Contaminated Blood

Andy Burnham Excerpts

Tuesday 25th April 2017 Commons Chamber

[Andy Burnham (Leigh) (Lab)]

Through you, Madam Deputy Speaker, may I thank Mr Speaker for giving me this opportunity to make what will be my last speech in this House? I make it on the subject of contaminated blood for a simple reason: knowing what I know, and what I believe to be true, I would not be able to live with myself if I left here without putting it on the official record. I will be honest: this is a speech made with a sense of guilt in that all of us here are collectively culpable of failing to act on evidence that is there before us if only we cared to look and, by extent, failing thousands of our fellow citizens who are the victims of perhaps the greatest untold injustice in the history of this country.

First, let me explain the genesis of my speech. Last year, the chair of the all-party group on contaminated blood, my hon. Friend the Member for Kingston upon Hull North (Diana Johnson), who has done absolutely outstanding work on behalf of those who have continued to struggle for truth and justice, invited me to a meeting to discuss where next for the campaign. There was a raising of expectations in the last Parliament—I am talking about a lot of goodwill on both sides of the House and a sense that people wanted to do something to help. That continued in the early part of this Parliament, with a sense building that something was going to be done. However, following those expectations, victims now feel that they have been led up to the top of the hill only to be let down once again.

Although I do not doubt the sincerity of the former Prime Minister’s apology at his last PMQs, the Government’s failure to back it with substantial action has left people feeling in the wilderness all over again. To try to find a way forward for them, my hon. Friend asked me to speak to the all-party group about whether my experience on the Hillsborough campaign might provide some insights that would help those still campaigning today, after all these years, for justice for those who have suffered from contaminated blood.

When I focused on that question, I had something of a penny-drop moment—this was when I was preparing to speak to the group. The more I thought about it, the more the parallels between the contaminated blood scandal and Hillsborough became clear. Obviously, both relate to the 1980s and both resulted from appalling negligence by public bodies, but there is also the fact that both have been subject to an orchestrated campaign to prevent the truth being told. It is that failure to give the victims the truth that compounds the injustice and the suffering.

Here is what I think is the crux of the problem. Contaminated blood has always been viewed through a financial prism. That suits the Government. It keeps the victims in a position of subservience, forced to beg for scraps of help from the various funds that have been set up. By the way, let me make it clear that I am talking about not just this particular Government—although I am talking about this Government—but all Governments. To the extent that the public know anything much about this scandal, there is a vague sense that it is an argument about money. In my view, it is in the Government’s interests to keep it there; they want to keep it there. Why is that? Just as with Hillsborough, if the great British public knew the real story here, there would be such a wave of public support for the victims that demands for full and fair compensation simply would not be able to be resisted by the Government. That is the experience of Hillsborough. When the truth was told, such was the huge groundswell of popular support that there had to be action. Perhaps that is why the Government do not want the truth to be told—they know that there would be little place for them to go in answering those calls.

I have brought this debate to the House today to try to break through that impasse. I want to refocus everybody on giving victims what they have never had—the truth. From what I know, this scandal amounts to a criminal cover-up on an industrial scale. I will present direct evidence to support that claim. There are hundreds of victims of this scandal who can point to evidence of crucial pages missing from their medical notes. Of course, the authorities have an excuse in these cases. They can always say, “Human error—they were lost. When we moved offices, the box got misplaced.” As implausible as that excuse is, they get away with it because how can we prove otherwise? But I want to focus on a small number of specific cases that reveal deliberate, provable acts of cover-up.

[Diana Johnson (Kingston upon Hull North) (Lab)]

I pay tribute to my right hon. Friend’s outstanding work on the Hillsborough inquiry and what he achieved there. Obviously there is still more to do. On behalf of the all-party group, I am so grateful that my right hon. Friend was willing to share his experiences with us in relation to contaminated blood.

I want to raise a point about Lord Owen’s request for documents, when he was the Health Minister in the 1970s. He was told then by officials that those documents had all been destroyed. The Archer inquiry, which I am sure my right hon. Friend will refer to, found no reason why that should have happened. I know he is going to talk about specific cases of documents being lost or doctored in some way. From what happened to a Government Minister, and given this idea of an industrial scale cover-up, does my right hon. Friend think that what happened with the individuals he is about to describe and with Lord Owen just shows how deep-seated this cover-up is?

[Andy Burnham]

My hon. Friend has put her finger on the point. With Hillsborough, when we finally got to match up documents held at a local level with those held at the national level, the full picture began to emerge. It is my contention that exactly the same would emerge here. The direct examples of a cover-up that I am about to give, relating to individual cases, would then be put together with what we know about documents held—or, indeed, not held, which itself implies wrongdoing—at a national level. In the end, it is the putting together of that picture that gives people the truth and allows them to understand how this happened. I will come directly to that point later.

I will focus on three cases. I highlight them not because they are the only ones I have seen or been sent, but because I have met or spoken directly to the individuals concerned, have a high degree of confidence in the facts and believe that these cases are representative of many more. The first case is of a gentleman who does not want to be named. I will call him Stuart, but I do have his full details.

[Sir Peter Bottomley (Worthing West) (Con)]

One of the reasons why this has not taken off widely as a real campaign is that victims understandably do not want to advertise their condition to those around them. I pay tribute to those who have talked to Members of Parliament, even on a confidential basis, so that some of us have some ammunition.

[Andy Burnham]

The hon. Gentleman is absolutely correct. There is a stigma related to HIV and hepatitis. People do not want to talk about it openly. Although I have drawn a parallel with Hillsborough—the hon. Gentleman was outstanding in his support for me on that issue—there are many differences, and one major difference is that, with Hillsborough, the event happened on one day, and everybody was watching it and can remember where they were when the pictures came through. This scandal was a silent one, which affected people in all parts of the country and all walks of life—not people from a similar place. These people were spread about and unable to organise in the same way the Hillsborough campaigners were. That is another reason why they have not been able to move things forward, and the reason the hon. Gentleman gave is true, too.

When Stuart was six years old, he was sent by Maidstone hospital to the Lewisham and Oxford haemophilia centres to have tests to see whether he had haemophilia. When he was seven, they wrote back and said that all the tests were normal and that he did not have a bleeding problem. When he was eight, he attended Maidstone hospital with a swollen knee—nothing more. It was not life threatening, and he had no bleeding problem associated with it.

Then, with no warning to Stuart or his parents, Maidstone hospital treated him with 12 transfusions of contaminated blood products over three days. According to his medical records later, that should not have happened. Then, in 1986, the hospital, unbeknownst to Stuart, carried out an HIV and a hepatitis B test on him. He was never tested for hepatitis C, even though his records show that a test was available at the time. He was not tested in 1989 or called back as other tests became available. He has all his medical records, but one thing is missing: the batch numbers for the contaminated blood products.

Stuart was eventually told he had a hepatitis C infection in—listen to this, Madam Deputy Speaker—January 2013. He was also told that it was too late for him to pursue a court case, despite the fact that legal experts said that what had happened to him was negligent and he firmly believes there has been a cover-up.

Let me move on to the case of a woman called Nicola Enstone-Jones. She wrote:

“As a female with haemophilia diagnosed in the ‘70s. From the age of 9 my parents spent years trying to find out what happened to me after receiving Factor VIII, this was in 1980…Dr’s denying anything was wrong with me, referring to me as having psychological problems, as there was nothing wrong with the treatment they gave.”

She says that that was not unusual for haemophiliacs growing up then. She goes on:

“It was when I was 24”—

24!—

“in 1995 that I asked a nurse if I’d ever been tested for Hepatitis C, as my mum had seen on the news about Haemophiliacs being diagnosed and dying from this new strain of Hepatitis, and all the signs and symptoms listed was me.

The nurse laughed at me and said ‘you won’t have that’; then came back with my medical notes and informed me I was positive to Hepatitis C from a test…done in 1991. A test I knew nothing about... like a true haemophiliac and after spending years of searching for answers I had suddenly found out why I had suffered health problems since childhood.”

However, it was only later, when Nicola was able to access her medical notes, that she found an entry for 1990, which she has drawn to my attention, and I have it in my hand. The notes say: “Discussed hepatitis C”. Nicola has told me directly that that never happened—it was never discussed with her in 1990. She found out for the first time in 1995.

This story actually gets quite a lot worse. Let me read out what Nicola goes on to say:

“Little did I know almost 19 years later I would be at a police station reporting what I”

believe

“to be a criminal act and a form of abuse on my own child, once again…Dr’s performing tests”

without consent,

“another well-known”

practice

“which Haemophiliacs are sadly used to.

I had found out in 2013 that my 9 year old haemophilic son had been tested for HIV and hepatitis’s and no doubt a whole host of other viruses and pathogens, just like I had been when I was younger. Given my daughter has a bleeding disorder too, there is no doubt in my mind she will have been tested...I found this out third hand, by chance in a letter which was another professional”

asking

“if my son needed treatment abroad. The letter stated ‘This 9 year old haemophilic has a factor VIII level of 10% and…has been tested for HIV and hepatitis…which he is negative to.’”

She had never been told about this or given consent for her son to be tested. She says:

“Surely this isn’t right, in this day and age”.

In my view, it is a criminal act to test a child without a parent’s knowledge.

Let me come on to the third case, which, in my view, is the most troubling of them all. It relates to a gentleman called Kenneth David Bullock—Ken Bullock. Ken was a very high-ranking civil engineer who worked around the world. In his later career, he spent time advising what was then called the Overseas Development Agency. He was a haemophiliac. Sadly, Ken died in 1998—a very traumatic death, unfortunately. Let me read from the letter that his widow, Hazel Bullock, sent to me a few weeks ago:

“I am so relieved to hear you are still committed to an active”

inquiry into

“the contaminated blood tragedy…Between the 15th November, 1983 and the 3rd December, 1983, my husband stopped being a Haemophiliac patient who had been infected with NonA-NonB type Hepatitis to being a clinical alcoholic…This accusation continued and escalated during the next fifteen years completely unknown to him, he was refused a liver transplant in 1998 and left to die still unaware of these appalling accusations. He did not drink alcohol.”

Mrs Bullock has examined her late husband’s medical notes in detail. Again, I have them here in my possession today. An entry in his notes from February 1983 says, “Acute Hepatitis”. Another from March says:

“NonA NonB Hepatitis which he probably obtained from Cryo-precipitate”—

the recognised treatment at the time. Again in 1983, the notes say:

“In view of his exposure to blood products a diagnosis of NonA NonB was made.”

However, it would seem at that point that all mention of blood products was to be stopped, very suddenly. Mrs Bullock says:

“They were never again to be found anywhere in my husband’s notes. From the 15th December, 1983 all the hospital records refer only to alcoholic damage to the liver. I have in my possession full copies of all the following notes.”

In December 1983, the notes say, “alcohol could be considered”; in 1994,

“likes a few beers at week-ends”;

in 1995, “alcohol related hepatic dysfunction”; in 1995 again, “clinical alcoholism”; and in 1996, “chronic high alcohol consumption.” In 1998, the year that Mr Bullock died, they say, “alcoholic cirrhosis.”

Mrs Bullock concludes her letter:

“My husband died on the 3rd October, 1998. At no time during this 15 years should alcohol have been mentioned. My husband’s rare and occasional glass of wine was minimal. He never drank beer or spirits. Alcohol was never a part of our lives and he had his last glass of wine on 18th June 1995, my 60th birthday. My husband died completely unaware of these accusations that have shocked family, friends and colleagues alike.”

Just as the evidence of amended police statements provided the thread that we eventually pulled to unravel the Hillsborough cover-up, so I believe the evidence that I have just provided must now become the trigger for a wider inquiry into establishing the truth about contaminated blood. There is a very disturbing echo of Hillsborough—is there not?—in what I have just said. People who were the victims of negligence by the state were suddenly the victims of smears perpetrated by those working on behalf of public bodies, particularly smears related to alcohol, suggesting that the disease that afflicted Mr Bullock’s liver was self-inflicted. That reminds me, of course, of the front-page newspaper stories that appeared straight after Hillsborough that alleged that Liverpool fans were drunk. It is a time-honoured tactic—is it not?—to deflect the blame from where it should be over to somewhere else.

It is of course possible that in each of the cases that I have mentioned the hospitals and clinicians concerned were acting on an individual basis to prevent their negligent practices from being known. I have to say, however, that I doubt that that was the case. My suspicion, as I said a moment ago to my hon. Friend the Member for Kingston upon Hull North, is that there are documents held at a national level, either by the Government or by regulatory or professional bodies, that point to a more systematic effort to suppress the truth.

I actually have two documents in my possession—this will save the Minister and the Government time if they want to suggest that there are no such documents—and I want to put them on the official record. The first is a letter sent in January 1975 by Stanford University’s medical centre to the Blood Products Laboratory, which was the UK Government’s wholly owned blood products operation. The letter goes to great lengths warning about the risk of the new factor VIII products that were coming on to the market. The gentleman who wrote it, Mr Allen, said of one particular product that the

“source of blood is 100 percent from Skid-Row derelicts”.

He was writing to warn the British Government about the blood products that were being used.

The second document is from the Oxford Haemophilia Centre and it was sent in January 1982 to all haemophilia centre directors in England. It says of the new products coming on to the market:

“Although initial production batches may have been tested for infectivity by injecting them into chimpanzees it is unlikely that the manufacturers will be able to guarantee this form of quality control for all future batches. It is therefore very important to find out by studies in human beings to what extent the infectivity of the various concentrates has been reduced. The most clear cut way of doing this is by administering those concentrates to patients requiring treatment who have not been previously exposed to large pool concentrates.”

In other words, it is saying: let us find out whether there is “infectivity”—to use its word—in the products by using patients as guinea pigs, without regard for the consequences. That is proof, in my view, of negligence of a very serious kind.

That brings me to the point that my hon. Friend the Member for Kingston upon Hull North raised earlier. When we read the warning from the Americans in 1975 about blood products being derived from blood that had been taken off convicts on skid row and the letter some seven years later in which the Oxford Haemophilia Centre stated that it was necessary to push on with trials—to find out whether the products were infectious by giving them to patients—we soon start to see that there was something here that needed to be hidden.

In addition, we must consider the fact that all the papers belonging to a Health Minister were, as I understand it, comprehensively destroyed under something called the 10-year rule. I have been a Minister, and I have never heard of the 10-year rule. Have you, Madam Deputy Speaker? It is a new one on me. A Minister’s papers were destroyed without his consent. To me, that sounds alarm bells and suggests that something is seriously amiss.

[Diana Johnson]

Was my right hon. Friend shocked, as I was, to learn that in November 1983, the then Health Secretary told Parliament:

“There is no conclusive evidence that acquired immune deficiency syndrome (AIDS) is transmitted by blood products”?—[Official Report, 14 November 1983; Vol. 48, c. 328W.]

Only months earlier, however, the Department had been preparing a document that stated that AIDS was almost certainly transmitted in such a way, and the Advisory Committee on Dangerous Pathogens had also told of strong circumstantial evidence that the disease was blood-borne. It seems as though there were real issues about what people and Parliament were being told. Ministers must never mislead Parliament, yet clearly the information that was being given to Parliament at the time was not correct.

--- Later in debate ---

[Andy Burnham]

I fear that my hon. Friend is right once again. I am aware that individuals received Crown immunity to protect the Government from litigation at the time. That paints a strong picture, and that is why we need to see the papers and find out what happened. I do not want to stand here and accuse Ministers in that Government of anything—that is not my aim—but let us have a look at the papers, so that we can at least see whether any misleading statements were made.

The cases that I have brought before the House provide evidence of several things. First, people were used as guinea pigs. Secondly, people were given inappropriate treatment, as Stuart was. Thirdly, tests were done without people’s knowledge or consent. Fourthly, the results of tests, even when they were positive, were withheld for years—decades, in some cases—from individuals. It has even been suggested that those individuals, who were simply living their lives and did not know that they were HIV-positive or hepatitis C-positive, subsequently infected others who were close to them. Fifthly, as we saw in the case of Ken Bullock, medical records were falsified with slurs and smears to suggest that liver disease was self-inflicted. These are criminal acts.

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

I pay tribute to the work that my right hon. Friend did when he was Secretary of State for Health. I was in the Department with him as a Parliamentary Private Secretary. Are we saying that the information is immune from the Data Protection Act and the Freedom of Information Act? Have they ever applied in this situation?

[Andy Burnham]

I think people have applied for documents, but many of those documents have been withheld. I will come on to that in a moment.

I was a Minister in the Department of Health just after the publication of the Archer report and the Government’s response to it. At the instigation of the late Paul Goggins, I sought to reopen the whole issue, and I encountered a lot of institutional resistance, if I may put it that way. I am myself standing here out of a sense of guilt—I wish that I had done more over the years—but having looked at it all and having pieced it all together, I think the documents that have been withheld would fill in some of the gaps I have described.

[Chris Stephens (Glasgow South West) (SNP)]

I pay tribute to the right hon. Gentleman for the work he has done on this issue and many others. The third case he described is surely one of defamation. Does he not agree that all families affected must, if they have not done so already, access their medical records and those of family members who have passed away?

[Andy Burnham]

It is a case of at least defamation. A range of potential offences, such as misconduct in public office, could be considered. It remains the case that people have not had access to their full medical records. There are just so many examples of people saying that crucial pages are missing. They obviously cannot prove that, but I have put on the record things that I think are provable and are, in my view, criminal. This cannot be left there, and the Minister is going to have to answer that point directly when she responds.

[Jim McMahon (Oldham West and Royton) (Lab)]

I pay tribute to my right hon. Friend and my hon. Friend the Member for Kingston upon Hull North (Diana Johnson) for the work they have done in exposing this issue. When Alex Smith, a constituent of mine, first came to my advice surgery to tell me the story of how he lost his wife through contamination and how he had contracted hepatitis C through a contaminated blood product, I could not help but feel aggrieved on his behalf. It now feels, however, as though this has moved on to something completely different—a very sinister cover-up—and I pay tribute to my right hon. Friend for his work in exposing it and for getting this far.

[Andy Burnham]

I think it has such a feel. For me, the whole thing about finance—it is always about finance, and about whether we can give them a bit more—has been helpful to the Government, because it has meant that they have never focused on the issue they should really focus on. As I said at the beginning, if this had been known about, the wave of support behind the people struggling to find out the truth would have been massive—absolutely massive—and the Government would have had nowhere to go and would have had to respond. Consequently, people are still struggling, such as my hon. Friend’s constituent, and I hope that they will not have to struggle for much longer.

[Sir Peter Bottomley]

It seems to me that the right hon. Gentleman is making three major points. The first is that those still alive who are affected and their families need proper, generous help without delay. The second is that there should be an inquiry into what went wrong all the way through, especially about whether people have interfered with the preservation of evidence. Whether people are prosecuted is a separate issue, but actually knowing what happened is what matters most. The third point—this is really the one in my mind—is that there was a difference, as Richard Titmuss pointed out in 1970 in his book “The Gift Relationship”, between blood donations in Britain, where they were freely given by the healthy, and donations in the States, which came from the sources the right hon. Gentleman has mentioned. If that was stated in a book in 1970, people should have paid attention as soon as they had any warning at all, whether from Stanford or from anybody else.

[Andy Burnham]

That was the direct content of the Stanford letter. There was a worry that the NHS was using such products in a completely different context, not understanding the difference between the two systems. That was the Stanford letter.

I am not standing here claiming to be an expert on all the papers, because I am not; I am saying what I know, from the people I have spoken to, to be wrong, and linking that to the documents in order to say what I believe to be the case. I may not be right, but we need to find out whether I am right, and that is the point that I will be putting to the Government.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I was not going to intervene, but the hon. Member for Worthing West (Sir Peter Bottomley) made the point that generous treatment is needed. The victims of this NHS scandal are not receiving generous treatment. I have a constituent who was infected during the scandal as a child at the Royal Manchester children’s hospital. When he discovered that his cirrhosis, if it remained untreated, meant that he ran a 25% chance of developing liver cancer, he was told that he would be denied treatment by the NHS. The treatment he needed to clear the virus load from his system cost £100,000, and at that point he decided to use the ex gratia payment that he had been given—such a payment is supposed to be some compensation, although it is not enough—to try to do so. That is the situation that victims such as my constituent are in at the moment, and it is a disgrace: they should not be fighting this and having to use their own money for their own treatment.

[Andy Burnham]

It is a total disgrace. Absolutely there must be full, fair compensation now. I say to the Government, do not delay; do what Ireland and other countries have done. They should do that now. They raised expectations and they should do it. We would all support it.

Mrs Bullock, whom I mentioned, is reduced to sending begging letters. She has had to sell the family home and move away from everything. She is sending begging letters to the Skipton Fund for a stair-lift. She is not well herself now. How can that be right? We are making a woman who has lost everything send begging letters for a stair-lift, as she tries to cope on her own because her husband is no longer there. On the point about medical treatment, I understand that Mr Bullock may have been refused a liver transplant because his notes said that he was an alcoholic. There is injustice upon injustice here. It is absolutely scandalous. I hope the House now understands why, as I said at the beginning, I could not live with myself if I left this place without telling it directly what I know to be true.

[Mr George Howarth (Knowsley) (Lab)]

My right hon. Friend is making a powerful case that there was a systematic cover-up. By joining together the dots in the way that he has, a picture seems to emerge that needs to be examined further. Even if he is wrong and what we are confronted with is systemic administrative and medical failures, the argument for immediate compensation for all the people affected is so powerful that the Government need to look at it urgently and, if possible, say something sensible about it today.

[Andy Burnham]

Absolutely; I could not agree more. It is downright immoral to make these people carry on begging in the way they have been forced to do. The Government raised their hopes; they should deliver on the former Prime Minister’s promise and do what my right hon. Friend has just described.

The story is becoming clear, is it not? Warnings from the United States were ignored. There was a wish to drive on with these new products from the Oxford haemophilia centre: “We’ll just push them out there to find out the results before we really know whether there is infectivity.” Problems started to happen and perhaps there was the idea, “Oh no, the Government might be exposed to litigation. Let’s not have it in people’s notes so that a story does not build about how there has been negligence and people might have a compensation claim.” That is the story I have got; I do not know what anybody else thinks. Worse, for some people, they said, “Don’t just destroy their notes; falsify their notes.” That is the story. We need to find out whether it is true or not. In my view, these are criminal acts. They did not just happen by chance. A major injustice has happened here.

In making this speech tonight, I think of our late, great friend Paul Goggins, who I miss every single day. He did so much to advance the cause of justice for those who suffered. I also think of his constituents, Fred and Eleanor Bates, and of the promises I made to act for them in Paul’s name. In a 2013 debate like this one just before he died, Paul made an impassioned call for:

“A serious Government-backed inquiry…with access to all the remaining records and the power finally to get to the truth of what happened and why.”—[Official Report, 29 October 2013; Vol. 569, c. 201WH.]

His demand was as undeniable then as it is now, yet it pains me that, in the four years since then, this House has not moved it forward at all. If that continues to be the case after what I have said tonight, I am afraid that this Parliament will be complicit in the cover-up.

In reply to the demand of my hon. Friend the Member for Kingston upon Hull North for an inquiry in a letter she wrote in October 2016, the Prime Minister said:

“the relevant documents have been published on the Department of Health and the National Archives websites and it is unlikely that a public inquiry would provide further information.”

In my view, that is a highly debatable statement. I do not think that a Prime Minister who has a good track record in helping to secure justice for those to whom it has been denied should have put her name to such a letter, which was probably drafted by the Department of Health. I remember exactly the same thing being said to me by those who opposed the setting up of the Hillsborough independent panel. “Everything is out there, it’s already known,” is what they always say. If the Prime Minister is confident in her assertion—I say this to the Minister—then rather than just publishing the documents the Government have selected as relevant, why not publish all the Government-held documents so that we can all decide whether her claim is true? On the basis of the evidence I have presented tonight, I believe it would be quite wrong for this House to resist that call.

To be clear, I am not calling for a lengthy public inquiry; I am calling for a Hillsborough-style disclosure process, overseen by an independent panel, which can review all documents held by government, NHS and private bodies. Just as with Hillsborough, the panel process should be able to view documents withheld under secrecy protections and make the necessary connections between documents held locally and nationally. It should then produce a report on the extent to which the disclosure of those documents tells a new story about what has happened.

So tonight I issue a direct challenge not just to the Government but to all parties in this House, including to my own Labour Front Bench and the Scottish National party: do the right thing and put a commitment in your election manifestos to set up this Hillsborough-style inquiry into contaminated blood. That, in my view, would be the most effective way to get as quickly as possible to the full truth and the whole story, as it was, effectively and efficiently, with Hillsborough.

I want to be very clear tonight with the Minister and with the House. If the newly elected Government after the general election fail to set up the process I describe, I will refer my dossier of cases to the police and I will request a criminal investigation into these shameful acts of cover-up against innocent people. I say to the Minister that the choice is hers. People are asking me why I do not just go straight to the police with the evidence I have, and I owe them an explanation. It is my view that the individual crimes I have outlined tonight are part of a more systematic cover-up and can only be understood as a part of that. If we refer them piecemeal to the police, they may struggle to put together the bigger picture of what lies behind the falsified medical records. That, in turn, may delay truth and justice. If the Government will not act, however, I believe a police investigation is the correct next step and that is what I will request. I cannot keep this information in my possession and not do something with it.

As we know, time is not on the victims’ side, so I will set a deadline. If the Government do not set up a Hillsborough-style inquiry by the time the House rises for the summer recess, I will refer my evidence to the police and request that investigation.

[Barbara Keeley]

My right hon. Friend is making an incredibly powerful case in his final speech in this place. The shadow Health team discussed this matter earlier and entirely support his call.

[Andy Burnham]

I am very pleased to hear that. I hope that means a commitment in the election manifesto of the kind I have just called for.

[Chris Stephens]

Does the right hon. Gentleman agree that there should be a Backbench Business debate on this issue when Parliament returns and before the summer recess, so that Back Benchers from all parties can pressure the Government to meet his demand?

[Andy Burnham]

I will not be here, but I make a plea to the hon. Gentleman, if he is returned—do not rule out Labour in Scotland, it is on the way back. I make a plea to everybody here in the Chamber today and to the candidates who may be coming here that they must act on this information. They cannot leave this where it is. Their conscience must tell them that they have to do something about it.

When the Government ruled out an inquiry into Orgreave, despite the existence of clear evidence of serious wrongdoing by the police, they did so on the basis that “nobody died”. I am afraid that that threadbare defence will not hold here. People have died—2,000 in all—and they have been the victims of both negligence and a cover-up. In its heart of hearts, this Parliament knows that to be true, and so the question is: what are we going to do about it?

I will end with a quote from an email I received from another victim, Roger Kirman, who became infected with Hepatitis C in 1978 but only found out by accident when having a hip replacement operation in 1994—this despite having raised his family in between. His brother George died from AIDS in 1991. He wrote:

“I have been fortunate to make it as far as I have but I have a real sense of anger against successive governments for their indifference to the plight of so many. Politicians should not be surprised at the loss of confidence in Parliament when candour is not forthcoming and they are seen as interested only in preserving their own position and the status quo.”

I suspect that Roger speaks for every single family affected by this scandal.

It has been an enormous privilege to serve my constituents in the House, and it is with real sadness that I prepare to leave, but in my 16 years here I have also had my eyes opened to its shortcomings. The simple fact that since Hillsborough I have been approached by so many justice campaigns—many of them from the 1970s and 1980s—tells me that this place has not been doing its job properly. Westminster will only begin to solve the political crisis we are living through when, in the face of evidence, it learns to act fearlessly and swiftly in pursuit of the truth and gives a voice to those of our fellow citizens who through no fault of their own have been left in the wilderness.

Collectively, we have failed the victims of contaminated blood. I do not exempt myself from this, and I wish to apologise to all those affected for coming so late to this issue in my speech tonight. I also apologise to you, Madam Deputy Speaker, for the length of my comments—but in a way I do not actually: the House should be delayed tonight on this matter. Truth and justice have been delayed for people, so the House should be delayed tonight, as it hears directly what they have been through. I hope that we have given a flavour of that tonight. I say to Members here and those who might follow: it is never too late to do the right thing. [Interruption.]

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. I do not want any clapping; “Hear, hear” will be fine.

As the right hon. Gentleman concludes his valedictory speech in the House, I am sure that the whole House will join me in wishing him well.

[The Parliamentary Under-Secretary of State for Health (Nicola Blackwood)]

I thank the right hon. Member for Leigh (Andy Burnham) for securing this debate, his last in the House, on what is a very important issue, not just for him and his constituents, but for many other Members and their constituents. I would like, in particular, to pay tribute to the courage of all the victims who have allowed their stories to be told today. The value of this, in reminding us why we are all here and in driving us to find the best solutions to this very difficult issue, cannot be overestimated. We should all take a moment to remember that.

That is exactly why the Government have introduced the infected blood payment scheme, alongside the commitment of up to £150 million up to 2020-21 for all those affected. It will more than double the annual spending during that time. I am sure, though, that the whole House will share my view that nothing can make up for the suffering and the loss that families have experienced, and no financial support can change what has happened to them, as the right hon. Gentleman said. I hope, however, that all those here today will recognise that the support provided is hugely important for those facing such significant medical challenges and is materially more than any previous Administration have provided, and recognise that it is a measure of how seriously the Government take the issue.

I would also like to take a moment to clarify some issues to do with the consultation, because there has been confusion about it in recent weeks. The consultation response announced on 13 July 2016 introduced for the first time an annual payment for all individuals affected with HIV or chronic hepatitis C through NHS-supplied blood or blood products. The recent consultation, which closed on 17 April 2017, asked for comments on the special category mechanism. This mechanism will allow those with hepatitis C stage 1 who consider their infection or its treatment to have a substantial or long-term adverse impact on their ability to carry out routine daily activities to apply for the higher annual payment, which is equivalent to the annual payment received by beneficiaries with hepatitis C stage 2 disease, such as those with cirrhotic liver and its complications, or those infected with HIV. We anticipate that a significant proportion of stage 1 beneficiaries will benefit from the new process and the higher annual payment it will offer.

Those co-infected with HIV and hepatitis C stage 1 will also be eligible to apply through the SCM. Those co-infected with HIV and hepatitis C stage 2 already receive the higher annual payments for both infections. The consultation proposes, however, that those payments will not increase in 2018, as originally set out in the 2016 consultation response. The recent consultation also included a question on the type of discretionary support that beneficiaries would find most useful. We remain keen to ensure fairness of support between all beneficiaries, based on need and individual circumstances. We have had consultation submissions, but we have to consider them over the purdah period. We cannot make decisions until after that.

I wanted to make those points before turning to the right hon. Gentleman’s point about a further inquiry. As he will know from a number of previous debates on the issue, the Government have been clear that we do not at this point believe that a further inquiry would be beneficial, because there have been previous inquiries. I would like to say a little about why those inquiries were quite useful. Lord Archer of Sandwell and Lord Penrose have already separately undertaken independent inquiries in the last decade. Neither inquiry found the Governments of the day to have been at fault and they did not apportion blame.

The Penrose inquiry began in 2009, when the right hon. Gentleman was himself the Health Secretary. In the course of the inquiry, evidence was taken over nearly 90 days of oral hearings, resulting in more than 13,000 pages of transcript, in addition to 200 witness statements and more than 120,000 other documents.

[Andy Burnham]

I accept that there have been two inquiries—Penrose was commissioned by the Scottish Government—but it is not acceptable for the Government to point to Archer. That was not a Government-backed inquiry. It did not have access to all the Government papers. The Minister cannot use that as an excuse or say, “We don’t need an inquiry because of Archer.”

[Nicola Blackwood]

That is why I was speaking about Penrose. The final report from the inquiry was published as recently as March 2015 and includes an appendix that lists witnesses and many of the most significant statements and reports that the inquiry considered. Although the Department of Health was not called to provide witnesses to the Penrose inquiry, it co-operated fully with Lord Penrose’s requests for documentary evidence, and the departmental evidence that Lord Penrose used is referenced in his final report. Lord Penrose published the report of his public inquiry into infections acquired in Scotland on 25 March 2015. Nothing was withheld. Any redacted documents provided to the inquiry were redacted in line with both standard practice to protect personal information and current freedom of information requirements.

--- Later in debate ---

[Nicola Blackwood]

The right hon. Gentleman has made a good point. However, given the release of Government papers that has already taken place and the numerous statements made about the issue by Ministers in both Houses, it is hard to understand how an independent panel would add to current knowledge about how infections happened, or the steps taken to deal with the problem. As with a public inquiry, the Government believe at this point that setting up such a panel would detract from the work that we are doing to support sufferers and their families without providing any tangible benefit.

[Andy Burnham]

rose—

[Nicola Blackwood]

Will the right hon. Gentleman allow me to proceed to the next paragraph, which I think he will want to hear?

Let me now turn to the evidence that the right hon. Gentleman has presented today, with a great deal of passion. He will appreciate that I have not seen that evidence; this is the first that I have heard of it, so I have had no chance to give it proper consideration. He will also be aware that we are now entering the pre-election period, and that we are therefore in purdah. I ask him please to submit his dossier to the Secretary of State for Health, and also to Lord O’Shaughnessy, who is the Minister responsible for this area of policy. Of course, if the right hon. Gentleman does indeed have evidence of criminality, he should contact the police, but I want him to be aware that the Health Secretary has made patient safety, learning from mistakes and transparency key personal priorities, and I am sure that if the papers hold the concerning matters to which the right hon. Gentleman has referred, he will give them the highest priority.

I do not doubt the right hon. Gentleman’s sincerity. He knows a great deal about this issue, because it was live when he was Health Secretary, and I appreciate the apology that he has made to victims today. I must, however, ask him to recognise that we are taking action on what is an undeniably difficult and complex issue, and trying to get things right for the victims who have waited far too long for action. I also ask him to recognise that we are acting with the best of intentions, even if he disagrees with the way in which we are doing so.

Let me end by offering the right hon. Gentleman my very best wishes for his future. He has left an indelible mark on British politics, and I am sure that he will experience great success in that future, wherever it may be.

--- Later in debate ---

[Sir Peter Bottomley]

That is one of the reasons why I believe that over the election period the advisers to Ministers—not just to Health Ministers, but perhaps also to Home Office Ministers—should consider what could be obtained by the kind of call for evidence and inquiry that the right hon. Member for Leigh has rightly proposed.

[Andy Burnham]

rose—

[Sir Peter Bottomley]

If the right hon. Gentleman has any other points he wants to make through me, he is welcome to do so.

[Andy Burnham]

I am grateful for the opportunity. The Minister was very kind in her remarks, but the point that perhaps was missed when referencing Archer and Penrose is that I am calling for a different process that takes documents at a very local level and matches them with documents higher up the chain. It is only then that we can put the jigsaw together and start to understand why someone was acting in a certain way in a particular hospital. That is what we are looking for, and that was the strength of the Hillsborough independent panel: it was able to paint that canvas and put all the pieces of the jigsaw together.

I will send the evidence to the Department. The amended police statements only came to light properly just before the 20th anniversary of Hillsborough. What I have presented to the House tonight is altered medical records—that is a fact; that has been given to me. In my view, that is the same trigger and it should be looked into so that the facts can be established. That is new evidence that the Government now need to consider, to take a new decision on this.

[Sir Peter Bottomley]

The right hon. Gentleman has taken the words out of my mouth, and has said it better than I could have. We are all grateful to him. The point is that this scandal should never have happened, when it was started it should have been stopped, and when it had been stopped people should have known why it had gone on for as long as it did. The right hon. Gentleman has done a service.

Oral Answers to Questions

Andy Burnham Excerpts

Tuesday 7th February 2017 Commons Chamber

[Mr Dunne]

We have announced the first 1,000 nursing associates. In fact, the first cohort commenced at the beginning of this month. I visited, in Queen’s hospital, Romford, the first very enthusiastic group of nursing associates. We have announced a second wave of 2,000 associate roles. I regret to say that Wiltshire does not have any of those at the moment, but that will not stop it bidding for them in future. I will look at my hon. Friend’s point about further education colleges.

[Andy Burnham (Leigh) (Lab)]

When the Secretary of State scrapped the nursing bursary, he claimed that his reforms would lead to an increase in nursing applications. Last week, figures from UCAS showed that there had been a drop in nursing applications of 23%—a worrying trend when the demands of Brexit will mean that we need more home-grown nurses. Will he scrap this disastrous policy or, at the very least, give Greater Manchester the ability to opt out of it and reinstate the nursing bursary?

[Mr Dunne]

I urge the right hon. Gentleman not to indulge in scaremongering about the number of people applying to become nurses. There are more than two applications for each of the nursing places on offer to start next August. He needs to be careful about interpreting this early the figure for applications from EU nationals, which has gone down significantly, because it coincided with the introduction of the language test for EU nationals.

Agenda for Change: NHS Pay Restraint

Andy Burnham Excerpts

Monday 30th January 2017 Westminster Hall

[Dr Whitford]

Yes; I would expect to speak at the end, if other Members wish to speak.

[Andy Burnham (Leigh) (Lab)]

rose—

[Mr Nigel Evans (in the Chair)]

I call Andy Burnham.

[Andy Burnham (Leigh) (Lab)]

Thank you, Mr Evans. I also thank the SNP spokesperson. I had not intended to speak but will grab this opportunity because it is an incredibly important debate.

First, I pay tribute to the Royal College of Nursing and the Nursing Times, which have captured the voices of nurses all over the country. We heard some of those voices in the excellent speech by my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell), and I think they speak for the vast majority of those in the nursing profession.

We meet at a time when the NHS is under unprecedented strain—certainly in recent times. Workforce morale is at the heart of the quality and sustainability of NHS services. What is often forgotten and missed when we debate this subject is that the vast majority of nurses in the NHS—nearly all, actually—work beyond their contracted hours.

I will never forget being at a meeting in Bristol with a nurse from the Bristol Royal infirmary. It was when the Government were looking at introducing regional pay, which the RCN led a campaign against. At the time, the nurse was being presented with a contract and asked whether she was prepared to vary her Agenda for Change conditions by moving from a 37-hour working week to a 39-hour one—it may have been 39 to 41 hours, but it was an increase. I asked her, “What did you do?”, and she said, “Well, I signed it straight away.” I asked why, and she said, “Because I’m currently doing a 45-hour working week, but they don’t know that.” In many ways, that illustrates the point: management do not know the value of what they get from the nursing profession.

That anecdote tells the story about the job. It is more than a job to people. As my hon. Friend the Member for Newcastle upon Tyne North said, people give all of themselves to this job, but they have limits. When they feel as though those above them do not understand the commitment and the huge contribution they make to the NHS, and when they feel taken for granted, the good will and morale start to dry up. That is when the Government are in danger of achieving a false economy. The price of holding down nurses’ pay in the way that has been done over the past six years is, in the end, nurses not feeling able to go above and beyond as they normally willingly do.

[Stephen Timms (East Ham) (Lab)]

I agree with the points that my right hon. Friend is making. The RCN has told us that the pay of a significant group of nurses has fallen in real terms by 14% over the period he refers to. Does he agree that that is a pretty startling statistic?

[Andy Burnham]

My hon. Friend the Member for Foyle (Mark Durkan) said that this is a pay cut. We should not call it a pay freeze because it is, in fact, a pay cut. The Government have manipulated the figures in this area. Let us call it what it is: a pay cut that has now been sustained over a number of years.

People are at their limits. They cannot carry on having their pay cut every single year while they face other pressures and rising costs, such as accommodation costs, without there being a consequence. The consequences will be for their own sense of wellbeing, their own mental health or, indeed, their children’s quality of life. Nurses are now saying, in large numbers, that enough is enough.

[Mary Glindon (North Tyneside) (Lab)]

Further to what my right hon. Friend just said, does he agree that there is a culture under this Government and the previous coalition Government of devaluing the whole of the public sector? This is one stark example of what is happening across the public sector.

[Andy Burnham]

That is how it begins to appear. The Government are pushing people beyond their limits. There was the attempt to introduce regional pay, and there was the attempt to cut what is called the unsocial hours payment—there has been a whole series of initiatives that try to strip away support for the profession. It begins to feel like an attack on the profession. That is certainly how junior doctors felt, and I think GPs feel the same. The nursing profession is making clear today that it feels the same too.

As I said, this is a false economy. As well as damaging the good will and the extra hours that people were willing to offer before, it has also, as my hon. Friend the Member for Foyle indicated, pushed people into the arms of private staffing agencies. That, in the end, is another false economy for the national health service. Over recent years, we have seen the bill for private staffing agencies in the NHS increase year on year, to the point where it is now in the region of several billion pounds every year. Many trusts are in the grip of the private staffing agencies. That, of course, is also a factor in the cuts to nurse training that we have seen in recent years.

[Dr Poulter]

The right hon. Gentleman is making some very fair points. I hope he recognises that one of the first things I did in ministerial office was to reverse what was happening on regional pay and stick to the national pay contracts. He makes an important point about temporary staffing. If we look at the approach with the junior doctors’ contract, many junior doctors will now see a huge reduction in in-house locum pay for the work they are doing; it is sometimes a reduction of £10 an hour. That will feed locum agencies and drive up the temporary staffing bill. We need to see nurses and other Agenda for Change staff paid properly, to stop them needing to do agency work. That is one of the main drivers of the agency business.

[Andy Burnham]

I am glad to hear the intervention of the former Minister, whom I worked well with in the previous Parliament. I want to take this opportunity to say that he did listen on regional pay. We made an argument about that issue, backed up by the RCN and others, and, to be fair, it did not go any further than the experiment in the south-west. I give credit to him for that. I also give credit to him for consistently showing a real regard for the pressures faced on the frontline.

The hon. Gentleman makes an important point that the Minister would do well to reflect on. There is a huge false economy here. It makes sense to have fairness in terms of headline pay for staff, to maintain good will, but on top of that, it makes sense to provide them with incentives to give any additional shifts or time to the in-house bank, rather than private staffing agencies. The Government have lost sight of that in recent times.

[Mr Jim Cunningham]

My right hon. Friend makes an interesting point. It can be a false economy to rely on agencies to staff hospitals, whether it be nurses or doctors. At the end of the day, training suffers. That makes it difficult for the NHS to recruit, so it is a false economy in a number of ways.

[Andy Burnham]

It is not only a false economy; it directly damages the quality of patient care. When people arrive on the ward who do not know the team or the environment and have to be told everything, it builds in confusion and delays because staff have to take them through things. It does not make sense to use private staffing agencies to the extent that they are being used in the NHS. The cost is exorbitant—that is No. 1—but it also damages morale, because it leads to staff in the permanent employ of the trust working on the ward alongside people who are being paid significantly more than them for the same shift, despite having just arrived on that ward. That does not build a sense of team on the ward; it builds a sense of resentment.

[Dr Huq]

My right hon. Friend makes a powerful point about the lack of continuity with agency staff coming in. He talks about recruitment and retention. The NHS traditionally has had a large overseas workforce. Does he agree that the £35,000 salary required to settle in the UK has not helped matters? Nurses normally start at £23,000. Our NHS would crumble without overseas workers. We have also heard that in the post-Brexit climate, people from overseas feel less welcomed by this nation. Does he have any comment on that?

[Andy Burnham]

My hon. Friend makes two important points. The first was on the effect that Home Office immigration rules could have had on the nursing profession. I think the former Home Secretary, now the Prime Minister, made some changes in that regard.

My hon. Friend is right that there is a much bigger context here: the post-referendum climate. The Government have been absolutely wrong not to guarantee the status of EU nationals currently working in our national health service. I have an example from my constituency of a Polish community nurse, who every day gets up early to go on her local round delivering insulin to vulnerable patients who are diabetic and housebound. One morning she heard a cry of, “Go home!”, out of one of the bedroom windows opposite. What does that make that nurse feel like, and is she likely to stay when we are in this prolonged period of uncertainty in which this growing hostility is felt to be around? There is a real risk here. We cannot simultaneously refuse to give clarity to those tens of thousands of nurses from other parts of Europe who are currently working in our NHS and run down the good will of nurses who are UK nationals. In the end, something will give, and it will be patient care, if we operate policies of that kind.

Alongside that, there is the attack on nurse training. We have seen cuts to nurse training places over a number of years, so there is a shortage of nurses coming through. Many places are being and have been forced to recruit from overseas. In those circumstances, with everything else that I have described, including the downward pressure on headline pay, how can it possibly make sense to scrap the nursing bursary? Will that not just be another factor that adds to the growing sense of crisis in the profession? Every single piece of support that is there to develop the nursing profession is systematically being stripped away.

We have seen years of that approach and are beginning to see the consequences in the national health service. Labour, of course, did not get everything perfect—I am not saying that—but I can say with some pride that when I was a Minister in the Department of Health, we brought through a major programme of investment in the nursing workforce, through Agenda for Change. It was the subject of hard discussions, but in the end it was agreed between the trade unions and the Government of the day. We did have in the Department of Health a social partnership forum, which brought together NHS Employers, trade unions and the Government to iron out problems relating to the nursing workforce. We did massively increase the numbers in the nursing profession. We did ensure that they were properly rewarded and had proper access to training. My worry is that we are seeing some of that break down.

In the immediate aftermath of the financial crash, it was acceptable, it seems to me, to ask the nursing profession to make a contribution to deficit reduction, but here we are, six years on, expecting people who are out there today, working flat out to keep an NHS in crisis going, to take pay cuts for the privilege of doing so. At some point, that strategy begins just to fall apart, and the NHS falls apart with it. I say to the Minister that we are not far from that point now.

[Chris Stephens (Glasgow South West) (SNP)]

Is there not a wider economic point that if we keep pay freezes in place for so long—six years—that ends up harming the private sector economy, because if 70p in every pound of public sector money ends up in the private sector economy, some of that is wages, including nurses’ pay?

[Andy Burnham]

Of course, and the point is very well made, but I will also say again that it does not help deficit reduction if nurses are being pushed into the grip of private staffing agencies as a consequence of pay policies. That is another way in which the Government’s short-sighted approach has not in the end produced benefits for the economy, as the hon. Gentleman says, nor helped us meet the target of deficit reduction, because so much money is being wasted every year.

I will conclude on that point. The voices that have been mobilised in support of the lobby of Parliament today are real voices, as we heard from my hon. Friend the Member for Newcastle upon Tyne North. These people are the backbone of the national health service, the backbone of our communities and the backbone of our country. They have limits, though. Their limits are higher, but they do have limits, like everyone else. They feel taken for granted. Right now, the NHS cannot afford to lose the good will of the nursing profession. The Minister needs to listen carefully to what is being said today and he needs to make urgent representations, through the Secretary of State, to the Chancellor of the Exchequer in advance of the spring statement. A signal needs to be given to the nursing profession that the Government are listening and will take action, within the bounds of what is possible, to treat the nursing profession properly. I hope that, if nothing else, the Minister takes that message away from today.

[Mr Nigel Evans (in the Chair)]

There being no one else standing in their place, we will move to the winding-up speeches.

--- Later in debate ---

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Evans. I congratulate my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell) on the eloquent and knowledgeable way that she introduced this debate on behalf of not only the Petitions Committee but the more than 100,000 people around the country who signed this petition.

When she introduced the debate, my hon. Friend said that it is not enough for us simply to state our support for NHS staff—it has to be shown. The excellent attendance that we have had today, despite the important international business taking place in the main Chamber, has shown the huge support for our NHS staff and it is high time that the Government matched that support with action. In an intervention, the hon. Member for Kettering (Mr Hollobone) put the proposition that it is incredibly hard for the Government to justify ignoring the recommendations of an independent pay review body when we as Members of Parliament have our own pay agreed and implemented by an independent body. Can the Minister not see how repeatedly ignoring independent pay reviews strikes at the very heart of the bond of trust that exists in an employment relationship? Can he not see how it makes us look like we are uncaring and wrong? It is self-defeating and the approach needs to change.

My hon. Friend rightly highlighted the particular problems in ambulance trusts and the issues with the recruitment and retention of paramedics. She described the expenditure on agency staff as “nonsensical”. Certainly, no business would consider this a sustainable model. The personal testimonies that she gave from her constituents were compelling. None of us could fail to appreciate how difficult the situation is for some of our nurses. One said that she grieves for her profession, and that highlights just how dire the current situation is.

We also heard from the hon. Member for Foyle (Mark Durkan) about his perspective in Northern Ireland. He told us how the use of terminology appears to lead to people in different jobs being paid lower rates of pay for effectively the same job. That is certainly not how Agenda for Change should work in practice, and the pay freeze only exacerbates the sense of injustice that individuals feel. He summed up the situation perfectly when he said that the long-term pay freeze is in fact a pay cut. He said their sense of vocation “is being exploited”. He was right about that, but is it not incredibly sad that a Member of this place can say that without fear of contradiction? Just how low have we sunk?

We also heard from my right hon. Friend the Member for Leigh (Andy Burnham), who has great experience in the health service. He rightly said that nursing is “more than a job” and it is clear that he appreciates that, but he is right that when nurses feel that those above them do not appreciate what they are doing, it becomes a false economy and drives people into the arms of staffing agencies.

[Andy Burnham]

My hon. Friend has just mentioned people feeling a sense of fairness, particularly in the pay of those above them. Does he share my concern that in this current climate, while nurses’ pay is being cut, we are seeing large pay increases self-awarded to members of clinical commissioning groups and senior management? Does that not completely demoralise the whole local profession?

[Justin Madders]

I agree entirely. We all know—it is well documented—the financial pressures that the health service is under. It defies belief or explanation that those in senior positions can still fly in the face of that. I can only sympathise profusely with how nurses must feel when they see those headlines.

Accelerated Access Review

Andy Burnham Excerpts

Tuesday 13th December 2016 Westminster Hall

[Ian Austin (Dudley North) (Lab)]

I beg to move,

That this House has considered the implications of the Accelerated Access Review for cystic fibrosis and other conditions.

It is a pleasure to serve under your chairmanship, Sir Alan. I start by thanking three Dudley residents—Carly Jeavons, Samantha Carrier, and Samantha’s fiancé Rob Evans—for contacting me about accessing new treatments, and for what they have taught me about cystic fibrosis. I also thank Ed Owen, the brilliant former chief executive of the Cystic Fibrosis Trust, Darren O’Keefe and all of the staff at the trust for all their help and advice in organising the debate. Finally, I thank all of the right hon. and hon. Members who have taken the trouble to come here today to speak up on behalf of their constituents who have cystic fibrosis and other long-term conditions.

Just over a year ago, I was contacted by Carly about her work with the Cystic Fibrosis Trust to push for new treatments, such as Orkambi, to be offered on the NHS. She has continued to campaign, and I had the pleasure of joining her, her father Robert and her son Corey to deliver a 15,000-name petition to Downing Street earlier this year. Carly said to me:

“Before, I was always exhausted, I couldn’t work the hours I was contracted to and I had a little boy, Corey, to look after. I couldn’t do everything I needed to do and keep on top of my health, but this drug has given me some control back. I can now do everyday things and walk to the park with my five-year-old, which I could never do before. I personally feel like I have got better and better the longer I have been on it. I have a new way of living.”

Thanks to a clinical trial of Orkambi, Carly now needs to visit a cystic fibrosis clinic less than half as frequently as she used to. That allows her to carry on working, to go on holiday with her family and to do the things that the rest of us take for granted. She continues to benefit from Orkambi, but only thanks to a compassionate use scheme offered by the drugs manufacturer, Vertex. She and other users of Orkambi need the certainty that they will be able to benefit from the drug well into the future with NHS support, which is why we are here today.

I also thank Samantha Carrier, another Dudley resident, who is campaigning to raise awareness and raise funding after her young daughter, Daisy, was diagnosed with cystic fibrosis. Samantha has seen the difference that drugs such as Orkambi can make, and she wants her own daughter to have access to them as soon as possible, so that she can live as full a life as possible. She has told me about the hours of care and support that her daughter needs every day—which makes work so much more difficult for many parents of children with cystic fibrosis.

Samantha said to me:

“I am not ashamed to say I didn’t know how to cope with it all. But one day you wake up and you realise ‘This is it now’. All we can do as a family is try to do our best by her and give her the best life we can.”

I have been very moved by Carly, Samantha and Rob’s determination for something positive to come out of these diagnoses. I think their fundraising and campaigning for the Cystic Fibrosis Trust is nothing short of inspirational.

Personalised medicines can transform life for people with cystic fibrosis and a range of diseases, including muscular dystrophy and Alzheimer’s, but without a process for appraising these medicines that is fit for purpose, patients are unable to access these innovative medicines. That is why we called for today’s debate.

Cystic fibrosis is a life-shortening inherited disease that affects more than 10,000 people in the UK. It causes the lungs and digestive system to become clogged with mucus, making it hard to breathe and digest food. The damage that cystic fibrosis causes to the lungs means that many people eventually need a lung transplant. There is no cure for cystic fibrosis but many treatments are available to manage it, including physiotherapy, exercise and nutrition. The median survival age is just 28. What people like Carly, Sam and countless other families across the country need to hear today is the hope that a way forward can be found that will bring an end to an agonising and unnecessary wait that has gone on for well over a year now.

Orkambi was licensed in November 2015. It is a first-of-a-kind personalised medicine that treats the cause, not just the symptoms, of those with a particular mutation of the genetic defect that causes cystic fibrosis. Around half of the people with cystic fibrosis in England stand to benefit. Personalised medicines offer a revolution in cystic fibrosis care. People in countries such as France, Germany and America who have been on the drug for some time are beginning to report total transformations in their health, with some improving enough to come off the lung transplant waiting list—on which one in three people with cystic fibrosis die. Clinicians in England are desperate to prescribe Orkambi. Those who are prescribing it, on compassionate grounds, report that the drug, which halves hospital admissions—that lasts for months—for people with cystic fibrosis, could help ease the severe and worsening shortage of beds on cystic fibrosis wards.

I stood in this Chamber a year ago to raise concerns that the appraisal process for Orkambi was not suited to an innovation of this kind. The existing National Institute for Health and Care Excellence appraisal system makes decisions on the efficacy of a drug based on 24 weeks of clinical trials data, but fails to take into account the long-term benefit to sufferers’ quality and length of life. The focus on measuring the benefits of a treatment in terms of quality-adjusted life years does not work for genetic diseases such as cystic fibrosis, because it massively underestimates the impact that the drugs have on quality of life over the long term. It also fails to take account of the wider benefits for society of these medicines, such as the way that they can help sufferers or their carers get into work. In short, the existing system cannot provide an accurate assessment of new treatments that offer long-term, preventive stabilisation of cystic fibrosis.

I highlighted that, due to those concerns, the Cystic Fibrosis Trust was proposing an innovative solution under which real-world, long-term data could be gathered using the UK cystic fibrosis registry. The registry already provides real-world data to health commissioners and pharmaceutical companies, so that they can monitor the efficacy of treatments.

[Andy Burnham (Leigh) (Lab)]

My hon. Friend is making an incredibly important point. I congratulate him on securing this debate, which will give hope to the many people out there who suffer with cystic fibrosis. Is he aware of new 96-week data that have recently been published that show that Orkambi slows decline in lung function by around 42%? Those data were not available to NICE when it made its appraisal. Do those data alone not make the case for a further accelerated review process on this absolutely compelling?

[Ian Austin]

My right hon. Friend is completely right; he raises a point I will make shortly. It is good that he is here to support people with cystic fibrosis in his constituency, and to bring his knowledge and experience of the national health service to bear in the debate.

The Cystic Fibrosis Trust’s proposal would provide foundations for a managed access scheme for the drug. That was in line with the interim findings of the accelerated access review, which recommended the merits of such an approach and referred to the UK cystic fibrosis registry as an exemplar. I will say more about the accelerated access review in a few moments.

As expected, seven months later NICE referred to a lack of long-term data in rejecting Orkambi for use in the NHS. That was despite Orkambi’s being proven to halve hospitalisations and NICE’s recognising it as a

“valuable new therapy for managing cystic fibrosis”

with significant clinical benefits, as well as

“wider benefits to society for people with cystic fibrosis and carers of people with cystic fibrosis.”

--- Later in debate ---

[Andy Burnham (Leigh) (Lab)]

I congratulate my hon. Friend the Member for Dudley North (Ian Austin) on the spirit in which he introduced the debate and on his consensual tone. I also commend him for the quality of the case he outlined in his excellent speech. He could not have done a better job of representing his constituents and all those represented by the Cystic Fibrosis Trust. My hon. Friend the Member for Bristol East (Kerry McCarthy) is right to pay tribute to Ed Owen, the departing chief executive of the CF Trust, who made an enormous difference to so many people during his tenure.

I sympathise with the Minister, because I have been there when such difficult issues have arisen. I assure him that there is no party politics in this room today. We have heard excellent speeches from both sides of Westminster Hall on issues of great importance to our constituents, and Members have made their points in that spirit.

I was involved in the establishment of NICE, which my hon. Friend the Member for Cambridge (Daniel Zeichner) mentioned, and it did become a world leader. I am the first to say that it can never be right for politicians to sit in judgment on treatments—judging that those who shout the loudest should therefore get the treatment. NICE was established for an important reason and, as a Minister, I always sought as best I could to stick to NICE’s judgments and not to undermine them. On occasion, however, treatments would come along that were, quite simply, exceptional and that could not be considered within the narrow confines of the NICE appraisal process. Those treatments were often innovative and related to chronic conditions where the drug, if used, might have a long-term beneficial social impact, rather than an impact that would necessarily return money to the NHS budget.

To be open about the shortcomings of the NICE process that we established, NICE was not able to consider the wider public budget, the Department for Work and Pensions budget and other budgets. My hon. Friend the Member for Dudley North spoke about people being able to work and care for their kids, and often the failure to fund a drug has a much wider social cost, yet the narrow process applied by NICE often did not take that into account. Orkambi is one such treatment where we need exceptional consideration of its potential wider impact. The accelerated access review has given the keys to the Minister. There are things that can be done, and we all urge him to use those flexibilities today.

I could say a lot more, but the best way to use the time remaining to me is to refer to some of my constituents, many of whom have been in touch to encourage me to speak today. My office manager, Karen Aspinall, has a son in his 20s who has CF. Through her, I know how it is to live day to day with the challenges presented by CF.

I close with the direct words of my constituent, Leigh resident Philip Grimshaw. He is 28 years old and his words say far more than I could. He and his sister Melissa were diagnosed with cystic fibrosis when they were very young, and this is what he wrote to me:

“Melissa was diagnosed with CF as a baby after being very unwell since birth, and I was diagnosed as a result of this, at 7 years old. All our lives we have had to take a cocktail of medications and have had frequent stays in hospital.

In my opinion Orkambi would, amongst other things, reduce the number of hospital stays and also reduce the need for occasional extra antibiotics due to CF related illness (because we would be in better health as a result of Orkambi). Both of these mentioned would save the NHS money. I understand that it’s not a cheap medication but neither is a two week hospital stay, on a specialised ward, on extra antibiotics, six times or more a year.

I do think that the stress of losing our mum had an impact on Melissa’s health.”

Sadly, Melissa died in 2013. The letter continues:

“The problem with CF is that once your health starts to slide, it’s very difficult to bring back to where it should be. If Melissa was on Orkambi then it could have kept her in a better state of health and prevented her becoming as ill as she was and would have prevented the worst.

As for me; I’m looking to settle down and have children in the near future. Orkambi would help me to watch my children grow up rather than live to the predicted age of being in my 50s. I have had the dilemma of whether or not to pay into a pension because I won’t live to see retirement age and maybe even not long enough to be able to take a lump sum out at 55!

Orkambi can change that. It would be nice to have the confidence to know that I could see my children graduate university, start jobs and even have children of their own.”

I am sure that Philip’s words would be shared by many other people in their 20s, or younger, with cystic fibrosis if they had the opportunity to vent them in this place. They are the appropriate words on which to finish.

I recognise the difficulties, but we were here before with Kalydeco and we managed to find a way through. As my hon. Friend the Member for Bristol East said, nobody now doubts that that drug has made a huge difference to so many lives. We are in exactly the same position again, so let us learn from that experience. Let us not test people’s patience. Let us get the appraisal process moving towards a positive resolution. I realise that that is a challenge, but Ministers sometimes need to cut through the bureaucracy. The Minister is a good man, and I urge him to do that today.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (David Mowat)]

It is good to serve under your chairmanship today, Sir Alan. I congratulate the hon. Member for Dudley North (Ian Austin) on leading the charge in this debate. The right hon. Member for Leigh (Andy Burnham) rightly said in his very good speech that this is not really a political issue. Every Member in this Chamber has constituents who would benefit from these drugs. There are 10,500 people in the country with cystic fibrosis and it is massively important that we do everything we can to make progress on the issue. I also congratulate the Cystic Fibrosis Trust on its work and on its “Stopping the Clock” campaign. Debates such as this give prominence to these issues and to the need to make progress.

The debate is really about two drugs, a drugs company and an evaluation process. I shall speak about all of those and about where we are going with the accelerated access review. The two drugs are Kalydeco, which applies to something like 4% of cystic fibrosis sufferers, and Orkambi, which would apply to a further 40% of sufferers. Both are relatively small populations: for Kalydeco it is something like 400 people in England, and for Orkambi it is something like 2,700 or 3,000. Kalydeco has been routinely available on the NHS since 2013. As mentioned today, it was extended on 4 December to children aged two to five. It makes a big difference and we are pleased to have made that progress. Both Kalydeco and Orkambi are produced and owned by a Boston-based drugs company called Vertex, which I shall talk about later.

Orkambi could be used by around 3,000 patients. It has a price of something like £100,000 per annum—the implication being that the cost of its approval in England would be in the order of £300 million or £400 million a year. As several Members have said, it is obviously right that there is a process that weighs that cost of £300 million to £400 million a year against other NHS priorities and other drugs. That process is the NICE process. A number of comments have been made about the efficacy of that process, and it has been suggested that it may have deficiencies in respect of providing precision drugs to small numbers of users. I will try to address those concerns. I think everybody agrees that we need a consistent method of evaluating these matters, and there needs to be a way forward based on that.

When NICE evaluated Orkambi in July, it found that it had clinically significant and important benefits, which several Members have spoken about. There is no dispute about that, but the evaluation process—which is based on quality-adjusted life years, as has been said—also found that it was not cost-effective. I spent some time last night reading the NICE evaluation, and make the point to colleagues and other Members that it was not a near miss. It looks like there is a factor of 10 in NICE’s evaluation of its cost-effectiveness. I guess that is largely driven by the price of £100,000 per annum and what that would mean.

[Andy Burnham]

It is obviously reassuring to everybody that the Minister has taken such a close interest in the issue before coming to the debate. He says it was not a near miss. That may have been the case on the data that NICE had, but does he accept the point made by my hon. Friend the Member for Dudley North (Ian Austin) and other Opposition Members that those data were very limited indeed? The 96-week trial data that are now available would probably have produced a very different overall calculation.

[David Mowat]

To be honest, I am not qualified to have an opinion on that. The right hon. Gentleman rightly said that decisions of this sort should not be made by politicians and that there has to be a process around them. It is clear that if NICE is presented by Vertex with new clinical data, or indeed new price data—this is perhaps equally relevant, but we have not really discussed it—a review could be carried out quickly without any need for us to go through the whole process again. There is a precedent for that, and if those data exist and Vertex presents them, they would be looked at. I give my commitment, and certainly that of the Minister responsible for this policy area, that that would be the case and there is no impediment to that. I do not want to raise false hopes by saying that, and I do not think I have done so. The fact that it is not a near miss—it is possibly out by a factor of eight or 10—implies that there is quite a lot of work to do on pricing.

It is worth recapping what other countries have done. Orkambi is available in Germany, although it appears from the data available that its use there is quite mixed, with perhaps no more than one in five eligible people having access to it. In France, the other country in Europe that has authorised it, Vertex has booked no sales yet this year. The picture seems quite mixed in those countries. The countries that have not authorised Orkambi include Scotland.

National Health Service Funding

Andy Burnham Excerpts

Tuesday 22nd November 2016 Commons Chamber

[Mr Hunt]

The right hon. Lady is right that the Care Quality Commission was set up by the last Labour Government, but it did not have independence from the Government in its inspection reports. When we legislated for that, Labour tried to vote it down. We got it through and changed the inspection system, and it is working extremely well.

I want to move on to the substance of the debate, which is about the funding of the NHS. I congratulate the hon. Member for Leicester South (Jonathan Ashworth) on his courage—indeed, his chutzpah—in confronting the issue of funding, despite inheriting a Labour policy to cut NHS funding by £5.5 billion a year by the end of the Parliament. He is right that there has never been greater financial pressure—we have had the financial crisis in 2008, the deficits and the growth in demand from the ageing population—but he must accept that that makes it all the more extraordinary that Labour wanted to cut the NHS budget in 2010 and to cut it from the current levels in 2015. I simply say that we could, as a Government, have chosen to cut NHS funding from this year’s level by £1.3 billion, as under Labour’s plans, but we would have had to lay off 11,000 doctors or 40,000 nurses.

[Andy Burnham (Leigh) (Lab)]

The problem with the Conservatives’ script is that they talk about NHS funding, but they completely neglect social care. There can be no debate about the fact they have cut social care every year for the last six years, taking support away from half a million older people, many of whom are now trapped in hospital beds. Greater Manchester says that it has a shortfall of about £80 million in social care; the figure is £1 billion nationally. Has the Secretary of State raised this issue with the Chancellor? Has he made an emergency bid for funding? Will there be more money for social care this year?

[Mr Hunt]

That is not the problem with our script; it is the problem with the right hon. Gentleman’s script, because as shadow Health Secretary he sanctioned a policy that would have given the NHS £1.3 billion less this year, and at the last election the then shadow Chancellor said he would give not a penny more to local authorities, whereas we are seeing social care funding go up by £600 million this year. More money is going into the NHS and the social care system under a Government who are committed to funding them both.

What is especially wrong with the argument made by the shadow Health Secretary, whom I welcome to his place for his first Opposition day debate, is his suggestion that the Government have not honoured their promises to the NHS. What did the independent commentators say at the time of last year’s spending review? Simon Stevens, whom he quoted, said

“our case for the NHS has been heard and actively supported.”

NHS Providers, which he quoted, said it was

“a good settlement for the NHS.”

The King’s Fund, which he quoted, said it was

“a good settlement for the NHS”.

In fact, because of the Government’s commitment to the NHS, we are spending 10% more on it as a proportion of GDP than the OECD average—that is more than Norway, Finland, Korea, Australia and New Zealand.

--- Later in debate ---

[Mr Hunt]

I do recognise that. It has been going up in Scotland as well. It is short-sighted of both Administrations not to work with us to tackle the problem; otherwise, staff living in border areas play off one system against the other.

[Andy Burnham]

The Secretary of State is trying to blame hospitals for the deficit, but the point is that the spend on agency staff has ballooned in England over the past six years. The reason is that the Government, and their predecessor, cut nurse training places and left hospitals in the grip of private staffing agencies. It is therefore simply not fair of the Secretary of State to stand at the Dispatch Box and blame hospitals for a problem of the Government’s making.

[Mr Hunt]

I am not blaming hospitals. We are supporting hospitals to deal with the problem. The root cause of the problem, set out in the Francis report, was hospitals covering up bad problems. We said no to that and said that we were going to sort it out by having more nurses on our wards. That is why, in the four years that I have been Health Secretary, we have had 10,000 more nurses on our wards.

Social Care

Andy Burnham Excerpts

Wednesday 16th November 2016 Commons Chamber

[Mr Hunt]

I will give way shortly, but I want to finish my point about the critical role played by care staff. In total, 1.5 million people work in the social care sector, and I want to mention one group in particular: the 90,000 who come from the EU. They do a brilliant job and we value their contribution to the sector.

If the House will forgive me, I want to share one story from early in my time as Health Secretary about an absolutely brilliant manager, who is Polish, of a dementia care home in Swiss Cottage. The people at the home had advanced dementia and many were unable to talk or move, so the atmosphere in the home was challenging to say the least. I asked the lady how she motivated her staff every day, and she said, “If I can get a resident to smile, they won’t remember it the next day, but I do, and I go home with a smile on my face.” The care that was being provided was, to be frank, completely remarkable. This is a moment for all of us to reaffirm what the Prime Minister said today at Prime Minister’s questions: we want these people to remain and we are confident and optimistic that we will be able to get them to remain.

[Andy Burnham (Leigh) (Lab)]

rose—

[Mr Hunt]

I will give way to the right hon. Gentleman, but I want to give way first to my former ministerial colleague.

[Mr Hunt]

I absolutely want to be someone in this role who confronts poor care and does everything possible to fight for the highest standards. That is exactly why I am doing this job. Poor care comes in different forms and, yes, funding is an issue. As the health and social care system goes through perhaps its most financially challenging period since the founding of the NHS, I particularly want to ensure that we protect the high standards that the right hon. Gentleman cares about.

[Andy Burnham]

I heard the Secretary of State’s earlier words about EU carers. I am sure that they were genuine, but words are not good enough for them. The longer the Government leave them in limbo, the greater the risk is that they will leave. Our national health service and our care system could not cope with losing all those staff, so what more is he doing? Is he petitioning the Prime Minister for a decision now that will give them leave to stay and properly respects their contribution to our society?

[Mr Hunt]

With respect to the right hon. Gentleman, with whom I have enjoyed many debates in this House, neither he nor I wanted the Brexit vote to happen, but now that it has, we have to cope with a very changed world. The Prime Minister said that she is confident of getting an early agreement. I hope that what we are saying in this House this afternoon will resonate with people and make them understand just how valued they are.

--- Later in debate ---

[Andy Burnham (Leigh) (Lab)]

I congratulate my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley)—my good friend—on an excellent speech. She has no equal in this House as a champion for older people and their carers. Her speech, unlike the speech by the Secretary of State, was firmly rooted in the real world.

This is the century of the ageing society. Caring for people as they live longer lives is the greatest public policy challenge of our times, but for years Parliament has shown itself to be unequal to that challenge. I want to speak today to tell the story of the efforts to reform social care over the last decade, because I want the facts to be on the record, so that people can understand what happened and vow to do better. The story explains the mess we are in today. To be honest, it is quite a shocking story of partisan point-scoring and, worse, political cowardice, which have seriously failed millions of older and disabled people.

The story started nine years ago at the spending review in 2007. I was Chief Secretary to the Treasury at the time, and at the insistence of the Treasury I gave the Department of Health the condition on its spending review settlement that it would conduct a root and branch review of the funding of social care. There was a recognition, even in the Treasury, that if we allowed the situation to continue, it could, in the end, damage the national health service. Quite clearly, the funding was not sustainable, and if social care was left to collapse, it would drag down the NHS with it.

The urgency of such action had been recognised almost a decade earlier, in 1999, when a report by a royal commission on the matter recommended free personal care, paid for by general taxation. It did so for the reason that if we pay for free preventive care in people’s homes, those people do not end up in hospital and costing us all more. Nothing was done, and by 2007 the need for reform was urgent. So between 2007 and 2009, a huge amount of detailed modelling work was done and options were looked at.

When I arrived in the post of Health Secretary in 2009, the work had come to a head. The analysis supported a clear conclusion that radical reform, rather than patching up, was needed. Department of Health officials supported the Treasury analysis that there would be risks to the NHS if social care was allowed to decline. A Green Paper was published in July 2009, and the idea of a national care service was first put forward. The thinking was that only by bringing the systems together, with a system of clear national entitlement, would we be able properly to move towards integration. The maintenance of two entirely differently funded systems—one free at the point of use and the other means-tested and charged for—would mean that they would never be able to speak the same language and there would always be barriers to integration.

I was ready to grasp the nettle, because it was clear to me that the NHS was facing a decade of lower funding from 2010 and 2020, and that one of the ways it could cope with that was with the efficiencies we could unlock through properly and fully integrating health and social care and by moving from a hospital-based medical model to a person-centred social model of care starting in the home.

This is where things went wrong. Picking up that I was ready to up the momentum for reform, the then shadow Health Secretary, Andrew Lansley, approached me in Portcullis House just before Christmas 2009 and asked me for cross-party talks. I thought about it, but I agreed. I thought, as my hon. Friend the Member for Barrow and Furness (John Woodcock) has suggested, that we should take the issue out of party politics, which would be better for everybody. We had a couple of meetings, in which we went round the issues. I favoured the more ambitious, comprehensive reform of paying for social care on the NHS principle—that everybody contributes, but everybody is covered for their care needs and has peace of mind in later life. Andrew Lansley wanted a more voluntary system, in which the insurance market would come up with solutions. That was where we left it.

Then a bombshell was dropped in February 2010: the poster saying, “Now Gordon wants £20,000 when you die.” I very vividly remember the day when it landed. I was told that Andy Coulson had put pressure on Andrew Lansley to do it, and that he did not really want to, but felt he could not say no. I do not know whether that is true, but I know that the Conservatives, who asked me for cross-party talks, betrayed the confidence that I gave, and they have never seen fit to apologise for that. The point is not about the personal political damage that that did, but about the chilling effect the poster had on the social care debate. It instantly killed any talk of radical reform, and it actually had a deadening effect for the rest of the following Parliament—the last Parliament—during which no real progress was made.

That brings me to what happened after the election, when, as shadow Health Secretary, I challenged the Government from the Opposition Front Bench about the poster that they had put out during the election saying that they would cut the deficit, not the NHS. I made the point that if they did so, they would in effect cut social care: if they prioritised NHS spending within the reduced envelope, that would have devastating consequences for social care and would in the end come back to affect the NHS.

From the Dispatch Box at every Prime Minister’s Question Time, the then Prime Minister used to quote me as claiming that it would be irresponsible to give the NHS real-terms increases, but he never commented on the second part of what I had said, which was that it was irresponsible to do so if we were cutting social care. I did say that, and it was irresponsible to social care in the way they did to pay for their commitment to the NHS. Social care was cut by 9% during the last Parliament, with 400,000 vulnerable people losing support in their homes. Those people ended up in A&E or trapped in hospital beds, piling pressure on the hospital system.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I pay tribute to the right hon. Gentleman—this may be my last chance to do so—for the work he has done as a Member and wish him well in his future career if he is successful in his election. Does he agree that the chilling effect of the outcome of those conversations before the election and perhaps the betrayal of his confidence, as he puts it, is that there could no longer be a rational conversation about properly funding the health and care system through any form of taxation? That is the problem that has emerged, and perhaps the best way to fix it is through general taxation.

[Andy Burnham]

I am very grateful to the hon. Gentleman for his intervention and the spirit in which he made it. He is absolutely right: that set everything back and meant that there was no possibility of a cross-party approach. There will have to be such an approach if we are to fix social care and, indeed, to give the NHS what it needs, because they will both need more funding during this Parliament. That is the real shame. I did not make my point about Andrew Lansley for political reasons; I just want people to understand what happened, so that the current generations of politicians might do something different.

The answers we have since had from the Government are wholly inadequate. We have heard today that the precept does not raise enough money, particularly for poorer councils. It is no answer; in fact, it just cynically devolves the responsibility for the whole issue to local government, even though councils did not create the problem. I still favour an all-in system. I will say it: I favour a system in which we ask older people to pay a set contribution, so that they have peace of mind in later life, with all their care costs covered.

[Mr Jeremy Hunt]

I am listening very carefully to the right hon. Gentleman. In the spirit of wanting to rise above party politics, will he agree that it was totally wrong of him to suggest at any stage in the last Parliament that the Government wanted to privatise the NHS, when we have never had the intention to do so? It was wholly irresponsible to scare the public about that.

[Andy Burnham]

In a week when Virgin Care is taking on a huge community care contract, I do not think the Secretary of State should be making that point—particularly the Secretary of State who privatised ambulance services in Greater Manchester. I honestly do not think we need to go there.

The point that I am making is about funding social care. The Conservatives claimed that we were introducing a new inheritance tax. Do people not understand that just 3.4% of estates in this country attract inheritance tax? Why is that? Because the vast majority of estates are whittled down by the costs of care—tens of thousands of pounds, or hundreds of thousands of pounds for some people. That is not fair and it is not sustainable. We must be able to do better.

I feel so strongly about this because I saw my grandmother go through the care system in England 20 years ago and, frankly, it was nowhere near good enough. I arrived here saying that I would do something about it. I tried to do something about it, but we have not got anywhere near a solution to the scale of the challenge. People will need to put party politics aside and find common ground. The point scoring and failure to grasp big issues have led to a situation where people have low regard for this place.

We are left with a malnourished, privatised care system in England that is sinking lower as we speak. A culture of slap-dash 15-minute visits is entrenched, in which staff do not get properly treated, trained or respected. Standards in care homes have slipped even further, and stories of neglect and abuse abound—we hear them all the time. Countless vulnerable people and their families still have to pay these cruel dementia taxes, which have risen under this Government, losing everything they have worked for and going into later life with everything on the roulette table: home, pension, savings—the lot. That is not the care system we should have in 2016 in this country. At what point are we going to say, “Enough is enough,” and actually do something about it?

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (David Mowat)]

We have had a good debate, with a number of very good speeches from both sides of the House. I will try to respond to the points, or the themes of those points, that have been made.

First, I want to address the accusations, made by Labour Members, of criminal behaviour in relation to the minimum wage not being adhered to. If such evidence exists—I think the hon. Members for Sheffield Central (Paul Blomfield) and for Tooting (Dr Allin-Khan) raised this issue—please bring it to me. I will see that it goes to Her Majesty’s Revenue and Customs. Those involved will be named and shamed. Such behaviour is illegal and is not to be tolerated. I think the hon. Member for Tooting also said she had evidence that a care home or domiciliary supplier was forging attendance sheets. Again, if there is evidence of that I would like it to be brought forward. It should not just be bandied about here in a political way. We should investigate it and we will. If she brings that evidence to me, we will look at it.

One of the big themes in this debate, and one with which Members on both sides of the House can agree, is the importance of carers. The hon. Member for Worsley and Eccles South (Barbara Keeley) spoke about that and, rightly, about the need for a better career structure and clearer training requirements, a point the Cavendish report also addressed. Some 1.5 million people work in domiciliary and care homes, but—this is a very difficult statistic—the annual turnover is about 25%. That is caused not just by poor pay—I am proud to be part of a Government who have increased the pay of many of these people—but by a lack of career structure and, frankly, of regard, and we need to do more on that. She was right to raise it.

My right hon. Friend the Member for North East Bedfordshire (Alistair Burt) made the important point that, as well as the 1.5 million paid carers, there are 1.1 million unpaid carers. In many ways, these are the unsung heroes of the entire system, and we can all agree we need to do better by them. When he was doing my job, he kicked off the carers’ strategy, which we will be coming forward with. It is a cross-Government initiative and will result in concrete actions to make the 1.1 million-strong unpaid carer cohort better off.

Several people talked about finances and money. Of course they are tight. The Secretary of State made it clear that in the last Parliament, in order to respond to the situation we inherited, there were cuts to local government funding. During the course of this Parliament, there will be a real increase in the rate of adult care funding, but that is not to say we do not understand that the system is under pressure. We understand that, as Simon Stevens said, if more money was available, it would be good if it went into the social care system.

Members on both sides of the House spoke about bed-blocking caused by a lack of money, and about delayed transfers of care, and it is true. Of course there is a correlation between the amount of money in the system and the number of delayed transfers of care, but one of the most extraordinary things about the numbers is that, between the best and worst 10% of local authorities, in terms of the number of DTOCs, the difference is a factor of 20 to 25. That is not just about budgets—budgets are not 20 to 25 times different—it is about leadership; about good people doing good work; about spreading best practice; about shared assessments, early discharge and discharge to assess; and about integration in the widest sense, as my right hon. Friend the Member for North East Bedfordshire said. Those councils, local authorities and health systems that have gone fastest and furthest with integration—the holy grail that the right hon. Member for Leigh (Andy Burnham) talked about—are those at the top end of the DTOC statistics. We should all think about that when we say, “We want more money.” We should all think about the reasons for that difference.

I would make another point about finance. An Opposition Member talked about the GDP equation getting worse in this Parliament. That is not true, but I would just make this point: in 2016, the OECD looked at the money spent on adult social care right across the major economies of Europe, and we in the UK spend about 20% to 25% more than other major industrialised countries such as Germany and France. That is not to say that the system is not under pressure in our country—it clearly is—but the facts are that other countries do a better job in terms of long-term saving, social insurance and some of those types of things. We clearly have an issue with this. Let me repeat that Germany and France, which in the round spend more on the entire health system than we do—about 1% more as a proportion of GDP—spend 25% to 30% less on adult social care. It is critical to spend what we can spend better.

[Andy Burnham]

I hear what the Minister says, but it seems to me that, in common with the Secretary of State, he is avoiding the main issue. The main issue is the urgent financial crisis that councils are facing. They have not got enough money to care for the people who need care. Will the Minister answer a direct question? Has he or the Secretary of State made a submission to the Treasury for more funding for social care as part of the autumn statement—yes or no?

[David Mowat]

We are not having the autumn statement today, and we are not going to give a commentary on what will come out of the autumn statement. We—the Secretary of State and I—have accepted that the care system is under pressure. I was just making the point that other countries spend less, and that we need to spend every penny we can as effectively and as well as we can. During the course of this Parliament, moreover, there will be a real increase in the amount of spending on social care.

Contaminated Blood

Andy Burnham Excerpts

Monday 20th July 2015 Commons Chamber

[Ben Gummer]

My hon. Friend is right to say that action needs to be taken. He will understand why, if we are to do the right job for victims and the beneficiaries of previous schemes, we must do so in a considered way and with speed, but it must be a proper process. Large amounts of public money are involved, and we must also ensure fairness to those people who have suffered as a result of this terrible series of events. I hope my hon. Friend will understand why we will undertake a consultation, even though it will be short. That does not preclude beneficiaries coming forward now with their views about what should be changed in the existing schemes to ensure fairness and equity in the schemes that supersede them.

[Andy Burnham (Leigh) (Lab)]

I pay tribute to my hon. Friend the Member for Kingston upon Hull North (Diana Johnson) who has been tireless in pursuit of answers for the victims of contaminated blood. Her powerful words today will have spoken for many people across the country.

This scandal is one of the worst injustices this country has seen. Thousands died, and thousands of families were destroyed through the negligence of public bodies. For years, the response from Governments of all colours to the victims could be described at best as grudging, and at worst as dismissive, and it falls to this Parliament to resolve today to end this injustice once and for all.

The Prime Minister’s apology in March marked an important moment on the journey for justice, and we welcomed his commitment to respond to the Penrose report

“as a matter of priority.”

We do not doubt the sincerity of that commitment, but does the Minister understand the disappointment that people felt when instead of the promised full statement, a written statement was released at 2 pm on a Friday afternoon, which failed to answer the key questions? The Minister failed to set a clear timetable for when the £25 million promised by the Prime Minister will be made available to those currently receiving support, and I think I heard him imply that it might go into the next financial year of 2016-17. May I press him further? Will he work to ensure that the funding is made available to victims this year, as I think that is what people want to hear from him today?

On disclosure, I welcome the fact that the Government have committed to releasing additional documents, but does the Minister accept that alongside that release we need a process to help families understand those documents and finally to get to the full truth of what went wrong? Will he commit, at the very least, to a panel on the Hillsborough model, or to a public inquiry, to provide a full commentary on the extent to which disclosure on this matter would add to public understanding of the scandal?

Finally, although no amount of money can ever fully make up for what happened, we owe those still living with the consequences the dignity of a lasting settlement. People will therefore be disappointed that any decisions on future support appear to have been postponed until the spending review. Will the Minister put a timeframe on when the Government will make their next statement about a full and final settlement? Given the widespread concerns about current arrangements, does he acknowledge that the longer this goes on, the longer we leave in place a system that is not working and leaves victims going cap in hand for support, which only adds to their sense of injustice?

We congratulate the Government on their progress in recent months, but now is the time for a resolution. This injustice has gone on long enough. Further delay adds insult and injury to that injustice. A full, fair and final resolution is now required.

[Ben Gummer]

I thank the right hon. Gentleman for his measured words. He is right to say that it falls to this Parliament to come to a reasonable and fair conclusion. He is also right to point to the Prime Minister’s apology. I know from my own experience of talking to victims that that was a very important moment for many.

The right hon. Gentleman asks about the £25 million. What I meant by my remarks is that I hope it will be spent this year in furtherance of the transition to a new scheme, but should money not be spent it will not be squirreled away for other purposes. It will remain allocated for beneficiaries.

On the timing of the statement, our purpose was to update Parliament on progress as soon as possible. Beneficiaries have been waiting for 30 years, so it is understandable that they would like to see faster work. We are working at full pelt, but that work has to be done in tandem with discussions on the spending review. This will be one of the first outcomes from the review, which is why we anticipate having a transition to the new scheme and a consultation finished by the end of this year.

Finally, the right hon. Gentleman refers to a panel and to the work done by the Hillsborough inquiry. I know he has personal experience of that, not least because of his own extraordinary work in bringing it about. I would suggest that in this instance speed is of the essence. I think we all understand where we need to get to. We need to ensure that the new scheme is comprehensive in addressing the perceived and actual failings in the existing five schemes, and that that is done as quickly as possible. I would not like an inquiry to get in the way of the speed with which we can do that.

NHS Reform

Andy Burnham Excerpts

Thursday 16th July 2015 Commons Chamber

[Andy Burnham (Leigh) (Lab)]

I thank the Secretary of State for his statement and for advance sight of it. Let me say at the beginning that I support much of what he said. I will focus my remarks on his plan for seven-day working, and then touch on some of the other issues he raised.

Ensuring that our health services are there for everyone whenever they are needed—be that a weekday or a weekend—should be our shared goal across this House for a 21st-century national health service. Illnesses do not stop at the weekend and nor should our NHS. Although we support the principle of what the Secretary of State is trying to achieve with seven-day working, and will work with him where possible, I urge some caution in the manner in which he is attempting to drive through these changes. His remarks contain no acknowledgment that the NHS right now is in a very fragile condition. It has gone backwards, not forwards, in recent times. A&E is in crisis, and primary care services are overwhelmed. There is a shortage of staff and an over-reliance on agency workers. Staff are demoralised and worn out. If he does this in the wrong way, many may walk away and that would make matters even worse. Given all that, it is not immediately clear how seven-day services can be delivered in the timeframe he has set out without significantly impacting on the rest of the NHS.

The Secretary of State said that around 6,000 people lose their lives every year because we do not have a proper seven-day service. Of course that is an appalling statistic, but is there not a risk of implementing seven-day services by simply spreading existing resources more thinly? A recent study published in “Health Economics” concluded:

“There is as yet no clear evidence that 7-day services will reduce weekend deaths or can be achieved without increasing weekday deaths.”

Will the Secretary of State tell us on what evidence he has based his announcement and, crucially, what steps he is taking to guard against what the study warns could be an increase in weekday deaths?

If the Secretary of State wants to make changes on this scale, it is vital that he works in partnership with NHS staff. I gently say to him that briefing headlines such as “Declaring war on doctors” have not got us off on the right foot, as doctors are already feeling worn out and put upon. The British Medical Association said:

“Today’s announcement is nothing more than a wholesale attack on doctors to mask the fact that for two years the Government has failed to outline any concrete proposals for introducing more seven-day hospital services.”

Will the Secretary of State take care to avoid provocative statements such as “Declaring war” and will he rethink the manner in which he is pursuing these negotiations? Talk of imposing deals at this stage is not helpful; it is premature and it would be better to proceed in a more constructive manner.

Staff across the entire hospital system—not just doctors —will be needed to run these services, but the Government confirmed only last week that many of them will face another five years of pay cuts. In total, that will amount to a decade of pay cuts. Has the Secretary of State looked at the detail of the Chancellor’s announcement on pay for NHS staff? Will he tell the House what effect he believes this deal could have on staff numbers and retention?

The Secretary of State said very little about how he will fund seven-day services, but given that the NHS is struggling to fund weekday services, it is likely to need significant investment over the next five years, over and above funding attached to the five-year forward view. Can he confirm that the money allocated to fund the five-year forward view does not include seven-day working? That is not specifically mentioned in the “Five Year Forward View”. If so, what extra funding will be made available specifically to deliver seven-day working, and when will this funding be available? The announcement today appears to be unfunded and it will not escape the House’s attention that the 2010 Conservative manifesto also promised to deliver seven-day services. The Secretary of State has a lot of convincing to do if he expects people to believe him this time.

In a statement last week in another place, Lord Prior, the Under-Secretary of State with responsibility for NHS productivity, said he was establishing an independent inquiry into extending charges in the NHS. This has sounded alarm bells among many patient groups. Will the Secretary of State say more about the terms of reference for this independent inquiry and when it will proceed with its work?

The Francis “Freedom to speak up” report contained a number of important recommendations to foster a more open culture and we support his work to implement them. The right hon. Gentleman will know that there have been a number of appalling examples of poor care in recent times at Orchid View, Oban Court and Winterbourne View, and these scandals were exposed only when undercover reporters infiltrated the care home. Will he look seriously at the idea of an independent body to receive complaints from NHS staff and social care staff so that they are not faced with the problem of always going to their employer if they are to blow the whistle?

I welcome what the Secretary of State had to say about the Kirkup report and his acceptance in full of its recommendations. We, too, think of the families affected by the failures at Morecambe Bay. I supported steps to improve the regulation of midwives, but the big question mark over the right hon. Gentleman’s commitment is the failure to bring in a Bill on professional regulation. This was an important recommendation of the Francis report and the continued delay in implementing this proposal is putting patients at risk and preventing regulators from doing their job. Will the Secretary of State now commit to legislating at the earliest opportunity for the Law Commission’s reforms?

These are extremely serious matters and I do not believe that some of the Secretary of State’s more political comments today were appropriate, nor do I believe they will build the consensus that will be needed across this House to deliver these important changes. Labour introduced more transparency into the NHS with the establishment of independent regulation and the inspection of hospitals. I appointed Robert Francis to begin the work of looking at what went wrong at Mid Staffs. Where the Secretary of State seeks to build on these constructive changes, we will support him, but he will not achieve his goals by provoking confrontation with doctors or playing politics with patient safety.

[Mr Hunt]

I thank the right hon. Gentleman for his support on many of the measures that we are announcing today. Where we can work together, we should. I thank him for his support for the principle of seven-day working, although I gently point out that this was in our manifesto in May and it was not in his. I shall deal in turn with the points that he raised.

On funding for seven-day services, the right hon. Gentleman has just fought an election on plans that would have meant that the NHS would get £5 billion less than this Government are prepared to commit. We are committing £10 billion to the NHS to implement the five-year forward view, which we can do on the back of a strong economy. That includes plans for a seven-day service.

The right hon. Gentleman talked about comments by Lord Prior in another place. There is no independent review on charging for NHS services. After the election, he should be very careful of such scaremongering. That is what he was doing for the whole election. When he makes such comments, he frightens NHS staff. He should think about the effect on morale when he does that.

The right hon. Gentleman said that the NHS has gone backwards, not forwards, but I have just presented figures showing that public confidence in the NHS is going up; the number of people who think that the NHS is one of the best systems in the world has increased. I gently point out that the reports we are publishing today are a response to problems that happened on his watch and that we are facing up to, so he should have a little modesty in this situation.

The right hon. Gentleman asked an important question about spreading services currently offered on five days over seven days. A lot of work has been done on this. The truth is that having services only on five days is not only dangerous for patients but incredibly inefficient for hospitals. For example, someone admitted to hospital on a Friday in need of a diagnostic test might not get the result until the following Monday or Tuesday so will have to stay in hospital for the weekend even though they could possibly have been discharged. That is bad for the patient and expensive for the NHS, so these measures will result in huge cost savings.

Most importantly, the right hon. Gentleman talked about carrying staff with us. Doctors go into work every weekend throughout the NHS and do a fantastic job, but often it is not recognised and they are not thanked. We want a more professional contract that recognises that contribution. That is why these measures are supported by the Royal College of Surgeons, the Royal College of Physicians and the Royal College of Emergency Medicine.

When the previous Labour Government changed the consultants’ contract in 2003, senior doctors did not like it. They said that it led to

“a loss of a sense of vocation and what it means to be professional”.

That quote is from a King’s Fund report. It undermined the basic relationship between doctor and patient. We are not blaming doctors, and actually we are not blaming unions, because unions will always ask to see what they can get—the right hon. Gentleman spends more time with unions than I do, so he knows that better than I do. The people responsible for that decision in 2003 were the Ministers who signed off changes to the consultants’ contract and the GPs’ contract. It was Labour politicians who were responsible for those changes, and they must take responsibility for the fact that it was the wrong thing to do.

Finally, this is the most important question of all, and we have not heard an answer today: does the right hon. Gentleman support the measures that the Government are putting forward to make our hospitals safer with seven-day working or not? Leadership is about making choices, and today’s choice is this: is he on the side of the patient or on the side of the union? We know whose side we are on. For Labour, once again, the politics matters more than the patients.

Oral Answers to Questions

Andy Burnham Excerpts

Tuesday 7th July 2015 Commons Chamber

[Mr Hunt]

Absolutely; I had the pleasure and privilege of visiting Plymouth during the election campaign to see some of the radical changes being offered in community care. There is huge enthusiasm for transforming the situation in Devon. It is a very challenged economy, but by bringing together the health and social care system and by putting more resources into primary and out-of-hospital care we will be able to give a better service to my hon. Friend’s constituents, which I know he will welcome.

[Andy Burnham (Leigh) (Lab)]

Ten years ago, this great city lived through one of the darkest days in its history. Our thoughts today are with all those who were affected and we pay tribute to the heroic staff of London’s NHS, who did so much to help them.

The latest GP patient survey is important for the simple reason that it covers the first full year of the Government’s GP access challenge fund. The results do not make good reading for the Secretary of State. The percentage of patients dissatisfied with their surgery’s opening hours has increased and patients found it harder to get appointments last year than the year before. Will the Secretary of State admit that his policies are simply not working and that GP services are getting worse on his watch?

[Mr Hunt]

First, I echo the right hon. Gentleman’s comments about the extraordinary bravery of the emergency services, particularly the London Ambulance Service, in response to the terrible tragedy of 7/7.

I do not accept the picture the right hon. Gentleman paints of general practice. The Prime Minister’s challenge fund has been extremely successful: by the end of this year, 18 million people will be benefiting from the opportunity to have evening, weekend and Skype appointments with their GP. We have also announced the biggest increase in the number of GPs in the history of the NHS. The Labour party left us with a GP contract that ripped the heart out of general practice by removing responsibility for evening and weekend care and by getting rid of personal responsibility by GPs for their patients. The right hon. Gentleman should show a little contrition and modesty about Labour’s mistakes.

[Andy Burnham]

People who have been ringing surgeries this morning unable to get appointments will not be convinced by what they have just heard. The truth is that the disarray in the Secretary of State’s primary care policy goes much deeper. Not only has he made it harder for people to get a convenient appointment, but he now wants to charge people who miss the appointments they are able to get. We all want to reduce waste, but there are many reasons why people do not turn up, including family emergencies. That is presumably why No. 10 slapped him down. He will have worried people, so for the avoidance of doubt, will he today confirm that he will not return to that idea in this Parliament?

[Mr Hunt]

There are no plans to charge people who have missed appointments. That is precisely the sort of scaremongering that the British public rejected at the last election. The right hon. Gentleman put the NHS on the ballot paper, and the country voted Conservative; he might want to think about the lessons from that. Missed appointments cost the NHS £1 billion a year. We want that money to be spent on doctors and nurses. Labour spent billions on wasted IT contracts and the private finance initiative, and did not spend enough on front-line staff. We are putting that right.

NHS Success Regime

Andy Burnham Excerpts

Thursday 4th June 2015 Commons Chamber

[Andy Burnham (Leigh) (Lab)]

(Urgent Question): To ask the Secretary of State for Health if he will make a statement on the success regime.

[Hon. Members]

Where is he?

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

I welcome the success regime, details of which were published by Monitor yesterday. The purpose of the success regime is to improve health and care services for patients in local health and care systems that are struggling with financial or quality problems. It will build on the improvements made through the special measures regime, recognising that some of the underlying reasons may result from intrinsic structural problems in the local health economy. This will therefore make sure issues are addressed in the region, not just in one organisation.

The regime is designed to make improvements in some of the most challenged health and care economies. The first sites to enter the regime—North Cumbria, Essex and North East and West Devon—are facing some of the most significant challenges in England. They have been selected based on data such as quality metrics, financial performance and other qualitative information.

Unlike under previous interventions, this success regime will look at the whole health and care economy: providers, such as hospital trusts, service commissioners, clinical commissioning groups and local authorities will be central to the discussions. It will be supported by three national NHS bodies, whereas existing interventions tend to be delivered by individual organisations and to concentrate on one part of a health economy—for example, the commissioning assurance framework led by NHS England that concentrates solely on commissioners, or special measures led by NHS England, the Trust Development Authority or Monitor, which focuses on providers.

Together, Monitor, TDA and NHS England, with local commissioners, patients, their representatives such as Healthwatch England and health and wellbeing boards will aim to address systemic issues. The national bodies will provide support all the way through to implementation, with a focus on supporting and developing local leadership through the process.

[Andy Burnham]

As we have just heard, this announcement has far-reaching implications for people in Essex, Cumbria and Devon. It was being finalised on Tuesday, when the House was engaged in a full day’s debate on the national health service, yet there was not one single mention of it during the debate. What are we to make of that, and why was the Secretary of State not here to make this announcement to the House? Why does he think that it is always more important to make announcements in television studios or to outside conferences than to Members of Parliament in the House of Commons? That is not acceptable. People in Cumbria, Essex and Devon will be worried about what the Minister has just said, and what it means for health services in their areas.

First things first. Can the Minister confirm that services in those areas are safe and sustainable? Are there enough staff, and will work be undertaken immediately to deal with staff shortages? Are plans being drawn up to close A and E departments, or other services, as part of this process? Could it mean mergers between organisations, and job losses?

We welcome action that means taking a broader view of challenged health economies—indeed, my hon. Friend the Member for Copeland (Mr Reed) has long called for such action—but what will the new regime mean for local NHS bodies? Will it be possible for NHS England to overrule them? The House will recall the last occasion on which the Secretary of State tried to take sweeping powers to close health services over the heads of local people in south London. It did not end well; indeed, it ended with his being defeated in the High Court. Can the Minister assure us that patients will be consulted before any changes go ahead?

Is not the fact that NHS is taking drastic powers over whole swathes of the NHS in three counties a sign of the failure of the Government’s plans for local commissioning, and evidence of five years of failure of Tory health policies? Is it not evidence that care failures are more likely, not less likely, on the Tories’ watch?

This is no way to run a health service, and no way to treat Parliament. The Minister, along with the Secretary of State, is trying to shift the blame for things that have gone wrong in the NHS on their watch—for problems that are of their making. We will not let the Secretary of State do that. He should have been here to do Members who are affected by this announcement the courtesy of giving them answers, and I ask his junior Minister to relay that to him directly after the debate.

[Ben Gummer]

The shadow Secretary of State has spoken at length—in his answer to his urgent question—about NHS bodies. He has spoken about local commissioners, about NHS England and about the Department of Health, but Members will have noted that there was one group of people about whom he did not speak, and that was patients. It is extraordinary that, once again, he has come here to speak, again and again, about structures—about the NHS and its bodies, about jobs, about providers and about deliverers—but not about the people who are being failed at local level, namely patients in Essex, west and north-east Devon and north Cumbria.

Let me deal with the right hon. Gentleman’s points in detail. First, he made accusations about television studios. I think it is a bit of a cheek to make such claims—and I should tell the House that the Secretary of State will very shortly be addressing the NHS Confederation.

[Andy Burnham]

So that is more important than this?

[Ben Gummer]

The urgent question was submitted this morning.

Coming from a shadow Secretary of State who is, one might suspect, using urgent questions and the subject of the NHS not to address issues relating to the quality of care, but for his own political reasons—as he always has—this was a shameless attack. It reflected rather badly on the right hon. Gentleman himself, rather than reflecting on the cause that he should seek to pursue: the better care of patients, which lies at the heart of what NHS England is attempting to do. If he had read what Simon Stevens said when he announced the plans yesterday to the NHS Confederation, he would have noted that they are being drawn up, co-ordinated and, in part, led by local commissioners rather than—as was the case before—by monolithic centralised bodies headed by bureaucrats. This process is being led, locally, by clinicians, who are being supported and helped by NHS England and professional regulators.

The right hon. Gentleman asked about staff shortages. I am surprised that he mentions that, given that he was in part the author of the staff shortages that hobbled the NHS at the end of the previous Administration and that led in part to the problems at Mid Staffordshire that we have been seeking to address. Only this Government, in their previous incarnation, promised to correct that situation, in part through our pledges on GP numbers over the next five years.

The right hon. Gentleman asked about plans for accident and emergency departments and about job losses. I would say to him that it is different this time. These plans are being drawn up by local commissioners, who are now beginning the process of working out how to improve their local health economy. This is not a plan that will be devised centrally in Whitehall, imposed on local areas and announced as a done deal for local people. I know that that is what the right hon. Gentleman is used to, but in this instance it is a genuine conversation between local patients and local commissioners with the aim of improving their local health economies, and it will be supported by national bodies.

The right hon. Gentleman asked about south London and about consultation. I was a candidate in a constituency that had a solution imposed on it, during his tenure as Minister for Health, without any decent consultation. That proposal was eventually thrown out. The previous Government never consulted local people properly when he was in control, but we have changed that. These local plans will involve local people, patient bodies and health and wellbeing boards from the outset.

The shadow Secretary of State asked about the powers of NHS England, about localisation and about the co-ordination of local services. I ask him once again to go back and read Simon Stevens’s speech. He will see how things have changed. This is not about decisions being made by politicians in Whitehall. I dare say that the right hon. Gentleman does not know the solution to the problems in the local health economies in Devon, Essex and Cumbria—