Junior Doctors Contract

Andy Slaughter Excerpts

Friday 20th November 2015 Commons Chamber

[Alistair Burt]

My hon. Friend reflects well the feelings of Chief Medical Officer Professor Dame Sally Davies, who urged junior doctors to think again because the severity of the proposed action is a step too far. I find it difficult to conceive of a circumstance in which I would support a medical practitioner withdrawing their labour, and I hope that anyone would think that such things should not happen. The Secretary of State is doing everything he can to make clear the terms of the contract, the safety principles on which it is based, and to deal with misleading information. Even at this stage, he urges the BMA to come back and sit round the negotiating table and—I repeat—he has not ruled out conciliation after that.

[Andy Slaughter (Hammersmith) (Lab)]

I have hundreds of junior doctors in my constituency and I have spoken to many of them. They feel misled, but not by the BMA. Does the Minister understand that the anger that led to the 98% vote in favour of action is because junior doctors were told that they would get a pay rise, when many would get a pay cut? Disgracefully, they have been told that somehow they may be responsible for unnecessary deaths. The only way to restore trust now is independent arbitration. Will the Secretary of State agree to that without preconditions?

[Alistair Burt]

In an attempt to build on the opportunity of trust, after the BMA withdrew from negotiations last year, the work went to the independent Review Body on Doctors’ and Dentists’ Remuneration to urge an independent look at the issue and to get recommendations based on that independent review. When those recommendations appeared, the BMA still did not go into negotiations. That independent review has been sought, and the recommendations are there to talk about. When the hon. Gentleman spoke to junior doctors in his constituency—probably about misleading information that they may have had from the BMA—I hope he said clearly that he does not support strike action. It might be helpful if he told the House that that is what he said.

Access to Medical Treatments (Innovation) Bill (Money)

Andy Slaughter Excerpts

Tuesday 3rd November 2015 Commons Chamber

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

There are many ways for a surgeon to share their experience if they have carried out an operation in the heat of the moment to save someone’s life. The BMJ publishes things on a weekly basis and can share interesting cases. The danger of the Bill is that the database is being used as a fig leaf to make it sound like access to innovative treatments. The hon. Member for Daventry (Chris Heaton-Harris) said that a doctor would have to prove that something was safe, but the first person prescribing liquorice for cancer has no method of proving that it is safe. That is the basis of research.

Phase 1 trials involve a small group of patients who fully consent to undergo treatment and know what they are taking on, based on pre-clinical research. Phase 2 is larger, and phase 3 involves multiple hospitals. We have that process to avoid a couple of doctors in a canteen saying, “That’s not a bad idea. I’ll back you if you back me”, and patients being given something dangerous. The Bill would not, of itself, undermine research in some way, but if patients and the public feel that they are guinea pigs for any old treatment that someone wants to have a bash at, that will undermine research.

It has taken decades to get to our current level of safety, checks and balances. That has been streamlined, and single ethical permissions are carried out once for the whole country, and then recognised in all health boards and areas. That has made things a lot easier, but it is crucial that patients who sign up to a treatment know that there has been a degree of rigour before they are given that drug.

If someone is bleeding to death in the middle of the night, of course a surgeon can innovate because every operation is slightly different, but we are talking about access to medical treatment that will predominantly involve drugs that have not had sufficient pre-clinical work. That is of concern to research charities and the royal colleges—I am a member of the Royal College of Surgeons—because of patient safety. The absolute concern is not even the secondary impact on research; it is the impact on patient safety and people finding that they are being given something totally unproven.

[Andy Slaughter (Hammersmith) (Lab)]

The hon. Lady is making a good point, and I agree with everything she says. As a lawyer rather than a doctor, I think the problem with the Bill is that—unintentionally, I am sure—it also undermines carefully constructed jurisprudence on clinical negligence, and it is dangerous for that reason.

[Dr Whitford]

Of course the Bill is well intentioned, and its title will attract support from people who think that it means getting access to drugs to which we do not currently have access. It is not that any doctor can prescribe anything—we cannot. We can prescribe drugs that are licensed and recognised, and have a basic safety profile. In Westminster Hall we often debate access to expensive, innovative, brand-new treatments, but that is not about our right as a doctor to prescribe them; it is about who will pay for them because some of those drugs are expensive. As the Minister has said, that would still be an issue. In what sense would a commissioning group have evidence to allow a doctor to prescribe a drug that has absolutely no basis, but that would have to be funded?

The Bill is basically a bit of a mess. What problem is it trying to answer? People think it means that they will get earlier access to new drugs, but drugs should be taken forward on the correct path to protect patients and doctors. Doctors need to know that what we are doing is right, and not some random thing that has been on a database after somebody tried something once and it seemed to work. We know that there are placebo and random effects.

--- Later in debate ---

[Andy Slaughter (Hammersmith) (Lab)]

I will be brief. The hon. Member for Daventry (Chris Heaton-Harris) may be beginning to think that he had a lucky Friday when he got the Bill a Second Reading. When one looks at it in detail, it has a number of flaws.

Action against Medical Accidents, a reputable organisation that I have worked closely with, has stated:

“We believe that the proposed changes would have serious unintended consequences such as lowering protection for patients and patient safety”—

a point a number of Members have dealt with—

“causing confusion about the law which could hamper rather than help medical innovation; and leaving patients who have been harmed as a result of what currently would be deemed negligent treatment with no redress.”

It is the last of those points that concerns me. Many leading QCs in the field of medical negligence have also raised concerns about it. If people have been injured by negligent medical treatment, they must have redress. That redress was substantially withdrawn in the Legal Aid, Sentencing and Punishment of Offenders Act 2012. It is only right that we are clear that we want to preserve it, not only for the individuals involved but because standards of medical practice are enhanced and improved if they are attacked on the rare occasions when they fall below standard. For those reasons, I oppose the money resolution.

Junior Doctors’ Contracts

Andy Slaughter Excerpts

Wednesday 28th October 2015 Commons Chamber

[Heidi Alexander]

The problem with how the Government have handled the negotiations is that they have provided absolutely no clarity to junior doctors about what the proposals would mean for them individually. Everyone thinks that they are going to lose out.

The Government say that they want to reduce the number of hours defined as “unsocial” and thereby decrease the number of hours that attract a higher rate of pay. They say that they will put the rate of pay for plain time up to compensate, but there is no guarantee that the amount by which basic pay goes up will offset the loss of pay associated with fewer hours being defined as unsocial. Does the Secretary of State understand that those who work the most unsociable hours, the junior doctors who sacrifice more of their weekends and nights, feel that they have the most to lose?

[Andy Slaughter (Hammersmith) (Lab)]

That is exactly the point, and I am glad that my hon. Friend is exposing the misleading comments of the Government, who are defending the indefensible. It is exactly those doctors—in maternity, in paediatrics, in emergency medicine—who will lose out the most and will see their pay cut by up to a third.

[Heidi Alexander]

My hon. Friend is right. His concern is shared by the President of the Royal College of Emergency Medicine, along with 14 other leaders of medical royal colleges and faculties, who point out that as currently proposed, the new contract would

“act as a disincentive to recruitment in posts that involve substantial evening and weekend shifts, as well as diminishing the morale of those doctors already working in challenging conditions.”

It cannot possibly be right.

--- Later in debate ---

[Dr Whitford]

I agree that it is important to investigate, but it is also important to understand the cause of the problem. A lot of the problem at Mid Staffs was the ratio of registered nurses to patients. That was echoed by Bray in his review of 103 stroke units, which showed that additional consultant ward rounds at weekends had no impact on death rates, while a better ratio of registered nurses reduced them by a third. We need to know the problem before spending billions trying to solve the wrong thing.

[Andy Slaughter]

I am grateful to the hon. Lady for busting this myth about weekend death rates—these might be sick people admitted at weekends who die within the 30 days. In fact, fewer people die in hospitals on Saturdays and Sundays than on other days. The Secretary of State is not giving the right impression of the figures.

[Dr Whitford]

I agree.

Since coming here, I have heard stories of people unable to access diagnostic imaging or to work up patients, but there is no argument about that from the profession. That is what we need to focus on, yet a lot of this seems to be about routine. There are fewer doctors at weekends because we do not do routine work. We have teams of people doing toenail and blood pressure clinics in the week. Professor Jane Dacre estimates that doing those at weekends would require 40% more doctors. We cannot do that. We need to make sure that hospitals at weekends have enough people and the right people to be secure, but junior doctors are already there—it is not they who are missing—and emergency services already have a consultant on call. We might need more discussion about their being physically in, but that is a discussion to have with the profession, whereas what we heard on 16 July, which gave the public the impression that senior doctors only worked 9 to 5, Monday to Friday, was very hurtful to the entire profession.

--- Later in debate ---

[Andrew Gwynne (Denton and Reddish) (Lab)]

We have had a comprehensive and powerful debate, with 23 speakers and many more Members who would have liked to contribute if we had had more time. I would particularly like to thank my right hon. Friend the Member for Oxford East (Mr Smith), my hon. Friend the Member for West Ham (Lyn Brown), my right hon. Friend the Member for Enfield North (Joan Ryan), my hon. Friends the Members for Wakefield (Mary Creagh), for St Helens South and Whiston (Marie Rimmer), for Workington (Sue Hayman), for Bolton South East (Yasmin Qureshi), for Easington (Grahame M. Morris) and for Ealing Central and Acton (Dr Huq); the hon. Member for Central Ayrshire (Dr Whitford), the right hon. Member for North Norfolk (Norman Lamb) and the hon. Member for Strangford (Jim Shannon); and the hon. Members for Totnes (Dr Wollaston), for Bristol North West (Charlotte Leslie), for Finchley and Golders Green (Mike Freer), for South West Wiltshire (Dr Murrison), for Blackpool North and Cleveleys (Paul Maynard), for Morecambe and Lunesdale (David Morris), for Vale of Clwyd (Dr Davies), for Sherwood (Mark Spencer), for Erewash (Maggie Throup), for Boston and Skegness (Matt Warman) and for Morley and Outwood (Andrea Jenkyns).

Members of all parties have spoken with great passion and praise for our junior doctors, who work tirelessly to deliver good quality services—despite the challenges they face in an NHS that is increasingly under pressure and under strain.

[Andy Slaughter]

rose—

[Andrew Gwynne]

I do not have time to give way, I am afraid.

I echo those sentiments of sincere thanks, but we have heard of junior doctors who already work weekends, already work nights, already work holidays and give their all for their patients. Despite all this, the junior doctors now face a situation that has left them feeling deflated, demoralised and devalued.

Patient safety has been a key theme of today’s debate. Some Members have valiantly leapt to the Health Secretary’s defence, but those voices have been far outnumbered by Members who are deeply concerned that this contract is unsafe for doctors and unsafe for patients.

Members have argued that the removal of the financial penalties that apply to hospitals that force junior doctors to work unsafe hours risks taking us back to the bad old days of overworked doctors, too exhausted to deliver safe care. The BMA says this safeguard, which is built into the current contract, has played an important role in bringing dangerous working hours down. Removing this financial disincentive to overworked junior doctors is extremely alarming, especially at a time when junior doctors are already coming under an enormous amount of pressure and strain. If the Health Secretary would just listen, he would hear junior doctors shouting loudly and clearly that they cannot give any more.

Many Members highlighted the protests and marches that have taken place throughout the country in recent weeks. We had only to catch a glimpse of the placards that were waved as thousands of junior doctors marched against the contract to understand that those doctors now fear for their own health and well-being. I was struck by one banner which read, “I could be your doctor tomorrow, or I could be the patient”, and those doctors’ concerns have been echoed by many Members today. How can the Secretary of State possibly say that he is acting in the interests of patient safety if the very people who work in the NHS say he is putting safety at risk?

Another argument that has been advanced today is that the contract is necessary to ensure that our NHS works seven days a week. Not only does that argument do a huge disservice to our NHS staff who already provide care seven days a week and 24 hours a day, and reveal just how out of touch some Conservative Members are with the realities of working on the frontline in our NHS, but it is wholly inaccurate. If this junior doctor contract were imposed in its current form, it would have the opposite effect, as many independent clinical voices have warned.

It is a bitter irony that the problems that the new junior doctor contract was supposed to be trying to address when it was originally proposed back in 2012—the need to introduce better pay and work-life balance—are the very problems that will be made worse should the contract go ahead in its current form. In letters to the Secretary of State, the presidents of a number of royal colleges and faculties have made it very clear that they share those concerns, but he presumably thinks that they too have been misled.

The Secretary of State said that he did not intend to cut the pay of any junior doctor, but his sums simply do not add up, and everyone can see through the spin. No one with a GCSE in maths can believe that no doctor will be worse off as a result of the new contract. Let the right hon. Gentleman come to the Dispatch Box in the minute that I have left, and answer this question. To what percentage of junior doctors currently working within the legal limits will what the Secretary of State has said today apply? Is it 50%? Less than a quarter? What is it?

Contaminated Blood

Andy Slaughter Excerpts

Monday 20th July 2015 Commons Chamber

[Ben Gummer]

I can reassure my hon. Friend that treatments, including new treatments, will be provided on the basis of need, but again, it will be for NHS England to determine how they are released to the service. I know that my hon. Friend the Under-Secretary of State for Life Sciences will give my hon. Friend further details if he requires them.

[Andy Slaughter (Hammersmith) (Lab)]

Contrary to the Minister’s assertion, there is a lack of urgency, which is shown by the fact that there was no statement by the Prime Minister, as had been promised. We know the defects of the current schemes—they are not redeemable—and we know what needs to be done. Will the Minister confirm what I think he said, namely that there will be a final assessment by next March? Will he also guarantee that the money will be available, and will not be ring-fenced or offset against other departmental spending?

[Ben Gummer]

What I have said, very clearly, is that we will launch a consultation in the autumn, and that we hope it will be as short as possible so that we can arrive at a settlement as rapidly as possible. I also hope that it will be in the tightest possible timeframe, as the hon. Gentleman suggests.

As for the issue of money, I know that the hon. Gentleman may not understand this, but the money has to come from somewhere, and it will come from the health budget, which is where it is designated to derive from.

A&E Services

Andy Slaughter Excerpts

Wednesday 24th June 2015 Commons Chamber

[Andy Slaughter (Hammersmith) (Lab)]

I hope, Madam Deputy Speaker, that you and the House will indulge me if I spend my six minutes giving an update on the “Shaping a healthier future” programme, which afflicts west and north-west London. I have done so several times during the three years since—to the consternation and disbelief of 2 million people in those areas—the programme was announced, although there was something of a hiatus over the election period.

I do not want to be self-indulgent, but I think that the subject of “Shaping a healthier future” is one to which all Members will wish to pay attention, because it is the biggest closure programme in the history of the NHS. Four out of nine A&E departments and two major hospitals have been substantially downgraded. Many see the programme as a prototype for the Keogh review of urgent and emergency care. I wonder what has happened to the latest stage of that review; we heard nothing about it from the Under-Secretary of State. It was put on ice last year because a proposal for the downgrading of most of the type 1 A&E departments in the country was seen as political suicide, but it now seems to have disappeared completely. I hope that there are good clinical reasons for that.

Reference has already been made to the excellent briefing with which Members were provided yesterday by the Royal College of Emergency Medicine. Here are three of the statistics that the college came up with. The increase in A&E attendances last year was equivalent to the workload of seven large A&E departments; only 2% of A&E attendances involve major trauma, stroke and heart attack patients; and a maximum of 15% of patients who attend A&E departments could be seen in a non-hospital setting. Even that must be subject to a caveat, because I suspect that a fair number of the people who go to A&E departments are not knowingly accelerating their symptoms or time-wasting, but have genuine concerns, perhaps for a child with a fever that might be a symptom of flu but, again, might be due to meningitis.

The solution proposed by the Royal College of Emergency Medicine is co-location. Its briefing states:

“Costly and time-consuming efforts to encourage patients to seek advice on urgent care by telephone or to attend elsewhere…have not reduced A&E attendances. Rather than blaming patients for attending A&E, when we know they have great difficulty accessing supposed alternatives, RCEM advocates a completely new approach. We believe that the issue should be dealt with by collocating”.

However, many hospitals in west London are already co-located, so that cannot be a solution for them.

There have been a number of developments in the past three or four months. Chelsea and Westminster hospital is about to take over West Middlesex University hospital. That new trust will believe that it can maintain two fully functioning type 1 A&E departments—unless another is to close in the area. Why, then, is Imperial College Healthcare NHS Trust expected to manage with only one major A&E service in its three hospitals?

Ealing hospital’s maternity unit will close on 1 July. My hon. Friend the Member for Ealing, Southall (Mr Sharma), who could not stay for this part of the debate, asked me specifically to mention that, because it is a matter of great concern, not least because it will have an impact on other maternity services in the area.

We are still suffering the effects of the closure of the A&E departments at Hammersmith and Central Middlesex hospitals last September, including four-hour waiting times at other hospitals such as Charing Cross hospital in my constituency, which is persistently below target. At the same time, stroke services are being centralised at Charing Cross for at least the next five years, having been transferred from St Mary’s hospital, although the plan is to move them away in due course.

In the last two years, £33 million has been spent on consultants just for the purposes of the “Shaping a healthier future” programme, of which £12.5 million was spent on a single consultant, McKinsey. That is £27,000 a day, and it could pay for 300 new nurses. Imperial College Healthcare NHS Trust is spending one eighth of its staffing budget on bank and agency staff, and the most recent figures show that it had an £18.5 million deficit.

Against this crisis—and it is a crisis—in A&E, the proposal in relation to Charing Cross, a major emergency hospital in my constituency, is that all its buildings be demolished, that its beds be reduced from 360 to 24, and that it lose all consultant emergency services. The population of London, and of west London in particular, is going to go up massively over the next 10 years. That is unprecedented. This is a very poor scheme, not just clinically for the reasons that the Royal College of Emergency Medicine gives, but logistically, spatially and financially.

I am grateful to the Minister and the Secretary of State for the opportunity, at last, before the summer recess to meet and discuss these matters in depth. I will therefore say no more about them today. I look forward to that opportunity, and I know the Minister will attend in good faith and look at the concerns we all have about the “Shaping a healthier future” programme. These are not idle concerns. It is obviously in the Whips’ brief for Government Members to say, “Let’s not make the NHS a political football,” but I do not think any Opposition Member is doing so. We are not in an election period.

[Wes Streeting (Ilford North) (Lab)]

It is a bit rich for Government Members to accuse us of using the NHS as a party political football, when prior to the 2014 local elections the Ilford North Conservative Association put out a leaflet claiming that King George hospital’s A&E would not close, when before the general election we were told its closure would be reprieved, and when the NHS trust chief executive has now told us that the closure plan will be published in the next six to nine months. That was playing party politics with the NHS, cynically.

[Andy Slaughter]

My hon. Friend makes a very good point. I make sure that every time I refer to what is happening in my local NHS now, I look into the voluminous papers on “Shaping a healthier future”, or what the Imperial College Healthcare NHS Trust actually says, so that I am clear that I am describing what is happening, not giving my opinion or saying something that has come from a party political standpoint. I simply wish that the Government would listen and respond in kind.

[John McDonnell (Hayes and Harlington) (Lab)]

I apologise for coming late to my hon. Friend’s speech. The reason why is that outside Ealing hospital there are currently 200 people demonstrating because of the maternity unit’s closure, which will put undue stress on the local community. He has listened to many of the arguments regarding its closure, and none of them stacks up. Perhaps those 200 people will be listened to.

[Andy Slaughter]

I am very grateful to my hon. Friend for his intervention. No one does more than him, directly and positively, to draw attention to the crisis in the NHS in west London. His local hospital, Hillingdon, is not closing, but throughout the process over the past three years he has been absolutely steadfast in defending and supporting those of us whose local NHS is being downgraded, not just because he is a good comrade, but because he knows that the knock-on effect of hospital closures will make it impossible for any of the 2 million people throughout north-west and west London to receive a decent health service.

I shall say no more today, as other Members wish to speak. I again thank the Minister for the opportunity we will have to make our case. I hope the Government are listening on this matter, which is the most urgent matter that I have dealt with in my 30 years as a councillor and as an MP. It is about the preservation of the NHS for a substantial part of London’s population. These are genuine and legitimate concerns, and I hope the Government will listen to them.

Oral Answers to Questions

Andy Slaughter Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Mr Hunt]

I welcome the hon. Lady back to her place, although I know she hopes it will be for only a brief time, and say to her that we have not failed. We made very good progress delivering seven-day access to GP surgeries for nearly 10 million people during the last Parliament, and we have committed to extending that to everyone during this Parliament. I think the hon. Lady said that what is right is what works, and what works is having a strong economy so we can put funding into the NHS that will mean more GPs.

[Andy Slaughter (Hammersmith) (Lab)]

8. What effect the implementation of the Keogh urgent and emergency care review will have on type 1 A&E departments in England.

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

The Keogh review is all about responding to the long-term challenges facing the NHS, many of which we have already discussed in this Question Time. The implementation of the recommendations of the Keogh review will improve urgent and emergency care services and ensure patients get the right care in the right place.

[Andy Slaughter]

The “Shaping a healthier future” programme in north-west London, which is seen as a prototype for Keogh in closing or downgrading A&Es, is causing great concern, from the tragic death of Guy Bessant reported yesterday to the more than £20 million spent on external consultants last year. Eleven west London MPs would like to meet the Secretary of State and, I hope, the Under-Secretary, to discuss those concerns. Will they agree to meet us?

[Jane Ellison]

I read of the tragic death of that gentleman, who was a Wandsworth resident. Our hearts go out to his family.

As the hon. Gentleman knows, “Shaping a healthier future” is a clinically led programme supported by all eight clinical commissioning groups in the area and all nine medical directors of the trusts involved. There are no plans to make changes to A&E services at Ealing hospital, contrary to what was put about during the election, but I recognise that this is the subject of ongoing concern. All the recommendations of the Keogh review are entirely driven by one thing, which is putting patients and patient safety first, but I am happy to meet him and his colleagues to discuss it.

Penrose Inquiry

Andy Slaughter Excerpts

Thursday 26th March 2015 Commons Chamber

[Jane Ellison]

All relevant matters will need to be considered by the next Government. By the time the next Government are formed, and the next Parliament is assembled, Members will have had more chance to look at Lord Penrose’s detailed narrative of these tragic events.

[Mr Andy Slaughter (Hammersmith) (Lab)]

The Minister says she regrets that more has not been done in this Parliament. The main reason for that was that we were waiting for the Penrose inquiry—so that is doubly disappointing today. She says that much of the work has been done. I appreciate that her writ is about to run out, but has she or the Government formed the opinion that there should be a comprehensive financial settlement, of which what the Prime Minister announced should be just the downpayment?

Oral Answers to Questions

Andy Slaughter Excerpts

Tuesday 24th February 2015 Commons Chamber

[Jane Ellison]

I can only reiterate this Government’s complete commitment to openness when it comes to patient safety and say again that confidentiality agreements cannot be used to prevent individuals from making a protected disclosure in the public interest.

[Mr Andy Slaughter (Hammersmith) (Lab)]

22. What plans he has for the NHS in west London.

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

Clinicians in west London are leading a process that is very much aimed at improving services for people in west London. As the hon. Gentleman is well aware, the local NHS is pressing ahead with the implementation of service improvements as part of the clinically led reconfiguration programme, “Shaping a healthier future”.

[Mr Slaughter]

The Minister does not sound very convinced by that herself. I wonder whether she saw the comments from the College of Emergency Medicine yesterday, which said that attempts to dissuade people from going to A and E have been a dismal failure and that what we should do is locate primary care services alongside A and E. That is the model we have at Charing Cross hospital and in the rest of west London, and it is succeeding. What is failing is the closure of emergency departments, which is creating an intolerable strain. Will the Government look again at the issue? Will you stop closing A and Es in west London?

[Jane Ellison]

I am afraid that the hon. Gentleman has a dismal track record of campaigning on this issue. We have all seen the leaflets being put out in west London. I can only say to his constituents that in the run-up to the election they would glean more from reading their tea leaves than from reading his leaflets if they want to know the truth about the NHS in west London.

National Health Service

Andy Slaughter Excerpts

Wednesday 21st January 2015 Commons Chamber

[Mr Andy Slaughter (Hammersmith) (Lab)]

It has been a dispiriting afternoon, listening to the Secretary of State and Government Back Benchers saying that they do not play politics with the NHS while doing exactly that by blaming a previous Labour Government. They say they respect and care about NHS staff but they are not even prepared to pay them the 1% increase that has been recommended. Most of all, they say that they care about individual incidents but ignore statistics, whereas those statistics are simply the aggregate of so many individual tragedies that are going on at the moment.

Let me explain what I mean by that last point. This week, the Evening Standard has been running a series on the London ambulance service, and yesterday it was revealed that the head of the service had resigned after producing the worst results in the country—in only two thirds of the greatest emergency cases did the ambulances arrive within the target time. On Monday, it was reported that there had been a two thirds increase between November and December in stacking—ambulances waiting more than 30 minutes outside hospitals—across London. What those statistics, bad as they are, hide is shown in the e-mails I get every week from my constituents.

One such e-mail was about an incident where someone on a pizza delivery bike was hit by a car, with the rider badly injured. The police arrived rapidly and administered first aid. They were

“overheard to say that the victim was bleeding from the ear and his injuries may be ‘life-changing’”,

but that the fact they had arrived might itself delay an ambulance arriving. In this case, it took an hour and a half for that to happen. Another e-mail was about an elderly man who fell, cut his head and was lying in blood. The neighbours came out to help, but after an hour, during which time no ambulance had arrived, he was helped back into his home. Another e-mail relates to the case of a constituent who came to the aid of somebody who had come off their bicycle and broken their nose on Shepherd’s Bush road. My constituent was told by a paramedic, who was phoning back, that it would be at least two hours before an ambulance arrived, and they managed to get a police officer to take the injured person by minicab to Chelsea and Westminster A and E. I am sorry to say that I get those e-mails every week.

That is about the ambulance service, but what is happening to A and E? The A and E departments of the Imperial College Healthcare NHS Trust are performing at a level where about one in four people wait more than four hours, but at Christmas it was one in three. In neighbouring hospitals, performance has been as low as having half the people wait more than four hours—for example, at Northwick Park before Christmas. Let me read out what one constituent has written. He is the son of a 94-year-old woman and the following words say it all:

“She was seen by her GP…and he arranged for her to go to Charing Cross A & E department by ambulance and we arrived there at 6 pm. The department was extremely busy with people waiting in corridors due to a lack of beds.

Although it was not ideal I agreed with the doctor to start her treatment while she was sitting in the corridor. I say treatment but it was only preliminary things such as taking blood and inserting a line feed in her arm in order to administer antibiotics.

My mother is incontinent and needs help with going to the toilet. Because the staff were rushed off their feet she could not receive the help she needed in a timely manner.

It is obvious that the closure of the other A & E departments in West London has had an adverse effect on those that remain open.

It was not until about midnight”—

six hours later—

“that she was given a bed and a room of her own…where finally she was given an examination by another doctor.

At 1 am I left the hospital and returned the next morning to be told she was being transferred to Hammersmith Hospital because there were no beds available at Charing Cross.

I think you will agree that this level of care is unacceptable. While I cannot fault the staff at Charing Cross the whole Conservative policy of closures in West London is the worst political decision they have ever made.”

The point is that I could have been talking about anywhere in England, although in reality the situation in west London is much, much worse. Two of our A and E departments closed last September, and A and E figures plummeted after that. At last night’s meeting of the council committee that scrutinises Imperial College Healthcare NHS Trust managers, I asked whether they would now review—not cancel but simply review–their decision to close the A and E department at Charing Cross hospital, demolish that hospital, lose 93% of the in-patient beds and lose the best hyper-acute stroke unit in the country. Still they would not answer. They would not say yes and they would not say no. They are frozen; they cannot do anything but continue. Perhaps that is why the CQC said that all that trust’s hospitals requirement improvement, why the trust’s foundation status bid is on hold at the moment and why I and several of my west London colleagues have written to the Secretary of State to ask him to intervene. I am not holding my breath. Even though we represent more than 1 million people between us, he has done nothing and has not been willing to meet us for the past two years. That is a disgrace.

Contaminated Blood

Andy Slaughter Excerpts

Thursday 15th January 2015 Commons Chamber

[Alistair Burt]

I am deeply grateful to my hon. Friend, but the gratitude should actually be given to the sufferers and their beneficiaries who have made an attempt to approach MPs, sometimes for the first time. This year, we were able to bring it home to people that despite all the privacy and other reservations they might have had—some have not been able to tell family or close friends what they have been suffering—there is a need to approach MPs such as my hon. Friend to make them aware of the issue. That has been a new element of the campaign and is another reason for this debate.

[Mr Andy Slaughter (Hammersmith) (Lab)]

I do not wish to embarrass the right hon. Gentleman, who has cross-party support on this issue, but I think that he is being very modest and that his intervention with the Prime Minister has helped to galvanise the position. Given that it now looks as though Penrose will not be published until late March, is there sufficient time to get that settlement before the general election campaign and the election itself?

[Alistair Burt]

Again, I am grateful to the hon. Gentleman for his kind remarks. I do not think there is time, because I think it is possible that Penrose will have such far-reaching implications that no Government could make sensible decisions on future financial considerations until it had reported. I hope that my hon. Friend the Minister might be able to say a little more today about what might be done outside the financial considerations. I think that a conclusive settlement cannot now be reached. Penrose was originally supposed to report in March last year, which would have given time. That was the timetable we were all hoping to work to, but needs must and we are where we are.

--- Later in debate ---

[Mr Andy Slaughter (Hammersmith) (Lab)]

In preparing for this debate, I looked at the debate that my hon. Friend the Member for Coventry North West (Mr Robinson) sponsored at the beginning of this Parliament—in October 2010. I noticed that I, like a number of Members, said that action was needed more than contemplation. Since then, we have had many further debates. Indeed, we had a debate last week on hepatitis C in Westminster Hall, to which the Minister responded. We have had other such debates, the ongoing Penrose inquiry in Scotland, attempts to reform the existing arrangements and the very good report yesterday from the all-party group.

Tributes have been paid to the right hon. Member for North East Bedfordshire (Alistair Burt) for his sterling efforts to work towards a final solution. I note also that there is further legal action. Today, a letter for action has gone to the Department of Health from three sufferers of hepatitis C through contaminated blood about the inequity of their treatment compared with those suffering from HIV. The issue is not that nothing has been going on, but how much further on we are after four and a half years. I think the answer is not that much. It is easy to say that that is no one’s fault or everybody’s fault, but we must take some responsibility here. It is the role of this House to hold the Government to account when they are not living up to their moral obligation, which they are not at present.

Let me say one quick word about the existing arrangements. The report is good. It produces a lot of evidence for why the current schemes are not working, and we have heard individual criticisms of Macfarlane, Caxton and Skipton. Having read the report, my conclusion is that none of the trusts and funds is fit for purpose. If they are to continue while we await a final settlement, we must have root and branch reform and the funds must be resolved into one effective body. The politics is wrong. The funds purport to be independent bodies, but they appear to be too close to the Department of Health, meaning they have neither the benefits of independence nor the clout of accountability that should lie with the Department of Health. At the same time, they have become part of this degrading process where sufferers, who are largely reliant on benefits, are effectively begging for resources and often living in a state of penury.

That is only one part of the ongoing situation, which includes Penrose. The same situation has happened in the past, where we have been waiting on a report for consideration. Both the final conclusion on a financial settlement and the clear identification of culpability and responsibility are awaiting an outcome. I am grateful to my constituent, Andrew March, for giving me a very thorough briefing for this debate. Off the top of his head, he set down 14 reasons why unfairness has been caused to sufferers. They include the failure to act by successive Governments, which meant that products were not banned early enough and contaminated products were not withdrawn; that haemophiliacs were tested for both HIV and hepatitis C without their consent and not informed of the result; that haemophiliac children were subjected to hepatitis in infectivity trials; that minors were informed of their status without their parents being told; and that individuals were told of their status either by letter through the post or in public places. I could go on. Those are disgraceful actions. We need closure and an inquiry that will bring those matters to light.

I understand that we are to be told later today that the Penrose inquiry will report on 25 March. That is just before the purdah period and, as the right hon. Member for North East Bedfordshire said, leaves very little time for any conclusions based on those findings to be released before the election. That is deeply to be regretted, because whoever is in government after May will have many pressures on their time. I hope that this issue, if it is still not resolved by then, will not be lost. I would like to hear from both Front-Bench teams today that it will be a priority, whoever is in government, not to let the work that is done, if it is not resolved by then, fall foul of where we are.

[Diana Johnson]

My hon. Friend makes a good point about the difficulty produced by Penrose’s not reporting much earlier. The APPG was hoping that when we produced our report the Penrose report would be available, and that we could then have the conclusion to the negotiations in Downing street. The delay from Penrose has been very frustrating.

[Mr Slaughter]

It has been. It is, I think, tragic that we may go into another Parliament without a solution to these issues. If I had to say one thing, it would be this. Yes, we do need a public inquiry. We do need to identify responsibility and culpability. We do need to have the fullest apology based on the clearest evidence of what has gone wrong. We do need to make sure that interim and existing arrangements work properly, and we do need transparency. But, above all, I think we need compensation, and that cannot be delayed, perhaps for years, while all those processes are worked through.

I will, if I may, read a short statement from Andrew March, who will be familiar to many campaigners on this issue. He was the applicant in the judicial review case. He has studiously and devotedly pursued these matters for many years. He says:

“I am one of only 300 HIV positive haemophiliacs who remain alive and was infected at only nine years of age. Of those originally infected in the 1980s, more than three-quarters have died during the course of the past 3 decades. Many of them were my friends. I was also infected with Hepatitis B and C, and despite treatment, I continue to live with the adverse effects of cirrhosis of the liver. I am also one of the 3,872 haemophiliacs…who have been notified as being considered ‘At-Risk’ of variant CJD…Despite the authorities always maintaining that the risk was merely ‘theoretical’, I was shocked to learn in February 2009, that an elderly haemophiliac had been found with vCJD…in his body during post mortem…This news was not entirely unexpected, but I still became very worried that vCJD had the capability to become yet another ravaging illness.

More recently, I was informed by my doctors that I had been exposed to yet another pathogen, this time, Hepatitis E…As I sigh in disbelief that there seems to be no end to the multiple infections, I try to keep looking forward with some degree of hope that this will, one day, be sorted out once and for all.”

Those are the words of an extremely brave and resolute man. He and all the other sufferers deserve respect—which they are not getting from the current financing arrangements—they deserve justice and they deserve a full and proper compensation package. That should include compensation for family members. It should deal with all conditions, and it should remove the stigma of means-testing, ATOS assessments and so on. That is the least that we, as a country, can do for people who have suffered as a consequence of the state’s action.

--- Later in debate ---

[Jane Ellison]

I will come on to why I do not entirely agree with the hon. Gentleman, but my concern is essentially that after families have endured so much, I would hate to tell them the way forward only for that to be unpicked and revisited in the light of any recommendations by Penrose. I am afraid that I do not agree with him, because it is important to consider the report.

[Mr Slaughter]

A moment ago, the Minister said that, given the late reporting of Penrose, she would have to consider the scope of the Government response. Will she be a little more specific: what are the Government likely to say and how far will they go before the election?

[Jane Ellison]

I will come on to that. Although I cannot be as specific as I would like, I will try to give the House some sense of the way forward.

I stress that the support currently provided is over and above any other state benefits that infected individuals and their families may receive, and moneys paid under the schemes are not subject to tax. Some hon. Members have raised issues relating to the DWP, and I will of course bring those concerns to its attention.

I am aware that many hon. Members have concerns, which they have expressed in some detail, about the way that support for those affected is delivered. During the past year, I have listened to and actively considered the thoughts of all colleagues about how to improve the system. I have met the officers of the all-party group, and spoken a number of times to my right hon. Friend the Member for North East Bedfordshire.

I acknowledge that there is scope for reviewing the support system. I have been open with hon. Members about the fact that I share their concerns about the charitable basis of that support. I thank my right hon. Friend and the all-party group for the survey on which they recently collaborated. This is the first large-scale effort to consult beneficiaries, their families and the wider public on the current system. I will certainly consider its findings—I have looked at the executive summary of the report, which was only published yesterday—and all the other sources of information. From my conversations with Members over the past year, I have a good sense of the report’s direction of travel and of their concerns.

As I have said, in considering possible reforms to the current system, we must take into account Lord Penrose’s findings and recommendations before any specific proposals are made, but I have been ably supported by my civil servants in looking at possible reforms. His report is likely to be lengthy: to give the House some sense of that, the interim report published in 2010 exceeded 600 pages.

If Penrose does not publish until shortly before the House rises, it will be challenging, as Members have recognised, to provide a considered and thoughtful Government response in such a short time. I want to give due respect and consideration to Lord Penrose and his report, not least because it matters so much to so many individuals and families. As I have said, after all they have been through, it would be terrible for us to announce measures that then had to be unpicked or revisited. I reassure the House that however late in the Parliament Penrose reports, we will make a response, although that will inevitably have to be an interim response.

Having acknowledged that not everyone is satisfied—far from it—with the current system of support, it is extremely important to remember that the system makes an enormous difference to the lives of many beneficiaries. To date, more than £365 million in support has been paid to more than 5,000 people in the UK affected by HIV and hepatitis C and their families. Through the reforms made in January 2011, which some Members have mentioned, the Government have improved the system of support. Since they were introduced, more than £70 million in extra funding has been made available in England.

Something that is new since the House last debated this issue is the therapies that are coming through. Members have spoken about the side effects and impacts of existing therapies. Many of the new therapies have a much higher cure rate than existing ones, with far fewer side effects. We understand that cure rates for new therapies are between 90% and 95%, and that the courses of treatment are much shorter. Those figures are based on clinical trials. New data from the early access programme will be evaluated to confirm the robustness of that finding, but it is obviously encouraging news.

I am encouraged by some of the improvements that we can make to the quality of life of those who have suffered from their infections for so long. New treatments for hepatitis C are becoming available through the NHS. While we have been waiting for NICE to publish its final appraisal of the first of the new drugs—Sofosbuvir and Simeprevir—NHS England has taken two important steps to ensure that eligible patients with late-stage hepatitis C can expect to have received treatment by the end of 2015. In April 2014, it published an interim clinical commissioning policy statement to provide access to the new therapies for patients with liver failure. More than 700 patients have already been treated through this policy, at a cost of £38 million. Specialist centres were procured to deliver this early access treatment around the country.

The NHS is developing a further interim clinical commissioning policy for patients with compensated cirrhosis to reduce the risk of their developing decompensated cirrhosis or liver cancer. Subject to its internal approval processes, the NHS is aiming to have that in place from this April. I have confirmed with the clinical director that if any hon. Members are approached by constituents with hepatitis C, they should advise them to consult their GP about a referral to a hepatology specialist to determine whether they have developed cirrhosis.

Medical advances continue to improve the ways in which HIV and hepatitis C can be treated and managed, and I want to take this opportunity to assure the House that the UK now has one of the safest blood supplies in the world, and independent experts continually review current safeguards.

This debate has again allowed me to hear about the issues with which many of those affected live daily. I of course recognise that improvements must be made to the system that provides financial assistance, and I have given considerable thought to that over the past year. Together with those we represent, we need to be realistic about the challenge of making changes that are fair and sustainable. It is very welcome that we can work on a cross-party basis—that is absolutely vital—and it is most reassuring that several hon. Members have emphasised that.

I am hugely frustrated that the much longed-for closure cannot realistically be achieved in this Parliament. Nevertheless, a new Parliament is imminent, and it will provide an opportunity for the next Government to provide closure.