Oral Answers to Questions

Debate between Anna Soubry and Virendra Sharma

Tuesday 11th June 2013 Commons Chamber

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

That is a good point, but I have to say that I am not convinced that it is just a Labour-run council that might have chosen to invest their staff pensions in this way; I strongly suspect that all political parties are guilty of this. While this is, of course, a matter for local authorities, it is also the sort of great campaigning work that MPs can do with their local councillors. It is even more important that they do that, given that they now have this great responsibility for public health.

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

T3. I welcome the leading role that the Department is taking in the formulation of a national strategy for TB. Its importance was reinforced by a recent all-party group report on resistant forms of the disease. One of the key points in the report was the importance of joint working in the development of the strategy, and that it should be public health-led. Does the Minister agree that NHS England also has a crucial role to play in the development of the strategy? Will she ensure that it works closely with Public Health England to develop it?

[Anna Soubry]

The short answer is yes. I pay tribute to the hon. Gentleman for the work of his APPG. We had a good meeting in December and I am looking forward to our follow-up meeting tomorrow when we will discuss this matter further.

Health Inequalities

Debate between Anna Soubry and Virendra Sharma

Tuesday 23rd April 2013 Westminster Hall

[Anna Soubry]

I can say that absolutely. The hon. Member for Ealing, Southall asked whether the Government are committed to reducing health inequalities and making the sort of progress that we did not see in 13 years of the previous Government. I assure him that it is not just a question of blind intention, but an absolute fact that we have already done it.

[Interruption.] I am making a noise because I am removing the script of my speech. I am not good at following a script from my officials. They are extremely helpful, and it sometimes causes them concern that I go off script and speak off the cuff.

I am familiar with the Health and Social Care Act 2012. What the hon. Gentleman either does not know—this is not a criticism—or may have forgotten is that, for the first time ever, there is a statutory duty, not just on the Secretary of State, but throughout the NHS, to improve health inequalities. It is not a question of targets, which have not always delivered the right outcomes, and Mid-Staffordshire NHS Foundation Trust is a good example, as was identified in the Francis report. That duty is statutory so the Secretary of State and all those involved in the NHS must deliver, and the Secretary of State must give an annual account of how his work in leading the Department of Health and being the steward of the NHS in England has delivered a reduction in the sort of health inequalities that we all understand. That is there in law, but in 13 years in government, the hon. Gentleman’s party failed to do that.

[Mr Sharma]

I am not disputing the matter and, as I said at the beginning of my speech, I do not want a blame culture or to say what happened during those 13 years, but I ask the Minister to join me in my constituency on Saturday when thousands of people will march from Southall to Ealing. At the last march in September, there were more than 20,000 people, and we expect more this time. She will then know whether people believe that services have improved or got worse.

[Anna Soubry]

I am grateful to the hon. Gentleman but, with great respect, he does not understand that reducing health inequalities is not simply about saving an A and E department. I hope that, when the hon. Gentleman is marching on Saturday, he will remonstrate with anyone who has a banner saying “Fight the NHS cuts”. Whenever anyone looks at reconfiguration, they do so on the basis of how to make the service better.

Accident and Emergency Departments

Debate between Anna Soubry and Virendra Sharma

Thursday 7th February 2013 Commons Chamber

[Anna Soubry]

I have only about nine minutes, and I hope he will forgive me if I do not take any interventions. I will answer any points that he wants to raise in a letter or in any other way.

Yesterday, many of us took the view that we had seen one of the best moments in Parliament, when the Prime Minister rose to talk about the Francis report. It has been noted not only by Members but in the press and elsewhere that his statement and the responses of Members on both sides of the House were made without any finger-pointing, any blame or any party political point scoring. Many people think that it was a refreshing moment. I want to remind the House of what the Prime Minister said in response to an hon. Member’s question to him. He said:

“Let me refer again, however, to one of the things that may need to change in our political debate. If we are really going to put quality and patient care upfront, we must sometimes look at the facts concerning the level of service in some hospitals and some care homes, and not always—as we have all done, me included—reach for the button that says ‘Oppose the local change’.”—[Official Report, 6 February 2013; Vol. 558, c. 288.]

In quoting the Prime Minister, I pay tribute to the comments of my right hon. Friend the Member for Newark, my hon. Friends the Members for Banbury (Sir Tony Baldry) and for Croydon Central (Gavin Barwell) and the right hon. Member for Tottenham (Mr Lammy). These matters are not easy. My hon. Friend the Member for Croydon Central explained how he sat on one side of the fence, regarding the reconfigurations in his area, and in direct contrast to the hon. Member for Mitcham and Morden (Siobhain McDonagh). She is doing the right thing in talking about the needs of her constituents and fighting for them as she does, but that is an example of a reconfiguration in which two Members want to do their best but are effectively at odds. That is inherent in these sorts of changes, and in these concerns about the future of our accident and emergency services. Indeed, I have had meetings with my right hon. Friends the Members for Carshalton and Wallington (Tom Brake) and for Sutton and Cheam (Paul Burstow), because they too have views on the reconfigurations in their area, as we might imagine.

I want to set the record straight and make it clear that the reconfiguration of clinical services is essentially a matter for the local NHS, which must, in its considerations, put patients at the heart of any changes. As my hon. Friend the Member for Banbury said, the NHS has always had to respond to the changing needs of patients and to advances in medical technology. As lifestyles, society and medicine continue to change, the NHS needs to change too. The coalition Government’s overall policy on reconfiguration—if I have to repeat it, I will, to make it absolutely clear—is that any changes to health care services should be locally led and clinically driven. That is our policy, and those who seek to say otherwise do so in order to score cheap political points, which do them no favours whatever.

Let me turn, if I may, to the comments made in the excellent speech by my hon. Friend the Member for Newark, which was also touched on by the hon. Member for Hartlepool (Mr Wright). It is absolutely right and it is the case that there is confusion about the terminology. What does “urgent care” mean; what does “A and E” mean; how does it all fit in; where do we go? The hon. Member for Hartlepool made a very good point when he talked about the need for good public transport services to be part of any reconfiguration. I accept that.

I am pleased to say that on 18 January 2013, the NHS Commissioning Board announced that it is to review the model of urgent and emergency services in England. The review, which will be led by the medical director Sir Bruce Keogh, will set out proposals for the best way of organising care to meet the needs of patients. The review will help the NHS to find the right balance between providing excellent clinical care in serious complex emergencies, and maintaining or improving local access to services for less serious problems. It will set out the different levels and definitions of emergency care. This will include top-level trauma centres at major hospitals such as my own, the Queen’s medical centre in Nottingham —and here I hope that my hon. Friend the Member for Newark would accept that the journey to that centre down the A46 has added to provision for the great town of Newark. The definitions will be looked at and the review will take into account, as I say, the trauma centres at major hospitals, but also local accident and emergency departments and facilities providing access to expert nurses and GPs for the treatment of more routine but urgent health problems.

[Mr Virendra Sharma]

rose—

[Anna Soubry]

I am not giving way. I really, truly do not have the time, and I am trying to respond to all the points raised. I want to make reference, and indeed give credit, to all Members who have taken part in the debate.

As part of the review’s work, it needs to consider public understanding of the best place to go for care.

Let me refer to the important and valid speech from my hon. Friend the Member for Ealing Central and Acton (Angie Bray). She spoke about the fact that many of her constituents and others—full credit to a cross-party campaign—feel that this has been a fait accompli or a done deal. She spoke about the need to work with people—other hon. Members have talked about that, too—and the need for those conducting these configurations to work with the people and to explain things to the people. She put it very ably, if I may say so, when she emphasised the importance of “taking people with you”. I think everybody should remember that important point.

I pay tribute to the remarks made by my hon. Friend the Member for Enfield North (Nick de Bois). He made a number of points, all of which, he will be pleased to know, I have written down. I know he is meeting the Secretary of State in just a couple of weeks’ time or it may be next week. Again, this is a cross-party meeting. I will not go through all my hon. Friend’s points, but I think they are important ones, which I know he will put with great force to the Secretary of State.

My hon. Friend the Member for Eastbourne talked about the four principles and four tests of any reconfiguration, and the importance of support from GP commissioners.

I see in their places the right hon. Member for Lewisham, Deptford (Dame Joan Ruddock) and the hon. Member for Lewisham East (Heidi Alexander) who raised points about the very difficult decision taken on Lewisham and other hospitals—a decision that I think was absolutely right. I know it has caused great concern, but Lewisham will not lose its A and E. It will see a reduction, but it will not lose it. Those Members and others have stressed the need for GPs to be part and parcel of what happens. My hon. Friend the hon. Member for Enfield North expressed concern about the possibility that the fact the clinical commissioning groups had yet to come into operation had not been taken into account.

I see that the clock is against me. I had many more things to say, but I cannot now say them. What I will say is that I thank all who have contributed to what has been a good debate, and that, if I have not replied to any points that have been made, I will write to the Members concerned.