Oral Answers to Questions

Barbara Keeley Excerpts

Tuesday 7th July 2015 Commons Chamber

[Mr Hunt]

My hon. Friend can tell them that when Labour Members opposed the Health and Social Care Act 2012, we were doing the right thing for patients, with 18,000 fewer managers, 9,000 more doctors and 8,500 more nurses, whereas the Labour party was posturing. We can see the results of that posturing in Wales, where more people wait for A&E, more people wait for their cancer operation, and 10 times more people are waiting for any kind of operation.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

The Secretary of State talks about having similar levels of care, but we do not have similar levels of safe staffing around the country. Peter Carter has said about the decision on NICE:

“If staffing levels are not based on evidence there is a danger they will be based on cost.”

Is my hon. Friend the Member for Wirral West (Margaret Greenwood) not right? NHS England should reverse that decision and let the independent body be the judge of safe staffing levels.

[Mr Hunt]

I gently say to the hon. Lady that we will not take any lessons in safe staffing from the party that left us with the tragedy of Mid Staffs. We have recruited 8,000 more nurses into our hospitals because we have learned the lessons of the Francis report. The important lesson in the report is that it is not simply about the number of nurses; it is about the culture in hospitals and making sure that nurses are supported to give the best care. We want to learn those lessons as well.

A&E Services

Barbara Keeley Excerpts

Wednesday 24th June 2015 Commons Chamber

[Mr Reed]

Everything that transpired in my hon. Friend’s constituency made the situation much worse, as many medical professionals have said.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Is there not an extra pressure, with many trusts ending the year with deficits? Wythenshawe hospital, which is looking at a £3 million deficit, has decided to try to cut 33 district nursing posts, yet when the Health Committee looked at winter A&E pressures we found that it was important to hang on to district, community support and hospice nurses. Is it not just madness to force hospitals with deficits to cut district nurse posts?

[Mr Reed]

My hon. Friend puts her finger on the problem precisely. It is absolute madness, and it is happening at trusts throughout England, as their deficits edge up towards £1 billion for this financial year.

The number of patients waiting more than four hours each year has rocketed by more than 1 million, meaning that there are now almost four times as many people as there were five years ago waiting more than four hours. That is a damning record, and based on the performance over the previous Parliament five more years of the same will see almost 2.5 million patients each year waiting more than four hours by 2020. For the benefit of patients, medical professionals and the healthcare system as a whole, that cannot be allowed to continue.

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[Ben Gummer]

I am not sure I get the gist of the hon. Gentleman’s point, but I do think that the shadow Secretary of State for Health should propose the motion in an Opposition day debate on health matters. I hazard a guess that there has been a disagreement between the two shadow Ministers—perhaps a suggestion that one of them is using health debates as opportunities to grandstand. I hope that that is not the case.

I am slightly concerned that we are about to see another episode of the ongoing psychodrama which is the Labour party. We had the TB-GBs and then, when that very happily came to an end, we had the Miliband “Band of Brothers”—a disaster for that family but happily not for the country.

[Barbara Keeley]

On a point of order, Madam Deputy Speaker. I really wonder whether this is within scope. Is it at all orderly to be debating which Minister is answering or proposing a debate? This happens quite a bit in this House—for example, the Chancellor did not come last week. It is just not orderly to be starting off the debate in this way.

[Madam Deputy Speaker (Natascha Engel)]

I thank the hon. Lady for that point of order. I think the point has been made. Perhaps we can move on with the debate.

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[Ben Gummer]

It is a real delight to respond to my hon. Friend. It is a good thing for the shadow Minister and those living in England that they do not have to endure the experiences of people in Wales, which have, I am afraid, been inflicted on them by the appalling management of the Labour Government there, who chose not to invest in the NHS in the way that we did, in a time of constrained budgets across the public sector. I have to say to the shadow Minister that by concentrating on money—he cannot match the Conservative party’s commitments on that anyway—he misses the points around quality and safety, which are conjoined with money. If we go back to the Mid Staffordshire NHS Foundation Trust—[Interruption.] Opposition Members may groan, but they may wish to reflect on why Stafford hospital went wrong. It was within budget and was hitting its targets, yet at the same time it was killing people. Until that simple fact is remembered, and until we put quality and patient care first, we will not get the efficiency, as regards either care or money, that I am sure Members on both sides of the House wish to see.

[Barbara Keeley]

rose—

[Ben Gummer]

I am sure that the shadow Minister has come to the House without reading the speech in which my right hon. Friend the Secretary of State directly addressed the issues caused, in some trusts, largely by agency spending, which took place because of the chronic understaffing created by the previous Government, and put right by us. That led in part to the catastrophe at Mid Staffs. The shadow Minister has not read my right hon. Friend’s comments about limiting the salaries of highly paid managers in the NHS, or his comments about cutting consultancy pay. It is precisely that kind of action—including enabling chief executives of NHS trusts to control their budgets—that this Government are taking to ensure that, nationally and locally, we are living within our means.

[Ben Gummer]

I can guarantee that to the hon. Gentleman. On minimum staffing, it was in response to the Francis inquiry that this Government, in their previous incarnation, set the Care Quality Commission a specific target of doing something about minimum staffing. That did not happen before then. He understands that relationship between safe care and money. I just wish that he was able to explain it to his colleagues on the Front Bench, because if they went to the Salford Royal hospital, they would see how, through instigating safer care, it is saving £5 billion a year. It is by combining quality and efficiency that we get the double benefit of better care for patients and better returns for the taxpayer.

[Barbara Keeley]

rose—

[Tom Pursglove]

rose—

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[Ben Gummer]

My hon. Friend, and our hon. Friends in Northamptonshire, have worked hard together—as Northamptonshire MPs did previously on a cross-party basis—to find the best configuration of services for their county. It is a great shame that that model of cross-party working cannot be echoed or reflected across the House. In that vein, I would prefer it if the Opposition had come here to talk about plans for social care. They have two competing visions for social care. We sometimes hear thoughtful remarks from the shadow Minister for care and older people, but then there is the shadow Secretary of State’s repetition of the phrase about wanting a top-down reorganisation of the NHS around a social care model. None of that will deliver what we all want: an integrated NHS and social care model, which is what we are beginning the journey of creating. We are doing that by reflecting locally what local places need in terms of integration rather than creating a national model to which they have to adhere. Again, it is important to fix all this—

[Barbara Keeley]

Will the Minister give way?

[Ben Gummer]

I will after I have finished this comment.

It is important to put all this in the financial context. I have been through the Lobby with the shadow Minister and with many Labour Members who were in the previous Parliament. We went through the Lobby just before the election when we agreed to cuts in public expenditure in the first two years of this Parliament and the former shadow Chancellor committed the Labour party to cuts in local government spending. Difficult choices are forced on us by the catastrophe and chaos that we were left in 2010. Labour Members need to confront those difficult choices. They cannot have it both ways. They cannot, on the one hand, say that we need massive increases in payments for social care and, on the other, say that they are going to constrain public spending. The answer to that dilemma is surely to try to find a better way of integrating social care that I hope would see cross-party consensus rather than the politicking we have just seen at the Dispatch Box.

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[Ben Gummer]

My right hon. Friend never planned to close Lewisham hospital. I give the hon. Lady this promise: I will certainly come and speak to her about her constituency before anything happens—in fact, if nothing happens—because I care very much about the provision of secondary and tertiary care there. That also goes for my colleagues on the Front Bench.

Let me give the facts of what we are doing in funding better social care and integrated social care in the NHS. We are already transferring £1.1 billion of NHS spending into social care funding as part of the additional £8 billion over the next five years. That money will be for social care as well as the NHS. It is part of an integrated system that NHS England envisages. Through the better care fund, funded to the tune of £5.3 billion, we are funding the local integration of social care and health care. That will produce a different solution in Manchester than in Ipswich, and that is a good thing because those two places are different.

[Barbara Keeley]

Will the Minister give way?

[Ben Gummer]

I will.

[Barbara Keeley]

I thank the Minister for giving way eventually, because he has made a number of points about my local area. In Salford, we are moving heavily into integration—we are one of the better places in the country for that—but the work there is not assisted by a number of things. The better care programme funding is not extra funding. A large hole has been created, as in Lewisham, by cutting back on social care funding. Even at a smaller level, the closure of walk-in centres in Salford and the ending of active case management as efficiency cuts are made have not helped. All these things are part of the jigsaw. All we have seen is cuts.

[Ben Gummer]

Walk-in centre closures were supported by the hon. Lady’s hospital because that gave a safer service. I walked through the Lobby with her also. Because her party is unable to make a decision about money being spent on benefits and on the general budget for government, she would not be able to pledge any more than my party; in fact, she could only promise less funding for social care. She has to be straight with voters. Labour Members cannot have it both ways. They cannot spend money on the NHS, benefits and all the other things that they are pledged to increase funding on, and also claim to be the party of fiscal responsibility. It just does not hang together.

Oral Answers to Questions

Barbara Keeley Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for raising that case and I will happily look into it. That is a perfect example of why we need to change the way we look after people with long-term conditions, such as dementia, out of hospital. If we can improve the care that we give them at home and give better support to people such as that man’s wife, we can ensure that the kind of tragedy my hon. Friend talks about does not happen.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Unpaid family carers play a key role in the care of people with dementia, many with heavy caring workloads of 60 hours a week or more. Can the Health Secretary understand how fearful carers now are of talk of cutting their eligibility for carer’s allowance and will he fight any moves within his Government to do that?

[Mr Hunt]

I absolutely recognise the vital role that carers play and will continue to play, because we will have 1 million more over-70s by the end of this Parliament, and we need to support them. I hope that she will recognise that we made good progress in the previous Parliament with the Care Act 2014, which gave carers new rights that they did not have before.

Health and Social Care

Barbara Keeley Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Andy Burnham]

My hon. Friend anticipates me, because this is precisely the issue I am coming on to. Under the Lansley reorganisation, workforce planning went out of the window, and that led to today’s huge workforce crisis and hospitals being in the grip of private staffing agencies. That is the single biggest driver of the NHS deficit that I mentioned a moment ago, and I will talk about that shortly.

The Secretary of State gave us a pious warning about temperate language, yet this is the Secretary of State who today on the front page of The Daily Telegraph is saying that the NHS has enough cash and now must deliver:

“the time for debating whether or not”

it has enough money is over, it

“now needs to deliver its side of the bargain”.

Not for the first time, that is a statement by the Secretary of State that will have caused jaws to drop across the NHS. People will not forget the time he accused hospitals of coasting when they were in the middle of an A&E crisis, but even by his standards this was a staggering piece of spin.

The simple fact is that the NHS does not have enough money. In fact it is seriously short of money. It is facing a £1 billion deficit this year, with two thirds of hospitals in the red, which marks a major deterioration from what the Conservatives inherited in 2010, when there was a surplus of over £500 million.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Are not some rather stupid decisions about to be made? Wythenshawe hospital has a £3 million deficit and is talking about cutting 28 district nursing posts. The Secretary of State said earlier that community resources are important. Of course they are, but if we are going to cut district nurses every time there is a trust deficit like the one at Wythenshawe, we are not going to get through another winter without a much more serious A&E crisis.

[Andy Burnham]

That is exactly the point. When we are in a crisis like this, short-term, knee-jerk cuts are made, which make the situation wrong in the long term.

When I raised these deficits in the election campaign, the Secretary of State said I was scaremongering, but just two weeks after the election the truth emerged. [Interruption.] He says I was, but we now know the truth. There was an £822 million deficit in the NHS last year, a sevenfold increase on the previous year. [Interruption.] The Secretary of State says he is dealing with it. That is not good enough. That is appalling mismanagement of the NHS. Financial grip in the NHS has been surrendered on this Secretary of State’s watch, and things are looking even worse this year. Far from scaremongering, these issues are real and should have been debated at the last election. The NHS is now facing a £2 billion deficit this year. As my hon. Friend the Member for Warrington North (Helen Jones) said earlier, that will mean cuts to beds, to staff and to services.

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[Barbara Keeley (Worsley and Eccles South) (Lab)]

It is a pleasure to follow the speeches of so many new Members, in particular the excellent speech of my hon. Friend the Member for Bristol West (Thangam Debbonaire), as well as another fine speech by the hon. Member for Eastleigh (Mims Davies), which we have just heard. Both those speeches were excellent expositions of the highlights of the Members’ local areas, and I was pleased to hear the commitment to carers that the hon. Member for Eastleigh has just made; I will expand on the issue of carers later.

I am delighted to have been elected by the people of Worsley and Eccles South to represent them in what is my third parliamentary term. There are 73,000 people in my constituency and I vow today to represent them all to the best of ability. Today, however, I want to talk about the 10,800 or so of my constituents who are unpaid family carers and part of the 6.5 million people who are carers across the UK. That is appropriate, because this year is the 50th year of the movement to support carers, and, as the hon. Member for Eastleigh has just said, next week is carers week. Carers week is a time when we celebrate the unpaid work of family carers, like the hon. Lady herself, and also a time when we should think about how we can better support those carers. Before I talk in more general terms, I pay tribute to Salford Carers Centre, which is part of the Carers Trust, and Salford Young Adult Carers project. I feel fortunate, as an MP in Salford, to know that the carers centre and the young carers project are providing such excellent support.

In April, when we were all busy campaigning, Carers UK published a survey of the state of caring. Over this Parliament, an estimated 10.6 million people will take on a new caring role for a family member or friend who is disabled, elderly or seriously ill, and the report tells us that we will not give them the support they need and deserve unless we make changes to ensure adequate care services and improved quality of care and, where we can, maintain and improve the financial support for carers.

It should be no surprise, after the last Parliament, that more than half of carers surveyed said they were worried about the impact of cuts to care and support services over the next year. They are right to be worried, because since 2010 Government cuts to local authority budgets have meant that more than £3.5 billion has been cut from adult social care budgets. Besides the quantity of support services available, which is important, family carers also worry about poor quality services. My right hon. Friend the Member for Leigh (Andy Burnham) rightly referred earlier to those terrible 15-minute care visits. Only just over a quarter of carers reported positive experiences of home care or respite care, and just over a fifth reported bad or terrible experiences of care, with the rest reporting mixed or fair experiences.

I say to the Minister, whom I am glad is in his place, that we should not be happy to hear that there is a lot of poor quality care out there. Poor care services mean that family carers have to take even more on themselves, with little respite from caring. Again, it is no surprise that six out of 10 carers told Carers UK that they were at breaking point. Caring can have a substantial impact on the health of the family carer. More than eight out of 10 carers reported to Carers UK that caring was having a negative impact on their health, and that figure is much higher for people caring for someone with dementia. Some 74% of carers report that they are struggling to get a good night’s sleep, and 47% are having difficulty maintaining a balanced diet.

Sixty thousand carers are affected by the bedroom tax. In the last Parliament, I introduced a Bill to exempt households with one extra bedroom from the bedroom tax if a carer in the house was eligible for carer’s allowance. While a disabled person who needs overnight care from a paid careworker or non-resident relative is exempt from the bedroom tax, they are hit by the tax when the care is provided unpaid by a partner or another carer living in the same house. That is unfair. Subjecting carers to the bedroom tax is illogical as well as unfair. One aim of the bedroom tax was to improve work incentives for working-age claimants, with the assumption that people should seek work or increase the number of hours they work to pay the bedroom tax. But for many unpaid carers that is not an option—entitlement to carer’s allowance means caring for someone for more than 35 hours a week, and Carers UK reports that 60% of those caring for people with dementia care for 60 hours a week. Clearly they cannot move back into employment without reducing their ability to care.

It is an insult to the 2.3 million people who have made the difficult decision to give up work so that they can care for a family member to be penalised further for that decision. Last week, I asked the Prime Minister to confirm that the planned £12 billion of welfare cuts would not include a measure to cut eligibility for carer’s allowance. He did not answer the question, and neither did the Health Secretary today. It is even more worrying for the 670,000 carers who get carer’s allowance that it is going to be cut.

I have not read all the Conservative manifesto, but I know that it said little about carers. It said only this:

“We will increase support for fulltime unpaid carers.”

I have suggested that this will mean ensuring sufficient funding for social care as well as for the NHS and improving the quality of the care services. It will also mean that carers should not suffer financial hardship as a result of their caring. Full-time family carers should not be subject to the bedroom tax, and carers should not be worrying, as they now are, about losing their eligibility for carer’s allowance. My party was committed to making it a duty on the NHS to identify carers—a measure that would help carers’ health—and I hope we can see that brought forward, if not by the Government, then in a private Member’s Bill.

I have raised today a number of issues of great importance to 6.5 million carers. It is time that their issues achieved more prominence in the House, and I will continue to raise them, as I have done today.

Vaccine Damage Payments Act

Barbara Keeley Excerpts

Tuesday 24th March 2015 Westminster Hall

[Barbara Keeley (Worsley and Eccles South) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Caton. I congratulate my hon. Friend the Member for Dumfries and Galloway (Mr Brown) on securing this debate and on the moving way in which he opened it.

I am here to speak briefly on behalf of constituents. Their daughter was born healthy in 1972, but they noticed a sudden change after she received the whooping cough vaccination. Unfortunately, their daughter had suffered brain damage. They tell me that she was examined by several doctors, including doctors at Alder Hey hospital in Liverpool. They have lived with the damage done by the vaccine ever since. They have looked after their daughter for 42 years at considerable cost, both physically and mentally, and they are members of the vaccine victim support group, which is fighting for compensation for all those who have suffered severe adverse reactions after being vaccinated under the Government vaccination programme.

My constituents tell me that, as they are now ageing, they are desperately anxious to provide for the future of their daughter. It must certainly be true that parents now in their 60s and 70s with children in their 40s and 50s will feel the same way. My constituents have sacrificed everything over the past 42 years to ensure that their daughter is loved and cared for by her family, rather than by the state. To date, the family have received only what were purely initial and top-up vaccine damage payments—certainly not compensatory payments—to cover four decades of care. As my hon. Friend said, even the £120,000 top rate of payment under the current scheme would really only pay for one year of care, and my constituents have not even received payments at that level.

My constituents feel that all responsible Governments should have a vaccination programme, but they feel that Governments then have a moral responsibility to care for those whose lives are damaged by vaccination. They referred me to the paper, “Reform of the Vaccine Damage Payments Act 1979”, that was presented to Ministers in October 2011. They point to the recommendation in that paper that any vaccine recommended by Government should be covered by the Act. My hon. Friend detailed a number of vaccinations that were left out of the Act, and they should not be. More modern vaccines, such as the HPV vaccine that was referred to, should be included. Importantly, to avoid expensive litigation, the scheme should cover proper compensatory levels.

We can only imagine the pain endured by my constituents’ having a daughter, the first child of four children, suffering after vaccine damage. My constituents are now in their 60s and very worried about the future of their daughter. They are finding it more and more difficult to give her the time and care that she needs 24 hours a day. Their son tells me that seeing his parents struggle with a 42-year-old daughter, severely disabled as a result of vaccine damage, but not having received adequate compensation, is a total injustice.

My constituents tell me, and I imagine we would all agree, that my hon. Friend has fought tirelessly for their cause, and I thank him for that work. It was only recently that I got to know of the case of my constituents and their daughter through the work of the all-party group, which they recommended I join, and I was happy to do so. I have spoken only briefly, but what I have said on their behalf speaks for the reason why the victims of vaccine damage should get proper compensation and not rely on expensive litigation, which, as my hon. Friend has said, is not feasible.

Four decades of care is a great deal to give—avoiding the care having to fall on the state—but the family members, the unpaid carers of victims of vaccine damage, should be supported. All carers should be properly supported with compensatory payments, and I hope that this debate today has raised the issue so that it will go forward into a future Parliament and that real action will be taken.

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[Jane Ellison]

My sense is that the scheme, which aims to provide proportionate help, has got the balance about right, but I have heard the concerns expressed today. It is worth noting that successive Governments have considered this matter and chosen not to alter the scheme. That consideration would have involved looking at it in some detail. Equally, I note gently that the shadow Minister, analysed the situation and asked many questions, but made no commitments, although she aspires to sit in my place in just a few weeks.

The House will note that many successive Governments of different parties have looked at the scheme and have, I think, drawn the same conclusion, which is that the balance is about right. That is not to say that the hon. Gentleman’s concerns are not listened to: far from it. I have listened to his concerns and will take those away and reflect on them.

There are no current plans to make any changes to the time limits. Again, the hon. Gentleman made his case about that, as did other hon. Members.

[Barbara Keeley]

I hear what the Minister is saying, but this may be the last chance to comment. I talked about a case where the payments are not in any way compensatory. Previous Governments lifted the level of payment substantially up to £120,000. Can she not give any hope to parents in their 60s who are struggling with care? Care is expensive, and increasingly so under her Government. What can she say to give some hope to parents in that situation, of whom, as we have heard, there are very many, including my constituents?

[Jane Ellison]

The challenge is that a number of aspects of the scheme, which has existed under successive Governments, make some individual cases particularly hard. The hon. Lady has touched on some reasons for that in her contribution.

The Government have no plans to change how the scheme is run, as one might expect in the last week before the House rises before the general election, and there are no plans to review it, as I have said. However, we are about to have a new Parliament. I am sure that the hon. Member for Dumfries and Galloway and other hon. Members may wish to return to this subject. The work of the all-party group will continue. The hon. Gentleman has indicated that he wants to raise the reform of the Act in the new Parliament. The shadow Minister has made some points, but no commitments. The hon. Member for Dumfries and Galloway may therefore wish to use the next few weeks lobbying within his own party, if he cannot speak in Parliament, making his case forcefully to his colleague.

I note the concerns expressed today. I am not in a position to say that the scheme will be reviewed. As is the way of these things, all these matters will now be for a new Government to consider. However, the hon. Member for Dumfries and Galloway put his points thoughtfully, as ever, and they have been thoughtfully taken on board and will be considered.

Francis Report: Update and Response

Barbara Keeley Excerpts

Wednesday 11th February 2015 Commons Chamber

[Barbara Keeley (Worsley and Eccles South) (Lab)]

May I support the suggestion from my right hon. Friend the Member for Leigh (Andy Burnham) to extend to social care the measures recommended by Sir Robert Francis? I know from my own casework how hard it is for a whistleblower in social care working for a small organisation to reveal issues of bad care. In addition, the Health Select Committee pointed out that many whistleblowers suffer in their careers, including in social care, lose their job and find it hard to find a new post, and it recommended that whistleblowers who are vindicated receive an apology and practical redress. Does the Secretary of State agree?

[Mr Hunt]

I agree with the hon. Lady’s argument. Just as poor care has been identified in hospitals, so we have seen terrible examples of things happening in residential care and of inadequate domiciliary care. It is more complex, because the delivery of social care is more diffuse, but one way to deal with this is through the proper integration of health and social care and the proper assessment of quality based on the entire package of care that people receive, not just in individual institutions but across the board. We are doing a lot of work on that.

NHS Major Incidents

Barbara Keeley Excerpts

Wednesday 28th January 2015 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right to say that. It is why many people in the NHS will be so astonished to hear the shadow Secretary of State, who presided over a culture where precisely that kind of leaning from on high happened, making it difficult for people to make those local operational decisions in the interests of patients, now trying to make a political point. This was a local decision and it was confirmed today that Ministers had no involvement in it, and Labour should stop trying to score political points.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

This Government caused confusion about decision making and accountability because of their reckless and expensive restructuring of the NHS. Now, to achieve what the Secretary of State wants to achieve, he has to resort to the sorts of measures we are discussing. We have had two major incidents declared in local hospitals in Salford in one week recently, and I have great concerns that this sort of guidance means that it is harder for clinicians to take the steps necessary to resolve the A and E crisis. They should not have to think about the issues listed in this document: politics and whether there is a risk of reputational damage. I do not want Salford Royal hospital and the Royal Bolton hospital thinking, “We can’t do this because of reputational damage.” This should be done entirely on the basis of clinicians’ reasoning.

[Mr Hunt]

That advice was issued in the west midlands, and not in Salford. The hon. Lady talked about the reorganisation. Well, that reorganisation means that we have been able to afford 82 more hospital doctors and 589 more nurses in her area, which is helping her constituents. Salford is one of the best examples of integrated care in the country, which is why any hospital declaring a major incident should think about the impact on the rest of the NHS locally. That is what the guidance says.

NHS (Government Spending)

Barbara Keeley Excerpts

Wednesday 28th January 2015 Commons Chamber

[Chris Leslie]

It was quite a simple question. The Minister could have dealt with it there and then, and pushed the matter to one side. I half expected him to do so. But no, that is not the answer he gave. Perhaps we are seeing the return of Michael Howard. The patient passport rears its head again.

What else can we expect from the Conservatives? More privatisation and more market-based changes.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I, too, serve on the Health Committee. Alongside the things that we have heard about today and the concerns expressed by Opposition Members following the Health and Social Care Act 2012, is it not a really worrying development that £1.2 billion of cancer services and end-of-life care services in Staffordshire and Stoke— a wide geographical area—are being tendered out in a 10-year contract? That is a risky thing to do and it has never been done before for a single disease. Will all patients with cancer who are at the end of their lives be able to rely on those services, given that the majority of those tendering are private companies? Is that not the big issue? Will the Minister answer that point?

[Chris Leslie]

That is the sort of ideological stain that has pervaded the NHS policies of recent years. We must recognise that, should the Conservatives win the general election, we will see more of the same. That is the course the NHS will pursue. Not just that, but the Government breach the NHS constitution time and again on safeguards, waiting times, ambulance responses and cancelled operations. The squeeze on resources will force patients increasingly to pay for private treatment.

It fell to the generation after the second world war to build the NHS. It fell to Labour in 1997, after 18 years of Conservative neglect, to save the NHS. Today, it once more falls to Labour to rescue the NHS and rebuild it for the 21st century. The choice is stark: a tangible and fully funded 10-year plan to boost investment in our NHS with Labour, versus more decline and more of the same from the Tories, as they dismantle the NHS by stealth. It is beyond doubt that the NHS as we know it cannot survive another five years under the Tories, because once the NHS is gone, we will never get it back.

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[Dr Poulter]

Through the “Agenda for Change” settlement, many nurses will receive an incremental pay rise worth an average, I think, of between 3.2% and 3.4%. On top of that, we have come to an agreement with the unions to give a 1% rise, particularly to the lower paid NHS staff. That is something I hope the hon. Lady welcomes. It is worth highlighting that one of the biggest things that supports front-line staff is increasing numbers. In Plymouth Hospitals NHS Trust, the number of hospital doctors since 2010 has increased by 25 and the number of nurses by 62. That shows that the investment we are making at national level is paying dividends at local level in her trust.

[Barbara Keeley]

Will the Minister give way?

[Dr Poulter]

I am going to make some progress and I am sure I will give way to the hon. Lady later on.

The investment we are making in the NHS also means that our NHS is caring for more patients than it has ever done before. Last year, compared with Labour’s last year in office, there were 1.2 million more episodes of in-patient care, including 850,000 more operations, 6.1 million more out-patient appointments, 3.6 million more diagnostic tests and almost 460,000 more GP referrals seen by a specialist for suspected cancer, meaning that under this Government more patients are receiving early referral for important care. We have also reduced the number of administrators in our NHS by 20,000. That is freeing up more cash to be reinvested in the front line of patient care.

--- Later in debate ---

[Dr Poulter]

Well, I am a doctor. It is a pity there are so many professional politicians in the Labour party. Had they experience of real life, they might be able to make a more valuable contribution to debates in this place.

In 2015-16, funding for front-line NHS services in England will be £2 billion higher. Of this additional funding, £1.5 billion will go to local NHS services to meet the ever-growing demand for services and to provide better care for the frail elderly and people with long-term medical conditions, such as heart disease and dementia. In addition, £200 million will go towards piloting new care models set out in NHS England’s “Five Year Forward View”; £250 million will provide the first tranche of the new £1 billion fund, spread over the next four years, for investment in new primary and community care facilities; and about £30 million will go to the NHS to develop the best approaches to caring for young people with eating disorders in both in-patient and community settings—which further answers the question from the hon. Member for Liverpool, Wavertree by confirming this Government’s commitment to providing better care for people with mental illnesses.

[Barbara Keeley]

rose—

[Dr Poulter]

I will give way one more time, but after that I will not give way for a while, as I want to make some progress.

[Barbara Keeley]

I thank the Minister for giving way, particularly as he is a doctor. He never took into account my real-life experience in IT when we debated care.data, so he wants to be careful about saying that people do not have real-life experience—several of us have real-life experience in different industries, but he does not take that into account.

[Chris Heaton-Harris (Daventry) (Con)]

Point to them.

[Barbara Keeley]

I am pointing at myself.

[Madam Deputy Speaker (Dame Dawn Primarolo)]

Order. Mr Heaton-Harris, will you allow the intervention to take place? I am sure you will have a chance to join the debate when you catch my eye later. However, I do not want interventions to be overlong either, because we do not have much time left in the debate. Barbara Keeley, will you therefore please be brief?

[Barbara Keeley]

Will the Minister address the issue of delayed discharges and the impact of cutting community resources? We have touched on social care in general practice, funding for which has really been cut, but the big issue that comes up again and again before the Health Select Committee concerns the loss of thousands of district nurses. I heard yesterday that in the north-west agencies do not even have supply district nurses. Will he address the matter of those community resources? He is talking about community care for the elderly and vulnerable. What will be done about district nurses?

[Dr Poulter]

As the hon. Lady will be aware, front-line staff use IT and understand the importance of joining it up to benefit patient care while also protecting confidentiality. On the point about district nurses, she is right that we need to transform the model of care, which is why the Government set up the £5.2 billion better care fund—to ensure we join up more effectively what happens between our acute hospitals, the wider NHS and adult social care. This approach will be transformative, delivering better care for the frail elderly and providing more care in people’s homes.

Of course, part of that is about changing work force models and ensuring that staff who have traditionally worked only in hospitals, supporting people with long-term conditions such as multiple sclerosis, can also work in the community. [Interruption.] The hon. Lady is chuntering away, but I have answered her question in an informed and sensible way, having spoken about how our work force models need to change as part of our investment in integrating and joining up care so that patients looked after now in a purely hospital environment can have access to staff across both community and hospital care, which is important for people with long-term conditions such as diabetes, multiple sclerosis and dementia. I hope she can support that.

It is also important to consider some of the equally important funding decisions we have made in maternity care. In 2013-14, we provided £35 million of capital funding for the NHS to improve birthing environments, which represents the single biggest capital investment in maternity care for decades. That has benefited more than 100 maternity units, including through the establishment of nine new midwifery-led birthing centres in eight areas, and transformed many local maternity services across the country. Improvements delivered by our maternity investment fund include: more en-suite bathroom facilities in more than 40 maternity units, providing more dignity and privacy for women; more equipment such as beds and family rooms in almost 50 birthing units, allowing dads and families to stay overnight and support women while in labour or if their baby needs neonatal care; and bereavement rooms and quiet areas at nearly 20 hospitals to support bereaved families after the thankfully rare but always tragic loss of a baby.

Our £35 million maternity investment has made a big difference to the experience mums and families have of NHS maternity services.

--- Later in debate ---

[Mr Spencer]

That is where the hon. Gentleman’s party falls down. Labour Members obsess about cash and forget about clinical operation. That is why we ended up with crises such as that at Mid Staffs hospital, with people dying in their beds because of bureaucracy, target setting and obsession with process rather than the care of patients.

The Opposition also have an obsession with the private sector. My father had to have a new knee, unfortunately. He went to the local hospital, which happens to be the one that the constituents of the hon. Member for Nottingham East attend. Rather than being treated in the NHS Queen’s medical centre, he was sent to a hospital in Sherwood in his constituency, which looked after him very well. It was a private hospital and this was in 2008—under the previous Government. The NHS was making use of private services back then. It was very efficient and well delivered. I do not understand this obsession with the private sector. We need to remember that private companies make the drugs that the NHS uses; private companies make all the crutches and the ambulances; and GPs are, in effect, private companies. It works very well. As long as we can deliver a service that is free at the point of use and run in the most efficient way but with the highest levels of care and consideration, I think that is the right place to be.

[Barbara Keeley]

Let me return to my earlier point. Would the hon. Gentleman be comfortable if his constituents with cancer or those at the end of their lives had to contend with a totally privatised service? That is what we might have to contend with, because we might be faced with a 10-year contract to privatise all those services. It has never been done before, and it is highly risky—and the oncologists were not even consulted about it. We are not talking about supplementing; we are talking about private services replacing the NHS.

[Mr Spencer]

I thank the hon. Lady for that intervention. What my constituents who are in the unfortunate position of suffering from cancer care about is whether they are going to get better. Is the service going to deliver a service that makes them better and gets them over the disease? Frankly, if it does not cost constituents any money, and if the level of care and service is the highest, I think that is what really matters to them.

It is easy to stand here and talk. Politicians talk—they will always talk—but we have to look at what politicians do. This Government, to their credit, have in this Parliament put in an extra £12.7 billion. Let us compare that with how politicians have operated in Wales, where the budget has been cut by 8%. I think it says a lot to our constituents about how the NHS is going to be managed in future and how much we genuinely care about and want to support the NHS system.

--- Later in debate ---

[Margot James]

That is a good example, and I know how hard my hon. Friend has worked in his constituency to assist in bringing about that improvement.

The polls clearly show that the public have very little confidence in Labour’s proposals to manage the economy. However, I want to make sure I do everything I can to get the public to cast a weather-eye over the Opposition’s plans for the NHS, and to remember which party introduced privatisation into the NHS, and why. I remember calling on an elderly lady who had been waiting almost two years for a cataract operation on both eyes. That was what the previous Government presided over, and in desperation they called in the private sector to reduce those waiting times. They could not bring about change within the NHS because of their target-driven management culture and their command and control-driven philosophy, so they had to bring in the private sector.

What we are seeing now is a tiny increase: the whole of the private sector accounts for less than 7% of total NHS activity, so we are talking about a small element that the Opposition are blowing up out of all proportion.

[Barbara Keeley]

Will the hon. Lady give way?

[Margot James]

I am sorry, but I am running out of time.

Labour’s record in government, when the producer interest held sway, stands as a salutary lesson which I hope people will remember.

No wonder there are serious divisions within the Opposition about their health policy, as was reported in the press only today. One Labour Front Bencher was anonymously quoted as saying that it would be a “fatal mistake” to increase the health budget without reforming it. I know there are some people with common sense on the Opposition Benches, but it is a shame they are not in control of health policy.

--- Later in debate ---

[Jane Ellison]

I remind all Opposition Members of their predictions about employment at the beginning of this Parliament. If any of them wants to remind us of those, they can be my guest.

We recognise the significant and continuing pressure on services in the short term and the need to invest in new ways of providing care for the future.

This Government have put more performance data in the public domain and have put an unprecedented emphasis on transparency. Indeed, some of the statistics Members quote in these debates are in the public domain only because the Government have put such an emphasis on transparency. Transparency is one of the key drivers of safety in our system.

As public health Minister, I welcome the focus on prevention in the “Five Year Forward View”. I think this is common ground across the parties. Prevention has to be a key part of the NHS’s plans. When we keep people healthy and out of hospital, it is a win for them and a win for the NHS. Mention has been made of the national diabetes prevention programme. We will be the first country in the world to implement such a programme at scale to help prevent the onset of the disease and reduce demand on the NHS. Investing in the NHS with a focus on prevention is one of the keys to a sustainable footing for the NHS in the long term.

Thanks to the work of NHS staff and the funding protection provided by the Government, the NHS is treating more patients than ever. Again, that flies in the face of all the dire threats about its peril. There are 9,000 more doctors and 3,300 more nurses. The additional funding announced by the Chancellor in the autumn statement will enable the NHS to continue to meet the rapidly rising demand in the short term, while making investments in new services and facilities to transform care for patients and ensure that the NHS is sustainable in the long term.

[Barbara Keeley]

The Minister mentioned an increase in the number of nurses, but there is no increase in the number of district nurses, of whom we have lost thousands. Week in, week out, the Health Committee keeps being told how serious that is for all aspects of care in the community.

[Jane Ellison]

I am sure that, like me, the hon. Lady will welcome the 589 new nurses in her trust.

The more sensible Opposition Front Benchers have made it clear in interviews that the link between reform and investment is important. I want to pay tribute to the NHS, which is well on track to make up to £20 billion of efficiency savings to be reinvested in front-line care. For example, the NHS is securing savings of £2 billion a year as a result of the drive to tackle waste and improve procurement. Tough decisions were taken at the beginning of this Parliament to protect the NHS budget—against the advice of the Labour party—that have allowed us to strengthen family doctoring and reform out-of-hospital care. We all agree that integrating health and social care is important, and that is exactly why the Government have the £5 billion better care fund. It is an area on which—despite what Opposition Members say—there is significant consensus. They should support that fund instead of, as I recall, inviting us to put it on pause.

We have heard about how Labour plans to raise more money for the NHS, but in 2015-16 it would raise nothing. The Government are already consulting on a tobacco levy. The tax on family homes, by the Opposition’s own admission, would not start until 2016-17 and has already been spent three times—paying down the deficit, funding the NHS, getting rid of the 10p rate. As a London MP, I have to say that the chance of the homes tax surviving Labour’s London mayoral candidate race is minimal, given the ire raining down on it from Labour MPs in London. On top of that, Labour plans to spend an extra £5 billion, including more than £2 billion on committing equal resources to physical and mental health and more than £1 billion on GP access—it just does not stack up.

We came to government with a long-term economic plan to reduce the deficit and build a stronger economy, with a commitment to protect and safeguard the NHS. We have kept that important promise on the NHS and we kept our promise on the success of our economic plan. We recognise that the NHS still faces significant challenges, both short and long term, as the hon. Member for Leicester West (Liz Kendall) laid out—rising demand, an ageing population and growing expectations—but it is only through sticking to our long-term economic plan that we are able to put the investment in. We are making a down-payment of £2 billion on the NHS’s five-year forward view and we fully support the long-term vision for the NHS, by the NHS—by the most senior and experienced clinicians in our country. The Government have committed to put more resources in now and in the future to give all our constituents a better service, free at the point of use and fit for the future.

Question put.

National Health Service

Barbara Keeley Excerpts

Wednesday 21st January 2015 Commons Chamber

[Andy Burnham]

My hon. Friend describes the problems well. I know the hospital because I have been there with him. He is right that older people are becoming trapped in hospital. The support is not there for them in their own homes, and nursing home places are not available. I will come back to that theme in a moment.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

On exactly that point, the Health Committee looked at the A and E crisis last week and was told by the president of the College of Emergency Medicine that delayed discharges were due to underinvestment in the community, by which he meant social care, GPs and district nurses. Indeed, one third of delayed discharges were down to social care. One third of frail elderly people, or vulnerable people, cannot go home because of the issues with social care, which has been cut by £3.53 billion under this Government.

[Andy Burnham]

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

--- Later in debate ---

[Mr Hunt]

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

[Barbara Keeley]

rose—

[Frank Dobson (Holborn and St Pancras) (Lab)]

rose—

--- Later in debate ---

[Mr Hunt]

Privatisation is one of the most pernicious fears that Labour is seeking to stoke up—not least because, as Secretary of State, the right hon. Member for Leigh allowed the decision to go through that Hinchingbrooke hospital should be run by the private sector. He has been running away from that decision faster than anything that anyone has seen before, because he is still trying to curry favour with the unions.

The companies on the shortlist for Hinchingbrooke hospital were Circle, Serco and Ramsay Health Care. He could have stopped that as Secretary of State, but he did not. He knows—[Interruption.] Those were the three bidders—the private sector-led bids. He could have stopped that process when he was Secretary of State, but he chose not to. That makes my point very well.

[Barbara Keeley]

The Secretary of State and the right hon. Member for Wokingham (Mr Redwood) asked what had changed. Under Labour, we did not have tendering for £1.2 billion of cancer and palliative care services, as we are seeing now in Staffordshire and Stoke, where the majority of those tendering are private companies. We did not have that.

[Mr Hunt]

What the last Government did, that was right, was to say that—[Interruption.] I am just saying what the last Government did right. The hon. Member for Worsley and Eccles South (Barbara Keeley) might want to hear this, because I do not usually compliment the last Government.

To bring waiting times down to 18 weeks, the last Government said that they would support the NHS by allowing the private sector to do some operations. We have continued that policy, not changed it. The result, the hon. Lady will be pleased to know, is that 6,000 more operations are happening every year in her constituency under this Government than in 2010.

For this Government, it is about the patients. That is why we increased the NHS budget; why we hired 9,000 more doctors and 6,000 more hospital nurses; why we are doing nearly 1 million more operations a year than four years ago, with fewer long waits than ever; why we have increased cancer referrals by half, saving an estimated 1,000 lives every single month; and why we have learned the lessons of Mid Staffs by putting in place safe staffing, having independent inspections and turning around six failing hospitals.

Patients say—[Interruption.] The right hon. Member for Leigh should listen to what patients say, because he did not do that when he was Secretary of State. Patients say that their care is safer and more compassionate than ever, with the independent Commonwealth Fund saying that under this Government, the NHS has become the best health care system in the world.

Oral Answers to Questions

Barbara Keeley Excerpts

Tuesday 13th January 2015 Commons Chamber

[Mr Hunt]

I agree with that, and I hope that the hon. Gentleman will campaign to make sure that the Northern Ireland Executive put the extra money they have received as part of the Chancellor’s autumn statement into precisely that—good GP services for the people of Northern Ireland.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

It is increasingly recognised that the causes of the A and E crisis include the closure of walk-in centres, such as the one in Little Hulton in my constituency and this Government’s savage cuts to council budgets, leading in Salford to 1,000 fewer people getting care packages funded this year. When will the Health Secretary start to take responsibility for his own Government’s policies and do something to ensure investment in social care to ease that pressure on A and E? The better care fund is not the answer.