Francis Report

Debate between Andy Burnham and George Freeman

Wednesday 5th March 2014 Commons Chamber

[Andy Burnham]

I, as part of the previous Government, left the lowest waiting times in the history of the NHS, and A and E was performing much better at the end of the previous Government than it is now. Hospital A and Es have dropped right down, so we do not need to take lessons from the hon. Gentleman.

Let us return to the issue of England and Wales. The mantra or script of Government Members is almost to deny that there are problems in England. Last week, 16 major A and Es in England were below the Welsh average on waits in A and E. Some trusts are seriously struggling, such as in Leicester, in the constituency of my hon. Friend the Member for Leicester West (Liz Kendall), and Great Western Hospitals NHS Trust and North West London Hospitals NHS Trust, where one in four patients were waiting more than four hours.

Another trust below the Welsh average was Barking, Havering and Redbridge, which includes Queen’s hospital, Romford. May I recommend to the Secretary of State that instead of sitting there mumbling away, he read an article on The Guardian website today by Saleyha Ahsan, an A and E consultant who has worked at Queen’s hospital, Romford? She writes:

“Being a doctor in accident and emergency has at times resembled being a medic in a war zone.”

May I remind him that this is the English NHS she is talking about—the one he is supposed to be responsible for? She goes on to say that the severe shortage of A and E doctors is a result of his predecessor’s failure to listen to the warnings from the College of Emergency Medicine about the looming recruitment crisis, because it was obsessed by its reorganisation. Dr Clifford Mann said he felt like

“John the Baptist crying in the wilderness”

because the Government’s reorganisation brought “decision-making paralysis” to the NHS. What does Dr Mann say now? He says that even after the reorganisation these issues cannot be dealt with, because

“there are now a lot of semi-detached organisations to deal with”.

Government Members do not like hearing it, but the fact is that the reorganisation by the right hon. Member for South Cambridgeshire (Mr Lansley) damaged front-line care in the NHS. May I remind the Secretary of State that just 12% of people think standards in the NHS have got better under the coalition, while 47% think they have got worse? Rather than pointing the finger at Wales, the Government need to spend a bit more time sorting out the problems they have created in England.

As my hon. Friend the Member for Easington (Grahame M. Morris) says, an urgent area that needs to be addressed is mental health. Some 1,700 mental health care beds have been cut over the past two years because these Ministers have allowed the first real-terms cut in mental health spending for a decade. As a result, alarming stories are emerging of very vulnerable children and adults being held in inappropriate accommodation, such as police cells. According to Mind, many trusts are reporting more than 100% bed occupancy. One trust in London has had to turn office space into temporary wards with camp beds.

We are also hearing of children being sent hundreds of miles to find an available bed. In a constituency case, my hon. Friend the Member for Leicester West found that there was simply no bed available in the public or private sector anywhere in England on a day when a very vulnerable child needed support. A recent freedom of information request by Community Care found that in 2013-14 10 trusts sent children to young people’s units more than 150 miles away. The furthest distance was 275 miles, from Sussex to Bury. A 12-year-old girl from Hull was sent 130 miles away to a unit in Stafford. Her child and adolescent mental health services team were searching for a bed for two days, and were told that the Stafford bed was the only one available in the country.

[George Freeman]

On a point of order, Madam Deputy Speaker. I came to have a debate on the Francis report. The shadow Secretary of State is not mentioning the Francis report; he is launching a criticism of the Government’s record since the report, which has nothing to do with it.

[Madam Deputy Speaker (Dawn Primarolo)]

Frankly, that is my business and I do not require any help to decide what is in order. The shadow Secretary of State is remaining in order, as the Secretary of State remained in order. I think it is best that we continue with the Front-Bench opening speeches to make sure that we can get in all the Back Benchers who wish to speak in this important debate.

--- Later in debate ---

[Andy Burnham]

My hon. Friend has raised an important point. People are confused about the new NHS, and confused about who has responsibility for what. The Government have created more organisations, not fewer; the NHS is more top-down than it was before; and that is not changing the culture. Robert Francis himself has said that the culture is not changing. The Government are utterly complacent if they think that they have got everything sorted out.

[George Freeman]

Will the right hon. Gentleman give way?

[Andy Burnham]

Time is against us, I am afraid.

The Secretary of State is wrong if he thinks that top-down regulation is the only answer. It cannot prevent things from going wrong in the first place. The Secretary of State should accept all the recommendations of the Francis report, including the recommendations that are designed to change the culture at a local level.

Let me now turn to the future of Stafford hospital, and address the point made by the hon. Member for Stone (Mr Cash). If there was one thing that the people of Stafford deserved after what had been a long and painful process, it was the legitimate expectation that, at the end of that process, they would see a fully functioning local hospital that was both safe and sustainable. That is why I believe that the conclusion of the trust special administrator process is both wrong and unfair on them. It will result in a significant downgrade of the hospital, and there is still no clarity in regard to important services such as maternity.

The issue of the future of Stafford hospital goes to the heart of the handling of the inquiry and the decisions made about it. When I arrived at the Department of Health in June 2009, the official advice that I received was that I should not hold any further inquiry into what had gone wrong, because it would distract the hospital from the essential task of making immediate improvements. I could not accept that advice, because I believed that we needed to get to the full truth of what had gone wrong. That is why I appointed Robert Francis to conduct an independent inquiry. However, I stopped short of a full public inquiry because I had been warned that such an inquiry could destabilise the hospital and prevent it from making improvements. The Secretary of State nods.

That is the advice that I was given, but I told Robert Francis that he could come back to me and ask for powers to compel witnesses to appear before him if he felt that that was necessary. He came back to me to say that he felt that he had had all the co-operation that he needed. Indeed, he had had more, because of the nature of the inquiry that I had set up.

As the Secretary of State will recall, after the first Francis report I commissioned a second-stage inquiry into regulatory systems. I did not disagree with the coalition’s decision to upgrade it to a full public inquiry, as that was always a finely balanced judgment, but I did warn at the time that the hospital would need further support, given what a full public inquiry would entail. I do not believe that it has been given that support. Worse, the administration process that it has undergone has been brutal. I do not believe that there is a district general hospital in the land that could survive a three-year public inquiry followed by financial administration. The Labour party’s view—informed by the Lewisham and Stafford examples—is that the Government are misusing the administration powers created by the last Government to drive through reconfiguration on cost rather than clinical grounds, and we will therefore move to delete those powers from the Care Bill next week.

NHS

Debate between Andy Burnham and George Freeman

Wednesday 5th February 2014 Commons Chamber

[Andy Burnham]

Yes, there has always been pressure on the ambulance service at this time of year, but if the Minister wants me to join in with his complacency, I am afraid I will not. The past 12 months have been the worst in A and E in a decade, and there are reports of ambulances across the country held in queues. Is the Minister satisfied with the performance of the ambulance service in his region of east England? Was he satisfied with the way the case I mentioned was handled? I do not believe he was or that his complacency at the Dispatch Box will be appreciated by his constituents.

[George Freeman (Mid Norfolk) (Con)]

As a Norfolk MP I assure the right hon. Gentleman that we are on the case regarding ambulances, and the Minister is leading the charge. I am interested in the facts. Is not the truth that we are treating 2,000 more patients every day in under four hours in A and E, and that we have 350 more A and E consultants? In Norfolk and Norwich hospital, people tell us that it was under Labour, with the IT issues, integration, GP contracts and working time directive that A and E became chaotic. The right hon. Gentleman’s attack is unfair, ill-judged and overly partisan.

[Andy Burnham]

I acknowledged that there is always pressure in A and E, but the fact is that it performed better in every month when I was Health Secretary than it has under the current Health Secretary. The hon. Gentleman mentions Norfolk again. We have been looking at the Minister’s website, which makes us wonder whether he considers himself a Minister or an observer of events in the NHS. Under the headline “Norman Lamb’s North Norfolk Ambulance Survey” he states:

“I have been campaigning over the last year to improve unacceptable ambulance response times in rural Norfolk.”

My God, this is the Minister! He is campaigning against his own Government.

Health and Social Care Bill

Debate between Andy Burnham and George Freeman

Tuesday 13th March 2012 Commons Chamber

[Andy Burnham]

I will not give way.

As I said, we need to see whether we can find common ground and put the NHS before party politics. That is the test that I set for the debate, and it is the spirit in which I wish to frame it. Today is not just an Opposition day but Merseyside derby day. Usually both occasions put me in a highly partisan mood, yet despite having double reason to be in tribal mode, I am going to take the unusual step of urging Labour Members not to vote for our motion but to consider the amendment tabled by the hon. Member for St Ives (Andrew George) and his Liberal Democrat colleagues. We will listen with interest to what he has to say. The amendment sets out a sensible way forward that we can all unite around. It sends out the simple message that the importance of the NHS to us all and to our constituents should trump any tribal loyalty. It is important to say that, because I fear that sheer gut loyalty, political pride and the need to save face are the only forces driving a deeply defective Bill towards the statute book.

[George Freeman (Mid Norfolk) (Con)]

I had the great privilege of working in biomedical research in and around the NHS for 15 years before coming to the House. Is it not the case that the challenges of an ageing population, the explosion of new biomedical treatments, diagnostics and devices, and the aspirations of modern patients demand reform? Did not the Labour party use to be the party of reform? Is not the right hon. Gentleman’s partisan posturing simply an illustration that Labour is no longer fit for Government?

[Andy Burnham]

Those factors demand service reform. I remind the hon. Gentleman that he stood at the election for a moratorium on such reform, which was a dishonest pledge that would have prevented the NHS from making the changes that it needs.

The NHS model that the hon. Gentleman and his colleagues seek to break with the Bill is judged to be the most efficient health care service in the world. The Secretary of State says today that that model is simply unsustainable in this century, with the ageing society and all the other pressures on it. I put it to the hon. Gentleman and the Secretary of State that that model is not the problem but the solution to the challenges of an ageing society, because it is proven to be the most fair and cost-effective way of delivering health care to the whole population.

We need to be honest with ourselves today. I mentioned the fact that it is just political pride and gut loyalty that are driving the Bill towards the statute book. Those motivations, however understandable and human they are and however familiar to politicians of every stripe, do not justify inflicting a sub-optimal legislative structure on our most cherished public service and making the already difficult job of health professionals even harder as they struggle to make sense of Parliament’s intentions.