Managing Risk in the NHS

Debate between Anna Soubry and Andy Burnham

Wednesday 17th July 2013 Commons Chamber

[Andy Burnham]

This is debate is about the NHS in England, and if the hon. Gentleman has concerns about the NHS in Wales, why does he not have a word with his right hon. Friend the Chancellor of the Exchequer and get a better deal for the Welsh Assembly so that a bit more money could be put back into the Welsh national health service?

As I was saying, the Government have put staff morale at rock bottom, and where are the promised benefits of this reorganisation? Clinical commissioning groups are not, as we were promised, the powerhouse of the new NHS; they are embryonic at best and anonymous at worst. Members of all parties, I am sure, write letters to CCGs that get passed to NHS England, which then either does not provide a proper answer or passes them on again. [Interruption.] I hear the public health Minister saying it is dreadful that Members do not get proper answers. When my hon. Friend the Member for Easington (Grahame M. Morris) wrote to her about cancer services in his constituency, she also brushed it off to NHS England. Is this proper accountability? No.

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

rose—

[Andy Burnham]

I hope the Minister is going to deliver some accountability now.

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[Anna Soubry]

Will the right hon. Gentleman please agree and accept that I have not only answered his letters, but met him on at least one occasion? It is right under the new system for such letters to go to NHS England, but that does not stop me making representations. We have introduced a much better system than we used to have under his Administration.

[Andy Burnham]

We have just heard it; this is what the NHS has been reduced to. The Minister has to make representations to NHS England about cancer services of all things. My goodness, if Ministers are not responsible for cancer services, what are they responsible for? Who is making the decisions and who is responsible for what? Even now, confusion reigns.

What precisely is the role of the Secretary of State in this new world? He has cast himself in a new role as a detached commentator on the sidelines, magnifying all of the NHS’s failings and accepting none of the responsibility to fix them. I assume that that is all for NHS England, too. With the NHS already laid low by cuts and reorganisation, the Secretary of State has opened up a new front on staff: nurses repeatedly blamed for not caring enough; hospitals blamed for coasting, as I have said; GPs blamed for causing the A and E crisis. Everything is someone else’s fault.

Then we get to this weekend. The Keogh report rightly exposed poor care standards, which should never be tolerated; we support action to tackle to them. The report, however, exposed something else, too—a Government who are now actively spinning against the NHS for which they are responsible, generating misleading or, in Sir Bruce’s words, “reckless” headlines about 14 already troubled hospitals. What chance do they have of improving when the man supposedly in charge is actively doing them down?

Oral Answers to Questions

Debate between Anna Soubry and Andy Burnham

Tuesday 16th April 2013 Commons Chamber

[Anna Soubry]

My hon. Friend the Member for North Norfolk (Norman Lamb) is having a break on that one. The continuing outbreaks of TB cause a lot of concern, especially in certain communities. I have no hesitation in agreeing to meet my hon. Friend to explain what NHS England is doing and the development of a national strategy.

[Andy Burnham (Leigh) (Lab)]

Here comes another request for a meeting with the very obliging Minister. Last month he promised the House that he would rewrite the section 75 regulations to rule out enforced competitive tendering in the NHS. However, before Easter the respected House of Lords Secondary Legislation Scrutiny Committee said this of his redraft:

“The substitute Regulations are substantially the same as the original Regulations.”

It is no surprise that it seems to many that the Government are intent on privatisation by the back door, putting large parts of the NHS up for sale. With a crunch vote in the Lords next week, it is turning into another shambles. I make this offer to the Minister: will he again agree to withdraw the regulations and to sit down with us and the professions this week and come up with wording that is acceptable to all?

Sudden Adult Death Syndrome

Debate between Anna Soubry and Andy Burnham

Monday 25th March 2013 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Streeter.

I thank everyone who has spoken in this excellent debate. A debate normally consists of one side of an argument versus the other side, but today we have had an outbreak of agreement and there has been no one side or the other. The debate is also momentous because I can say with my hand on my heart that I found myself in agreement with not only my hon. Friend the Member for Brigg and Goole (Andrew Percy) but, most concerning, the hon. Member for Bassetlaw (John Mann), with whom I share history, because I was born and brought up in his constituency. I would be absolutely delighted to take up the hon. Gentleman’s invitation to visit, because it means a great deal to me. To be serious, however, because I was being flippant, this has been a good debate. I pay tribute to all those who signed the online petition and particularly to the hon. Member for Liverpool, Walton (Steve Rotheram) who opened the debate so well. He spoke with great passion and feeling and with considerable knowledge. We have had a good debate because of the outbreak of agreement and some well formed speeches, based on real argument, facts and figures, as well as on constituents’ experience.

Where are we? We all agree that defibrillators are good things; many hon. Members have spoken about the role that they can play and how we need considerably more of them. We all agree that we need more people trained in their use and in CPR and all manner of emergency measures for someone in a life-threatening situation. I congratulate the hon. Member for Bolton West (Julie Hilling) on her speech; she explained how training our children could bring us real benefits in the number of people trained, which would mean more lives being saved. I pay tribute to my hon. Friend the Member for Brigg and Goole, who spoke about his experiences as a community first responder and about how volunteers from the community, not only young people at school, could be trained in such skills. He gave some good examples of how effectively such a programme could be rolled out. Other hon. Members talked about the value of screening and, for example, I pay tribute to the right hon. Member for Knowsley (Mr Howarth) for his comments on the need for screening.

Unfortunately, I am going to be somewhat of a fly in this otherwise rather pleasant ointment, because I do not agree with everything said about legislation. My view is that we do not need legislation. We already have all manner of programmes locally. I am not denying that our system is patchy and that some parts of the country are clearly doing a far better job than others, but it is understandable why the previous Government decided to put defibrillators and training down to the local ambulance trusts: they know their communities best and they are the people to ensure delivery, to the best of their abilities, to meet the needs of their communities.

I usually flinch from legislation, because it can take a long time to go through this place and because when we start to be prescriptive, we can run into all sorts of dangers. We have accepted that different communities have different needs, and I pay tribute to the hon. Member for Bassetlaw for his compelling case for defibrillator training to be rolled out through our communities, depending on the nature of the community. For example, his constituency has a large number of parish councils—mine does not have as many, but it matters not—and he discussed putting pressure on and working and campaigning with the parish councils to start installing defibrillators. The parish councils can look at their own communities and at what would suit the needs of those communities. He then made a good point about work forces and the possibility of defibrillators in every place with more than a certain number of employees, and that is where the debate begins, because the difficulty with legislation lies in whether we look at a workplace with 50, 100 or 1,000 employees. The hon. Gentleman described how he could work with the trade unions in his patch and in effect, as a result, roll out a campaign of asking the work forces whether they think something is a good idea in a particular workplace or not in another. If we begin to prescribe, however, we will not deliver the sort of service that we want.

[Andy Burnham]

I realise the situation is slightly unusual: the Minister is defending the policy of the previous Government and I am asking her to reconsider and to go further. She said that ambulance services are best placed because they understand their communities. I partly agree, but the problem is that ambulance services do not have the power to insist on defibrillators going where they are most needed. The ambulance services are not the planning authority or the owners of the big buildings; they can only use persuasion and cannot ensure that defibrillators go where they really need to go, where lives can be saved. That is why legislation is necessary. If she is worried about overly burdensome legislation, it could start with a simple requirement to have a defibrillator publicly available in towns of, for example, 30,000 or more; it could be a modest requirement to get the ball rolling, as other countries have done.

[Anna Soubry]

I am grateful for the intervention, but it rather makes my point. Once we stipulate, for the sake of argument towns of 30,000, we can imagine that in the towns without that level of population people will think, “Well, we’re all right, so we won’t do much work on it.” That is the problem with a more prescriptive approach.

While we are discussing ambulance services, and referring again to the speech of the hon. Member for Bassetlaw, I wish to set the record straight on the East Midlands ambulance service. EMAS has been struggling for some time, with a number of difficulties that the hon. Gentleman and I are familiar with. As mentioned by my hon. and learned Friend the Member for Harborough (Sir Edward Garnier), my hon. Friend the Member for Loughborough (Nicky Morgan) has been involved in a campaign following the death of Joe Humphries, who did not live in her constituency but went to school there. As a result of her work, for which I am grateful, Leicestershire has 109 static defibrillators in public areas, 14 of which were installed in partnership with the Leicestershire police, and there are 24 Heartstart schools in the county.

The hon. Member for Bolton West also talked about the Heartstart scheme and its success in her area, although I can see that that may not be the case universally throughout the country. What is happening because of the debate, however, is that not only are we holding it and everything is being recorded in Hansard, but I will certainly go away and not hesitate to have that conversation with the relevant Minister in the Department for Education. An extremely forceful message has come out of this debate about the need for such training to be included in the national curriculum. I could not possibly give my own views on that, but the argument has been advanced extremely strongly and it has much merit and power.

Oral Answers to Questions

Debate between Anna Soubry and Andy Burnham

Tuesday 26th February 2013 Commons Chamber

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

I am grateful for that question, because my right hon. Friend has identified the fact that TB is a growing problem. We are exploring the effectiveness of an approach across health sectors for a national strategy on TB, while ensuring that we recognise the local variances. We need to improve in that area.

[Andy Burnham (Leigh) (Lab)]

I am sure that, like me, the Secretary of State has spent recent weeks absorbing the Francis report and its recommendations; there are lessons for everyone at every level, particularly on staffing. New analysis to be published later today will show that the NHS is set to lose 12,000 nurses over the course of this Parliament, raising doubts about its ability to respond to Robert Francis’s recommendations on staffing. Will the Government say today whether they accept those recommendations and the principle of a minimum staff-to-patient ratio?

NHS Funding

Debate between Anna Soubry and Andy Burnham

Wednesday 12th December 2012 Commons Chamber

[Andy Burnham]

I think that the hon. Gentleman should withdraw that remark, because there was no reduction in health spending on my watch. I left plans for an increase, as I am about to explain. He illustrates the point that I am making: we are getting half-truths, spin and misrepresentation from Government Members on NHS spending. Indeed, we just got some more, and it is about time that we had a bit more accuracy in the House from them.

The story starts with the 2010 Conservative party manifesto. Let me quote from it:

“We will increase spending on health in real terms every year”.

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

Absolutely right.

[Andy Burnham]

Mr Dilnot may be watching; the Minister needs to be careful what she says.

That promise was carried into the coalition agreement, which said:

“We will guarantee”—

guarantee, mind—

“that health spending increases in real terms in each year of the Parliament”.

The Secretary of State has stopped nodding; he was nodding earlier. [Interruption.] I will be interested to hear how the Conservatives make those claims stack up, because week after week, Ministers from the Prime Minister downwards have stood at the Dispatch Box and claimed that that is exactly what they have delivered.

Until recently, this appeared prominently on the Conservative party website:

“We have increased the NHS budget in real terms in each of the last two years”.

Then, on 23 October, the Secretary of State said to the House:

“Real-terms spending on the NHS has increased across the country.”—[Official Report, 23 October 2012; Vol. 551, c. 815.]

[Interruption.] “It has”, he says again today. Okay, but this is where the story changes, because last week, he received a letter from the chair of the UK Statistics Authority, Andrew Dilnot CBE. Let me quote the key sentence, which puts Mr Dilnot and the Secretary of State at odds, if I heard the Secretary of State correctly a moment ago:

“On the basis of these figures, we would conclude that expenditure on the NHS in real terms was lower in 2011-12 than it was in 2009-10.”

[Interruption.] I am coming on to it all. In other words, NHS spending is lower, in real terms, after the first two years of the coalition, than when Labour left office.

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[Andy Burnham]

I am coming to the point made by my hon. Friend the Member for Stoke-on-Trent South (Robert Flello), because the context is that £1.6 billion, on the Government’s own figures, was spent on the back office, and taken away from the front line. The Chair of the Select Committee says that the cut was a little one, as though that is okay—“It’s really an increase, because it’s only a little cut”—but one has to add £1.6 billion to that to see the full extent of the diversion of funds from the NHS front line.

As the chair of the UK Statistics Authority has established, NHS spending was lower in the first two years of this coalition than when Labour left office. [Interruption.] The Secretary of State says that it is the same. Let us have some honesty here. Mr Dilnot says that it was a cut; accept what he says, and get on with the job. If the Secretary of State starts being a bit more honest at the Dispatch Box, he might get a bit more respect from the public.

The Prime Minister has cut the NHS—fact; but just as he airbrushed his poster, he has tried to airbrush the statistics, and he has been found out. To be fair, the Conservatives admitted it and corrected the Tory party website, but the problem is that we have a long list of similarly false claims made in the House that, as of now, stand uncorrected. Today, we invite the Secretary of State to correct the parliamentary record in person.

I am not surprised to see a few sheepish looks on the Conservative Benches, because we have been checking Conservative Members’ websites, and we found that the hon. Members for South West Bedfordshire (Andrew Selous), for North Herefordshire (Bill Wiggin), and for Hendon (Dr Offord), the hon. and learned Member for Sleaford and North Hykeham (Stephen Phillips), and the hon. Member for Mid Derbyshire (Pauline Latham)—

[Anna Soubry]

They are sheep, are they?

[Andy Burnham]

They are certainly sheepish today; they need to get back to their offices pretty sharpish to amend their websites in light of the letter from the chair of the UK Statistics Authority.

Health and Social Care Bill

Debate between Anna Soubry and Andy Burnham

Tuesday 20th March 2012 Commons Chamber

[Andy Burnham]

No, I do not, is the answer—[Interruption.] Well, what has that proved? We had trusts earning income, but the foundation trust legislation set a cap: it allowed the principle but tightly controlled it for the vast majority of hospitals. That was its purpose. This Bill removes those tight controls. This Bill, supported all the way on that point by Liberal Democrats, now allows hospitals completely to change character over time. In time they can turn to US-style hospitals and devote half their facilities to the treatment of private patients—

[Anna Soubry (Broxtowe) (Con)]

That is rubbish.

[Andy Burnham]

It is not rubbish. They can earn 49% of their income, according to this Bill, from the treatment of private patients. That is a fact, and why the hon. Lady shouts “rubbish” I have no idea.

NHS Risk Register

Debate between Anna Soubry and Andy Burnham

Wednesday 22nd February 2012 Commons Chamber

[Andy Burnham]

My right hon. Friend eloquently makes the point I made at the beginning of the debate: people with long-term conditions, such as diabetes, who depend utterly on the NHS have a right to know whether there is any risk to the continuity or integration of the care they receive. I understand that representatives of patient groups, who perhaps have not been heard enough in this debate, made that point directly to the Prime Minister on Monday. It is absolutely essential that their voice is heard. They say that the Bill represents a danger to the integrated care that they receive and depend upon. It seems pretty clear to me that the Government are not following their own policy—[Interruption.]

[Anna Soubry (Broxtowe) (Con)]

indicated dissent.

[Andy Burnham]

I quoted from the policy, but the Secretary of State is not publishing the risk register—

NHS (Private Sector)

Debate between Anna Soubry and Andy Burnham

Monday 16th January 2012 Commons Chamber

[Andy Burnham]

My hon. Friend anticipates me. I shall come to precisely that point in a moment, and it will backs up his point that the Bill is akin to the privatisations of the 1980s.

[Anna Soubry (Broxtowe) (Con)]

What?

[Andy Burnham]

Just hang on and listen. Nothing has been done to the Bill to bring together the Prime Minister’s and Deputy Prime Minister’s promises that there would be no privatisation. There has been no substantial change since the pause.

Let me come directly to whether the Bill represents a privatisation of the kind that we saw in the 1980s. In doing so, I shall refer to a report from the King’s Fund, which I recommend to the hon. Lady. The Government have failed to introduce measures that they promised, months after the pause, so it is still considered appropriate for a body as respected as the King’s Fund to make a fairly shocking comparison that, indeed, the Bill is similar to the privatisations of the Thatcher Government. The report says:

“The Government’s proposals draw heavily on the regulatory framework developed in telecoms and utilities regulators …Interestingly, Secretary of State for Health Andrew Lansley’s own ideas for the reform of the NHS, developed while in opposition, were born out of his experience of the privatisation and regulation of utilities in the mid-1980s when he was Principal Private Secretary to Norman Tebbit.”

There we—[Interruption.] Okay, there we have it. That is the view of the King’s Fund—this is a privatisation along the lines of those we saw in the 1980s.

To back up that point, the King’s Fund quotes from a speech that the Secretary of State gave in 2005 to the NHS Confederation. He said this of the 1980s privatisations:

“The combination of the introduction of competition with a strong independent regulator delivered immense consumer value and economic benefits.”

There are two problems with that statement. First, there are real questions about whether gas, electricity, water and rail customers feel that they have had immense value. Secondly, it is troubling that the Secretary of State for Health, of all people, considers the delivery of health care directly comparable to telecoms and utilities.