NHS Investigations (Jimmy Savile)

Lord McCabe Excerpts

Thursday 26th June 2014 Commons Chamber

[Mr Hunt]

My hon. Friend makes an important point. Today’s report is about the NHS and the BBC report is ongoing, as is the report being done by the Department for Education and the work being done by other Departments. We have to wait for the BBC to make its own statement on the matter, but my priority now is NHS patients, and the reason that I wanted to go at speed on this was to make sure that any changes we need to make now, we do so.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

The Secretary of State says, quite understandably, that we cannot undo the past, but there are several people culpable in this affair who are still drawing substantial NHS pensions. Why does he not consider docking their pensions, as a consequence for their behaviour and as a clear warning to others?

[Mr Hunt]

I do not rule that out at all. If someone has behaved in a way that is in breach of either the law or the regulations that were in place at the hospital in which they worked, and there is a way to have legal redress such that things like pensions can be docked, I think that they should face the full consequences of that.

Oral Answers to Questions

Lord McCabe Excerpts

Tuesday 10th June 2014 Commons Chamber

[Mr Hunt]

Well, I must say that that sounds like a pretty irresistible offer, and I will give it careful consideration. Local community hospitals have an important role to play in our NHS because of the high standard of compassionate care that they deliver, and because they are easy for relatives to get to. I am delighted to see my hon. Friend campaigning for his local hospital, and delighted that it is doing so well.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

T2. A Birmingham trust has recently announced that it will be possible to cut 1,000 beds across the city by setting a maximum stay of seven days for most patients. Not surprisingly, this has caused some alarm. Are Ministers aware of that proposal? What guidance, if any, can they offer in regard to such proposals?

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

As the hon. Gentleman will be aware, patients need to be treated according to clinical need, and bed stays should not be determined by anything other than that. So if what he describes is actually the case, it would be very disturbing. If he would like to raise the issue further with me, I would be happy to look into it for him.

Health

Lord McCabe Excerpts

Monday 9th June 2014 Commons Chamber

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

It is great to address the packed Benches on the Government side of the Chamber. This Queen’s Speech ought to be remembered as the last Queen’s Speech of the first coalition Government since 1945. I confess I am one of those who thought that it might never happen, but to their credit the coalition Government have put aside their differences and come up with a plan for a Bill to levy a 5p charge on poly bags. That would normally earn them a place in history, but this Queen’s Speech has been overshadowed, as we saw again today, by the row between the Home Secretary and the Education Secretary. Since the theme of today’s debate is health, let me say to the Education Secretary that trying to humiliate that lady could be very bad for his health—ask the Police Federation! Perhaps he should try to recruit a retired counter-terrorism officer to mind his back.

This has always been a Government built on hype. It has been there from the beginning, when they claimed that trebling tuition fees and slashing public spending were all for our benefit and would eliminate the deficit within five years. That much heralded and rebranded long-term economic plan aims to cut the deficit by the same amount as my right hon. Friend the Member for Edinburgh South West (Mr Darling) would have achieved. What has become long term is the prospect of continuing cuts and a deficit stretching years into the future.

We were led to expect a Bill to regulate health and social care professionals, but that is absent, despite Winterbourne, the Francis report and the latest Anglia Retirement Homes scandal. I regret that, because there is little doubt that we need to regulate those professions and provide greater assurance and security to patients, residents and relatives. I want to be able to tell my constituent whose elderly relative was induced to give a loan of several thousand pounds to her carer to buy a car that something will be done and that such crooks will not get away with it. I want to be able to tell the family of Ms Jones that, if they see the call button by the bedside disabled or find their elderly relative naked from the waist down and covered in excrement, something will be done. I want to know that the people who are doing the caring have been properly vetted and have suitable qualifications and training, are supervised and will be given the time to provide the care that their patients need.

Of course I would have liked an admission that section 75 of the Health and Social Care Act 2012 was a disaster. Far from putting GPs at the heart of decision making, it has reduced clinical commissioning staff to second-rate auctioneers. At a time when Simon Stevens is calling for more local and community services to provide care for the elderly, section 75 requires doctors to act like second-hand car salesmen. The way forward is to construct models that bring together statutory and voluntary services. We need the local state working alongside bodies like churches, community groups and even neighbours. Clinical commissioning groups should be creative and imaginative; instead they are stymied by the Government’s market dogma.

As this is carers week, I would have welcomed a law that recognised the rights and needs of the users of health and care services, that empowered them so that joint commissioning bodies were not allowed to close respite care facilities because accountants advised them it was an easy saving. I am battling to protect the Kingswood bungalows in my constituency, a purpose-built facility less than 15 years old, but targeted by those whose priority is to manage the books, not the interests of patients; and my constituent with severe autism who has lived in a specialist autism community for over 17 years. It is his home, but just as we have seen the crass contempt for people’s needs with the bedroom tax, we are seeing people like him threatened with eviction because the accountants and the joint commissioning administrators think they have found a way to save a few quid. I would have liked some legislation to regulate and enforce action against those who look after their own interests while wrecking the lives of others.

I welcome the promise to raise the number of apprenticeships, because if there is one issue that threatens the health and well-being of a generation, it is the spectre of unemployment and the denial of a future for our young people, but how many will be real apprenticeships targeted on the 16-to-19 age range? As with every other bit of hype, too many of the current apprenticeships go to those over 25 and are often just an existing job that has been redesignated. This is, after all, the Government who think they can send a young graduate already engaged in productive voluntary work to Poundland to learn how to stack shelves.

A Bill promising proper training, relevant qualifications, a chance to build a portfolio of skills, real employment opportunities and the full engagement of employers: that is what young people need. If we are living in the age of micro-businesses, and self and portfolio employment, then let us give young people the training that allows them to make a go of these things, rather than leaving them to be ripped off and exploited.

Sadly, this is a Queen’s Speech with none of those relevant interests served.

Care Homes

Lord McCabe Excerpts

Thursday 1st May 2014 Commons Chamber

[Norman Lamb]

My hon. Friend is right. That is why the Government have taken steps to ensure that the Care Quality Commission can prosecute when there are examples of the new fundamental standards of care we are introducing being breached. In future, no one will be able to get away with allowing poor standards of care in their workplace. We will take action through prosecution and the fit-and-proper-person test to drive up standards.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

The Minister has spoken a fair bit about the extra powers he will give the Care Quality Commission, but staff at that agency gave the Old Deanery home a clean bill of health in November 2013. Two months later after the “Panorama” revelations they found significant failings. What will the Minister do about inspectors who failed to do their job? Will they be free to carry on as if nothing has happened?

[Norman Lamb]

I am grateful to the hon. Gentleman for raising that point. In a way, he makes the case for why the inspection regime needs to be much more robust and not a tick-box exercise. More effective inspection, with inspectors talking to staff and, crucially, relatives of those in the care home, will provide a much better picture of what is going on there. It is for the CQC as the employer to address any concerns it has about the way in which its staff have conducted themselves, but the new tough inspection regime is being introduced, with 1% of care homes already covered. It will be fully implemented by October this year.

Oral Answers to Questions

Lord McCabe Excerpts

Tuesday 14th January 2014 Commons Chamber

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

T7. The Secretary of State has had a letter from 118 specialists about the MenB—meningococcal B— vaccine. It is available to parents who pay privately, but denied to most of our children by the Joint Committee on Vaccine and Immunisation. Will the Secretary of State agree to meet the families of children who have had meningitis B and consider all the points raised by the clinicians before letting the JCVI rule out access to the vaccine?

[Mr Hunt]

I recognise the real concern over the previous advice given by the JCVI. I hope that the hon. Gentleman agrees that, on something as important as this, it is helpful to have an independent body coming to these decisions and making a ruling. When a ruling is made, we are legally bound to accept the advice, which means that there is a measure of independence. I have met families campaigning for the MenB vaccine. We are waiting to hear what the JCVI says in February. We should let it come to its conclusion after re-reviewing all the advice and the literature.

Care Bill [Lords]

Lord McCabe Excerpts

Monday 16th December 2013 Commons Chamber

[Nick Smith (Blaenau Gwent) (Lab)]

It is a pleasure to follow the right hon. Member for Sutton and Cheam (Paul Burstow).

There are many challenges for the social care sector as we continue to live longer. In Wales, 20% of our population of 3 million is over 65, and that figure is predicted to rise to 25% over the next 20 years. It is essential that our older people live their lives with dignity, respect and in safety. Other Members have mentioned the costs of care and improving hospitals, but I want to concentrate my remarks on regulation and safeguarding in care homes.

The rising number of elderly people, some of whom need residential care, has led to significant private equity investment in the social care market. In 2011, many Members were troubled by the billion-pound collapse of Southern Cross Healthcare, whose quick-buck business model caved in when the global recession arrived. The media have now reported that care providers NHP and HC-One are expected to be put up for sale soon with US private equity interest.

Private and voluntary providers now account for 92% of all residential care and nursing home places, and 89% of care home care hours are outsourced by local authorities. The Care Bill gives the CQC in England extra powers to oversee the social care market, in particular companies that are deemed “too large to replace”. I welcome that, but we may need to oversee better business models at a more local level. The Association of Directors of Adult Social Services budget survey 2013 showed that more than half of directors expect providers in their areas to face financial difficulty, given the squeeze on local authority budgets that other Members have mentioned. Perhaps those oversight powers should better cover small and medium providers too. I hope the Minister will reassure the House that the CQC will have the resources and expertise to assess whether all care home owners are fulfilling their obligations regarding their financial viability. My constituents who went through anxious times with Southern Cross would like more stable care home operators and better financial scrutiny by regulators.

The other issue I wish to address is adult safeguarding. I have previously told the House about the horrendous instances of historic neglect and abuse in care homes uncovered by Gwent police’s Operation Jasmine. The £11.6 million investigation started in 2005 and gathered 10,500 exhibits and 12.5 tonnes of documents. It led our police to brand the negligence discovered as “death by indifference”. There were 103 alleged victims of care home abuse and neglect, yet, like their relatives, I was dismayed that Operation Jasmine secured just three convictions for wilful neglect by carers. Worse, charges brought against a care home owner did not directly relate to poor care for residents in his homes, but instead to breaches of health and safety legislation and false accounting. That cannot be right.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

At a time when children’s safeguarding boards are subject to so much scrutiny and questions about their performance, does my hon. Friend share my fear that the Government may be adopting a model that is flawed and needs a great deal more work? If that model is replicated for older people and adults in need of care, we may see a repetition of the same problems.

[Nick Smith]

My hon. Friend makes a good point.

I was struck when speaking to victims’ families in south Wales that although many were regular or even daily visitors to their loved ones’ homes, they were not informed about bedsores or concerns that their relatives were not eating or drinking properly—such concerns were just brushed aside. Yes, individuals must be responsible for their actions, but what was uncovered was institutionalised neglect, with instructions on cutting back on food and incontinence pads coming from the top.

I am pleased that in Wales the First Minister has agreed a review of Operation Jasmine, led by Dr Margaret Flynn, who wrote the excellent Winterboume View hospital report. Although it will not report in time to amend this Bill, I hope the Government will consider any additional measures that that crucial review may highlight because we know that such issues are not just a problem for Wales. Information supplied by the House of Commons Library shows that, in 2011-12, 65,580 allegations of abuse of vulnerable adults aged 65 or over were made at different locations in England. Of those, 29,555—about 45%—were alleged to have taken place in care homes. This is a big national issue.

Looking to the future, we must improve the law on wilful neglect. If a patient does not die from poor care and does not have a loss of capacity under the Mental Capacity Act 2005, guidance from the Crown Prosecution Service states that a criminal offence is difficult to identify. Given that, respected groups such as Age UK support the proposal that organisations—not just employees—found to have contributed to abuse or neglect in a care setting should be liable to criminal prosecution.

Oral Answers to Questions

Lord McCabe Excerpts

Tuesday 26th November 2013 Commons Chamber

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

The Minister will know that following the neuromuscular services review an explicit commitment was made to fund a care adviser and paediatric consultant post for the west midlands. Is he willing to meet me, patients and representatives of the Muscular Dystrophy Campaign to discuss the service and that commitment?

[Norman Lamb]

I would be happy to do so. I understand that NHS England is scheduling a meeting with Birmingham Children’s Hospital NHS Foundation Trust, which I hope will make some progress in ensuring that there is sufficient co-ordinated care for people with muscular dystrophy in the west midlands.

Oral Answers to Questions

Lord McCabe Excerpts

Tuesday 22nd October 2013 Commons Chamber

[Mr Hunt]

I am greatly looking forward to visiting my hon. Friend’s hospital on Thursday and going out on the front line. I agree that we need to celebrate success. This has been a difficult year for the NHS as we have learned to be much more transparent about problems when they exist, but one of the advantages of having a chief inspector is that his team will be able to identify and recognise outstanding practice, so that everyone will understand that, as well as some of the problems that get more attention, brilliant things are happening throughout our NHS.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

Is the Secretary of State comfortable with a surgeon such as Ian Paterson flitting between the NHS and the private sector, making the same blunders in both but being subject to different levels of accountability and his victims having access to different levels of redress?

[Mr Hunt]

As I said in response to an earlier question, the responsibility to be transparent about care should apply equally in the public and the private sector. Obviously, in the public sector we have more levers, because we are purchasing care and we can impose more conditions than it is possible to do in the private sector. The most important thing is to have a culture in which such problems come to light quickly when they happen, so that they are dealt with and not repeated.

Accident and Emergency Departments

Lord McCabe Excerpts

Tuesday 10th September 2013 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. The truth is that many in the NHS had their fingers burnt when the previous Government, with the best of intentions, tried to address the problem, unfortunately with abysmal results and billions of pounds wasted. I do not think that we should let that failure stop us doing what we know can transform services. When we look at the changes that have been made in the banking, airline and retail industries, we see that we need to use the benefits of modern technology in the NHS. It will save thousands of lives.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

How could any Secretary of State imagine that it is okay to preside over a situation in which there are only five consultants working overnight in A and Es across the entire country?

[Mr Hunt]

I agree with the hon. Gentleman that consultant cover is not as good as it needs to be, and not just in A and E departments, but across NHS hospitals, so I hope that he will support me in moving forward with a seven-day NHS, which is a very big change and might be opposed by people working in the NHS. I am delighted that I can be assured of his support.

Oral Answers to Questions

Lord McCabe Excerpts

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

We are considering whether something can be done with the NHS number. At the moment, people can visit any GP and, completely legally—whether or not they are entitled to NHS care—get an NHS number. That number can then become a passport that can be used throughout the system, so we are examining whether there is a way of giving people either a temporary NHS number, or a different NHS number, that can be tracked through the system so that if they undergo complex medical care that is chargeable, we are able to trace that and collect the money from them.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

If we are to make this work, do not we need a clearer idea about the real cost? Is it the £200 million that the Secretary of State has been quoted as using, the £10 million suggested by the Prime Minister, or the £33 million that the Under-Secretary of State for Health, the hon. Member for Broxtowe (Anna Soubry), has cited in a parliamentary written answer?