National Health Service (Amended Duties and Powers) Bill

Andy McDonald Excerpts

Friday 21st November 2014 Commons Chamber

[John Healey]

I did not want to open up all the old arguments that we fought in 2010-11, though it was extraordinary to see the extreme lengths to which the Government went—seen before only on matters of military information—to stop the disclosure of the risk register about the potential impact and likely consequences of their policy. My hon. Friend was a great supporter of mine in trying to use the Freedom of Information Act to allow the public and this House to see the terms of what the Government knew could happen to the NHS if they passed the legislation.

My second C is complexity. NHS services are now so much harder to plan and so much harder to hold to account because of the changes the Government have made. We saw new national quangos responsible for tens of billions of pounds of spending of public money in each and every one of our local areas in England. The commissioning role, which was previously undertaken by one body, the primary care trust, is now fragmented with at least five different bodies trying to do the same job.

On the third C, competition, the Secretary of State has his foot lightly on the accelerator of privatisation for now, but let us make no mistake, if the Tories win the next election, he will press it hard down to the floor immediately afterwards. Even though they are soft-pedalling on the privatisation that their Act put in place, we have seen in the 18 months since it came into force 131 contracts won by companies such as Care UK, Virgin Care and BUPA. According to the NHS Support Federation, that is already valued at £2.6 billion. At that win rate, the contracts already currently advertised will mean another £6.6 billion in the private sector—getting on for 10% of our NHS run by private companies in private hands.

[Andy McDonald (Middlesbrough) (Lab)]

Has it come as any surprise and is it just a coincidence that the very companies securing these major contracts are six-figure donors to the Tory party?

[John Healey]

It comes as no surprise, and I am grateful to my hon. Friend for underlining that point. I was not planning to make that point, but I am glad that it has been made so clearly.

My argument is with the Prime Minister. So much for what he said, and so much for his word when he said back in 2011 that

“we will not be selling off the NHS”.

Perhaps the most serious consequence of this fragmentation, this privatisation and this contractualisation is the fact that the most important and fundamental value at the heart of the NHS—an imperative at its heart—is the ability properly to plan, co-ordinate and deliver services. That is being made much harder, as the Health Select Committee has said, and sometimes impossible by the operation of the Health and Social Care Act and competition law. If anybody doubts it, they should look at the case of the two NHS trusts—the Royal Bournemouth and the Poole NHS Trusts—whose merger made great sense to patients, but was prevented by this Government’s legislation.

Let me say a few words about the transatlantic trade and investment partnership. I have chaired the all-party group that has followed these negotiations for the last 18 months in order to try to encourage a better and more balanced public and parliamentary understanding and debate, as well as to put the Government on the spot and hold them to account for what they are doing. We are trying to ensure that if we get a deal, it will bring real benefits not just to British business, but to British workers and British consumers.

Two things have become clear. First, the NHS can be fully protected in TTIP. I am convinced of this, not just because other EU trade agreements have protected public services, but because if the Government want them, there are specific member state reservations to cover public services and because we have heard the confirmation, directly from the chief negotiator whom I have met twice about this, that even with ISDS—investor-state dispute settlement—provisions, which I do not support, nothing could prevent a future Labour Government from bringing parts of the NHS now in private hands back into public hands.

The second thing that has become clear is that these commitments have been secured despite, not because of, Government Ministers. It is clear that Ministers have done next to nothing to try to influence the negotiations and secure the full exclusion and protection we require for our NHS and wider public services. Indeed, rather as the right hon. Member for Banbury (Sir Tony Baldry) observed, the Minister for Trade and Investment, Lord Livingston, who is responsible in government for leading the British position, has said that he would welcome the inclusion of health services in any deal. When the Minister gets up to speak, perhaps he will—formally, in this House—make the Government’s position clear. What is clear is that if we are properly to protect our NHS in any future TTIP, we must have a strong British voice in Brussels, which we do not have at the moment.

--- Later in debate ---

[Andy McDonald]

Perhaps the hon. Gentleman would like to clarify, for the benefit of the House, whether his party is in favour of a private insurance-backed approach to health care or whether it actually believes in the NHS.

[Mark Reckless]

My party believes in the NHS as a service that is free at the point of delivery. My father is a doctor, and my mother is a nurse. That belief is core to my values, and to the values of my party. [Interruption.] That is our policy. Our policy is determined by our party, and it is to support an NHS that is free at the point of delivery.

Oral Answers to Questions

Andy McDonald Excerpts

Tuesday 1st April 2014 Commons Chamber

[Jane Ellison]

So desperate are the Opposition, I think the shadow Minister actually used the same opening line that he used at the last Health orals. It really is time to change the script. The NHS has seen more people in A and E than ever before. Waiting times have halved since the last Government left office. If he wants to come to the Dispatch Box and highlight problems in A and E, why does he not try the 86.6% of people being seen in Wales, which is a truly shocking performance statistic.

[Andy McDonald (Middlesbrough) (Lab)]

8. What progress has been made on achieving parity of esteem between physical and mental health.

[Paul Blomfield (Sheffield Central) (Lab)]

12. What progress has been made on achieving parity of esteem between physical and mental health.

--- Later in debate ---

[Andy McDonald]

If the Minister really believes in parity of esteem, how can he possibly justify cutting the funding for mental health trusts by 20% more than has been the case for other hospitals? Six leading mental health organisations warned that that decision will put lives at risk. Will the Minister now rethink the matter?

[Norman Lamb]

It is because I really care about parity of esteem that I described the decision by NHS England as flawed. It cannot be justified. It is not based on evidence. I am pleased to say that since then the former chief executive, David Nicholson, has written to all his area teams to make it very clear that in their commissioning plans and clinical commissioning groups, and in determining contracts with mental health providers, they must apply the principle of parity of esteem. Let us wait to see what emerges from that, but any reduction in funding for mental health this year would be unacceptable.

--- Later in debate ---

[Dr Poulter]

My hon. Friend has campaigned with great vigour on the issue, and rightly so. The European working time directive, to which the previous Government signed up in a headlong and reckless way, has damaged continuity of patient care and the training of the consultants of tomorrow. That is why we set up the independent review. We look forward to its recommendations and we will make sure that we respond to those appropriately in due course.

[Andy McDonald (Middlesbrough) (Lab)]

T8. The Health Secretary talks about Welsh patients flocking to the English NHS, but is he aware that the number of English patients going to Welsh hospitals has increased by more than 10% since 2010? Does that mean that the English NHS is in crisis?

[Mr Jeremy Hunt]

Unfortunately, a third of Welsh patients do not get things such as urgent scans within six weeks, compared with just 1% of patients in England. The Welsh NHS is struggling badly. I urge Labour, if it is to be consistent, to work closely with its colleagues in Cardiff to give a better standard of care to people in Wales, because they deserve a good NHS as well.

Accident and Emergency Provision (North-East)

Andy McDonald Excerpts

Wednesday 13th February 2013 Westminster Hall

[Tom Blenkinsop]

I thank my hon. Friend for that point, which I will try to extrapolate from during the debate.

Paramedics say that delays prevent them from responding to calls, and fear that such delays could lead to a tragedy. As recently as last week, it was reported that the hospital was the second worst in the north-east for hospital handover delays of longer than two hours. Any hospital handover delay of more than two hours is classified as a serious incident by the NEAS. Of equal concern is the fact that in December, the hospital failed to meet national targets of responding to 75% of the most serious incidents—classified as red incidents—within eight minutes; its result was 69%.

Accident and emergency departments are the foremost example of NHS front-line services. If they appear to be failing, it is hard to deny that something is not right. It is not justifiable to have patients queue in a corridor, as Gladys Herbert had to. She described the situation:

“It’s as plain as the nose on my face there’s not enough beds and not enough staff in the hospital”.

That occurred at James Cook hospital, where there was a queue of up to 10 ambulances at one point. Frankly, that is an appalling risk to patient safety. The Prime Minister has personally promised to protect the NHS, but he is leaving patients such as Mrs Anderson and Mrs Herbert waiting longer in pain and discomfort.

[Andy McDonald (Middlesbrough) (Lab)]

I rise to support my hon. Friend, and I congratulate him on securing this debate. I entirely support what he is saying, because some weeks ago my own mother lay on a hospital trolley for five hours at James Cook hospital, waiting for admission to a ward. Ambulance staff had to remain with her until she was admitted before they could go on to their next task, which is a complete and utter mismatch of resources. I support my hon. Friend’s comments.

[Tom Blenkinsop]

My hon. Friend makes an excellent point. It is a sorry state of affairs, and personal experiences, that people from our area are reporting. The warning signs are there, and I believe front-line staff when they say, as has been reported:

“Somebody is going to die somewhere down the line and it could be the most vulnerable, children. Families of sick people arrive at hospitals and expect to find them in a bed, but they are still outside in an ambulance.”

In fact, a tragedy has already taken place. Last year, an ambulance crew brought a patient to the hospital, but he was not officially handed over to A and E staff. Before he could be seen by a nurse or doctor, he went into a fatal cardiac arrest. The patient, who has not been identified, died at James Cook university hospital, having waited for emergency treatment for more than two hours.

The delays are obviously stretching resources all over the place; for example, ambulances from as far away as Lancashire are being brought in to cover other emergencies. I fear that, with changes in NHS provision elsewhere in the north-east and north Yorkshire, James Cook hospital’s resources might become even more stretched. Surgeries’ general reduction in their late opening times for out-of-hours appointments in some areas across the north-east is putting further pressure on regional A and Es. For example, in County Durham, 69 GP surgeries offered late opening appointments in 2011, but in 2012 that was down to 61 surgeries, which is a 7.6% drop. In Newcastle, 33 GP surgeries offered late appointments in 2011, which dropped to 24 surgeries in 2012. In Hartlepool, 15 GP surgeries offered late appointment times in 2011, but that dropped to 10 in 2012, which is a 31.3% decrease. As the Minister will admit, triage is essential, and that is enormously helped by walk-in centres in my constituency, across Middlesbrough and in Redcar, especially as regards less affluent transient populations who are often not on GP registers.

As the Minister knows following the meeting he kindly agreed to have with me and a representative of the trust, urgent care provision in east Cleveland is facing particular problems. The trust claims to be taking steps to resolve the problems, but if the issues are not resolved, I fear that in the interim—and possibly in the longer term—a reduction in urgent care provision in east Cleveland might further increase the demand faced by James Cook hospital’s accident and emergency department, as patients search for alternative treatment. To an extent, we have already seen that with the draw-down in services at Guisborough general hospital’s minor injury unit.