NHS Outsourcing and Privatisation

Debate between Anna Soubry and Jonathan Ashworth

Wednesday 23rd May 2018 Commons Chamber

[Jonathan Ashworth]

My hon. Friend has hit the nail on the head. The problem is that, when the Government allow our national health service to deteriorate by such a scale and push it into this level of crisis, they are essentially forcing people, often reluctant refugees from a public NHS, into self-pay options. That is what happened last time the Conservatives were in government and it is happening again.

[Anna Soubry (Broxtowe) (Con)]

rose—

[Jonathan Ashworth]

I will give way to the former Health Minister.

[Anna Soubry]

Will the hon. Gentleman confirm that five GP surgeries in Broxtowe have been rated outstanding and that we yet again have a 2% increase in CCG spending? Why is he always talking down the NHS?

[Jonathan Ashworth]

I am delighted that GPs in Broxtowe have been rated outstanding, but patients in Broxtowe will be concerned that bed occupancy rates at Nottingham University Hospitals Trust are at 94.9%. That is what people in Broxtowe and across the east midlands are concerned about.

[Anna Soubry]

Would the hon. Gentleman like to speak to Nottingham City Council, which is run by Labour? It has repeatedly refused to unblock beds at NUHT, unlike Conservative-run Nottinghamshire County Council, which always ensures that it has social care available so that there is no bed-blocking in Nottinghamshire. The problem is Labour in the city—

--- Later in debate ---

[Jonathan Ashworth]

I know that Councillor Jon Collins of Nottingham City Council is a talented man, but he does not run Nottingham University Hospitals Trust. The people running the health trusts are the chief executives, who have to rely on the budget settlements that the right hon. Lady and her party have been denying—

[Anna Soubry]

rose—

[Jonathan Ashworth]

No, I am not giving way again. The right hon. Lady has had two chances; she can contribute to the debate later.

We have overcrowded A&Es and—perhaps the right hon. Lady can listen to this—patients are not even able to get a bed, often lying confused on trollies in corridors. In the last year of the previous Labour Government, 60,000 people were designated as trolley waits—

[Anna Soubry]

On a point of order, Mr Deputy Speaker. Could the record please record that indeed the leader of Nottingham City Council does not run NUHT, but he is responsible for social care in the city? That was the point I was making.

[Mr Deputy Speaker]

I think that is clarification.

[Jonathan Ashworth]

I am grateful to the right hon. Lady for that. I invite her to make another point of order, because Nottinghamshire County Council is closing five care homes.

[Anna Soubry]

I am happy to take that up. My understanding is that Nottinghamshire County Council is looking responsibly at the provision of—[Interruption.] Well, the hon. Gentleman invites me to give him information; I am trying to assist him. In my constituency, the county council is making sure that the money that it spends on social care goes to the very many care homes in my constituency that are rated as good or outstanding—

NHS Winter Crisis

Debate between Anna Soubry and Jonathan Ashworth

Wednesday 10th January 2018 Commons Chamber

[Jonathan Ashworth]

I am grateful to my hon. Friend for raising this issue. She has been a passionate defender of King’s, speaking out in this House on numerous occasions. Before Christmas, we saw the resignation of Lord Kerslake as the chair of King’s, when he spoke out about the real pressures facing our NHS, which were dismissed at the Dispatch Box by the then Minister when we had a debate in this House.

[Anna Soubry (Broxtowe) (Con)]

Does the hon. Gentleman acknowledge that it was under a Labour Government that a walk-in centre in Broxtowe closed? However, I do not seek to blame that Labour Government, because it was a local decision made by local practitioners. Would he not at least accept, in a spirit of trying to build some sort of sensible debate about our NHS instead of always weaponising it, that this Government have put in an extra £437 million specifically for the winter period? Would he not at least give the Government credit for that planning, which we have never seen before?

[Jonathan Ashworth]

The right hon. Lady is a former Health Minister, so she will know that in her local hospital trust 771 patients have waited longer than four hours on trolleys, unable to get a bed. She talks about the winter money. We were calling for winter emergency money back at the general election, and we repeated those calls in September. That money did not come through until the November Budget, and hospital trusts were not told their allocations until a few days before Christmas. That is no way to prepare for the winter. I suspect that when she was a Health Minister, she would have been saying that to the officials in her Department.

[Anna Soubry]

The point is that for the first time a Government have done everything they possibly could—[Hon. Members: “No.”] They have, because no Government can predict what the weather may be like, or the uptake of flu vaccinations. It is wrong to suggest that this is the fault of the Government in England when there has a problem across the whole United Kingdom, including in Scotland and Labour-run Wales.

[Jonathan Ashworth]

The right hon. Lady will know that we have had eight years of sustained underfunding of our national health service because of decisions by this Government, of which she was a member until very recently.

NHS Pay

Debate between Anna Soubry and Jonathan Ashworth

Wednesday 13th September 2017 Commons Chamber

[Jonathan Ashworth]

May I make a little progress?

The hon. Member for Croydon South said that pay does not affect retention and recruitment, but the Opposition say that the pay cap is at the heart of the retention and recruitment crisis. Earlier this year, NHS Providers, which represents hospital trusts, warned that low pay is causing staff to leave the NHS to stack shelves in supermarkets. Chris Hopson said:

“Years of pay restraint and stressful working conditions are taking their toll. Pay is becoming uncompetitive. Significant numbers of trusts say lower paid staff are leaving to stack shelves in supermarkets rather than carry on working in the NHS.”

[Anna Soubry (Broxtowe) (Con)]

Does the hon. Gentleman appreciate that anybody listening to his speech would take away from it a story of gloom and doom about our NHS? While there are difficulties and challenges, every day millions of people overwhelmingly enjoy one of the finest health services anywhere in the world, and I and many others are sick and tired of Labour talking it down.

[Jonathan Ashworth]

The right hon. Lady says that we are talking the NHS down. We are not talking it down; this Tory Government are running it down. She seemed concerned about public sector pay in the NHS a few months ago when she tweeted:

“The important retention & recruitment of public sector workers is about working conditions (esp in NHS) as well as pay”.

If she stands by that tweet, she should join us in the Lobby this evening.

National Health Service Funding

Debate between Anna Soubry and Jonathan Ashworth

Tuesday 22nd November 2016 Commons Chamber

[Jonathan Ashworth]

What world is the Secretary of State living in? Half a million patients have waited for four hours or more in A&E in the past three months—the worst performance for this time of year for more than a decade—and he says it is nonsense. Some 350,000 of our constituents are waiting longer than the promised time for elective treatment—some have been waiting more than a year—and he says it is nonsense. Delayed discharges from hospitals are at record levels, and he says it is nonsense. The number of people waiting for 12 hours or more on trolleys has increased by over 700% since 2011-12.

[Anna Soubry (Broxtowe) (Con)]

Will the hon. Gentleman tell the House why it is that, after 12 minutes, he has yet to praise all our hard-working doctors, nurses and other health professionals? Why is he constantly talking down our great NHS, including the hospitals in Leicester?

[Jonathan Ashworth]

I praise the hard-working staff in the NHS every day of the week, but I rather suspect that staff in the NHS will have more sympathy with the position I am outlining than with the right hon. Lady’s position, not least when, according to surveys, 88% of NHS staff think that the NHS is under the most pressure they can remember, and 77% think that there is less access to resources, putting the quality of patient care and clinical standards at risk. That, I say to her, is what NHS staff are saying.

Children’s Cardiac Surgery (Glenfield)

Debate between Anna Soubry and Jonathan Ashworth

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.

Whitsun Recess

Debate between Anna Soubry and Jonathan Ashworth

Thursday 24th May 2012 Commons Chamber

[Anna Soubry (Broxtowe) (Con)]

It is a great honour to speak in this Adjournment debate before the recess. Hon. Members should welcome the fact that I do not intend to speak for well over half an hour, so that everybody can participate in the debate and then go out to enjoy the sunshine and, more importantly, return to our constituencies to carry on the work that we do on a daily basis for our constituents.

I will talk about an issue in my constituency that I believe has an impact on other Members: the threat to the green belt in Broxtowe. I will address two direct threats to the green belt in Broxtowe. The first is an uncontroversial issue in that all political parties in Broxtowe are in agreement about it. We are united in our opposition to an application by UK Coal for an open-cast mine on a piece of land between Cossall and Trowell called Shortwood. It is a 325-acre site, and this is the third time that UK Coal has made an application to Nottinghamshire county council in respect of it. We have already held one public meeting, and there will be another one on Friday.

There is no merit whatever in the application that UK Coal has made. It would undoubtedly lead to an excess of dust and noise and the loss of an amenity that is much loved by many of my constituents. Perhaps the greatest irony of the application is that 1.5 million tonnes of coal and clay would be removed from the site and put into lorries. There would be eight heavy goods vehicle movements every hour along an already overly congested road, up to the equally congested Nuthall roundabout and on to the M1. The coal and clay would then be driven all the way back down the M1 to the Ratcliffe-on-Soar coal-fired power station. It is the stuff of madness that in this day and age we are still extracting coal in that way and burning it in power stations. We should now have alternatives up and running.

The second most important threat to the green belt in Broxtowe, which I believe also affects other areas, is housing development. Many hon. Members should be greatly concerned about it. What I will say is, in effect, an open letter to the Secretary of State for Communities and Local Government. In a nutshell, we have a serious problem in Broxtowe and other boroughs in Nottinghamshire and, I suspect, across the land. Councils have adopted and accepted the targets that were laid down under the last Administration’s old—they should be old—regional spatial strategies. That means that they have no alternative but to build on our green belt.

Only last week Broxtowe borough council voted on and accepted, with only the Conservatives dissenting, a top-down housing target of 6,150 houses being built in a 16-year period or so, as set down under the last Administration’s structures. We have very little green-belt land left in Broxtowe, because we have built on it over the years. We are now the most densely populated borough in the whole of Nottinghamshire, and arguably in the whole east midlands. Hon. Members do not need me to remind them that the whole purpose of green-belt land is to prevent urban sprawl and protect communities so that they stay just that—identifiable communities that people love and enjoy, for all the reasons that one can imagine.

The other great benefit of green-belt land, as well as its preventing the coalescence of communities, preventing sprawl and retaining identities, is that it provides green, open spaces that people can love and enjoy in many ways. They walk their dogs there, take their children there and so on. We do not have much of it in Broxtowe, which has become overdeveloped. Now we have the housing target, and we have only brownfield land or green-belt land to build on, so we face the real threat of yet more of our green belt being lost.

The situation flies in the face of the national planning policy framework that the Government announced at the end of March, and of the statements of the Secretary of State for Communities and Local Government and various other Ministers including the Leader of the House and the Prime Minister. They have made it crystal clear that green-belt land should not be developed on save in exceptional or very special circumstances, and then only after robust public consultation. There is a complete disconnect between what the Government are rightly saying—they could not say it in clearer or firmer tones—and what some councils are actually doing in the real world.

There is an argument about the amount of brownfield land that is available in Broxtowe, but up to 2,000 homes are to be built on our green-belt land. I believe that the majority of people in Broxtowe are against that. However, our Labour and Liberal Democrat council has steamed ahead in the face of local people’s views and without proper consultation. Instead of adopting Labour’s admirable policy of brownfield sites first and green-belt land afterwards, Broxtowe council is doing the reverse. The very first site that has been put forward for development—it is almost a done deal—is a place called Field farm in Stapleford. That piece of land separates Stapleford from Trowell, so it is doing its job and providing a buffer to prevent urban sprawl. It is also a place that people love very much. They go there to enjoy the wildlife and so on.

An application has gone in for 450 homes on that land, and the deep irony is that the two local councillors—Labour and Liberal Democrat—not only failed to vote against the plans that have made the land ripe for development, but spoke in favour of them last week. That flew in the face of the people whom they are meant to represent. Many people have found it ironic that it has been the Tories, and a Conservative MP, who have spoken out in defence of that green-belt land.

[Jonathan Ashworth (Leicester South) (Lab)]

The hon. Lady is speaking very well. I am an east midlands MP, as is she. She will recognise that a report published earlier this week suggested that the east midlands faces a potential housing crisis, and that in the next 20 years or so we will probably need 22,000 extra houses. I recognise her argument entirely, but those houses will have to go somewhere.

[Anna Soubry]

I am grateful to the hon. Gentleman and understand his point. Unfortunately, when we run out of land on which we can build houses, we have to look elsewhere. This is not about nimbyism; it is about the fact that my constituency only has enough brownfield land for about 3,000 houses. The target has been accepted, and the only other place to build is on the green belt. He mentions homelessness, and it is a valid point, but the number of people on the waiting list in Broxtowe is 2,254. As he will understand, that list often indicates the level of interest in finding houses that the council may have available. The number of homeless people recorded in my constituency is probably fewer than 10, if that.

I do not want to trouble the House any longer, but people in my constituency are concerned that their voices will yet again not be heard. Only this week, I was publicly admonished by the planning officer in an e-mail that was unfortunately copied to Labour councillors and my predecessor. The e-mail told me that my advice to my constituents was in some way inaccurate, but it was not at all. I have come to this place to achieve a number of things, but perhaps most importantly I am here to represent my constituents, whether they voted for me or not. I intend to continue to do that. In so doing, I speak out in favour of protecting the green belt in my constituency, whether from open-cast mining or from a housing target that my borough council did not have to accept.

I hope the Deputy Leader of the House will forgive me if I am not here at the end of the debate. I will be quiet very soon, so that others can speak. I hope that the Secretary of State for Communities and Local Government will make the Government’s policy quite clear yet again. I hope he will say that local authorities are under a duty to determine their own housing targets and make their own plans, and to protect their green belt from development at almost all costs.