(5 years, 5 months ago)
Commons Chamber(6 years, 2 months ago)
Commons ChamberFirst, we have made it clear in our regular contact with the Saudi authorities that there has to be a proper independent investigation and a credible explanation from Saudi Arabia of what happened, and we do not believe that we have had that to date. Secondly, when the facts emerge and when they have been confirmed, we will make a judgment with our allies about the appropriate thing to do. We have had lots of suggestions today of things that we could do, and we will make a considered response. I think that we have been very clear that that response will be commensurate with the scale of what has happened.
CNN is reporting today, based on CCTV obtained from Turkish security, that a member of the assassination squad walked around Istanbul in Jamal Khashoggi’s clothes after he was killed, in an attempt to show that he left the consulate alive. That shows a level of co-ordination that must have come from the top, and I do not know how much more evidence the Foreign Secretary needs to be persuaded of that. When he is persuaded, will one of the steps that he considers be to suspend diplomatic relations with what is increasingly seen as a bandit regime?
If the hon. Gentleman were in my shoes, he would not be announcing the actions that the United Kingdom would be taking until the proper investigation had been completed. I read the same media reports as the hon. Gentleman does, and when I see the stories of a body double of Khashoggi walking around the streets of Istanbul even though his fiancée waited outside the consulate for 11 hours for him to come out, it suggests to me that the story we are getting from Saudi Arabia is not yet credible. If we are to continue this strategic partnership, we need a credible explanation for what happened and we need to see the results of that investigation. I could not have been clearer: we will take serious action if these stories turn out to be true.
(8 years, 1 month ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I salute my hon. Friend for the campaign he is leading at the moment, standing up for his constituents. He is right to point to PFI as one of the principal causes, and we now have to find a way to deal with that issue in a way that improves and does not detract from the quality of care offered to the people he represents.
According to Sir Richard Sykes, the chair of Imperial College Healthcare NHS Trust, “the problem is funding”, we are “killing” NHS staff by making them work 18 hours a day, and it is not in a position to close any more accident and emergency facilities in north-west London because there is not the capacity to do so. How is the NHS in north-west London supposed to save £1.3 billion over the next four years, as its sustainability and transformation plan proposes?
Give a serious answer to a serious question—you’re a buffoon! [Hon. Members: “Ooh!”]
(8 years, 8 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
My hon. Friend is right. Doctors who strike will need to explain that to paramedics, healthcare assistants and nurses working in their own operating theatres. In the end, that issue is why this strike is happening. The BMA said in writing in November that it would negotiate on Saturday pay; it went back on its word in February. As a result, this is the only outstanding issue, and we now have this extreme step—the withdrawal of emergency care. I find that very hard to justify.
At the beginning, the Secretary of State said he was publishing a model contract, which he believed trusts, including foundation trusts, would by convention implement, but he has subsequently said that there is a legal duty that he can impose. He needs to clarify that, and it would be helpful if he could publish the legal advice. That would not be a surprise in the judicial review cases, because his lawyers are presumably doing their skeleton arguments. We have a right to know the answers to these questions.
With respect, all the hon. Gentleman needs to do is look in Hansard at my response to the urgent question, which made it clear that we have the right to introduce a new contract. On the basis of the conventions that currently apply in the NHS, that contract will apply to all junior doctors. Foundation trusts do indeed have the right to set their own terms and conditions, but they choose not to do so.
(9 years ago)
Commons ChamberI 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.
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.
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.
(9 years, 6 months ago)
Commons ChamberI 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.
8. What effect the implementation of the Keogh urgent and emergency care review will have on type 1 A&E departments in England.
(9 years, 11 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I agree with pretty much all the College of Emergency Medicine’s 10-point plan. That has very much informed our approach to helping the NHS over this winter. Co-location of GP surgeries on hospital sites is very helpful, but we also need more proactive care for the most vulnerable older people before they feel the need to go to hospital. That will be at the heart of the changes that we want to see.
The reason that west London now regularly has the worst waiting times for A and E, with up to 50% of patients waiting more than four hours, is a direct result of the Secretary of State’s decision to close the Hammersmith and Central Middlesex A and E four months ago. These are sick people who need A and E, not GP services. We have GP services at those hospitals. What we need is for him to cancel or at least review the downgrading of the A and E departments at Charing Cross and Ealing hospitals to GP-led emergency centres. Will he at least do that?
I say gently to the hon. Gentleman that if we are to solve the problems in his area and others, we should listen to the doctors about the structures that will work best. The structures that we put in place are the structures that doctors advised us to set up. That is why we are supporting them.
(10 years ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I commend my hon. Friend for championing this cause. He is absolutely right that we need first aid. I think that my hon. Friend the Member for Brigg and Goole (Andrew Percy)—I am not sure he is here—is a first responder, and I want to commend him for the work he does in that respect, because it makes a big difference in emergency situations if we can people to patients more quickly.
The CQC report into Imperial, to which my hon. Friend the Member for Westminster North (Ms Buck) referred, found poor standards of cleanliness, too few nurses and thousands of patients awaiting surgery. It is the third CQC report in west London in four months, and it has found five major hospitals as requiring improvement and three A and E departments inadequate. The only one that is not inadequate—Charing Cross, which is good—is the one the Secretary of State wants to close. Waiting times are down to some of the worst in the country, yet they used to be among the best. We in west London do not recognise what he is saying. After two years of refusing, will he now meet me and other west London MPs to talk about the crisis in west London health care?
On the contrary, it is the hon. Gentleman’s constituents who do not recognise what he says or all the scaremongering leaflets about what is happening to NHS services in north-west London. We have plans to open two brand-new hospitals; we have weekend opening of GP surgeries; and we have big improvements happening in A and E departments. Let me gently say to him that, along with his Front-Bench team, he voted not to have a chief inspector of hospitals who could provide independent information about the quality of services. Now that he is quoting that information, I hope he realises that that was a mistake.
(10 years ago)
Commons ChamberWill the Secretary of State confirm a report in The Guardian today that he shelved the downgrading of the majority of accident and emergency departments in England under the Keogh review because that is “political suicide” and because of criticisms from the College of Emergency Medicine, the Care Quality Commission and chief executives of trusts? Will this mean that he can now suspend Shaping a Healthier Future and remove the threat to the Charing Cross and Ealing A and Es?
I am always happy to confirm that a Guardian story is wrong. Let me tell the hon. Gentleman that there was no plan to downgrade the majority of A and Es. The plan is to invest in A and Es—to continue with broadly the same number of A and Es as we currently have but to recognise that some of them will need to specialise in different things. We will stick to that plan—it is a good one.
(10 years, 5 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I am happy to do that, and I would particularly like to congratulate my hon. Friend on the insight he has brought with regard to the power of data. In one example of why this is so important, the latest figures showed 43 or 44 people dying in the NHS because of medication errors, but if the person giving the medication had been able to see the patient’s entire prescription history, those horrific tragedies might have been avoided. That is why proper sharing of data is so important.
I want to ask about the safety of the 22,000 patients who use Hammersmith hospital A and E every year. There is no increased capacity in the acute primary or community care services locally, which the Secretary of State set as a prerequisite for any A and E closures in west London. Will he ask Imperial Healthcare Trust to review plans to close the A and E at Hammersmith on 10 September? Will he answer that question, as my constituents in Shepherd’s Bush and White City deserve an answer to it, not the spin and the game playing that I always get from the Secretary of State?
I am afraid I will take no lessons in spin and game playing after what the hon. Gentleman wrote in local election leaflets in Hammersmith and Fulham, failing to tell his own constituents about the brand new hospitals, the opening of a seven-day GP surgery and the 800 out-of-hospital professionals. I think he behaved absolutely disgracefully.
(10 years, 6 months ago)
Commons ChamberT10. Last October the Secretary of State said that Hammersmith accident and emergency would be closed when it was safe to do so. Imperial proposes to close it on 10 September, when on its own admission there is insufficient capacity at St Mary’s and it is not safe to do so. Will he keep his promise and ensure that Hammersmith A and E does not close, especially when there is not sufficient capacity in the system?
I keep my promises, but may I point out to the hon. Gentleman that the way in which he has campaigned on those issues has been totally irresponsible? He put out leaflets in the local election campaign saying that Charing Cross hospital would be demolished. He failed to mention that it was going to be rebuilt as a brand-new hospital with an A and E department. I hope that he will not be invited to it when it is reopened unless he apologises to his constituents for the way he has presented this issue.
(10 years, 6 months ago)
Commons ChamberThe right hon. Gentleman should have listened to what I said: I said he was right to say it is tough out there, and I also said that this week we will be announcing measures to help the NHS deal with operational pressures. He talks about how long people are waiting for operations, so let us look at one particular statistic that sums up what I am saying: the number of people waiting not 18 weeks but a whole year for a vital operation. Shockingly, when the right hon. Gentleman was Health Secretary, nearly 18,500 people were waiting over a year, and I am proud that we have reduced that to just 500 people. Those results would not be possible without the hard work and dedication of front-line NHS staff, and whatever the political disagreements today, the whole House will want to pay tribute to their magnificent efforts.
Will the Health Secretary comment on the shambles he has reduced the NHS to in west London, where he is closing A and E departments, like that at Hammersmith on 10 September, while there are inadequate numbers of beds at the only hospital people have been directed to? It means that there is no acute care, and primary care is in such a state that there is an emergency in-year redistribution of money across north-west London. How is he going to sort that out?
What is happening in north-west London is going to make patient care better. It involves the seven-day opening of GP surgeries, over 800 more professionals being employed in out-of-hospital care, and brand new hospitals. That is a huge step forward, and the hon. Gentleman is fighting a lone battle in trying to persuade his constituents that it is a step backwards.
This Government recognise the pressure that the NHS is under, as I was telling the shadow Health Secretary. The fact that the population is ageing means that the NHS now needs to perform 850,000 more operations every year than when he was in office, which we are doing. That means that some patients are not receiving their treatment as quickly as we would like, so NHS England is this week announcing programmes to address that, ensuring that we maintain performance while supporting the patients waiting longest for their treatment, something that did not happen when he was in office. We will not allow a return to the bad old days when patients lingered for years on waiting lists because once they had missed their 18-week target, there was no incentive for trusts to treat them.
A and Es, too, are facing pressure and are seeing over 40,000 more patients on average every week than in 2009-10. NHS staff are working incredibly hard to see and treat these patients within four hours, and it is a tribute to them that the median wait for an initial assessment is only 30 minutes under this Government, down from 77 minutes under the last Government. However, as we did last year, we will continue to support trusts to do even better both by improving their internal processes and working with local health economies to reduce the need for emergency admissions. This will be led by NHS England, Monitor and the NHS Trust Development Authority.
(10 years, 10 months ago)
Commons ChamberThe hon. Lady is right to highlight the fact that there has been a long-standing issue with recruitment into A and E. We have made some good progress. We have 350 more consultants in post than at the time of the election, but we need to do even better, so we are looking at the training process for A and E consultants. We are also looking at the contractual terms for A and E consultants, particularly as they relate to things such as shift work, to try to make it a more attractive profession. I am confident that these issues are now being addressed—in fact, I have had some encouraging feedback from the College of Emergency Medicine saying that it, too, is confident about that.
I will give way in a minute, but this is an Opposition day debate, so I want to return to the central motion. Let me remind the right hon. Member for Leigh that he told this House—in fact, he had an Opposition day debate to do it—that the NHS budget had been cut in real terms. It had not: it rose. He also claimed that the number of nurses was being cut, when actually it went up. His attempts to talk up a winter crisis have been disproved time and again. That is important, because we have not had a proper apology to this House in relation to the letter he received from the chief executive of the south-western ambulance trust complaining about his spinning, which stated:
“information provided to your office in response to a Freedom of Information request…has been misinterpreted and misreported in order to present a grossly inaccurate picture for the purposes of apparent political gain.”
The right hon. Gentleman should not be playing politics with the pressures in A and E; he should be getting behind front-line staff, who are working extremely hard and who find that kind of tactic extremely demoralising.
I will tell the right hon. Gentleman exactly what the facts are. The other word I heard him use several times in his speech was “complacency”. I will tell him what complacency is: it is complaining about an English NHS that is hitting its A and E targets and completely ignoring Labour-controlled Wales, where the NHS has been missing its A and E targets since 2009. Something else that is complacent is this idea Labour has that, almost a year after the Francis report, the lessons of Mid Staffs stop at the border of England and Wales—that Wales has nothing to learn and does not need to do a Keogh report into excess mortality rates, which the Welsh Labour Government have consistently refused to do. People in Welsh hospitals are suffering because the Welsh NHS has refused to bite the bullet on excess mortality rates.
Tonight, at a “Save Our Hospitals” meeting in west London, I shall be speaking to A and E doctors and GPs about the largest-ever closure programme: four NHS emergency departments are to close in west London. Eight west London MPs, including me, have asked the Secretary of State to meet us and discuss the issue. Shall I tell those who attend tonight’s meeting that the Secretary of State is still refusing to meet eight MPs who collectively represent nearly a million people in west London?
As the hon. Gentleman knows, I must follow a strict legal process in relation to such decisions, and we have had an extensive consultation. However, let me say this to him. When he talks to those MPs, he should tell them the facts about the proposals for north-west London which I approved—proposals for three brand-new hospitals in which seven-day working is to be introduced, 24/7 obstetrics, 16/7 paediatrics, seven-day opening of GP’s surgeries, and a range of other services which will help to address precisely the issues raised by the right hon. Member for Leigh in connection with transforming out-of-hospital care, which I support. As a result of those proposals, the services that I have listed will be available in north-west London before they will be available in many other parts of the country. I hope that the hon. Gentleman will inform the MPs whom he is meeting of those important facts.
(11 years, 1 month ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I am in regular contact with the Northern Ireland Minister for Health, Social Services and Public Safety about good practice in Northern Ireland, and I am delighted to hear that they are doing some good things in urgent and emergency care. We should be open to all good practice, not just in our country but all over the world.
The Secretary of State may have seen the report in The Sunday Times at the weekend about the dispute between the medical director for London, who said that 20% to 30% of blue-light A and Es should close, and Sir Bruce Keogh, who said that less than that should close. Disgracefully, the Secretary of State has not told us what is in Sir Bruce Keogh’s report, but we know that it is below that figure, so why did he announce to the House two weeks ago that four out of nine—45%—of blue-light A and Es in west London would close, pre-empting the Keogh review?
Because it is going to save the lives of the hon. Gentleman’s constituents; it will mean that 800 more people are employed in out-of-hospital care; it will mean three brand-new hospitals for the benefit of his constituents; it will mean seven-day working; and it will mean seven-day opening of GP surgeries. That is why.
(11 years, 1 month ago)
Commons ChamberMy hon. Friend speaks wisely. It is disappointing that we are not having a more intelligent debate. When Labour was in power, it closed or downgraded 12 A and E units in 13 years. The then Government realised that there were problems. He is right that they started the problem in Chase Farm. That is why, when we are facing such difficult decisions, it is important to have a responsible debate. I accept that MPs have views on their constituencies, but we have to start looking above the parapet to the wider interests of patients. That is a difficult thing to do, but I would have hoped for more leadership from the shadow Secretary of State, who used to be Health Secretary.
The Secretary of State is destroying services in four great London hospitals, two of which are in my constituency, in the biggest closure programme in the history of the NHS. Why is he closing A and Es in two of the most deprived communities in London—Brent and White City—and why, rather than certainty, is he installing chaos into Ealing and Charing Cross hospitals? What is happening to the 500 beds at Charing Cross? What is happening to the best stroke unit in the country? What does he mean by A and Es that are different in size and shape? When will he answer those questions? This is a cheap political fix. How can anyone have confidence in the Secretary of State—
(11 years, 3 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I congratulate my hon. Friend and his Milton Keynes colleague on their assiduous and regular conversations with me on the pressures on their A and E. I recognise that it is operating way above its original planned capacity and hope that today’s announcement will make some difference, but we will continue to look at long-term solutions because we recognise that there are long-term pressures.
In view of the continuing and worsening crisis in A and E, will the Secretary of State concede that closing four out of nine A and E departments and 500 beds at Charing Cross hospital is now unsustainable? Will he abandon those plans, or at least suspend them until the crisis is over?
I take issue with the hon. Gentleman’s suggestion that this is a worsening crisis in A and E. We have hit our A and E target for the last 22 weeks. We recognise that there are real pressures and are seeking to address them. On the proposals for north-west London, he knows that I cannot comment until I have received the Independent Reconfiguration Panel’s advice. I will look at it very carefully, but obviously, considering the pressures on A and E departments across the country, I will want to ensure that any proposed solution makes sure that his constituents get the service they need when it comes to urgent and emergency care.
(11 years, 7 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
All decisions on reconfigurations have to be taken on a case-by-case basis. The really important thing is to ensure that, when we reconfigure services, we have a good alternative in place and we are able to give the public the confidence that it is in place. As the hon. Gentleman knows, we follow the four tests before any ministerial approval is given for a reconfiguration to go ahead.
Tomorrow is the 40th anniversary of the opening of the present Charing Cross hospital. The Secretary of State is welcome to come to the party, although he might be unpopular, as the A and E department there is one of the four in west London that he wishes to close. Three months ago, at Health questions, he told me that he would refer those decisions to the IRP, but he now appears to be telling my hon. Friend the Member for Ealing, Southall (Mr Sharma) that he is taking advice on whether to do that. Will he stick to his promise and make that referral for a full review?
(11 years, 9 months ago)
Commons ChamberLast week’s decision to close four north-west London A and Es, including Charing Cross and Hammersmith in my constituency, will shortly be on the Secretary of State’s desk, as he predicts. It was referred by Labour Ealing council because Tory Hammersmith and Fulham council supports the closures. Will the Secretary of State refer the matter for independent review? This is the biggest hospital closure programme in the history of the NHS. It will see a world-class hospital downgraded to 3% of its size.
I am aware how concerned people are throughout north-west London about the proposals. If the matter is referred to me by Ealing council, I will indeed ask the independent reconfiguration panel for its independent view on the proposals.
(12 years, 2 months ago)
Commons ChamberThe excellent children’s heart surgery unit at the Royal Brompton hospital will be pleased that a full review has been announced. Why does it have to report within four months, including the Christmas period, and why were previous referrals by both Brompton and Leeds refused? Will the review be full and impartial or not?
It will be a totally impartial and very thorough review. This is an extremely important decision, and that is why I asked the Independent Reconfiguration Panel to take the time that it needs to do the review properly; that is the least that the hon. Gentleman’s constituents would want.
(12 years, 7 months ago)
Commons ChamberI do wish that Labour would allow these issues to be considered in a calm manner, because they are very, very difficult issues. We need to get the right solution. We are not saying that we got everything right in our party over the years; we are saying that there is a process of reform that needs to happen—very importantly, a process of reform that protects freedom of expression, which is the foundation of our democracy, and we want to work with all parties to sort this out. That is the way to deal with this issue—not the rank opportunism that I am afraid we have seen this morning.
On the key issue of reference to the Competition Commission, the Secretary of State did not take independent advice, so his protestations that he did not always act in Mr Murdoch’s interests sound rather lame. Is he not in fact following his own office’s advice to Murdoch, which is to find some political cover for a decision that he had already taken?
I did take the independent advice. The independent advice was that this should be referred to the Competition Commission, and I immediately did as I am required to do in the legal process: I wrote to News Corporation and said, “I am minded to refer this to the Competition Commission.” It then has the right to offer undertakings in lieu, and I have a duty to consider those undertakings. I then wrote to the independent regulators again, to get their opinion before I took any further decisions. We have been scrupulously fair in this entire process. The proof of the pudding is that we took decisions that News Corporation did not like.