Coronavirus

Alun Cairns Excerpts

Tuesday 7th July 2020 Commons Chamber

[Matt Hancock]

We are constantly learning what we can do to improve the response to coronavirus. We have been clear about that right from the start. The gathering evidence on asymptomatic transmission that we saw during March and April is a case in point, because it changed policy and how we deal with this virus.

[Alun Cairns (Vale of Glamorgan) (Con)]

The welcome opening of pubs in England has made a major difference to the morale of a nation. In Wales, pubs will not be able to open until next Monday, and then only outside. Will my right hon. Friend share the best practice of one-way systems and appropriate screening to ensure that landlords, pubs and breweries do not go out of business needlessly, if only Wales follows the English model?

[Matt Hancock]

I am very happy to work with my Welsh colleagues on how it is possible to open pubs and hospitality in a covid-secure and safe way. Wales has a great tradition of great pubs. I very much hope that they can be open as soon as the Welsh Government make their decision.

NHS Funding Bill

Alun Cairns Excerpts

Legislative Grand Committee & 3rd reading: House of Commons & Legislative Grand Committee: House of Commons & Programme motion: House of Commons & 3rd reading & Programme motion
Tuesday 4th February 2020 Commons Chamber

[Justin Madders]

My hon. Friend makes a pertinent point. Both my parents are residents of north Wales but on occasion use the Countess of Chester Hospital. This process does not take account of the reality on the ground. As I said before, the fact that there will be Barnett consequentials from the Bill suggests that we have made a serious error in not allowing those from the devolved nations to vote on it.

We know what some trusts have told us about the lack of capital investment and what that means on the frontline: Morecambe Bay has said it has “unsuitable” environments for safe clinical care that have led to the closure of its day case theatre; the Queen Elizabeth Hospital in King’s Lynn has warned of a direct risk to life and patient safety from the roof falling in; and at the Royal Derby Hospital, a failing emergency buzzer system in the children’s ward means that staff would be unable to warn colleagues if something went seriously wrong. That is not acceptable.

The capital maintenance backlog will not be addressed unless the Government take note of what NHS Providers says in the report that came out this morning. It talks about the need for the NHS to have a multi-year capital settlement and a commitment from the Government to bringing the NHS capital budget in line with those in comparable economies, which would allow the NHS to pay for essential maintenance work and invest in long-term transformational capital projects of the kind we have touched on. One of our criticisms of the Bill is that capital allocations have not been included in the figures in clause 1, so in order to protect those allocations we have tabled amendment 3, which we hope to push to a vote, to stop the Government’s continual sticking-plaster approach.

I move now to performance targets and our new clause 4. We all know about the record investment and record patient satisfaction levels that the last Labour Government bequeathed to the Conservatives, but another part of their legacy was the NHS constitution, introduced as part of a 10-year plan to provide the highest quality of care and services for patients in England. It included a clear statement of accountability, transparency and responsibility, and standards of care for accessing treatment. These are the figures we often trade across the Dispatch Box.

Only last month, across this very Dispatch Box, the Prime Minister gave us assurances on performance. He said:

“We will get those waiting lists down”—[Official Report, 15 January 2020; Vol. 669, c. 1015.]

We would all like to see that, but we should remind ourselves of the Government’s sorry record: the target for 95% of patients being seen within four hours in A&E has not been met since July 2015; the target for 92% of people on the waiting list to be waiting fewer than 18 weeks for treatment has not been met since February 2016; the target for 1% of patients waiting for more than six weeks for a diagnostic test has not been met since November 2013; and the NHS has not met the 62-day standard for urgent referrals for suspected cancer treatment since December 2015. I fail to see how the Prime Minister can drive down waiting lists when the level health expenditure he is proposing is not enough to meet existing demand.

[Alun Cairns (Vale of Glamorgan) (Con)]

I note the statistics the hon. Member has shared with the House, but how do they compare to the outcomes that my constituents in Wales face? I would suggest they fare much worse.

[Justin Madders]

Across the piece, some areas in Wales are actually performing better than areas in England. The direction of travel is the right one. If the right hon. Member is so interested in the performance in Wales, he should stand for the Welsh Assembly; he will have the opportunity to do so in the not-too-distant future. I am sure he was aware when he stood for this place that health was a devolved issue.

Health

Alun Cairns Excerpts

Monday 9th June 2014 Commons Chamber

[Andy Burnham]

I think that that is exactly the reason. They introduced a reorganisation that nobody wanted, that nobody voted for, that put the wrong values at the heart of the NHS and that has dragged the NHS down, and all the while they are softening it up for accelerating privatisation. That is the record on which they will have to stand before the country in less than 12 months’ time. If the Secretary of State can justify that record and breaking the coalition agreement to his constituents, I would be very surprised indeed.

[Alun Cairns (Vale of Glamorgan) (Con)]

Will the right hon. Gentleman give way?

[Andy Burnham]

No, I am going to make some progress.

On the day of the Gracious Speech, 60 senior NHS leaders wrote to a newspaper to warn

“that the NHS is at the most challenged time of its existence.”

Just when it needs real leadership, it is being offered a period of drift from an increasingly dysfunctional Government and, sadly, the same is true on public health. The Government should have used this moment to regain the initiative and publish regulations on standardised packaging for tobacco and smoking in cars. Ministers announced on 3 April that they would publish the draft regulations on standardised packaging later that month—that was what the Minister responsible for public health, the hon. Member for Battersea (Jane Ellison), said. They have not, and since then almost 40,000 children have taken up smoking.

The public health Minister wrote to my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger), the shadow public health Minister, saying

“we will now push ahead”

with banning smoking in cars following the vote in this House, but we are still waiting. We did not hear anything on public health from the Secretary of State today. When will they show some leadership and set out a timetable for these important measures?

It is not hard to guess the reason for this pre-election period of NHS silence. On every measure that matters to the public, contrary to what the Secretary of State said, the evidence is clear that the NHS has gone downhill under this Government and that it is getting steadily worse.

--- Later in debate ---

[Andy Burnham]

But regulations are needed. If the Minister does not know that—[Interruption.] It was the Opposition who brought forward the vote on smoking in cars and she committed to introduce regulations to implement it. She cannot duck the question. When will she do that? If she does not realise that she is going to introduce regulations, she needs to go back and do a bit more homework.

It is not hard to guess why the Government want a period of silence. On every measure, the evidence is clear that the NHS is getting worse. When the Prime Minister was challenged—

[Alun Cairns]

rose—

[Andy Burnham]

No, I will not give way. When the Prime Minister was challenged on the wisdom of his reorganisation, he said that it should be judged by its effect on waiting times—[Interruption.]

[Alun Cairns]

rose—

[David T. C. Davies]

rose—

--- Later in debate ---

[Andy Burnham]

I think that it would behove Government Members to have a bit more self-reflection and humility. The hon. Lady was not a Member of the House at the time, but she may recall that before 1997 people used to spend years on NHS waiting lists, and some never came off them. Over Labour’s 13 years in government we saw waiting lists come down, and down, and down, to the point that, when we left office, they were at their lowest ever level. I am not claiming that the NHS was perfect and did everything right, but it had the highest ever level of public satisfaction. We must have done something right. A bit of balance and accuracy in this debate is just what the NHS needs.

[Alun Cairns]

rose—

[Mr Sheerman]

rose—

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[Andy Burnham]

What I find surprising is that all over the country plans are being developed to close A and E departments. How can that make sense when we are in the middle of an A and E crisis? In west London my hon. Friend the Member for Hammersmith (Mr Slaughter) has done much work to raise concerns about the changes to hospitals there.

[Alun Cairns]

Will the shadow Secretary of State give way?

[Andy Burnham]

The question I would put to the Secretary of State is this: have the Government looked at the latest evidence? Are they looking at the fact that this year hospital A and E departments have missed his target for 46 weeks? If that is the case, is it safe to proceed with changes on this scale?

[Alun Cairns]

On a point of order, Mr Speaker. I seek your advice. I am trying to raise a relevant point with the shadow Secretary of State. I want to point out that A and E waiting times in Wales have not been hit since 2009—

[Mr Speaker]

Order. The hon. Gentleman must not use an attempted point of order to try to make a point that he would make in the debate if he got the chance to contribute. He said that he wanted my advice. My advice to him is that persistence pays and he should keep at it, as I am sure he will.

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[Andy Burnham]

My shadow responsibilities do not extend to the NHS in Wales, but the Government have spent a year or more running it down. Just a few weeks ago, a Nuffield Trust report said that the picture was more mixed and that there were some areas in which the NHS in Wales was better than the NHS in England and vice versa. The Government need to look at themselves and to be fair to NHS staff, and not constantly repeat the mantra of running down the NHS in Wales and in England.

It was to prevent the NHS from being in this limbo—this silence—that we have brought this debate to the House. Until the Government face up to some of the problems caused by their reorganisation, the NHS will not be able to move forward. In the remainder of my time, I want to focus on two areas—leadership and competition—where uncertainty urgently needs to be removed.

First, on leadership, one of the major flaws of the Health and Social Care Act is that it has created confusion on that most fundamental question of all: who is in charge? Ever since the Act was passed, I have been told of continued tension between Ministers and NHS England. Ministers have repeatedly tried to instruct and overrule, ignoring the independence of NHS England for which they legislated. The problem is that thousands of NHS staff are left receiving mixed messages as to who is in charge.

I want to illustrate that point with reference to the growing crisis in mental health services, which the Secretary of State did not mention once. There are reports of growing problems in accessing mental health care and, in particular, a dangerous shortage of crisis beds. Despite that, NHS England has made a decision on the tariff which will lead to even deeper cuts to mental health care than to the rest of the NHS. This takes the NHS into new territory, because for the first time, as far as I can see, there is a direct contradiction between Department of Health policy and NHS England policy. The Government claim to support parity between mental and physical health, but their NHS policy is actively widening the disparity.

Therefore, in mental health—a policy of growing importance—we have complete confusion. People still look to Ministers to sort it out, but they have legislated themselves into the position of bystanders, shouting on the sidelines with the rest. The care Minister took to Twitter, no less, to vent his disgust at the “outrageous decision” by NHS England. People up and down the land will see that and say, “You’re the Minister! Don’t just tweet—do something about it!” The fact is that Ministers should have the power to enforce their own policy of parity, but in the interim NHS England should reconsider the decision to inflict cuts on a mental health system that is already in severe distress.

In the end, the answer to this uncertainty is simple: the Government should be legislating in this Gracious Speech to correct the flaws of the Health and Social Care Act and restore the Secretary of State’s duty to provide a comprehensive universal service. At a stroke, everyone would know where they stand and who is in charge, restoring grip and leadership in the NHS when it faces one of the most uncertain periods in its history.

The second area about which there is still considerable confusion is that of competition policy. When the Health and Social Care Act was going through, the Government’s mantra was that GPs would decide how best to organise care, but that is not what has happened in practice. Section 75 regulations are forcing commissioners to put services out to competitive tender when they do not think it necessary. That is leading to protracted legal disputes and millions spent on competition lawyers.

The nonsense that the Health and Social Care Act has inflicted on the NHS was plain for all to see last year when the then Competition Commission intervened in the NHS for the first time in its history to prevent collaboration between two NHS hospitals on the grounds that it was “anti-competitive”. What nonsense this is. It was succinctly summed up by the chief executive of the NHS, who said that

“you’ve got competition lawyers all over the place…We are getting bogged down in a morass of competition law causing significant cost in the system and great frustration for people in the service about making change happen. In which case, to make integration happen, we will need to change the law.”

That is precisely what this Gracious Speech should have done: change the law to help the NHS get on and make the changes it needs to make and remove the competition policy, which is fragmenting the NHS, not integrating it. That is the challenge the Government have ducked completely. The problem is that if they stay on this path, the NHS will head in the wrong direction. This Government and their Health and Social Care Act have placed the NHS on a fast track to fragmentation and privatisation when the future demands the integration of care.

The Opposition are clear that the market is not the answer to 21st-century care. The NHS now needs solutions of scale to rise to the increasing challenges that it faces. The NHS needed such leadership in this Queen’s Speech, but it was offered nothing. Instead, this Queen’s Speech leaves it lumbered with a Health and Social Care Act that puts competition before collaboration and the NHS on the wrong path for the future. The NHS urgently needs a Government who want to talk about the issues it faces and to get on with the job of securing its future. Let there therefore be no doubt that the next Labour Queen’s Speech will repeal the 2012 Act and pave the way for the full integration of health and social care.

I am coming to the end of my speech—I need only a couple more moments—but I will give way to the hon. Member for Vale of Glamorgan (Alun Cairns), as I promised.

[Alun Cairns]

I appreciate that some light-hearted comments have been made on both sides of the House, but my constituents have to wait longer for treatment, particularly for cancer care, as they do not have access to a cancer drugs fund. Will the right hon. Gentleman use all his influence with the Welsh Health Minister to get him to look at introducing such a fund so that my constituents have the same access as people in England?

[Andy Burnham]

That is obviously a matter for the Welsh Government, but let me provide some clarity on the issue of cancer care. In Wales, 92% of people start their cancer care treatment within 62 days, compared with just 86% in England. I ask the Conservative party to think about that, given that it has constantly run down the NHS in the hon. Gentleman’s own country and constituency, and has misrepresented the outstanding job it does to treat patients with cancer.

We will legislate for an NHS that has the right values back at its heart: collaboration before competition, people before profits. We will ask the NHS to lift standards in social care, working to bring an end to the culture of 15-minute visits. We will make sure that people can access care closer to their homes, giving patients clear rights, such as the right to see a GP within 48 hours. This is a plan to put the NHS back on track, and it shows why a Labour Government cannot come a moment too soon for the NHS.

Francis Report

Alun Cairns Excerpts

Wednesday 5th March 2014 Commons Chamber

[Andy Burnham]

My hon. Friend anticipates me, as I will come on to that subject. My point that the NHS has gone downhill is no better illustrated than by the crisis that is developing in mental health provision.

[Alun Cairns (Vale of Glamorgan) (Con)]

Will the right hon. Gentleman give way?

[Andy Burnham]

In a moment.

On all measures, this winter has been just as bad as the last, with some patients waiting hours on trolleys, or held at the door of A and E or in the back of ambulances. A and E is the barometer of the whole health and care system, and that barometer is warning of severe storms ahead.

--- Later in debate ---

[Ann Clwyd (Cynon Valley) (Lab)]

I congratulate the hon. Member for Stafford (Jeremy Lefroy) on his eloquent presentation. The Francis report carries lessons for everyone involved in health care—whether it be hospitals and their boards, regulators, professionals or Governments. However, those lessons need to be learned all over Britain. It is a matter not just for England, but for Scotland, Northern Ireland and Wales.

The letters keep coming. When I gave evidence to the Health Committee the other week, I was asked what had changed. I said that I did not know and could not honestly answer the question. Perhaps I will know when the letters stop coming. Every time I open my mouth, I am punished by yet more letters. I have had hundreds of letters from Wales; and hundreds too from England, Scotland and Northern Ireland. When I was carrying out my review, I received 3,000-plus letters and e-mails, and they still keep coming.

My concern today is for my constituents in the Cynon Valley and those elsewhere in Wales where health is a devolved function. I will not be popular for saying this, but when this House is asked to give yet more powers to Wales, I will ask many questions, because the main things for which the Welsh Assembly is responsible are health and education. I was a keen pro-devolutionist in two campaigns, but in future I will think very carefully before giving any more powers to the devolved Administrations.

Many people were to blame for what happened at Mid Staffs, just as there were many people to blame for the worrying situation that was revealed at several other English hospitals in subsequent investigations by Professor Sir Bruce Keogh. There is nothing to be gained by politicising such catastrophic situations and everything to be gained from being honest about the problem and seeking appropriate solutions. After all, we are talking here about sick and vulnerable people who are often afraid and in pain. Political bun fights here or in the Welsh Assembly are of little interest to them; they just want something to change for the better.

What was so shocking in Mid Staffs of course was that no one spoke out and the warning signs of a trust in meltdown were ignored. Robert Francis has listed some of those warning signs and they read directly across to many of my concerns about the NHS in Wales.

The first warning sign is an accumulation of patient stories that detail adverse incidents, bad practice or neglect. As I have said, I have had literally thousands of those, and they continue to arrive in my office every day from all over Wales and from England.

The second warning sign, said Francis, is the level of mortality statistics. In fact, they appear to be dangerously high in many hospitals in Wales. Confusion remains on how accurate the data are. The system by which they are collected is questionable, to say the least, and there is a backlog in the coding of cases for inclusion in the risk-adjusted mortality index—RAMI—so we are now seeing retrospective alterations in the figures in at least one hospital, thus making it difficult to compare hospitals in Wales, or to compare England and Wales.

[Alun Cairns]

I pay tribute to the right hon. Lady for her work in championing patients and in drawing attention to some very unpleasant outcomes in many hospitals across the whole United Kingdom. In relation to the higher mortality rates that she refers to, does she share my concern about the political rebuttal to an e-mail from one clinician in England to another clinician in Wales simply asking for further investigations?

[Ann Clwyd]

I am grateful to Professor Sir Bruce Keogh for offering to assist. Given his vast experience, the people whom he offered to assist would be sensible to take the offer very seriously indeed.

The Transparency and Mortality Taskforce, which was set up by the Welsh Assembly a year ago, has today announced recommendations on a measure of mortality for Wales. Although I welcome its finally releasing the recommendations, I will await details on their implementation, which is unlikely to start until the autumn of this year. On mortality statistics, the taskforce provides an interesting academic discussion of the pros and cons of using mortality statistics as a measure of service quality and a means to compare hospitals and countries. Of course, none of that is new, but neither approach is impossible.

After almost a year, it is disappointing that a taskforce of 31 members has failed to arrive at the benchmarks on mortality that are urgently needed, so that fair international comparisons can be made between Wales, England and other countries. That was the taskforce’s job. The promise of a further statement in September 2014 appears to put the resolution of this matter even further away; one can only speculate on the reasons for that. Some good intentions may be expressed, but that is not enough, given the high level of public concern.

We continue to have only the published RAMI figures to go on. Six Welsh hospitals have RAMI figures of between 105 and 115, with 100 showing cause for concern, as we all know by now. A figure of more than 100 was described as a smoke signal. If the figure is way over 100, there is a big fire. It is not surprising that people are worried about what is actually going on. This is horribly similar to the murkiness that surrounded the mortality statistics for Mid Staffs.

We now know for certain, however, the position as reported by the Royal College of Surgeons after visiting the University hospital of Wales at Cardiff in April 2013 to investigate poor standards of care. It describes certain parts of the hospital as dangerous. It was worried about people dying on hospital waiting lists while waiting for heart surgery. Even those who got their surgery had deteriorated on the waiting lists. When they got their surgery, they were much more ill than they would have been.

Last week, the Royal College of Surgeons wrote to Healthcare Inspectorate Wales to ask what action has been taken about concerns raised last July in a report about patients dying while waiting for heart surgery. Following its initial report, the Royal College of Surgeons wrote to Healthcare Inspectorate Wales in August to claim that 152 patients had died in the past five years while waiting for heart surgery at the University hospital of Wales and Swansea’s Morriston hospital. I put on record my alarm about the lengthy delay in the promised revisit of the Royal College of Surgeons to those hospitals. It was promised in September, but it still has not taken place.

Other warnings to be heeded, said Francis, should come from complaints made by patients. Well, what do we know about this in Wales? Complaints trebled last year, according to the Welsh ombudsman, but the system for dealing with complaints, let alone learning from them, is highly unsatisfactory, so much so that an inquiry is under way after several high-profile cases. Obviously, we look forward to seeing the outcome of that, mindful that the retiring Welsh ombudsman said in November last year that accountability in NHS Wales has “broken down” and that there is a “lack of challenge” in the system. He asked:

“Where is the voice of the patient in the NHS in Wales?”

The fourth warning sign that Francis mentioned was signals from staff and whistleblowers. Many of them have reached me, too. Some people have told me that they are no longer able to do their jobs properly. I have had several phone calls from consultants who will not even give their names and who say that, if they gave their names, they would be sacked from their jobs.

More people are speaking out openly, and this week a letter appeared in the Western Mail from a consultant paediatrician, who said:

“The intervention of Sir Bruce Keogh, Medical Director of NHS England, expressing concern regarding high mortality rates in several Welsh Hospitals may not be welcome… It deserves to be taken seriously.

Mortality rates are ‘risk adjusted’, which means that the mortality rate is ‘adjusted’ for hospitals that deal with a disproportionate number of seriously ill patients, some of whom, sadly, but inevitably may not survive their treatment. It’s therefore appropriate to review clinical practice in all hospitals whose mortality rates are above 100. The recent publicity relating to high death rates at the University of Wales following liver surgery, where an independent Royal College of Surgeons’ report identified 10 deaths that were deemed ‘avoidable’ highlights the sluggish response of the hospital’s own management to information that should have been spotted far earlier.

A ‘Wales-wide’ investigation...or indeed a ‘health board-wide’ investigation would be too general, and would probably fail to identify clinical practice where there is a need for improvement.

Any review needs to be ‘department-wide’. All health boards have sufficient information available to them that allows identification of individual departments, possibly individual practitioners, where clinical outcome falls below the norm”—

the outliers.

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[Barbara Keeley]

I would prefer not to. That money could and should have been spent on improving staffing, particularly nursing staffing. Those patients and family members who have been let down by NHS failures, of which we have heard innumerable examples, deserve to know that everything possible is being done to avoid such failures in future.

Of all the things I have talked about, safe staffing is crucial, as is transparency and staffing ratios. We increasingly have to take on board the fact that there is a funding gap in both the NHS and social care. Indeed, the chair of the British Medical Association said in his new year statement that the funding gap in the NHS is so bad that if the NHS was a country, it would not have even have a credit rating. That is what we are facing.

[Alun Cairns]

Will the hon. Lady give way?

[Barbara Keeley]

No, I do not have time.

Given that situation, we have to learn that precious NHS resources cannot be wasted on reorganisation and redundancies any more, particularly where staff are being rehired. The NHS will reach its 70th birthday in 2018, so let us hope that all the measures we are talking about today, and the implementation of whole-person care under a Labour Government, will help it be in better shape.

[Alun Cairns (Vale of Glamorgan) (Con)]

Thank you for calling me to contribute to this debate, Mr Speaker. I am sorry that the shadow Health Secretary is not in his place. After repeatedly refusing to take any interventions from me during his lengthy speech, he said that I would have time to make my contribution later, and I wish he was here to hear it, because I will be referring to him and seeking his help and support.

I approach this debate with mixed emotions. I am extremely sorry about the need for the Francis report in the first instance and believe that there remain serious questions about why there was such a long delay before a thorough investigation took place into the lack of care and the misconduct at Mid Staffs. I pay particular tribute to my hon. Friend the Member for Stafford (Jeremy Lefroy) for his contribution earlier and for the role he has played in pursuing this matter right through to the end, and to my hon. Friend the Member for Stone (Mr Cash) for his contribution and for raising this matter from the outset. My heart goes out to those who suffered needlessly and to their families who campaigned for so long. It is also worth remembering that for every one person who went public and put their head above the parapet, there are probably tens who stayed quiet and are probably still silent on issues that will have affronted them.

On a positive note, I am pleased about the progress made over the past 12 months. I am also pleased about the strong action has been taken by the previous Health Secretary and by this one, and about the leadership and determination that the Prime Minister showed at the outset in 2010 in seeking to root out the issues. The present Health Secretary has taken direct action to ensure: that nursing numbers are published; that there is data transparency; that details on surgery outcomes by consultant will be available for inspection; and that named consultants will be available for older patients. Those positive interventions will make a significant difference and will go a long way to preventing any recurrence.

Ultimately, the staff involved deserve the credit for the change, but the Health Secretary has been key to being the patients’ champion. A culture has developed where we can rightly champion the NHS and can even question it. We have now come to a point where we can criticise the NHS without being seen as undermining it. All of the best organisations welcome feedback, particularly negative feedback, because it gives the best chance of putting problems right to prevent any recurrence.However, my mixed emotions are far more complex than that. As I see changes and improvements taking place in England, I remain concerned about what is happening to the national health service in Wales and the impact that that is having on my constituents. It is quite obvious from this debate that the concerns that have been raised are shared by Members on both sides of the House, which is something that we should view positively. However, I am not so sure that those concerns are shared in all quarters, especially by Members on the Labour Front Bench. Again, I must pay tribute to the right hon. Member for Cynon Valley (Ann Clwyd) for her determination and persistence in rooting out these issues wherever they occur—be it in Wales, Scotland, Northern Ireland or England.

It is fair to say that political points can be made about the cuts to the NHS budget in Wales, but I fear that the situation is even more serious and dangerous than that. Any criticism of the NHS in Wales is now dismissed as party political or politically motivated. It is the identical culture that existed at the time of the Mid Staffordshire crisis.

Only two weeks ago, my hon. Friend the Member for Bristol North West (Charlotte Leslie) discovered that Professor Sir Bruce Keogh, the NHS medical director in England, had last November written to his counterpart in Wales, Dr Chris Jones, raising concerns about the mortality rates at some Welsh hospitals—at six in particular. It has now come to light that that action was prompted by the right hon. Member for Cynon Valley. In the e-mail, Professor Keogh, who had investigated 14 hospitals in England for the same reason, offered his assistance. I have a copy of his letter here. It was not a criticism; it merely questioned the data and offered help should there be any need for further investigation.

There was no response from Dr Jones, which is worrying in itself. Most alarming, however, was the response from the Welsh Health Minister when the matter became public. Mark Drakeford rightly pointed out that simple comparisons cannot be made because of the different ways in which data are collected. However, in response to calls for an inquiry, he said that he was “coldly furious” and that it was

“a concerted political attempt by the Conservative Party to drag the Welsh NHS through the mud.”

He even had the audacity to accuse the NHS in England of being in crisis. He clearly felt that attack was the best form of defence. What worries me most is the blatant rebuttal without wider consideration. The politics appear to be more important than the patients. This was a letter from one clinician to another, yet it was a politician using every political tactic possible to undermine its contents.

A pragmatic approach would have been to point out the differences in the collection of the data and to have reassured patients. I suspect that the reality was that the Welsh Health Minister was responding in the full knowledge of all the other statistics on the NHS in Wales, such as those on waiting times and diagnostic delays, which could well contribute to higher mortality rates. Again, a pragmatic approach would have been to announce an investigation, or at least to seek out the root causes of the apparent high mortality rate according to the way in which the data were collected.

It is ironic that the Welsh Health Minister has today announced a change in the way the data are collected. Obviously, that is some shift, but I note that it has come out only after the political games had taken place. It is two weeks since my constituents were alarmed by the accusations that I had dragged the Welsh NHS through the mud.

In researching for this debate, I looked at recent cases that have become public in the NHS in Wales. There are troubling similarities with those that led to the Francis report. Lilian Hopkins received treatment from a local health board that treats patients from my constituency. For several days, a sign was left above her bed that said “Nil by mouth”. That left Mrs Hopkins too weak to lift a glass of water. Her prosthetic limb was not removed for two weeks, when she was left in bed for that time. Screams of pain at night were treated with sedation. At an earlier date, her family had asked for an investigation. It was promised, but not conducted. Three nurses have been arrested for falsifying records.

This is the same local health board where the police are investigating the circumstances surrounding a man who waited four hours in an ambulance outside the hospital, only to die at the same A and E department some hours later. The right hon. Member for Cynon Valley has listed several examples that I could refer to, but these are examples that I have picked up in the past couple of weeks.

The Royal College of Surgeons published a report last July that claimed that 152 patients have died over the past five years while waiting for cardiac surgery across two local health boards alone in Wales. The royal college also stated in its report that 2,000 cardiac operations were either cancelled or not scheduled between January and March last year. The report says that south Wales is the only part of the UK where patients are regularly dying on cardiac surgery waiting lists. It says that the provision of urgent and emergency surgery is simply inadequate.

I should like to be able to report that the situation has improved since the publication of that report last July, but it has not. Some patients are now being sent across the border to England to be treated in the independent sector, which strikes me as emergency action; instead, attempts should be made to identify the culture and issues that potentially parallel the Mid Staffordshire crisis.

I could point to lots of data, but I shall pick up just a few of the differences between Wales and England. Urgent cancer waiting times have not been met in Wales for the past five years. On average response times, in Wales 58% of patients are seen within eight minutes in category A calls. In England, the figure is 72%. One of the most worrying statistics, which Professor Sir Bruce Keogh particularly identified, relates to diagnostic services. In his e-mail, he pointed to the statistic that in Wales 26,000 patients are waiting more than eight weeks for diagnostic services. In England, 9,000 patients are waiting longer than six weeks. We need to bear in mind the difference between the populations: 3 million people in Wales and 50 million in England, yet 26,000 people are waiting for diagnostic services in Wales and 9,000 waiting in England. The statistics speak for themselves.

Peter Watkin Jones, a lawyer involved with the Mid Staffs inquiry, has said that a culture change is needed in the NHS in Wales. Having heard the shadow Health Secretary’s contribution, I do not think he recognises that. Again, I was sorry he felt that attack was the best form of defence. The right hon. Member for Cynon Valley has said that high mortality rates are a smoke signal indicating that something is wrong. The Royal College of Nursing has said that its members do not always have time for training and staff development in Welsh hospitals.

If the right hon. Member for Leigh (Andy Burnham) genuinely wants the lessons of Mid Staffs to be learned, if he wants to ensure that patients in Wales do not have to suffer the same indignity and if he wants to play a positive role in informing health care across the UK, I ask him to agree to make every effort to influence his colleagues in Wales to respond positively to the questions that are being asked, to put party politics aside and to introduce an effective inquiry for the sake of my constituents and those across the whole of Wales; otherwise, everything that he has said today will simply be hollow.

--- Later in debate ---

[Liz Kendall (Leicester West) (Lab)]

It is a pleasure to speak in this important debate. Members on both sides of the House have shown that we are determined to learn the true lessons from the appalling failings at Mid Staffordshire and to understand what needs to change to prevent them from happening again.

We have heard many serious and thoughtful contributions, but I want to start by paying tribute to the hon. Member for Stafford (Jeremy Lefroy), whose calm, considered, thoughtful and dignified approach to the issue and the work he has done on behalf of his constituents is a lesson to us all. My right hon. Friend the Member for Cynon Valley (Ann Clwyd) hit the nail on the head when she said that there is nothing to be gained by politicising these issues, but everything to be gained by understanding the lessons and being open about the problems so that they can be tackled properly.

My hon. Friend the Member for Stalybridge and Hyde (Jonathan Reynolds) and my right hon. Friend the Member for Rother Valley (Kevin Barron), along with many other hon. Members, emphasises the importance of openness. As a constituency MP, I have seen how the NHS too often tries to sweep patient complaints and mistakes under the carpet, ignoring them and pushing patients away. Being open early on, admitting mistakes and learning the lessons is a much better way forward.

A number of hon. Members spoke specifically about the process that Mid Staffordshire hospital is currently going through. My hon. Friend the Member for Stoke-on-Trent North (Joan Walley) and the hon. Member for Stafford rightly said that there is a lack of clarity about the process and the timetable. I hope that the Minister, when he responds, will give those hon. Members and their constituents much greater clarity on what will happen.

My hon. Friends the Members for Rotherham (Sarah Champion) and for Wythenshawe and Sale East (Mike Kane) raised important points about making the system more accountable and how that is much harder since the NHS reorganisation, with all the different bodies—a point I will return to in a minute. My hon. Friends the Members for Worsley and Eccles South (Barbara Keeley), for Easington (Grahame M. Morris) and for Stockton North (Alex Cunningham) rightly talked about staff shortages and the serious impact they can have on patient care. If we are to get to the root of the problem, simply publishing data every month is not good enough. I was really pleased that the right hon. Member for Sutton and Cheam (Paul Burstow) talked about mental health. We have been talking mostly about physical health, but he was right to raise those concerns.

In the time available I cannot do justice to all the points raised today, or to the Francis report’s 290 recommendations, so I will focus my comments on the two most fundamental challenges we now face: first, ensuring that the views of patients, their families and the public are heard and acted on, at every level and at all times; and, secondly, ensuring that there is clear leadership to make the service changes we need to improve safety and quality at a time of unprecedented pressures on the NHS. Unless we do that, there is a risk of the failings in Mid Staffordshire happening again.

[Alun Cairns]

Will the hon. Lady give way?

[Liz Kendall]

I will give way to the hon. Gentleman this one time.

[Alun Cairns]

I am grateful to the hon. Lady for giving way, unlike her colleague earlier. In the spirit with which she has opened her contribution, and in relation to the comments made by the right hon. Member for Cynon Valley (Ann Clwyd), the comments of the Royal College of Surgeons and the example I highlighted of worrying cases in the NHS in Wales, will she make every effort to influence her colleagues in the Welsh Government, and indeed the Welsh Health Minister, to conduct a Keogh-type inquiry into the NHS in Wales?

[Liz Kendall]

Wherever there is evidence of poor care, it must be looked into. The hon. Gentleman did not mention that the Welsh Assembly has ordered a specific independent inquiry by experts outside Wales into aspects of care at the Princess of Wales and Neath Port Talbot hospitals, which I welcome.

Of all the lessons to be learned from Mid Staffordshire, the most important one is that the primary cause of the failures was the hospital and the trust board not listening to patients and their families, and not putting their needs and concerns first. Sir Robert Francis rightly says that there must be fundamental changes to ensure the real involvement of patients and the public in all that is done and to secure a common patient-centred culture throughout the NHS.

National Voices, a coalition of more than 130 patient, user and carer organisations, says that a concerted drive to listen to patients and carers must be a top priority for all trust boards and care organisations. It emphasises that over and above regulation, which it says has

“an important but limited role in ensuring quality and safety.”

Ministers have rightly spoken about the need for effective regulation and have taken some welcome steps, but the Care Quality Commission and the new chief inspectors will not be the main way of preventing the sort of failings we saw at Mid Staffordshire. Regulation identifies problems when they have begun, rather than preventing them from happening in the first place. Regulators cannot be everywhere all the time, but patients and their families are, which is why their views must be heard from the bedside to the boardroom, and at the heart of Whitehall.

The Labour Government made important progress. They published, for the first time, data on stroke and cardiac care. That helped to improve standards for patients and was a powerful incentive for staff to make changes. The next step is to provide systematic and comprehensive patient feedback. That must move from being the exception to being the norm.

The Government’s friend and families test is welcome as far as it goes but, as National Voices says,

“it is a crude measure on which the NHS would be unwise to place too much reliance.”

It asks only whether patients would recommend an NHS service to others, but not why, and it does not provide the detailed, real-time feedback that patients want and staff need to improve the quality of care. Developments such as the patient opinion and care opinion websites offer a powerful way forward. They enable people to tell the story of their NHS or care experience online, in writing or on the phone. That gives patients a voice, allows other people to see what is being said about a service, and in a simple and cost-effective way provides staff with a direct incentive to improve.

The Secretary of State said we must all be champions for change, and hon. Members may remember that I wrote to everyone saying that as a Member of Parliament they should sign up because it is a great way for us to understand what is really going on. I have asked my hospital trust and other services to do the same. That will be a powerful way of making change happen.

We must also look at how staff are trained to ensure that they always put patients first. Places such as Worcester university are leading the way: patients and families help to interview people who are applying to be nurses and health care assistants; they help to develop the content of courses so that they include what really matters to patients; and they take part in teaching students. Ministers should have spent the last three years championing such initiatives instead of reorganising the training structures as a result of the Health and Social Care Act 2012.

Individual patient voices are not the only ones that must be heard. We need a strong collective voice for users. The Francis report recommended investing in patient leaders to speak out on behalf of the public, to help to design services locally, and to hold them properly to account. Ministers claimed that that is what Healthwatch would do, but their rhetoric is simply not matched by the reality: national Healthwatch has nowhere near the same power, authority or levers to change services as NHS England, the Care Quality Commission or Monitor.

Local Healthwatch bodies are also weak. They were late out of the starting blocks and are woefully understaffed. Last week, we heard that £10 million of the £40 million budget that was promised for local Healthwatch has gone missing, despite the explicit recommendation in the Francis report that

“Local authorities should be required to pass over the centrally provided funds allocated to its Local Healthwatch”.

If Ministers are serious about giving patients a strong voice locally, they must look again at the support that Healthwatch is getting on the ground.

A strong patient voice is more essential than ever before because of the huge pressures on local services. Across the country, the NHS is struggling to cope with the increasing number of frail elderly people ending up in hospitals that were designed for a different age. Twenty per cent. of hospital beds have older people in them who need not be there if they had the right support in the community or at home. Half a million fewer people are receiving basic help to get up, washed, dressed and fed as council care budgets are cut to the bone. Mental health services, especially for children, are under intolerable strain as money for vital community services is being diverted to cope with pressures elsewhere in the system. This is not good for patients and families, it puts staff under pressure, and it ends up costing the taxpayer far more as people end up in more expensive hospital care or, in the case of mental health patients, being transported hundreds of miles around the country.

The NHS needs radical change, not to its back-room structures but to its front-line services and support. Improving safety and quality means that some services must be concentrated in specialist centres and others must be shifted out of hospitals into the community and towards prevention, fully integrated with social care. Under the previous Government, plans had been drawn up to reorganise services in every English region through Lord Darzi’s next stage review, but rather than pushing forward with those plans and making the changes that patients want and need, Ministers scrapped them simply because they were developed under the previous Labour Government. Instead, they embarked on a huge back-room NHS reorganisation, wasting precious time, effort and resources.

As several hon. Members have said, the new NHS structures are utterly confusing, with no clear lines of accountability or responsibility. There are now 211 clinical commissioning groups, 152 health and wellbeing boards, 27 NHS England local area teams, four NHS England regional teams—I am not sure what they are doing—23 commissioning support units, and 10 specialist commissioning units, alongside Monitor, the Care Quality Commission and NHS England. Can you make sense of that, Mr Deputy Speaker? Who is providing the leadership? Who is to be held to account? Across the country, people are doing their contract negotiations for next year, trying to make changes to services, and they say to me that there is no clear leadership in the system. That must change.

We have heard a lot about changing the culture in the NHS. That culture is about behaviour and the millions of personal interactions that happen every single day in the NHS. Getting those right will not happen through regulation alone but by giving patients and the public a powerful voice in every part of the system. This issue has had too little attention since the Francis report was published. Crucially, the culture is about leadership, and leadership comes from the top.

I warn Ministers not to be complacent about saying that the bullying culture has gone. On Friday, I met the chief executive of a trust who showed me an e-mail from the NHS Trust Development Authority, which is quite close to Ministers’ doors. I will not be able to say exactly what it said because it contained swear words, but it said, in effect: “Open the beep beds; just beep do it.” That was in an e-mail to a chief executive. The bullying culture is still going on. Ministers need to get a grip, particularly on what is happening at the NHS Trust Development Authority, which is causing real problems in the system.

Oral Answers to Questions

Alun Cairns Excerpts

Tuesday 22nd October 2013 Commons Chamber

[Jane Ellison]

I am interested in looking at what the hon. Gentleman says, and I will be happy to talk to him about that.

[Alun Cairns (Vale of Glamorgan) (Con)]

10. What steps his Department is taking to promote a culture of openness and transparency across the NHS.

[The Secretary of State for Health (Mr Jeremy Hunt)]

We need to change the culture of the NHS so that where there are problems with care or safety, people feel able to speak out. The Government have banned gagging clauses, they are introducing a statutory duty of candour, and they have for the first time published surgery outcomes for 10 specialties by consultant.

[Alun Cairns]

I commend the Secretary of State for his transparency agenda, which has uncovered previously untold horrors. What more can he do to ensure that in future no Minister can ever cover up failure in the NHS?

[Mr Hunt]

I know this is difficult territory for the Labour party, but the most important thing is for regulators to feel that they can speak out about poor care without fear or favour. I am afraid that did not happen under the previous Government, so let me just—

Managing Risk in the NHS

Alun Cairns Excerpts

Wednesday 17th July 2013 Commons Chamber

[Andy Burnham]

I want to make some progress, but I will give way again later.

People have a right to know whether any of the recent pressure that we have seen in the NHS was predicted and made known to Ministers before they proceeded with their reorganisation, which has led to thousands of good, experienced, committed people leaving the NHS. It left in charge less experienced people, who had never seen an A and E winter crisis and who did not know what to do. It led to millions in large redundancy payments being handed to people who were then re-employed by a new NHS organisation. Overall, £3 billion was siphoned out of the NHS front line to pay for this upheaval. Managers got six-figure pay-offs, and 4,000 nurses got P45s. It is no wonder that morale among staff is at rock bottom.

[Alun Cairns (Vale of Glamorgan) (Con)]

rose—

[Andy Burnham]

I will give way to the hon. Gentleman, but I hope that his intervention will not be about Wales. [Interruption.]

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. I want to hear Mr Cairns.

[Alun Cairns]

Mr Deputy Speaker, I can assure you that my intervention will be about Wales, because it is about my constituents who are suffering. Will the right hon. Gentleman pay tribute to the transparency that the right hon. Member for Cynon Valley (Ann Clwyd) is seeking to enforce by exposing the different data that apply to Wales and England? Does he share my dismay that only 83% of patients who are admitted to A and E are admitted, treated and discharged in hospitals in Wales, compared with the 91% who are admitted, treated and discharged in hospitals in England? Why do my constituents have to wait 89 days, compared with the 51-day waiting time in England—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. Mr Cairns, do not take advantage of the situation; it is not fair to other Members who also want to intervene. We want this debate to be heard in the best possible way.

Oral Answers to Questions

Alun Cairns Excerpts

Tuesday 26th February 2013 Commons Chamber

[Norman Lamb]

The Minister who will visit Newark is, in fact, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), but I am grateful to my hon. Friend the Member for Newark (Patrick Mercer) for raising this issue and for highlighting the importance of mental health care. The mandate makes it very clear that the Commissioning Board and the NHS must make measurable progress towards achieving parity of esteem by 2015.

[Alun Cairns (Vale of Glamorgan) (Con)]

15. What recent estimate he has made of the potential savings to the NHS of making better use of technology.

[The Secretary of State for Health (Mr Jeremy Hunt)]

PricewaterhouseCoopers estimates that the NHS could save £4.4 billion every year through proper investment in IT, which is one of the reasons I set the NHS the challenge of becoming fully paperless by 2018.

[Alun Cairns]

I am grateful to the Secretary of State for his answer, but can he assure me that investment in new technology will release resources for patient care, rather than follow the pattern over the past 15 years, when investment in new technology has detracted from the available resources?

[Mr Hunt]

My hon. Friend makes an important point. In encouraging such investment, we are thinking about the nurse who recently reported that in order to admit someone to trauma she had to fill out a 22-page admission form and another 10 forms after that. The whole point of this move is to free up the time of professionals on the front line so that they can spend more time with patients.

--- Later in debate ---

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

I thank the hon. Gentleman for his question. The friends and family test will give real-time feedback about patient services, but we need to ensure that the data from the test are used effectively by local trusts and scrutinised by the Care Quality Commission and other organisations so that they can go in if there are problems to ensure that they stand up for the rights of patients.

[Alun Cairns (Vale of Glamorgan) (Con)]

T7. Kevin Davies, a constituent from Cowbridge, visited my surgery yesterday. He is a prostate cancer patient and robotic surgery was deemed to be the most appropriate form of care. Unfortunately, robotic surgery for prostate cancer is not available in Wales and he was forced to travel to Bristol and pay £15,000 for the treatment. Will my hon. Friend agree to work with the Welsh NHS either to come up with a formal agreement whereby facilities are available to Welsh NHS patients or to press it to invest in its own facilities?

[Anna Soubry]

My hon. Friend makes a good point: in England, the NHS is benefiting from not suffering a cut in funding such as that imposed by the Labour Administration in Wales.

Cancer Care (England and Wales)

Alun Cairns Excerpts

Tuesday 12th February 2013 Westminster Hall

[Alun Cairns (Vale of Glamorgan) (Con)]

Thank you, Mrs Riordan, for calling me to speak and for chairing this debate. It is a privilege to serve under your chairmanship.

The subject under discussion is cancer care in England and Wales. Naturally, I understand that the Minister who is here is only responsible for treatment and care in England, and that health is a devolved matter, with responsibility for it in Wales falling to the Welsh Government. However, the different approaches will allow each nation to share best practice and compare outcomes, with the objective of raising the standard of cancer care wherever we live.

I do not want this debate to be party political; this issue is far too important for that. I want to compare the facts and to recognise success, wherever that may be found. The starting point for the debate must be mortality rates or, to put it another way, the success of any medical intervention. Overall, life expectancy among men in Wales is 77.6 years, and in England it is 78.6 years. Among women, life expectancy is 81.8 years in Wales and 82.6 years in England. I am sorry to say that the figures for Scotland and Northern Ireland are worse than the figures for either England or Wales.

However, focusing purely on life expectancy is too broad an approach, and we need to consider the influences on life expectancy. There may be historical and social reasons for the differences in life expectancy, but it is fair to say that cancer survival rates are a significant factor, which brings me to my key points. The most commonly diagnosed cancers are breast cancer among women and prostate cancer among men.

[Lilian Greenwood (Nottingham South) (Lab)]

Is the hon. Gentleman aware of the “Hear me now” report by Rose Thompson, the chief executive of BME Cancer Communities, which was launched here in Parliament yesterday? It revealed that the death rate from prostate cancer is 30% higher among black men than among their white counterparts. Does he agree that such inequalities in cancer outcomes must be addressed?

[Alun Cairns]

I am grateful to the hon. Lady for making an extremely valid point. The collection of data is exceptionally important, to identify which groups are potentially more vulnerable or which groups are not seeking the right sorts of treatment. Comparison between the home nations is important, but so is comparison between groups within the home nations, in order to bring the data together. It is exceptionally important if we are to reach the right conclusions.

I will focus on breast cancer to begin with. As I have already said, the mortality rate from breast cancer in England is 24.3 per 100,000 people, and in Wales it is 25.8 per 100,000 people. Clearly, those are worrying data, and it is worth considering the different approaches to treatment in the two nations.

In England, a patient concerned about the possibility of breast cancer can expect to see a consultant within 10 working days of the GP referral. In Wales, there is a different approach, which means that a GP differentiates between urgent and non-urgent cases. In cases that are deemed urgent, 95% of patients should expect treatment to start within 62 days, and in cases deemed non-urgent, the patient should expect treatment to start within 26 weeks. I want to underline this situation: a woman in England who is concerned about the risk of breast cancer will be reassured, or have her case elevated to the next level, within 10 days. In Wales, however, a patient has no such guarantee of consultant expertise until much, much later in the process.

We need to recognise that these are different measures and approaches. Breakthrough Breast Cancer has a helpful quote. It says that waiting for a referral is like being “left in the dark”.

[Glyn Davies (Montgomeryshire) (Con)]

The issue of waiting time for treatment and diagnosis is important to me. Does my hon. Friend agree that there should be an absolute focus on awareness, particularly regarding colon and rectal cancer, from which the chance of recovery is far greater if diagnosed early? There has to be a focus on early diagnosis, because it greatly increases the chances of recovery.

[Alun Cairns]

My hon. Friend makes a valid point about screening and awareness. Today I want to focus on treatment, but awareness and screening are exceptionally important and no doubt warrant another debate.

[Simon Hart (Carmarthen West and South Pembrokeshire) (Con)]

My hon. Friend has in some respects taken the words out of my mouth. To what extent does he attribute some of the differences between England and Wales to a problem of education and diet, as well as to the problems of treatment and early diagnosis?

[Alun Cairns]

My hon. Friend raises an important point about diet. There are historical and social issues. Diets and issues like that are relevant and also need wider consideration, perhaps in another debate that my hon. Friend may choose to nominate.

[Mr Andrew Smith (Oxford East) (Lab)]

Does the hon. Gentleman agree that however good the cancer care in hospitals is—it is excellent in many places—it often leaves a gap in psychological, emotional and social support? Excellent work is being done by Maggie’s centres in that respect. There is one in Swansea, and I believe one is due to open in Cardiff. There are also many centres in England and Scotland, including in my constituency. Will he endorse the value of their work?

[Alun Cairns]

I am grateful for the right hon. Gentleman’s valid point. I absolutely endorse the role that independent and charitable organisations can play; I quoted Breakthrough Breast Cancer. Emotional support is exceptionally important, and that relates to my point about delays in receiving treatment. A consultant can reassure people on many occasions, give a realistic assessment of the condition and provide the wider support available from some of the charitable organisations that have been mentioned.

[Mr Mark Williams (Ceredigion) (LD)]

Will my hon. Friend acknowledge the importance of care in the recovery of cancer patients? Statistics from Macmillan Cancer Support reveal that 19% of 18,000 newly diagnosed cancer patients in Wales were deemed to lack that kind of support, not just during diagnosis or treatment but, critically, in aftercare.

[Alun Cairns]

I am grateful to my hon. Friend for sharing those data. In interventions, hon. Members have talked not only about pre-screening, awareness, social issues and treatment, which I will focus on, but the aftercare that is needed, the emotional support that is provided, and the need for and responsibility and role of a whole host of agencies, including those in the charitable sector.

Returning to the point about treatment, I had been comparing the different approaches to breast cancer in England and Wales. The wait before seeing a consultant in England is 10 days. It is interesting to note that the Welsh Government removed 10-day monitoring in 2006. Although data are recorded locally, they are not published nationally. In the interests of transparency, it would be helpful if those data were published to allow fair and just comparisons. Waiting time targets improve survival outcomes, reduce emotional distress and improve the quality of life for people with cancer and those who turn out not to have cancer.

There are similarly alarming figures for prostate cancer. Five-year survival rates can be higher than 80%. There are no figures comparing the rates of the home nations, but the side-effects of the sort of treatment one receives for prostate cancer can be significant and can have a huge impact on future lifestyle. Again, there is a different approach to prostate cancer care in the two nations.

I want to draw attention to the availability of treatment. There was significant attention some years ago to access to brachytherapy. Even when it was finally approved by the Welsh authorities, after having been widely available in England, Scotland and Northern Ireland, the threshold for intervention was much higher in Wales. As far as I know, that remains the case.

Currently an identical debate is focused on robotic surgery. A constituent who suffers from prostate cancer, who is qualified medically and who consulted widely before making the decision with his clinicians on the most suitable form of treatment for himself, wrote to the Welsh Health Minister. He shared a copy of the letter with me, in which he said:

“I was both surprised and disappointed to find that this option is not available to Welsh men in Wales and that a significant number of Welsh men are opting to go to England, where this technology is established and available throughout the country.”

[Tessa Munt (Wells) (LD)]

Does my hon. Friend accept that if that kind of treatment—be it robotic or radio surgery—was available perhaps in a location such as Bristol, it would be accessible for patients in south Wales, along the M4 corridor and elsewhere, and those who go down the M5, right the way through to Cornwall?

[Alun Cairns]

My hon. Friend makes a valid point about the need for joint working and better co-ordination between the health services. Devolution can provide valid comparisons to establish the success of various treatments, but on many occasions there is a need for joint working where capital investment is needed, allowing patients to benefit from a different sort of intervention, but with shared responsibility between the two organisations.

I was talking about my constituent who had wanted robotic treatment for prostate cancer. He was later forced, in his stressful situation, to raise the £13,000 necessary to receive the form of treatment that he thought best suited him. I am pleased to report that the outcome of the treatment was positive.

The Wales Minister argued that if local heath boards do not provide treatment routinely, people could follow a process for individual patient funding requests. The panel meets monthly, which hardly reflects the urgency of some cases. I am not aware that any case of robotic treatment has been successfully applied for.

That leads me on to the cancer drugs fund, which is available in England but not in Wales. The fund allows clinicians and patients to prescribe and receive the latest drugs. Again, that is not available in Wales, where there is a cumbersome process to seek such a prescription.

The Rarer Cancers Foundation reported that 24 cancer treatments that are not routinely available in Wales may be available in England through the cancer drugs fund. It concludes that people in Wales are five times less likely than people in England to gain access to a cancer drug that is not routinely available. It also states that if the same approval rate occurred in Wales as it does in England, 159 cancer patients in Wales would gain access to life-extending treatment, instead of the 31 recorded. I raised the issue with the Welsh Health Minister, and she reported that establishing such a fund would reduce the money available for treating other serious conditions, as in England. I find that worrying, and I would be grateful if the Minister could address that point in her response.

That deficiency applies to other cancers, too. Selective internal radiation therapy is an innovative treatment for inoperable liver tumours. Although the University hospital of Wales in Cardiff is part of the UK-wide phase 3 clinical trial, not one patient from Wales has been funded for treatment. The patients under trial have been financed by the cancer drugs fund, yet the hospital is in Wales and demonstrates the expertise that exists in Wales in the field.

Survival rates for pancreatic cancer also differ significantly, and I could go on at length about those. When it comes to five-year survival rates for pancreatic cancer, Wales scores better than England. Unfortunately, that tends to be the exception rather than the rule. Those differences are worrying, and had I referred to Scotland and Northern Ireland selectively, I would have been able to paint a more alarming picture, but that is not the point; it is not about the politics of the issue, but about sharing best practice and getting the right treatment for the right people.

The motivation for the debate came from individual cases in my surgery. Having researched the data, I was forced to bring the matter to the House’s attention. I hope the Minister and Members present will be able to use their influence on colleagues here and elsewhere to raise standards, allay fears and improve survival rates for cancer patients.

Social Care Funding

Alun Cairns Excerpts

Monday 11th February 2013 Commons Chamber

[Mr Hunt]

Yes.

[Alun Cairns (Vale of Glamorgan) (Con)]

I pay tribute to the Secretary of State for the significant progress he has made on this issue, which was ignored for so long by the Labour party. The shadow Health Secretary, the right hon. Member for Leigh (Andy Burnham), has called for a bigger and bolder response. What estimate has my right hon. Friend made of the potential costs of a bigger and bolder response, and does he not think that any such criticism should have allied to it a source of funding in order for it to have any credibility?

[Mr Hunt]

I thank my hon. Friend for his question. The shadow Health Secretary complained this morning that we have not adopted the precise cap that Andrew Dilnot said he would have liked. That would have cost an extra £2.4 billion a year by 2020, on top of the plans that we have announced. It is up to the Opposition to tell us how they would find that money if that is what they want to happen.

Business of the House

Alun Cairns Excerpts

Thursday 6th September 2012 Commons Chamber

[Mr Lansley]

I am grateful to the hon. Gentleman. I never expected to be called “Leader”; to be called “dear Leader” was beyond my expectations.

At yesterday’s Cabinet Office questions, the Minister of State, Cabinet Office, my right hon. Friend the Member for West Dorset (Mr Letwin), explained the current situation and noted that there have been many responses to the consultation on this matter. They are being seriously considered and he will make a statement in due course.

[Alun Cairns (Vale of Glamorgan) (Con)]

I congratulate the Leader of the House on his appointment. From his previous post, he will be acutely aware of the different approaches to cancer care across the UK. Sadly, my constituents in Wales have less money spent on drugs, longer waiting times and higher mortality rates than those in other parts of the UK. May we have a debate on cancer treatment and the merits of the various approaches, so we can at least show that Wales is getting a worse deal on cancer drugs?

[Mr Lansley]

I understand, and greatly sympathise with, my hon. Friend’s point, and I will ask my colleagues at the Department of Health to respond to him. The coalition Government should be especially proud of tackling directly the issue of access to new cancer medicines. As a consequence of the Cancer Drugs Fund, more than 12,500 people with cancer have received access to the latest medicines over the last two-and-a-half years who would not have done so under the arrangements the last Government left us.