotten. Edward Maitland died because he was fed solid food. I could name others; those are just two of the patients who have died unnecessarily. And yet high mortality rates made it on to the board’s agenda in Buckinghamshire only because of a trigger relating to concern for reputational risk. The board had no robust risk management practices in place, and there were no plans to introduce any. Furthermore, certain key elements relating to changes in urgent care were missing. In setting out to champion patients, will my right hon. Friend set out how it will be possible to remove an entire board, or any members of a board who are not performing well?

[Mr Hunt]

Absolutely. I congratulate my hon. Friend on his extraordinary campaigning on behalf of his constituents. It is very difficult for a local Member to take on his own hospital when he finds failings, but he does it with great bravery. Yes, we need to ensure that the way we judge hospitals is not just about meeting waiting time and A and E targets, important though they are; it must also be about safety, about compassionate care and about governance. Other things matter as well. That is what we are changing.

Accident and Emergency Waiting Times

Steve Baker Excerpts

Wednesday 5th June 2013 Commons Chamber

[Mr Stephen Dorrell (Charnwood) (Con)]

I welcome the fact that we are debating increased evidence of service pressures in the national health service. Having attended health debates in the House of Commons for quite a few years, I can say that there is a depressingly familiar tone to this debate. May I tell the right hon. Member for Leigh (Andy Burnham) that if we want to develop party points in the House and convince the electorate that there is something in it, it is not a bad idea to begin by establishing where the real differences exist between the Government and the Opposition? If we look at the evidence for why we have experienced increased service difficulty in the health service, we see that it is not the differences between the Government and the Opposition that are striking but the fact that there is a shared analysis. However, there is an apparent unwillingness to apply that analysis and work it through in the necessary large-scale service change that we require.

As for the roots of increased service pressures in the health service, I agree with quite of lot of what my right hon. Friend the Secretary of State said about the GP contract, but that is not why those pressures exist. Their true roots go back to the time in which the right hon. Member for Leigh was Secretary of State. In 2009, David Nicholson said that demand would go on rising in the health service, and that given the state of public finances we had to find ways of meeting that demand without continuing to make calls on the taxpayer on the scale that we had grown used to over the first 60 years in the history of the health service.

[Steve Baker (Wycombe) (Con)]

In Wycombe, ever since our A and E was closed under the previous Government, people have wanted nothing more than to get it back. It is clear that medicine has changed and that they will not do so, but does my right hon. Friend agree that there has been a long-standing failure to explain those pressures to the public?

[Mr Dorrell]

I absolutely agree with my hon. Friend. We cannot blame people in the country for not understanding the need for change in the health service if politicians never explain why that need has arisen. I quite often quote Enoch Powell—not someone who wins a consensus across the House—who as Health Minister went to the equivalent of the NHS Confederation conference, which is now under way in Liverpool, to explain the need for the change in the service model in mental health. He said in his speech that

“Hospitals are not like pyramids, built to impress some remote posterity”.

That is the case that we need to begin to explain.