Junior Doctors Contract

Angela Smith Excerpts

Monday 30th November 2015 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. What is the common ground between the Government and junior doctors? We want to make sure they are working safe hours; we do not want to cut their pay; we want safer services for patients; and we want to make sure that the many junior doctors who do work weekends get proper consultant support and training opportunities at weekends as well as during the week. I think that that is enough on which to come to a deal.

[Angela Smith (Penistone and Stocksbridge) (Lab)]

In his approach, the Health Secretary has implied that the current junior doctors contract arrangements compromise patient safety, so will he tell us which hospital chief executives have confirmed to him that that is the case?

[Mr Hunt]

I can tell the hon. Lady that NHS Employers, which represents all NHS hospital trusts, has said:

“Trusts are clear that the current contracts for both consultants and junior doctors must be reformed to provide modernised and safe 7 day services in our hospitals.”

Human Fertilisation and Embryology

Angela Smith Excerpts

Tuesday 3rd February 2015 Commons Chamber

[Luciana Berger]

I understand that the FDA has written to the British press in the course of the last week to contradict that position. There is a very different political situation in the US, and there is a very different set-up there in terms of the FDA compared with here and what we are discussing today.

[Angela Smith (Penistone and Stocksbridge) (Lab)]

Does my hon. Friend agree that the fact is that any scientist would say that no technique is entirely safe but the risk in this case is very low indeed, and completely justifies the leap of faith she describes, which is in effect a further advance in the use of IVF technology—which itself was pioneered as a leap of faith in 1978?

[Luciana Berger]

My hon. Friend makes some very important points, particularly about the assessment of risk, which has been done extensively throughout this process.

The question is whether the benefits of preventing the transmission of mitochondrial disease, and the likelihood that children will continue to be born who will die in infancy, outweighs the risks of the techniques. The scientific community and the families experiencing mitochondrial disease say that they do; and according to research, almost 2,500 women in Britain of child-bearing age are at risk of passing the condition on to their children. It is now up to Members to decide whether they agree.

--- Later in debate ---

[Steve Baker]

The hon. Gentleman is absolutely right, which is why I began by expressing the humility I feel on this subject as a result of meeting and having had a lengthy conversation with a family who face just that issue. I remind myself, however, that we are dealing here not with a cure for those who have already been born, but with ensuring that those who are subsequently born do not suffer from that disease. If we were discussing a cure for those already living, perhaps the circumstances might be different.

[Angela Smith]

Is prevention not better than cure?

[Steve Baker]

Prevention certainly is better than cure, but the question is: at what risk? I simply accept that on the earliest stages of human life there is a space for conscience; we will have different beliefs, some of which will be religious, and it is a matter of conscience. There are noble reasons for disagreeing about that stage and about what is and is not legitimate risk taking with human beings.

The second point I wish to make is that in the course of this conversation there seems to have been what, at best, I could describe as semantic sophistry as to whether or not this process is genetic modification. As always, there is space for debate about the definition of terms, but the germ line is to be modified if these techniques go ahead. The Minister has stated that plainly—

National Health Service

Angela Smith Excerpts

Wednesday 21st January 2015 Commons Chamber

[Andy Burnham]

We have record numbers of delayed discharges in the NHS right now. The number may even go past the 1 million mark—I am talking about days lost in the past year. That reorganisation that I mentioned a moment ago cost at least £3 billion, probably more. The budget was flat so where did that money come from? As my hon. Friend rightly says, it came from cuts to the general practice budget, cuts to the community services budget, cuts to the mental health budget and cuts to the social care budget. That is why the community has been stripped bare and people are trapped in hospital. This is a mess of the Government’s making.

[Angela Smith (Penistone and Stocksbridge) (Lab)]

Does my right hon. Friend not agree that the same explanations apply to ambulance response times, by which I mean the closure of the NHS Direct service, the cuts to the social care and the difficulties in seeing a GP?

[Andy Burnham]

That is exactly my argument.

--- Later in debate ---

[Mr Hunt]

Exactly. My hon. Friend makes the point very well, and I will tell him something else about the hospital in his constituency. The George Eliot hospital was a failing hospital with very high mortality rates, and its deeply entrenched problems were swept under the carpet by the previous Labour Government, but this Government have turned it around and it is now a successful hospital. It is doing incredibly well because we faced up to the problems that Labour ignored.

[Angela Smith]

Sickness-related absence is going up around the country. In Barnsley, it has gone up by two percentage points in the past two weeks. A one percentage point increase equates to £1 million a year. Not only will that hit budgets, but it is a real sign that the NHS is under severe pressure.

[Mr Hunt]

The NHS is under pressure, so the hon. Lady will welcome the fact that Barnsley Hospital NHS Foundation Trust in her constituency has 34 more doctors and 74 more nurses, and that we are currently doing about 2,000 more operations every year for her constituents. Yes, there is pressure, but this Government are investing on the back of a strong economy so that we can put more money into the NHS and give her constituents a better service.

--- Later in debate ---

[Angela Smith (Penistone and Stocksbridge) (Lab)]

I feel privileged to take part in this important debate, which has focused on how the state of the NHS is playing out in Members’ local areas. The contribution of my right hon. Friend the Member for Manchester, Gorton (Sir Gerald Kaufman) encouraged me to reflect on just how recently the NHS was formed. It was launched by Nye Bevan on 5 July 1948, which means that anybody alive today who is in their late 60s or older would have been born before the NHS was created.

My parents, for instance, were war babies, born well before the NHS was launched. That reflection serves as a reminder not just of how recent the NHS is, but of how easy it might be to let the NHS slip away from our grasp. It is not something that we can take for granted. It is the responsibility of all of us in this place who truly believe in the NHS not only to fight for its survival—that is not good enough—but to see it strengthened and always fit for the challenges of our time. Currently, those challenges are many.

In an intervention earlier, I referred to the sickness and absence levels beginning to emerge across the country, including in Barnsley, in my constituency, and in Sheffield, and how much that is costing the NHS, but also how much it reflects the problems that the NHS faces.

I want to focus briefly on ambulance services, because they have not featured very much in today’s debate yet they are a pressing issue in my constituency. I represent an outlying area of South Yorkshire, which extends well into the national park. It is predominantly rural and is suffering from serious problems. I will use two cases to demonstrate the problems that we are facing.

Mr Offord collapsed on 16 April 2013, at approximately 11 pm. A 999 call was made, but a double-staffed ambulance did not get to Mr Offord until 11.25, by which time he was in respiratory arrest. On being transferred to the floor from the sofa, he was determined to be in cardiac arrest. He died the following day. The coroner ruled that there was a serious lost opportunity in the failure to consider alternative sources of support for a lone paramedic—the first response to the call—and that Mr Offord would probably have survived if he had received medical attention earlier. Mr Offord’s family, obviously very distressed, have settled that case out of court, but they want a wider justice for their son and brother. They want to see ambulance services and response times improved.

Mr Bailey, who I mentioned in my parliamentary question earlier today, collapsed in a shop. As I said, it took an hour and four minutes—and it was a Red 2 priority call—for an ambulance to get to him, despite the fact that the symptoms described in the emergency call were apparently those of a stroke; indeed, he had suffered a major stroke. This detail is horrific, but I must place it on the record: he had to have part of his skull removed because of the severity of the stroke. In summary, the dispatcher made two errors, which contributed to the delay in an ambulance attending to Mr Bailey, and—these are the words of the Yorkshire ambulance trust itself—“no checks” were

“made for an available ambulance from 13:31 until 14:03; and no allocation”

was made

“of one of the nearer ambulances identified at 14:11.”

All the ambulance trust has to say is:

“Please pass on my sincere apologies to both Mr and Mrs Bailey for the errors and the delay caused.”

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I am so pleased that my hon. Friend has raised this important issue. I have had so many people write to me about the state of the ambulance service. One gentleman, over a year ago, had to wait for two hours. I have also been contacted by a whistleblower from the call centre who is discouraged from sending ambulances—they have to dig and try and find any way. Does my hon. Friend agree that this is desperate and needs to be sorted out?

[Angela Smith]

I thank my hon. Friend for that intervention and I am really sorry to hear of the cases she raises. The situation really does need to be sorted out, because the Yorkshire ambulance trust goes on to say that

“the service was experiencing a high level of demand in the South Yorkshire area around the time of Mr Bailey’s incident. Overall, demand was 12% above predicted levels and the level of ‘Red’ call demand was 55% above predicted levels…Rising demand on all health care resources continues which requires changes to deliver improvements in urgent and emergency care.”

I shall say no more about Mr Bailey’s case because it will be referred elsewhere and it may well go to law—I have simply set out the facts of the case as they have been put to me—but the point is this: why are we experiencing these problems with response times in the ambulance service? Why are we hearing, week after week in Prime Minister’s questions and on the Floor of the House in other debates, that the ambulance service is letting people down—even in the most serious cases, when people are going into cardiac arrest or having a major stroke?

We need to establish the reasons, and I suggest that there are three obvious ones. There may be more—there may be problems with the management of ambulance services, and in many cases there clearly is a problem in the case of YAS—but I would suggest that there are three obvious problems. One problem is the increasing difficulty that people have in getting access to GPs’ surgeries. The evidence was laid before the people present for this debate earlier, by the shadow Secretary of State, so I will not go through it again.

Secondly, there has been the closure of NHS Direct and the establishment of NHS 111. There is no way that NHS 111 can be compared with NHS Direct; it is like comparing apples and pears. I have used NHS Direct in the past. It was a superb service that enabled me to decide which was the appropriate place to go to for my treatment and to get the right treatment at the right time. I can assure hon. Members that the one place I did not end up, having used NHS Direct, was A and E—that would have been the last place I had to go to.

Thirdly, social care cuts represent one of the most fundamental problems of our time. As my right hon. Friend the Member for Wentworth and Dearne (John Healey) said, £1 in every £10 has already been cut from social care budgets. It is obvious, even to the most disinterested observers of the debate on health, that cutting social care budgets at local authority level will ultimately impact on the health service. I was in local government for 10 years, and I saw for myself the importance of the local authority and the local NHS working together to enable elderly people to stay in their own homes and to keep them out of the health system—the acute health system, in particular—as much as possible.

The shadow Secretary of State, my right hon. Friend the Member for Leigh (Andy Burnham), outlined what needs to be done in the very long term, strategically, to get the NHS in the right shape. He also outlined the more immediate actions that a Labour Government would have to take if they gained power in May: providing more clinically trained staff to handle NHS 111 calls; restoring the GP guarantee of an appointment within 48 hours; and ensuring that councils, the NHS and the local voluntary sector work together to identify older people at the highest risk of hospital admission and link them up with the right support. I cannot wait for 8 May to see that strategy for the short term being put in place.

Ambulance services are crucial to the trust that people have, and need to have, in their local health services. One can broadly measure the trust that people have in their local health service by how much they can rely on their ambulances. Everybody likes to think that if they need an ambulance they will get one, and get it quickly. I was disappointed this afternoon that the Prime Minister used my question to indulge in petty political point-scoring. These issues are too serious for that. He did not even express sympathy for the family affected and instead made a cheap point about NHS staff. That was disgraceful. It is not good enough, and it is not good enough—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order.

Oral Answers to Questions

Angela Smith Excerpts

Tuesday 13th January 2015 Commons Chamber

[Norman Lamb]

PALS was not the direct replacement of community health councils; a different scheme was set up for the patient and public voice independent of hospitals. My hon. Friend raises important concerns about PALS and the Government are intent on looking at the service to ensure that it performs effectively for patients.

[Angela Smith (Penistone and Stocksbridge) (Lab)]

T8. My constituent Mr Offord waited 22 minutes after a 999 call for a double-crewed ambulance, and his death was referred by the South Yorkshire coroner to Ministers because of a concern that he might have survived if he had received medical help sooner. The Yorkshire ambulance service has just settled the case brought by Mr Offord’s family out of court. When will the Secretary of State recognise the growing crisis in ambulance services and support my right hon. Friend the shadow Secretary of State’s call for an investigation?

[Mr Hunt]

I do recognise the pressures on the ambulance service and the hon. Lady’s local area has had £1.6 million extra to help to deal with winter pressures. We have 1,700 more paramedics in the ambulance service and they are doing 2,000 more emergency journeys every day, but none of that is any consolation to the family whom she talks about, and that is why we must always ensure that every lesson is learned.

Oral Answers to Questions

Angela Smith Excerpts

Tuesday 14th January 2014 Commons Chamber

[Angela Smith (Penistone and Stocksbridge) (Lab)]

6. When he expects to publish a revised adult autism strategy for England.

[The Minister of State, Department of Health (Norman Lamb)]

The Department of Health is currently leading a review of the 2010 adult autism strategy for England, “fulfilling and rewarding lives”, and we will publish a revised strategy by the end of March.

[Angela Smith]

Given some of the difficulties encountered by local areas in developing and sharing innovative practice in progressing the strategy he has just talked about, what consideration has the Minister given to the National Autistic Society’s proposal for an innovation fund as laid down in its “Push For Action” report?

[Norman Lamb]

I thank the hon. Lady for her question. The National Autistic Society is doing fantastic work, working closely with the Government. It has put this idea forward and we are considering it seriously; it has real merit. We shall announce our decisions when we announce the results of the consultation in March.

Health and Social Care Bill

Angela Smith Excerpts

Tuesday 28th February 2012 Commons Chamber

[Mr Lansley]

I am glad that my hon. Friend has made that important point. People such as the former Chair of the Select Committee on Health, the right hon. Member for Rother Valley (Mr Barron), who is no longer in his place, are fond of asking why we are introducing competition into the NHS. We are not. The Bill does not introduce competition to or extend competition within the NHS. The legal advice disclosed in one of today’s national newspapers makes it clear that the previous Labour Government introduced the reach of competition law into the NHS by introducing the elective choice programme in 2006.

[Angela Smith (Penistone and Stocksbridge) (Lab)]

If the Health Secretary believes so much in the value of his Bill, why did he not take the time to explain it to voters before the general election, instead of promising that there would be no top-down reorganisation of the NHS?

[Mr Lansley]

I refer the hon. Lady to pages 46 and 47 of the Conservative party manifesto and, to understand the Bill fully, to the Liberal Democrat manifesto.

Oral Answers to Questions

Angela Smith Excerpts

Tuesday 18th October 2011 Commons Chamber

[Mr Lansley]

The review will develop the recommendations to ensure that children’s heart surgery services deliver the very highest standard of care for children and their families. The joint committee of primary care trusts will consider all the relevant evidence before making a decision on the future configuration of children’s heart surgery services, and I hope that that will reassure my hon. Friend.

I should emphasise that no aspect of this review is driven by money: it is entirely about how to ensure sustainable high-quality surgery. The issue is in how many and which centres surgical teams should be based in order to maintain that high-quality care.

[Angela Smith (Penistone and Stocksbridge) (Lab)]

There is a deep-rooted belief that this review is biased against the survival of the Leeds unit. Will the Minister therefore please assure the House that the decision will be made purely on the evidence, and not on the basis of any preconceived idea of which units should survive and which should not?

[Mr Lansley]

It is an independent review and I can assure the hon. Lady that that is indeed the case. It will be based on the evidence. I am sure that she will have heard the response to a debate earlier in the year by the Minister of State, my right hon. Friend the Member for Chelmsford (Mr Burns), who said that while the review has put forward options for consideration, it should not be constrained to consider only those options.

Health and Social Care Bill (Programme) (No. 2)

Angela Smith Excerpts

Tuesday 21st June 2011 Commons Chamber

[Mr Burns]

I was about to come on to what we propose to do, but I will give way to the hon. Member for Penistone and Stocksbridge (Angela Smith), and then I will make progress.

[Angela Smith (Penistone and Stocksbridge) (Lab)]

I thank the Minister for giving way.

It is not unprecedented for Bills to come back to the House having been changed by the Government, but previously the whole Bill has gone back to Committee. Why are the Government not doing that?

--- Later in debate ---

[John Pugh]

None is not the correct answer. The issue that Labour Members need to understand is that the NHS, as a result of the Budget that most of them voted for in 2010, needs to find £20 billion, and we cannot do that unless—[Interruption.] If it is a disgrace, it is a disgrace that the Labour party inflicted on us. We cannot do that against a background of complete and utter uncertainty, not knowing who will be running the NHS and having to find those savings. Members can check for themselves, but that is the view of the local people running their hospitals. Regardless of the merits of the legislation, they now want a decision.

[Angela Smith]

Given that the hon. Gentleman voted for the Bill on Second Reading and got that wrong, how can we be confident that he has got it right today?

[John Pugh]

If the hon. Lady checks Hansard, she will find that I did not vote for the Bill on Second Reading––okay?

A third and more consensual reason—I might now withdraw it—is that I can assure the House that, having served on the Bill Committee, it could not find a better or more informed set of individuals who are on the ball. The Opposition drilled down on every clause with laser-like precision. There are some very talented individuals sitting on the Opposition Benches, and there is still that galaxy of informed talent. They might feel, as I do, that it is a little like being sent back to the trenches, but the fact is that if that team cannot win the arguments for either accepting or rejecting these changes in the time allotted, frankly there is no hope for this House. They must approach the matter in the right spirit, although that seems somewhat in doubt. I urge Opposition Members to have confidence in their team, the timetable and the ability of the British public to judge if it all goes horribly wrong, but it will not go horribly wrong simply because of the programme motion.

--- Later in debate ---

[Mr Bone]

The hon. Gentleman makes a really important point, one that I am wrestling with before I decide how to vote. If we had a business of the House committee, that problem would not arise, because the decision would be made in public and not by the Executive, but we are where we are. To the Government’s credit they avoided Standing Orders by allowing us to have a debate—however short—today. Standing Orders called for this motion to be decided forthwith and without a debate, so the Government should get credit for that.

There are a number of issues, but an important one is whether the whole Bill should be recommitted. I can see many arguments for that, but I can see also an alternative view, which says, “You’re going to look in more detail and have more time if you look at provisions that have effectively been changed.”

The Government talk about moving 160 amendments, and the Opposition will move amendments, but I hope that in Committee Back Benchers will do so, too. The problem for the Committee’s Chairmen is that they will have to consider how to deal with those amendments that are approved and consequential to earlier parts of the Bill, but I think that they will do so sensibly.

I have some doubts about the same people being on the Committee. I volunteered to sit on it and wrote to the Chairman of the Committee of Selection. There is an argument for fresh faces on the Committee, but the really important point is how Members on both sides behave in Committee. If they go there to scrutinise the Bill, if they are willing to table sensible amendments and if they vote according to their conscience and not on party lines, we will have real scrutiny.

[Angela Smith]

I appreciate what the hon. Gentleman says, but under the programme motion the Bill has to be completed by 14 July, meaning a maximum of 12 sittings. How can that possibly be adequate time to scrutinise the changes being brought forward?

[Mr Bone]

The hon. Lady asks another important question on which we as parliamentarians have to decide today. As I have said, I am against programme motions that include end dates; I am against programme motions anyway. We could recommit the Bill without including a timetable on when it must leave Committee, but unfortunately we live in this world and that tactic was invented not by my right hon. and hon. Friends on the Treasury Bench, but by the previous Government—[Interruption.] The hon. Member for West Ham (Lyn Brown), the Opposition Whip, who of course did not actually say anything, makes the point that two wrongs do not make a right, and I agree.

I know other Members want to speak, but I wish to return to my previous point. If Committee members, at least those on the Government side, vote according to their conscience and are not whipped, we will have a much better Bill. Of course, that is what the Prime Minister said in his famous speech on 26 May 2009, but I encourage such behaviour, because, if the Government do not like any amendments that are carried, they can always reverse them when the Bill returns to the House on Report.

NHS Future Forum

Angela Smith Excerpts

Tuesday 14th June 2011 Commons Chamber

[Mr Lansley]

My hon. Friend will know that many of us in the House were deeply frustrated in the past that Ministers would say at the Dispatch Box that primary care trusts were responsible for local decisions, and then nobody found locally that the PCT was in any practical sense accountable to them or the population they represented. In future, there will be proper accountability: clinical accountability through the commissioning groups and democratic accountability through local authorities.

[Angela Smith (Penistone and Stocksbridge) (Lab)]

Will the Secretary of State apologise to the people of this country for a botched process that will lead to nothing but chaos and confusion in the NHS?

[Mr Lansley]

I think the hon. Lady should read the NHS Future Forum report where she will find that right across the service there is support for the principles we set out, and agreement that change is necessary. I do not know where she imagines that change will come from if not by going through a process of the kind we have engaged in.

Future of the NHS

Angela Smith Excerpts

Monday 9th May 2011 Commons Chamber

[Mr Lansley]

It was also a period during which complaints to the NHS reached their highest ever levels. If we ask the public who they think are best placed to design the services patients need, we will find that the answer is their general practitioners, hospital doctors and nurses, not politicians on either the Government or the Opposition Benches. This is about doctors and nurses being in charge, not politicians.

It took this Government to focus on cancer outcomes. It took this Government to provide the drugs patients need through the cancer drugs fund. Under Labour, patients went without new cancer medicines that patients in every other European country were getting access to. It is this Government who are investing in more diagnostic equipment, and more screening and early diagnosis, so that we get better outcomes.

[Angela Smith (Penistone and Stocksbridge) (Lab)]

I must say that I admire the consistency with which the Secretary of State defends his proposed legislation. However, will he tell us what he plans to concede, given the threatened veto by the Deputy Prime Minister and the Liberal Democrats?

[Mr Lansley]

I do not want to correct the hon. Lady, but everything I have been saying up until now has been about defending the NHS and defending our focus on delivering better results by giving the NHS greater front-line devolved responsibility. That is not a matter of debate and disagreement between the coalition parties; we are all in favour of that. The point is this: how can the Bill best support the principles on which we are agreed? I thought the right hon. Member for Wentworth and Dearne and the Labour party were agreed on those principles; that seemed to come out from his interview last week. Indeed, at the end of his speech today I was not quite sure whether or not he agreed with us.