Health

Debate between Alex Cunningham and Jackie Doyle-Price

Monday 9th June 2014 Commons Chamber

[Jackie Doyle-Price]

I cannot agree with the hon. Lady. The important thing is that Government Members make it clear to the NHS that we expect it to put the interests of patients at its heart. I want again to draw attention to what has happened in Basildon and Thurrock university hospitals trust because it is perhaps the best example of the profound change we have had in NHS culture over the last five years. We now have a Government, and leaders within the NHS, who are finally prepared to face up to what is going wrong and to deal with it, rather than to cover up, be complacent and say, “We’re no worse than anyone else.”

I have to say that it has been a turbulent journey for those of us involved in Basildon hospital over those five years. The shadow Health Secretary, who is not in his place, will recall coming to this House in 2009, at the same time as he spoke about Mid Staffordshire, to highlight exactly what was going wrong at Basildon. Since then I have had a number of conversations with senior managers in which I was told, “Well, we’re no worse than anyone else. You’ll find this everywhere.” That was not good enough, but after two and a half years of not making any progress at all, Members of this House had very robust discussions with Monitor and said, “This needs proper intervention.” That led to a complete change in the leadership. A new board was appointed that was more inclined to give challenge where it was due. We had a leadership team that put stronger emphasis on good clinical leadership, and a chief executive was appointed who was determined to make sure that Basildon hospital delivered the standards of care that all patients deserve. What we have had is cultural change, and cultural change comes from leadership; it does not come from legislation. As I have said in many contexts, any organisation is a creature of the person at its top, so when we get good leadership in individual hospitals we get a step change in performance.

I also wish to pay tribute to the Secretary of State for the continued emphasis he places on patients, because when the head of the NHS—the person operationally responsible here in Parliament for performance—is articulating that, it will spread the cultural change which will deliver the real change in performance. I pay tribute to Clare Panniker, Basildon hospital’s current chief executive, who has delivered this significant change in the 18 months she has been in post. She has taken Basildon from being one of the worst performing hospitals to a position where it is coming out of special measures. She has been ably supported by the chairman of the trust, who has also been prepared to give a robust challenge and to stand behind her when she was doing so. Most of all, I wish to pay tribute to all the staff at Basildon. It has not been easy for them—it has not been good for their morale to see in the newspapers regular reports of the latest horror story of poor care within the trust—but they have reacted to the cultural change that Clare Panniker has brought. They have bought into it and given good, honest feedback, and I no longer get whistleblowing letters from staff about the latest incident. They have procedures to act on things and the management then implement that change. It says a lot about the commitment of the staff in that hospital that they have bought into that process and delivered us to where we are now. We all need to learn that sunlight is indeed the best disinfectant. It is not good enough to pretend that there is not a problem when there so clearly is, and it is important that we continue to put patients at the heart of the NHS. Only by doing that will we be able to ensure that the incidents witnessed at Mid Staffs and Basildon will become a thing of the past.

I wish to turn my attention to another issue that was not mentioned in the Queen’s Speech but which is on the Government’s legislative timetable for the coming year: the plan to introduce standardised packaging for tobacco products. I have to say to the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb) that it is a very bad idea. I fully support the policy objectives of tackling tobacco consumption and, in particular, of dissuading and preventing children from ever taking up smoking, but I have worries that this tool is not effective and that its unintended consequences may bring about worse health outcomes than doing nothing at all. Sir Cyril Chantler is said to have examined that as part of his review, but I am not persuaded of the evidence. In particular, I believe that introducing standardised packaging will worsen the public health outcomes if unregulated illicit tobacco products replace the regulated ones. We all know how toxic regulated cigarettes are, but when unregulated products enter the market the health outcomes will be very much worse.

Sir Cyril Chantler has concluded that Her Majesty’s Revenue and Customs has been very effective in tackling contraband and illicit tobacco, and he has cited figures going back to 2001. Although they show an improvement, the nature of the problem has changed over that period. European Union enlargement took place during that time and there was an immediate rise in the amount of illicit tobacco, but that has been tackled, mainly through co-operation with tobacco manufacturers. That illicit tobacco was also a legal product, whereas the illicit tobacco coming into this country today is not from Europe and it is not from regulated markets; it tends to be made in places such as China and Indonesia. Some of these products are extremely nasty, with tobacco rolled with whatever is available and containing high levels of tar. I commend The Sun for the exposé it ran last week in which an illicit producer from Indonesia explained just how toxic some of his products are and how standardised packaging will help him make money by reducing the costs of production.

[Alex Cunningham]

The Government’s own inquiry showed that there would not be an increase in the amount of illicit tobacco traded in this country. Does the hon. Lady not trust her own Ministers and the report they commissioned?

[Jackie Doyle-Price]

I was quoting that report and challenging its conclusions, which are based on a flawed analysis of the market—that is what I have been trying to explain. No, I do not trust that report. It is superficial and it has been put together with a particular agenda. As I say, it will lead to unintended consequences which will be very bad for public health.

My constituency contains Tilbury docks and the Purfleet ferry terminal. Despite the best efforts of Border Force, Essex police and the port of Tilbury, these products are getting through. Despite large seizures every week, Border Force does not believe that it is getting even 10% of the illicit product that is coming into the marketplace. It is estimated that one in three cigarettes smoked in London are illicit, and a good proportion of them will come through the ports in my constituency. Standardised packs will inevitably reduce costs for illicit manufacturers, who will be able to produce the product without differentiation in brand. I believe this proposal is a charter for a lot of very nasty people to make a lot of money, and if they do, the health outcomes we wish to see will not be achieved.

Let us be frank: we are talking about packets of cigarettes sold from holdalls behind pubs for a couple of pounds. Children do not start smoking by walking into their newsagents and picking a branded product; they are introduced to smoking via that holdall, at the back of the bike sheds or at the back of pubs. When cigarettes become that cheap, because of the proliferation of illicit products in the market, these children will be smoking some very nasty things. I ask Ministers to think again, because this is not the best tool for achieving a reduction in smoking and there will be unintended consequences for public health. I ask this Minister to sit down with Border Force and understand just how difficult the fight is that it is waging against serious organised crime and smuggling.