NHS Commissioning Board (Mandate)

Steve Brine Excerpts

Tuesday 13th November 2012 Commons Chamber

[Mr Hunt]

The hon. Member for Strangford (Jim Shannon) may know that there is a mental health helpline specifically for veterans because we recognise the importance of this decision. He will also have seen from the mandate that mental health is mentioned in virtually every part of it, whether in the context of avoiding mortality from extreme mental illness or helping people with long-term conditions, which would also cover post-traumatic stress disorder.

[Steve Brine (Winchester) (Con)]

The Secretary of State rightly places survival rates at the top of his agenda and identifies the importance of early diagnosis. When it comes to breast screening, the switch to digital is critical in spotting cancer early. Does he agree that the NHS must move faster in making that switch to digital?

[Mr Hunt]

I absolutely agree. That can be hugely transformational in terms of patient outcomes. Many patients would be astonished to know that a full medical record is not available to consultants in hospitals before they operate on them. We need to put that right because it could transform the decisions that surgeons take in extreme cases. So my hon. Friend is right, and we must press on with this very fast.

Business of the House

Steve Brine Excerpts

Thursday 6th September 2012 Commons Chamber

[Mr Lansley]

Matters relating to honours are matters for the Prime Minister.

[Steve Brine (Winchester) (Con)]

I welcome the new Leader of the House to his post. I know he will do well for the House, as he did day in, day out for the health service in the last two-and-a-half years in government.

My right hon. Friend was present for the end of Department for Business, Innovation and Skills questions, and he will have heard the representations made about the Post Office. May we have a statement from the new Minister with responsibility for the Post Office about the Driver and Vehicle Licensing Agency contract? The Government say they support post offices and making them viable front-office businesses. We need to put our money where our mouth is, so we are not at the mercy of a Europe-wide tendering process. Kings Worthy post office and its customers have made many representations to me over the summer, and this decision could very well close the business.

[Mr Lansley]

I did, indeed, hear the answer rightly given by the new Department for Business, Innovation and Skills Minister. I should put this matter in context. The post office local model is an excellent model, and we are seeing substantial take-up, which is in many instances reviving post office services. The Government are absolutely clear that we will not entertain a process of post office closures, which is what happened under the last Government. On the specific point, this contract process is currently live and it would not be proper for Ministers to comment or interfere during the course of that.

National Health Service

Steve Brine Excerpts

Monday 16th July 2012 Commons Chamber

[Andy Burnham]

No, it was not. Agenda for Change was one of the proudest achievements of our Government, and we always staunchly defended national pay arrangements. The hon. Gentleman talks about warnings, but I have just read out the explicit warning that was given to the current Secretary of State that this was the wrong time to reorganise the NHS. It was unforgivable to proceed in those circumstances. This was the single most reckless gamble ever taken with the NHS, and patients and staff are already proving to be the biggest losers.

[Steve Brine (Winchester) (Con)]

I was not reading the book that the right hon. Gentleman has mentioned at the weekend, but I was listening to Radio 4 last night while I was doing the washing up, as I do. I heard one of his colleagues, the hon. Member for Wigan (Lisa Nandy), say that Labour was committed to repealing the Health and Social Care Act in its entirety. Will the shadow Secretary of State tell me whether, when I am in Winchester over the summer recess, I should tell the clinical commissioning groups that are getting on with their work that all that work would be undone, and that the Hampshire primary care trust and the South Central strategic health authority would be recreated if Labour were to form the next Government?

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. We are short of time, so may I request short interventions, please?

Oral Answers to Questions

Steve Brine Excerpts

Tuesday 12th June 2012 Commons Chamber

[Mr Burns]

No. I do not think the hon. Lady is right in that—[Interruption.] As she will appreciate if her hon. Friends on the Opposition Front Bench would just hush and listen for minute, there will be allocations for public health, but there will also be allocations for acute care in clinical commissioning groups. Those will be done to reflect the needs of areas up and down the country. No one area will be penalised at the expense of another. What is more, they will be done on the basis of independent advice, as I said to the hon. Member for Chippenham (Duncan Hames) in my earlier response.

[Steve Brine (Winchester) (Con)]

15. What progress his Department has made in introducing fully digital breast screening; and if he will make a statement.

[The Minister of State, Department of Health (Paul Burstow)]

As at 1 May 2012, 74 out of 80 local breast screening services had at least one digital X-ray set, and 53 were fully digital. All services must have at least one digital X-ray set in order to enter the breast screening randomisation project and extend screening to women aged 47 to 73.

[Steve Brine]

I thank the Minister for his reply, but may I press him on making digital happen in my constituency? Where is funding responsibility in the new NHS for investment in new digital equipment and for making the switch? Does it fall 100% with the foundation trust wishing to be commissioned to provide the service, or with the body wanting to commission it, or—dare I say?—is there a third way?

[Paul Burstow]

There are three aspects to that question. The first is that we need to ensure that providers can purchase equipment at the lowest possible price. That is why NHS Supply Chain is making arrangements to ensure that digital mammography is available at the lowest possible price to providers through the various initiatives it is taking. The primary responsibility sits with the provider to provide the equipment against which they have been commissioned to provide services. Of course, in the specification it makes for the service, the commissioner will make it clear that digital is required.

Health and Social Care Bill

Steve Brine Excerpts

Tuesday 20th March 2012 Commons Chamber

[Liz Kendall]

The right hon. Gentleman might think that that on its own will protect the system, but as he well knows, I am pointing out what public health professionals are saying. [Interruption.] What I am saying is that the Secretary of State’s interpretation of the Bill is not shared by those who work in public health who think that there are huge risks in it. I was also making the point that when it comes to the fundamental issue of the control or powers of the health and wellbeing boards, we should be very clear that they do not have sign-off. That was my point.

[Steve Brine (Winchester) (Con)]

I was unfairly chuntering from a sedentary position a minute ago, and I thought I would like to place something on the record. The hon. Lady refers to the Faculty of Public Health, and I have obviously heard its public comments about the Bill. However, it is right there in new section 1B in clause 3 that the Secretary of State has a duty “to reduce inequalities”. I heard an Opposition Member chuntering from a sedentary position earlier, too, to the effect that this is a matter of faith and trust, but this House’s job is to scrutinise and enact legislation. There it is in the Bill in black and white—on green —[Interruption.] Yes, for the first time in 13 years, as I do not recall seeing it in any national health Bill before.

[Liz Kendall]

The point is that the rest of the Bill absolutely trumps that. That is the concern of others—[Interruption.] Conservative Members groan, but people who work in the system say that the Bill—[Interruption.] The hon. Member for Winchester (Steve Brine)has not stumped me. He said that one phrase in a Bill is supposedly going to outweigh the rest of the implications in the Bill, which the Faculty of Public Health says will increase the postcode lottery and widen inequalities, without providing value for money or improving the quality of services. Conservative Members should listen to the concerns of the people who work in the system.

NHS Risk Register

Steve Brine Excerpts

Wednesday 22nd February 2012 Commons Chamber

[Steve Brine (Winchester) (Con)]

I have sat in my place for a long time, and I must say that I find today’s debate deeply troubling in many respects. It is troubling because I dread to think what some people watching our debate must think. It is troubling because, as many of my hon. Friends have said, we are once again not really discussing the principles of the Health and Social Care Bill or what it will mean on the ground in constituencies such as mine. It is troubling, above all, because this Opposition day debate—I note it has fallen rather flat yet again—is not about the NHS. As my hon. Friend the Member for Kingswood (Chris Skidmore) said, it is about politics and about the latest, almost embarrassing, bandwagon rolling out of what used to be new Labour. Today’s Opposition day debate was clearly a Trojan horse for other issues; Labour has been successful in that respect. As has already been said this afternoon—and I suspect that it will be said again—the last Labour Government never routinely released risk registers. I enjoyed the analysis of my hon. Friend the Member for Kingswood, who demolished Labour’s argument earlier.

I am a member of the Justice Select Committee and Members will be aware that this week we began an inquiry into the Freedom of Information Act. The key things I want to understand from that inquiry are whether the shadow Health Secretary was right to refuse freedom of information requests during his time, and what some of the key people involved in the political birth of this Act think of it now. As luck would have it, I have some primary source material, so let us reflect on it.

There is a longer quote, but I will not spoil someone else’s thunder. I will cite what Tony Blair said in his autobiography:

“Freedom of Information. Three harmless words…I quake at the imbecility of it.”

Now, far be it for me to disagree with a former Prime Minister, but that is putting it a little strongly, in my opinion. I do not share his views, but they are, by any standards, astonishingly candid words. He went on:

“I used to say…to any civil servant who would listen: Where was Sir Humphrey when I needed him? We had legislated in the first throes of power. How could you, knowing what you know have allowed us to do such a thing so utterly undermining of sensible government?”

Well, Mr Blair should not have been so hard on himself. He built in safeguards to protect against the very undermining of sensible government—the sensible government that so concerns him now—and I believe that that is the issue we are discussing today.

Were the last Government, and the present coalition Government, right to refuse FOI risk register requests? Let me turn to the wise words of the former Cabinet Secretary Gus O’Donnell, who, when, speaking to the BBC earlier this month, said:

“The problem we face with the way FOI is working is it’s driving stuff underground or into non-FOI-able routes, as the jargon has it. You just don't know when you write something down whether that is eventually going to be decided by a tribunal of people who may have never worked in government whether or not that should be released.”

When asked if he could provide an example of the way in which the Freedom of Information Act was preventing proper discussion between Ministers and civil servants, he cited—yes, you guessed it—the topical example of the calls being made for the publication of Government risk registers, and the dangers, as he saw them, that it would have for contingency planning in the case of a nuclear Iran, when the Government might consider options which, if made public, would undoubtedly provoke an overreaction on the part of the media and the public. It could be said that today’s call from the Opposition is deeply irresponsible.

Is the coalition arguing for secret government, or is this yet another example of the devil having the best tunes, and of our not allowing the facts to get in the way of the myth? The present Government are committed to transparency, and are publishing more information than has ever been published before to help patients to make the right choices about their care. That is at the heart of the Health and Social Care Bill. Governments of all political stripes have recognised that risk registers are specific policy tools that present risks in “worst-case scenario” terms. Releasing such documents would damage the ability of Ministers to receive accurate advice, it would mislead public debate, and be detrimental to the public interest.

Many Members have referred to myths surrounding the Bill, and I have no time to go into some of them now, but let me just say that the myth that annoys and upsets me most as a new Member is that perpetuated by Opposition Members that only they care about the national health service, that only they have ever used the national health service, and that Government Members have no idea about it. Let me, in the words of the Prime Minister, bust that myth. I care deeply about the national health service, and—in the words of the Deputy Prime Minister himself—if I thought for one minute that the Bill would damage the national health service or lead to its privatisation, I would not be supporting the Government, let alone the Bill.

Oral Answers to Questions

Steve Brine Excerpts

Tuesday 21st February 2012 Commons Chamber

[Mr Lansley]

The hon. Gentleman should go back to last year and recall that not only did we consult on the White Paper, but—following the listening exercise last year with dozens of independent health professionals, who conducted hundreds of meetings with thousands of professionals across the service, who made a substantial series of recommendations, and with the Future Forum clear that the principles of the Bill were supported, just as many organisations continue to say that they support them—we took on board and accepted those recommendations. That is why the Bill, which is in another place, was supported by a majority in this House and was supported by a majority there.

[Steve Brine (Winchester) (Con)]

There has been much talk today about improving outcomes of patient care—when we move beyond the politics—so will the Secretary of State commend the excellent hyper-acute stroke service that he saw with me in Winchester just a few weeks ago? As he knows, the service rightly enjoys the support of the emerging care commissioning group. Indeed, he also met those in the group and saw how positive they are about the changes.

[Mr Lansley]

Yes, and I am grateful to my hon. Friend for the invitation that he extended to me to visit Winchester, which is now forming part of the Hampshire Hospitals NHS Foundation Trust and looking to do so very successfully. I share with him the optimism derived from a meeting with the members of the West Hampshire clinical commissioning group. They, like others across the country, are demonstrating how they will use the responsibilities that they will be given to improve care for patients.

Breast Implants

Steve Brine Excerpts

Wednesday 11th January 2012 Commons Chamber

[Steve Brine (Winchester) (Con)]

I welcome the Secretary of State’s statement. As he knows, I co-chair the all-party group on breast cancer and we will want to monitor how women are treated by the NHS and private providers, and we will certainly feed that into the Department. For women who have fought breast cancer and been through the trauma of reconstructive surgery, this will bring it all back and be tremendously upsetting. Does the Secretary of State therefore agree that speed is of the essence in respect of replacement surgery where it is wanted, so that those women can again put this nightmare behind them?

[Mr Lansley]

I am grateful to my hon. Friend and I completely recognise the points he makes. As he will know, the overwhelming majority of the approximately 3,000 women who had PIP implants through the NHS will have had them as breast reconstruction surgery following mastectomy. From day one, we were clear that we wanted all those women to be able to get advice, investigation and remedy, and removal and replacement, should they wish. If the NHS was responsible for the original operation, we will be responsible for the replacement with new implants, if that is what is wanted.

The NHS is very clear about this issue in the advice that was presented. I welcome the fact that my professional colleagues in the associations are making it clear that, through the NHS, replacement procedures for these women should be possible rapidly, but it should not prejudice the availability of urgent referral for cancer, which will continue to be an operational requirement in the NHS.

National Health Service

Steve Brine Excerpts

Wednesday 26th October 2011 Commons Chamber

[Debbie Abrahams]

No, I am sorry; I am not going to give way.

We should compare our health care management costs with those in the United States, where they run at over 20%. We need to be very careful about what we are talking about.

[Mr Steve Brine (Winchester) (Con)]

rose—

--- Later in debate ---

[Stephen Pound (Ealing North) (Lab)]

There are few areas of our work in this House that may be described, honestly and without hysteria, as matters of life and death. The national health service is so utterly central to our existence, our future and the hopes of our country that it is no surprise that the emotions it engenders are as strong as those that have been witnessed on the Floor of the House this afternoon.

I have to tell the Secretary of State that he has a problem. He is a man of great charm, he is widely liked and he is popular, yet he has not sealed the deal on his disintegration, disaggregation and atomisation of the national health service. He has not been able to persuade the Royal College of General Practitioners, which tells us that three quarters of its members oppose it. He has not been able to persuade Professor Malcolm Grant, his own choice to run the commissioning board, who describes the plan as “completely unintelligible”. The Secretary of State wishes to persuade the nation that it is appropriate, at this time of all times, to spend about £3 billion on reorganisation—money that could be far better spent dealing with the dental abscess of the hon. Member for Southport (John Pugh) and all the other problems that face us.

The hon. Member for Truro and Falmouth (Sarah Newton) spoke for many in the House when she prayed for a depoliticisation of this issue. The reality is that the national health service was born amid the gun smoke of political opposition; it was born opposed entirely by one political party in this House and supported by another. Of the supporters—

[Mr Brine]

rose—

[Stephen Pound]

Hold on a moment, I am just having a rant.

Of the supporters, let us give credit—because there once was a time when we could give credit to a decent, humane, sensible, consistent bunch of men and women—to the Liberals of those days and to Beveridge for the work that he did. Above all, let us never forget the transcendent genius of a south Wales miner’s son who left school at the age of 14, Aneurin Bevan, who gave us our national—I emphasise “national”—health service.

[Mr Brine]

I apologise profusely for interrupting a rant that I was enjoying. While we are on the subject of opposition to the conception of the national health service, can we place on record the fact that the British Medical Association also opposed it?

[Stephen Pound]

May I thank the hon. Gentleman? I do not know how anyone persuaded him to bowl me that patsy ball that I can immediately crack to the boundary. He is absolutely right. Dr Hill, the radio doctor, opposed the national health service. Aneurin Bevan said that he had had to

“stuff their mouths with gold”.

Of course the producer interest opposed the beginning of the national health service because it was about the consumers—that was its major difference. Of course the vested interests opposed the creation of the national health service—that is no surprise. But that was then.

The national health service was born in compromise. I was born in July 1948, as was the NHS. For many years I was suspected to have been the first child ever born on the NHS, in Queen Charlotte’s hospital, but somebody in Salford beat me to it.

Ovarian Cancer

Steve Brine Excerpts

Wednesday 12th October 2011 Westminster Hall

[Mr Steve Brine (Winchester) (Con)]

It is a pleasure to follow such a powerful speech. I pay tribute to my hon. Friend the Member for Pudsey (Stuart Andrew). We have worked together before, and he is getting quite a reputation for calling good debates in this place. I pay tribute to him for bringing this issue before us.

Like my hon. Friend, I come to the House with many experiences, which have shaped my life thus far. Cancer—not just ovarian cancer—has touched my life many times, and I have fought it many times. So far, it has won more times than I have, and such experiences shape the work that I do in the House.

In the next few minutes, I will not rehearse the arguments we have heard or repeat the statistics that my hon. Friend set out, but I will reinforce some of the things that have been said. Clearly, the most effective way of promoting awareness and understanding of the symptoms of ovarian cancer is to raise its public profile, and I hope that this debate will, if nothing else, go some way towards doing that.

I am a member of the all-party group and I pay great tribute to Target Ovarian Cancer and cancer charities generally, which do such an excellent job on this issue. I, too, have been struck by how effective they are as a lobby and by how powerful they are; the fact that so many Members are here today and that so many are interested in this issue is testament to that.

I thought that I would give Members a few reflections on my role as co-chair of the all-party group on breast cancer. I hope that is not insensitive; it is meant to be helpful, because there are really powerful lessons to be learned from the fight against breast cancer, and I hope that they can help women with ovarian cancer.

Thirty years ago, the breast cancer survival rate in this country was barely 50%; today, it is more than 80%. My goodness, that is testament to the effort that has been made. There have been many debates in the House, which have played a tiny role. There has also been funding, and large amounts of research and expertise have been applied to the issue. Awareness, too, has been critical. Similarly, there have been new treatments and a screening programme. All those things have made a difference, and they have all been essential to the significant progress we have achieved.

What has been key, however, has been the number of women who have been prepared to stand up and put their personal experiences on the record to keep breast cancer high on the nation’s agenda. Obviously, there have also been some high-profile deaths. There are so many to list, but what struck me, and it is often quoted, was when Linda McCartney lost her fight against the disease. So many women had grown up with the McCartneys, and her death did so much to place breast cancer on the agenda.

Breast cancer ambassadors continue to play a crucial role in raising awareness by sharing their personal experiences and promoting cancer campaigns in their local areas, as well as nationally, through the national media and through this place. That really brings home issues of which people might otherwise have remained unaware. It was not always the case that women immediately thought a lump might mean breast cancer; that was due to a huge amount of hard work and a huge number of awareness campaigns. The ambassadors really filled the gap effectively, and I hope we can see more of that in the fight against ovarian cancer.

As a member of the all-party group on ovarian cancer, I know that some representatives of the charities might be thinking that the lack of survivors makes fighting this disease more difficult, but that is a reason to try harder, not to give up. The lack of survivors means that people such as the hon. Member for Slough (Fiona Mactaggart) and other Members who take part in debates such as this are more important than ever in raising the issue and in keeping it high on the political agenda, and we will raise it again and again.

The high number of fundraising and public awareness drives promoted by the Department that the Minister represents, as well as politicians’ willingness seriously to grapple with the issue, have meant that the fight against breast cancer has retained its high profile, to the benefit of tens of thousands of women and their friends and families. Governments have produced very effective awareness campaigns over the years to encourage women regularly to check themselves and to ensure they know what they are looking for. The TLC—touch, look, check—campaign by Breakthrough Breast Cancer, which Target Ovarian Cancer works closely with, has been incredibly effective, and TLC day is part of breast cancer awareness month, which is this month. That is another exceptionally powerful way of reminding the public of that issue and of raising awareness of the fight against breast cancer.

Such simple messages, which can be spread through the champions I mentioned, can be used successfully and powerfully in the fight against ovarian cancer. We can send a bold message that women can fight the disease and beat it, and the hon. Member for Slough is wonderful living proof of that.

Many large national studies with large research grants were carried out in years gone by in the fight against breast cancer, and we need greater commitment and funding for research grants from the Government and charitable bodies at national level in fighting ovarian cancer. By demonstrating the commitment that exists in the research community to provide the wherewithal for large studies, huge strides can be made in bringing ovarian cancer to political and public attention. Perhaps the Minister can shed some light on his Department’s proposals on the future funding and commissioning of studies on the disease. Any information that he can share with us would be much appreciated.

Notwithstanding the connection between the familial forms of breast and ovarian cancer, which share the same defective genes to some extent, the age profile of the women affected is broadly similar, although, as the hon. Member for Upper Bann (David Simpson) rightly said, a striking number of younger women are affected by ovarian cancer. In that respect, I received the briefing from the Teenage Cancer Trust, which was very powerful.

It is not inconceivable that the same women who take on board the messaging about breast cancer symptoms will be open to messaging about ovarian cancer. We are always told, so it must be true, that women are much more receptive to health messages than men. That is absolutely right, so we have an important opportunity to make significant and potentially life-saving progress.

Obviously, there are still huge improvements to make in the fight against breast cancer, and that is even truer of the fight against ovarian cancer—particularly in terms of diagnosis and treatment. Like other Members, I urge the Minister to take action on ovarian cancer awareness as soon as possible. Currently, we are barely getting past first base. This is a silent killer, but it is also a silent national scandal. If we achieved what has been achieved in the fight against breast cancer in the past couple of decades through raising awareness, screening and better treatments, 3,000 of the 4,000 deaths a year from ovarian cancer might not occur. That might have saved the grandmother of my hon. Friend the Member for Pudsey, and it might have saved mine.

I ask the Minister please to ensure that the Government take swift action and make a start on dealing with this issue. At the moment, there is little DOH-led activity to improve awareness of symptoms among women and GPs, despite the fact that the Government have rightly committed themselves to saving the lives of 5,000 cancer sufferers a year as part of their excellent cancer strategy. I have worked closely with the Minister on the Health and Social Care Bill, and he knows that I am a huge supporter of that cancer strategy. With investment of £12 million in awareness work towards achieving that pledge, some might describe tackling ovarian cancer as low-hanging fruit.

The Minister said earlier in the year that the main focus for the Government’s national symptoms awareness campaign would be bowel cancer, but he also stated that new campaigns were being piloted on other cancers and their symptoms. I hope that he will update hon. Members on the progress that his Department has made in piloting the campaigns. Including ovarian cancer in the awareness budget will help the Government to meet their targets—I am sure of that—while enabling them to improve survival rates for those with ovarian cancer, which are among the worst in Europe at the moment. If they improve, the lives of many women can be saved.

Target Ovarian Cancer gave me an excellent booklet, “An MP’s guide to ovarian cancer”, shortly after I was elected, and it contains a lovely quotation from a lady whom I met at an ovarian cancer reception last year. Her name is Eilish Colclough—I always get it wrong when I attempt it—and she is a mother of five. We have seen her speak before, and she is fighting terminal ovarian cancer. She says:

“I look at myself as living not dying.”

Whenever she speaks, and whenever such patients, survivors, fighters and livers come to speak to the all-party groups that I am involved in, it is always infinitely more powerful than any Member or Minister. In my experience—and I have had a lot of it, as I have said—people with cancer are not just their cancer; they are everything else as well. I hope that we can find many more people such as Eilish—survivors—to give more proof of that, to help us fight ovarian cancer, and to drive down the number of women we lose to it.

[Several hon. Members]

rose—