Warm Homes Healthy People

Anna Soubry Excerpts

Thursday 22nd November 2012 Written Statements

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

This is to inform the House of the award of funds from the warm homes healthy people fund (WHHP) 2012.

On 13 September 2012, the Department issued a circular to upper-tier local authorities in England inviting them to apply for funding from the WHHP.

The aim of the WHHP fund of £20 million is to support local authorities and their partners in reducing the levels of death and morbidity in England due to cold housing in the winter of 2012. With this funding, local authorities and their partner organisations are encouraged to undertake a variety of projects to support a range of national and local initiatives.

The Department, along with other Government Departments, already provides a range of advice and support to help individuals, families and carers to prepare for cold weather, including the “Cold Weather Plan for England 2012” published on 26 October 2012, which is available at: www.dh.gov.uk/health/2012/10/cwp-2012/.

The evidence that the annual cost to the NHS due to cold private housing alone is over £850 million is compelling. More work is underway to improve the health and well-being of the most vulnerable, and the WHHP provides support to help vulnerable people deal with winter weather.

A list of successful proposals detailing recipients of the funding from the warm homes healthy people fund for this year has been placed in the Library. Copies are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office. We are able to provide funding to 149 out of 162 local authority proposals.

Because of the success of the WHHP fund last year, we were oversubscribed with suggested proposals for 2012, and have had to reduce the funds provided across the board by 19% to stay within the limit of the total fund.

The process is similar to that of last year’s fund so that funding goes to local authorities quickly, in time to make a real difference this winter. Proposals display co-operation with local partners, from the voluntary and community sector, who have been fully engaged in the bidding process, as they will be with the delivery of the projects.

Social Science Research Committee

Anna Soubry Excerpts

Friday 9th November 2012 Written Statements

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

The Food Standards Agency (FSA) has commissioned an independent review of the Social Science Research Committee (SSRC) in line with the Cabinet Office requirement that all non-departmental public bodies (NDPBs) should be reviewed every three years. The SSRC is an advisory NDPB which provides the FSA with independent expert advice on the use of social science evidence. The review will be carried out by Helen Lucas (Lucas Associates Ltd), an external independent consultant and will be complete by the end of December 2012. The review process will include consultation with the committee chair and members, key stakeholders and the FSA chief scientist. The report of the review together with the responses to the review recommendations from FSA and the SSRC will be published on the FSA’s website in July 2013.

The main objectives of the review are to assess:

whether there is a continuing need for the function provided by the committee;

whether the role, remit and the status of the committee is clearly defined and appropriate to provide this function and to ensure it has the most impact and value;

the methods of operation and effectiveness, including committee’s terms of reference and composition and the openness and transparency of its procedures (including with reference to the standards set out in the CoPSAC¹ and the good practice guidelines²);

the relationships between the committee, the commissioning Department and other bodies with related responsibilities (in particular the other scientific advisory committees that advise the FSA);

the implementation of the recommendations from the FSA’s 2002 report³ on the review of scientific committees, the revised code of practice for SACs and the current governance structure; and

adherence to the principles laid out in the 2005 Royal Society Report⁴ on potential social science insights for risk assessment.

This review is part of the FSA’s rolling programme of independent reviews of the Scientific Advisory Committees (SACs) that advise the FSA.

Notes:

¹http://www.bis.gov.uk/assets/goscience/docs/c/11-1382-code-of-practice-scientific-advisory-committees.pdf

²http://www.food.gov.uk/multimedia/pdfs/goodpracguide.pdf

³http://www.food.gov.uk/multimedia/pdfs/CommitteesReview.pdf

⁴http://royalsociety.org/uploadedFiles/Royal_Society_Content/Influencing_Policy/Themes_and_Projects/Themes/Governance/fsa_final.pdf

Regional Pay (NHS)

Anna Soubry Excerpts

Wednesday 7th November 2012 Westminster Hall

[Mr Ben Bradshaw (Exeter) (Lab)]

I am pleased to see some of my west country colleagues here and to see the Minister in her place.

In May, the BBC asked the Deputy Prime Minister about regional pay, and he could not have been clearer:

“There is going to be no regional pay system. That is not going to happen.”

Yet, as we speak, plans are under way at 20 of our biggest hospitals and mental health trusts in south-west England to introduce just such a regional pay system. The organisations involved include the main hospitals in Exeter, Plymouth, Truro, Taunton, Yeovil, Poole, Bath, Bournemouth, Bristol, Gloucester and Salisbury. In total, more than 88,000 NHS staff in the south-west are affected.

Early this summer, the trusts announced their intention to form a pay cartel and to move away from the national pay negotiating process known as Agenda for Change. They committed £10,000 each to spend on business consultants to help them draw up their plans; they employed lawyers; and they set up a website. Based on the initial proposals, the trade unions, royal colleges and other organisations representing staff estimate that nurses and other NHS staff in the south-west could face a 15% pay cut, as well as changes to their holiday and other entitlements. The cartel has threatened to sack and re-employ staff to force through its plans.

I have to tell the Minister that, in my more than 17 years in this place, I have never received as many letters and e-mails expressing such anger and dismay as I have on this issue. Here is a taste of just some of them. A senior nurse in Exeter wrote to me, saying:

“My staff are at breaking point. I predict a mass exodus and patients will not receive safe high quality care.”

Another constituent wrote:

“Myself and my care workers are sick with worry over this and how I will be able to look after my family.”

Another wrote:

“I am the sole provider for a family of six and do two other jobs on top to cope. This will be the final straw.”

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

I thank the right hon. Gentleman for giving way so early in his speech. Will he undertake to share all those e-mails and letters with me so that I, too, can write to all his constituents to assure them of the Government’s plans?

[Mr Bradshaw]

I am not prepared to reveal the identities of those people without their permission. I have already written to the Secretary of State and his predecessor, and I will come in a moment to the way that they responded, which was totally unsatisfactory. However, I have given the Minister the gist, and I hope that she is not challenging the veracity of my constituents’ concerns.

Another constituent wrote:

“Myself and many nurses are planning to leave or move abroad if this happens.”

Finally, another wrote:

“I have not worked a single shift without working late or missing my break. This has sent staff morale to rock bottom.”

It is clear from the testimony of my constituents—loyal NHS staff—that even before this plan is implemented, the mere discussion of it is having a devastating impact on morale. As the Minister will know, staff morale is an invaluable and extremely precious commodity in the NHS. There is a clear correlation between high morale and safe and high-quality care. Most NHS staff go the extra mile in their jobs, but they have already had two years of pay freezes, and doing unnecessary and avoidable damage to staff morale will inevitably affect the quality and safety of patient care.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

It is a pleasure to serve under your chairmanship, Mr Crausby. I congratulate the right hon. Member for Exeter (Mr Bradshaw) on securing the debate, although it does not seem to have been much of a debate, in the sense that no one else made a speech, although I am grateful for the interventions. I noted with great care—which is why I intervened on the right hon. Gentleman—his claim that he has had more e-mails and letters on the topic than on any other topic in his 17 years in this place. That is an astonishing achievement.

[Mr Bradshaw]

The Minister is quoting me inaccurately.

[Anna Soubry]

I am so sorry.

[Mr Bradshaw]

I said I have never received so many e-mails of such strength of feeling, individually written, that were not part of a campaign such as on hunting, but were from individual, hard-working staff in the NHS writing to me about their experiences and their anger. The Minister should take note of that.

[Anna Soubry]

I am extremely grateful for that clarification and I take note. My offer remains: if the right hon. Gentleman would be so good as to contact all those people who wrote to him and seek their permission—in my experience hon. Members often do not need to seek such permission from someone who has contacted them, but simply pass messages on to the Minister—I will happily reply to every one of them, explaining the Government’s view on the matter. I very much hope that the right hon. Gentleman, too, will share my comments today with all the people who have contacted him.

First, I pay tribute to everyone who works in the national health service, for their continuing hard work and dedication to the NHS. The Government have made it clear that they support the continued option of national terms and conditions in the NHS. We expect most employers will want to continue to use them, provided that the terms remain fit for purpose and affordable. However, every pay system needs to be kept under regular review, to ensure that it remains sustainable. The responsibility for that, in respect of the Agenda for Change pay system, rests with the NHS Staff Council, a partnership of NHS employers and trade unions. The council has been considering the possibility of changes to the national terms of the Agenda for Change for about two years. Indeed, I understand that the right hon. Member for Leigh (Andy Burnham) asked them to explore the possibility of more

“flexibility, mobility and sustained pay restraint”

as long ago as 2009, when he launched “From good to great”, but there was no change then, and we are still waiting for any change.

The trade unions tell us that we should stop the south-west consortium—and the right hon. Member for Exeter makes the same point—until we can see whether a national deal is achievable. However, experience suggests that that would be a battle of hope over experience. Negotiations in the current economic climate are not easy and they are not helped when some smaller unions have already declared that they will not support any change. They prefer to stick their head in the sand and put NHS organisations and their members’ job security at risk, rather than engaging in any meaningful way. There is no point believing that the Government can wave a magic wand and make the financial pressures disappear.

[Kerry McCarthy]

When did the Department of Health first find out about the formation of the consortium? When I have written to Ministers in the past, all that I have been told by way of response was factual information about when the document was leaked to the press. They have refused to answer that question about whether they were involved in setting up the consortium, or encouraging people to set it up before it was formed.

[Anna Soubry]

I believe we were not, but I will make further inquiries of my officials, and we will write to the hon. Lady and give her assurances about that. If I am in any way wrong I know that I will be corrected, and will be happy to say so.

It is my understanding that several options have been put forward. No decisions have been made, but every effort is being made to engage with the staff to reach an agreement. I just wish that all the trade unions that represent so many people in the south-west consortium would engage in that process. It is my firm view that that is the absolute duty and aim of all responsible trade unions.

[Andrew George]

It is my understanding that the cartel is not entirely engaging with the unions in the way that the unions believe it should. What powers do the Government have to intervene in the activities of the cartel, within the powers and guidance that were conveyed to them by the previous Government in the regulations?

[Anna Soubry]

I hope to answer those points in my speech, in the time available to me. If I do not, I will of course write to the hon. Gentleman and answer those questions in full.

I want to talk about the financial situation in the national health service. We have already guaranteed the NHS preferential funding for the current spending review, ensuring real-terms growth every year and additional cash of more than £12 billion per annum by 2014, going into 2015. We are driving up £20 billion of quality, innovation, productivity and prevention savings, stripping out bureaucracy, cutting management costs by up to one third and shifting resources to front-line services. To be blunt, we cannot spend more on public expenditure without putting our national financial reputation at risk. We must demonstrate that we have the commitment to ensure that our economy is sustainable.

The south-west consortium faces a stern choice. It can either continue to ignore the problem, and hope that it will go away, or it can face the challenge, share it with its staff and their representatives, and work in partnership to achieve the best outcome for everyone concerned, especially patients. I used to be a shop steward and a member of the National Union of Journalists. I understand and value the role of good partnership working with staff and trade unions. I believe that the south-west consortium is taking a mature approach. It published two discussion documents in August, setting out the scale of the financial and service challenge that it faces. It has not made any decisions. It has produced a paper, setting out a wide range of options for changes to terms and conditions, and how they might help. It has included options affecting all staff, including doctors, so that every opportunity is considered, no stone is left unturned, and there are no sacred cows. I believe that that is a responsible approach.

The consortium reaffirmed its commitment to national terms and conditions and agreed not to put any proposal to its boards until December, allowing reasonable time for the conclusion of national negotiations on a possible agreement to make Agenda for Change changes sustainable. I believe that that, too, is responsible.

[Mr Bradshaw]

The Minister sounds, from what she is saying, and what she said a little earlier, as if she supports the south-west cartel, which is an interesting development in Government policy; but she also says that she wants progress at the national talks. How does she think that having a parallel negotiation going on in one region will help her to get agreement at national level?

[Anna Soubry]

I absolutely support anyone who takes a mature and sensible approach to the matters. I also understand why the south-west consortium—like many others, no doubt—is frustrated, because a two-year set of negotiations continues when it should have reached an agreement. The trade unions must take a responsible approach to ensuring that we have a national health service that is sustainable. It is in the interests of their members, and they are meant to represent their members, whose interests they should put first.

The consortium has published two discussion documents. What is our attitude and what are we to do as a Government? To be clear, we support national terms and conditions of service, but not at any cost. Individual employers must have the right to exercise the freedom, which the Labour Government gave foundation trusts in 2003, to be free of ministerial control. That is what the previous Government did.

[Mr Robert Buckland (South Swindon) (Con)]

Having been contacted by many concerned constituents about the matter, I took the trouble to meet my local NHS trust chief executive to discuss those concerns and put them directly to her. Will the Minister assure me that the worrying spectre of a monolithic regional pay structure that would ill-suit employees in Cornwall as much as in Wiltshire will not be welcomed by the Government?

[Anna Soubry]

I agree with my hon. Friend. Monolithic structures would not be welcome. What is welcome is when trusts take a responsible view to ensure that they act in the best interests of their employees and that they have a financially sustainable system. That is in the interests of everyone—staff and patients.

[Andrew George]

Following my intervention on the right hon. Member for Exeter, he responded that the only flexibility is to exceed existing pay and conditions, not to go below them. Is that also the Minister’s understanding?

[Anna Soubry]

My understanding is that foundation trusts—the hospitals—have powers and a great deal of autonomy. That was the system set up and backed throughout by the previous Government, and it continues today. NHS employers are better placed to decide how best to reward and motivate their staff for the benefit of patients. They are better placed to assess whether national terms are fit for purpose or sustainable in the light of local competition, and to assess the options and risks of any recruitment or retention problems that might follow from introducing local pay. Such decisions should not be, in my view, made by Ministers.

Some Members have expressed concern that it is not fair to pay different rates for the same job in different areas, as it could undermine recruitment or morale. I understand and appreciate the arguments advanced by many people and the concerns raised by those on both sides of the House. However, if that was the case, one might have thought that the Labour Government should not have included high-cost area supplements or recruitment and retention premiums when they introduced Agenda for Change in 2004, and that they should not have abolished the right of the Secretary of State to direct foundation trusts in 2003. The Labour party gave those powers to employers, and I make it quite clear that they were right to do so. We now have to trust employers to exercise their judgment wisely and to use the skills and expertise of their non-executive directors to consider what is in the best interests of their patients. We have to recognise that they know what rates of pay are fair and necessary in their local communities.

The Opposition need to allow the system that they created to work, without the political interference and micro-management that typified their term in office. If they want to do something useful, they should encourage the trade unions—those that fund many of their Members of Parliament—to ensure a swift and successful conclusion to national negotiations. That will secure the Agenda for Change as a sustainable option for employers and staff alike. Above all, it will put patients first and foremost.

Polycystic Kidneys

Anna Soubry Excerpts

Tuesday 6th November 2012 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

I congratulate the hon. Member for Bridgend (Mrs Moon) on securing the debate; I know that this is an issue she campaigns on regularly. I pay tribute not only to her work, but to the excellent work of the Polycystic Kidney Disease Charity right across the UK in raising awareness of the condition and supporting those with it. I am of course more than willing to meet her and the charity and look forward to doing so. I think it will be a very worthwhile meeting.

I will do all I can to answer the hon. Lady’s many questions and deal with her requests, and not only in my remarks this evening, because, as she knows, I will not be able to respond to everything tonight. It might well be that a letter can deal with her questions, so I will certainly take away all she has said. I hope to give her some assurance about the work that is being done. As I know she understands, I can respond only as the Minister responsible in England, because health is a devolved matter. I am confident that she will raise these matters with the Welsh Assembly.

The Welsh Assembly Government—we have made inquiries—published in April 2007 a national service framework and policy statement, “Designed to Tackle Renal Disease in Wales”. Improving the quality of care for people with renal disease, or at least at risk from it, is the cornerstone of that policy statement and of the national service framework—the NSF.

In 2008, the Welsh Assembly Government issued a further three-year strategic framework, for 2008 to 2011, setting out the key interventions required of the NHS in Wales in implementing NSF standards. In England, we have successfully introduced a number of programmes to change outcomes for people with kidney disease. For example, we have introduced into the quality outcomes frameworks—known as QOF—the identification and management of chronic kidney disease and the inclusion of chronic kidney disease in the NHS health checks programme. Having raised awareness of chronic kidney disease in primary care, we now have 2.3 million people on primary care registers in England, but we want to do still more.

The NHS health checks programme is being rolled out across England this year and next. The programme invites everyone between the ages of 45 and 74 to a vascular health check. It is estimated that up to 20,000 cases of diabetes and kidney disease will be detected earlier every year. Such early identification is key to the better management of people with these conditions and ensuring they receive optimum treatment and improved outcomes.

On the particular issues raised about polycystic kidney disease, unfortunately, as the hon. Lady mentioned, PKD is not preventable; it is a genetic disorder. I pay tribute to how she has relied on the various experiences of her constituents and others connected with her work to explain with great compassion and care how the disease affects so many people and to set out its awful nature.

I am pleased to hear that international studies are currently under way, three of which are being hosted by the National Institute for Health Research, looking at the viability of new drug therapy and disease management to give improved quality of life for those with PKD. I very much heard the hon. Lady’s comments about clinical drug trials and the gathering of data. As she said, the £50,000 cost seems large, but it may be argued that in the overall sum of things it seems like a drop in the ocean, although of course I cannot make any promises. I am sure that somebody somewhere will take that on board and we will explore the matter more when we meet.

The hon. Lady asked for increased access to radiological and ultrasound scanning, and rightly so, and I would welcome the development of guidelines about best practice in that area. I know that a quality standard for chronic kidney disease was published last year by the National Institute for Health and Clinical Excellence. That sets out what high-quality, cost-effective care looks like so that commissioners and providers can assess standards of care and target improvement efforts where they are most needed.

The NICE quality standard clearly states that patients with a genetic family history of PKD over 20 years of age should be referred to secondary specialist care. Chronic kidney disease, or CKD, is associated with reduced quality of life. Quality of life varies depending on the disease stage, medical management and the presence of co-morbidities and complications. It is crucial, therefore, that those diagnosed with PKD have access to specialist care to help them deal with this long-term condition and to support them and their families emotionally. As we have heard, it is a genetic disorder.

[Tracey Crouch]

The Minister will have heard from my intervention that a constituent of mine suffers from polycystic kidneys. He was recently assessed under the Work programme as fit for work despite suffering from that horrific condition. The decision has been reversed, as there is now proper understanding of the condition and its impact on his ability to work. However, will the Minister work with the Department for Work and Pensions in issuing guidance so that unnecessary pressure is not put on people suffering from this debilitating disease during assessments?

[Anna Soubry]

I thank my hon. Friend for that helpful intervention; as ever, she makes a good case. I will take the issue up and explore it further. If she will be good enough to put her points in a letter, that will help me in my consultations and discussions with the Department for Work and Pensions.

We estimate that up to one in 1,000 of the population has PKD globally. Based on that estimate, more than 60,000 people in the UK are at risk of developing PKD. However, we do not currently collate centrally the numbers of people with PKD in England, a point raised by the hon. Member for Bridgend. I will ask the national clinical director for kidney disease to see what further action can be taken accurately to determine national incidence in England.

If the hon. Lady is good enough to make the same representations to the Welsh Assembly and indeed the Scottish Assembly, we will have a far better picture of the situation throughout the United Kingdom. [Interruption.] I should also include Northern Ireland, of course, as the hon. Member for Strangford (Jim Shannon) is urging me to do. Looking at the care received by people with polycystic kidney disease, most patients are seen in general renal clinics, and they may receive little or no genetic counselling or specific disease management advice, or a thorough needs assessment. I am aware that in the early stages there may be no symptoms, and sometimes the cysts may not be noticed until adulthood or through family screening. However, some children present early with symptoms that can be confused with another form of PKD called, as the hon. Lady said, autosomal recessive PKD. The common symptoms will vary by individual and may include back or abdominal pain, recurrent urinary infections or blood in the urine, kidney stones, and kidney failure.

People with polycystic kidney disease can require special consideration for dialysis and transplantation due to the nature of their disease and size of the cysts. I welcome all the comments made by the hon. Member for Strangford about transplants and donors and the urgent need to make sure that more people donate their kidneys—indeed, all their organs.

[Glyn Davies (Montgomeryshire) (Con)]

Does the Minister agree that we have a duty as parliamentarians to do everything in our power to increase the level of organ donation? Does she also agree that we should implement every recommendation of the organ donation taskforce? It is working very well, but we need to move quickly to maximise the number of organs available.

[Anna Soubry]

I absolutely agree with everything that my hon. Friend says. I was horrified to discover in a recent meeting that unfortunately in England we are not making the progress on organ donation that we should. It is a serious problem. We know that so many lives can be saved or seriously improved if people are good enough to indicate that they are willing, on their death, for their organs to be donated.

Let me go further and say this: of course I understand why, when somebody dies, the family struggle in their bereavement to give permission to allow the loved one’s organs to be donated. However, I urge people to do so, even in those very difficult situations. It is a most wonderful way to create a real legacy by enabling somebody literally to live on through someone else. If more people could, in those dark moments, see that, it would make a profound difference to improving, and indeed prolonging, lives.

[Jim Shannon]

I thank the Minister for her pertinent words about transplants. I understand that when people renew their driving licence there is a box they can tick if they want to be on a donor register for the rest of their life. It is a painless exercise that commits them for ever and provides the authority for all their bodily items to be transplanted. Given that it is so easy to tick that box, perhaps more of those who are renewing their licence should do so to say, “Yes, I want to be a donor.”

[Anna Soubry]

The ability to do that is a golden opportunity for people, and I wish they would take it. One of the problems, though, is that someone applying for a licence will think, “Well, I’m applying for a driving licence and I can’t deal with all that now; I’ll come back to it another day”, and unfortunately they do not return to it having got their driving licence.

I would very much welcome a serious look at how we can solve this problem by campaigning harder to ask people to tick the box, make their views known, and speak to their families. Each and every one of us should talk among our families about the things that we want on our death. I know that these are difficult subjects, but this is, as we all know, a wonderful legacy that people can leave which makes a huge difference to the quality and length of the lives that people could lead.

As provision could be improved with the introduction of evidence-based best practice guidance both at diagnosis and for the management of people with polycystic kidney disease, I will ask my officials to raise this with the appropriate agencies to see what further actions can be taken.

I pay tribute to the hon. Lady and all those who have contributed to this debate, and thank them for drawing attention to this specific and important disease area. I also congratulate those at PKD Charity on all their hard work. I look forward to meeting them and the hon. Lady to make sure that we raise the profile of polycystic kidney disease.

Question put and agreed to.

Induced Abortion

Anna Soubry Excerpts

Wednesday 31st October 2012 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

It is a pleasure to serve under your chairmanship, Mr Crausby. I congratulate my hon. Friend the Member for Mid Bedfordshire (Nadine Dorries) on securing this debate on a subject in which she has a long-standing interest. I have listened to the views expressed by Members, and I acknowledge that many of them are deeply and strongly held. The nub of both sides of the debate is best encapsulated by the speeches of the hon. Member for Feltham and Heston (Seema Malhotra) and my hon. Friend the Member for Congleton (Fiona Bruce). They gave speeches based on their beliefs, knowledge and sound arguments.

[Nadine Dorries]

Will the Minister give way?

[Anna Soubry]

Forgive me, but I want to make progress, because the clock is against me. I will give way when I have made some points. In the short time available, it is important that I make some of the main points in my speech.

It is right that abortion is a matter of conscience. It is important to respect the views of all individuals and accept that we have different views, whichever side of the political fence we sit on. My hon. Friend the Member for Southend West (Mr Amess) reminded us that certain Cabinet members have expressed their own views on the upper limit for legal abortions. They all made it clear that those are their own personally expressed views. I want to make it quite clear that, notwithstanding the fact that some Cabinet members may want a reduction in the upper limit, the Government have no plans to bring about a change to the time at which an abortion can be carried out. I want to stress that point again, so I repeat: we have no plans to review the Abortion Act 1967.

We are by no means complacent. When I was fortunate enough to be made a Minister, I made it clear that in the time I am in office I want a reduction in the number of abortions. We all want that, but there is a debate about how we best achieve it. I take the view that we best achieve it through better contraception and by empowering our young men and women to make the choices that they want to make, if they have a sexual relationship.

[Naomi Long (Belfast East) (Alliance)]

Will the Minister give way?

[Anna Soubry]

I will, but I want to make these points because they are important. I want better counselling services—

[Nadine Dorries]

Will the Minister give way on that point?

[Anna Soubry]

I will. I also want more work done on why so many women have more than one abortion, which is of great concern to people on both sides of the argument. There is a lot of work to be done.

I want to say something on counselling that may interest my hon. Friend the Member for Mid Bedfordshire in particular. As the new Minister with responsibility for this matter, I have carefully considered how we move forward on abortion counselling. I believe that the best way forward is about contraception, how we reduce the repeat abortion rate, how we empower young men and women and how we improve abortion counselling services for women generally. A committee was formed as a result of the measures that my hon. Friend tried to introduce. There is also a cross-party inquiry into unwanted pregnancy, led by my hon. Friend the Member for Hastings and Rye (Amber Rudd). I commend that. They will do important work and hear important evidence, but the simple reality is that we therefore no longer plan to undertake a separate consultation on abortion counselling. I am sorry if that disappoints members of the committee.

For the purposes of transparency, I will today place in the Library a short document on abortion counselling, representing the great work done by my predecessor, my hon. Friend the Member for Guildford (Anne Milton). I pay tribute to the work she did when she was Minister for Public Health, and to the cross-party committee, which looked at counselling arrangements for women requesting an abortion. I am extremely grateful for the work it did, and I thank its members for their efforts. I am sorry if there is disappointment, but we do not intend to change the law, so a separate consultation would be an otiose exercise.

[Nadine Dorries]

It is not a case of changing the law, but changing the Government’s commitment. The Government made an absolute commitment to consult. In fact, the British Medical Association moved a motion in agreement. Why have the Government changed their mind about the consultation on non-compulsory independent counselling?

[Anna Soubry]

The committee has done some good work. I do not think that it would be right to take the matter any further. I am sorry if that disappoints people, but that is my view. I can see no purpose in a consultation, because we do not intend to change either the law or the guidelines.

As the committee identified, counselling services throughout the NHS are patchy. That is not acceptable. It also decided that it is of primary importance that there are no delays when a woman seeks a termination of her pregnancy. That is why it is important that if a woman is going to have a termination, she does it as quickly as possible. The group was in unanimous agreement on that, which I welcome. There is other work to be done on counselling, but I take the view that that is not the primary issue that we should address, which is why I made the decision I did.

[Naomi Long]

Everyone, whether pro-life, like me, or pro-choice, agrees that we would like a reduction in the number of abortions. Does the Minister have any concerns that the policy of limiting child-related benefits to two children could increase the financial pressure and stress on people who find themselves pregnant, thus driving up the number of abortions, rather than reducing it?

[Anna Soubry]

No is the simple answer, but I am happy to discuss it further with the hon. Lady.

In the short time I am allowed, I want to talk about viability, bearing in mind the points made by my hon. Friend the Member for Mid Bedfordshire and the helpful interventions of the hon. Member for Feltham and Heston. The current clinical evidence shows that although there have been medical advances in caring for premature babies, only a small number of babies born at under 24 weeks’ gestation can survive, and there may well be questions about their quality of life. Most have severe problems. The situation markedly improves at 24 to 25 weeks, which reaffirms why the limit of 24 weeks was chosen.

Results from the EPICure study, which looked at the chances of survival and later health status of children born at less than 26 weeks, show that survival to discharge was 0% at 21 weeks, 1% at 22 weeks, and 11% at 23 weeks. Of the two children in the study born at 22 weeks’ gestation who survived to discharge, one had severe disability and one had mild disability at 6 years of age.

The British Association of Perinatal Medicine stated, in evidence to the 2007 Select Committee on Science and Technology inquiry on abortion, that it was concerned that lowering the legal definition of viability would imply that quality of survival has improved for infants below the present limit of 24 weeks. The evidence for the UK population to date does not support that.

Even though some babies have survived at a very early stage, the threshold of viability cannot be continually pushed back, because there is a limit beyond which the lungs will simply be insufficiently developed to sustain life. Although embryonic lungs start to form as early as four weeks into a pregnancy, their maturation continues until the end of a normal pregnancy. Recent data published by the Office for National Statistics show that 0.1% of live births occurred at less than 24 weeks, and the mortality rate for those babies was 877.3 deaths per 1,000 live births.

We are right to ask why women have late abortions. Women who have such abortions do so in the most extreme situations. They work with their doctors, nurses and loved ones to make what must be the most difficult choice that any woman, or her partner, will ever face. We have heard why so many hon. Members feel that the current 24-week limit should be retained, and why others feel strongly that the limit should be reduced. I personally support the retention of the 24-week limit, but my priority is to reduce the number of women who turn up at a clinic or doctor’s surgery seeking a termination.

My hon. Friend the Member for Gainsborough (Mr Leigh) spoke about the pain and suffering of women who undergo termination of a pregnancy, but perhaps he forgets the pain, suffering and mental distress of women who found that the law did not allow them that choice. My priority is ensuring that women have informed choice, and that we have fewer abortions.

Leeds Children’s Heart Surgery Unit

Anna Soubry Excerpts

Tuesday 30th October 2012 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

Here we are again. It is a pleasure to speak under your chairmanship, Mr Hollobone. It is about a week since we had a very similar debate, also under your chairmanship. That has already been described by my right hon. Friend—sorry, I always call my hon. Friend the Member for Pudsey (Stuart Andrew) the right hon. Member for Pudsey. [Hon. Members: “Soon!”] Perhaps I am trying to elevate him too soon, but as he has explained, we had a similar debate only last week about the situation at Glenfield. I join everyone else in paying tribute to him for securing this debate.

I pay tribute to all hon. Members who have spoken, of whatever party. In many ways, this has not actually been a debate, because normally in a debate there is a degree of disagreement and people put forward their arguments for or against a particular motion or notion, but that has not been the case in this debate. Here, we have had an outbreak of complete unity, which I acknowledge, between all political parties. It is right and proper that, on this matter, people come together, are not divided by political party and are determined not to score any form of party political point in making their argument. All hon. Members have come to this debate for the right reasons. They have come to represent their constituents and to put forward all the arguments that they can on behalf of their constituents and with full force. That is absolutely right and as it should be, but I want to make this point as well, and not because I am any form of coward—after all, I spent 16 years defending, largely, the indefensible.

I have to say that the hon. Member for Denton and Reddish (Andrew Gwynne) was treading somewhat on my good humour with some of his remarks when he was asking me for my opinion because, as we all know, this whole review has taken great pride in the fact that it has been an independent review—independent of Government. It was set up, quite properly, by the last Government, on a cross-party basis, and it was on the basis that we needed fewer but larger and more specialised children’s heart services in England. It was accepted—I say this with great respect to my hon. Friend the Member for Cleethorpes (Martin Vickers)—that that was the basis of it all and that it was being done so that we could secure the best children’s heart services for babies and young children that we could possibly obtain, and so that we could ensure that those services were sustainable. We wanted to concentrate the specialist heart surgeons in a smaller number of centres to ensure that they had the best skills for dealing with babies and young children.

At the end of the day, we are talking about arguably some of the most specialised surgery that exists. There are instances in which surgeons are operating on a baby’s heart that is no bigger than a walnut. As I say, it is perhaps the most specialised and the most precarious of all types of surgery, so their skills have to be the best. It is also the case that if we have fewer, but larger, more specialised units, we can ensure that those surgeons, those doctors, those nurses and the other health professionals are training the future surgeons, doctors, nurses and other health professionals to do this very important and highly specialised work.

I pay tribute to my hon. Friend the Member for Pudsey. As we would all have expected, he advanced a thoughtful, well researched and sound set of arguments on behalf of his constituents. He gave the examples of Lauren, Libby and Abi. The hon. Member for Scunthorpe (Nic Dakin) also spoke with considerable feeling about what his constituents had told him. That is only right and proper. I am sure that all those constituents will welcome the comments of their Members of Parliament in advancing their arguments for keeping their children’s heart surgery unit open. It is quite clear from the various interventions that this has all-party support. We heard from my hon. Friend the Member for Shipley (Philip Davies), the right hon. Member for Leeds Central (Hilary Benn) and my hon. Friends the Members for Skipton and Ripon (Julian Smith) and for Brigg and Goole (Andrew Percy). As I said, people are coming together, whatever political differences they might otherwise have, in agreement and in support of children’s heart surgery at Leeds general infirmary.

A number of matters strike me from the speeches that have been made. In addressing some of the remarks made and arguments advanced by hon. Members on both sides of the Chamber, I shall try to give a response that perhaps allays some fears and certainly answers some questions.

[Fabian Hamilton]

I am sorry to intervene when the Minister is about to give those responses, but she said that the review, quite rightly, was independent; it was set up by the previous Government to be independent of Government. I think that the prevailing view this afternoon is that it was not impartial. Will she comment on that?

[Anna Soubry]

I will not comment on that, quite deliberately, because it is imperative that I am seen and, indeed, fellow Ministers are seen to be completely independent and impartial ourselves. Of course, that does not prevent hon. Members from making their own judgments and vocalising them, and there may be merit in them, but it is not for me to say whether there is, because, as hon. Members know, this has all been referred to the Independent Reconfiguration Panel—that is right and proper, in my view—and it will look at all aspects of how these decisions have been made. It will take evidence not just from the NHS, clinicians and local authorities, but from Members of Parliament. I am in no doubt that all hon. Members who are here today will make their own representations to the IRP on behalf of the children’s heart services at Leeds general infirmary and will make them with the force with which they have made them today and on the basis of as much information, sound evidence and argument as they have shown us here today.

[Julian Smith]

Will the Minister give way?

[Anna Soubry]

I was going to try to move on to some of the issues, but I will happily give way.

[Julian Smith]

I thank the Minister for giving way. Can she confirm that the panel will include some people who are actually living in the north? What is the make-up of the panel?

[Anna Soubry]

I shall be absolutely blunt: I cannot answer that question. I took a strong view some time ago that if I did not know the answer to a question, I would say so. However, I am more than happy to write to my hon. Friend and answer his question as much as I can.

Travelling times were mentioned by a number of hon. Members. I was going to go through all those who mentioned them, but I may not have time to do so. I shall just make this point. Of course, it is surgery that it is proposed will be lost from Leeds and will go to Newcastle. It is very important that all hon. Members, when they communicate to their constituents about this debate, make the point that the plan is that the surgery will take place in Newcastle, but all the follow-up, all the support and all the other things that we might imagine are involved when a baby or a small child has surgery will continue to be provided at Leeds. It is not the case that the whole thing will move up to Newcastle; it is simply the surgery. I just put that into the pot because the point was made about travelling times. Of course, it is for others to say, but it may be that they take the view that those were very good points that hon. Members advanced in the debate today.

The hon. Member for Leeds East (Mr Mudie) asked specifically about the JCPCT’s refusal, or otherwise, to disclose information. The hon. Member for Leeds North West (Greg Mulholland) spoke with passion, as ever, and commented on that, as did my hon. Friend the Member for Pudsey and other hon. Members. It is for the JCPCT to decide what information should be disclosed, in accordance with the requirements of the Freedom of Information Act. I am told that the Yorkshire overview and scrutiny committee has indicated its intention to refer the matter to the Information Commissioner, which is the established recourse laid down by legislation. I am afraid that it is not for Ministers to order the JCPCT to disclose information to the OSC in Yorkshire or any of the other local authorities involved. The various authorities are open to make applications under the Freedom of Information Act. I hope that answer deals with that point.

The powerful arguments the hon. Member for Leeds East put forward were largely based on population figures. I have already alluded to the contribution of my hon. Friend the Member for Cleethorpes. In large part, my hon. Friend and I disagree on the basis of the review. He said that different experts have different views, but I have to tell him that we have seen an outbreak of unity on this issue among many of the royal colleges, experts and leading clinicians in the field, who welcomed the decision of the JCPCT.

[Martin Vickers]

We heard from my hon. Friend the Member for Leeds North West that experts in Scotland disagree, so there is clearly some basis for doubt.

[Anna Soubry]

I am grateful for that contribution, but I know that when the JCPCT’s decision was announced, it was universally welcomed by many of the clinicians who have been involved in such specialised surgery, certainly throughout England, but I cannot comment on the views of those north of the border.

I have a short time left to speak. The Independent Reconfiguration Panel is just that—an independent reconfiguration panel. I can provide details to those who need to know its composition. It comprises independent experts, and Members can be assured that they will conduct a full and independent review. As I said, they will take evidence from NHS organisations, local authorities and local MPs. It is hoped that their deliberations will conclude at the end of February. It will then be for the Secretary of State to receive the findings and recommendations and to decide whether to act on them. There is a concern that there may be some delay due to a legal challenge.

In last Monday’s debate my hon. Friend the Member for Pudsey made a helpful intervention, to which I responded that if any local authorities in Yorkshire are minded through their OCSs to refer the matter to the IRP, they should get on and do it. I want to put that into the pot, because the one thing that nobody wants is any more delay.

This debate began back in the 1990s, and hon. Members talked about what happened in Bristol. It was determined then that we needed to ensure that our babies and young children had the finest specialised heart surgery services possible, which is why it has been a long process. It is difficult and painful, but the Safe and Sustainable review was set up on the basis that there would be a reduction in the number of units. No one wants to set one hospital against another, and I pay tribute to everyone who has avoided doing so, but unfortunately sometimes tough decisions have to be made. It is always important to remind ourselves that they are made for the very best reason, which is to ensure that our babies and young people are safe and get the very best service.

Oral Answers to Questions

Anna Soubry Excerpts

Tuesday 23rd October 2012 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

We will soon publish the final recommendations of the independent advisory committee on resource allocation. That committee reviews the approach and the formula under which money is allocated to clinical commissioning groups and local authorities so that they can fulfil their public health duties.

[David Mowat]

There have been two problems with how the formula has worked over the past few years. First, it has not placed enough emphasis on ageing as a criterion, and secondly the Department of Health has not implemented it properly, in so far as flat-rate increases have been given to primary care trusts, meaning that there has been no impact from changes. Both these things have worked to the detriment of Warrington. Will the Minister resolve these issues?

[Anna Soubry]

I am glad to assist my hon. Friend and assure him that fairness is imperative when it comes to distributing money and deciding where it goes. One reason the Government are keen to make the formula fair is our determination to reduce health inequalities, especially given the last Administration’s legacy of increased inequalities.

[Jenny Chapman (Darlington) (Lab)]

The former Secretary of State wanted to make age the only factor in the formula, which would have totally ignored poverty and the local cost of care—[Interruption.] He said it. It would have taken £295 per head away from the north-east. Will the Minister confirm that the local cost of care and poverty will be included in the formula allocation?

[Anna Soubry]

That was not my understanding of the former Secretary of State’s comments, but I can say that we are absolutely determined to ensure that fairness is achieved, and all the factors she mentions are important in ensuring that fairness.

[Mary Macleod (Brentford and Isleworth) (Con)]

9. What steps the Government are taking to improve care for people with dementia.

--- Later in debate ---

[Mark Durkan (Foyle) (SDLP)]

10. What recent progress he has made on improving early diagnosis of pancreatic cancer.

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

We are providing more than £450 million during this spending review period to help diagnose cancer earlier. In January, we are planning to pilot a general symptom awareness campaign that will be relevant to a range of cancers, including pancreatic cancer. Unfortunately, however, pancreatic cancer is often very difficult to detect in the early stages.

[Mark Durkan]

Has the Minister considered the early diagnosis summit report from Pancreatic Cancer UK highlighting that currently half of diagnoses are emergency diagnoses? It also makes strong cases for new referral pathways, risk assessment tools, direct access for GPs to investigative and diagnostic tools and the development of a National Institute for Health and Clinical Excellence quality standard for pancreatic cancer. Can we expect progress on any of these before the 2013 cancer awareness campaign?

[Anna Soubry]

I thank the hon. Gentleman for his work. I am aware of the campaign that he has been running effectively in his constituency, based on the experiences of one of his constituents. As I say, however, and as he will know, pancreatic cancer is, by its nature, a particularly difficult cancer to diagnose early. We will all, of course, remember the untimely death of Sir Stuart Bell. Unfortunately, he was diagnosed only very shortly before his death. I wish that were not as common as it is, but we are doing everything we can to improve screening. I thank the hon. Gentleman again for his campaign, and I would be happy to meet him to discuss it further.

[Liz Kendall (Leicester West) (Lab)]

Cancer networks have played a crucial role in improving patient care, including by earlier diagnosis. The former Health Secretary promised this House that their funding would be guaranteed in 2011, but the South East London Cancer Network now says its budget was cut by 40% between 2009 and 2011. This year, it has been slashed by a further 55% and its staff have been cut from 15 to eight. Will the Minister now admit that her Government have cut funding for vital front-line cancer experts and have broken their explicit promises on cancer care?

[Anna Soubry]

My information is that any 40% reduction is a result of cuts in administration—and that, if I may say so, seems the right way to go about things. This Government are determined to make sure that when we make cuts of that nature, they are not actually cuts—[Interruption.] It is about moving money around so that it goes to front-line services. This Government are determined to reduce bureaucracy in the NHS and to make sure that patients get the benefit of our spending—unlike under the last Administration, who had it round the other way.

[Tim Loughton (East Worthing and Shoreham) (Con)]

11. What steps he is taking to deliver better access to mental health services for school-age children.

--- Later in debate ---

[Dr Julian Huppert (Cambridge) (LD)]

13. What assessment his Department has made of the extent to which the cancer radiotherapy innovation fund will increase access to intensity-modulated radiotherapy.

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

The £15 million radiotherapy innovation fund is designed to ensure that from April 2013 radiotherapy centres will be ready to deliver intensity-modulated radiotherapy to all patients who need it. We are working with professional bodies and Cancer Research UK to develop a programme, including support visits, training and criteria for allocating the fund.

[Dr Huppert]

I thank the Minister for that answer and she will know that the UK’s first clinical trials of IMRT were carried out at Addenbrooke’s hospital in Cambridge, funded by the Breast Cancer Campaign, and showed reduced side effects and improved cosmetic outcomes. How many breast cancer patients a year does she think could benefit from IMRT and how will she ensure that they all manage to do so?

[Anna Soubry]

We know that 9% of all radical radiotherapy treatment should be delivered using forward-planned IMRT and that that should be used for and will benefit breast cancer patients. A survey of radiotherapy centres was carried out in preparation for the launch of the new fund that showed that 26% of radical activity was being delivered using forward-planned IMRT. The hon. Gentleman might say that that does not exactly answer his question and I am more than happy to make further inquiries and, if necessary, to write to him in full detail.

[Andrew Miller (Ellesmere Port and Neston) (Lab)]

What is the Minister doing to ensure that such investments are equally accessible to people across the UK?

[Anna Soubry]

That is important. I have recognised in the short time in which I have been in my post that there is often disparity across the country and in certain areas, frankly, the service is not as good as that in others. One of our aims is to ensure that regardless of where someone lives they will get good treatment from the NHS.

[Chi Onwurah (Newcastle upon Tyne Central) (Lab)]

14. What steps he has taken to ensure that children with profound multiple learning difficulties have their health care needs met while at school.

--- Later in debate ---

[Annette Brooke (Mid Dorset and North Poole) (LD)]

T2. What steps is the Department taking to tackle the growing incidence of drug-resistant cases of TB, which increased by more than a quarter in the past year?

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

We are funding TB Alert to raise public and professional awareness of TB. We also expect the NHS organisations and their partners to ensure early detection, treatment completion and co-ordinated action to prevent and control TB. The Health Protection Agency maintains diligent monitoring of all types of TB and the National Institute for Health and Clinical Excellence also includes specific guidance on treatment and rapid contact tracing of people in contact with any type of drug-resistant TB.

[Helen Jones (Warrington North) (Lab)]

T5. Before the last election, the Prime Minister promised a “bare knuckle fight” to save district general hospitals and promised that they would be enhanced. Now that we know that the board of St Helens and Knowsley hospitals is looking at a merger with Warrington and Halton to solve its problems, can the Minister give the House an unconditional assurance that no services at Warrington will be downgraded or removed, whether that merger goes ahead or not?

--- Later in debate ---

[Nick de Bois (Enfield North) (Con)]

T6. As breast cancer action month comes to an end, recent research by Breast Cancer Campaign has shown that 76% of women would like more information about breast cancer signs and symptoms. What steps are the Government taking to encourage early diagnosis of breast cancer?

[Anna Soubry]

Achieving early diagnosis of symptomatic cancer is key to our ambition to save an additional 5,000 lives a year by 2014-15. As I explained in an earlier answer, we are providing more than £450 million in funding over the spending review period to support early diagnosis. From January to mid March 2013, we will be running a regional pilot of our previously tested local campaign on breast cancer symptoms in women over 70. We are targeting those women because that is an area where, unfortunately, survival rates are particularly poor.

[John Healey (Wentworth and Dearne) (Lab)]

Since his promotion, the Secretary of State has said little and, I assume, read a lot. Did his starter pack include details of the Prime Minister’s promise:

“This year, and the year after, and the year after that, the money going into the NHS will actually increase in real terms.”?

Did it include Treasury figures that show there has been a real terms cut each year since the election? What is he saying to NHS staff and patients who see the cuts and see the Prime Minister’s big NHS promise being broken?

[John Stevenson (Carlisle) (Con)]

T9. The food labelling consultation closed in August. Could the Minister indicate when the Government response is likely to be issued and confirm that the Government will not bring in unnecessary burdens on the food industry over and above those set out in European regulation?

[Anna Soubry]

This is an area that is important to the Government’s work. At this stage it is important to make sure that we do not over-regulate but that we work with industry and manufacturers. The four Governments across the United Kingdom will shortly issue a statement about front-of-pack nutrition labelling, and we expect to publish the formal response to this year’s consultation within the next few weeks.

[Mr Andy Slaughter (Hammersmith) (Lab)]

The 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?

--- Later in debate ---

[Justin Tomlinson (North Swindon) (Con)]

What specific consideration is being given to matching the annual growth funding uplift to actual changes in population? That is essential to my constituency, which has high population growth.

[Anna Soubry]

It is my understanding that that is already part of the formula, but my hon. Friend makes a good point, and I am sure that he joins me in wanting to make sure that the formulas are fair, so that we reduce health inequalities. I am happy to discuss the issue with him further.

[Nick Smith (Blaenau Gwent) (Lab)]

The Public Accounts Committee says that 11 of the 144 foundation trusts across England are now in serious financial difficulty. What contingency funding is in place for those trusts, to protect patients?

Children’s Cardiac Surgery (Glenfield)

Anna Soubry Excerpts

Monday 22nd October 2012 Westminster Hall

[Jonathan Ashworth (Leicester South) (Lab)]

It is a pleasure to speak in this debate under your chairmanship, Mr Hollobone.

I pay tribute to the hon. and learned Member for Harborough (Sir Edward Garnier) for securing this debate, and I am grateful to the Backbench Business Committee for allowing us to hold it this afternoon.

The hon. and learned Gentleman, who is one of my parliamentary neighbours, spoke with typical eloquence, as is his wont, and I for one am disappointed that he no longer graces the Government Front Bench. The Front Bench’s loss is the Back Bench’s gain, and I thought that he spoke extremely well. I apologise in advance if I echo many of his points, but that indicates the cross-party support for the campaign. Although we are perhaps blessed in not having any Liberal Members in the east midlands, I am sure that, if we did, they, too, would support the campaign.

As I am sure that the Minister, who represents an east midlands seat, is aware, this issue has caused considerable concern, not only in my Leicester South constituency, but across the east midlands region. It is no surprise to those of us who have been involved in the campaign that the e-petition has hit 100,000 signatures, and I pay tribute to Adam Tansey, the father of Albert Tansey, who set up the e-petition.

There has been widespread opposition to the proposals from the Safe and Sustainable review and how they affect Leicester. The review recommended the closing of the children’s heart unit and the associated moving of Leicester’s world-class extracorporeal membrane oxygenation service to Birmingham. Local people have campaigned vigorously against the proposal, and I pay particular tribute to Ms Robyn Lotto—a constituent of mine who has magnificently led much of the local campaigning in recent weeks. We should also pay tribute to Glenfield’s staff, who are very concerned, as the hon. and learned Gentleman indicated when he read out the circular that we were all sent.

Many organisations in Leicester and beyond have spoken out. The vice-chancellor of Leicester university, Sir Bob Burgess, said:

“Glenfield is a leading international heart hospital where excellent clinical care takes place within a context of internationally significant research. I would therefore ask that the proposal to move the Glenfield services be reconsidered and this valuable facility retained for people of our region.”

The Bishop of Leicester, who I see observing us, said:

“It is not…clear that the movement to Birmingham will be straight forward… In fact I fear that the movement of these services will be harmful to the nation as a whole”.

As I have mentioned, politicians from all parties have come together on this campaign. Politicians on the Labour-dominated Leicester city council are working alongside politicians on the Conservative-dominated Leicestershire county council and on what I assume is the Conservative-dominated Lincolnshire county council, and they have all expressed their concern.

MPs on both sides of the Chamber are speaking up, and, as the hon. and learned Gentleman did, I pay tribute to my hon. Friend the Member for Leicester West (Liz Kendall), who in many ways has spearheaded the campaign from our side with her usual pizzazz, and to the hon. Member for Loughborough (Nicky Morgan), who cannot speak in this debate because she is a Government Whip—fortunately for me, Opposition Whips can speak—but who I am sure would speak if parliamentary convention allowed.

I am, of course, pleased that the Secretary of State for Health has today announced that the independent committee will conduct a full review and report back at the end of February next year. Notwithstanding that welcome announcement, I want to make a number of points on which I hope the Minister can provide clarification.

On demand and capacity—I appreciate some of these points might be for the review committee, but it is important to get them on the record—genuine questions have been raised about the assumptions on demand and the capacity on offer at Birmingham that the joint committee of primary care trusts used. As I understand it, the national projections used by the review assume that demand will be flat, yet the most up-to-date data show demand increasing, because birth rates in the east midlands and west midlands are well above national averages. The projections of population trends used by the review team were based on data from 2006-07. Using those data would suggest a relatively stable work load rising to 3,990 cases in 2025, but, if the latest data on population expectations from the Office for National Statistics are used, the projected rise in surgical case loads hits 5,422 in 2025. Questions have also been raised about the likely patient flows, with clinicians suggesting that Sheffield and Doncaster have indicated a preference for Birmingham rather than Newcastle.

Given that extra surgery work, the movement of the ECMO provision, the increased population projections for the midlands and the worries about increased patient flows from south Yorkshire, I would be grateful to the Minister if she let us know whether the Department is confident that Birmingham has the capacity to meet what is clearly set to be considerably increased demand.

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

The hon. Gentleman knows, of course, that the Independent Reconfiguration Panel will no doubt consider all his points. As he knows, from the outset, this has been an independent process decided by clinicians. In those circumstances, I am sure that he will make it clear that I am in no position to answer any of his points, which must be addressed by the IRP. Does he agree with me on that?

[Jonathan Ashworth]

The Minister makes an important point. None the less, I still think that, even if it is not appropriate for her to respond, as I suggested might be the case, this is an appropriate forum to put some of those points on the record, and I will continue to do so. I entirely understand her position.

I have a couple of points to make on Leicester’s paediatric cardiac intensive care unit, which the hon. and learned Member for Harborough mentioned. There is concern about how the decision will affect the wider paediatric cardiac intensive care on offer in Leicester, with the potential closure of the unit at Glenfield increasing pressure on the other Leicester hospitals and, more generally, reducing the supply of paediatric intensive care across the east midlands and placing more demand on Birmingham. Again, that is an important point. If the Minister cannot respond, I hope that the committee at least will take it into account.

I want to focus on the ECMO service, as the hon. and learned Gentleman did, and as I suspect many other hon. Members will, too. As I said at the outset, I entirely welcome the Secretary of State’s announcement this morning, but—I will quote from the letter, as the hon. and learned Gentleman did—I am disappointed that he said:

“The decision of the SoS taken regarding the removal of the ECMO equipment”—

he uses the rather bland word “equipment,” but the decision is quite controversial, so describing it in that way is unfortunate—

“from Glenfield to Birmingham should not form part of the review as the decision was not taken by the Joint Committee of Primary Care Trusts.”

That is right, but as has been said, the two things go hand in hand.

I shall repeat some of the points that have already been made. The ECMO service at Glenfield is the longest-established and provides 80% of ECMO capacity nationally. Many of its staff have more than 20 years’ experience. Glenfield’s ECMO service has some of the very best mortality rates. The mortality rate for ECMO at Glenfield is 20%, but the national mortality rate is 50% higher. Will the Minister address the decision not to include ECMO in the review? Does she expect to be able to pick up an ECMO unit in one hospital, plonk it into another and find that the same expertise and mortality rates will transfer with it? As has been said, many international experts do not think so—certainly not in the short run. We have already heard about Kenneth Palmer, the expert ECMO adviser, who told BBC Radio Leicester:

“They could never have the same survival rate in another unit if you move it like this.”

He also said—I think that the hon. and learned Member for Harborough quoted this, and I will repeat it:

“Moving one unit to another place is the same as totally closing down and rebuilding from zero in the new place... I have been very clear…that you cannot move a unit; you can just destroy it and rebuild with many years of decreasing survival rate and increasing morbidity.”

In other words, he is concerned that lives will be lost.

Another international ECMO expert, Dr Thomas Müller, says that

“in the interest of best patient care the decision to close down the most experienced centre in the UK is difficult to comprehend.”

Jim Fortenberry, the chair of the ECMO leadership council in Atlanta, has already been quoted in the debate. He said on BBC Radio Leicester that the ECMO unit is

“considered one of the finest ECMO units”

and described it as a “real jewel”. When he was asked on the radio whether he thought lives would be lost he said:

“I do agree with that unfortunately, I think the risk is great”.

International experts are therefore deeply concerned about moving ECMO from Leicester to Birmingham. One of their concerns is that the institutional memory, built up over a generation by the team, will be lost. That is one reason why I find it slightly disappointing when the Secretary of State presents the matter as just moving equipment from Glenfield to Birmingham. We have already heard that many of the staff feel that they will not be able to move. I shall repeat the quotation from the letter that they sent us all, because it is worth focusing on:

“We are not in a position to leave our homes and families, to move to Birmingham to work. As a team of (predominantly) women, we are (predominantly) second wage earners, with husbands, children and homes.”

As I understand it, 13 nurses are required for one ECMO bed, so there are concerns about Birmingham’s ability in the short run to build and develop a dedicated team of expert staff similar that at Leicester.

Given that the review panel will not consider the ECMO decision, I should be grateful to the Minister if she shared her analysis, or the Department’s analysis, of the risk assessment of moving the ECMO facility. It has been suggested in past debates—indeed, if my memory serves me correctly, it was suggested in a useful meeting that we had with the previous Minister, now the Minister of State, Department for Transport, the right hon. Member for Chelmsford (Mr Burns)—that different experts had advised the Department and that they did not share the analysis of Mr Palmer and others. I apologise if my memory of that is slightly wrong, but if that is the case, perhaps the Department will agree to publish the evidence.

We have a campaign including an e-petition signed by 100,000 people—clinicians, staff and members of the public—who are deeply concerned about the proposal to move the ECMO unit. They accept the argument made by Mr Palmer and others. If the Department thinks that there is a different analysis to be considered, perhaps it will finally publish it, so that both sets of analysis can be properly scrutinised, and we can come to a considered opinion. That would reassure us on the point about mortality rates.

I would be interested in hearing the Minister justify the decision not to allow the IRP to consider the ECMO decision. Was not the decision to move ECMO taken and presented as a necessary consequence of the decision taken by the JCPCT in relation to the Safe and Sustainable review? Given that that was the context in which the ECMO decision was made, does it not seem odd that the review committee will not now consider the decision to move ECMO? If the justification is that there is a procedural argument that the various local authorities have asked the committee to consider the outcome of the Safe and Sustainable review and that ECMO was not part of that, fair enough, but it would leave a rather sour taste in the mouth of many campaigners who signed the petition. If that is the case, is there any way in which the ECMO decision can be reviewed? Can the Secretary of State consider reversing the decision of the previous Secretary of State? Many of us who are involved in this cross-party campaign would be grateful for guidance on that from the Minister. I am not sure whether the campaigners would feel pleased if, despite their winning the review, the ECMO unit were still to be shifted.

Many hon. Members want to speak, and because of the cross-party nature of the campaign, we are probably all making similar points, so I will conclude my remarks, but I encourage the Minister to focus on the point about ECMO. There is deep concern about it. People will be pleased about the review, but concerned that ECMO seems to have been excluded from it, and I hope that she can give us some reassurance.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate my hon. and learned Friend the Member for Harborough (Sir Edward Garnier) on securing the debate and other Members on all the contributions that we have heard. I pay tribute to all Members who have attended today, as well as those who have spoken. My hon. Friend the Member for Pudsey (Stuart Andrew) attended the debate but, unusually perhaps, has not made a speech, although we have not been discussing the hospital for which he has campaigned so hard.

I pay tribute to all Members who have spoken in numerous debates in the House, written letters to Ministers, met and conferred with local groups and experts and spoken at length to their ordinary constituents. As a result, we have heard a moving story from the hon. Member for Leicester West (Liz Kendall) about the services offered at Glenfield, and there are many more stories to be told about children’s heart services centres throughout England. All such Members have campaigned locally to have decisions overturned or reviewed in some way, or to ensure that the right decisions have been made on the right basis. They have brought such arguments and their campaigns to the House, as they should do, because each of them is doing their job as a first-class, local constituency MP by bringing important issues to this place.

I also pay tribute to great cross-party work, which my hon. and learned Friend the Member for Harborough mentioned, both in Parliament and locally. Forgive me for speaking not only as a Minister but with my other cap on as the Member of Parliament for Broxtowe. On my local television service, I have seen and witnessed such cross-party work, which is to be commended; such issues are not party political and certainly nothing to do with any alleged cuts. This is about how we ensure that our children and babies get the very best heart surgery services that we can give them.

I must pick out my hon. Friend the Member for Loughborough (Nicky Morgan) and the hon. Member for Leicester West, who together have spearheaded the campaign, but I also pay tribute to all the work and effort of the hon. Member for Leicester South (Jonathan Ashworth), who joined them at the meetings. Everyone involved in the process up to the decision of the joint committee of primary care trusts has been motivated by the very highest of intentions to ensure that our children and babies receive the very finest heart surgery services that we can provide, and that those services are sustainable.

I will deal with as many of the points that have been raised today as I can. As I said at the outset, hon. Members should make and have made their points so that they can be recorded—not just so that their constituents can see how they have advanced the argument, but so that those who, in turn, must look at the decisions that have been made and consider the arguments can see how important these matters are, because they have been raised in Parliament by local Members.

I turn to what has happened today and what is, in some respects, the nub of the debate, which has been very good. As many hon. Members know, councils have a right to challenge the JCPCT’s decision, and today the Secretary of State has agreed that the Independent Reconfiguration Panel should conduct a full review. I will come to what that means in a moment. He has asked the panel to report back by the end of February—my hon. Friend the Member for North West Leicestershire (Andrew Bridgen) was worried about the time factor—or, and this may concern my hon. Friend, after conclusion of the legal proceedings brought by a Leeds-based charity, which may delay things, although I hope not.

The review will consider whether the proposals for change under the Safe and Sustainable review of children’s congenital heart services will enable the provision of safe, sustainable and accessible services, and if not, why not. The panel’s review will also be able to consider how the JCPCT made its decisions and—hon. Members may think that this is the most important point—the implications of those decisions for other services.

The Independent Reconfiguration Panel today received instruction from the Secretary of State and will now begin to consider how to constitute its review. It is, of course, a matter for the panel to decide how to conduct that review. It is an independent body, but I make it clear that it will look at all the decisions and—for many hon. Members this is most important—at the implications of those decisions, which includes the implications for the unit at Glenfield.

[Stuart Andrew]

rose—

[Liz Kendall]

rose—

[Anna Soubry]

I shall give way to my right hon. Friend the Member for Pudsey, then to the hon. Member for Leicester West.

[Stuart Andrew]

I thank my hon. Friend for the promotion. I am grateful that there has also been cross-party support in the campaign to keep the unit in Leeds open. I want absolute clarification on the IRP. Will she assure me that it will consider the whole decision-making process, including the initial assessments and all the data that were submitted? That is where many of us believe there to be inaccuracies, which have brought about the wrong decision.

[Anna Soubry]

I am grateful to my hon. Friend. It will be for the IRP to decide the full extent of its review of all the decisions that have been made, but the points that he has made here and in various letters will no doubt be put to it for consideration. I am told that, so far, it has not had a formal request from Leeds city council’s overview and scrutiny committee, and perhaps he can prevail on the committee to make that submission as a matter of urgency, so that we can all be absolutely sure that the review will be concluded by the end of February, and that there will be as few delays as possible.

[Liz Kendall]

The Secretary of State’s letter today says that his decision regarding removal of ECMO from Glenfield to Birmingham should not form part of the review. Is the Minister saying that the IRP will not look at the Secretary of State’s decision, but that it can look at ECMO services, although not at what he said? I am afraid that that is still unclear.

[Anna Soubry]

I am grateful for that intervention. I will explain why the Secretary of State has not been able to review the previous Secretary of State’s decision in this way. However, I am making it clear that the IRP will look at the implications of the decisions, and I will shortly turn to why the previous Secretary of State’s decision is not part of the process. I will then answer some of the specific points that have been raised by the hon. Member for Leicester South, but I want to finish dealing with the IRP.

More generally, in undertaking its review—this may assist my hon. Friend the Member for Pudsey—the IRP will interview and take evidence from a number of parties, including, but not limited to, NHS organisations, local authorities and local Members of Parliament. That will normally include evidence used in developing recommendations and proposals, taking decisions and national guidance.

I turn to the specific point about why the decision to move the children’s ECMO services over to Birmingham from Glenfield is not part of the review, or at least part of today’s decisions. Decisions about ECMO for children at Leicester being moved to Birmingham follow from the decision to transfer heart surgery to Birmingham. In other words, it was a consequence of the JCPCT’s decision. Children’s ECMO services are a nationally commissioned service, so the decision was taken by the Secretary of State, not the JCPCT. The Secretary of State made his decision based on the Advisory Group for National Specialised Services. To be clear, the JCPCT having made the decision, AGNSS then looked at the children’s ECMO services at Leicester and recommended to the Secretary of State that, in light of the JCPCT’s decision, those services should also be transferred to Birmingham.

I want to make it clear that it is unfortunate that the word “equipment” has been used. I am more than aware that the matter involves considerably more than pieces of equipment at Glenfield, and I pay full tribute to the team who work there, and indeed to the children’s heart surgery team there and to every team throughout the country. It is important to make it clear that no one is saying that a good service is not being provided, or that a service is bad or poor. The issue is all about ensuring that we get the very best service in fewer but bigger centres.

[David Tredinnick]

The Minister said that the issue is all about patients getting the best service, but I take her back to the point about the mobile service, which has been the subject of the thoughts of various hon. Members. Is there any way we can ensure that that aspect of the service is fully considered? If Birmingham will not commit to providing a mobile service, it is crystal clear that a number of patients will suffer.

[Anna Soubry]

I am grateful for that intervention. It may be argued that that is one of the implications of the JCPCT’s decisions. The children’s ECMO services at Leicester are being been moved over to Birmingham. That is an implication of that decision. Another implication is that there are concerns about the mobile unit for children’s ECMO as well.

The previous Secretary of State accepted the recommendations of AGNSS—the advisory group for national specialist services—and it is that information to which the hon. Member for Leicester South referred when he told us about his meetings with the then Minister, now the Minister of State, Department for Transport, my right hon. Friend the Member for Chelmsford (Mr Burns). The recommendations of AGNSS are made to the Secretary of State, on, as I understand it, a confidential basis. It is not normal for them to be disclosed, but the previous Secretary of State made his decision based on the advice of that service.

The question, as it has been rightly put today, is whether there is any challenge now to that decision. I am told that that is for the Secretary of State; he can, in exceptional circumstances, revisit that decision if those exceptional circumstances are made out. If the IRP wants another full review of all that has happened—it effectively calls into question the whole process, and so on—it obviously flows from that that the ECMO children’s service at Leicester must be retained in that event, because it flows from the JCPCT’s decision about where to have the specialist children’s heart services. In any case, if there is some other new or exceptional evidence that can be placed before the Secretary of State, or that he is aware of, he may be able to look again at the decision that was made by the previous Secretary of State. I hope that that is of some help. I can go no further and give no more detail, except, safe to say, that I am told that that is a rare and unusual event.

I remind everyone, as I conclude my remarks, what led to the review, the recommendations and the decisions. Concern about children’s heart services began a long time ago as a result of serious incidents in Bristol back in the 1990s. For some 15 years, therefore, it has been accepted, almost by everyone, that children’s heart surgeries were of great concern. National patient groups all agreed that what was needed was to ensure that we had surgeons, nurses and other health professionals based in larger, but fewer, specialised centres. That is why, as the hon. Member for Leicester West has identified, the previous Government set up the review. In many ways, it took courage to do so, because there had been a lot of talk about the issue but not much action. Everyone agreed absolutely that reducing the number of centres was necessary, so that we would have bigger numbers of surgeons, nurses and other specialists, and that the service could be better, but in fewer units. Therefore, to put it crudely, somebody was always going to lose out.

Although I have listened with great care to the remarks made by my hon. Friend the Member for Cleethorpes (Martin Vickers), this is an example in which we do not want a greater number of smaller units; it is a good example of where we want fewer, but much bigger units. It is perhaps worth remembering that children’s heart surgery has advanced considerably over the years, so that surgeons now operate on children who are often only two days old, with hearts the size of walnuts. It is argued that that is the most specialist, delicate and difficult of all surgery.

It is not surprising, given the service’s nature—the fact that it is for children and babies—that so many people who have experienced what Glenfield provides speak with such passion about it, and why they are so concerned about its future. That, too, goes for other places that have been told their facilities will be moved away—for example, from Leeds up to Newcastle. I pay tribute to all who have gone to the trouble of signing the e-petition in support of Glenfield. I can speak about the great campaign that was organised, having attended a Leicester Tigers rugby match some time last year; every seat had a leaflet on it and an event was organised in support of Glenfield. Other places, too, have organised campaigns, and rightly so. It is an indication of the passion and loyalty that such services engender in people.

There has, however, been a long process. There has been an independent review, aimed at ensuring that our children are operated on safely and given the very best services. As a result, tough decisions have been taken by the JCPCT. It has done that independently, and with considerable support from clinicians, royal colleges and many eminent bodies, as well as others who have spoken out in favour the proposals. However, today’s decision by the Secretary of State is to be welcomed. Everybody can now be assured that there will be an independent review of the decision—I stress the word “independent”. I have also made my observations about the possibility, if there is new evidence in exceptional circumstances, that the previous Secretary of State’s decision about the future of children’s ECMO at Glenfield may also be considered.

I hope that that will give some reassurance to hon. Members who have attended the debate. All their comments are listened to by both the Department and me. It is to be hoped that the review will be thorough, as I am sure that it will be, and swift; it will be concluded by the end of February.

Tonbridge Hospital/Edenbridge Hospital

Anna Soubry Excerpts

Tuesday 16th October 2012 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

First, I congratulate my right hon. Friend the Member for Tonbridge and Malling (Sir John Stanley) on securing the debate and on the many questions that he has raised. As the clock is against me, I shall deal at the beginning of my response to his speech with some of the issues that he has specifically asked me to deal with.

It strikes me that these matters should and could have been dealt with locally. As my right hon. Friend will appreciate, one of the Government’s aims has been to ensure that national politicians do not get involved in the stuff of sorting out the NHS locally. He raises concerns about his local PCT and calls into question procedures undertaken by it. He says that decisions that it has made should have been referred to the overview and scrutiny committee. I do not know whether that is right or wrong. What I do know is that it is incumbent on local politicians to raise such matters, as they do the length and breadth of England. It may be that the horse has bolted from the stable and it is too late, but I think that I can say with some certainty that it is not the role of the Secretary of State for Health to seek legal opinion on whether the PCT has acted lawfully.

With respect to my right hon. Friend the Member for Tonbridge and Malling, I suggest that those are local matters, to be determined locally, and it is for the league of friends, himself, councillors and other concerned people to look into the legality of the decisions that have been made and the processes that have been chosen. It is for the local NHS and local politicians to deal with that. It is not the role of Whitehall and Ministers to get involved in the stuff of local NHS decisions and those processes.

[Sir John Stanley]

The league of friends and I have pursued these issues in detail over a considerable period with the local PCT. Does the Minister not agree that under primary legislation, the Secretary of State ultimately has a responsibility for addressing issues of NHS trusts’ compliance with statute?

[Anna Soubry]

I am grateful to my right hon. Friend for his comments. I will look further into the matter. I cannot give a definitive answer, but in my experience such matters are invariably taken up by local politicians, often led by their local Member of Parliament, who go to the overview and scrutiny committee of the county council to urge upon it all the reviews and challenges that he has sought and raised in this debate. I will, however, look into this further, and if he will forgive me, I will come back to him probably by way of a letter or a meeting between the two of us. May I move on to the future of his community hospitals?

I am reliably informed that there are no plans whatsoever to close either of the two hospitals. I will get through as much of my speech as I can in the time available—I will be guided by you, Mrs Osborne, but I think I have to sit down at half-past 4. I make it absolutely clear again that the future of hospitals is not determined by national Government, but is in effect determined by the local commissioning process. From what I am told, there is no reason to fear for the future of either the Tonbridge Cottage hospital or the Edenbridge and District War Memorial hospital, because the services that they provide will be commissioned by the local clinical commissioning group. They are doing a grand job now, so there is no reason to think that they will not continue to do a grand job, and therefore their services will continue to be commissioned.

Many Members have great affection for their community hospitals, and rightly so. As my right hon. Friend alluded to, they provide a wide range of vital services, from minor injury clinics to intensive rehabilitation. They inspire much love and respect in their communities. They are fiercely defended and rightly inspire loyalty.

My right hon. Friend and the local league of friends have raised the issue of the beds at Tonbridge hospital. I am not the PCT’s mouthpiece, but as he will appreciate, inquiries are made and I am supplied with information. I am assured that the 12 community beds in question were designated as general rehabilitation beds. They were then redesignated as stroke rehabilitation beds and are now housed in the new £400,000 purpose-built stroke unit, which opened at the hospital in September 2011. The PCT then created 12 additional general rehabilitation beds across west Kent, to replace the 12 community beds that had been redesignated. Of those 12, two, as he mentioned, are at Tonbridge hospital. We do not agree that there was a loss of beds, because 12 of the beds became stroke rehabilitation beds. I take the point that there were 12 community beds previously and now there are two community beds, but we should not forget that there are an additional 12 stoke rehabilitation beds.

It was the opinion of the PCT at the time that there was no real change in the use of the beds at Tonbridge hospital, because their primary function had been rehabilitation. The 12 community beds were designated for rehabilitation, and the 12 stroke beds are obviously for rehabilitation, too. The hospital has gained two extra beds for community rehabilitation that were designated specifically for older people. The PCT therefore considered that there was no real service change, so it did not deem formal consultation necessary or appropriate.

The Government have pledged that in future all service changes must be led by clinicians and patients, not driven from the top down. That principle has been at the heart of our reforms for the NHS. To that end, we have outlined and strengthened the criteria that we expect decisions on NHS service changes to meet: they must focus on improving patient outcomes, consider patient choice, have support from GP commissioners and be based on sound clinical evidence.

Everything that we do in central Government is designed to support local clinicians and patients changing the local NHS for the better and to ensure that improvements are made to primary and community services. As a result of the Health and Social Care Act 2012, primary care trusts will be abolished from April 2013 and responsibility for commissioning services will move to clinical commissioning groups, so local doctors, clinicians and experts are in control. I see no reason why they would not commission services from those two excellent community hospitals.

My right hon. Friend mentioned the community hospital estate and its future. The 2012 Act requires new ownership arrangements for current PCT estates. In August last year, the Department of Health announced that NHS providers would have the opportunity to acquire parts of the estate. Therefore, providers, such as community foundation trusts, NHS trusts and NHS foundation trusts, will be able to take over those parts of the PCT estate that are used for clinical services. That of course includes the community hospital estate. We have put safeguards in place, so that providers cannot just dispose of newly acquired land and make a quick profit. I hope that that satisfies him.

[Sir John Stanley]

Before the Minister concludes, will she respond to my request that before Ministers take a final decision on whether individual hospital properties go to NHS providers or NHS Property Services Ltd, they consult on the proposed final destination of the properties, so that local people have an opportunity to express a view?

[Anna Soubry]

I cannot give that undertaking. The point is well made; I will take it back to the Department and ensure that the Secretary of State is aware of it. Many such decisions will be taken locally. My right hon. Friend and the league of friends should continue to make all the representations that they have already made, and I know that they will do so.

The safeguards have been put in place. As my right hon. Friend knows, where any former estate becomes surplus to NHS requirements, 50% of any financial gain made by the provider must be paid back to the Secretary of State for Health and will go straight to front-line NHS services. Based on what I have been told and what I have seen in the 2012 Act, I am of the view that if a community hospital—if this is what occurs—is transferred to NHS Property Services Ltd, it will not in some way be deemed surplus to requirements by NHS Property Services Ltd.

The two hospitals that my right hon. Friend rightly champions would only ever become surplus to requirements if the CCG stopped commissioning their services. I am told that that is extremely unlikely to happen. He should have no fear at all that NHS Property Services Ltd will sit and looking at its assets and simply decide to sell things off for a quick buck. The hospitals’ future is secure. I thank him for securing the debate and for the points that he has made. I have not answered them all, but I will, in either a meeting or a letter.

Environment, Food and Rural Affairs Committee Report on Desinewed Meat (Government Response)

Anna Soubry Excerpts

Tuesday 16th October 2012 Written Statements

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

We have today laid before Parliament the Government’s response (Cm 8462) to the House of Commons Environment, Food and Rural Affairs Committee Report on Desinewed Meat, which was published on 24 July 2012.

On 28 March 2012, the European Commission issued demands, in accordance with its interpretation of European Union (EU) food law, that the production of desinewed meat from ruminant bones in the UK should cease. Desinewed meat produced from non-ruminant bones should be categorised and labelled as mechanically separated meat (MSM), which has significantly less commercial value and cannot count towards the meat content of products in which it is used.

In response to these demands, which required the UK to take action within five working days, the UK Government decided to implement a moratorium to achieve compliance with the Commission’s interpretation of EU food law. The alternative was to face the prospect of emergency safeguard measures which would have prohibited UK-produced meat preparations, meat products, minced meat and MSM from being placed on EU and domestic markets. This would have had significant negative economic and reputational impact on the UK meat industry and supply chain.

The Environment, Food and Rural Affairs Committee launched an inquiry into the circumstances surrounding the moratorium. The report of this inquiry was published on 24 July 2012, providing a detailed assessment of the chain of events and the implications of the Commission’s decision.

The Government welcome the Committee’s report and its recommendations. Some of the issues that have been raised by the Committee are specific to the Food Standards Agency (FSA) while others are wider in scope. The Food Standards Agency has liaised closely with the Department of Health, the Department for the Environment, Food and Rural Affairs and counterparts in the devolved countries in considering the Committee’s recommendations and developing the overall response.

The Committee rightly highlights the need to continue to press the Commission on this matter. The Food Standards Agency has been working and will continue to work closely with other Government Departments and with industry to press for the Commission to ensure a level playing field across the European market. The European Food Safety Authority has been mandated to provide an opinion on MSM which is due at the end of March 2013 and, in light of this, the FSA will push for discussions with the Commission and member states to be re-opened with a view to developing a more proportionate and risk-based approach to the production of desinewed meat and MSM.

Today’s publication is in the Library and copies are available to hon. Members from the Vote Office.