(6 years, 10 months ago)
Commons ChamberI would like to put on the record my thanks to my hon. Friend for the work he did as a Minister in my Department that led to the setting up of the expert working group, which I think has taken this issue forward and which he championed. His experience of the life sciences industry was incredibly helpful. I take on board both his points. It is absolutely right that this needs to focus on patient safety and how we put in place processes that help people suffering now and avoid it happening in the future. His point about training is a very good one.
I welcome the Secretary of State’s statement, although would have been nice for the victims to have heard a little more about the legal aid and compensation issue. He was absolutely right to describe our regulatory framework as world leading. It is, of course, European and precautionary based. Will he dissociate himself from the Foreign Secretary’s comments last week in which he included medicines regulation in the list of those areas for which he favoured full regulatory divergence?
As the right hon. Gentleman knows—we have had these discussions at the Health Select Committee—this country makes an enormous contribution to medicines regulation across Europe, because of our extensive scientific base, and we very much hope that those links continue.
(7 years ago)
Commons ChamberWith patients in Exeter now waiting more than a year, in pain, for vital surgery—well beyond the 18-week maximum guaranteed in the NHS constitution—can the Secretary of State explain the contradictory statements of the Chancellor, who said at the time of the Budget that he expected significant “inroads” to be made into growing waiting time lists, and the NHS England board, which met the following week and said that NHS waiting time standards
“will not be fully funded and met next year”?
I have been waiting for the right hon. Gentleman to issue the press release welcoming the £1.4 million of extra funding that the Royal Devon and Exeter got in the Chancellor’s Budget, but for some extraordinary reason it has not been forthcoming. Let me tell him that, as many people have commented, the NHS got a lot more money than it was expecting in the winter announcement—
(7 years, 1 month ago)
Commons ChamberMy hon. Friend is right to raise the question. I visited a GP surgery in Thornbury, in his neighbouring county, on Friday and discussed some of these issues. The NHS has an obligation to make sure that people can access its services, and in certain circumstances people are entitled to funding to help them do that. I thank him for raising the issue, however, and know that he will continue to fight hard on it.
All four witnesses who gave evidence to the Health Committee inquiry into the current workforce crisis last week described the current situation as “unprecedented”. Janet Davies, the head of the Royal College of Nursing, said that if Brexit happened, it would be devastating. Does the Secretary of State accept that if there is no deal next month on the rights of EU nationals, the current stream of EU workers leaving our NHS and social care system will become a flood?
With respect, I do not think it helps to reassure the brilliant NHS professionals from the EU who are working in the system when the right hon. Gentleman asks questions like that. The reality is that those people are staying in the NHS, and I take every opportunity to ensure that they feel welcome. I try to stress how important they are, and how the NHS would fall over without them. The Government continue to make every possible effort to secure a deal for their future, which we are very confident that we will achieve.
(7 years, 2 months ago)
Commons ChamberMy hon. Friend is absolutely right to raise this issue. The Alex is going through a difficult period and I know that as the local MP she is giving it a lot of support. The fact is that in 2014 we turned down 37,000 applicants to nurse degree courses. That is why we think that we need to do much, much better in training a number of people who would make brilliant nurses. That was why we announced the big increase last week, which will help the Alex and many other hospitals.
University admissions departments have reported an 8% fall in the number of people accepted on to nursing courses this autumn, so the situation is getting worse, not better as the Secretary of State claims. What contingency does he have in place, in the event that we crash out of the European Union, to address a further haemorrhaging of European Union staff from the NHS, and when will he review his disastrous decision to abolish nurse bursaries, which has had such a negative impact?
Let us be clear: we took the difficult decision on nurse bursaries precisely so that we could have the biggest expansion in nurse training places we have ever had. When we had the higher education reforms in 2011, which the right hon. Gentleman’s party opposed, we also saw a drop in initial applications, but then we saw them soaring to record levels. That is what we want to happen with nurses, because we need more nurses for the Royal Devon and Exeter, and all the hospitals that serve our constituents.
(7 years, 5 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
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I am happy to confirm that. I am also happy to say that the problems in the old Mid Staffs, which I am afraid we had in many parts of the NHS, are being addressed much more quickly because of an independent oversight regime—the new Care Quality Commission inspection regime—and the appointment of a chief inspector of hospitals, who is independent in law and gives his judgment independently in law. That is something the Labour party regrettably tried to vote down.
May I commend to the House the record of the debate I secured in November 2011, in which I warned the Government in terms about the very poor record of SBS and urged them not to part-privatise what had been an excellent NHS service? Ministers said at the time that the new contract would save £250 million. Will the Secretary of State now tell the House how much this scandal has cost, rather than saved, the taxpayer? Will he apologise both to the staff and the patients affected?
The costs are in excess of £6 million, and we are seeking to recover as much of that as we can from the company involved. I know that the regime in the Labour party has changed, but to try to turn this into an issue of privatisation when under the right hon. Gentleman’s own party’s Government—and indeed, during his own time as Health Secretary—we had problems at Mid Staffs that were squarely in the public sector is wholly inappropriate. This is about proper assurance of what is going on in the NHS, and both sides of the House need to learn the lessons.
(7 years, 9 months ago)
Commons ChamberThere is no greater champion for Somerset than my hon. Friend. What I would say to her is what I would say to all medical students, which is that general practice is going to be the biggest area of expansion in the NHS over the coming years; in fact, we are planning to have the biggest increase in GPs in the history of the NHS.
It will take many years for the doctors the Secretary of State has just talked about to come on stream, and we have a workforce crisis in the NHS now, partly because of the cuts the Government made in the last Parliament, but also because of their irrational pursuit of the hardest of Brexits. He could do something very simple today to address this crisis in the short term, and that is to announce that all EU nationals who do vital work in our NHS will be able to stay when we leave the European Union.
(7 years, 9 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
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I raised my concerns about the contracting out of the patient record service to SBS back in 2011, and I was told by the Secretary of State’s predecessor that this was about saving money. Will he tell us how much money has been saved, given all the problems, and how many of the 708,000 patients affected are in the south-west?
The south-west was one of the regions affected, as I mentioned in my statement. I am happy to write to the right hon. Gentleman to tell him exactly how many patients I think were affected in the south-west. I gently say to him that the use of the private sector was championed when his Government were in office and when he was a Health Minister. I know that this is not very fashionable in his party at the moment, but on this side of the House, we think that if we want the NHS to be the safest and best in the world, we should be open—
(7 years, 10 months ago)
Commons ChamberMy hon. Friend is absolutely right. It is a national health service, not an international health service. I was disappointed to see comments from the Opposition yesterday that the money this would raise would be a drop in the ocean—[Hon. Members: “It is.”] We are seeking to raise £500 million. That is enough to finance 5,000 GPs, who could help the constituents of everyone in this House.
Is it not a coincidence that, whenever we hear about disastrous figures for NHS performance and a huge deterioration in waiting times, as we did at the weekend, the Government re-announce yet another measure to crack down on health tourism? Is not the main problem with our health and social care system the fact that it is chronically underfunded, and that this Government are doing nothing about it?
I will tell the right hon. Gentleman what we are doing about the underfunding. We are raising three times more from international visitors than when he was a Health Minister, and that is paying for doctors, nurses and better care for older people in his constituency and in all our constituencies.
(7 years, 11 months ago)
Commons ChamberMy right hon. Friend speaks extremely wisely. At the heart of it, we have a good commitment—the four-hour commitment, which was introduced by a Labour Government. I think it is one of the best things the NHS does: the promise that if someone is ill and needs urgent help, we will do something about it and get them under proper medical care within four hours. However, if we have the situation that NHS England now describes, where up to 30% of the people in A&E departments do not actually need to be there, we risk not being able to deliver that promise for the people who really do need it. That is why looking at how we can control demand from the people who do not need to be in A&Es, such as through the significant increase in investment in general practice and other measures, is going to be vital if we are going to crack this.
The Secretary of State seems to be blaming the public for overwhelming A&E departments, when he well knows that the reason they go to A&E is that they cannot get to see their GP and social care is in crisis. Will he confirm that he has just announced another significant watering-down of the four-hour A&E target, following the watering-down by the coalition in their first year in office back in 2010? What is he personally doing to address the chronic long-term underperformance of hospitals, such as that at Worcester, where two people died on trolleys, and Plymouth, which is one of the hospitals that had to call in the Red Cross over the Christmas period?
I think—probably because of the forum we are in now—the right hon. Gentleman is misinterpreting what I have said, and it needs to be put right. Far from watering down the four-hour target, I have today recommitted the Government to that four-hour target. In just the answer before he spoke—maybe he was not listening—I actually said I thought it was one of the best things about the NHS that we have this four-hour promise. But the public will go to the place where it is easiest to get in front of a doctor quickly, and if we do not recognise that there is an issue with the fact that a number of people who do not need to go to A&Es are using them, and we do not try to address that problem, we will not make A&Es better for his constituents and mine. If he asks what we are doing to turn around hospitals in difficulty, we have introduced the new Care Quality Commission inspection regime and a chief inspector of hospitals—the most rigorous inspection regime in the world, which the Labour party tried to vote down.
(8 years ago)
Commons ChamberMy hon. Friend is absolutely right. I thank him for bringing Professor Tim Briggs to see me to explain just how superb this programme is. Infection rates for orthopaedic surgery vary between one in 20 patients in some trusts to one in 500 in others. Getting this right can transform care for patients and save money at the same time.
I associate myself with the Secretary of State’s comments about Berlin, my one-time home.
Does the Secretary of State accept that we have the best clinical leaders anywhere in the world? The challenge facing the NHS is not one of clinical leadership, or the dedication or skill of staff, but one of chronic underfunding by this Conservative Government.
We do indeed have superb clinical leaders, such as Marianne Griffiths at Worthing, which was recently given an outstanding rating. We also have superb non-clinical leaders, such as David Dalton at Salford Royal. I would gently say to the right hon. Gentleman that if he is worried about funding, why did he stand in the election on a platform that would have seen the NHS have £1.3 billion less this year?
(8 years, 1 month ago)
Commons ChamberLet me tell the hon. Lady that what is different now is that we have a special measures regime. When Labour was in power, the problems were swept under the carpet and not dealt with. Now they are being dealt with because we want every NHS patient to have confidence that we will not have another Mid Staffs. That is why we are making very good progress. With respect to funding, may I respectfully tell her that had we followed her party’s spending plans, the NHS would have £1.3 billion less this year?
The Secretary of State will know that with depressing regularity the same hospitals come up on that list that he has just referred to. Sustainability and transformation plans provide the opportunity to address some of the unsustainable elements of local health economies, but only, as my hon. Friend the Member for Lewisham East (Heidi Alexander) says, if the money is there. With the health service facing its tightest financial settlement in its history, these plans are just not deliverable.
The right hon. Gentleman understands health extremely well, both from his ministerial position and from being on the Select Committee. If he looks at the hospitals going into special measures, he will see that we are beginning to succeed in moving hospitals out of special measures, but because we have an independent inspection regime, sometimes other ones go in. That is how it should be. That is what works very well in the education sector and is beginning to work well in driving up standards in health care as well.
To go back to my answer to the hon. Member for Lewisham East (Heidi Alexander), £1.3 billion more in the NHS this year compared with what would have been put into the NHS if Labour had won the last election means 30,000 nurses, 13,000 doctors or 200,000 hip replacements that we are able to do because of this Government’s funding of the NHS.
(8 years, 1 month ago)
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It absolutely does. I much enjoyed visiting with my hon. Friend some health facilities in his constituency during the general election campaign. The difference between Conservative Members and Labour Members is that we recognise that every penny of the NHS budget has to come from a strong economy. We know that if we take that for granted, we end up having to cut the NHS budget, which is what has happened in Spain, Italy, Greece, Portugal and many other countries that have lost control of their national finances. That is something that Labour Members would do well to remember.
The Government have been well and truly found out on this issue. Rather than quote selectively from Simon Stevens, the head of the NHS, will the Secretary of State confirm that among the conditions that Mr Stevens put down to the Government as part of the five-year review was an increase in public health spending, not a 20% cut, and a policy of maintaining spending on social care? Will he also confirm—he was there in Simon Stevens’ presence before the Select Committee—that Mr Stevens made it quite clear that those conditions and others had not been met?
Actually, what Mr Stevens said—I was there—was that social care and, indeed, public health provision needed to be maintained. We are increasing the social care budget by £3.5 billion over this Parliament. Although I accept that difficult cuts are being made to the public health budget, we are doing other things that do not cost money to make sure that we continue to improve this country’s excellent record on public health.
(8 years, 7 months ago)
Commons ChamberI am afraid that junior doctors, who work incredibly hard and are the backbone of the NHS, have not been well represented by their union. The BMA is currently telling junior doctors not to co-operate with trusts in any discussions about the implementation of the new contract. The kinds of issues mentioned by my hon. Friend are exactly those that we want to sit down and talk to the BMA about. I wrote to Mark Porter, the chair of the BMA’s council—in fact, I talked to him earlier this afternoon—about the possibility of talks to go through all those extra-contractual issues and the contract itself to ensure that we implement it in the best possible way. That is the kind of dialogue that the Government are willing to have and that we would welcome, but we need another party to come to the table if we are to succeed in doing so.
The Health Secretary knows well that seven-day working has absolutely nothing to do with his proposed new contract. The Health Committee recently visited Salford Royal hospital, to which he referred earlier and which is already running a seven-day service on the existing contract. His petulant rejection of the all-party proposals to pilot the contract shows that tomorrow will be his responsibility and his alone.
Let us be absolutely clear. The people who are responsible for the strike tomorrow are those who choose to do the BMA’s urging and withdraw emergency care for patients. That is where the responsibility lies.
Let me deal with the right hon. Gentleman’s point directly. There are a couple of trusts in the country that have been good at introducing seven-day standards in urgent and emergency care, but my judgment, and that of the Government, is that it would not be possible under the current contractual structures to roll that out across the whole NHS. Those trusts happen to have some of the NHS’s most outstanding leaders, and we need to learn from what they have done, but we also need to make it possible for those same things to happen at all hospitals, including the right hon. Gentleman’s own.
(8 years, 9 months ago)
Commons ChamberGiven the latest, very worrying reports about goings on at the office of the Parliamentary and Health Service Ombudsman, does the Secretary of State still have confidence in the leadership of this vital regulator?
I have expressed my concerns on the behalf of patients about some of the things that have been happening, but I respect the fact that it is a matter for this House and its relevant Committee, not for the Government, to deal with. I do have concerns, and it is important that patients have confidence in the ombudsman, because it is a vital, independent avenue to challenge NHS trusts when things go wrong.
(8 years, 10 months ago)
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I am happy to undertake that the Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison), will look urgently into whether such a campaign would be right. I can reassure my right hon. Friend that the package that we put together and announced last January did contain what most people felt was necessary, but we can always look at whether more needs to be done. I commend her for her campaigning on the issue of sepsis. On a more positive note, when the NHS has decided to tackle conditions such as MRSA and clostridium difficile, it has been very successful. In the past three years, the number of avoidable deaths from hospital-acquired harms—the four major ones—has nearly halved, so we can do this. We should be inspired by the successes that we have had to make sure that we are much, much better at tackling sepsis.
One reason why the number of calls to 111 has trebled is that people find it impossible to get to see their GP. As well as the shocking failings of this family’s GP, is it not the case that the Government were warned of the consequences of abolishing the popular and successful NHS Direct and of replacing it with a non-clinician led service? Will the Secretary of State look personally at the performance of 111 in the south-west, which has been bedevilled by failings ever since it was set up?
I gently say to the right hon. Gentleman that when 111 was set up it had the support of the Opposition. The shadow Health Secretary at the time looked at the risk register. The number of calls has increased dramatically partly because demand for NHS services has increased dramatically. That does not mean to say that there are not important things that need to be improved. We need to look honestly at what went wrong. The 111 service was one of the four areas where we should have done better. I am happy to look carefully at what is happening with 111 in the south-west. One improvement is that, in many areas, we are integrating the commissioning of 111 with the Ambulance Service, and that is something that happens in the south-west. On the whole, that has been a positive experience, but I know that there have been problems in the south-west, and I am happy to look further at them.
(8 years, 11 months ago)
Commons ChamberMy hon. Friend is absolutely right. That system does not work for people who have to go to work, and we want to make it easier for people to book appointments online or using an app on their phone. We also want to make it easier for people living in rural areas such as his constituency of North Cornwall to have telehealth appointments where appropriate, so that they can see someone without actually having to go to the surgery.
Given the increasing difficulty that members of the public are having in getting an appointment with their GP quickly and at a time that is convenient to them, does the Secretary of State believe that his predecessor was wrong when, as one of his first acts, he scrapped Labour’s 48-hour GP access guarantee?
No I do not, because that had perverse consequences. When that target was in place, the number of people waiting to see a GP increased rather than decreased. In the last Parliament, the number of GPs went up by around 1,600—a 5% increase in the workforce—and we have plans to increase it by 13%, which would be one of the biggest-ever increases in the GP workforce in the history of the NHS, on the back of a strong economy.
(9 years ago)
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I can absolutely give that assurance to my hon. Friend’s constituents. I hope they will consider the tone of my earlier remarks and realise that we are not looking at this simply as an issue for Southern Health. Clearly, important changes must happen there and must happen quickly, and we will do everything we can to make sure that they happen. I also think, however, that there is a systemic issue in relation to the low reporting of avoidable and preventable deaths and harm, and the failure to develop a true learning culture in the NHS, which in the end is what doctors, nurses and patients all want and need.
I thank the Secretary of State for his statement and congratulate NHS England on what sounds like a very thorough report. I remind him that challenging the methodology was exactly the same first line of defence used by the now disgraced management at Mid Staffs hospital. Will he answer the specific question my hon. Friend the Member for Lewisham East (Heidi Alexander) asked as to when Ministers first knew about problems in the trust, which we hear go back to 2011, and what action they took as a result?
I thank the right hon. Gentleman for his comments. I hope I did address that by saying that the first time was when we realised there were issues around the tragic death of Connor Sparrowhawk. That is what started the process and led to the independent investigation. Because NHS England wanted it to be very thorough, that investigation went right back to 2011 and up to 2015. It looked at all unexpected deaths in that period, and at the reporting culture and lessons that had or had not been learned as a result. A lot of action has been taken. I can also reassure the right hon. Gentleman that during that period we have been implementing the recommendations of the Francis report, which has meant that throughout the NHS there is a much greater focus on, and transparency in, patient safety.
It is important to give the NHS credit. During the past three years, we have actually seen a 25% increase in the number of reported incidents. I think people are treating this much more seriously than in the past, but there is much more to do.
(9 years, 5 months ago)
Commons ChamberI am more than happy to meet my hon. Friend to discuss those matters. Wythenshawe is an excellent hospital—I have been there—and it has provided a number of staff who have helped to turn round the standard of care at Tameside hospital, which has seen dramatic improvements. I recognise that Wythenshawe is an excellent hospital, and I am very happy to meet him to listen to his concerns.
How will the Secretary of State pay for his very laudable objective of seven-day working when he has lost control of NHS finances? Contrary to what he claimed about the situation in Devon, as things now stand our patient care is suffering, waiting times are rocketing and we are facing a £434 million deficit.
Let me tell the right hon. Gentleman why so many places are going into deficit. They have looked at the lessons of Mid Staffs and said, “We don’t want that to happen here.” That is why, in the past two and a half years, hospitals have employed 8,000 more nurses on hospital wards to deal with the scandal of short staffing that they faced and wanted to do something about. In the end, if it is not sustainable, it is not quality care, so we have to find smart ways to control deficits—not by reducing the staff and making care unsafe, but by making changes to process and through efficiencies, such as making sure that nurses do not spend too long filling out forms and can spend more time with patients. In terms of funding, I would just say that the only way to fund a strong NHS is to have a strong economy, and that is why the country voted in a Conservative Government in May.
(10 years ago)
Commons ChamberI thank my right hon. Friend for his comment, because the use of police cells is not an issue with which we should be playing party political games. As it happens, their use was much higher under the last Labour Government. We are starting to address that issue, and he is right: even one person spending a night inappropriately in a police cell is one person too many. That is why we are making good progress, but in the end it will require people who purchase health care in local areas to look at people with mental health needs in a holistic way—not just trying to solve issues problem by problem, but looking at and addressing the whole problem and making sure they get the treatment they need.
The Secretary of State should not be at all surprised by this terrible case of the young girl kept in a police cell in Devon over the weekend, because I and other Members have been raising this personally with him for at least the last three years. What has he been doing over that period to address the scandal of young people’s mental health services in Devon and nationally?
I will tell the right hon. Gentleman what I have been doing: I have been putting in place a strategy that will see over the next few months a reduction of 51% in the number of mental health patients who use police cells. That is progress. It still means that there are too many people in police cells, but I would just gently urge him not to try to make party political capital out of this, because a higher number of them were used under the last Labour Government. We are addressing a long-standing problem in a responsible way, and are determined to go further.
(10 years ago)
Commons ChamberT10. When I asked the Prime Minister two weeks ago about the financial crisis facing Devon NHS, he seemed completely unaware of it, so could the Health Secretary please explain why Devon NHS faces an unprecedented £430 million deficit and what he is doing to stop the rationing, cuts and total withdrawal of some services that is now being proposed?
We are not rationing services. In fact, we are doing 1 million more operations every year than were done under the previous Government. I will tell the right hon. Gentleman why that financial pressure exists: we have an ageing population, with nearly 1 million more over-65s than four years ago, and huge pressure to deliver good care in the wake of the Francis report. The NHS will be supported if we have a strong economy that can fund real-terms increases in health spending—something that never happens if the deficit is forgotten.
(10 years, 6 months ago)
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I would like to thank my hon. Friend for the support that she has given to her constituent, whom I think I have also met. My hon. Friend is absolutely right: we have to stop this system of consequences for people who do the right thing and speak out. It is not right for me to comment on an individual case, because legal proceedings are often involved, but one hears of situations where people have spoken out and then been victimised by a trust, and that is wrong. We need to be better at looking after whistleblowers, but we need to go further and eliminate the need for whistleblowing by creating a culture where trusts are hungry to hear from their own staff about safety concerns because they want to put them right.
An Exeter psychiatric nurse of more than 20 years’ standing wrote to me in despair this week saying that
“mental health services are in collapse”,
and that patients are regularly placed in “life threatening” situations or sent as far away as Bradford because there are no beds locally. Vulnerable people are waiting a shocking three months for the co-ordination of their care. How dare the Secretary of State come to the House today and claim that our mental health services are not in crisis?
There are real pressures in our mental health services, but the right hon. Gentleman should recognise the progress that the Government have made. That includes doubling the money going into talking therapies, having global summits on dementia and putting a massive amount of money towards raising the profile of dementia in this country and across the globe, and legislating for parity of esteem as between mental and physical health—something that never happened under the previous Government. There is a lot of work to do, but I think he should give credit where it is due.
(10 years, 8 months ago)
Commons ChamberLast week, I launched a campaign to save up to 6,000 lives by halving avoidable harm and avoidable death in the NHS. I am inviting all NHS trusts to sign up to safety, by putting together their own plans, with support provided by NHS England, Monitor, the NHS Trust Development Authority and the NHS Litigation Authority. Learning from hospitals with the best safety records anywhere in the world, such as Virginia Mason in Seattle and Salford Royal here in England, we have a once-in-a-generation opportunity to put behind us the tragedy of Mid Staffs and make the NHS the safest health care system in the world.
People in Exeter and Devon with mental illness are now waiting more than two years for treatment. This is totally unacceptable and will, if it has not already, lead to the loss of lives. The Minister has repeated today his criticism of NHS England’s decision to cut funding for mental health, but as the shadow Minister reminded him, he is not a passive observer; he is the Minister responsible. What will he do about it?
The reason we are not passive observers is that we have made some substantial improvements in mental health provision since coming to office, including legislating for parity of esteem, which is precisely why the right hon. Gentleman feels able to ask that question. There are 55,000 more people every year getting a dementia diagnosis and nearly 80,000 people going on to psychological therapies. Lots has been done, but there is lots more to do, and we will continue to do everything we need to until we get that parity of esteem.
(11 years, 1 month ago)
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May I assure the Secretary of State that the people of Exeter are not confused about their walk-in centres, but appreciate them and have been using them in ever-increasing numbers? These centres are now under threat, so will he at least admit that closing NHS walk-in centres and scrapping Labour’s GP access targets has been a dreadful mistake?
Perhaps the right hon. Gentleman might like to hear what the British Medical Association said yesterday about walk-in centres. The BMA is not known for its support of Government policies, but it said that urgent care centres
“were often opened in places with little patient demand…The result has been a lot of money being spent on these facilities with some now closing because commissioners have found there is not sufficient demand”.
That is the problem we are sorting out.
(11 years, 3 months ago)
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As so often on these matters, my right hon. Friend speaks extremely wisely. Since April, we have been working hard to deal with the underlying pressures on A and E departments while ensuring that we have cash available for short-term measures while those longer-term measures are put in place. He is absolutely right that joined-up integrated services are critical for A and E departments, because one of the biggest problems that they mention is the difficulty in discharging people from hospital, which makes it hard for them to admit patients who need to be admitted, often in very distressed circumstances. We also need to address the longer-term IT problems that mean that A and E departments cannot access people’s medical records and the question of alternatives to A and E, particularly in the community and through enhanced GP services.
If the Secretary of State is serious about people not attending A and E unnecessarily, why did he cut Labour’s extended GP opening hours and why is he allowing NHS walk-in centres to close up and down the country?
The fact is that one thing we need to do is to address why people go to A and E instead of the alternatives, such as walk-in centres. Communication about the alternatives to A and E is not as good as it needs to be. We are addressing those issues, but I must say to the right hon. Gentleman that the previous Government failed to address this problem when he was Health Minister and the difficult issue of the reconfiguration of services was never fully grasped. We are grasping it and that is why Professor Sir Bruce Keogh is undertaking his review right now.
(11 years, 6 months ago)
Commons ChamberI agree with much of what my hon. Friend says. He is absolutely right that accountability for what went wrong is crucial in this. I know that the CQC wanted to publish the report in full today, including the names of the individuals involved, but was given legal advice that it would be against the law to do so. However, the CQC is keen to have maximum transparency as soon as possible and is looking into how it can make sure that happens. There should be no anonymity, no hiding place, no opportunity to get off scot-free for anyone at all who was responsible for this. This is the problem we have to address in the NHS: all too often, people are not held accountable for what went wrong. However, the system also bears responsibility. This is not just about bad apples and how we root them out more quickly; it is also about creating a system that brings out the best in people—that plays to the decent instincts that got people to join the NHS in the first place, rather than making them think that targets at any cost matter more than the care and dignity of the patients in their trust.
The CQC’s chairman said on the radio this morning that he could not publish the names of those responsible for this scandal because of the Data Protection Act, but there are clear and explicit exemptions to the Act when it comes to
“protecting members of the public from dishonesty, malpractice, incompetence or seriously improper conduct, or in connection with health and safety”.
Will the Secretary of State please challenge the CQC’s interpretation of the Act and, if necessary, ask the Information Commissioner to rule on this flawed decision?
I can reassure the right hon. Gentleman that neither the chairman of the CQC nor I have any interest whatsoever in keeping these names secret. He did receive legal advice telling him that he could not publish them, but I will go back to him with what the right hon. Gentleman says. I know that the CQC chairman would like to be as transparent as possible. The choice he had, on the basis of the legal advice, was either not to publish the report or to publish it without the names. I think he took the right decision, given the advice he had, but I will ask him to consider what the right hon. Gentleman says.
(12 years, 1 month ago)
Commons ChamberI support the principles behind “Agenda for Change”, which were introduced in 2004 by the Labour Government of which the right hon. Member for Leigh was a member. I also support a number of other flexibilities introduced by the Government—the right hon. Gentleman supported the legislation—in respect of foundation trusts.
The south-west cartel is not about flexibilities introduced to allow hospitals to attract staff and pay them more, as they in fact did; it is about a regional pay system. The Secretary of State has to decide: is he for or against the south-west cartel? Does he say yes or no?
Perhaps the right hon. Gentleman will explain why he voted for the Health and Social Care (Community Health and Standards) Act 2003, which gave foundation trusts the freedom to introduce their own terms and conditions. Until he explains that, which we are simply supporting, I am afraid that his position is extremely tenuous.
I support proper negotiations between NHS employers and unions to revise, reform and improve “Agenda for Change” so that it is fit for the very different financial circumstances in which the NHS now finds itself. The vast majority of NHS trusts and foundation trusts, including in the south-west, would rather negotiate on national pay scales, but that means the unions being realistic about what is sensible in this financial climate. That is why employers need to use the system more efficiently and effectively, extending the use of high-cost area supplements when they can be justified to tackle the recruitment and retention issues that affect a particular area or region.
Like the previous Government, we want to retain the flexibility that allows individual employers to use recruitment and retention premiums and, like the previous Government, we want any changes to be introduced incrementally in full partnership with NHS employers and trade unions.
I have already given way to the right hon. Gentleman once.
The greatest risk to national terms and conditions is that they will become rigid, inflexible and no longer fit for purpose. If that happens, employers will be more likely to use the freedoms given to them by Labour to abandon “Agenda for Change”, which was where those freedoms came from, and introduce local terms and conditions.
The Opposition has a clear choice. They can wolf whistle to their trade union sponsors in a hollow attempt to distance themselves from legislation that they passed, or they can prioritise the interests of low-paid NHS employees by encouraging the unions to work for constructive, negotiated improvements to “Agenda for Change”. Sadly, this afternoon’s debate shows that they have made that choice—the motion is nothing more than a shameless attempt to frighten the hard-working staff of the NHS.
The debate is scandalous scaremongering from a party that did more to introduce regional pay during its time in office than any other Government in history and outrageous opportunism from a party that wanted to cut the NHS budget. Rather than singing to the tune of their trade union paymasters, the Opposition should be telling them to get around the table and negotiate seriously on “Agenda for Change”; rather than scaring NHS employees, the Opposition should be celebrating their achievements; and rather than talking down the NHS, the Opposition should, painful though it is, be celebrating the achievements of a Government who have delivered record NHS performance. I urge my colleagues to support the amendment.
(12 years, 7 months ago)
Commons ChamberMy hon. Friend is exactly right, and given that the Leader of the Opposition has previously said that he thinks it is right that the Leveson inquiry should take its course—that the most important thing is that it gets to the bottom of what happened, of what Labour did, of what the Conservatives did, and we reach a judgment about that—it is curious that he is now trying to pre-empt its conclusions.
Both the Culture Secretary and the Prime Minister have repeated again today that they always followed Ofcom advice. They did not. Ofcom thought this bid should be referred to the Competition Commission; so did the Business Secretary, so did the Labour Government. Why did the Culture Secretary change that policy?
I know that the right hon. Gentleman was disappointed yesterday, as he was looking for a smoking gun that showed that the process had not been properly pursued. The very first decision I took was to say I was minded to refer this bid. That is the proper process. If a Minister wants to refer a bid to the Competition Commission, the proper process is to tell the interested party that they are minded to do so, and it then has the opportunity to come back with undertakings, which the Minister has a duty to consider. That is the process set up by the right hon. Gentleman’s Government in the Enterprise Act 2002, and that is what I was doing.
(13 years, 5 months ago)
Commons ChamberWill the right hon. Gentleman accept that it was on the basis of Ofcom’s independent advice that the media merger should go ahead that I made that recommendation to the House? On Monday morning, I wrote back to Ofcom to ask whether it stood by that advice, as a result of which the bid ended up being referred to the Competition Commission.
We will discover that when all the papers are published, which is my next point. However, what happened came only after the Secretary of State intervened on behalf of News International in a negotiation with Ofcom.
To dispel any suspicion in the House and among the British people that the Government acted under pressure from News Corporation, the Government must now disclose the details of all meetings, discussions and communications involving Ministers, officials and representatives of News Corporation, or their representatives. That must include details of the now infamous back-door visit to Downing street straight after the election, and the Prime Minister’s Christmas dinner with James Murdoch and Brooks in Oxfordshire.
May I finish with some friendly advice to the Government? The information will come out. It is far better for the Government to put it voluntarily into the public domain now than to have it prised out by freedom of information requests or by the forthcoming judicial inquiry. As my right hon. Friend the Member for Kirkcaldy and Cowdenbeath has said, it is rarely the initial mistake, incompetence or bad judgment that is fatal, but the cover-up.
I will tell my hon. Friend why that is the case. Typically, when there is a referral to the Competition Commission, it could decide to block the deal entirely or it could negotiate undertakings, circumstances and conditions under which it would consider it acceptable for the merger to go ahead. The Competition Commission is considering media plurality, just as I did. It is not considering broader competition issues, but if as part of that consideration it decided to accept any undertakings, it would want to be sure that they were credible, which is why compliance with the “fit and proper person” requirements of the Broadcasting Act 1990 will be extremely important.
Did the Secretary of State know about the dinner involving the Prime Minister, James Murdoch and Rebekah Brooks two days after he was handed responsibility for this policy area? Why, shortly after that dinner, did he abandon the previous approach by the Business Secretary and reject Ofcom’s clear recommendation to send the matter to the Competition Commission?
I did not know about the dinner, and I did not reject Ofcom’s recommendation. If the former Culture Secretary had been listening to my statement, he would know that I actually accepted its recommendation. On 25 January, I wrote to News Corporation saying that I was minded to accept what Ofcom was recommending, namely a referral to the Competition Commission.
(14 years, 6 months ago)
Commons ChamberI also welcome my hon. Friend, and particularly as someone whose background includes working both as an ITV broadcaster and as a BBC journalist, because BBC journalists have often tended to be represented more on another side of the House. The answer to his question is that we have to ensure that BBC news provision has competition. That is essential, although it is not necessarily the case that that competition must come from ITV; it might come from more local news providers. That is why the plans that we are putting forward will be so significant.
I give a warm welcome to the Secretary of State and his colleagues in their new posts, but could he please explain to the House why he has allowed his Department to be downgraded, in that we have lost 15 minutes from our previously hour-long Question Time?
On regional news, is the reason why the hon. Member for Bath (Mr Foster), who is an excellent Member of this House, has been excluded from this Front-Bench team—indeed, why all Liberal Democrats have been excluded—that they agree with us on this question and not with the Secretary of State?
I thank the shadow Secretary of State for the courtesies that he extended to me when I was in his position and he was in mine. He will be amused to know that local newspapers from his area are still being delivered to my private office, because it takes some time to cancel the subscription. I would like now to give him a copy of the Western Morning News, in case he is missing it. Let me tell him that under this Government, my Department has not been downgraded; it has been upgraded, because we are now responsible for the Olympics, which we were not before.
The right hon. Gentleman might like to know that tickets to the Royal Opera House for him and his wife have been delivered to my home in London—tickets that I have been foolish enough to send back to the Department. However, given what he has just said about local and regional news, can he point to a single other European country—not America, where market conditions, including in the advertising markets, are completely different, as he knows—where his model flies?
I cannot, because no other country in the world is trying to allow the emergence of truly cross-platform multi-media local media operators in the way that we are envisaging. If we look at countries such as France and Germany, we see successful local TV stations in places such as Paris and Lyon. I would ask him why, when he was Secretary of State, he did nothing to progress proper local TV in this country, when it is something for which communities up and down the country are crying out.