(8 years, 8 months ago)
Commons ChamberAgain, I urge Government Members not to be so complacent. The hon. Gentleman may have seen that there was a fire in north London, around Euston, in the last couple of weeks where the London fire brigade missed its response target and, sadly, there was a fatality. I would not be so complacent if I were him, because fire services up and down the country are missing their recommended response times. If he believes that the cuts to London’s fire brigade and to fire and rescue services around the country can carry on in the way that his party proposes, I think he is putting public safety at serious risk.
The Government’s answer to the funding challenges is to have greater collaboration and greater use of volunteers. Neither is wrong in principle; the question is how they will be implemented. There are risks inherent in both policies if they are done in the wrong way. Together, they do not add up to a convincing solution for the future of emergency services. Patching two leaky buckets together does not make one that works. As the police and crime commissioner for Northumbria, Vera Baird, said today, the Bill looks suspiciously like a plan for “policing on the cheap”.
My right hon. Friend talked about leaky buckets a few seconds ago. This country has faced tremendous floods over the past few months, and fire and police services have been stretched to the limit and have drawn in resources from all over the country. What will happen if there is a much more widespread flooding problem in the future? We will not have the resources, will we?
What I have heard from my fire services in the north-west is that they did not have enough resources to cope. Greater Manchester fire services were drawn up to Cumbria when the bad weather hit, but when the flooding came down to Greater Manchester, they did not have enough resources to cover it. We heard at Christmas about a hastily concocted plan to cut the incident response units, which are there to deal with a dirty bomb. These cuts are going too far. The question the Government have to answer is simple: can they give us a guarantee that there are enough fire and police resources in place to ensure that if a major incident or Paris-style attack were to happen in one of our big cities, public safety would not be compromised? I do not believe that they have answered that question and, until they do, I will keep on asking it.
As I was saying, the Bill looks like a plan for policing on the cheap. I will come back to part 1 later, but first I will go through the measures that we support.
Part 2 deals with police accountability. Although there has been progress in that area, I think it would be accepted on both sides of the House that there is much further to go. Ongoing historical cases such as Hillsborough, Orgreave, and the Daniel Morgan murder, stand as testimony to the uphill struggle that ordinary people face in holding the police to account, even when there is clear evidence of wrongdoing. As the Home Secretary said, there is no sign that public confidence has improved, given that so many people who are dissatisfied choose not to pursue their complaint.
There is also evidence that the current system is not as fair as it should be to police officers who face disciplinary charges, with professional standards branches encouraged to adopt a heavy-handed approach. We agree with the Government that the system for handling complaints is in need of serious reform, and we welcome clarification that all complaints should be recorded, ending the confusion that comes with leaving that decision up to police officers. I give a cautious welcome to the new role for police and crime commissioners in that area, but it is still early days for PCCs, and many have yet to show that they can effectively hold a whole police force to account. An individual who is close to the force on operational matters may struggle to hold it to account on disciplinary matters. That is an open question, and the Government should not have too much trust that that will materialise.
(9 years, 10 months ago)
Commons ChamberI want to make some more progress; I will give way later.
We need to know the reasons for the increase in A and E attendance. Safely meeting that demand would require an extra eight accident and emergency departments in England, but the Government have been closing, not opening, A and E’s. That is why there is so much pressure in the system.
There has been an even more dramatic increase in the last year. NHS England figures show that there were an extra 446 extra visits to A and E in the 2014 calendar year. That is a dramatic change on the Secretary of State’s watch and the time has come for some honesty from him about the real reasons for it. Until he faces up to those reasons, however uncomfortable they may be for him, he will not be able to develop a proper solution and the situation will get worse. We cannot let that happen.
Let me list what I believe are the decisions of this Government that led to the increase. I will identify four and take each in turn. The first, as Opposition colleagues mentioned, is the decision to scrap NHS Direct and replace it with the flawed NHS 111 service. NHS 111 was originally intended to be a call-handling service, and indeed was conceived by the previous Government. It was intended to simplify access; it was intended to patch people through to the relevant agency, be it the GP out-of-hours service or NHS Direct.
However, when the present Government came into office, they made a major change: they decided that NHS 111 would not signpost NHS Direct but replace it. That was a major mistake. The established and trusted NHS Direct model, a single national contract in the public sector, was replaced with 46 patchwork contracts in the public and private sectors across the country. They replaced the model of nurses on the end of the phone, to provide reassurance for families, with call handlers and computer screens. As a result, where 60% of calls to NHS Direct were handled by nurses, with NHS 111 it is only 20%.
But the present system of call handlers and computer screens is not a case of “computer says no”. The problem is that too often it is a case of “computer says, ‘Go to A and E.’” NHS England figures show that there has been a dramatic increase, in the last year, in the number of people calling NHS 111 who are referred to A and E, or to whom an ambulance was dispatched. In November 2014, there were 67,000 referrals to A and E—a 26% increase on the same month in 2013—and 108,000 ambulances dispatched—a 20% increase on November 2013.
All these problems have led to an increase in the number of days that people are taking off as a result of stress—nurses especially. Thousands of days are being lost to the system, adding to the crisis. Should we not be appreciating the staff in our NHS hospitals, and maybe starting by awarding them the 1% pay rise that the pay review body recommended for all of them?
The Secretary of State’s decision to reject the independent advice of the pay review body about what was fair and affordable, and to single out NHS staff for exclusion from the promise that the Chancellor had made that the public sector, as part of his restraint policy, would get 1%—to say that NHS staff would get less than that—was a kick in the teeth, and was to risk staff morale just at the moment that the NHS needed to be recognising and rewarding those staff, who are working so hard to keep things going. To make inflammatory comments such as those that the Secretary of State has made in the newspapers today is the wrong response. He should be getting back round the negotiating table with those staff. He should be working with them to find solutions. They are keeping the NHS going right now, and they deserve a bit better than they have had off this Secretary of State.
(10 years, 5 months ago)
Commons ChamberI will give way to the hon. Gentleman before the end of my speech, but not now; I will do so when I am ready, because I want to develop my point, which is this: a successful NHS was thrown into chaos by reorganisation. Four years after Lansley’s big bang, the dust has still not settled. People out there are struggling to make sense of the 440 NHS organisations that have replaced the 163 that the Government inherited. They cannot make it all fit together and so are still sweeping up the mess. It was always nonsense to commission local GP services from a national level. To correct that, NHS England is now suggesting a new round of structural changes. This is the reorganisation that never ends. It is now rumbling into the fifth year of this Parliament. In fixing one problem, I fear the Government are going to create another—a local conflict of interest with GPs commissioning GPs. The truth that they do not like to face is that the former Health Secretary presented a defective and confused plan, and they now know, in their heart of hearts, that instead of pausing it, as they did, they should have stopped it altogether. They did not, and however much they tinker it will never make sense.
That is why the only Bill in the Gracious Speech with any link to health is the one that tries to clear up the mess of reorganisation. The small business, enterprise and employment Bill restricts redundancy payments to public officials. If ever there were a Bill that locked the stable door after the horse had bolted, this is surely it. When the Health and Social Care Act 2012 went through the House, there were repeated warnings from Labour Members, including my hon. Friend the Member for Leicester West (Liz Kendall), that the reorganisation would result in primary care trust staff being made redundant and then rehired, with, as a result, a huge waste of NHS resources. In June 2011, the Leader of the Opposition challenged the Prime Minister in this House on precisely that point. The Prime Minister failed to act on the warning. As a result—these are shocking figures; Government Members should listen to them—over 4,000 people have subsequently been made redundant and then rehired within the NHS. In the first three years of the reorganisation, there have been over 32,000 exit packages, averaging £43,500, and 2,300 six-figure pay-offs, 330 of which were worth more than £200,000. The total bill is £1.4 billion and counting. What a scandalous waste of NHS resources when people are waiting longer for cancer care.
We always know when this Government are on the ropes: it is when they furiously try to blame the previous Government. This time, they cite employment contracts, but that excuse will not wash. Given that they were explicitly warned about this when their health Bill was going through the House before the reorganisation took place, people will ask why on earth they did not bring forward the measures on redundancy in this Queen’s Speech before the NHS reorganisation, not after it. It all adds up to mismanagement of the country’s most cherished asset on a spectacular scale.
I would like my right hon. Friend to know about Port Clarence, a very isolated community in my area which lost the nurse it had for four hours a week. People are having to go through a tremendous tangle within the NHS to find out who is responsible. The local doctors cannot commission the service because they provide the nurse, so they have to go to NHS England, yet we cannot get any progress. It is a terrible state of affairs.
This is the point. The NHS is still struggling to make sense of the mess that the Government inflicted on it. Just when it needed clarity and leadership, what did it get? It got drift and chaos. That is the problem it is struggling to deal with.
The redundancy payments did not only cost £1.4 billion; they have also cost the NHS dearly in lost morale. I ask the Secretary of State to imagine how these redundancy payments and six-figure pay-offs look to the staff to whom he has just denied a 1% pay increase—an increase that would have cost a fraction of that £1.4 billion. The truth is that he does not know how they feel because he refused to meet front-line staff protesting about his decision at the NHS Confederation conference. Well, I did meet them, and I can tell him how they feel. They find it truly galling and feel that they have been singled out by the Secretary of State, whose decision seems like a calculated snub. May I suggest that he urgently reconsider this approach and find the time to sit down with staff representatives? Right now, a fragile NHS simply cannot afford a further drop in staff morale. The Chancellor promised this increase and the pay review body judged it affordable; the Secretary of State should honour it.
The truth is that a whole lot more is needed if the NHS is to be put back on track. It finds itself today in a dangerous place. It is facing escalating problems but has a Government who will not talk about them.
(10 years, 8 months ago)
Commons ChamberI hope that the Secretary of State was listening to my hon. Friend. The point I was making—he did not like it—was that there is plentiful evidence that the NHS has gone downhill in the 12 months since the publication of the Francis report. The chaos in A and E has increased, and pressure on mental health services has reached almost intolerable levels.
Trusts face great difficulties in recruiting sufficient A and E doctors—a central issue in the Francis report, as it addresses safe staffing numbers.
I agree that this is a debate about the whole NHS, and the 111 service is failing people. On Saturday night, I had direct experience of that with my six-month-old grandchild. I phoned the 111 service, but nobody could tell me when I could speak to a doctor. What did I do? I went to A and E.
That is the problem. The Government’s focus is on hospitals. All the while, alternatives to A and E are being degraded and taken away. It is an undeniable fact that it has become much harder to get a GP appointment under this Government. The Patients Association warns that it may soon be the norm to have to wait for up to a week. [Interruption.] The Secretary of State says, “Nonsense.” He should get out and speak to people. The people I speak to tell me they are getting up in the morning and ringing the surgery at 8 am or 9 am, only to be told there is nothing available for weeks. As my hon. Friend the Member for Stockton North (Alex Cunningham) said, they ring 111 and the advice given is to go to A and E.
The Government have created the situation that the Secretary of State will not address. He wants to put it all in his own terms, but this is the reality in the NHS right now and this is what has happened since the publication of the Francis report. He has put more pressure on hospitals, because he has made it harder for people to get a GP appointment, and hospitals today face greater difficulty in meeting their targets. Indeed, as I just said, in the 12 months since the Francis report, hospital A and Es have missed the target 32 times running. These issues go to the heart of what we are debating today.
(12 years, 8 months ago)
Commons ChamberNo, because we brought down NHS waiting lists to their lowest ever levels and we left patient satisfaction at its highest ever level. Those same waiting lists are going up under the right hon. Gentleman’s Government and he should be ashamed of that. He will not publish the information about the risk to waiting times because he is frightened of putting it before the House and the public, but we will remind them of the truth.
The Government proclaimed that they were going to be the most open and transparent Government in history. Today, it still says on the Treasury website in a statement of the Government’s principles for risk management:
“Government will make available its assessments of risks that affect the public, how it has reached its decisions, and how it will handle the risk. It will also do so where the development of new policies poses a potential risk to the public.”
May I suggest that the Government take down that misleading statement of policy? Their actions have left it in tatters, together with the grand claims of openness and transparency. The tribunal, they will say today, has not given us its reasons. Ministers will try to argue that the public and Parliament’s right to know about the impact of their policy decisions is outweighed by the public interest in the preservation of a safe space for policy advice.
Those arguments were considered, first, by the Information Commissioner, and subsequently by the Information Rights Tribunal. They found the opposite to be the case: that the public interest lay in full disclosure. But it does not matter; Ministers are simply re-running the arguments of a case that they have lost. They have no leave to reopen the substance of that argument, but they are not the only arguments that they have lost.
In an attempt to rescue the Bill last year, the Prime Minister made a number of claims for it. They cover issues that we know are in the local and regional risk registers which have been published. First, he said the Bill was needed as the NHS does not
“deliver the patient-centred, responsive care we all want to see”.
He cited heart services and claimed that someone in this country is twice as likely to die from a heart attack as someone in France. That was before new research in January reported a 50% fall in heart attack deaths in the past decade.
Then the Prime Minister said that cancer services were failing people, compared with other countries. That was before new research in November 2011 which showed that the NHS in the past decade achieved the biggest drop in cancer deaths of any comparable health system in the world. Thirdly, the Prime Minister and all the Ministers on the Government Front Bench have routinely trotted out the same script for years—that NHS productivity has declined in the past decade. That was before new research on NHS productivity from Professor Nick Black published in February in The Lancet showed that, far from falling, NHS productivity increased in the past decade at the same time as the NHS achieved patient satisfaction.
One by one the Government’s arguments for the Bill have fallen apart. They have comprehensively lost the argument. They have convinced nobody and now they are running scared, resorting to the only remaining option of ramming the Bill through Parliament before they are required in law to publish the real assessment of their policies.
I am sure my right hon. Friend will join me in wishing well 11-year-old Bailey Stark in my constituency as he and his family cope with his condition that means that he is unable to swallow. His mother is worried sick about the changes in the health service, which might mean that he will not get the treatment he requires in Newcastle. Does my right hon. Friend agree that that risk is all the more reason for publishing all risks, as we should know the truth about what is happening to our NHS? [Interruption.]
Members shout “Scaremongering” from the Government Benches, but the Government will not publish the evidence to back up their claims. We have read the local and regional risk registers which warn precisely of the case that my hon. Friend mentions—of damage to the continuity of care, risks to patient safety, longer waits for cancer patients, risks to child safeguarding. Those are the facts in the regional risk registers and they are the facts that Ministers are trying to withhold from the public.