Contaminated Blood

Andy Slaughter Excerpts

Tuesday 12th April 2016 Commons Chamber

[Andy Slaughter (Hammersmith) (Lab)]

I add my thanks and congratulations to my hon. Friend the Member for Kingston upon Hull North (Diana Johnson) on what she has said today and on her outstanding leadership on this issue. She will be encouraged by the commonality of view—it goes further than consensus—across the House, and I hope that the Minister will take note. Back-Bench debates are often not party political, but I cannot remember another debate in which Members’ sympathies have been so clearly at one. I am sure that many Members feel, as I do, quite let down by the consultation. I will not personalise the matter by referring to the Minister. It is a Government responsibility, and this Government are now in power.

We need to bear some basic facts in mind. This is an NHS scandal. The Secretary of State, perhaps more than any other Secretary of State, has been keen to identify where things have gone wrong with hospitals, practitioners and events in the NHS, and to point the finger and say that what happened was not right. This is the clearest case of that, and it is the biggest scandal in the NHS. We are talking about innocent victims. Many of us—even if the Government do not admit it—believe that there has been negligence and there is culpability, but I think we all agree that there is a moral responsibility.

I hope that we all still believe in the welfare state that was set up after the second world war, and that we all think that the state should act as a safety net. The matter goes further than that, however; it is about state error. It is about the state making mistakes that it is bound to correct. The state has made a variety of mistakes—Equitable Life, flooding and many others—after which it has been able to dig into its pockets and find money because it believes that there is a compelling case for doing so. Perhaps a closer analogy is mesothelioma. Mesothelioma victims have not had the complete compensation that they need, but at least the responsibility to make provision for those people has been recognised, even if one cannot point the finger and say that it is anybody’s fault in particular.

I want to say that this has been a very long struggle. I have been engaged in it only since my constituency boundaries changed in 2010 and I found that I had some sufferers, victims of incidents of contaminated blood, in my constituency. Since then, I have been pretty active as a Member by taking part in meetings, debates, reviews and the all-party group. There have been some important interventions. I credit the Minister for Community and Social Care for the work he has tried to do, and the Prime Minister for the apology he made in relation to that. There have also been concessions, such as that the existing schemes are inadequate and badly run, and that there are too many of them.

We have asked for a full and final settlement, for the overall impact on victims to be assessed and for each victim and their family to be dealt with as individuals, so I do not think that we expected to be in the position we are today. It is a position in which the Haemophilia Society can write quite baldly that

“the majority of people currently receiving financial support will be worse off under the new scheme.”

How did we get into this situation?

If I and other Members feel let down, what do our constituents feel? What do people such as my constituent Andrew March feel? His whole life has been fundamentally altered by this. His health, his life expectancy, his earnings ability and his career, as well as aspirational things such as the ability to own his own home and to live a normal life—I thought the Government believed in them—are all out of his reach now. This is a fundamental change, but it has been going on not for years but for decades.

I would say to the Minister that the issue of reduced income must be looked at in full, whether that reduction is because of discretionary payments or other reasons, as must the overall impact on the individual and their family, and the implications, more widely than simply health, on their whole lifestyle. We should not confuse treatment, including the good and innovative schemes that are now available—anybody should receive such treatment from the NHS, to which we all pay in, as of right—with paying proper compensation and ensuring that people are properly rewarded.

Let me end by making two quick points. First, it has been said that Scotland has set an example. It is not a perfect example, but I strongly believe that we should at least be able to match what happens in Scotland. Secondly, my constituents have told me that they do not feel comfortable filling in responses to the consultation. They do not believe the consultation is presented clearly and honestly, and the questions are phrased so prescriptively that they are unable to communicate what they think. The Government can do what they want—it would have been better if they had withdrawn the consultation, but that has not happened—but they do have the power to respond by saying, “We have made a mistake. We haven’t taken into account everything that should be done. We have to act with compassion and with honesty, and we have to give proper compensation.”

Finally, I must say that I disagree, as I rarely do, with the hon. and gallant Member for Beckenham (Bob Stewart). This is about justice, and justice can be delivered by recognising the needs of the community who have been infected in this way. I think that the Government have a duty to act.

Junior Doctors: Industrial Action

Andy Slaughter Excerpts

Thursday 24th March 2016 Commons Chamber

[Ben Gummer]

We are increasing the number of junior doctors and the number of other doctors, consultants and nurses over the next five year years in order to meet the increasing challenges facing our national health service.

[Andy Slaughter (Hammersmith) (Lab)]

The Minister said that he had reached agreement on 90% of matters, including some that were not on the table, and he is to be warmly congratulated on that. Perhaps he has a future at ACAS. What my constituents would like, however, is for him to go back to negotiate the other 10%. Is it not the case that the junior doctors want a resolution and have said that they will negotiate? The Minister should square the circle: he says they will not negotiate; they say they will. Will he give it one more chance?

[Ben Gummer]

The credit that the hon. Gentleman has kindly given me is due to Sir David Dalton, who achieved the 90% agreement on the contract. As for the remaining 10%, his judgment was that the junior doctors committee would refuse to negotiate. At that point, the Government had to make a decision about whether to proceed or to cave in. We decided to proceed, which is why we will implement the contract later this year.

NHS in London

Andy Slaughter Excerpts

Thursday 24th March 2016 Westminster Hall

[Dr Huq]

I completely agree with my hon. Friend. We are trying to have a serious debate, but we are pooh-poohed at every turn. When my hon. Friend the Member for Hammersmith (Andy Slaughter) asked a question about the Mansfield report, he was told that he was living in a bygone age. I cannot recall the exact remark, but it was something like, “You’re an old soldier fighting a war that’s concluded.” Dismissing people in that way does not inspire confidence.

[Andy Slaughter (Hammersmith) (Lab)]

I always do what I am told by my hon. Friend—the dismissive comment was that the Mansfield report was commissioned by five Labour councils. I have actually had a slightly more considered response, but it was still dismissive. It was a very serious independent report, and I am sure my hon. Friend will agree that the Minister should take it a bit more seriously.

[Dr Huq]

My hon. Friend puts it very well. People’s concerns are serious and should not simply be dismissed.

I also agree with my hon. Friend the Member for Eltham (Clive Efford) that the community pharmacy network is a vital component of our country’s health and care system. Suddenly, the Government seem to be imposing arbitrary cuts in a high-value, easily accessed, community-based facility, which relies on private investment as well—pharmacists are small businesspeople. Hiten Patel of the Mattock Lane pharmacy opened my eyes when I spent a bit of time shadowing him there. I saw how the burden on the NHS and GPs is reduced by people having such pharmacies at the end of their street. For most people, they are much nearer than a hospital or even a GP service.

Hiten Patel and his staff help people to make lifestyle choices. They provide a range of services and information to promote health, wellbeing and self-care. They are a useful check on prescribing errors and are dedicated and trusted people. We have such pharmacies all over the country, and they form obvious back-up and support at a time of crisis for GP recruitment and retention. We should value those people, not make life more and more difficult for them.

Last Sunday, I collected my elderly mum’s meds from Harbs pharmacy in South Ealing Road. That pharmacist is open out of hours. I recall that one year he was open even on 25 December—I did not go past this year, but he was probably open then as well. That releases the Ealing Park surgery practice next door for more acute and specialist care, but the Government seem to do short-termism. The long-term impact of eroding the network will have a disastrous effect.

Another troubleshooting service that is located at the heart of the community and has hidden value is opticians. They, too, have a valuable role of social contact, with networks and support mechanisms, and they can contribute to signposting and safeguarding the vulnerable. As the right hon. Member for Carshalton and Wallington (Tom Brake) pointed out in connection with community pharmacists, opticians can also catch things early.

I visited the Hynes opticians in Northfield Avenue, where staff are worried about the continuity of their supply chain. Joint strategic needs assessments enable clinical commissioning groups and local authorities to work in tandem, and the Ealing Council assessment mentions effective eye services and sight loss, but the NHS Ealing CCG does not use the JSNA in its commissioning decisions. Will there be some guidance from the Minister about how to integrate CCGs and local authorities better?

I could go into mental health services, which are chronically underfunded and a huge cause for concern. The Prime Minister made a speech about them last month, but I would like to see more action. Labour has a shadow mental health services Minister. The chief executive of Central and North West London Foundation Trust, Claire Murdoch, has claimed in an interview that mental health can be an “easy target” at times of belt tightening, saying that

“during recessions mental health tends to be hit first and hardest and recover most slowly…There is an absolute anxiety that people are depressed and really are suffering as a result of some of the economic reforms. What we don’t know yet is the extent to which some of the welfare reforms are driving people to real, serious illness.”

I have the sense of morale taking a nosedive locally. My constituent Michael Mars, who is now retired but was a senior consultant at Great Ormond Street hospital, said:

“The essential problem is the feeling of impotence experienced by those at the coal face

because of an

“overwhelming management culture where clinical knowledge and experience is secondary to management.”

Such words echo, because we hear them from a lot of other public service professions such as teachers and the police. They all say that they are doing all the paperwork and are not allowed to do what they are supposed to do. Michael Mars talked about survival in the culture of management and worries that we might be in danger of forgetting what clinical consultants are appointed to do.

At the other end of the career scale are junior doctors, on whom there was a debate in this Chamber on Monday. I have had numerous representations from constituents who are junior doctors. The latest NHS staff survey showed that the percentage of junior doctors suffering from work-related stress has gone from 20% in 2010 to 34% in 2015.

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[Bob Blackman (Harrow East) (Con)]

It is an honour to serve under your chairmanship, Mr Turner. I congratulate the hon. Member for Ealing Central and Acton (Dr Huq) on securing the debate on London’s NHS. The subject is vital to people not just in London but nationally and internationally because we provide a health service for not just people resident in London but those who work in London and those who come to London for specialist treatment. I apologise that I may not be here for the winding-up speeches; I must attend the debate in the Chamber where I am the lead speaker. My apologies if I have to scuttle off before other contributions.

I want to speak about three issues in my contribution: primary care; the position at Northwick Park hospital; and the Royal National Orthopaedic hospital. In terms of primary care, without doubt, one problem we experience in London is that people have difficulty getting on to a list for a GP and then getting appointments when they are ill. As a result, when a person is ill, they immediately say, “Well, if I can’t get an appointment with my GP, I will go to A&E or the urgent care centre or whatever facilities are around.” That means that people turn up at A&E and at urgent care centres who should be seen by GPs or even by nurses at GP surgeries—they do not necessarily need to be seen by doctors.

We all have anecdotes we can share, but at the health centre to which I go the GP appointments system is now such that people can only register for appointments 48 hours in advance—it is always quite difficult to know whether one will be ill in 48 hours—or walk in and wait; however, how long will it take to be seen after all the appointments? That leads to a challenge. Immediately, people say, “I’m not going to do that, because I can turn up at A&E or the urgent care centre and make sure I am seen.” Therefore, the all-party parliamentary group on primary care and public health, which I co-chair, has pointed to the need for better signposting in the national health service to point patients to the right place and to ensure that primary care in particular can provide care for those who need it.

I will move on to Northwick Park hospital. As I said in my intervention on the hon. Member for Ealing Central and Acton, who led the debate, its A&E performance was truly dreadful. I can speak from personal experience: I waited in A&E for some eight hours before I was seen on an urgent care basis and received medical intervention. It was a disgrace. People were waiting for far too long and never, ever were the targets achieved. However, in November 2014, the Government invested in the new A&E at Northwick Park hospital and since then there has been a complete transformation.

One of the problems we had with Central Middlesex hospital having an A&E was that its brilliant doctors and nurses were sitting around, waiting for patients to arrive; patients would go to the A&E at Northwick Park because it was nearer and more convenient. The consequence of the A&E at Central Middlesex closing and those doctors and nurses transferring to Northwick Park was that performance transformed overnight.

I have the latest figures. When we talk about stats, we should talk about what is going on now in reality, not what happened in the past. At Northwick Park, in January, 89% of patients were seen within four hours and—[Interruption.] I accept that the target has not been reached, but the key issue is that that is far from the dramatic underperformance that the hon. Lady described. The reality is that 90.3% of patients were waiting less than 18 weeks to start treatment at the end of January, and we all accept that January is probably the hardest month for the NHS because of difficulty with the cold weather.

Cancer waiting times are a vital aspect, and Northwick Park hospital meets the targets: 94.1% of patients with suspected cancer were seen by a specialist within two weeks. I would much rather see that figure at 100%, but that is above the target of 93%. Of patients diagnosed with cancer, 99.2% began treatment within 31 days—the target is 96%, so that is an outstanding performance. Finally, 86% of patients began cancer treatment within 62 days of an urgent GP referral; the target is 85%. It is therefore fair to say that Northwick Park hospital—it is not in my constituency but virtually all my constituents use it—has transformed itself under this Conservative Administration. It is important to get the facts on the record, so that people can congratulate the health providers, who are delivering an excellent service. Of course, there are always challenges. We know there is a deficit, but the key is that Northwick Park hospital’s funding from the CCG will see a 6.01% increase this year. That is a good performance; we can see that money is being invested.

Just before the 2010 election, when I was elected for the first time, under the previous Labour Government, there was a review of accident and emergency services in north-west London. We heard not a squeak from Labour MPs about the fact that as part of that review they wanted to close down five of the A&Es in north-west London. [Interruption.] Oh yes. The incoming Health Secretary said, “We are going to stop that review in its tracks, and any review of A&E services will be clinically led, not driven by particular elements or arguments.” The reality is that this is nothing new; this is being driven by the NHS and the NHS bureaucracy. That is what I want to move on to finally.

[Andy Slaughter]

The hon. Gentleman needs to substantiate both elements of what he just said. To go back 10 years to try to defend the current crisis in the NHS in his constituency is a bit unnecessary. The fact is that promises were made by his party about specific hospitals as well as about A&E generally and it has gone back on almost every single one of those. A little less hubris from him would be appropriate.

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[Andy Slaughter (Hammersmith) (Lab)]

It is a pleasure to be here under your chairmanship, Mr Turner, and to be called early in the debate. I thank the Backbench Business Committee for giving us this long and generous slot on the last day before the recess. Given that it is the last day, there is a good turnout from London Labour Members, and one or two London Conservative Members. Indeed, we had the whole of the Liberal Democrat representation for London, but he has gone now.

I particularly thank my neighbour and hon. Friend the hon. Member for Ealing Central and Acton (Dr Huq) for introducing this debate in a comprehensive manner, which permits me to make my contribution shorter than it otherwise would have been, because I am going to deal with some of the same issues. I preface my remarks by saying that London Members deal with a great many health service issues—on the whole successfully—through their clinical commissioning groups, hospital trusts and the other myriad health service bodies that the Government inflicted on us in the last top-down reorganisation.

We have heard about primary care, mental health and community pharmacies. The reason why we—particularly the 11 Labour MPs for north and west London—keep returning again and again to the issue of acute hospitals and the “Shaping a Healthier Future” programme is not only that it is such a major reorganisation of services but that it has become very politicised. Of course, all these issues are political—money spent on the health service is always political—but we feel that we are either not being given information or being given the wrong information.

I must disagree with the hon. Member for Harrow East (Bob Blackman). My memory goes back a long way. I was part of the campaign against the closure of Charing Cross hospital in the early 1990s. It was successful, obviously, but it was a long and hard-fought campaign, and again, the grounds for closure were entirely spurious. I remember the former Member for Brentford and Isleworth, who was a Health Minister, leading that campaign when she was the head of nursing there.

[Dawn Butler]

I remember leading a campaign in 2006 to save Central Middlesex hospital’s A&E, which was successful. Unfortunately, it then closed when I was not an MP in, I think, 2011.

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[Andy Slaughter]

We all bear these scars. I am grateful for all the efforts that Members have made to protect their local health services.

The next time that Charing Cross hospital came up, it was in the context of the 2005 election campaign, when a Conservative candidate, now the right hon. Member for Chelsea and Fulham (Greg Hands), shamelessly said that it was going to close, with no evidence whatever; there were no plans to close it. The candidate running against me in 2010 did exactly the same in relation to the hospital in my constituency. The difference was that immediately after the 2010 election, plans began to be drawn up—we did not see them until 2012—by McKinsey and others. The reference to consultants was well made by the hon. Member for Harrow East, because the spend on consultants on “Shaping a Healthier Future” alone is running at something like £20 million per annum at the moment.

I did not recognise, in what the hon. Gentleman said, what has actually happened. The brief history is as follows. Those plans were presented. They were kept under wraps and took us all by surprise with the dramatic changes they contained—the downgrading of the four A&Es and what was going to happen to Ealing and Charing Cross hospitals. However, that was a long time ago now, in the summer of 2012. The only revision to those published proposals was at the end of the so-called consultation process in February 2013. Apart from references in board papers and other statements, we have not had a formal upgrade to the process since then. That is more than three years ago, yet the proposals affect about 2 million people across the whole of west and north-west London.

I accept that there can be faults on all sides and that in the run-up to elections, people get quite emotional and political about these issues, but that is partly because they matter so much to our constituents. At the 2015 election, at least we were getting emotional and political about something that was actually proposed, rather than something that was invented. Since the election last year, we have attempted—certainly I have, and I think this goes for a number of my colleagues—to engage in the process with Ministers and officials, partly to find out what is going on and partly to try to influence the outcome. The Minister met a group of MPs last summer and said that there would be a great deal of engagement and transparency. I have not given up on that, but it has not happened so far.

The key document in the “Shaping a Healthier Future” programme—the implementation business plan—is still under wraps. We have been asking for it for the best part of three years, formally, informally or through freedom of information requests. Different reasons have been given at different times—“It’s a work in progress,” or “It’s commercially confidential”; all the usual reasons. It becomes a bit ridiculous after a while. I am not sure it is very helpful to the Government or the NHS, because in the end we have to rely on what information we can scrape together.

Of course, the world has changed a lot in those three years. Let me give some examples. The London head of NHS England, Anne Rainsberry, came to brief Labour London Members earlier this week and gave us some quite interesting information. First, “Shaping a Healthier Future” alone will not deal with the financial problems, which have got substantially worse. My trust, Imperial College Healthcare NHS Trust, last reported that it was running a £25 million deficit, but I know that other trusts, including London North West Healthcare Trust, have higher deficits than that.

The position has got markedly worse. I know the Government say there is a clinical basis for “Shaping a Healthier Future”, but it is interesting that there has been a concession that there is a financial basis to it; it is about saving money. Opposition Members would say that it is mainly about saving money, but the Government might say that that is an ancillary purpose. We are now being told that even if “Shaping a Healthier Future” were implemented, it would not save enough money given the deteriorating situation.

The shadow Secretary of State, my hon. Friend the Member for Lewisham East (Heidi Alexander), mentioned the shift from capital to revenue, partly as a bail-out. That may be a crisis move to offset the immediate financial crisis, but it has implications, particularly for a grandiloquent project such as “Shaping a Healthier Future”, which is about a major redesign of hospital sites—particularly the Charing Cross and St Mary’s sites, which are taking the bulk of the money.

We know—the NHS is now being slightly more candid about this—that the Treasury is getting cold feet about the programme, and the date is being pushed back and back. That is good in a way, because originally we were told that Charing Cross was going to be demolished in 2016-17, and now we are talking about 2020 at the earliest. I am delighted by that, because the longer it is pushed back, the less likely it is to happen, but it reflects serious concerns in the Treasury, and possibly in the Department of Health, about where the programme is going.

[Dawn Butler]

My hon. Friend is being generous with his time. Is he concerned, as I am, by the letter from Clare Parker, the senior responsible officer for “Shaping a Healthier Future”? Brent has been trying to get hold of the latest version of the implementation business case. She notes the request, but states:

“Unfortunately this document is in draft form and not currently suitable to be shared.”

Does he wonder, as Brent and I do, when we will be able to have sight of that document?

[Andy Slaughter]

That is exactly the document I have been discussing. In some ways, Clare Parker’s embarrassment comes through in that letter. She is a good officer. She is the officer primarily responsible for delivering “Shaping a Healthier Future” and is effectively running five CCGs in that capacity. I think she would like to be more candid with us than she is in that letter. I urge the Minister to encourage people in CCGs, trusts and the Department to be more candid. She might find that there is more understanding of the problems than she thinks.

The question is—I discussed it with Clare Parker only a few weeks ago—where are we going with this programme? If the Treasury is putting out alarm signals about whether it can fund the programme, and principally the rebuilding of St Mary’s and Charing Cross, what will happen? The strong rumour is that reductions in service will have to take place, because services have a financial cost. The type 1 A&E and other services will have to go from Charing Cross, with the hospital effectively becoming a primary care and treatment centre, and the situation will be similar at Ealing.

Rather than the demolition, clearing and part sale of those sites, followed by rebuilding, which would cost hundreds of millions of pounds, we may just mothball the existing buildings, which are on the whole ’60s and ’70s buildings, with part of them not being used at all and the rest being used for the new facilities. In some ways, that would be the worst of all worlds, although it would at least preserves the sites and the capacity for future Governments to reactivate them. That has certainly not been denied to me, although I think it was said that that is a more advanced plan at Ealing than at Charing Cross, where it is still plan B. In other words, demolition is still on the cards, but there has to be a fall-back position if the Treasury does not fund it.

There is another factor. Even if the NHS does not move on, the rest of the world does. My hon. Friend the Member for Westminster North (Ms Buck), who could not be here today, is pressuring strongly for the facts in relation to St Mary’s hospital, which serves her constituents, as I am for Charing Cross. Because of the grandiose scheme to build the “Pole”, or the new Shard, which would take up some of the land on the St Mary’s site, the existing plans will no longer be possible. Instead of the A&E, there will be a nice piazza outside a 95-storey office block, which I am sure is much more useful to constituents. Such fundamental changes will mean that the land is more valuable, the building costs are greater and the substantial plans for the modernisation of St Mary’s will not be able to go ahead, at least as planned. Yet many of the buildings there are listed, so what is happening? I like to think that something is happening, but I would also like to be told about it. It is unacceptable for three years to pass without any information being put on the record or given out.

Anne Rainsberry also said that we are still maintaining the Keogh principles, as if that would be a surprise or we would not welcome it. Many of the changes that have happened are, of course, improvements to the service. The hyper-acute stroke unit at Charing Cross has been classed as the best in the country. It is a fantastic unit that saves a lot of lives. The stroke unit from St Mary’s has just been moved to Charing Cross. Of course, the costs associated with that and with ensuring that it operates properly will apparently be wasted, because in four or five years’ time, the intention is to close it, demolish it and move it all back to St Mary’s again. I just cannot follow the logic, and I begin to lose confidence in the NHS’s ability to plan.

We have been through all this about three times in west London. We went through the whole Paddington basin fiasco and other schemes to do with merging Hammersmith and Charing Cross hospitals. In that time, demand has changed. The latest figures show that demand for A&E at Charing Cross has gone up by 13%, and none of the hospitals is meeting its A&E waiting target. There is massive population expansion, and I was pleased to be told by NHS England that when the business plan is produced, it will be based on the latest figures, so we will not be relying on the population statistics from five years ago.

The population is growing astronomically. When people drive through west London, they can see building going on on every street corner. The anticipated growth in population runs to tens or hundreds of thousands over a very short period, yet whenever I look at the plans—I assure hon. Members that I look at them all, as I monitor demographic changes—I never see any increase in public services. I never see the new schools, hospitals or GP surgeries, I just see massive blocks of luxury flats being put up everywhere. Even people who live in blocks of luxury flats get ill sometimes, although I have genuinely been told that it will mostly be wealthy young professionals living there and they will not need hospitals, so I do not need to worry too much about them.

[Ruth Cadbury]

Skiing injuries.

[Andy Slaughter]

Well, perhaps. The situation does not give us a lot of confidence in the plans that are being made.

I hope that I have given a flavour of what is happening. I cannot do much more than that, because I do not have the information available. This is the No. 1 issue for my constituents, yet when I look back to see how often I have raised it—I have made one speech on it since the election and asked a few questions to Ministers—I am sorry to see that on the whole, I get pretty dismissive answers. I do not think that is how this Minister would wish to behave.

I ask that sooner or later—sooner, preferably—we get the business plan so that we can see what changes are being proposed and what the timetable is. I also ask for a realistic reassessment of the need for acute hospital services, because I do not believe that “Shaping a Healthier Future”—2010 or 2012—will be the appropriate mechanism for doing that. If the Government are prepared to do that, I am sure that all Members, irrespective of party or of the proposals for their local hospital, will be prepared to sit down and negotiate.

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[Wes Streeting (Ilford North) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Buck, and a pleasure to follow so many contributions from hon. Members from across London. I congratulate my hon. Friend the Member for Ealing Central and Acton (Dr Huq) on securing the debate. I thank the Backbench Business Committee for granting us this opportunity to talk about the NHS across London.

The context is challenging across London, with a swiftly growing population, huge health pressures arising from demographic change and from London lifestyles, and a national health service that across the city is struggling to cope with those myriad pressures. We have seen that across the capital since the 2010 general election. A&E waiting times in hospitals throughout London, referral-to-treatment times and cancer waits have worsened throughout the period. As we have heard, Members from every corner of our capital city are reporting local pressures that reinforce that picture of national health service provision across London.

We feel that pressure acutely in Redbridge. Both the NHS trusts that cover our borough are in special measures: Barts Health NHS Trust, which covers the west of my constituency; and Barking, Havering and Redbridge University Hospitals NHS Trust, which serves patients throughout my constituency. Primary care is an issue, with patients increasingly struggling to get a GP appointment and finding new barriers put in their way, such as telephone consultations before a GP practice will even grant an appointment. There are also service reconfigurations.

We have already heard about service closures across the rest of London, and in Redbridge we remember the Conservative party’s commitment before the 2010 general election that there would be no enforced closures of accident and emergency or maternity units. Well, we lost the maternity unit at King George hospital, and the decision to close the accident and emergency department was taken in 2011 by Andrew Lansley when he was Secretary of State for Health. That decision still stands, although it has not yet been implemented because the NHS is in such a state of crisis locally. Our local A&E waiting times for the last six months show that we have failed at any point to hit the target of 95% of patients being seen within four hours. The worst rate in the last six months was 76.8%, in December, and the best was 92.6%, in February. People living in my constituency will not find that satisfactory. In the last couple of weeks, the chief executive of the Barking, Havering and Redbridge trust has had to apologise to the 1,015 patients who have waited more than a year for routine treatment such as knee operations, which is simply unacceptable.

There are some positives. I have mentioned the chief executive of the Barking, Havering and Redbridge trust. I have confidence in the trust’s leadership. Since they came on board, they have approached the task energetically. They inherited an absolute mess that developed over a number of years, and there are some improvements, but as recent events have shown, there is still a long way to go.

I welcome the work that the clinical commissioning group and GPs are leading on primary care transformation to try to improve primary care services locally, but we are yet to see the fruits of their labour. I also welcome the extent to which the local authority, which is now Labour-led, has been leading the way on integration to help partners across the local health economy. I am pleased to see that my borough is taking part in piloting the accountable care organisation initiative, which I hope will bring real benefits to patients through greater integration between healthcare providers and our local authority. In that context, the cuts to local government spending and, in particular, to public health budgets are a real concern.

I should probably declare that I am still a serving councillor in the London Borough of Redbridge, albeit an unpaid one, so I am excellent value for money for my constituents.

[Andy Slaughter]

They should be the judge of that.

[Wes Streeting]

They may well be the judge, but I am standing down as a councillor in 2018. I was elected to Parliament while serving as a councillor, which is a good indication.

Seriously, the London Borough of Redbridge has the fourth lowest public health grant in London. Given the diversity of our population, and the pressures that that brings, it is a cause for concern. In that context, I was even more disappointed to find that the Government have cut our public health grant in-year. As a former cabinet member for health and wellbeing in Redbridge, and as the former chair of our health and wellbeing board, I know that we were already struggling to meet our statutory duties on public health, not least the new responsibilities we have been given, such as for health visiting, for which the allocation received from the Government was not sufficient. We managed to squeeze some extra funding out of the Government, but we are still struggling.

The reduction is disappointing, particularly in the context of London, where people’s healthcare needs and lifestyles are placing pressures on the NHS. Public health investment is an upfront investment in people’s lifestyles that will reduce NHS costs in the longer term, as well as improving people’s health and wellbeing. I cannot understand why, in that context, preventive budgets such as public health budgets are bearing the brunt of cuts. I hope Redbridge’s public health allocation in particular is something that the Department of Health will revisit.

I have talked about the financial challenge for local authorities, and I will now address the financial challenge facing the NHS and our local health economy. I was concerned, as everyone else was, to read David Laws’s revelation at the weekend that, far from the £8 billion that keeps being mentioned as the hole in the NHS budget, Simon Stevens actually identified a £30 billion hole, of which he said £15 billion could be found through efficiencies and improvements. My maths makes that a £15 billion hole in the NHS budget, and it is a source of concern that the £8 billion promised by the Conservatives at the last election is still not there. We have seen the Chancellor having to shuffle money around. Earlier, my hon. Friend the Member for Lewisham East (Heidi Alexander), the shadow Secretary of State for Health, talked about the reallocation from capital to revenue in terms of the health budget.

--- Later in debate ---

[Jane Ellison]

We have been clear that we have given a large amount: £3.5 billion has been made available to local authorities for social care. Ditto on public health—we will spend £16 billion over the next five years. If I have time, I will come to the good point that was made earlier about the move to business rates retention. It is matter of record that the Government committed at the election to what the NHS had asked for in the five-year forward view, and we will continue to make that commitment.

The London health system—CCGs and provider trusts—has planned for a deficit in 2015-16 of about £350 million, and overall the system is expected to be in that position. Some recovery is expected during 2016-17, and I am sure we will debate that again. In addition, a £1.8 billion sustainability and transformation fund is available, designed to address provider deficits in 2016-17. However, I think all Members would accept that additional Government spending is not the only answer to the challenges faced by the NHS. We have taken action with our arm’s length bodies to support local organisations to make efficiency savings and reduce their deficits, but much of the change Members have talked about is driven by desire to get better healthcare rather than to make savings. If we can make savings as well, that is all to the good, because we can reinvest them in great healthcare.

In London, from early April, the new NHS Improvement body will be providing additional expert support and capacity to trusts experiencing particular financial challenges. That support will include identifying and implementing financial improvement and helping them to identify savings to put them in a stronger position to maintain those savings.

Let me talk about the pressures on urgent and emergency care. It is acknowledged that the urgent and emergency care system faces increasing pressure. More and more people are visiting A&E departments and minor injury units, which is stretching their ability to cope. Members listed some reasons for that in their speeches. A lot of visits are unavoidable, but some people are visiting because of inconsistent management of long-term health conditions, difficulty in getting a GP appointment or insufficient information on where to go.

Winter sees an even bigger rise in visitor numbers and pressure on staff. Although the debate inevitably dwelled on Members’ concerns about their local healthcare systems and problems in them, I am sure we all want to place on record our huge thanks and praise, as many have, to the staff of London’s NHS, who work extremely hard under a lot of pressure and delivering some really good results against that backdrop. I will come on to that.

London’s A&E units have been significantly challenged this winter, and that has been reflected in performance. However, despite those pressures, the capital’s urgent and emergency care system has proved its resilience, with fewer serious incidents declared than in previous years. This winter, London accounted for just three out of 625 serious incidents declared across England. It is important to praise the staff in saying that.

In January, London’s performance was significantly higher than all other regions, with 90% of patients seen within the four-hour A&E standard. London is also the highest-performing region in England this year to date, with 93.1% of patients seen within the four-hour standard. My thanks and congratulations on that improved performance go to the hard-working staff of London’s services.

Reconfiguration schemes have loomed large in the debate. The health needs of people in London are changing and demands on health services are increasing. The hon. Member for Ilford South in his excellent speech illustrated through his personal stories some of the reasons for the changes in the shape of our health service in terms of how we are investing in specialist services and centres of excellence. The work done to centralise stroke expertise was brought up earlier in the debate. I remind Members, although many will remember, that those changes were bitterly opposed by many people. I am not sure whether that includes anyone in the Chamber, but it certainly includes campaign groups. However, all our London clinicians now say with certainty that those changes, with centralised expertise and specialist care, have saved many lives. That is always worth reflecting on.

People are living longer, the population as a whole is getting older and there are more patients with chronic conditions. We often say that people are living longer, but we forget to say that they are living with chronic conditions for longer, and that presents a longer-term challenge than might be seen at first sight. Heart disease, diabetes and dementia will all increase as they are conditions associated with an ageing population.

We did not dwell on the prevention agenda, but I was delighted that the hon. Member for Edmonton (Kate Osamor) spoke about it. The shadow Secretary of State also touched on it when she mentioned dementia and the problems we all know of older people in hospitals. I urge her to look at the dementia implementation plan we published on 6 March, which is a detailed response to the Prime Minister’s 2020 challenge. Dementia has sat in my portfolio since the election, and that plan is a detailed look at how we deliver against that challenge and in particular at the joined-up care that is key to ensuring that people with dementia have safer and better care in our system and are kept out of the acute sector whenever that is possible.

In a number of areas across the capital, the local NHS has concluded that the way it has organised its hospitals and primary care in the past will not best meet the needs of the future. We are clear that the reconfiguration of front-line health services is a matter for the local NHS, tailored to meet the local population’s needs.

I was glad to hear that Members recently met with Anne Rainsberry. The Members who came to the cross-party “Shaping a Healthier Future” meeting last summer will know it is vital that officials at all levels and NHS managers engage with elected Members. I was therefore disappointed to hear what the hon. Member for Eltham (Clive Efford) said. I will ask my officials to look into that. A number of Members asked reasonable questions about why they could not have certain bits of information. I have some specific answers and it may be that we can take a moment after the debate and I will point them in the right direction.

[Andy Slaughter]

I am grateful for what the Minister has said. If she could give an indication to health officials that we must have an open review of where we are with “Shaping a Healthier Future”, look at the implementation of the business plan and consider the Mansfield commission report, which really just asks questions along those lines, it would be very useful indeed.

[Jane Ellison]

We have had the time, during a three-hour debate, to make inquiries, so I will perhaps give the hon. Gentleman an update afterwards.

There have been a lot of references to the interaction with Members. Members of any party may feel they are knocking their heads against a brick wall, but sometimes, to be fair, information cannot be shared for good reasons. There may be commercial confidentiality, or things may be at a particular stage where information cannot be shared. However, I am quite clear that all plans for the local populations that Members represent must be shared with the best level of detail possible, at the most opportune moment. I am always happy to hear from London Members if they feel that that is not happening.

Reconfiguration is about modernising the delivery of care and facilities. I recognise that proposals for those changes sometimes arouse concern. There has been a particular focus on “Shaping a Healthier Future” in this debate, but under that programme, many more community services are now in place across all eight boroughs, so more patients can be seen closer to home. Eleven new primary care hubs are now open. Improved access to GP services has meant an additional 32,000 appointments in Ealing since August 2015, while weekend appointments are now offered to more than 1 million patients across north-west London. Rapid access services in each borough are helping to keep patients with long-term conditions out of hospital where possible, which has already prevented 2,700 hospital admissions in Brent alone.

BMA (Contract Negotiations)

Andy Slaughter Excerpts

Monday 21st March 2016 Westminster Hall

[Helen Jones (Warrington North) (Lab)]

Thank you, Mr Amess. It is a great pleasure to serve under your chairmanship. I beg to move,

That this House has considered e-petition 121262 relating to contract negotiations with the BMA.

This is one of a number of petitions on the website about the junior doctors’ dispute, including the perennial favourite “Consider a vote of No Confidence in Jeremy Hunt”. We have chosen this one for debate because it was begun after the Government’s decision to impose the contract, and therefore relates to the position that we are in now.

It takes a lot to make doctors go on strike; their nature and their years of training mean they are inclined to stay with their patients. So, when facing the first doctors’ strike in 40 years, it is fair to ask how we reached this position and what can be done to resolve it. I am sorry to say that I think most of the blame lies with the Secretary of State and the atmosphere that he has created. In saying that, I want to make it clear that I do not think the current contract is perfect by any means. It is too complicated, and it throws up some anomalies in pay. However, it has proved impossible to negotiate changes to that contract properly, due to the atmosphere of mistrust and suspicion that has been created by some of the comments made by the Secretary of State.

That atmosphere goes back some years, but it reached its lowest point in July last year, when the Secretary of State said that the NHS had a “Monday to Friday culture”. I have read since that he has never actually visited a hospital at the weekend. If that is true, perhaps he should, because he would find that many staff are working. So incensed were they at the idea that they did not work weekends that they took to posting pictures on Twitter with the hashtag “#ImInWorkJeremy”.

The Secretary of State then went further by telling doctors to “get real”. I think that people who make life-and-death decisions every day, care for terribly sick patients, work with emergencies in accident and emergency while putting up with drunks and insults, work in special care baby units, and care for frail, elderly, often confused people know what reality is. They do so in a national health service under huge pressure. Much of the equipment is now out of date and there is a repairs backlog worth £4.3 billion, but the capital moneys available were cut by £1.1 billion in the Budget. Doctors are working with out-of-date scanners and computers that crash, and because the Government see all support staff as inessential bureaucrats, doctors are mopping their own operating theatres or doing data input that any competent clerk could do. I think that they know the reality of what they face. To be told that by someone whose gilded path to ministerial office went through Charterhouse, Oxford and management consultancy is beyond parody.

The Secretary of State, again, had to say more than that. He looked at weekend death rates, and jumped to the conclusion that they were caused by staffing levels. He said clearly:

“Around 6,000 people lose their lives every year because we do not have a proper seven-day service”.

He later used the figure of 11,000. Again, he said that was

“because we do not staff our hospitals properly at weekends.”—[Official Report, 13 October 2015; Vol. 600, c. 151.]

I will spend a few minutes on the research quoted by the Secretary of State, because it does not actually prove that at all. The research paper that reached the conclusion that there were 11,000 extra deaths considered admissions from Friday to Monday, not just at the weekend, and considered death rates within 30 days of admission. Anyone who designs research will say that it is almost impossible to allow for all the things that could happen in 30 days. The researchers themselves did not draw the conclusion drawn by the Secretary of State. What they said was:

“It is not possible to ascertain the extent to which these excess deaths may be preventable; to assume that they are avoidable would be rash and misleading.”

In fact, being rash and misleading is exactly what the Secretary of State was doing.

[Andy Slaughter (Hammersmith) (Lab)]

I thank my hon. Friend for her exposition of the petition. She is exposing behaviour by the Secretary of State that is not only insulting but misleading. This has been said to him time and time again, including by hon. Members in the Chamber. Does she draw the same conclusion as me? The Secretary of State knows what he is doing. He knows when he quotes those figures that he is quoting them wrongly, and that they do not prove what he says they prove.

[Helen Jones]

My hon. Friend makes a fair point. First, the research has its critics, and various bits of research done on deaths following weekend admissions have reached different numbers: 3,000; 4,400; 6,000. The problem is that it is difficult to ascertain cause and effect. If the research is adjusted for the fact that we admit different kinds of patient at the weekend—people are sicker and there are more emergencies, and not many elective patients in most trusts—there remains a slight increase in the death rate. The problem is that ascertaining the cause is difficult. As the hon. Member for Totnes (Dr Wollaston) pointed out in a previous debate on this issue, when hospitals look back at such deaths, it is difficult for them to find out what could have been done differently in those 30 days.

When a complaint was made to the UK Statistics Authority about the use of those data, it said:

“We are speaking with Department of Health officials to ask that future references to this article are clear about the difference between implying a causality that the article does not demonstrate, and describing the conclusions reached by the authors.”

The reason is that although the research shows us that something is going on that we need to investigate, it does not show exactly what is causing it. I do not know whether the Secretary of State understands that. If he does not, I must say that Oxford is probably not what it was. However, I suspect that he understands it very well.

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[Andrea Jenkyns (Morley and Outwood) (Con)]

Thank you, Sir David, for calling me to speak in this incredibly important debate.

There is no denying that this strike is totally unprecedented. No group of doctors has ever before been willing to walk out and put patient safety at risk over a dispute about pay, which is essentially what the dispute is about. It is about pay, about unsociable hours at weekends, about working the sort of hours that other people across the public and private sectors work every week. That is not to do down the incredible work that our junior doctors do. They work incredibly hard and entirely selflessly to keep us fit and healthy and I thank them for that but, like any other body of workers, doctors are not infallible.

Like the rest of us, doctors are driven by considerations of making enough to get by and to support their families, and of getting a fair reward for the work they do. Historically, they have got a pretty good deal, and like any other body of workers they have the right, through their union, to seek a better deal in pay and conditions. Seeking that better deal requires, as the petition notes, a meaningful negotiation between both sides in the debate.

I would like to cite the definitions of the two words that are so crucial in today’s debate. Meaningful is defined as “serious, important or worthwhile” and a negotiation is a “discussion aimed at reaching an agreement”. My argument is that it is the British Medical Association, and not the Secretary of State, the Department of Health or any of their negotiating team, that has failed in its duty to hold a proper, meaningful negotiation.

The history of the dispute is littered with resentment and half-truths. The BMA has repeatedly had the chance to negotiate with the Government and come to an agreement that is acceptable to all sides and, most importantly, that is safe for patients. Patient safety should be at the centre of the debate but, unfortunately, it has fallen by the wayside in the BMA’s entirely partisan quest to defeat the Government.

For many months we heard from the BMA that it was the Government and not the union who were not willing to come to the negotiating table. That is untrue, and it is backed up by the House of Commons Library’s account of the dispute, which I will not rehash in the short time we have available. Time and again the BMA has walked away from the negotiating table and balloted for industrial action, while the Department of Health negotiators have offered it the chance to come back to talks. The BMA even balloted for industrial action on the basis of the Government’s being unwilling to talk, when the Government had set a clear deadline for the BMA to come back to the table or risk imposition of the new contract. The BMA knew that imposition was a possibility, yet time and again did as little as it could to avoid it, all because it is driven by a desire, according to one of the doctors involved, to

“be the first crack in the edifice of austerity”.

Again, I do not want to go over old ground, but it is well documented that the BMA’s senior medics are Corbynites of the most militant kind. [Laughter.] Dr Chand, the association’s deputy chair, tweeted:

“Goebbels must be turning in his grave when he hears the lies and propaganda of Cameron.”

Dr Tom Dolphin congratulated the right hon. Member for Islington North (Jeremy Corbyn) on his victory and told him to take the fight to the Tories—if that is not partisan, I do not know what is. The BMA so misled its members when it put an utterly wrong pay calculator on its website, suggesting that doctors were in line to lose thousands of pounds, that the tool had to be taken down. Does that suggest that the BMA is taking the negotiation seriously? I would say that it does not. All the while, the Secretary of the State waited, and appointed the head of Salford’s trust to lead the negotiations, to ensure they were being led as well as possible by an expert in the field.

[Andy Slaughter]

Is the hon. Lady aware that 98% of junior doctors supported the BMA’s decision, and that her rather desperate attempt to portray the BMA as some sort of Scargill–like extremist organisation simply makes her look risible?

[Andrea Jenkyns]

I thank the hon. Gentleman. I think he needs to learn his facts. I think that it was 98% of BMA junior doctors, not junior doctors in their entirety.

The imposition of the contract is not something that the Health Secretary wanted. He wanted to reach a meaningful resolution. He wanted the union, which got 90% of the things it asked for, to put its political gripes to one side, do what was best for patient safety and follow the will of the millions.

--- Later in debate ---

[Andy Slaughter (Hammersmith) (Lab)]

It is a pleasure to be here under your chairmanship this afternoon, Sir David. I congratulate my hon. Friend the Member for Warrington North (Helen Jones) on her speech. In introducing the petition, which a large number of members of the public feel strongly about, she managed to explain in just a few minutes how the Government have put forward an entirely false perspective on the dispute from the beginning and continue to do so. I am sure that many more Members would be here for this debate this afternoon were it not for events in the main Chamber. I know that many people want to be present as witnesses or contributors to the dissolution of the Conservative party—not least members of the Conservative party—so perhaps the timing of the debate is unfortunate.

[Mr Andrew Smith]

I understand what my hon. Friend says about what is going on in the main Chamber, but is it not striking that only one Conservative Back Bencher has turned up to defend the Government’s handling of the dispute?

[Andy Slaughter]

I agree with my right hon. Friend, but I think that what the hon. Member for Morley and Outwood (Andrea Jenkyns) said was even more striking in its own way. I felt I could forgo the entertainment in the main Chamber because I feel so strongly about this issue, not least because my constituency hosts two of the main teaching hospitals in the Imperial College Healthcare NHS Trust, and because many thousands of junior doctors from that trust and other trusts live in my constituency. I have therefore followed the dispute with increasing anxiety and depression. I have met not only individual junior doctors but groups of them at Charing Cross hospital, and I have spoken to them at the BMA. The image of them put forward by the Secretary of State, and what we have heard from the governing party today, does no credit to that party. The slurs on junior doctors are extraordinary, and it is perhaps time to pause and consider matters again.

Are we seriously being asked to accept that junior doctors are some sort of militant clique looking to undermine the Government? That is pure fantasy. Anybody who has spent time with junior doctors will have seen exactly what is going on. The speech by the hon. Member for Morley and Outwood was tragic in many ways, but in some ways it was quite brave, because I suspect that any of her constituents who read it will begin to think, “What have I done in electing her last year?”

[Andrea Jenkyns]

First, the Select Committee on Health is on an away day today, otherwise there would have been more Members here. I should have been on the away day, but this is an important debate and I wanted to be here.

On the allegation that I have accused all junior doctors of being Corbynites, I said that key members of the BMA are strongly linked to the Leader of the Opposition. I was talking about not junior doctors but people on the BMA council.

[Andy Slaughter]

I will move on, because when someone is in a hole, they should really stop digging.

[Margaret Greenwood]

I could not let the comment made by the hon. Member for Morley and Outwood (Andrea Jenkyns) pass. Jeremy Corbyn is the leader of the Opposition, and the Conservative party is in turmoil today in the face of his leadership. Being a Corbynite and a member of the BMA is no bad thing—I just wanted to clear that up.

[Andy Slaughter]

I will try to put an end to this exchange, but it is tragic that a party of the stature of the Conservative party should turn its guns on the profession and on a representative body such as the BMA in this despicable way. It is extraordinary. I will go further and praise those in the BMA who have had their positions undermined and suffered character assassination and being idly quoted in tittle-tattle on Twitter. Last week the hon. Member for Central Ayrshire (Dr Whitford) hosted an open session for Members at which I was pleased to renew an acquaintance with Dr Johann Malawana, who has been a particular target of insidious and malicious personal attacks, supported by the jackals in the right-wing press. Is that really how a Government should behave in dealing with any industrial dispute, particularly one as serious as this?

Depending on when the debate ends, I may have to leave for a constituency engagement—I have said that to you, Sir David, and I apologise to you and to the Front Benchers—so I will make my comments brief to give other Members time to make theirs. I simply want to say to the Minister, who can no doubt take the message from this debate back to the Secretary of State, that there is nothing dishonourable about continuing negotiations in this dispute. There is an attitude of despair among junior doctors, which has led to some of the statistics we have already heard about those who now wish to leave the profession or move to other jurisdictions where they would be more appreciated.

The Government were initially resistant to going to ACAS, but in the end they agreed. Progress was made at ACAS, but at the end there were still matters outstanding. Everything that I have learned from talking to junior doctors suggests that not only do they not want to take industrial action, and not only do they want to continue serving their patients to the best of their ability, but they are prepared to sit down and compromise. However, they are faced with a wholly intractable Government.

Is the best that we can get from the Secretary of State the misappropriation of statistics to prove something that is clearly false on two levels? It is false because the so-called weekend deaths are not as he has presented to the public, and it is false to say that we do not have a seven-day emergency service now. Of course we do. I strongly believe that we need to restore trust and faith in the relationship between the NHS and junior doctors, and the Government have an important role to play in that. Unfortunately, individual trusts are under such financial pressure, and their management under such strain, that it is tempting for them to exploit junior doctors.

On the guardianship system, we know about the assurances that have been given and the protections in the existing contracts. I do not think there has been a previous example of a contract being imposed on the NHS in this way. I simply urge the Government to think again. There is a deal to be done, there really is. The fact that they are not even prepared to sit down and negotiate again implies that they do not want a deal to be done. They want to play hardball, and they want to get something that is completely different from what they say. They already have their emergency service and they already have junior doctors working the way they want, and they say they do not wish to save money. They have different motives from those that they are expressing. They therefore need to return to the negotiating table. They need a pragmatic solution, and they need to step back and calm down.

I will read the Front Benchers’ speeches tomorrow if I am not here for them, but I hope we will hear a better spirit of conciliation than we have heard so far.

--- Later in debate ---

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

It is a pleasure to serve under your chairmanship, Sir David, and it has been a pleasure to hear some of the contributions to the debate, which have included measured speeches, as ever, by the shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders), and the Scottish National party spokesperson, the hon. Member for Central Ayrshire (Dr Whitford). However, it disappoints me as much as it does many other hon. Members that we need to be here today. We would all have wanted the issue to be concluded some time ago. I hope that in the next few minutes I can describe why we are in this position and what we plan to do about it.

I will start by discussing something that the hon. Member for Hammersmith (Andy Slaughter) touched on, because I know he wants to leave early. I want to make these comments before he does. We are all here because we are interested in the future of the NHS, but, among various silly outbursts and fits of laughter, he described the speech of my hon. Friend the Member for Morley and Outwood (Andrea Jenkyns) as tragic. There is indeed tragedy behind my hon. Friend’s interest in patient safety, and that is that her father died as a result of a failure of patient safety. It is no coincidence that she is here today and that she cares so much about this important issue. It behoves hon. Members, and especially the hon. Gentleman, who is barely able to contain himself on matters of this kind, to pay a little attention to the motivations of Members, on whichever side of the House they sit, and the reasons why they feel strongly about the matter. That includes the Secretary of State, who considers it to be a question of patient safety through and through. A portion of that is about the delivery of seven-day services, but more broadly, to reflect on the wise words of the hon. Member for Central Ayrshire, it is about the fact that tired doctors who work bad rotas are dangerous. That is at the core of our reasons for wanting to change the contract.

It was not just the present Government who decided that it would be right to change the contract. It was the British Medical Association that confirmed, in 2008, that the contract was not fit for purpose, just a few years after the Labour party had introduced it.

[Andy Slaughter]

rose—

--- Later in debate ---

[Ben Gummer]

I will in a second; I will just answer this point.

From that point, as many Members have pointed out, considerable progress was made through the negotiations that we had under ACAS from December 2015 to February 2016—far more progress than in the previous negotiating period, partly because the BMA knew that an imposition would have to come if there could be no agreement. As the shadow Minister will understand, at some point an employer needs to move both on issues where there is agreement and on those where there might not be.

The fact that the Secretary of State chose Sir David Dalton to lead negotiations undermines the argument that somehow he was not trying to come to a negotiated settlement. He asked one of the very best chief executives in the NHS to lead the negotiations on his behalf. Even Sir David Dalton was unable to come to a final conclusion of the negotiations with the BMA, because the BMA refused to discuss the last remaining substantive issue—the rates of Saturday pay.

Herein lies the rub: in the heads of terms of the talks it began through ACAS, the BMA had agreed to discuss Saturday pay rates, yet it withdrew that agreement at the end. Sir David Dalton was therefore forced to write to the Secretary of State saying that in his judgment, there was no prospect of agreement on the remaining matters because the BMA was refusing to discuss them. When the Secretary of State or any negotiator has no counterparty with whom to negotiate, it is impossible to negotiate.

Far from the title of the e-petition, which suggests that the Secretary of State has somehow been unwilling, he has been negotiating in good faith all through the period since 2013. It was the BMA, right at the last minute and at previous moments that has refused to do that. I myself have called on it a number of times, both personally and in public, to come back to the negotiating table.

[Andy Slaughter]

Will the Minister give way?

[Ben Gummer]

I will not, because I know that the hon. Gentleman needs to go. I said that I would give way to the shadow Minister.

Community Pharmacies

Andy Slaughter Excerpts

Tuesday 23rd February 2016 Westminster Hall

[Andy Slaughter (Hammersmith) (Lab)]

Urban and rural areas share those problems. It is because people will only wait for so long for GP appointments—my hospital has exceeded waiting times for more than a year—that there is pressure is on community pharmacists. They are stepping up to the plate. Does the hon. Gentleman agree that they are being let down by this cut, when they are trying to do their best?

[Derek Thomas]

I hope to make the point that we need clarity about how the money will be found, if it must be found. I believe that there are other ways to save money, particularly involving the use and waste of drugs.

Community pharmacists are unsure about their future and unclear what support they can expect from the Government. The letter sets out the £170 million reduction in support for community pharmacists and asks them to prepare for the cut, but gives little detail about where the money will be cut, who will lose and what services can no longer be funded.

Oral Answers to Questions

Andy Slaughter Excerpts

Tuesday 9th February 2016 Commons Chamber

[Alistair Burt]

There have been 500 more consultants in A&E medicine since 2010. The new contract is under negotiation at the moment and the majority of it has been agreed with junior doctors. It is designed to replace the failures in the old contract, which everyone knew needed to be corrected, and it provides the basis for the profession for the future to deal with some of the issues the hon. Lady mentions. All of us are concerned to ensure that the negotiations continue and that there should be no strike tomorrow, so that this pattern for the future, which is wanted by doctors and patients alike, as well as by the Government, gets a chance to work.

[Andy Slaughter (Hammersmith) (Lab)]

4. What assessment he has made of the implications for his policies of the findings of the Independent Healthcare Commission on the NHS in north-west London.

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

It might assist the House if I were just to mention that this commission was commissioned by five Labour councils and was chaired by Michael Mansfield, QC. On the assessment of the commission’s findings, I can put it no better than the lead medical director for the “Shaping a Healthier Future” project, who said:

“The unanimous conclusion of the board’s clinicians was that the report offered no substantive evidence or credible alternative to consider that would lead to better outcomes for patients…above the existing plans in place”.

I concur with that judgment.

[Andy Slaughter]

Last July, the Minister held a constructive meeting with west London MPs and agreed that information on the review of our hospital services would be shared. We understand that a plan B is being considered that will still move hospital services from Charing Cross and Ealing but, because of rising costs, will retain and mothball existing buildings rather than redeveloping the sites. Can we see the current plans?

[Jane Ellison]

The hon. Gentleman rightly says that we had a constructive meeting but, as with everything in this area, it is time to move on. There is a grave danger of him appearing to be like one of those soldiers discovered on a Pacific island after the second world war still fighting the old war. Part of the reason for cost escalation in NHS projects is the constant challenge and delay, and “Shaping a Healthier Future” has complete clinical consensus across north-west London. The clinicians say that this

“will save many lives each year”.

It is time to get on with this project.

NHS Trusts: Finances

Andy Slaughter Excerpts

Monday 1st February 2016 Commons Chamber

[Ben Gummer]

There are many examples of success in the NHS, and hospitals, CCGs and community health organisations are delivering exceptional care within existing budgets. We must ensure that we spread that practice and approach to care across the NHS. Some parts of the NHS are not doing that, but with our ability to level up and “universalise the best”, as Bevan coined it, we will ensure that everyone gets the level of care that those in the best areas of the NHS already receive.

[Andy Slaughter (Hammersmith) (Lab)]

Last week Imperial College Healthcare NHS Trust reported a £25 million deficit, and announced a non-clinical vacancy freeze on top of 10% vacancy rates, and above-target use of agency staff. Its solution was to pay its chief executive £350,000 last year to oversee the downsizing of the major local hospital, Charing Cross. What is that other than a short-sighted and dangerous attempt to undermine the NHS?

[Ben Gummer]

Given the hon. Gentleman’s record of statements given to his constituents, whether on housing or hospitals, I would prefer very much comments from the clinicians running Imperial College NHS Healthcare Trust, than I do his own comments about this.

Infected Blood

Andy Slaughter Excerpts

Thursday 21st January 2016 Commons Chamber

[Jane Ellison]

One or two of those questions are probably a little too detailed to comment on now, but it is worth reiterating what I said about the devolved Administrations. I have not been able to speak to the Welsh Health Minister; we offered the opportunity of a call with other Ministers, including the Scottish Minister, but the Welsh Minister knows that he can get in touch. One of his officials was on the call this morning, and our offices have been talking to each other. I am happy to pick this up with the Welsh Health Minister if he wants to do so.

This consultation is for the scheme in England, but we have been working with counterparts in the devolved Administrations. While everyone in the UK is welcome to respond to the consultation and say what they think, health is now a devolved matter—that is different from when the first schemes were set up—so the devolved Administrations are responsible for providing financial support for those affected from each country. Treatment within the NHS is obviously a matter for the NHS in Wales, and I will look at some of the other points the hon. Gentleman made. We are happy to talk to him about the devolved aspects and write to him afterwards.

[Andy Slaughter (Hammersmith) (Lab)]

I thank the Minister for the consultation, the additional money, the scheme consolidation and the work that both she and the Minister for Community and Social Care have undertaken. I also thank, of course, the all-party group and my hon. Friend the Member for Kingston upon Hull North (Diana Johnson). Will the Minister concede that, for those of us who have worked closely with individual victims for a number of years, the resolution has to be, as far as possible, to put them in the financial position they would have been in but for the grievous harm done to them, and that that may in some cases mean a bespoke solution for individual victims—we are not dealing with unlimited numbers of people here?

[Jane Ellison]

That is clearly the hon. Gentleman’s view and I invite him to submit it to the consultation. This is exactly why we are consulting. We have made some proposals, but some of the questions are very open, and we will look at what comes back from the consultation. I urge him and other Members to take part in the consultation.

Victims of Contaminated Blood: Support

Andy Slaughter Excerpts

Wednesday 16th December 2015 Commons Chamber

[Andy Slaughter (Hammersmith) (Lab)]

Let me challenge the Minister on the phrase “quieter voices”, which I have heard her use several times. It seems to be a code for addressing the important but less costly issues of treatment and reform of the current scheme rather than a full and final settlement to what Lord Winston rightly called the

“worst treatment disaster in the history of the NHS”.

We have a moral duty here, so simply saying “the Chancellor will not give me the money” will not wash.

[Jane Ellison]

Again, I have said here today and previously in Westminster Hall what I believe the position to be with compensation. I accept that the hon. Gentleman has a different view and we had an exchange when he contributed to the discussion in November. I think it would be wrong to dismiss the idea of listening to quieter voices, which I have had the opportunity to do over the last couple of years, and as a result it has become clear that a number of people want a number of different things from a reformed scheme. It will not be possible to do everything that everyone wants. We are going to try to respond as best we can with a scheme that is sustainable, fair to all and responds to many of the points made here today.

Junior Doctors Contract

Andy Slaughter Excerpts

Monday 30th November 2015 Commons Chamber

[Mr Hunt]

I hope we can do that. The Opposition have talked regularly about social care, and rightly so. The fact is that both Labour and Conservative-run councils are responsible for the social care system, and being able to discharge into the social care system is a very important part of seven-day services. We are now about to enter a period of important reform in NHS and social care integration, so I see no reason why that approach could not be bipartisan.

[Andy Slaughter (Hammersmith) (Lab)]

Last Friday, 321 consultants at Imperial College Healthcare NHS Trust gave their full support to the junior doctors. That is just the latest indication that the Secretary of State has called this dispute wrong from the start. He now has an opportunity to rebuild trust. Does he accept that that is not helped by him coming to the House and denigrating junior doctors and their representatives again, as he has done today, and by continuing to conflate routine seven-day services with mortality rates? That just is not helpful.

[Mr Hunt]

I am afraid the hon. Gentleman is, as ever, completely wrong. First of all, I have not denigrated junior doctors. I have spent a lot of time praising their absolutely vital contribution as the backbone of the NHS. Secondly, I have not conflated routine services with mortality rates. In fact, I have done specifically the opposite. In answer to the hon. Member for Central Ayrshire (Dr Whitford), I confirmed that we are talking about urgent and emergency care and making sure that services are consistently delivered for urgent and emergency care across the week. That is our priority and that does link to mortality rates.