Congenital Cardiac Services for Children

Andrew Turner Excerpts

Thursday 23rd June 2011 Commons Chamber

[Mr Andrew Turner (Isle of Wight) (Con)]

I shall confine my speech to issues that uniquely affect my constituents. The Safe and Sustainable consultation is fundamentally flawed. Three of the four options envisage the closure of the Southampton centre. Those options are based on wrong assumptions and inaccurate data. Let me set out the background. The consultation document states:

“All options must be able to meet the minimum requirement to collect a child by ambulance…within three hours of being contacted by the referring unit”.

It then examined “detailed access mapping” using train and road journeys—that is important—and considered how existing networks were affected. More options that did not meet the “three hours” criteria were ruled out. Bristol is included in “all viable options” because south-west Cornwall and south Wales are more than three hours away from either Southampton or Birmingham.

Unfortunately, nobody in that expert team seems to have noticed that people cannot travel by train or road from the Isle of Wight. There is a clue in the name: it is an island, separated from the mainland by the Solent. I have said before that the ferries provide lifeline services for my constituents, but in this case that is literal. The error in the data was that because we must cross the Solent by ferry, the island is more than three hours away from either Bristol or London.

In May, that was pointed out to Mr Jeremy Glyde, the programme director of the Safe and Sustainable review. A statement issued on 3 June said that the team

“based retrieval times between the island and the mainland on travel by air. This was an oversight”

because the policy is

“to retrieve children from the Isle of Wight by road and ferry”.

That is very odd, because the consultation document explicitly states:

“Air travel has not been considered because it cannot always be relied upon”.

The statement goes on to say that

“an ambulance must reach the referring hospital within 3 hours, or within 4 hours in ‘remote areas’”.

The conclusion was that

“it is sensible to measure retrieval times to the Isle of Wight against the threshold for ‘remote areas’.”

On remote areas, the consultation document states:

“Removing surgery from some centres could have a disproportionate impact on children in some remote areas because ambulances would not be able to reach the child in three hours or less”—

meaning three hours or less from Southampton in my case.

On 3 June, Mr Glyde did not say why the Isle of Wight suddenly became a “remote area” when previously it was not. I am sure it did not move without me or any of the other 130,000 residents noticing. I asked Mr Glyde to point me to the guidelines that determine when an area is designated as “remote”. He told me that it was a “subjective interpretation” and that the review board recognised that the island,

“by its very nature, is remote from the mainland”.

Of course, that is accurate, but the board should have noticed earlier. After starting the consultation and working on it for years, it suddenly struck the board that there are

“unique factors around retrieval times by ferry”.

My Glyde was very helpful. He explained:

“We have been able to generate potential scenarios that could enable the ambulance to meet the standards”.

They did so not by using the “three hours” standard set out in the consultation, but by deciding that the “four hours” will apply to the newly remote Isle of Wight. It may be possible to generate scenarios in which an ambulance from Bristol or London can get to the island in four hours. I can generate some scenarios in which I become Prime Minister. Neither possibility can be entirely ruled out, but they do not reflect what is likely to happen in real life—[Hon. Members: “No!”]

Putting aside my political future, let us examine some realities. The AA route planner shows that it takes two hours to get to the other side of the Isle of Wight, and an hour at least—

[Mr Deputy Speaker (Mr Nigel Evans)]

Order.

Medical Students

Andrew Turner Excerpts

Tuesday 3rd May 2011 Westminster Hall

[Anne Milton]

Very much so. To some extent, the health of the nation rests on the skills of the professions that deal with the consequences of poor health. Medical students and doctors are part of that, so it is important that we get the system right. We need to maintain a competitive edge if we are to continue to produce medical graduates of the highest calibre. We shall not fail in our duty to make representations to other Departments, although working together is not always as easy for government as it sounds. However, we have made significant progress, and I think our words are being heard loud and clear.

As the right hon. Gentleman knows, universities will be able to charge a basic threshold of £6,000 a year for courses, and up to £9,000 a year for some, but subject to much tougher conditions on widening participation and fair access, which he mentioned in particular. There are still many such challenges, not only for universities but for our education system and at a wider societal level, if we are truly to get participation as wide as it can be. We need to look at all sorts of other drivers in the system directing young people to their choices.

We are shifting the balance of contributions from taxpayers to graduates, who benefit most from higher earnings over the course of their working lives. It is important to recognise that, after medical students have gone through the system and become consultants, they are probably among the top few percent of wage earners in this country. Contribution from them, therefore, is important. For poorer students, who might feel that the burden is too high, there is a balance or tipping point at which active participation in a fees scheme becomes a barrier. We have done a lot of work to ensure that that is not the case, and we continue to do so.

Many of the subjects associated with medicine cost more to teach, and we want a system in which anyone with the ability can access university and study such courses without being put off by the cost. That is why we will continue to provide additional funding for science, technology, engineering and medical courses.

The NHS bursary, which is in recognition of the length of time it takes to study medicine, will continue, helping students with their tuition fees and supporting those from low to middle-income families—sometimes, the middle-income families get squeezed in the middle. We have undertaken a review of the bursary, and will make some announcements shortly. In the review, we considered the views of the British Medical Association, which played an active part, ensuring that the perspective of medical students was considered.

In addition to the NHS bursary, last year an additional £890 million were invested by the NHS to provide clinical placements to medical students, ensuring that NHS providers continue to deliver high-quality clinical placements, which are an important part of such training.

The central investment in 2011-12 is £4.9 billion, a 2% increase on 2012-13. It is important that the funding mechanisms provide the right incentives and allow funding to be transparent, to drive quality and to be value for money, supporting a level playing field between providers. Any bursary schemes included should be easy to use and to access—sometimes, the mechanisms by which one can get support are only available to those at the top end of the IQ scale, because they are so complicated. Such complexity can be another significant barrier.

Current funding for clinical education and training is based on local agreements between strategic health authorities and providers. It can result in inequities in the funding of similar placements in different parts of the country. To resolve that, we have been working with others to develop proposals for a tariff-based approach to clinical education and training funding. Such tariffs would enable a national approach to funding all undergraduate clinical placements, including placements for medical students, as well as postgraduate medical training programmes. That will support a much more level playing field between providers. The variation in current funding arrangements means that the introduction of tariffs would have a bigger impact on some providers than others.

[Mr Smith]

Will the proposed tariff take account of the extra cost of living in certain places—obviously London but also places such as Oxford?

[Anne Milton]

We are looking at that issue at the moment. We have received about 500 consultation responses, so I am sure that it will be highlighted—it is something we need to look at. The other important thing we are looking at is proposed levies on private health care providers. Certainly, when I trained as a nurse—many years ago—that was an issue, and it remains so today.

The tariff ought to mean a more even and equitable system throughout the country. We will continue to work with SHAs and providers, and we will consider all the views expressed, to build understanding of what the tariffs will do and of how to manage the transition.

I assure the right hon. Gentleman that the Government recognise the importance of medical education and of continuing medical education. The new arrangements will take on board many of the issues he has raised, to ensure that we have a health care work force fit for the future.

Question put and agreed to.

NHS: Negligence

Andrew Turner Excerpts

Tuesday 1st February 2011 Ministerial Corrections

[Mr Andrew Turner]

To ask the Secretary of State for Health how much the NHS has paid to patients in ex-gratia payments to avoid ligation proceedings in each of the last three years.

[Official Report, 18 January 2011, Vol. 521, c. 732-33W.]

Letter of correction from Mr Simon Burns:

An error has been identified in the written answer given to the hon. Member for Isle of Wight (Mr Turner) on 18 January 2011. Unfortunately two of the figures in the table were incorrect.

The answer given was as follows:

[Mr Simon Burns]

HM Treasury consider ex-gratia payments to be a form of special payment. HM Treasury’s definition includes personal injury claims that are settled out of court. Information about local ex-gratia payments made by the national health service to patients to avoid litigation is not held centrally. Local NHS bodies record ‘losses and special payments’ in their consolidated accounts and these will include all ex-gratia payments, not just those paid to patients or to avoid litigation.

The NHS Litigation Authority (NHSLA) records data held centrally specifically on ex-gratia payments made for clinical, employer and public liability claims settled out of court. As the NHSLA settles the vast majority of its claims this way, they fall under HM Treasury’s definition of ex-gratia. Data provided by the NHSLA will cover payments to patients, although some will be made to families/dependants, employees and visitors.

Data on actual payments made each year can be provided only at disproportionate cost. The NHSLA has therefore supplied data in the following table which shows the total amount of damages paid on claims settled out of court where the claim was closed between 2007-10. It should be noted that some actual payments for these claims may have been made in earlier years to when the claim was closed.

Oral Answers to Questions

Andrew Turner Excerpts

Tuesday 2nd November 2010 Commons Chamber

[Mr Lansley]

The hon. Lady might not recall, but about five and a half years ago I visited Slough to meet the health trainers, particularly in the Asian community, who were going to help people. Their focus was on diabetes. It has been a very effective pilot and we will need to work—we will do so—with local authorities and the NHS. We should work together, using dedicated public health resources of precisely that kind, to identify the risk of diabetes and to tackle it at source.

[Mr Andrew Turner (Isle of Wight) (Con)]

On the Isle of Wight, the local NHS has decided that contraceptive pills may be given to girls as young as 13. Their parents and even their GPs are not involved. Nowhere else, I am told, shares that approach. Many of my constituents are horrified. What is the Secretary of State’s view?

[Mr Lansley]

My hon. Friend will know that these decisions were made locally. Indeed, we support local decision making. We will ensure that such decisions are taken not only in the health service but alongside local authorities as part of their public health function. It is important that one is clear that a young person is competent to make such decisions. Subject to that, however, we are always clear that patients have a right to access health care on their own cognisance if they are competent to do so.

Contaminated Blood and Blood Products

Andrew Turner Excerpts

Thursday 14th October 2010 Commons Chamber

[Mr Clarke]

I feel that there ought to be more humility on both sides of the House as we debate this matter, and I hope that I shall be able to exercise some myself. This issue has not been properly dealt with by Governments of all shades for a quarter of a century. It is amazing, but this is our first debate on the subject in a quarter of a century. I welcome the debate, and as the motion tabled by my hon. Friend the Member for Coventry North West is the only practical proposal before the House, I shall take pride in voting for it. I have held a number of responsibilities myself, including that of shadow spokesperson on disability. The hon. Member for Bristol North West (Charlotte Leslie) asked earlier what had been done so far, and the answer is: not enough.

[Mr Andrew Turner (Isle of Wight) (Con)]

Does the right hon. Gentleman recognise that this Government came into office only about five months ago, and that they are trying to get a lot of things sorted out? I am not blaming the right hon. Gentleman, but I am trying to explain what is happening. To wait for two or three months longer for this important decision is a small price to pay, and I do not understand why he and the hon. Member for Coventry North West are worried about waiting for three months, because that is the difference between the proposal in the motion and what the Government are proposing.

Health Funding

Andrew Turner Excerpts

Tuesday 22nd June 2010 Westminster Hall

[Mr Burns]

No. I have been generous, and I want to make progress.

That is the principle for the criteria, but it will not mean automatically that there will never be any changes because there is a block. We are strengthening the process to take account of local wishes and needs. There is a balance to be struck, which will emerge during the reconfiguration process.

[Mr Andrew Turner (Isle of Wight) (Con)]

Is my hon. Friend aware that we have a unique arrangement for health, and that a single organisation is responsible for both commissioning and delivery—the local hospital? That works for the Isle of Wight, and it has turned round a deficit of £3 million and broken even in the past three years. Can he assure me that the forthcoming White Paper will allow the success of the island’s health services to continue?

[Mr Burns]

I am grateful to my hon. Friend for that intervention. I assure him that the White Paper will be aimed completely at improving and enhancing the provision of health care throughout the country—not just on the Isle of Wight, but on the mainland from Cornwall and the south-west up to Hadrian’s wall in the north. That will be based on a principle of putting patients first and at the heart of health care provision so that they drive the national health service and so that it is there for them and their needs, rather than the needs of management bureaucracy or of politicians micro-managing the system from Whitehall down the road. However much affection and respect I have for my hon. Friend, I cannot be tempted to outline in detail now the White Paper’s contents, but I assure him that when it is published he will share my enthusiasm for the way in which the Secretary of State will unveil his vision for the national health service, not simply for the next five years, but thereafter. I trust that that satisfies my hon. Friend, if not the hon. Member for Worsley and Eccles South (Barbara Keeley).

My honourable colleague the Member for St Ives mentioned the current pace of change, and particularly the distance from target measurements used to assess relative progress towards target allocations. His constituency is in Cornwall and Isles of Scilly primary care trust. It received an allocation of £808 million in 2009-10, which increased to £856 million in 2010-11—an increase, as he knows, of 12.4% above the national average of 11.3%. However, under the formula established by the previous Government, and as many contributors to the debate have noted, that is still 6.2% or some £56.3 million below its target allocation for 2010-11.

I hope that my honourable colleague will appreciate that until the spending review is complete, I cannot comment on specific time scales or the future plans for NHS allocations, nor on the financial standing of specific local health services. I trust that he will be reassured that his partners in Government share a common assessment of both the problems facing the NHS and the solutions available to us.

During the spending review, we will examine rigorously all areas of health spending to identify where we can make savings—for example, by maximising the NHS’s buying power, renegotiating contracts and improving financial accountability throughout the system. The picture that I have painted is of an NHS in which decisions on resource allocation centrally are made by an independent NHS board. But although I cannot give the hon. Member for St Ives the commitment and promise that he wants now, the matter will be examined as part of the spending review between now and the autumn. When our reforms become reality, the NHS board will be responsible for the allocation of spending and will consider a whole range of areas.