North Middlesex University Hospital NHS Trust

Valerie Vaz Excerpts

Tuesday 12th July 2016 Westminster Hall

[Catherine West]

My right hon. Friend makes an excellent point about an issue that must be monitored. I look forward to the Minister reporting back on the lack of the leadership and clinical excellence that we expect on behalf of our constituents.

The cuts to public health provision will have an extra impact. I will give just one example, which many Members here have pursued—basic HIV/AIDS care. We are not doing the preventive work, and we are unnecessarily cutting back the public health budget, which will eventually lead to more people turning up at A&E or acute care departments in crisis. These issues in the health economy are all linked, and we need to do much more about all of them.

We are all aware that litigation accounts for a quarter of NHS expenditure. Why do we not get better at doing the proper work first, so that the money we spend on lawyers and expensive court cases when we get things wrong does not add up to so much? The situation is absolutely desperate. We need more investment, and we need to stop making mistakes so that we do not have to pay for litigation and so that instead of litigation there can be front-loading of resources into prevention, mental health and good-quality primary care and basic services. People accessing the NHS could then have confidence that their local service is as good as we should expect it to be.

Finally, we know that in London, there are a number of issues with the cost of living, the cost of transport and the cost of childcare for medical practitioners and nursing staff. Those issues are linked to the others that I have mentioned, and I would like to see a more robust approach from the NHS around London to the needs of those working in our hospitals and our public services. London is not like other areas, where it is cheaper to rent homes and so on. We are unable to recruit the medical practitioners and nurses we need because they cannot afford to live in the area, and we should examine that issue more energetically and not just in a theoretical way.

Thank you very much, Ms Vaz, for calling me to speak. I look forward to hearing the Minister’s conclusions.

[Valerie Vaz (in the Chair)]

I point out to the Front-Bench spokespersons that the wind-ups are starting now, and we are expecting a Division in the House at around ten to 4.

--- Later in debate ---

[Joan Ryan]

I appreciate the Minister’s expression of regret and his acknowledgement that something went badly wrong, but I take issue. A CQC report in 2014 noted added pressures in A&E that we are all aware of. I only came back into Parliament in May 2015, and over the past year a number of Members, including me, have raised the issue several times in the Chamber. We were given no information. The CQC report is very welcome, but for it to take more than three months to be published means it is of no use as a warning note with any detail. [Interruption.]

[Valerie Vaz (in the Chair)]

Before the Minister responds, there is a Division.

[Ben Gummer]

May I respond to the right hon. Lady before we suspend?

[Valerie Vaz (in the Chair)]

I do not know how long the Minister wants.

[Ben Gummer]

I will be 20 seconds, and then we can come back for part 2.

[Valerie Vaz (in the Chair)]

Okay.

[Ben Gummer]

I will answer the right hon. Lady directly. Of course there is more to do, but we are much further ahead than 10 years ago. There is no blame on any particular Government—we are further ahead than 20 or 30 years ago. The Care Quality Commission is a respected regulator that comes down with tough judgments and makes Members aware. When we come back after the Division, I will explain what we will do.

Point of Order

Valerie Vaz Excerpts

Tuesday 5th July 2016 Commons Chamber

[The Minister for Community and Social Care (Alistair Burt)]

On a point of order, Mr Speaker. As there is a slightly more relaxed atmosphere, I wonder whether the House will indulge me as I offer a broad thank you. Twenty-four years and one month ago, I answered my first oral questions as a junior Minister, and now I have just completed my last one. This is not a sudden post-Brexit resignation—it is not catching. A few weeks ago, I made it clear to the Secretary of State, the Prime Minister and the Chief Whip that, after the referendum, I would not seek a post in what I expected to be a reshuffled Government. In the event, I hope to carry on with my duties until September, but that was my last oral questions. Therefore, in taking the chance that most Ministers do not get because we never know when the end will come, I thank colleagues for their forbearance over many years in subjects as varied as child support, disability, and the Arab spring—and in the relentless pursuit of mental health data by the hon. Member for Liverpool, Wavertree (Luciana Berger). I am looking forward to taking part in more questions from another seat in the Chamber, and I wish all colleagues very well indeed.

[Valerie Vaz (Walsall South) (Lab)]

Further to that point of order, Mr Speaker—

[Mr Speaker]

I will come to the hon. Lady’s point of order, but first let me say that although that is a relatively unconventional way of expressing appreciation, the Minister of State was typically courteous in signalling in advance to me his wish to do so, and I simply want to say to the right hon. Gentleman—I think I can say it without fear of contradiction, and it was evident from the response to his point—that he is an extremely popular and respected Minister who commands widespread affection and loyalty in all parts of the House. We very much look forward to his continuing contributions, albeit in the future from the Back Benches. I thank him for what he said and the way in which he said it.

[Valerie Vaz]

Exactly on that point, Mr Speaker, may I, on behalf of everyone on the Opposition Benches, pay tribute to the right hon. Gentleman? He has been an absolutely fantastic Minister and he is a brilliant MP. Long may he continue.

[Mr Speaker]

That is extremely welcome and I thank the hon. Lady for what she has said.

Land Registry

Valerie Vaz Excerpts

Thursday 30th June 2016 Commons Chamber

[Mr Lammy]

The hon. Gentleman is demonstrating why he should be a Privy Counsellor and why he has been knighted. The Government should accept the cogent case being made by esteemed Members on the Government Benches. We are aware that there is a general sense that the Government are itching to privatise the Land Registry. Unlike with the 2014 consultation, this time around the status quo is not even being offered as an option. The wording of the consultation document is focused on how, not if, the Land Registry operation should be moved to the private sector. We know that the Government have commissioned bankers at Rothschild to size it up. We also know that potential buyers are linked to offshore tax havens. I am here today, alongside colleagues across the House, to make our opposition known and to call on the Government to think again.

[Valerie Vaz (Walsall South) (Lab)]

I congratulate my right hon. Friend on securing the debate. As a solicitor, I have often had to use the Land Registry. He is making the economic case for non-privatisation. Does he agree that the Land Registry is entirely self-funding? In fact, it has returned £126 million to the Treasury.

[Mr Lammy]

I am grateful to my hon. Friend for her intervention. I will repeat that point later.

Junior Doctors Contracts

Valerie Vaz Excerpts

Monday 25th April 2016 Commons Chamber

[Mr Hunt]

My right hon. Friend is right to say that the public will be extremely disappointed that professionals are putting patients at risk in such a way, and it is extremely tragic that they are doing so. I am afraid that I think this is a crossing of the Rubicon—crossing a line in a way that has not happened before. I think it is totally tragic, and I support the concern of my right hon. Friend.

[Valerie Vaz (Walsall South) (Lab)]

In his statement, the Secretary of State said that this was “in our manifesto”. This is about ideology, not about the NHS. If he cares about the NHS, will he hear the will of the House, contact the BMA straight after this statement and negotiate?

[Mr Hunt]

If by “ideology”, the hon. Lady means a commitment to make the NHS the safest, highest quality health care system in the world, I plead guilty to ideology. That is the NHS that I want, and that means a seven-day NHS in which we do not have higher mortality rates for people admitted at weekends. There was a time when the Labour party would have been prepared to take tough and difficult decisions to make things better for patients, but that day has passed.

Junior Doctors Contracts

Valerie Vaz Excerpts

Monday 18th April 2016 Commons Chamber

[Mr Hunt]

My hon. Friend is right. What patients want is a safe NHS where it does not matter on which day of the week they are admitted if something goes badly wrong. The big surprise here is that this is not something that the whole House can unite behind. It is something that people who believe in the NHS, as I think we all do, should strongly support. We are standing up for those patients, and I hope Labour, the party that founded the NHS, might do the same.

[Valerie Vaz (Walsall South) (Lab)]

I would be grateful if the Secretary of State could update the House on any legal action against the Department, and on whether the Department will be defending it.

[Mr Hunt]

We have two cases ongoing, and we are defending them vigorously.

Junior Doctors: Industrial Action

Valerie Vaz Excerpts

Thursday 24th March 2016 Commons Chamber

[Ben Gummer]

Reading Bevan’s remarks from 1948, as from 1946, are a revelation. There is so much truth in them. The fact is that there are parts of the BMA that want to come to a good and constructive deal with the Government. The general practitioners have just done so. It is just very sad that this once-respected trade union is being dragged to this position by the junior doctors committee. It is doing great damage to the reputation of the BMA, and, in allying themselves to that part of the BMA, great damage to the reputation of the Labour party.

[Valerie Vaz (Walsall South) (Lab)]

If the Minister really wants to avert the strike, I suggest he writes to the BMA today with a list of the sticking points and dates on which to meet.

[Ben Gummer]

Sir David Dalton wrote to the BMA with precisely that list. The BMA refused to reply to him. He made the judgment that there was no point in continuing negotiations because it was refusing to discuss, in any event, the remaining matters. The Government have to move ahead. We have been on this for three and a half years and it is better that we move ahead.

Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 22nd March 2016 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for his persistent campaigning on behalf of his local trust. He is right that there are big issues there. He is also right generally that the NHS has too rapid a turnover of chief executives. There is a new one, Stephen Eames, who is one of the top-rate NHS chief executives. The Care Quality Commission says that things are improving and mortality rates are going down. I will support my hon. Friend in every way I can to resolve the situation as quickly as possible.

[Valerie Vaz (Walsall South) (Lab)]

As the Manor hospital is in special measures, Walsall mothers-to-be are being denied the right to choose to have their babies at that hospital. Will the Secretary of State confirm that there are safe staffing levels at the Manor and at other hospitals?

[Mr Hunt]

What I can tell the hon. Lady is that we have 83 more doctors and 426 more nurses at Walsall Healthcare NHS Trust than we did in May 2010. The trust has a quality improvement plan, and it has had an improvement director since February.

Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 9th February 2016 Commons Chamber

[Mr Hunt]

The advantage of the special measures programme is that we tend to make much faster progress in turning round hospitals in difficulty than used to happen in previous years. My hon. Friend will know that, in the past five years, his local trust gained nearly 50 more doctors and more than 100 more nurses. We are making progress, but we need to do it much faster. The hospital will have my full support in getting these problems dealt with quickly.

[Valerie Vaz (Walsall South) (Lab)]

Walsall NHS trust has been placed into special measures, so what immediate action can the Secretary of State take to ensure that the Manor hospital can recruit the vital staff in paediatrics and A&E that it now needs—not agency staff, but long-term fully employed staff?

[Mr Hunt]

The hon. Lady is absolutely right that one thing that can tip hospitals into special measures is having too high a proportion of staff from agencies so that a trust cannot offer the continuity of care that other trusts can. There have been an extra 83 full-time doctors at Walsall Healthcare NHS Trust over the past five years, along with 422 full-time nurses. An improvement director started this week and we are looking to find a buddy hospital, which is what I think will help most. When it comes to turning hospitals round the fastest, we have found that having a partner hospital can have the biggest effect, as with Guy’s and St Thomas’s for the Medway.

NHS and Social Care Commission

Valerie Vaz Excerpts

Thursday 28th January 2016 Commons Chamber

[Valerie Vaz (Walsall South) (Lab)]

It is always a pleasure to follow the hon. Member for Stafford (Jeremy Lefroy), who is a great defender of the NHS, both locally and nationally. I congratulate the right hon. Member for North Norfolk (Norman Lamb), who was a very assiduous Minister; my hon. Friend the Member for Leicester West (Liz Kendall), who is not in her place but who was an assiduous shadow Minister; and the hon. Member for Central Suffolk and North Ipswich (Dr Poulter), who unfortunately cannot be here but who was also an assiduous Minister and a member of the Health Committee.

It is with great difficulty and a bit of sadness that I say that I do not support the motion. I know that it comes with great heavyweight backing from public figures—MPs and former Ministers—but I do not think that it will take the debate forward. When we set up a commission, it can feel like we are kicking something into the long grass, and that is what it feels like we are doing today. This issue has been going on for a long time, and it is, I feel, a lack of political will that is failing to drive the changes forward.

We have had the evidence. There has been a pilot scheme, which was set up by my right hon. Friend the Member for Leigh (Andy Burnham) in Torbay in 2009. The integrated care trust is operating. A former Secretary of State for Health, Stephen Dorrell, who was a very good Chair of the Select Committee on which I served, gave an interview on 22 January in The House magazine in which he recalls asking an adviser:

“What is the oldest quote from a health minister saying how important it is to join up health and care services?”

This answer came back:

“Dick Crossman, the Health Secretary in the late 1960s.”

That is how long this issue has been going on, and it has cross-party support.

I want to touch on what some hon. Members have been saying about cross-party support. Perhaps I have been on a different planet, or perhaps, a bit like Bobby in “Dallas”, I have woken up and it is all a dream, but I recall being on a cross-party Health Committee, ably chaired by Stephen Dorrell, that produced many reports, but never a minority report. We came up with a number of conclusions that Members are now saying that we should consider.

In our report on public expenditure, we said that very little of the money spent by the NHS on people with long-term conditions was spent in an integrated way, which meant that significant amounts of money were wasted. In our report on commissioning, we said the NHS Commissioning Board should work closely with local commissioning bodies

“to facilitate budget pooling and service integration to reflect patient priorities.”

In our 12th report of the 2010-12 Session on social care, we said that efficiency savings would not be possible without further integration between health and social care. That has been an aim of successive Governments, but has not been properly achieved.

In our 11th report of the 2012-13 Session, “Public Expenditure of Health and Social Care”, we said that

“health and wellbeing boards and clinical commissioning groups should be placed under a duty to demonstrate how they intend to deliver a commissioning process which provides integrated health, social care and social housing services in their area”

and that there was

“evidence, for example, that 30% of admissions to the acute sector are unnecessary or could have been avoided if the conditions had been detected and treated earlier through an integrated health and care system.”

In our seventh report of the 2013-14 Session, “Public Expenditure on Health and Social Care”, we said that

“fragmented commissioning structures significantly inhibit the growth of truly integrated services.”

In our second report of the 2014-15 Session, “Managing the care of people with long-term conditions”, we said that

“in many cases commissioning of services for LTCs remains fragmented and that care centred on the person is remote from the experience of many”

and that an integrated approach was necessary to relieve pressure on acute care.

Members of the Health Committee, including the hon. Member for Totnes (Dr Wollaston) and my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), who unfortunately had to leave this debate to go to a young carers’ meeting in her constituency, have all sat through that evidence. I know it is real, because it will be on the website of the Health Committee. There are pages and pages of evidence on where we can get things right.

In particular, our report on “Social Care” said:

“Although the Government has ‘signed-up’ to the idea of integration, little action has taken place... The Committee does not believe that the proposals in the Health and Social Care Bill will simplify this process.”

We called for a single commissioner with a single pot of money who would bring together the different pots of money and decide how resources would be deployed.

One thing we did as part of our inquiry into health and social care was to visit Torbay, which has not been mentioned today, where we saw integrated care in action. Mrs Smith, who is fictitious but could be any one of our constituents, has one point of contact: she only has to make one phone call. Mrs Smith has seamless social care up to the health service and back again. The health service workers have been upskilled and can help her through the whole system. The local authority and the local hospital worked together so that when Mrs Smith is unwell and has to go to hospital, she can be tracked through the whole system. That is integrated care in action in Torbay. One concern was what would happen and whether such integrated systems would work under the Health and Social Care Act 2012, but I have seen it working.

There is another interesting area where integrated care is working. Another visit we made was to look at integrated care in Denmark and Sweden. In Denmark, we saw the most fabulous building in which elderly people could be cared for, and where they could be visited by GPs. It looked more like a hotel than a home. We were told, “We are looking at your system. We are looking at Mrs Smith.” At that point, we nearly fell off our chairs, because we had come to Denmark to find out how its system works.

[Norman Lamb]

I appreciate the hon. Lady’s kind words. She is talking about all the various initiatives and the need for political will, but the conclusion is that none of those things has happened. There has not been the political will because of the acutely partisan environment in which we all work. Does that not make the case for a process—which the Government could buy into and all the parties could commit to—that will deliver change in a defined period?

[Valerie Vaz]

I think that the Health Committee structure has such a purpose.

[Norman Lamb]

The Government have not bought into it.

[Valerie Vaz]

Well, they have. The Government have a responsibility to respond to the Health Committee. If the right hon. Gentleman waits until the end of the speech, he will see where I am heading. I agree with his idea that something needs to be put together. I do not like knocking good ideas on the head; I like to see such things taken forward. As the hon. Member for Stafford (Jeremy Lefroy) said, it is either “a commission or whatever”. It may be that the right hon. Member for North Norfolk has a good role to play in pulling all this together and taking forward the idea somehow, but at the end of the day, it is a political decision for the Government of the day to consider.

I want to move on to discuss my local hospital, Manor hospital, and the local authority. In Walsall, we are lucky to have a settled community, and we have one local authority dealing with the local hospital. Work is carried out by the local authority and the hospital together, and they can talk things through. When difficulties arose at the hospital in Stafford—the A&E closed, and we had to take on extra maternity services—it was much more difficult, taking on patients from different areas, to deal with local authorities in different areas. Such relationships had not been built up, but they can be built up and, with the best will in the world, I am sure they will be. We know that workers in the health service work very hard and extremely well together to ensure that such relationships exist. If that works for one local authority, I am sure it can work for other neighbouring authorities.

Interestingly, the right hon. Member for North Norfolk has involved two former Secretaries of State for Health, Alan Milburn and Stephen Dorrell, in his commission. If I was really cruel, I might say that they were Secretaries of State for Health, so why did they not do something about it then and why do they think they can do something about it now? As I have said, there is a way forward. Many Members have alluded to the myriad reports. The King’s Fund has produced a report, the Nuffield Trust has produced one and many universities have produced reports. There have been lots of words, but we need a little more action.

My only difficulty with the proposed commission is the accountability structure. I am not sure who it would report to and there would be no obligation on the Government to respond to it in the way that they have to respond to the Health Committee.

I want to touch on the issue of money. We had a reorganisation of the health service that cost £2 billion and counting. If the Government can sit down with a company to reduce its tax liability and, hence, what flows into the coffers of the Treasury, that has an enormous impact on the Mrs Smiths of this world and on all of us. That is why, as our second report of 2014-15 stated, the Government said in evidence to the Select Committee that

“the ambition of achieving integrated health and care services by 2017 had been given ‘quite a turbo charge’ by the introduction of the Better Care Fund”.

The then Minister of State, the right hon. Member for North Norfolk, said that

“by 2015 the whole country will be starting to see a significant change.”

That may be something that the Health Committee could look at and produce a report on or even that the “commission”—in inverted commas—or whatever it is that the right hon. Gentleman and his colleagues extract from the Government could consider.

We have the evidence—we have the care trust and the pilot—and, in the Government’s own turbo-charged words, we have the will, hopefully. Finally, I am not persuaded that a commission will bring about the change that all of us so desperately need.

Infected Blood

Valerie Vaz Excerpts

Thursday 21st January 2016 Commons Chamber

[Jane Ellison]

I thank the hon. Gentleman for that question and his sustained interest over such a long time, speaking on behalf of people from his area. Based on our previous conversations, I recognise there might be aspects of the proposals that the hon. Gentleman does not feel meet his own aspirations, so again I invite him to respond to the consultation. I will take note of his—and all other Members’—views. These are our proposals. Some of the questions are very open and people can give us their views. I recognise that something different happened in the Republic of Ireland, and it is down to another Government to make those decisions. The circumstances were different for reasons I have gone into previously from this Dispatch Box.

[Valerie Vaz (Walsall South) (Lab)]

The Minister will know that some of the cases go back many years and the medical records may have been destroyed. Can she say in a little more detail what evidence is required both at the assessment stage and for those applying to the discretionary fund?

[Jane Ellison]

In truth, it is a little too early for me to give that level of detail. We want to ask for expert advice on that in order to get it right and, as I said in the statement, we are looking at the impact on people’s health now. We do not want this to be an invasive or onerous process for the people, who have gone through so much already, so we envisage involving people’s own clinicians as well as gathering other evidence. This is something we will ask experts to advise us on and we will come back at the end of the consultation.