Oral Answers to Questions

Alistair Burt Excerpts

Tuesday 7th July 2015 Commons Chamber

[Pat Glass (North West Durham) (Lab)]

15. What progress the Government have made on achieving parity of esteem for physical and mental health services.

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

The Government take mental health as seriously as physical health. We have introduced legislation to ensure parity of esteem, and with additional investment and the first access and waiting standards for mental health, we will hold to account and work with the NHS to achieve that aim.

[Matthew Pennycook]

There is understandable scepticism across the mental health sector about whether real-terms funding for mental health services has increased over recent years. In the interests of transparency, will the Minister commit to report on the levels of funding for mental health services that are provided nationally and to clinical commissioning groups, so that my constituents can have confidence that the Government are serious about achieving that parity of esteem?

[Alistair Burt]

I am happy to do that. There was an increase of £302 million in mental health spending in 2014-15, and there is an injunction on CCGs to ensure that a proportionate amount of any additional money they receive goes to mental health services. That is as transparent as it has ever been, and we will ensure that that standard is maintained.

[Angela Rayner]

Mental health budget cuts have hit us hard locally. I hope that the Minister will join me in paying tribute to the work of the Anthony Seddon Fund, which has raised thousands of pounds for mental health and wellbeing projects in Tameside and Failsworth? Will he promise real parity of esteem and pledge to increase mental health spending, not to cut it?

[Alistair Burt]

I refer the hon. Lady to the answer I gave to the hon. Member for Greenwich and Woolwich (Matthew Pennycook). Mental health funding is increasing, and parity of esteem is demonstrated by having access targets and targets for waiting times for the first time. Those measures could have been introduced by a previous Government but they were not, and the demonstration of parity of esteem shown by that legislation and by the increase in investment should help to reassure the hon. Lady’s constituents. I pay tribute to those who work in a voluntary capacity to assist those with mental health issues.

[Pat Glass]

In the previous Parliament the Education Select Committee said that child and adolescent mental health services were not fit for purpose, and it called them a “national scandal”. The situation is getting worse, with children and families left for up to five months without appointments. What is the Minister doing to deal with that national scandal?

[Alistair Burt]

The way that children and young persons’ mental health services have been handled over a lengthy period has been extremely poor, and many MPs have similar concerns on behalf of their constituents. That is why one of my major priorities for this Parliament is to build on the good work of the previous coalition Government, with £1.25 billion to be spent on transforming care services for children and young persons—a commitment that I think the Labour party would struggle to match.

[Sir Simon Burns (Chelmsford) (Con)]

Despite the excellent work done over the past two decades, does my right hon. Friend agree that the challenge facing us all—not only in government but among members of the public—is to end the disgraceful stigma that is associated with mental ill health, and break down the barriers of prejudice so that people suffering from mental ill health are treated in the same way as those suffering from a physical infirmity?

[Alistair Burt]

My right hon. Friend is correct. The damage that has been done over many years by not regarding mental ill health as seriously as it should be regarded, and by not having that parity of esteem, has been immense. The campaigns that have been launched against stigma, often fronted by brave people—including some in this House—have done much to correct that, but he is correct to say that the campaign against stigmatisation must continue.

[Edward Argar (Charnwood) (Con)]

The first NHS point of contact for many people with mental health issues is often their GP. Does my right hon. Friend agree that it remains vital that GPs and primary care staff have proper understanding and training in mental health care, and more broadly that such training forms a greater part of medical qualification and training?

[Alistair Burt]

Last Wednesday I spoke to 2,500 psychiatrists—if colleagues think that this audience is scary they should try speaking in front of them. The chairman of the Royal College of Psychiatrists said that there had been an increase in the uptake of the psychiatry training given to doctors before they enter general practice, which was leading to a greater interest in mental health issues. I entirely agree with my hon. Friend: it is important that such training exists because that first point of contact with GPs is crucial.

[Mike Wood (Dudley South) (Con)]

To build on that greater awareness and understanding of mental health among general practitioners, will the Minister look at ways in which we can rebalance mental health care away from an overreliance on acute care towards greater and more consistent primary care?

[Alistair Burt]

Yes, and the adaptation of new and innovative therapies will also assist. Ensuring that GPs are aware of the increased access to psychological talking therapies is making a huge difference. Initial reactions to that programme indicate that, since 2008, nearly 3 million people have had access, 1.7 million have completed their treatment, and 1 million have recovered. Increased awareness of that in primary care will be very important.

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

Last month’s Care Quality Commission report revealed serious shortcomings in emergency mental health care, including that too many people do not have access to urgent help around the clock. The lead mental health inspector said that those findings must act as a wake-up call. How is the Minister ensuring that people in a mental health emergency get the same support that we would expect them to get in a physical health emergency?

[Alistair Burt]

The extremely important report to which the hon. Lady refers was commissioned by the Government. It described the crisis care concordat, which is at the heart of dealing with mental health crises, as a “remarkable initiative”. It states:

“An extraordinary range of public services and other bodies have acknowledged their responsibilities”.

For me, it serves as a baseline for what we should do. The word “efficiency” is pointed out, not least in respect of A&E treatment of those with mental health crises. I regard it as a very good base on which to work and to gauge the success of what we do to deal with mental health crisis care over the next few years. I commend the crisis care concordat—it is in operation all over the country—as a first step towards ensuring that the sort of treatment we want in mental health crises becomes the norm.

[Margaret Greenwood (Wirral West) (Lab)]

8. Whether he expects that the efficiency savings identified in NHS England’s most recent “Five Year Forward View” will entail a reduction in staff numbers.

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[Henry Smith (Crawley) (Con)]

14. What steps the Government are taking to improve support for children and young people with mental health problems.

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

Improving children’s mental health services is one of my highest priorities. We want to achieve this by integrating mental health services for children and young people through a major transformation programme backed by additional funding; by expanding the children and young people’s access to psychological therapies; and by working with the Department for Education to develop single points of contact for mental health in schools.

[Henry Smith]

I pay tribute to the West Sussex youth cabinet that is looking into the issue of mental health provision for young people. Why does the Minister believe this area has been chronically underfunded for so long, and will he give me an assurance that this will not be the case in the future?

[Alistair Burt]

I agree with my hon. Friend when he commends the involvement of young people in discussing their services. Only last week, the Under-Secretary of State for Education, my hon. Friend the Member for East Surrey (Mr Gyimah) and I attended a youth select committee organised by the British Youth Council to do something very similar.

There are two reasons why I think these services have not been so good in the past. First, there is the difficulty of collecting information and data; and, secondly, there is the complexity of financing for services. I hope that we will address both of those, and we will ensure that people know about this so that things do not slide back by being more transparent about both.

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

T1. If he will make a statement on his departmental responsibilities.

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[Paul Blomfield (Sheffield Central) (Lab)]

T3. In March this year I had a very useful meeting involving Devonshire Green & Hanover Medical Centres in my constituency and the then Under-Secretary of State, the hon. Member for Central Suffolk and North Ipswich (Dr Poulter), who recognised the threat posed to practices that serve patients with complex, demanding, and therefore costly needs by the withdrawal of the minimum practice income guarantee. The hon. Gentleman promised to follow up that meeting, but since then we have heard nothing. Will the Secretary of State guarantee that no practice will close as a result of the withdrawal of MPIG, and what will he do to ensure that that is the case?

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

The withdrawal of the minimum practice income guarantee was announced in 2013 because it was unfair. In fact, more practices will benefit from its removal than will lose from it. As for those that will lose, NHS England is already in contact with people about transitional care support. The practices that the hon. Gentleman mentioned have received some of that support, and I understand that the conversations are continuing.

[John Glen (Salisbury) (Con)]

T5. Following my fourth Adjournment debate on the future of Public Health England at Porton Down two weeks ago, I remain concerned about value for money for the taxpayer. Will the Minister confirm that she has assessed the full value of the life sciences work at Porton Down to the United Kingdom economy, and that she remains committed to maximising the site’s potential regardless of the outcome?

[Mr Douglas Carswell (Clacton) (UKIP)]

T6. What concrete steps is the Secretary of State taking to increase the number of GPs and ensure my constituents can be seen by one when they need to be?

[Alistair Burt]

As has been discussed extensively during this Question Time, the Secretary of State has announced a programme that will include increasing the numbers training to be GPs, improving not only the recruitment but the retention of GPs, and work to make general practice more attractive to those who are worried about that. With all these measures, we will do our best to boost the position of general practice within an expanded primary care system in future, and I hope we can meet the concerns of the hon. Gentleman and his constituents.

[Heidi Allen (South Cambridgeshire) (Con)]

T7. This is a request really: will the Secretary of State please meet me and GPs from the surgery in Cambourne—which we could call a new town—who are significantly underfunded? The funding model does not work for them; they are at breaking point, and they need your help.

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[Julian Sturdy (York Outer) (Con)]

T10. The disparity in health funding allocations due to the imbalance in the system which favours deprivation over age has yet again been highlighted, this time by the British Medical Association’s annual meeting a couple of weeks ago. Having met the Secretary of State in the last Parliament, I know he is looking to address that. Will he update me and the House on this issue?

[Alistair Burt]

Yes, age and rurality come up quite regularly in discussions about funding for the contract. It can plainly be seen that there might be an increase in costs for rural areas, but it has been difficult for those involved in contract negotiations to pin it down to specific evidence. I assure my hon. Friend, however, that both age and rurality issues will remain very important for those deciding on the future contract and he can be sure that they will be taken into account.

[Natalie McGarry (Glasgow East) (SNP)]

T9. Given the proven link between poverty in childhood and ill health in adulthood, what advice has the Secretary of State given the Chancellor about not driving more children into poverty and ill health through cuts to tax credits?

[Huw Merriman (Bexhill and Battle) (Con)]

On adolescent mental care, capacity in my constituency can require lengthy in-patient care to be undertaken from Roehampton in south London. A constituent of mine makes regular visits to her young daughter making work impractical, but is unable to qualify for travel assistance as she is deemed physically able to work and does not qualify for benefits. As transport reimbursement is normally available only to those eligible for out-of-work benefits, will my right hon. Friend consider recommending widening the parameters to include those who have to travel outside their area?

[Alistair Burt]

I will look at the issue my hon. Friend raises. Clearly, in the first place, we want to make sure that more beds are available more locally, so that the issue does not arise. Greater concentration is being given not only to that, but to the level of care that can be provided before in-patient treatment is considered. I will take the point he makes about benefits and raise it with the relevant Department.

[Mr Speaker]

Extreme brevity is now required. I call Jim Shannon.

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[Rishi Sunak (Richmond (Yorks)) (Con)]

Last week, Reeth medical centre in my constituency received an “outstanding” Care Quality Commission rating. Will my right hon. Friend join me in congratulating it and recognise that small practices in rural areas are still an important part of our healthcare system?

[Alistair Burt]

I am always ready and very willing to congratulate rural practices and general practices anywhere on the work done by our family doctors and those in primary care. It is so important and it is nice that they get a big boost and a thank you every now and again, which they do not get nearly often enough. My dad would be really pleased, thank you.

[Paula Sherriff (Dewsbury) (Lab)]

A large number of my constituents have advised me that they are unable to obtain a dental appointment and inquiries reveal that not a single dental practice in my constituency is accepting new NHS patients. Will the Minister meet me as soon as possible with a view to resolving that unacceptable situation?

[Alistair Burt]

I will indeed meet the hon. Lady. Access to NHS dental practices has been improving, but I am aware that there are some difficulties in some areas. The best thing we can do is meet and talk about it, and see what I can do.

[Helen Whately (Faversham and Mid Kent) (Con)]

In the last Parliament we made great strides using transparency to drive improvement in the quality of patient care. Does my right hon. Friend agree that we can and should go further, particularly on the transparency of performance in primary and community care?

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[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

When will the Minister do more for parents whose children are on the autism scale?

[Alistair Burt]

Only last week, I met the autism board in the Department of Health. There is a widespread piece of work being done to improve access to services involving those with autism. Just last week, I went to see Linden House, which is run by the National Autistic Society. The matter is very high on our agenda, and the hon. Gentleman was right to raise it.

[Several hon. Members]

rose—

Ampthill Primary Care (Parking)

Alistair Burt Excerpts

Tuesday 30th June 2015 Westminster Hall

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

It is a great pleasure to serve under your chairmanship, Mr Howarth. Some years ago, I canvassed for the Conservative party in your by-election. I have many happy memories of that time, not least because I had the opportunity to meet regularly almost all the Conservative voters in the constituency, none of whom prevented you from being here.

I thank my hon. Friend the Member for Mid Bedfordshire (Nadine Dorries) warmly for her kind remarks, and I congratulate her on securing this important debate. She was right about a number of things, including my knowledge of Ampthill, where I have indeed bumped into her. She has been an excellent colleague and partner in a variety of matters that affect Bedfordshire, and our two constituencies abut each other. I know Ampthill well because I regularly run in the park and use the tidy tip. The significance of that is that the main street to the tidy tip from my home in Wootton is, of course, Oliver Street, so I know it extremely well. In the world of the future, new technology will make it possible for viewers of our debates to see maps of areas that we are discussing. It would be easy to project a map into a televised debate such as this. However, as we are in a Chamber full of words rather than pictures, I can merely allude to that idea.

My hon. Friend is absolutely correct in her description of Oliver Street. It is a tight street, which is closely parked. Whichever direction they travel along the street, drivers will at some stage have to stop behind parked cars and allow traffic from the other direction to pass. In the area surrounding the surgeries, there is a cluster of buildings and some car parking arrangements that my hon. Friend has described well. I emphasise that I know the street well, and I shall be happy to respond later to her comments on the car parking problems.

I shall start by talking about GP services. My hon. Friend referred in a recent blog post to the growth taking place in Ampthill. She has described the primary care group as “the Cinderella of Ampthill” and said that it has had none of the recent investment or money associated with that growth. I want to address the issue of GP care being a Cinderella service and the question of investment in Ampthill. I pay a particularly warm tribute to all who work in primary care, not least in Ampthill, and in general practice: the GPs, the practice nurses and all others who work for patients. Primary care is the bedrock of the NHS, and although we are all familiar with what happens in hospitals, too often we seem to take for granted the service that patients receive from primary care.

My hon. Friend spoke about primary care in the widest sense, and I echo that. Primary care is much wider than general practice; it is all the day-to-day healthcare provided by healthcare professionals, and thus it includes such professions as district nurses, pharmacies, dentists and other ancillary occupations. Accordingly, as my hon. Friend has said, the trend is for the expansion of primary care facilities to be more than simply GP surgeries, and the Government have recognised that. Recently, in his first speech about general practice during this Government, my right hon. Friend the Secretary of State reaffirmed the Government’s commitment to the primary care infrastructure fund. That is a fund of about £750 million spread over the next four years, which offers practices the opportunity to seek investment in premises for development and the like. Such investment is sought by way of a competitive bid, and that is being taken forward in various waves. If the practices involved have not put in a bid, it is a matter for them. Clearly, £750 million spread across the country will not solve everyone’s problems, but it recognisees the need for some practices to seek to grow and for their premises to have the sorts of ancillary functions that we will all start to take for granted as, hopefully, fewer people go to acute hospitals for treatment that can be carried out elsewhere. The modern practices of the future will do that.

Easy access has to be part of that future. There is no point in seeking to do minor ops at the various ancillary services provided in the community if people cannot park. My hon. Friend spoke about the wide range of places from which these practices draw their patients. Ampthill has a population of about 6,000, but the practices have a total of some 20,000 patients, so the majority of those patients will clearly not be walking but coming by car. It is therefore necessary to ensure that adequate facilities are available. Ensuring adequate parking will be important for the premises of the future.

Primary care probably has the widest scope in healthcare, and it includes patients of all ages, from every socioeconomic and geographic origin and with all manner of acute and chronic physical, mental and social health issues, including multiple chronic diseases. Consequently, a primary care practitioner must possess a wide breadth of knowledge in many areas. Some 90% of all NHS patient contacts take place in general practice, which is why it is important to ensure that modern general practices, and the practices described by my hon. Friend, have everything they require. What many of us think of first when we think about the primary care profession in this country over recent years is that it has developed a wide skill base and body of knowledge. GPs provide a complete spectrum of care within their local community for problems that combine physical, psychological and social components. They attend patients in surgery and primary care emergency centres, if clinically necessary, and they visit patients’ homes. GPs must be aware and take account of all factors when looking after patients.

In his recent speech, the Secretary of State made it clear that he recognises that GPs need to call on an extensive knowledge of medical conditions to be able to assess a problem and decide on the appropriate course of action. They must know how and when to intervene through treatment, prevention and education to promote the health of patients and their families. Recently, the Commonwealth Fund, an independent institute based in the United States, declared that the NHS is the best healthcare system in the world. Although many people assume that to be because of our acute hospital care, the bedrock for the research on which that determination was based turned out to be family care and general practice, which is a further reason for addressing the needs of general practice—in the widest possible sense, from availability to ease of access—as my hon. Friend has done.

Most GPs are independent contractors to the NHS. That independence means that, in most cases, they are responsible for providing adequate premises from which to practise and for employing their own staff. As we have heard from my hon. Friend, GPs are determined to do the right thing in relation to parking. It is noticeable that the three surgeries that serve Ampthill’s population of 6,000, and patients from the wider area, are located within yards of each other in the middle of town. There is already parking for staff and patients, and there is a bus service with a bus stop nearby. Oliver Street is a main through-route in Ampthill. It is busy and narrow, and the presence of a fire station, an ambulance station, a nursery and a school in the vicinity all contribute to heavy traffic, particularly at certain times of the day.

[Nadine Dorries]

I missed out a point that I want to put on the record. A fire engine was recently prevented from leaving the fire station because of congestion caused by cars coming in and out of the pre-school off Oliver Street, which is near the practices. A fire engine being trapped and unable to leave a fire station owing to traffic density is not good.

[Alistair Burt]

There are things that we are able to do and things that we are not able to do. The general traffic issues in the town are, of course, a matter for other authorities beyond the Department of Health, but my hon. Friend makes a perfectly fair point.

In the Houghton Close area, there is pressure on parking for both practice staff and patients. GP practices, as independent contractors, are responsible for providing adequate premises and for employing their own staff. In passing, I want to say a word about the way in which such practices look after their patients, which is entirely relevant. Good things are happening in primary care and in Ampthill. The key test of that is the GP patient survey, which gives patients a chance to comment on the performance of the practice where they are registered. Patients say that the three Ampthill practices—the Oliver Street, Houghton Close and Greensand surgeries—have a good story to tell. Overall, across all measures, the three practices are averaging around 90% satisfaction. Most of us would love to have that degree of satisfaction, although, Mr Howarth, you have that in your constituency, as indeed does my hon. Friend. No score of the practices is below 84%, and the scores are much higher in many domains. For example, all of Greensand’s scores are 90% or above, with 96% reporting satisfaction with their overall experience of the surgery. It is therefore clear that today’s debate concerns what patients agree are good, all-round, high-performing practices. While addressing their needs, I congratulate each practice on its commitment to providing the best service to patients, of which, to a degree, the subject of this debate is an element.

There is pressure on parking in the Ampthill area, which is why there have been recent moves, encouraged by my hon. Friend, to consider what can be done about it. In matters such as land purchases that affect the public sector, it is often advisable to take advice from the district valuer. The Ampthill practices have had discussions with the town council about purchasing a grassed area next to the fire station which they hope to convert to additional parking. NHS England is prepared to contribute part of the cost. However, the decision on whether to buy or sell the land is not for me or anyone in Whitehall; it properly belongs to the prospective purchasers and the landowners.

The town council has made a request to NHS England to fund the purchase and set up a car park to increase parking capacity in the area. The land, once purchased, would not be for the sole use of the practices but would be open to all users. The estimated cost of the land is between £8,000 and £9,000. NHS England has agreed to fund some 25% of the cost, which is believed to be a fair portion of the practices’ proposed usage of the area, with no commitment to recurring costs. NHS England was also asked to provide funding for maintenance of the parking facility. Although NHS England is prepared to contribute to the purchase cost, it is not prepared to fund the maintenance costs because it will not be the dominant or exclusive user.

My hon. Friend made a fair point about the recent addition of some 20 practice nurses in the practices at the request of NHS England, which carries a certain amount of obligation. I therefore hope that we will be able to go back and see what more can be done. In February 2015 the town council’s planning committee considered the matter and advised the practices to discuss it directly with the fire service’s landowners. I will therefore encourage the continuation of that process. We have discussed the matter further with NHS England, which is prepared to think again about the costs involved. Following this debate and the representations we have made, the way is open for my hon. Friend to further discuss the situation directly with NHS England, the town council and Central Bedfordshire Council. I am grateful for the advice of the leader of Central Bedfordshire Council, James Jamieson, to whom I spoke last night. I am pleased to accept the invitation to visit the area more formally, which will give me a great opportunity to speak to the practices involved, to see the situation on the ground and to consider whether there is anything further we can do.

Although this matter is not fundamentally the responsibility of the Department of Health, I acknowledge our interest in ensuring that these practices have what they need to provide what is obviously an excellent service to constituents, to consider the opportunity for purchasing proper parking facilities and to help and liaise in some of the discussions that will take place under other people’s auspices. Finally, I will have a chance to see the situation on the ground, rather than passing through on the way to the tidy tip or another run in glorious Ampthill Park.

I thank my hon. Friend for bringing this matter to the House today. Thank you for your chairmanship, Mr Howarth.

Question put and agreed to.

Deprivation of Liberty Safeguards Assessments

Alistair Burt Excerpts

Wednesday 17th June 2015 Westminster Hall

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

It is a pleasure to serve under your chairmanship once again, Mr Davies. I thank the hon. Member for Stockport (Ann Coffey) not only for raising an issue that she is closely involved in and has a great deal of knowledge about, but for kindly sending my office a copy of her speech to enable us to give the best possible response. I appreciate both that and the detailed but measured way in which she presented what has become a very difficult situation. She quoted the Chief Coroner as saying that

“the consequences of the law, however, may not have been appreciated at the time of enactment.”

If we all had £1 for every time that phrase was uttered, we would all be fairly rich. In answer to his quote, I would say, “You bet they weren’t,” but let me develop my argument further.

I welcome the opportunity to provide clarity and more information about what my Department is doing to support professionals in relation to DOLS. DOLS derive from the simple premise that a person who may lack capacity through a mental health disorder and is receiving care and support from the state has as much right to freedom of movement and choice as someone with full capacity. The background to DOLS is not always appreciated, but it is important, and I doubt that there is any difference between the hon. Lady and I on that point.

The phrase “deprivation of liberty” is, like “state detention”, an emotive one and derives from the legal framework. It may seem counterintuitive, but in some circumstances, a deprivation of liberty can be entirely appropriate in providing care and treatment for an individual who may lack capacity. Furthermore, it is worth emphasising that DOLS are firmly based within the Mental Capacity Act and, as such, reflect the Act’s core principles: namely, that a person’s wishes and feelings must be central to the decision-making process, and that the least restrictive form of care and treatment should be pursued wherever possible.

I stress that DOLS are a positive tool in that the assessments undertaken ensure that when a person is—in the legal sense—deprived of their liberty, it must be in their best interests. I entirely agree with the hon. Lady that where DOLS are working effectively, they can prevent unnecessary restrictive measures and prevent people with dementia from being required to stay in one place simply because it is easier for staff.

As the hon. Lady said, until March 2014 the number of DOLS assessments a year was approximately 13,000. The Care Quality Commission noted in its annual reports that that figure seemed low. Then, in March 2014, in the case of Cheshire West, the Supreme Court clarified the law on what constitutes a deprivation of liberty by setting out a so-called acid test. I will not repeat that test now because the hon. Lady and the House know it well, but it is clear that the effect of the Supreme Court judgment has been to lower the threshold for what constitutes a deprivation of liberty when compared with previous standard professional practice. Official statistics from the Health & Social Care Information Centre have borne that out, showing that there have been 113,000 applications in 2014-15—roughly a tenfold increase on the previous year.

I will turn to the wider issues related to that in a moment, but let me concentrate first on the implications for coroners, which the hon. Lady spent the majority of time dealing with in her speech. The Supreme Court’s judgment had a number of unforeseen implications. One, which I know to be of particular concern to her, is the rise in coroners’ investigations.

The Chief Coroner for England and Wales has provided guidance to coroners in which he states his view that, under the Coroners and Justice Act 2009, the death of a person who is subject to a DOLS authorisation is regarded as a “death in state detention” and, as such, should be subject to a coroner’s investigation. Helpfully however, the Chief Coroner states that coroners are able to make their own judgment on that matter. He also states that, where appropriate, any inquest could be paper-based and certainly that neither a jury inquest nor a post mortem is required. None the less, I have heard distressing reports of coroners’ investigations leading to unforeseen delays in funeral arrangements and causing great anguish for relatives.

The Department has issued guidance urging local authorities to work closely with their coroner to develop a proportionate response. I am aware that many have done so and, for the time being, that may be the way through the difficulties. I can tell the hon. Lady today that my Department will issue further guidance on this specific matter in the next few weeks. Furthermore, I commit to writing to the Chief Coroner to ensure that we are doing all we can to encourage an approach that minimises the potential distress to relatives.

[Ann Coffey]

As I think I said in my speech, part of the problem is that the Chief Coroner is a judge and his guidance is seen as a question of law. If he could perhaps make it clearer that he is giving discretion to coroners, that might also help move things forward. Might the Minister take that up with the Chief Coroner?

[Alistair Burt]

The hon. Lady, in her concluding remarks, suggested that there might be a legal challenge to the Chief Coroner, but at this stage, I am not persuaded that that would be the best way forward. Perhaps we might leave it at this: depending on the Chief Coroner’s response to my letter, I might seek a meeting with him, so that I might have the opportunity to talk to him in a slightly different manner about some problems that the hon. Lady has raised and get an opportunity to take things further. I ought to get the Chief Coroner’s written response in the first place, but I appreciate her point of view.

We want to encourage an approach that minimises relatives’ potential distress, which, as the hon. Lady set out, can be severe. The key to best practice is good communication and information exchange between partners in the system. Leicester City Council is indicative of a local authority that has worked closely with its local coroner. Together they have designed a shared protocol that includes the clear steer that, unless there are suspicious circumstances, notification of a death can wait until office hours, negating the need for distressing out-of-hours visits from uniformed police officers. In the vast majority of those cases, police involvement will not be necessary. Certainly, 999 calls are not appropriate.

I am grateful to the hon. Lady for stressing the importance of this issue. The Law Commission, which I will refer to in a second, is also looking at the issue of coroners’ investigations, and I want to see the results of that.

Let me say more about the Law Commission, having dealt with coroners to an extent. The Government’s policy is twofold in dealing with the significant challenge that has been given to local authorities and health and care providers now charged with implementing DOLS. First, we seek to understand whether legislative change can provide a system that is sustainable in the long term and that better balances the protection of individuals against the need for minimum bureaucracy to ensure that existing limited resource is maximised. Secondly, we are seeking to provide practical support and guidance to manage the challenges in the interim.

The case for a thorough review of the legislation in this area is unambiguous. The legislation underpinning DOLS was introduced by the then Government in 2007. It was criticised by Select Committees of both Houses, even before the implications of the Supreme Court judgment became clear. Following the judgment, the Government are funding the independent Law Commission to review the legislation underpinning DOLS. It will launch a four-month public consultation on a proposed new scheme on 7 July 2015.

Following the hon. Lady’s intervention, it has occurred to me that she and other parliamentary colleagues may appreciate a dedicated consultation event with the Law Commission on the parliamentary estate. If she agrees, I shall endeavour to make arrangements for that. I will contact the Law Commission to suggest such an event and I hope that it might want a session here so that it can listen to the expertise of colleagues. I am sure the commission would benefit from such expertise, and I will write to her and let her know what it makes of that suggestion.

Given the criticism of the current DOLS legislation, and bearing in mind the likelihood of unintended consequences, I strongly believe that it is important for the Law Commission to be given the time to consider the entire legislation in the round and, if appropriate, propose a comprehensive solution. It would be unwise to rush into specific legislative changes, the repercussions of which might not be clear, so I am not tempted at the moment to make any changes to the regulations.

However, I agree with the hon. Lady on greater urgency. The Law Commission’s review was scheduled to be completed, in the form of detailed policy proposals and a draft Bill, in the summer of 2017. I think, having taken up my duties, that that needs to happen quicker. Accordingly, I have proposed, and the Law Commission has agreed, an acceleration of the review to ensure that it will now be completed, in the form of detailed policy proposals and a draft Bill, by the end of 2016. I know that that is still some time away, but bearing in mind the complexity of the issue, I do not think we can afford to get the next bite at this wrong, so I hope that the hon. Lady welcomes that news.

In the interim, my Department has been working with various partners to support the system’s response to the Supreme Court judgment. I reiterate now that the response to that judgment must be rooted in the principles and values of the Mental Capacity Act. Our efforts have to be focused primarily on realising real benefits for individuals. DOLS are about people, not paperwork. My Department has issued clear guidance that has emphasised the importance of a proportionate Mental Capacity Act-centred approach, and emphasised that so-called bulk applications for all the residents of a care home are not acceptable. DOLS apply only to those who lack the specific capacity to consent to their accommodation. Many in care homes and hospitals will have that capacity and so not be eligible for DOLS. That must be made clear.

We recognise that the scale of the challenge set by the Supreme Court means that some local authorities will be unable to process DOLS applications within the 21-day legal timeframe. The Care Quality Commission has been clear that providers will not be unfairly punished for such technical breaches. However, the CQC has been equally clear, quite rightly, that a do-nothing approach is unacceptable, so providers and local authorities must have a plan in place for ensuring that those who stand to benefit most from a DOLS assessment receive one in a timely manner.

The Department has funded a reduction in the non-statutory bureaucracy accompanying the DOLS process, reducing the number of application forms from 32 to 13. The Association of Directors of Adult Social Services, which delivered that project, deserves particular praise for the support it has provided to its member organisations since the Supreme Court judgment.

The Department has funded the Law Society to produce excellent comprehensive guidance, in collaboration with practitioners, to assist in identifying a true deprivation of liberty, and in March this year, the Government announced that they would provide local authorities with an extra £25 million to support their efforts on DOLS in 2015-16.

I reassure the hon. Lady that I understand the concerns that some local authorities have about the cost of DOLS, and I praise the hard work of local DOLS teams. However, I am aware that there is considerable variation among local authorities as regards the number of applications that they have been able to process. Clearly, it is important that we identify and learn from current best practice, so my officials are in close contact with providers and local authorities, and I have instructed them to make further visits across England this summer to continue to understand the local response.

Although some may baulk at the idea of 100,000 DOLS applications a year, we should remember that every one of those applications represents a person having their care independently scrutinised. DOLS can help to shine a light on care that is unnecessarily restrictive and does not put the person’s views first and foremost. Therefore, we should strongly back the principles of DOLS. Our shared challenge now is, through the Law Commission review, to understand how those principles can be better applied in the day-to-day reality of the health and care system and after the unintended consequences of the judgment.

I thank the hon. Lady for raising these important issues. My Department and I would be grateful for any further insight she may have, conscious as we are of her expertise in the social care field. I hope that we have touched this afternoon—

[Philip Davies (in the Chair)]

Order.

Motion lapsed (Standing Order No. 10(6)).

Oral Answers to Questions

Alistair Burt Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Stephen Phillips (Sleaford and North Hykeham) (Con)]

4. What steps he is taking to reduce the burden of administration on GPs.

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

Before I respond, I should like to thank my two predecessors, who have covered most of this portfolio: my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) and the right hon. Member for North Norfolk (Norman Lamb). They have given me a firm foundation on which to build, and I am grateful to them for their work in the Department. Reducing the burden of administration on GPs is important to all of us in the Government. We have already cut the quality and outcomes framework by more than a third to help reduce administration, but we are looking for ways to do more because we recognise that this is a significant problem.

[Stephen Phillips]

Let me take this opportunity to welcome my right hon. Friend back to the Front Bench. I know that he will want to spend a lot of time in GP surgeries, and we look forward to welcoming him to Lincolnshire in due course.

I want to ask him about the use of information technology and computers during consultations with GPs. I am told by a GP in my constituency that so much time is spent collecting data and inputting them into the computer that there is a loss of focus on the patient, with a possible detriment to patient care. Will my right hon. Friend undertake to look into that and to come to the House in due course to say what can be done to ensure that, during every GP consultation, the focus is always on the patient and not on the computer?

[Alistair Burt]

Notwithstanding the importance of recording information collected during a consultation, my hon. and learned Friend’s constituent is absolutely right that it should not get in the way of the relationship between doctor and patient. We have already removed some of the administrative burdens by cutting a third of the quality and outcomes framework indicators that need to be recorded, but plainly more needs to be done. He is right to say that I am looking forward to seeing quite a lot of GP surgeries in the forthcoming months.

[Kevin Barron (Rother Valley) (Lab)]

I welcome the Minister to the Dispatch Box. Does he think that the community pharmacy could help in great ways with the proper integrated care of patients so that the burden on GP surgeries is shared with other health professionals?

[Alistair Burt]

Yes, the whole concept of out-of-hospital care involves an expansion of what is considered to be direct primary care, and it also involves other support services. I am aware of projects in which pharmacies are already connected directly to GP surgeries. We will be expanding some of the pilot work that has already been done. If my Twitter account is anything to go by, pharmacies are very keen to promote themselves and say what they can do for patients, and we will certainly be responding.

[Mark Spencer (Sherwood) (Con)]

Will the Minister pass on my thanks to the Secretary of State for visiting a GP surgery in my constituency in April? Will the Minister assure the House that during his tenure he will continue to visit GPs and to spread examples of good practice to other GPs who may have room for improvement?

[Alistair Burt]

I thank my hon. Friend for his question, and the Secretary of State will have picked up his thanks for the visit. Seeing GPs is really important. I will let the House into something that I am likely to say again, which is that my dad is a GP. I pay tribute to him, as he has just passed his 93rd birthday. I thank him and all other GPs for their devotion to practice and to looking after people so well. They are a vital part of the service. I will be keen and rather soft on GPs. I want to see them enjoy their profession as much as my father has enjoyed his.

[Karin Smyth (Bristol South) (Lab)]

What is the Minister’s plan to make GP premises fit for the 21st century?

[Alistair Burt]

I welcome the hon. Lady to her place. Briefly, there is a £1 billion fund to improve, over the next five years, GP surgeries and premises and access to GP practices. It is an important part of the process of improving access to GPs, which is good not only for patients but for GPs, who can feel fully engaged in their work without being overburdened. This support should certainly help.

[Graham Evans (Weaver Vale) (Con)]

5. What steps he plans to take to improve dementia diagnosis and care.

--- Later in debate ---

[Iain Stewart (Milton Keynes South) (Con)]

9. What proportion of their funding hospices in England receive from the NHS.

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

Adult voluntary sector hospices in England receive, on average, about a third of their running costs from the NHS. Although this amount varies for individual hospices and it is a locally commissioned service, the level of funding has remained broadly stable.

[Iain Stewart]

I delighted that my right hon. Friend is back on the Front Bench. He will know that hospices up and down the country, such as Willen hospice in Milton Keynes, do a marvellous job in caring for terminally ill patients and their families, yet they have an annual struggle to raise money from local communities to support their work. Will he assure me that he will do all he can to maximise the direct funding that hospices receive from the NHS?

[Alistair Burt]

I thank my hon. Friend for raising this subject. He is absolutely right: Willen hospice in his constituency, next door to mine, has an excellent reputation, as does St John’s hospice in Moggerhanger in my constituency. We are all indebted to hospices for the invaluable work they do. I am sure that he and the House will be interested to hear that, from April, there will be pilot projects working on a new funding formula for palliative care, with the aim of providing a fair and transparent process and improvements. I expect that there will be a report to the House in due course.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

Does the Minister agree that there is a deeper ongoing problem in the financing of hospices? Kirkwood hospice in my constituency faces it all the time. Is it not about time we tackled long term the roots of the problem of funding hospices?

[Alistair Burt]

That is probably tied into the whole issue of end-of-life care. A review of that is going on, as the hon. Gentleman may be aware. End-of-life care is important. Choices for people about where they wish to end their days is very important, and the Choice review which reported recently, whose recommendations the Government are considering, will make further progress. Hospice funding is part of that, but we expect local commissioners to take notice of what hospices can provide for those in their area.

[Suella Fernandes (Fareham) (Con)]

10. What steps he plans to take to improve the treatment of diabetes.

--- Later in debate ---

[Derek Thomas (St Ives) (Con)]

T2. Bringing health and social care together in meaningful integration is a priority for me and my constituents in St Ives. What can the Secretary of State do to help achieve this for the good people of west Cornwall and the Isles of Scilly? Will he accept an invitation to come to west Cornwall to discuss this challenge and see some of the good work that is already being done?

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

May I welcome my hon. Friend to his place? Among the many good reasons to go to Cornwall over the next few months will be to visit the Cornwall better care fund, which is part of the Government’s £5.3 billion better care fund, and get the opportunity to see the work of the Cornwall pioneer. Integration of social care and healthcare is extremely important, and it will be great to see it in Cornwall.

[Heidi Alexander (Lewisham East) (Lab)]

T3. For the first time in recent history, many of London’s more prestigious teaching hospitals—King’s College, University College London, Guys and St Thomas’s, and the Royal Free—are all forecasting deficit budgets. Apart from crossing his fingers and hoping the economy picks up to fund investment, what exactly is the Secretary of State going to do to tackle this problem?

--- Later in debate ---

[Tulip Siddiq (Hampstead and Kilburn) (Lab)]

The planned closure of a GP surgery in my constituency means that more than 1,000 patients will have to go elsewhere to seek basic primary care needs. Local doctors are particularly concerned about the impact this will have on the A&E department at the Royal Free hospital. Will the Minister agree to meet me and local doctors to address those concerns and to ensure that the future of GP surgeries in my constituency is protected?

[Alistair Burt]

I welcome the hon. Lady to her place. As has already been covered, the closure of GP surgeries is an issue. They happen from time to time. As my right hon. Friend the Secretary of State said, there will be an opportunity to meet inner-London MPs to discuss this matter.

[Mr John Baron (Basildon and Billericay) (Con)]

The all-party group on cancer has long campaigned on the importance of holding clinical commissioning groups accountable for their one-year cancer survival rates as a means of promoting earlier diagnosis. That will be part of the delivery dashboard from April onwards. What steps will the Government take to ensure that underperforming CCGs take corrective action?

--- Later in debate ---

[Pauline Latham (Mid Derbyshire) (Con)]

May I invite the new Minister with responsibility for GPs to meet me and a couple of excellent GP surgeries that want to expand their services for the local community but are being prevented by the local clinical commissioning group?

[Alistair Burt]

Of course I welcome my hon. Friend’s invitation. The innovative work being done by a number of GP practices around the country to expand services is welcomed by all; there is an opportunity to take good practice from one GP practice to another. In addition to my visit to Cornwall, I am clearly on the way to Derbyshire.

[Jack Dromey (Birmingham, Erdington) (Lab)]

With the accident and emergency crisis, over which the Secretary of State has presided, more and more police officers are queuing outside fewer A&E departments in ever-lengthening queues. Last year, there were 1,000 incidents in the Metropolitan police alone. In Liverpool, Patrick McIntosh died after waiting for an ambulance for an hour. Does the Secretary of State accept that after 17,000 police officers have been cut by his Government, this is the worst possible time to ask the police service to do the job of the ambulance service, and that he is guilty of wasting police time?

Radiotherapy Services (North East Hertfordshire)

Alistair Burt Excerpts

Wednesday 4th February 2015 Westminster Hall

[Sir Oliver Heald (North East Hertfordshire) (Con)]

This debate could not be better timed, because today is world cancer day, and the day on which we heard from the charity, Cancer Research UK, that although we are seeing better outcomes with cancer, more people are at risk. This is also an opportunity for me to ask for help for my constituents, who have to travel day after day, for many hours, to get their radiotherapy, which is tiring, dangerous, onerous and needs changing.

The situation that I am about to describe affects people not only in my constituency, but in Stevenage, North East Bedfordshire and Hitchin and Harpenden. I am glad to see my right hon. Friend the Member for North East Bedfordshire (Alistair Burt) and my hon. Friend the Member for Stevenage (Stephen McPartland) in the Chamber to support the campaign. I am also receiving great support from the public, patients and their families in seeking to ensure that radiotherapy treatment is available to cancer patients at the Lister in Stevenage, in my hon. Friend’s constituency. I pay tribute to his work in raising the issue so strongly.

I have asked questions in Parliament and have secured today’s debate. The Minister will, I know, listen to our case, and I hope that she will intercede for us with NHS England to break the logjam, so that we finally get the Lister hospital this facility, which it needs. The hospital recently opened a new cancer centre in conjunction with Macmillan Cancer Support, and radiotherapy would be an important addition. Furthermore, our local newspaper, The Comet, has long supported the cause.

Radiotherapy for people living in the Stevenage, Letchworth, Baldock and Hitchin area, and just over the border in Bedfordshire, at the moment takes place in Mount Vernon hospital in north London, in Hillingdon. It is a great hospital and the treatment is excellent but it is a difficult journey there, either by car or by the hospital bus service. That service takes all day—it collects patients at 7.30 am, delivering them back at 4 pm. Those long daily journeys are often needed for a three-week period, which is gruelling for patients and their families.

My constituents have described the visits as tiring and stressful. One young woman who is about to start treatment says:

“I am having to go for a three week stint at Mount Vernon, after my breast cancer op at Lister. I’ve been told by people in the same boat that it’s quite a stressful journey and the parking! Lister also has a small bus service pickup from your home at 7.30 back at 4ish! Daily. This is great but after all the patients go through it would be another stressful stage of getting well and to fight cancer.”

Another said:

“I had 39 Radiotherapy sessions for prostate cancer treatment at Mount Vernon Hospital. The treatment was excellent and was given by wonderful staff. Fortunately the transport was provided but this would have been saved if Lister had the appropriate facilities.”

One of the constituents of my right hon. Friend the Member for North East Bedfordshire told me:

“I am pleased to see you raising the question of installing a radiotherapy unit in the Lister Hospital. This treatment is sorely needed in N. Herts as the travel and journey is particularly onerous for what can be very repetitive and tiring treatment to Mount Vernon in Middlesex…from Stotfold where I live. Myself and two neighbours have had need of this treatment in the past 12 months…the requirement generated from a single road so the need is certainly there.”

[Alistair Burt (North East Bedfordshire) (Con)]

I have already apologised to both my hon. and learned Friend and the Minister that I am not able to stay to hear the Minister’s speech. I very much want to support my hon. and learned Friend. My constituent’s point is very pertinent. The A1 runs directly down from where that constituent was talking about to the Lister. Does my hon. and learned Friend agree that that is a perfect example of how a facility closer to north-east Bedfordshire would make all the difference to relieving our constituents’ suffering?

[Sir Oliver Heald]

I totally agree with my right hon. Friend. There are many arguments for the change. One patient from east Hertfordshire, who is a constituent of mine, said:

“Being diagnosed with cancer is devastating for the person and the family and to discover that part of the treatment involves regular journeys to north London just adds to the stress that family is undergoing.”

Another aspect to consider is patients with children. One constituent wrote to me about her daughter, who is in her 30s and has three children. She needs radiotherapy at Mount Vernon and will have to find someone to travel with her and someone to look after her children on a daily basis for three weeks. Her mother says:

“This all adds to the stress of having to deal with cancer, especially at such a young age.”

She ends her letter to me:

“Here’s hoping we are successful in making someone see sense.”

Contaminated Blood

Alistair Burt Excerpts

Thursday 15th January 2015 Commons Chamber

[Alistair Burt (North East Bedfordshire) (Con)]

I beg to move,

That this House supports a further review of the circumstances surrounding the passing of infection via blood products to those with haemophilia and others during the 1970s and 1980s; notes the recent report from the All Party Parliamentary Group on Haemophilia and Contaminated Blood into the support arrangements provided for those who contracted blood-borne viruses as a result; also notes that the Penrose Inquiry into these events will shortly be publishing its findings in Scotland; further notes that those who contracted viruses and their partners and dependants continue to be profoundly affected by what happened; therefore welcomes the Prime Minister’s commitment to look again at this issue; and calls on the Government to respond positively to the APPG report and engage actively with those affected with a view to seeking closure to these long standing events.

I will do my very best to stick to the rules, Mr Speaker, as I know other colleagues wish to speak. There is a lot to say and interventions matter, but I will do my level best. My first task is to express my thanks to a number of people. First, I thank members of the Backbench Business Committee for being good enough to allow this debate. Secondly, I thank the large number of colleagues who supported the calling of the debate: those who attended the Backbench Business Committee last week; the many others who have signed today’s motion; those who have been in contact with me; and those other colleagues closely involved. Thirdly, I give a big thanks to the all-party group on haemophilia and contaminated blood, particularly my hon. Friend the Member for Colne Valley (Jason McCartney) and the hon. Member for Kingston upon Hull North (Diana Johnson), not only for their support today, but for the immense amount of work they have put into this issue over a number of years.

Fourthly, I thank a small group of colleagues who have worked particularly closely with me: my right hon. Friend the Member for Cardiff Central (Jenny Willott); the hon. Member for Foyle (Mark Durkan); my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), who has been immensely helpful through his company; and a number of others. May I also welcome the Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison) to her place on the Front Bench? She and I have had a number of conversations about this issue since she was appointed to her role and she has been concerned and engaged with it. We have worked with No 10 and the Prime Minister’s advisers directly, of which more later.

I am also acutely conscious that all of us follow in distinguished footsteps we alas hear no more, from Peter Archer or Alf Morris, or, most recently, our friends Jim Dobbin and Paul Goggins, who respectively chaired and led the last debate held in Westminster Hall in October 2013. Paul, who had supported his constituents over a 16-year period before his death, is a particularly hard act for any of us to follow. In this regard, Paul’s great friend the shadow Secretary of State for Health is here to speak for the Opposition, and that is particularly welcome and important, emphasising how personally many of us have become engaged with the issue and how it has become one where both the Government and the Opposition feel a collective burden of responsibility for the events of the past. I hope they share a similar determination to reach a more satisfactory conclusion.

Like almost any of us here today, I could fill most of the three hours allocated with ease, but that is not the way this debate must proceed. I will therefore briefly outline a history that we and those watching are wearily familiar with, and move on to discuss why the debate is taking place today, what our main issues are and what our hopes may be. I will, where possible, illustrate with some of the words of those who have been in contact with us, as this is a debate for them and for their voices.

First, let me read from the opening to Lord Archer’s report, just to set the scene. He said:

“Throughout the 1970s and the first half of the 1980s, many in the UK who suffered from haemophilia were treated with blood and blood products which carried what came to be known as Hepatitis C, and some 4,670 patients became infected. Between 1983 and the early 1990s some 1,200 patients were infected with HIV, also through blood products. These infections had caused at least 1,757 deaths in the haemophilia community by the time this Inquiry started in February 2007, and more have occurred subsequently.”

Those figures can, of course, be updated for current circumstances. He continued:

“By the mid 1970s it was known in medical and Government circles that blood products carried a danger of infection with Hepatitis and that commercially manufactured products from the USA were particularly suspect. By the mid-1980s there were warnings of a similar situation in respect of HIV. But the products continued to be imported and used, often with tragic consequences. The reasons for the chain of decisions that led to this situation, and the alternative options which might have given rise to a different outcome, have been debated since that time.”

Yes indeed they have.

[Mrs Anne Main (St Albans) (Con)]

It is fantastic that my right hon. Friend has brought this debate before the House, and I was pleased to support him at the Backbench Business Committee. Does he recall that when we made our presentation to the Committee its members were surprised that this was still going on, after such a long time? That is the crux of today’s debate: now is the time.

[Alistair Burt]

My hon. Friend is right about that. I will go on to say why this debate is happening today, and that is one of the reasons. This issue has not gone away, and even more colleagues are now aware of it.

Since the Archer report there has been some positive recognition by the state of its responsibility. Over the years, efforts have been made for financial provision, but a complex and incomplete patchwork has been the result. Some people have been left behind—those bereaved and dependants in particular. Treatments for the severest infections have improved markedly, which has, in general, of course, been good news, but they also bring their own ironic consequences in giving longer life to those with originally no expectation of it and not always a quality of life for which we would all hope.

Efforts by the state to redeem itself have been hampered by a chronic inability to admit the past, to ensure that all the material was available for public scrutiny, and to give an opportunity to family members to ask the question that any one of us would need to ask: why and how has my loved one died? Its evasion of a public inquiry, the loss of key papers, the slow drawing out of what paperwork there was, and the failure to submit to questioning have left a mark of suspicion that lasts to this day.

Before I turn to the why-now question, let me dwell a moment on the scale of this tragedy. One of the most moving speeches heard in this or any other Session of Parliament was when the hon. Member for Liverpool, Walton (Steve Rotheram) read out, unforgettably, the names of the Liverpool 96. He did so to let the world know that behind the tragic statistics that the 96 had become were people with names, lives and hopes. Consider this: for me to do the same would mean that I would be reading out nearly 1,800 names. We will hear some of their stories today, but I ask the House to reflect on the scale of this. In terms of death toll, this is the 15th biggest peacetime disaster in British history in which the black death, at 3.5 million, is the worst. The awful Aberfan, the name of which we all know, is but the 142nd, with 144 lives lost. Contaminated blood has killed 12 times more.

[Jenny Willott (Cardiff Central) (LD)]

Does my right hon. Friend share my concern that in cases where haemophilia is passed down through the generations, entire families have been affected by this terrible scandal? The Lewis family in my constituency is one such example. Hayden Lewis tragically passed away. His brother was also infected and has also since died. Hayden infected his wife Gaynor with HIV before he was diagnosed, which will have an impact down the generations. That is why these families deserve far, far better treatment than they have so far received.

[Alistair Burt]

My right hon. Friend has been a doughty campaigner on this issue, and I have been grateful to her for her support. Let me put some flesh on what she has just said and on those figures. I will start with Hayden. His wife wrote to a friend of mine and said:

“I would dearly like to see an end to the campaigning and put this issue to bed. There needs to be an apology, there needs to be a big overhaul of the various Trusts… definitely not to make you feel as though you are going ‘cap in hand’ to them. That’s disgraceful. I want to go to Hayden’s grave and say once and for all ‘it’s sorted.’ Then I will know he is resting in peace.”

[Nadhim Zahawi (Stratford-on-Avon) (Con)]

On the point about the support mechanism, does my right hon. Friend agree that it is unacceptable that the very organisations that were set up to support individuals, such as the MacFarlane Trust, do not treat beneficiaries equitably? My constituent who went to the trust and questioned the response times was branded a troublemaker and her applications for grants were either delayed or, in some cases, frustrated completely. That is the reality on the ground. Will he say something about some of those organisations?

[Alistair Burt]

My hon. Friend is right that many beneficiaries have expressed deep concern about the workings of the trust. The all-party group report that came out yesterday will be addressed by other colleagues. On the MacFarlane Trust in particular he should know that I share his concerns. I do not believe that that trust is salvageable or saveable, and I will speak about that later.

[Albert Owen (Ynys Môn) (Lab)]

The right hon. Gentleman read out a list of people to whom he wished to pay tribute. May I add his name to the list? I am here today because constituents came forward after he sent out the letter on behalf of the all-party group. I pay tribute to him for that. When we talk about trusts across the United Kingdom, I feel that, because this matter predates devolution, there needs to be a UK response so that the Welsh Assembly and devolved Governments are not bearing the brunt of the problem themselves. This is a UK problem, and the UK Government should look either to work with those Administrations or to take the lead.

[Alistair Burt]

There is no doubt that these matters predated devolution. As most colleagues are aware, there is a Scottish inquiry going on. Almost inevitably when it reports, it must report on things that pertain to the United Kingdom Government. I notice that the Secretary of State for Health has joined us, which illustrates the importance of this issue to all of us. He is enormously welcome, especially given the burdens that he carries. The UK dimension of this is indeed very real.

[Mr Tom Clarke (Coatbridge, Chryston and Bellshill) (Lab)]

rose—

[Alistair Burt]

I will give way, but I hope that Mr Speaker will be understanding.

[Mr Clarke]

The right hon. Gentleman mentioned the Penrose inquiry. We are all awaiting that report with great interest. Given his discussions with the Prime Minister, is he in a position to tell us when that report is expected?

[Alistair Burt]

My latest understanding is that the Penrose inquiry has said that later this month it will announce when it will report so I think that by the end of January the leader of the inquiry will have announced when publication will take place. I will touch on that later; the non-reporting so far is one problem that we have had to deal with.

Let me give one further brief story as part of the background to the statistics. I have been privileged to work with one family where three brothers died. To give an indication of what that meant, the sister wrote to me:

“the story of my three brothers, all dead, as a direct result of the treatment given to them by the NHS. The impact on the family? A devastation that time has not and never will heal, owing to the lack of acknowledgement over these deaths by both the Government and the medical profession…Family life is never the same with any bereavement, and we can only cherish their memories and their offspring, but there are still so many un-answered questions as to the decisions made”.

Each of us has a number of stories that we could raise, and I apologise for not being able to read out more.

Why now? The answer is that there has been a lot going on in recent times. This Parliament began with the very first Back-Bench debate, initiated by the hon. Member for Coventry North West (Mr Robinson), who I am pleased to see in his place. I am sure that that helped lead to an announcement in January 2011 by the then Secretary of State of further changes to the funds providing payments, but underlying issues remained outstanding. We were all approached.

On 18 October 2013, I asked the Prime Minister a question on the issue. I will not repeat the detail, but it got a warm response from the Prime Minister who understood the problem and promised that he would put support into it, meet the gentleman that I wanted him to see, and take it up. To put this in historical context, the reason for approaching him was that the scale of the tragedy is certainly on a par with those issues for which the Prime Minister has apologised in this Parliament—Hillsborough and Bloody Sunday—having the bravery to recognise what had been done in the past, with the authority that only a Prime Minister could have.

We took the Prime Minister at his word. I was proud to take my friend, my constituent and his colleague to that meeting. We said we needed No. 10 to offer to work on what more might be done to close off the issue, and since then the Prime Minister has indeed put members of his policy team to work, together with my hon. Friend the Minister. I am grateful for the Prime Minister’s engagement and I am, of course, hopeful. I hope that my hon. Friend the Minister will say more about that work.

My question was followed up infinitely more powerfully by a debate on 29 October led by Paul Goggins, in which he outlined some of the issues that we agree are still to be settled. He spoke principally about the funds and people’s finances, the bureaucracy and inconsistency of the funds, the discrimination suffered by those who did not fit certain categories, the crude distinction between stage 1 and stage 2 hepatitis C sufferers, the inadequacy of funds for making discretionary payments, and the absence of transparency and accountability over the years. He suggested that if the Government were to continue to reject a public inquiry, there should be an alternative process, including:

“In addition to fair financial support, those who have suffered so much are still owed a full explanation and a sincere, profound apology.”—[Official Report, 29 October 2013; Vol. 569, c. 201WH.]

Hovering in the background of all our deliberations were a Government who were prepared to take on a public inquiry. In 2008, the then Health Minister for Scotland, now the First Minister, announced to her great credit the sort of judicial investigative inquiry on the transmission of infectious disease via transfusions in Scotland that has not been held for the UK as a whole. It covers effectively all the major issues dealt with by Archer, and will very likely have comments to make that will have a bearing on UK-wide policy. It may well have implications for financial considerations in respect of responsibility for what happens and what needs to be done.

As I told the right hon. Member for Coatbridge, Chryston and Bellshill (Mr Clarke), we do not yet have that report, but while MPs have waited for it we have not been idle. In April the all-party group and additional colleagues working with me, held two public meetings at Westminster. We wanted to keep the community informed of what was happening, discuss expectations and hear from them. As MPs attacked the issue yet again, we were asking the Government to focus on the key issues. Those meetings helped to reinforce our sense that we were talking about the right themes—the changes that life had brought for people who had not expected to live, and the financial considerations that that now brought them. There is the problem of leaving anything; the problem of mortgage and insurance; and the problem of the bereaved and the dependants, which we all know very well. They all have to be in the front of the Government’s mind as they approach this.

[Mr Jim Cunningham (Coventry South) (Lab)]

I thank the right hon. Gentleman for giving way and pay tribute to him for the tremendous amount of work he has done on the issue. It would be fair to say that since he has been involved there has been a degree of progress, although not total progress, because we will not have that until we get some action. Does he agree that many of the families feel very strongly about this and often feel frustrated by the lack of progress?

[Alistair Burt]

I am grateful to the hon. Gentleman for his kind remarks and I appreciate them very much. Yes, one thing we were told in our meetings in April was that people are sick of coming to Parliament. They have been coming for many years and many of them will feel that even today, but this is the best we can do as Members of Parliament. We know that those on both Front Benches are listening.

[Zac Goldsmith (Richmond Park) (Con)]

I must admit that this issue was not on the radar for me until recently, when I had a discussion with a constituent who was one of three siblings all of whom were contaminated as a consequence of this blunder. I want to put on record my gratitude for the work that my right hon. Friend has done and my support for this campaign. I wish him all the best and all my support as it progresses.

[Alistair Burt]

I am deeply grateful to my hon. Friend, but the gratitude should actually be given to the sufferers and their beneficiaries who have made an attempt to approach MPs, sometimes for the first time. This year, we were able to bring it home to people that despite all the privacy and other reservations they might have had—some have not been able to tell family or close friends what they have been suffering—there is a need to approach MPs such as my hon. Friend to make them aware of the issue. That has been a new element of the campaign and is another reason for this debate.

[Mr Andy Slaughter (Hammersmith) (Lab)]

I do not wish to embarrass the right hon. Gentleman, who has cross-party support on this issue, but I think that he is being very modest and that his intervention with the Prime Minister has helped to galvanise the position. Given that it now looks as though Penrose will not be published until late March, is there sufficient time to get that settlement before the general election campaign and the election itself?

[Alistair Burt]

Again, I am grateful to the hon. Gentleman for his kind remarks. I do not think there is time, because I think it is possible that Penrose will have such far-reaching implications that no Government could make sensible decisions on future financial considerations until it had reported. I hope that my hon. Friend the Minister might be able to say a little more today about what might be done outside the financial considerations. I think that a conclusive settlement cannot now be reached. Penrose was originally supposed to report in March last year, which would have given time. That was the timetable we were all hoping to work to, but needs must and we are where we are.

[Jenny Willott]

On the point that my right hon. Friend was just making about what could be done without any more money being made available in the interim, does he share my concerns about the process that people have to go through to access the support that is already available, how invasive and demeaning the processes often are and how much that upsets those who are already in a very difficult position, when they are simply trying to get what they should be getting anyway?

[Alistair Burt]

I thank my hon. Friend. The report by my hon. Friend the Member for Colne Valley and the hon. Member for Kingston upon Hull North, who I will call my hon. Friend for these purposes, covered those issues in some detail. I am sure that my hon. Friend the Member for Kingston upon Hull North will speak about some of the practical issues to do with financial provision.

Following the public meetings, we decided to take the opportunity to use new technology. Both the all-party group and my group of colleagues went out with surveys to as many people as we could find. I am deeply grateful for support given by YouGov and the personal support given by my hon. Friend the Member for Stratford-on-Avon, whose commitment and resource allowed us to do this job. It is a measure of the impact of this problem that about 1,000 people responded to our surveys, which is statistically way above the normal response to such surveys. We are profoundly grateful to those who responded so honestly and no doubt with much pain as they went over difficult and hurtful circumstances in an effort to inform us and the Government of what they had experienced. Key findings in our survey included the ideas that lump sums rather than ongoing payments might suit some sufferers better, that ongoing support for widowed partners and spouses was vital and that some form of inquiry was still relevant. All our findings have been reported to Government.

We then asked more people to contact their Members of Parliament, as my hon. Friend the Member for Richmond Park (Zac Goldsmith) has just mentioned. The number of colleagues now involved is well into three figures, and the number who have signed our motion can be seen on the Order Paper. I have colleagues who wanted to be here but could not—the hon. Member for Central Ayrshire (Mr Donohoe) and my hon. Friends the Members for West Worcestershire (Harriett Baldwin), for Ipswich (Ben Gummer) and for Erewash (Jessica Lee). I could go on about their stories for some time.

I do not expect the Minister to deal with the possibility of further financial relief today. I accept that the delay to Penrose means it is possible that it could report in such a way as to require some form of response from the Government that might have financial implications which it would be unwise to commit to now and have to revise again quite soon. However, I put it on record that I do not expect that closure can be effected without some further financial provision. There will always be inevitable arguments about money. The truth for a Government is always that at any one moment there is money and no money. When the banks needed to be bailed out, money was found. When we needed to compensate those who had lost their futures through Equitable Life, even if all the money could not be found, over £1 billion was found. If, God forbid, the country were to have a catastrophe tomorrow, we would find money. A catastrophe? Perhaps 1,800 dead is a catastrophe.

[Sir Gerald Howarth (Aldershot) (Con)]

Like other colleagues, I pay tribute to the work that my right hon. Friend has done on this. I do not have any constituents who are affected, but I have served in this House, along with him, since 1983, and I feel that this is business that neither the House nor successive Governments have properly resolved. Does he agree that as this blood was provided by the national health service—by the state—it is therefore the responsibility of the state to sort out the affliction that has affected these people over decades?

[Alistair Burt]

My hon. Friend puts it very well. He is yet another example of an MP who does not have a constituency interest but has recognised the responsibility that we all share, and the state shares, for what has happened.

Only this morning we saw in one of the newspapers that local authorities had spent £5 billion on consultants. As I say, at any one time a Government will have no money or can find money.

[Mr Gordon Marsden (Blackpool South) (Lab)]

I apologise for not having been here at the beginning of the right hon. Gentleman’s speech. I want to touch on his point about payments. My constituency has four times the national mortality rate from hepatitis C—of course, not all of it acquired from contaminated blood—and a number of constituents who are living with the condition have written to me about it over the years. The latest comments have been about getting a conclusion to this process as fast as possible. One of them says:

“Existing mechanisms should be disbanded and replaced as quickly as possible with a new improved arrangement for processing payments.”

Is that not a short-term consideration to go with the longer-term ones?

[Alistair Burt]

I personally think that it is. That process will be informed by what the all-party group has spoken of, and its members will speak today. I thank the hon. Gentleman for his intervention.

As I said to my hon. Friend the Member for Stratford-on-Avon, I am not sure that I fully share the conclusions of the all-party group’s report with regard to the MacFarlane Trust. There is a great deal of detail in the report. As I was not responsible for compiling it, I can be lavish in my praise of the effort that went into it. A lot of hard work was done by a lot of people connected with the offices of the hon. Member for Kingston upon Hull North and my hon. Friend the Member for Colne Valley, and I am grateful for that. On the basis of information contained in the report and other information that we have, I do not believe that the MacFarlane Trust is saveable or capable of reform. I and others have seen a copy of a letter to the Secretary of State from two former trustees that is quite damning of its leadership, and one from some 68 beneficiaries that is equally uncompromising.

It would be unfair to go into more detail now. It may be that the trust has an impossible role. However, there should be no doubt that a body set up to support beneficiaries and those who have been victims of what happened is anything other than on their side—not an arm of Government, nor seen to be, and prepared to take on the Government to argue for the funds it needs without fearing a conflict of interest. The Department of Health has contributed to the situation by structuring too cosy a relationship, possibly in its own interests, and that has to stop.

[Caroline Dinenage (Gosport) (Con)]

My right hon. Friend has worked very hard on this issue, as has the all-party group on haemophilia and contaminated blood. I attended a public meeting yesterday with survivors and their families, and there was a very strong feeling that they have just had enough. They have been through a series of betrayals and disappointments at the hands of those who were supposed to help them, including trusts, departments and the Government. Does my right hon. Friend agree that this is our last chance to get this right for those people who have to suffer so very much?

[Alistair Burt]

I thank my hon. Friend for her kind words, and I agree with her. I will come to the trust invested in us in a moment, but, given the effort that has been put in, the work being done by Members on both Front Benches and the acknowledgement that we all share this responsibility, perhaps there is a chance that we will get to where we want to be.

Mr Speaker has been very generous with time, so let me finish. Last week, on the day that we circulated information about today’s debate to the community, I received the following e-mail, which was addressed to all of us as MPs:

“Thank you for your continued persistence in this issue. I wish to continue to be informed of any developments but I am very bitter that my husband of 21 years who got Hep C as a child from being a Haemophiliac sadly lost his fight and passed away yesterday after years of suffering due to Hep C. He never had an apology for all the years of ill health, he was a fighter right up to the end but it was also a fight he should never have had to deal with. Again on behalf of my husband, my daughter and myself thank you for your continued support and I hope a speedy result is had for those who still continue to struggle with the physical and mental stress this situation has caused.”

Finally, a friend who was told as a child that he had HIV and hep C, and a life expectancy of four years if he was lucky, says:

“I find each and every day is like being on death row for a crime I didn’t commit. I long for the day that I can wake up in the morning and not have to fight the Gov’t for the right to have a better life. Imagine what it’s like to believe for years that what we have been given was an accident. The medical staff constantly told us ‘it was an unavoidable accident’ only for us to learn the truth for ourselves. Where did my human rights go at 12 years old. And WHY do I still not have any?

When you are stripped of your pride, your dignity, your finances, your job, career, your future, what do you have left? Your spirit and your fight, that’s what. Which is why we will be sitting there on Thursday and we will keep coming back until justice is done or the last one of us dies.”

As MPs, we have been privileged to be given the deepest, most personal details of these people and their loved ones. Some of us have been given family medical records, people’s deepest, darkest secrets and their hopes and fears. We have been privileged to have that. The words “devastation” and “struggle” appear far too often in the stories we deal with. We are not talking about a tiny handful of people, but about thousands who still feel wronged. As Members on both Front Benches prepare for an election, let us ensure that this Parliament as a whole remains committed to providing, finally, the best closure for those who trust us to do so.

[Several hon. Members]

rose—

--- Later in debate ---

[Alistair Burt]

I thank all Members who have spoken. What I am most proud of is my role in enabling this debate to take place, which has provided the opportunity for so many speeches. The best contributions were made not just by hon. Members, but by our constituents, because in very many cases we used the words that they have given to us so that we could be their voices. If memorable phrases from today’s debate are remembered, they will be theirs.

I warmly thank all colleagues for their hard work, and I thank those who have worked on the report, not least my secretary Sam Mackewn, who has done a great deal of work in the background. I say a huge thank you to all those in the community of sufferers and beneficiaries who have helped us.

If I have thought of anything during the debate, it is that there is a moment when one feels things shifting. The shadow Secretary of State was right: this Parliament is known for a number of things, but as we have seen through elected Select Committees and their Chairs, it exercises greater power than it used to, as was evidenced by what we heard today. We have all been involved in this issue for a long time—I have been involved with it for more than a decade—and I got the sense that Members of Parliament have just been here too long and listened too many times to the same things. There is almost a sense, not of anger, but of the frustration becoming something else, and I do not think that a future Parliament will wear a Government of any stripe who do not do something about it.

My hon. Friend the Member for South Norfolk (Mr Bacon) put things plainly, and with his support and the imprimatur of another couple of colleagues who are known to be restrictive about public finances, I think we are into a new age on this issue. Having seen that something is wrong, and that finance is needed to put it right, I get the sense that Parliament will demand that of its Government. If the Government cannot respond before the election—as I made clear, I entirely understand and accept what the Minister said—then all the parties have manifestos to write. We could all put something in our manifestos that gives a clear commitment about what will happen should we form part of a Government in the future, and there is no reason why that should not be done with some degree of co-operation. Those who have been so faithful in pursuing this issue, in circumstances that we heard described today, will know that at last they have a Parliament that will no longer take no for an answer.

Question put and agreed to.

Resolved,

That this House supports a further review of the circumstances surrounding the passing of infection via blood products to those with haemophilia and others during the 1970s and 1980s; notes the recent report from the All Party Parliamentary Group on Haemophilia and Contaminated Blood into the support arrangements provided for those who contracted blood-borne viruses as a result; also notes that the Penrose Inquiry into these events will shortly be publishing its findings in Scotland; further notes that those who contracted viruses and their partners and dependants continue to be profoundly affected by what happened; therefore welcomes the Prime Minister’s commitment to look again at this issue; and calls on the Government to respond positively to the APPG report and engage actively with those affected with a view to seeking closure to these long standing events.

Hepatitis C (Haemophiliacs)

Alistair Burt Excerpts

Tuesday 29th October 2013 Westminster Hall

[Alistair Burt (North East Bedfordshire) (Con)]

I congratulate the right hon. Member for Wythenshawe and Sale East (Paul Goggins) on securing this debate. My hon. Friend the Member for Cardiff North (Jonathan Evans) and I think that this is the first debate on this subject since the death of Lord Morris of Manchester. It is therefore highly appropriate that the first debate since Alf’s death was proposed by the right hon. Member for Wythenshawe and Sale East. I welcome my hon. Friend the Member for Battersea (Jane Ellison) to her new position as Under-Secretary of State for Health. Those of us who have followed her career for some time know that that is richly deserved. Perhaps the honour to set the seal on something that has been going on just that bit too long will fall to her.

[Jonathan Evans (Cardiff North) (Con)]

My hon. Friend and I had the honour of being in government more than 20 years ago. Looking back over those years, does he share my view—from our ministerial experience, although it was not in the Department of Health—that the outcome in this area has been less than satisfactory and that the issue should have been resolved a long time ago?

[Alistair Burt]

My hon. Friend is right. Hanging over the issue, particularly for those of us who were Ministers in successive Governments, is a sense that not enough has been done. No blame can be laid at the door of Back Benchers who have campaigned and done so much, and in their respective ways, Governments have sought over time to do something about the issue, but we are still here because of the overwhelming sense that whatever has been attempted has just not been enough.

One reason I raised the matter on the Floor of the House with the Prime Minister the other day was to capture that sense. Let me say more about that, but I shall try to be brief. I had a meeting with the then Minister with responsibility for public health, my hon. Friend the Member for Broxtowe (Anna Soubry), a few months ago. All of us have had meetings with the successive holders of that ministerial role over time. The history is familiar to us, but there is an overall sense that whatever has been tried—whatever honest attempts Governments have made—has just not been enough.

I supported the inquiry by Lord Archer of Sandwell, and in 2010, I seconded the early-day motion that called for the passage of the Bill that Alf Morris had introduced in the Lords to put into effect the recommendations of that inquiry. I was disappointed that those provisions were not put fully into effect, although the incoming Government made the changes mentioned by the right hon. Member for Wythenshawe and Sale East. We all welcomed that at the time, while recognising that it was still not enough.

Why are we making another attempt now? As has been made clear by the presence here of the right hon. Member for Leigh (Andy Burnham), there is now a different attitude towards uncovering past wrongs. The reason why I put the case so clearly to the Prime Minister is that his record in dealing both with the aftermath of the Hillsborough panel and with Bloody Sunday has demonstrated that he is a Prime Minister who is using his position and authority to right the wrongs of the past. Bearing in mind that he has a constituent affected by the issue, we know that he has a personal interest. That combination of circumstances perhaps means that the person in place has the determination to right the wrongs of the past. If information can be put together properly, something might therefore be done.

The sense of closure that must be achieved is palpable to all of us with affected constituents. I am here because of my relationship with a good—double-infected— friend, who has informed me about such matters over the years and for whom I desperately want to achieve something.

What has got wrong and what can we put right? The first point is that the process has taken too long: since the circumstances originated, it has all taken too long.

The second point relates to accepting that something has gone wrong. Undoubtedly, Ministers have said so and made that clear, but the Government’s acceptance of something having gone wrong has not been accompanied by the fullest disclosure of their full part. Even when the previous Government responded to the Archer inquiry— they published their response on 20 May 2009—they still, in relation to the release of documents on their website, stated:

“Further papers have been identified, which are being released today.”

In 2009, relevant papers were still being found and put in the public domain. The Government added the claim:

“We do not believe they add to our knowledge”.

Well, that is for other people to judge. All this is governed by a very real sense that not enough has been disclosed. The current Penrose inquiry, which has been mentioned, may provide an opportunity to revisit that matter.

The third point is that the process has been too divisive. Sufferers have been inadvertently set against other, being asked, “What have you got—hep C, or hep C and HIV, or some other variant?” It should not be like that. Everyone has suffered because they were all infected by the same process at the same time, and efforts should not be made to divide people.

The fourth point is that the premise has been wrong: it just does not work to use charity law to deliver support that ought to be the Government’s responsibility. Efforts made over the years to put matters right and make changes have not done the job. The premise needs to be scrapped—it should not be there—and colleagues have mentioned that the difficulties of separating stages 1 and 2 from hepatitis C only create new barriers and yet more unhappiness and anguish.

The problem about the Macfarlane Trust, which deals with double-infected patients, is that there is a conflict between whether it should act on behalf of the Government in disbursing funds or—as it should do—on behalf of the beneficiaries: arguing for as much support as possible and banging the drum for them. I sense that there is a conflict, because the trust is not doing that, so it is not doing its job.

Following up the Prime Minister’s response to my question, I will have an opportunity to meet him in a couple of weeks’ time, when I will be accompanied by my constituent. I hope to meet colleagues from all parties before that, just to get our lines straight, so that we can have a good go at this.

I say to those—the Minister and her officials—who will brief the Prime Minister, “Go for it this time. Don’t miss this opportunity.” There will be all the stuff in the Department about the difficulties and the things that cannot be done. They should not look at what cannot be done, but at what can be done. This is her and her Department’s chance, on behalf of those who did not get a chance in the first place, so let us go for it.

We need a proper apology and acknowledgment by the person from whom it will mean most, as well as some form of inquiry. I liked what the right hon. Member for Wythenshawe and Sale East said about doing that differently. The Government have got to take part in it, and questions must finally be answered. There should be an acknowledgment that the compensation system and the various trusts are just not working and that there must be a new system.

It is not for me to say what the figures for compensation should be, but in recent years, we have learned that we live in an entitlement culture: if someone walks away from a major job in a big corporation, their wallet is well padded; if someone walks away from a public sector job in the BBC, or even in some local authorities and public bodies, their wallet is well padded. What has happened to those who were wronged by the state?

To conclude, the cost of caring for the needs of those affected by the worst treatment disaster in the NHS are quantifiable; the laying to rest of a tragic incident and the righting of a wrong are priceless.

--- Later in debate ---

[Alistair Burt]

I thank the Minister for what she has said about her openness with respect to the inquiry. I recognise that she is new to her post, but if there is one subject that the Department knows all about, it is the one we are debating. It has all the information it needs.

I do not expect the Prime Minister to come to a definitive decision at the meeting in a couple of weeks about what he or the Department can do, but I hope that the Department will give a briefing of the right tone, saying that there is an opportunity to settle the matter. Somewhere among the options—either the first or the last—is the one that settles things. It has existed for some time. I ask my hon. Friend to do all she can, using the same spirit as is in her response on opening things up through an inquiry, to point the Prime Minister in that direction, so that as he deliberates on the question and she finds her feet in dealing with it, we can, as the debate has urged, move towards finding a way to close the matter.

[Jane Ellison]

My hon. Friend makes fair points. I spent much of the past three years chasing him in his previous role to put right a continuing historical wrong, and he is right to push me in the same vein. I take his remarks, as I have always taken his advice and thoughts, extremely seriously, and will reflect on them.

I want quickly to mention the Penrose inquiry, of which I am very aware. As the hon. Member for Kingston upon Hull North said, it will report in the spring. Right hon. and hon. Members may be interested to know that the Department of Health has provided all reasonable assistance to Lord Penrose, explaining what documents are held in the Department.