Contaminated Blood

Ben Gummer Excerpts

Monday 20th July 2015 Commons Chamber

[Diana Johnson (Kingston upon Hull North) (Lab)]

(Urgent Question): To ask the Secretary of State for Health to make a statement on the support available to victims of contaminated blood.

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

I apologise for the fact that the Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison), the Minister with responsibility for public health, cannot be here to respond to this urgent question. She is returning from an international tobacco control summit, which she attended at the request of the French Government, and could not be back in time.

In the 1970s, 1980s and early 1990s, thousands of patients contracted HIV, hepatitis C or both infections from NHS-supplied blood or blood products. This is rightly described by many as one of the great tragedies of modern healthcare. I would like to start by echoing the apology made by the Prime Minister in March and to say, on behalf of this Government, how sorry we are for what happened.

Since 1988, five ex-gratia support schemes have been set up to support those affected. While the current schemes of financial support have made a significant difference to the lives of many beneficiaries, we acknowledge that many people remain unhappy with the current system of support. I also know that many will have anticipated a more comprehensive statement on progress.

Ministers have listened to many of the criticisms of the current schemes. This is a very difficult issue, and many different voices on this matter will need to be taken into consideration in the context of the spending review. We then plan to give individuals affected by scheme reform the opportunity to express their views via a public consultation. That has never been done before in the history of the schemes.

The four UK Health Departments have been working together closely on this matter and will continue to do so. As a result of the direct links established between the Scottish Government and patient groups in Scotland following the publication of the Penrose inquiry, the Scottish Government are undertaking their own consultation with patient groups in Scotland. We look forward to seeing the results of that activity. When we launch our consultation later this year, we will continue to work with Scotland. That will enable all four countries to share their learning and therefore have far more robust information to inform the shape of any future reformed scheme.

As was previously announced, up to £25 million was allocated to support the transition to a reformed scheme. I confirm that we do not intend to use that for the administrative costs that might be associated with reforming the existing schemes. We expect to announce our plans for that money in the light of the consultation and once we have an understanding of how a new scheme might be structured. We intend to consult on proposals for a reformed scheme later this year.

[Diana Johnson]

Thank you, Mr Speaker, for granting this urgent question. I am mindful that I have just two minutes to deal with 30 years of injustice in this case. Members will know that this is the worst treatment scandal in the history of the NHS.

On 14 January, the all-party parliamentary group on haemophilia and contaminated blood published a report about how the current support is wholly inadequate. After the publication of the Penrose report on 25 March, the Prime Minister told the House that

“it is vital that we move as soon as possible to improve the way that payments are made to those infected”.

He added:

“if I am Prime Minister in May, we will respond to the findings of this report as a matter of priority.”—[Official Report, 25 March 2015; Vol. 594, c. 1423.]

On 3 June, the Prime Minister promised

“a full statement…before the summer recess”.—[Official Report, 3 June 2015; Vol. 596, c. 584.]

At 2 pm last Friday, a written statement was laid in the other place. In short, it means no extra help for victims for at least two more years. Tabling it in the other place when the Commons was not sitting was very shabby indeed.

I have four specific questions. First, when will we see a timetable for consultation on a reformed scheme of compensation? Will any of the £25 million be spent in 2015-16, as was promised by the Prime Minister?

Secondly, two years ago the Government sold an 80% stake in Plasma Resources UK, the company that creates plasma products for the NHS, to Bain Capital for £200 million. Was that capital receipt ring-fenced to compensate those affected by contaminated blood? If not, why not?

Thirdly, on 2 June the Secretary of State for Health wrote to one of his own constituents:

“Any additional resources found for a settlement will be taken away from money spent on direct patient care for patients in the NHS.”

Is that really the Government’s intention? Will the Minister comment on the starkly different approach the Government took in compensating Equitable Life victims?

Fourthly, there are now drugs available that would allow people like my constituent Glen Wilkinson to clear hepatitis C, but they are not available automatically on the NHS. The NHS gave him the infection and the NHS could now treat him. Where is the justice in withholding those drugs?

I cannot overstate the feelings of anguish that have been caused by the Government’s conduct in recent days. Many victims feel that they are being left to die in misery so that the costs of any eventual settlement scheme become more affordable. Before the election, the Prime Minister promised urgent action. Now is the time to deliver.

[Ben Gummer]

The hon. Lady has been a doughty campaigner on this issue for many years, along with others. I have a constituent who has been affected by this appalling tragedy. I know that many Members come to the House with similar experiences of talking to their constituents, so I understand the issues that she has raised today.

The hon. Lady is right to say that there is a long history behind this appalling series of events. We are seeking to address that now in the consultation that we are about to take forward. We are moving with some speed, compared with what has happened before. We had the Penrose report; then the election intervened, as she will understand, but it was one of the first items on the agenda that I was party to on returning to the Department of Health after the election. We are moving at speed to construct a consultation that will take into account the views, feelings and wishes of the beneficiaries for the first time ever, so that we hear their personal stories and give them a voice in a way that they feel has not happened so far.

The hon. Lady has rightly identified that there is a monetary implication. This matter has to be considered within the bounds of the spending review—it could not be otherwise—and it will come within the parameters of the Department of Health budget.

The hon. Lady asked about the timetable. The £25 million identified by the Prime Minister has been identified for this financial year. Should it not be allocated this year, it will be rolled over to the next year, so it will not fall if it is not spent. She also asked about the compensation fund, and I shall return to her with a written reply on that. She correctly made the point that some people will feel that time is running out and that they need a resolution quickly. That is why, within a few months, we intend to launch a consultation that we want to be completed very quickly—preferably within eight weeks, but should beneficiaries prefer, within 12 weeks. We will then launch the revised parameters of the schemes by the end of the year. We are moving quickly, and we intend those provisions to be in place so that people can feel the benefit, and feel that their voice is being heard and reflected in the changes that the Government have made, fulfilling their promises to do so.

[Jason McCartney (Colne Valley) (Con)]

May I save the Government the time of the consultation by referring them to the report issued earlier this year by the all-party group on haemophilia and contaminated blood, which I co-chair with the hon. Member for Kingston upon Hull North (Diana Johnson)? It made three recommendations: first, we need to make trusts and funds operate for the beneficiaries; secondly, we need a full and frank apology; and, thirdly, we need a full financial settlement for the victims. The victims are dying. Let us not wait any longer.

[Ben Gummer]

My hon. Friend is right to say that action needs to be taken. He will understand why, if we are to do the right job for victims and the beneficiaries of previous schemes, we must do so in a considered way and with speed, but it must be a proper process. Large amounts of public money are involved, and we must also ensure fairness to those people who have suffered as a result of this terrible series of events. I hope my hon. Friend will understand why we will undertake a consultation, even though it will be short. That does not preclude beneficiaries coming forward now with their views about what should be changed in the existing schemes to ensure fairness and equity in the schemes that supersede them.

[Andy Burnham (Leigh) (Lab)]

I pay tribute to my hon. Friend the Member for Kingston upon Hull North (Diana Johnson) who has been tireless in pursuit of answers for the victims of contaminated blood. Her powerful words today will have spoken for many people across the country.

This scandal is one of the worst injustices this country has seen. Thousands died, and thousands of families were destroyed through the negligence of public bodies. For years, the response from Governments of all colours to the victims could be described at best as grudging, and at worst as dismissive, and it falls to this Parliament to resolve today to end this injustice once and for all.

The Prime Minister’s apology in March marked an important moment on the journey for justice, and we welcomed his commitment to respond to the Penrose report

“as a matter of priority.”

We do not doubt the sincerity of that commitment, but does the Minister understand the disappointment that people felt when instead of the promised full statement, a written statement was released at 2 pm on a Friday afternoon, which failed to answer the key questions? The Minister failed to set a clear timetable for when the £25 million promised by the Prime Minister will be made available to those currently receiving support, and I think I heard him imply that it might go into the next financial year of 2016-17. May I press him further? Will he work to ensure that the funding is made available to victims this year, as I think that is what people want to hear from him today?

On disclosure, I welcome the fact that the Government have committed to releasing additional documents, but does the Minister accept that alongside that release we need a process to help families understand those documents and finally to get to the full truth of what went wrong? Will he commit, at the very least, to a panel on the Hillsborough model, or to a public inquiry, to provide a full commentary on the extent to which disclosure on this matter would add to public understanding of the scandal?

Finally, although no amount of money can ever fully make up for what happened, we owe those still living with the consequences the dignity of a lasting settlement. People will therefore be disappointed that any decisions on future support appear to have been postponed until the spending review. Will the Minister put a timeframe on when the Government will make their next statement about a full and final settlement? Given the widespread concerns about current arrangements, does he acknowledge that the longer this goes on, the longer we leave in place a system that is not working and leaves victims going cap in hand for support, which only adds to their sense of injustice?

We congratulate the Government on their progress in recent months, but now is the time for a resolution. This injustice has gone on long enough. Further delay adds insult and injury to that injustice. A full, fair and final resolution is now required.

[Ben Gummer]

I thank the right hon. Gentleman for his measured words. He is right to say that it falls to this Parliament to come to a reasonable and fair conclusion. He is also right to point to the Prime Minister’s apology. I know from my own experience of talking to victims that that was a very important moment for many.

The right hon. Gentleman asks about the £25 million. What I meant by my remarks is that I hope it will be spent this year in furtherance of the transition to a new scheme, but should money not be spent it will not be squirreled away for other purposes. It will remain allocated for beneficiaries.

On the timing of the statement, our purpose was to update Parliament on progress as soon as possible. Beneficiaries have been waiting for 30 years, so it is understandable that they would like to see faster work. We are working at full pelt, but that work has to be done in tandem with discussions on the spending review. This will be one of the first outcomes from the review, which is why we anticipate having a transition to the new scheme and a consultation finished by the end of this year.

Finally, the right hon. Gentleman refers to a panel and to the work done by the Hillsborough inquiry. I know he has personal experience of that, not least because of his own extraordinary work in bringing it about. I would suggest that in this instance speed is of the essence. I think we all understand where we need to get to. We need to ensure that the new scheme is comprehensive in addressing the perceived and actual failings in the existing five schemes, and that that is done as quickly as possible. I would not like an inquiry to get in the way of the speed with which we can do that.

[Chloe Smith (Norwich North) (Con)]

Will the Minister help me with two things? First, a constituent of mine said over the weekend that this looks like another case of the Government saying they are going to do something and then doing nothing. I am sure my hon. Friend will be able to reassure my constituent that that is not the case. Secondly, will he give us an update on making the new generation of drugs available to sufferers as quickly and as fully as possible?

[Ben Gummer]

My hon. Friend is entirely right to say there are some exciting medicinal prospects on the horizon. The demands, especially on those for hepatitis C, have to be seen in the round of all sufferers of hepatitis C, but this is an additional factor to be played in. We hope the particular group affected by hepatitis C will be considered by NHS England as part of its discussions on how to take forward future cures.

Penrose reported just before the election. There is an enormous amount of work going on in the Department at the moment, and this is a priority for the Department. We know we need to move quickly. I want to reassure my hon. Friend ‘s constituents that we want to have this matter settled before the end of the year.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

The problem of contaminated blood products was an international one, but Penrose was a Scotland-only inquiry. It could not compel witnesses from elsewhere in the UK and that needs to be borne in mind. The victims and their families are key. Many families were infected because patients were not warned, and families have been bereaved. What consultation has there been with the Scottish Government, who held the inquiry and apologised on the same day, about this apparent delay? How much of the £25 million will be spent? We must ensure access to treatment, whether that is the new antivirals or transplants. We hurt these people; we must not let them down.

[Ben Gummer]

I thank the hon. Lady. It is a good example of the new mode of working between our Governments that officials in the Department of Health have been working very closely with their counterparts in the Scottish Government. Of course, most of the events that the Penrose report refers to were pre-devolution. It is therefore entirely right that the recommendation is adopted across the United Kingdom, not just in Scotland. I expect that cross and close working will continue through the course of the settlement process.

[Dr Julian Lewis (New Forest East) (Con)]

My constituent Lesley Hughes was infected with hepatitis C 45 years ago, but the condition was discovered only relatively recently. Given that she is an older sufferer, the standard drugs do not agree with her or assist her to the extent that the new generation of drugs would. Is there a timescale that I can offer her to give her hope that she will be able to move from the less effective and less tolerable drugs to the new generation of drugs?

[Ben Gummer]

My right hon. Friend raises an important point. He may be aware that the Government have launched an accelerated review of hepatitis C drugs, and the Under-Secretary of State for Life Sciences, my hon. Friend the Member for Mid Norfolk (George Freeman), will be updating the House as soon as he has news on that. At the moment, I am afraid all I can promise is celerity rather than certainty.

[Sir Gerald Kaufman (Manchester, Gorton) (Lab)]

I thank my hon. Friend the Member for Kingston upon Hull North (Diana Johnson) for putting this urgent question and for all her dedicated work on this agonising issue. I put it to the Minister that if he had made his statement not to the House but to my constituents, including one in particular who lives in agony and fear, the reaction would have been less parliamentary than it has been this afternoon. The people who are waiting for this do not have an infinite amount of time, and the correspondence that I receive on this matter rends my heart. The consultation is taking too long, and action is essential.

[Ben Gummer]

I agree in large part with the right hon. Gentleman. He has been in this place for many years, and he will know that successive Governments have not acted on this great tragedy. We are moving quickly. In the wake of the Penrose report in March, the Prime Minister promised to move rapidly following the election of the new Government. We are updating the House at the moment, and we will be launching a consultation on a new scheme in the autumn. I hope that most sufferers will understand that that is about as quickly as we are able to move. The thing that they have asked for above all is action, and that is precisely what this Government are taking.

[David T. C. Davies (Monmouth) (Con)]

One of my constituents, Craig Sugar, is a sufferer. He has been a high-profile campaigner on this issue and he has visited Parliament. Will I be able to reassure him over the next few days that the consultation will lead to speedy action and that it will not simply be a delaying process?

[Ben Gummer]

My hon. Friend can certainly reassure his constituent that the purpose of this consultation is to ensure that it fits with what the beneficiaries, sufferers and victims want from the new scheme, and that it is also designed to be quick. That is why we are hopeful that we will have an eight-week consultation and that we can get on with implementing the results as quickly as possible.

[Stephen Kinnock (Aberavon) (Lab)]

I rise to speak on behalf of my constituent Tony Farrugia. Mr Farrugia lost his father and two uncles when they contracted AIDS and hepatitis C from contaminated blood. Days after the death of his father, Tony and his twin brother were separated and sent to care homes more than 100 miles apart. They were not reunited until a decade later. Will the Minister confirm that the emotional and psychological impact of such awful decisions will be included in the scope of the consultation?

[Ben Gummer]

The hon. Gentleman’s example is one of many that are similarly affecting in illustrating the appalling effects that this tragedy has had on individuals, their families and their extended families. I can promise him that the personal views of everyone who has been affected by this tragedy will be taken into account during the consultation. That is its purpose. It has not happened so far, but that is what we are going to deliver.

[Suella Fernandes (Fareham) (Con)]

I welcome today’s announcement. It represents progress on a tragic issue that has affected thousands of people in this country. My constituent Mrs Jackie Britton contracted hepatitis C in 1982 following a blood transfusion during childbirth, although she was not diagnosed until 2011. Will my hon. Friend provide the House with guidance on the availability of drugs, particularly sofosbuvir, which has been approved by the National Institute for Health and Care Excellence? Will it be made available for the treatment of cirrhosis?

[Ben Gummer]

NHS England has just announced a major package in respect of the drugs my hon. Friend mentions. I will ensure that my hon. Friend the Life Sciences Minister writes to her with further details.

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

May I add my thanks to those already given to my hon. Friend the Member for Kingston upon Hull North (Diana Johnson) and add to her comments about the pressing need for a settlement? I recently learned of a constituent who contracted hepatitis C in the 1980s. The reality of his life is that the drug treatment he needs is not funded, although it is available in Scotland. He is looking at paying out £35,000 for a 12-week course of treatment and cannot get life insurance for mortgage purposes. He also talks about the stress and discomfort of the treatment he has tried. His life is on hold. This is a pressing matter. What can we offer him?

[Ben Gummer]

The hon. Lady is right to highlight that for some people this has been a fact of life for 30 years or more. Within a year of the publication of the Penrose report, we hope to provide a scheme that settles the concerns of many sufferers. That is a fast pace at which to move given the complexity of what is required, the five schemes already in existence and the many hundreds and thousands of voices that need to be heard in the short consultation we plan to hold.

[Mark Menzies (Fylde) (Con)]

I know from first-hand experience that my right hon. Friend the Prime Minister and my right hon. Friend the Health Secretary care passionately about this issue. We need to make sure that the people suffering from these diseases do not feel at the mercy of a clunky civil service-led process, and that it is being driven by people who know about the issue and want it sorted out to the benefit of those people.

[Ben Gummer]

In my discussions with officials, there has been a great sense of urgency and professional commitment to making sure this is dealt with as quickly as possible, and we are moving quickly. As my hon. Friend will understand, the Prime Minister has form on trying to address historical injustices. This is another he intends to address in a like manner.

[Pete Wishart (Perth and North Perthshire) (SNP)]

There is a sense of profound disappointment among sufferers in my constituency, who see this as yet another delay and are totally frustrated with the process thus far. When the Minister talks about all these accounts and things, he sounds like a pound shop accountant rather than someone dealing with the deaths of our constituents month after month. If he has taken the £25 million off the table, will he make sure that the funds he talks about—the Caxton, MacFarlane and Skipton funds—are properly resourced in order to get our constituents through this difficult period and at least give them something to rely on?

[Ben Gummer]

The hon. Gentleman speaks of speed. We had the results of the Penrose inquiry in March. In the intervening period we have had the election, and now we are announcing to Parliament the remainder of the consultation period and settlement process. That is actually very quick, considering the complexity to which he alluded. I hope that the £25 million will be spent in full on the proper things it needs to be spent on, but it will certainly be used where appropriate in the transition to the new fund from the existing five.

[Mark Garnier (Wyre Forest) (Con)]

I am grateful to the Minister for his statement on this tragic occurrence. A constituent of mine, Rosamund Cooper, a sufferer, is worried that the consultation has no specific aim. Can he assure us that two of the aims will be to ensure that the hardship suffered by people is taken into account, and that they get the best possible access to the proper care and quality of care they deserve?

[Ben Gummer]

I hope that my hon. Friend’s constituent will be reassured by the aims of the consultation when they are published shortly. She should know that overall, we are trying to address the problems that sufferers, beneficiaries and victims have had with the existing five schemes. It is to that end that we will launch the consultation, the aims of which will be published in detail, and provide a settlement.

[Nia Griffith (Llanelli) (Lab)]

Taking action by the end of the year means that it will already be nearly a year since the report produced by the all-party group on haemophilia and contaminated blood. While impressing on the Minister the need to take urgent action, may I return to the panel that my right hon. Friend the shadow Health Secretary mentioned? What further answer can the Minister give about setting up a panel to provide more comprehensive answers to those who have experienced so many years of agony and waiting?

--- Later in debate ---

[Ben Gummer]

The hon. Lady can find her answer within her question. If we are to move quickly to a resolution, we cannot insert another inquiry process that would delay yet further what we need to do for the sufferers who have been waiting so long.

[Tom Pursglove (Corby) (Con)]

Some of my constituents have faced real difficulties when trying to access appropriate treatments. Can my hon. Friend reassure me that Ministers will take action to ensure that no new treatments are denied on the basis of cost?

[Ben Gummer]

I can reassure my hon. Friend that treatments, including new treatments, will be provided on the basis of need, but again, it will be for NHS England to determine how they are released to the service. I know that my hon. Friend the Under-Secretary of State for Life Sciences will give my hon. Friend further details if he requires them.

[Andy Slaughter (Hammersmith) (Lab)]

Contrary to the Minister’s assertion, there is a lack of urgency, which is shown by the fact that there was no statement by the Prime Minister, as had been promised. We know the defects of the current schemes—they are not redeemable—and we know what needs to be done. Will the Minister confirm what I think he said, namely that there will be a final assessment by next March? Will he also guarantee that the money will be available, and will not be ring-fenced or offset against other departmental spending?

[Ben Gummer]

What I have said, very clearly, is that we will launch a consultation in the autumn, and that we hope it will be as short as possible so that we can arrive at a settlement as rapidly as possible. I also hope that it will be in the tightest possible timeframe, as the hon. Gentleman suggests.

As for the issue of money, I know that the hon. Gentleman may not understand this, but the money has to come from somewhere, and it will come from the health budget, which is where it is designated to derive from.

[Mrs Flick Drummond (Portsmouth South) (Con)]

A constituent of mine, Sally Vickers, has lived for years with the consequences of contaminated blood transfusions, and we are having difficulty in finding accommodation that meets her needs. Her quality of life has been greatly undermined, and she may not last much longer. May I ask for the consultation to extend further than the issue of medicine and consider other needs as well?

[Ben Gummer]

As my hon. Friend will know, the existing schemes already provide additional support in the form of welfare or benefits. Any new scheme must not only include the measures in the existing schemes that work well but adjust the parts of those schemes that do not work well.

[Sammy Wilson (East Antrim) (DUP)]

We understand how frustrated many people will feel about the fact that the Government can rush through measures to deal with English votes for English laws—which is not even an issue in the current Parliament—while an issue that has been lingering for 30 years will now be subject to consultation that will itself be delayed, despite a manifesto promise. The results of the consultation will then have to be worked out. Moreover, the Minister has said four times that the decision will be made in the context of the spending review. Can he assure us that budgetary considerations will not delay the process even further?

[Ben Gummer]

The hon. Gentleman raises the issue of English votes for English laws. That has been deferred, because the House wishes to discuss it further.

On the issue before us, a report was delivered in March, but the general election then intervened, which effectively took six weeks out of the time in which the Government could make decisions. We began work the minute we returned to government, and I have now provided an update and the prospectus for a consultation in the autumn. It will be the first consultation that the sufferers have ever been able to enjoy, and we will finish it as quickly as possible in order to arrive at a settlement. That is rapid progress, given that it has taken us more than 30 years to reach this point.

[Mr Philip Hollobone (Kettering) (Con)]

I have been listening very carefully to my hon. Friend. Will he be kind enough to make it crystal clear to the House exactly what his intentions are? I understand from what he has said that he expects a new scheme to be up and running by the end of calendar year 2015. If that is incorrect, by when does he expect such a scheme to be established?

[Ben Gummer]

We shall be consulting this year, the consultation will be concluded by the end of the calendar year, and we hope that a new scheme will be up and running as soon as possible after that. It will, of course, depend slightly on the outcome of the consultation, but I expect the scheme to follow very rapidly on the heels of its conclusion. None of us has an interest in delaying this any further.

[Chris Stephens (Glasgow South West) (SNP)]

First, may I ask the Minister to take this opportunity to apologise to my constituents, who are very upset that the statement was made in the other place on Friday afternoon? Does he also acknowledge that these delays—indeed, any delays on this issue—compound the original error, and can he assure the House that we will be updated regularly so that all Members can represent their constituents on this matter?

[Ben Gummer]

I hope the hon. Gentleman will pass the message on to his constituents that we were doing the House a courtesy in explaining that we were making progress and outlining a consultation timetable, and that the substantive statement will come in due course owing to the amount of work needed to make sure it is as full and thorough as possible. That is why we made the written ministerial statement. We intend to move as quickly as possible, as we have promised to do.

[Mr Peter Bone (Wellingborough) (Con)]

With all due respect, that is not good enough. There should have been an oral statement in the Commons, which was what the House was led to believe would happen. The fact that there was not a lot to say was not a reason to put out a written statement in the Lords on a Friday afternoon.

Will the excellent Minister, whom I have a lot of time for, confirm the position on the drugs? I have constituents who need drugs that are available but that the NHS is not granting at the moment. There cannot be much money involved; there is just red tape. Can we clear the red tape and let constituents get those drugs?

[Ben Gummer]

I thank my hon. Friend, and I have taken note of his comments. NHS England has just announced an accelerated review into hep C drugs, and the Parliamentary Under-Secretary of State for Life Sciences will give my hon. Friend further details on that, but we are moving quickly to ensure that the new range of drugs for hepatitis C in particular is brought into service as quickly as possible.

[Huw Irranca-Davies (Ogmore) (Lab)]

A constituent of mine is one of the 300 so-called “forgotten few” primary beneficiaries. What is the Minister’s response to him when he says that

“‘the forgotten few’ have lived with this for so long now, further hold-ups and enquiries will make things far too late for many of us, considering some are well into their 60s by now. No one can give me back my brother or the life I’ve missed but to have financial peace of mind, knowing I can secure my family’s future is the number one priority for me now, after years of hardship and uncertainty”?

There seems to be a real difference in tone and substance between the Minister’s comments today and what the Prime Minister said before the election, and I am seeking real reassurance.

[Ben Gummer]

I completely agree with the hon. Gentleman’s constituent that further inquiries will not provide him and his family with the service they require. That is why we are moving quickly to the consultation, which will be launched in the autumn. It will be a short one, and then we will move to a settlement. I want the hon. Gentleman’s constituent to feel that this Government have addressed his tragedy swiftly following the publication in March of the long-awaited report.

[Richard Fuller (Bedford) (Con)]

I commend the work of my constituency neighbour the Minister for Community and Social Care, my right hon. Friend the Member for North East Bedfordshire (Alistair Burt), on this issue.

I want to draw my hon. Friend the Under-Secretary’s attention back to the question the hon. Member for Kingston upon Hull North (Diana Johnson) asked about BPL Ltd. Can he clarify what, if any, financial interest the Government retain in BPL? If Bain Capital realises a sale, will any of the funds be used for the financial consideration that we are discussing?

[Ben Gummer]

I too commend my right hon. Friend the Minister for Community and Social Care, who has done extraordinary work on this subject in the past and brings that experience and expertise to the Department.

I cannot give my hon. Friend an immediate answer on the company he mentions, but I will make sure we write to him with full details.

[Ms Margaret Ritchie (South Down) (SDLP)]

A constituent of mine, Brian Carberry, is a haemophiliac who was infected with contaminated blood products in the 1970s. He has now got hepatitis C. The one thing he wants to hear today is when there will be a full and final settlement and when the drugs will be made available, because there is little point after people get cirrhosis.

[Ben Gummer]

The hon. Lady should know that the two issues are separate. The drugs that she mentions are part of an accelerated access review, which my hon. Friend the Under-Secretary of State for Life Sciences launched recently. It will be available to all sufferers of hepatitis C, however they contracted the disease. We hope to move to that as quickly as possible, and I know that NHS England has it in hand.

A full and final settlement is exactly where we are trying to get to. The hon. Lady will be aware that this is an enormously complex area, and we want to ensure that all the concerns of sufferers and victims are taken into account in the consultation that we are going to lead, so that we can come to a final settlement that is equitable to all.

[Mark Pawsey (Rugby) (Con)]

My constituent tells me that, despite the fact that he was infected when he was in the sixth form, at an age when he saw little future, he now has a good job, a wife and, following IVF treatment, a daughter, although he still faces many challenges. Specifically, will the Minister include the right to funding for a second round of IVF? My constituent and his wife are very keen to provide a sibling for their daughter and are having to use their own funds to do so—funds that they had put on one side to support their child in future years.

[Ben Gummer]

I know that my hon. Friend has spoken about that issue to my hon. Friend the Member for Battersea, the Minister with responsibility for public health, and she will write to him shortly with an answer to his question.

[Kevin Foster (Torbay) (Con)]

My hon. Friend will be aware of the frustration of those waiting for a result, including some of my constituents. I heard what he said about consultation, but can he assure victims that a final decision will be made as soon as possible, given the decades that they have spent waiting for justice?

[Ben Gummer]

I can give that assurance.

Barking, Havering and Redbridge University Hospitals NHS Trust

Ben Gummer Excerpts

Wednesday 15th July 2015 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

It is a great pleasure to serve under your chairmanship, Mr Davies. I thank the hon. Member for Ilford South (Mike Gapes) for raising what is an important matter not only for his constituents, but for the whole health economy of east London, and for the measured way he presented his case. He has been a watcher of and campaigner on the matters in his constituency for a long time. This matter has been addressed and debated on several occasions in this Chamber, and I know he has raised it in the main Chamber too. The last time he raised it here was in January 2014, just after the trust had been put into special measures by the Care Quality Commission in December 2013.

The distance that has been travelled since then is quite considerable. I was able to see it for myself recently, as my first ministerial visit was to visit the Queen’s hospital site—albeit to hear about the trust as a whole. It was clear from talking to staff, which I was able to do without management being present, that the distance travelled over the past 18 months has been considerable and transformative not only for patient care, but for staff experience of the workplace—the two, as all Members will recognise, are coterminous. The most instructive moment came in the staff discussion, when a nurse explained that, the day before, a petition signed by 3,000 local people, which had not instigated by anyone at the hospital, had been delivered to say how much they valued staff efforts to turn around their hospital and how they felt that it was a different place from the one that had gained a mixed reputation in the many years before the hospital was put into special measures.

I will address each of the issues raised by hon. Members in turn, but I want first to set the context and add slightly to the narrative provided by the hon. Member for Ilford South in his recounting of the trust’s history. The key review in the matters that we are discussing was begun in 2009. The review took in the whole of Health for North East London and was conducted under the right hon. Member for Leigh (Andy Burnham), then the Secretary of State for Health and now the shadow Secretary of State. It began reporting just before the 2010 election and required an answer immediately after. The hon. Member for Ilford South will know the report’s conclusion, which is basically what we are still sitting with. It encompassed not only the health economy of north-east London, but the relationship with what is now the Barts Health NHS Trust, encompassing Whipps Cross university hospital, St Bartholomew’s hospital, Newham university hospital and the Royal London hospital.

Several hon. Members have discussed the Government’s intentions regarding reconfiguration, but the report was not led by the Government or Whitehall but was under the sensible regime set up by the previous Labour Government of clinically led reconfiguration panels. The principle behind it was a better organisation of A&E and urgent care in east and north-east London—in particular, being able to provide superior trauma care at fewer sites. That model has wide understanding across the House and is based on international evidence and, increasingly, the experience in the NHS. It has affected my constituency as much as it has others around the country.

I understand why hon. Members who are concerned about a hospital that will lose particular services—although King George hospital will retain a 24-hour urgent care service—will feel aggrieved by that change. When engaging with patients and constituents, however, I ask that we remind everyone that this was a clinically led decision that was set up under the previous Labour Government and that the recommendations were continued by the coalition Government as a result. However, none of that questions the fundamental reason why the hon. Member for Ilford South called for this debate, which was to ask, “How can you continue this reconfiguration when one part of the trust is in crisis?” Crisis is the correct word to use for a hospital that was put into special measures. It was not one of the Keogh trusts that were put into special measures due to adverse mortality; it was one of the first to be put in because of systemic and endemic problems at the trust, many of which the hon. Gentleman highlighted.

The change that has occurred over the past 18 months to two years—I am grateful to the hon. Member for Ilford North (Wes Streeting) for highlighting exactly what has gone on—has been one of culture. Another remark from a nurse with whom I spoke was that, since special measures, her comments about patient care were being noticed by management for the first time. That was the difference that the CQC inspection made. The change in culture has been recognised by local people and the result is much-improved family and friends figures. I do not recognise the figures provided by the right hon. Member for Barking (Margaret Hodge), but the most recent figures are close to the national average. I will receive those figures in a moment, but I believe the overall A&E figure for family and friends was up at 84%. That is not quite where it should be, but the in-patients figure had also risen to nearly the national average. The most recent family and friends figures showed an improvement in results.

Hon. Members recounted figures suggesting that the A&E performance was poor. It is true that the A&E department has failed to hit its required standard for a long time, but the most recent figures are encouraging. Performance for the first quarter of this year was 93.39%—just under the 95% target—compared with the figure for the first quarter of the previous year of 85.62%. That is like for like. Despite the problems encountered across the NHS over last winter, that hospital showed a sustained improvement in the first quarter of this year.

I second the remarks made by several hon. Members about the quality of the new chief executive and the team he has built around him. I have spoken to him, and although he was not going to make predictions, his confidence about going into winter, as well as the place the hospital was in, was significantly different from where he and his team were this time last year.

Let me clarify the A&E figures before I get upbraided. I believe that the figures are that 96% of in-patients would recommend the service to their family and friends, and 1% would not; in A&E, 84% would recommend and 10% not; in maternity, 98% would recommend; in antenatal, 95%; in postnatal wards, 93%; and in postnatal community, 97%. Those figures are roughly around the averages in national FFTs—family and friends tests—which is a significant and marked improvement, showing that local people are responding to the changes made in the hospital and to what needs to happen.

None the less, despite all the improvements, it is true that the A&E is not in a sustainable position to receive the services from King George hospital, either physically—I saw its buildings for myself—or in terms of the new rotas and rosters, although recruiting is now much better managed than in the past. I understand from local commissioners that there is no intention to move these services from the King George to the Queen’s site until the physical and staff changes have been made to the satisfaction of the commissioners and the provider—the trust itself. I understand also from the commissioners that the time limit they have imposed means that that cannot happen even within the next two years, because they need to see a degree of sustainability before they can have the confidence to make the changes.

[Mike Gapes]

Does the Minister accept that, given that the A&E will be closed, whether in two, three or four years’ time, there is a level of uncertainty? The CQC report comments on that. Is it not better for the sword of Damocles to be lifted and for us to go ahead on the basis of having two A&Es that work together?

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[Ben Gummer]

I understand the hon. Gentleman’s points. I accept that uncertainty is created at the King George site and that the effect of that is potentially destabilising, especially when the hospital and the trust have had to endure the whole process of special measures. His solution, however, is a false one in two senses.

First, the decision was clinically led in the first place, so to go against it would be to go against a clinical decision after several reviews. The hon. Gentleman is therefore suggesting that we make a political intervention against a decision made by doctors about the best distribution of trauma centres and urgent and emergency care centres according to population. Decisions have been made on a similar basis throughout the country. I do not believe that he really feels that that would be an acceptable route to take. Secondly, even were we to do that, it would not remove uncertainty, because there would still need to be some sort of reconfiguration in future in order to get the best outcomes for patients. So the uncertainty would remain.

The hon. Gentleman’s point is valid to an extent. If the situation were to occur again—clearly none of us would have wished things to proceed as they have done —we need to make it clear that reconfigurations can happen only when we have the correct sustainability in receiver organisations. That should be something we think about as we go ahead. However, we are where we are now with his trust, and to proceed on the basis that he suggests would not give either the patient outcomes or the certainty that he desires, whether for staff or his constituents.

[Margaret Hodge]

The Minister referred to a decision that was initiated in about 2009. That is correct, but circumstances change. Our area is the most rapidly expanding in London. I do not know the figures for Redbridge, but those for Barking and Dagenham show, potentially, another 30,000 to 35,000 houses being built over the next 10 to 15 years. That is massive expansion. I put it to the Minister that not only is the number of houses increasing, but the nature of the households is changing. What used to be a house lived in by a couple with perhaps two kids now tends to be lived in by intergenerational families with many more people. What regard has he paid to those changes? Should he not pay regard to them and review his decision in the light of them?

[Ben Gummer]

It is not ultimately my decision. It is the decision of the Secretary of State, but only on the advice of the Independent Reconfiguration Panel. The IRP takes a view over a long horizon, so it takes population growth into account in the original decisions—

[Margaret Hodge]

It did not.

[Ben Gummer]

I will come back to the right hon. Lady with a final comment, but that is what I understand. In the end, such decisions are left to local commissioners, who are the experts in buying the right kind of health provision for their patient groups. If their decision changes, that should be reflected in the IRP’s final decision, but the commissioners remain certain that that is the correct way to go for east and north-east London, and while that remains the case, we as politicians should support that clinical decision.

I will respond to some of the other points made by hon. Members. The finances of the hospital were brought up several times. It is true that it has had a sustained poor financial performance, but it is unlike other hospitals which have become indebted or are lifting up. The hospital’s position is a sustained one involving a large number—£38 million, which includes a very large figure for agency workers. That figure is now declining as the new management gets a grip on recruitment, and I heard some good stories about the improvement in recruitment when I went there only a couple of weeks ago. There is also £60 million annual provision for PFI payments, which is a problem in many trusts around the country, but there is no point rehearsing those issues, which the right hon. Member for Barking looked at many times in her previous role.

The chief executive is clear about the deficit. He shares my view and that of the Secretary of State that financial performance and quality go hand in hand. No hospital in this country offers outstanding care but has poor financial performance. We cannot get efficient care anywhere if the books are not being looked after at the same time, because the two work together. The chief executive understands that getting the trust into a decent financial position is central to providing the kind of consistently high-quality care that he wants to see across the trust, and not only in the specific areas rightly highlighted by the hon. Members for Dagenham and Rainham (Jon Cruddas) and for Ilford North.

The hon. Member for Ilford South was right to talk about capacity. There was a serious lack of capacity because of the failure to discharge patients and to get people through the system, which caused problems at the front end, in A&E. Remarkable change has been achieved in the past six months through the new measures put in place by the new management, but it is true that there is a great deal more to do. I heard a different story from the one the hon. Gentleman recounted: actually, they thought that the last CQC judgment was completely realistic; the action points highlighted were in large part already being addressed and needed to be done. The new management recognised that special measures was a regime that had to be exited once a sustainable improvement over time had been shown. That was gratifying to hear, because when it is heard from the shop floor, the management and the CQC, that shows that the whole team understands the problems and how they need to be addressed.

Several Members mentioned the problems in primary care, and I am aware of the acute issues in east and north-east London. They are the reason why my right hon. Friend the Secretary of State launched the new deal for GPs a couple of weeks ago. NHS England is now mapping hotspots of GP shortage across the country. It will use that information to target resources to make sure we are putting the new GPs being recruited into the right places and using every possible incentive to make sure that under-doctored areas are brought up to parity. Members will know that this is a historical problem and it will take a great deal of heavy lifting from all of us to change it. It is not simply about sheer numbers of GPs; we must have new models of delivering care and new diversity, so that we can deliver primary care appropriately rather than in a way that is based on a model that does not fit.

The right hon. Member for Barking raised understandable concerns that the existing system for the Barts trust was set up to finance one PFI deal. She is not alone in those concerns. I am taking a deep interest in the progress of the special measures regime at Barts. The financial performance and accounting procedures at that hospital and trust when it went into special measures were frankly shocking. They have now been changed, and we will be reviewing the situation on a weekly basis. I hope that if she discusses the matter with the CQC and the trust, she will understand better that it is not that the trust is subsidising one PFI but that there are systemic financial problems across the trust. I take her point completely, however. As we address the financial problems in east London we must reassure everyone that mergers have not happened simply to prop up one organisation at the expense of another.

Finally, I welcome the constructive approach and fair questions of the hon. Member for Denton and Reddish (Andrew Gwynne). I hope I have answered the majority of his questions, but I question the idea that Government policy has made the situation worse. The reason we are debating here is that the CQC gave an inadequate rating to the Barking hospital trust and put it into special measures. The ratings and the special measures regime were a creation of the previous Government. They have provided transparency and clarity that we did not have before and allowed us to have an honest discussion about what is wrong and what is right. I can now stand up and say where the problems are and accept responsibility for what needs to change. None of that was possible when we could not say that anything was wrong and had to pretend there were no problems, because there was a culture of denial rather than one of transparency and openness.

We are not at the acme. We have a great deal of distance still to make up, but we are in a much better place than we were back in 2013, when the trust was put in special measures, or in 2010, when the review was completed. We now have clarity about what we need to do and the process for doing it. I believe that we will soon have a much better health economy in north-east London than the one that Members have had to endure so far.

Oral Answers to Questions

Ben Gummer Excerpts

Tuesday 7th July 2015 Commons Chamber

[Mark Garnier (Wyre Forest) (Con)]

1. What assessment he has made of the effectiveness of recent reviews of acute services in hospitals.

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

The configuration of front-line health services is a matter for the local NHS. It is for NHS commissioners and providers to work together with local authorities, patients and the public to shape their local NHS in such a way as to improve the quality, safety and sustainability of healthcare services.

[Mark Garnier]

The review of acute services in Worcestershire has taken nearly two years longer than anticipated, and that has had subsequent negative implications for the health economy in Worcestershire. It is absolutely right that trusts carry out proper reviews from time to time, but has the system been written in such a way that it creates imbalances that prevent a conclusion from being reached? What steps is my hon. Friend taking to bring in practical measures to expedite the conclusion of such reviews?

[Ben Gummer]

I agree that the process in Worcestershire has taken too long. I am glad that the West Midlands Clinical Senate has made recommendations that are being looked at by commissioners at the moment. I have encouraged commissioners to come to as quick a resolution as possible—I hope within the next few months.

[Ian Austin (Dudley North) (Lab)]

Will the Minister conduct a review of car parking charges? Patients in Dudley are absolutely furious after the people running Russells Hall hospital put up prices by as much as 50% for a short stay. Will he get together with NHS civil servants and the people running the hospitals to sort this out?

[Mr Speaker]

Because of the impact of parking charges on those seeking to access acute services.

[Ben Gummer]

Thank you Mr Speaker—helpful as ever.

The hon. Gentleman is entirely right that those who seek to access acute services on a regular basis require special treatment. That is why we issued guidance in the previous Parliament. I very much hope that his local hospitals will be looking at that with due care and attention.

[Mr Philip Hollobone (Kettering) (Con)]

Kettering general hospital is looking to develop a £30 million urgent care hub—one of the first of its type in the country—to replace and enhance the accident and emergency department, which is under growing strain. This project enjoyed the support of the previous Government. Will my hon. Friend agree to meet me and the two other MPs from north Northamptonshire to make sure that it remains on track?

[Ben Gummer]

I very much look forward to meeting my hon. Friend and his colleagues, and I have already committed to doing so. I hope that the lead he has taken with his colleagues in forging a cross-party consensus will be copied across the House.

[Keith Vaz (Leicester East) (Lab)]

Each week, 1,000 diabetics suffer hypoglycaemic attacks, which require urgent medical treatment and access to acute services. Does the Minister agree that better management of diabetes services by GPs will lessen the pressure on our A&E services?

[Ben Gummer]

I do agree with the right hon. Gentleman, who is an expert in this field. We have a diabetes and obesity strategy coming later in the year. The Under-Secretary, my hon. Friend the Member for Battersea (Jane Ellison), who is responsible for public health, will be leading that effort.

[Bridget Phillipson (Houghton and Sunderland South) (Lab)]

2. What recent estimate he has made of the proportion of patients who waited for at least one week for a GP appointment in the past 12 months.

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[Richard Harrington (Watford) (Con)]

4. For what reasons his Department categorises corrective refractive eye surgery for medical purposes as cosmetic surgery.

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

The Department does not categorise refractive laser eye surgery for medical purposes as cosmetic surgery. Laser eye surgery is regulated through providers registered with the Care Quality Commission. Doctors carrying out the surgery must be registered with the General Medical Council and, like all doctors, they must recognise and work within their competence.

[Richard Harrington]

My constituent Mr Shabir Ahmed, whom I have visited, was repeatedly recommended, by the optician he went to for his NHS eye test, to have an eye operation involving complex refractive laser surgery. Over two years, the optician called him every month, bringing the price down until it was half what it was originally. It did not work out: the surgery led to a significant deterioration in his eyesight, and the company denies all responsibility and liability. It seems to me—

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[Mr Speaker]

Questions do need to be shorter, otherwise they will eat into everyone else’s time.

[Ben Gummer]

There are two parts to my hon. Friend’s question. The first is about the high-pressure tactics employed by providers. They will be covered by the new regulations brought in on 1 April by my right hon. Friend the Member for Bromsgrove (Sajid Javid), who is now the Secretary of State for Business, Innovation and Skills, by which we have given powers to the Information Commissioner. I suggest that my hon. Friend refers his question to our right hon. Friend. On the second point about failed procedures, refractive eye surgery operators are governed by the same regulators as hospitals, and achieve exactly the end that my hon. Friend wishes.

[Mr Speaker]

Pithiness personified, I hope—Mr John McDonnell.

[John McDonnell (Hayes and Harlington) (Lab)]

The regulatory procedures are not working. Ten years ago, our late colleague Frank Cook introduced a ten-minute rule Bill calling for regulatory reform, and I reintroduced that Bill three years ago. The Keogh report called for regulatory reform two and a half years ago, and nothing has happened. People are losing their eyesight as a result of some of the companies operating in this field. Will the Minister meet me and the hon. Member for Watford (Richard Harrington) to talk about progress in this field?

[Ben Gummer]

I am afraid that the hon. Gentleman is not right. Progress has been made. Ten years ago, that might not have been the case, but the Care Quality Commission was strengthened under the previous Government and it is regulating refractive eye surgery. Moreover, the doctors who perform those operations are regulated by the General Medical Council, and the Royal College of Ophthalmologists is bringing forward a certification scheme because of the moves that were taken by the last Government.

[Rehman Chishti (Gillingham and Rainham) (Con)]

5. What progress the Government have made on improving safety in hospitals in special measures.

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[Helen Jones (Warrington North) (Lab)]

9. What recent discussions he has had with NHS England on the future of district general hospitals; and if he will make a statement.

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

The NHS was launched in a district general hospital. The continuing commitment of NHS England to DGHs is shown in their serial mentions in the “Five Year Forward View”. I recommend that the hon. Lady reads that to see the future for district general hospitals and the important role they will play.

[Helen Jones]

I am grateful to the Minister for that answer, but it ignores the reality on the ground. In opposition, the Prime Minister promised a bare-knuckle fight to save district general hospitals. Since he came to power, Warrington has lost its vascular services and some of its spinal services, maternity services are under review, and a £15 million deficit threatens the future of the trust. Did that bare-knuckle fighter get knocked out, or did he not even bother to enter the ring?

[Ben Gummer]

I gently remind the hon. Lady that the difference is that changes to services provided at hospitals are now made on the recommendation of clinicians, rather than of bureaucrats and Ministers, as it was under the previous Government, in which she served. In respect of her own hospital, the number of diagnostic tests for cancer are up by 22,000 since 2010, the number of MRI scans by 6,000, the number of CT scans by 7,000 and the number of operations by 1,800. That is a record of which to be proud.

[Mr Steve Baker (Wycombe) (Con)]

Wycombe hospital could benefit from one of the excellent models in the “Five Year Forward View”. Will my hon. Friend make sure these excellent proposals are carried through with energy and alacrity?

[Ben Gummer]

The strength of the NHS forward view is that it is a creation of the NHS itself, and we, as the only party to back it in full with cash, will give it the kind of support it needs to make sure it is delivered.

[Heidi Alexander (Lewisham East) (Lab)]

How many maternity wards or emergency surgery departments currently located in district general hospitals will close as a result of the Government’s seven-day NHS plans?

[Ben Gummer]

It is telling that the hon. Lady wishes to talk about wards rather than outcomes. Over the last five years, we have seen a significant increase in the number of patients treated in emergency wards, and we will continue to see an increase, and the difference is that they will operate seven days a week, rather than just five days a week, as is currently the case for many services across the NHS.

[Mr Christopher Chope (Christchurch) (Con)]

11. Whether his Department has discussed with the Dorset clinical commissioning group the provision of accident and emergency services in Dorset; and if he will make a statement.

Ministerial Correction

Ben Gummer Excerpts

Thursday 2nd July 2015 Written Statements

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

I would like to inform the House of two inaccuracies in a statement I made in response to the Opposition day debate on A&E services in the House of Commons and to correct the record.

First, I stated that the number of training places for nurses,

“is now at a record level.”—[Official Report, 24 June 2015; Vol. 597, c. 921.]

Nurse training commissions are at near record levels, following an increase of training commissions of 14% over the last two years.

Secondly, I referred to the Salford Royal Hospital,

“saving £5 billion a year.”—[Official Report, 24 June 2015; Vol. 597, c. 924.]

when the correct figure is “£5 million a year.”

[HCWS79]

Operational Productivity in NHS Providers

Ben Gummer Excerpts

Wednesday 1st July 2015 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

It is a pleasure to serve under your chairmanship, Mr Pritchard. It is indeed my first appearance in this role in Westminster Hall and, therefore, under your chairmanship here.

I congratulate my hon. Friend the Member for Hendon (Dr Offord) on securing this important debate. I suspect that, in raising the important matters that he took up in his speech, he did not anticipate the glimpse of the promised land that the debate would give us. I have never sat in a debate on the NHS in this House—I have only been here for five years—when there was such a productive, interesting and bipartisan approach to such an important matter. I hope that it will be a model for things to come.

In seriousness, the differences between us, across the Floor, are far fewer than the things we agree on when we consider the NHS. A new Member, the hon. Member for Bristol South (Karin Smyth), said in her speech that now the election is over we have a fantastic opportunity to forge a greater consensus on the NHS, which will be better for the service and patients, and especially, in the present context, for the people who work in it. They get fed up with the politicisation of the NHS, which has happened since its creation in 1948.

The hon. Lady hit the nail on the head in her excellent speech: efficiency really comes from quality. We begin to get an NHS system that is truly efficient in using the resources that the taxpayer puts at its disposal and the hard work of those who work in it when the first consideration is care quality and safety. If we try to build a system around quality and safety, the efficiencies will flow from that and excessive costs will start to fall out. Part of the problem with trying to find efficiency savings in the NHS—indeed, in any public body or private organisation—is that a purely cost-cutting approach will almost certainly fail, in terms of not only the quality of the product being delivered, but the efficiencies being sought. I very much welcome the hon. Lady’s intervention on that point, because that is where we need to begin.

All of that lies at the heart of Lord Carter’s excellent report. It is an interim report—he will publish his final report, with a great deal more detail, in the autumn—but he has understood that it is the patient who feels the effects of inefficiency first and foremost. Their experience of care is not what it should be, because of how rostering is arranged or medicines are dispensed and administered. He gave specific instances in his interim report—for example, the range of products available for hip replacements—of where choosing one product over another can mean dramatic differences in the occurrence of revisions. As the hon. Member for Strangford (Jim Shannon) said in his speech, cheapest is not always best. Sometimes, a slightly more expensive hip replacement joint can mean a much higher chance that someone does not have to come back for surgery again in a few years’ time. Such decisions about balance lie at the heart of patient care. If we get the balance right, we have a huge prize: better patient care and a more efficient, cost-effective service.

I want to run through the main points of Lord Carter’s report and reflect on them in the terms raised by my hon. Friend the Member for Hendon. The NHS provides a varied picture of efficiency. The service has some of the most efficient hospitals in the world, but also some fantastically inefficient ones. That variation lies at the heart of the problem that we have to square in the next few years, which I will come to shortly when I address the specific points about the £22 billion target. As MPs, we all have anecdotal impressions from speaking to chief executives and managers in the NHS: they have come up with great ideas locally, but one knows immediately that no one is learning from that across the system. That was the case before the 2012 reorganisation, and it was case before all the previous reorganisations; it has been problem in the NHS since its inception.

We must also learn from best practice around the world. There is some fantastic practice around, and not only in France, Spain—specifically Valencia—and Germany; some of the best practice in the world for creating efficient healthcare is in American hospitals. I find it very exciting that there is some fantastic practice coming from Indian hospitals, because it shows how the world is changing. If we can draw in that expertise, we will do better for the NHS. I hope that, at the same time, we will export some of the best practice we have developed here—much of which has come from places not a million miles from the shadow Minister’s constituency—to hospitals and health systems around the world.

The changes in efficiency and productivity gains in the past few years have been considerable. Traditionally, the NHS has lagged behind in productivity improvements, but in the past few years it has overtaken productivity gains in the rest of the economy. Some of that has come from wage restraint, but there has been a genuine improvement in productivity, although it is not as much as we hope, anticipate and need to come over the next five years from system change, rather that just from wage restraint.

Lord Carter’s review covers some of the efficiency savings that can be made, especially in the provider sector. He has identified £5 billion of savings, of which £2 billion can come from improving workflow and workforce costs and £3 billion from static costs related to pharmacies, estates and procurement. As has been mentioned already, he has identified the fact that although there is much dispersed good practice, it is not shared, and there is no common understanding of what a good hospital looks like. On the back of Lord Carter’s principal recommendation, we are going to construct a good hospital. It will be a virtual hospital, so people will not be able to visit it, but they will be able to go to parts of it, because we are going to take the best practice and codify it.

Lord Carter has created a system called the adjusted treatment index, which is a rather dry term for an exciting idea. We will say, “This index is the best that the NHS is doing and we’re going to measure you all against it.” Every chief executive, manager and clinician will be able to see where their particular unit sits against the very best in the country. That will immediately prompt some questions: “Why are we not the best? Why are we a third or half of the way down? What can we do to close the gap?”

The second output from Lord Carter’s report is to provide a suggestion, in base terms, of how the poorest performing hospitals, along with those in the middle and those near the top, can improve and become the best. His final report will give far more detail, but this is of course a living process. We want to create a manual that will help clinicians to constantly improve their performance, measured against the very best—and the very best in the NHS will be measured against the very best in the world, so that our target keeps moving upward.

Lord Carter also identified issues with staffing, agency spend and locums, which formed the meat of the speech by my hon. Friend the Member for Hendon. I will quickly go through what we plan to do. In the long term, it is clear that the expansion of nursing recruitment places will meet our objective to improve staffing ratios and the quality of care in hospitals, but we do have a backlog to fill. I do not want to break the bipartisan consensus, but the fall-off in recruitment places did begin before 2010. It picked up again in 2012-13, partly in response to the recommendations of the Francis report, but we still have some way to go to ensure that we are up to pace.

It has become clear that although there was a need for agency staffing to plug the shortfall, some have been abusing that position. Now that we are getting more and more nurses into the system, it is the right time to bear down on agency costs, which is why the measures outlined by my right hon. Friend the Secretary of State a couple of weeks ago will make such a difference, by giving chief executives the tools to ensure that they are not paying over the odds on agency spend.

[Karin Smyth]

On agency recruitment, does the Minister agree that we should encourage more young people to see the NHS as a good career? Young people such as those in my constituency, Bristol South, do not always get the advantages of university and further and higher education qualifications, and they do not see working for the NHS as a good and positive career. It is still a very good career—well paid and well remunerated by pensions and so on—but it is no one’s job, directly, to sell a career in the NHS in order to bring through the next generation of young people in places such as Bristol South to work in the NHS. That is not a hospital’s direct role. Health Education England is a new organisation and has that responsibility, but, in the spirit of bipartisanship and cross-departmental working, will the Minister take our advice and talk to colleagues in skills and development and support apprenticeships to encourage young people to come through and fill the gap currently filled by agencies?

[Ben Gummer]

I do not want to ruin the hon. Lady’s nascent reputation by agreeing with her again—happily, there are very few Opposition Members present to notice, although that is not an implied criticism—but she is absolutely right. We are lucky that nursing places are quite significantly over-subscribed. The position is popular, but she is absolutely right that we need to not only make far greater use of apprenticeships but widen the skills base in nursing full stop. We are actively working on that in the Department—I have spent much of the day on it, and I am sure there will be more to come.

To help chief executives in this interim period, we have forced all agencies that want to offer their services to ensure that they are doing so through framework contracts, and we are ensuring that there is an hourly cap on the rate that can be charged. We have also taken additional measures on managerial salaries, along with a few other measures, to ensure that managers have the opportunity to be able to manage costs as they wish. We understand, however, that this is the first stage of a much deeper programme of reform that is needed. Lord Carter’s report points in that direction by suggesting that we use our existing workforce far better, so that people are doing the job that they are suited to and qualified for and that their time is not wasted. That is the great win, not only for efficiency and patient care, but for staff enjoyment of their jobs.

The hon. Member for Coventry South (Mr Cunningham) made some helpful interventions about NHS workers’ quality of life. It has been a sad but persistent truth of the NHS for many years—decades, in fact—that staff-reported incidents of harassment and bullying have been higher than the national average and that workforce stress and illness is higher than average. Some of that is to be expected—parts of the NHS are extremely stressful working environments—but we can do much more. Part of that is about ensuring, when people turn up to work, that they are doing the job they wanted to do, with a suitable but not excessive degree of pressure, and that the system is not wasting their time. If we make them happier in their jobs, their patient care will improve and their commitment to the service will be even greater. I am therefore aware of the prize, not just in pounds, shillings and pence, but in an improvement to staff morale and therefore patient care.

[Jim Shannon]

One of the things that concerns me from a Northern Ireland perspective—this has also been raised in discussions with other Members in the Chamber today and outside—is that the NHS greatly relies on, in our case, Filipino workers, which is an immigration issue. Has the Minister had any discussions with the Minister for Immigration, the right hon. Member for Old Bexley and Sidcup (James Brokenshire), to ensure that there will be no shortfall when the gaps left by those who are here on work visas need to be filled and that the quality service in the NHS will not be lost? The hon. Member for Bristol South (Karin Smyth) referred to training people to ensure that keen, interested and able replacements are available. Has the Minister given any thought to that?

[Ben Gummer]

I was going to come on to that, so I shall do so now that the hon. Gentleman has prompted me. There have been long and deep discussions about this. Our estimate is that no more than 700 nurses will be affected by the time the new rules are in place, which is a different number from that given by the Royal College of Nursing, whose number we do not recognise. It is small challenge given the scale of the workforce and one that we will surmount at the time, but we must see it within the broader policy of reducing immigration to this country from the hundreds of thousands to the tens of thousands—a policy that has broad support across the House and certainly in the country at large. It would be wrong for the largest employer in the country—one of the largest employers in the world—to exempt itself from that overall ambition.

In the end, we will achieve a sustainable workforce in this country only if we do all we can to ensure that those who are British and have grown up here and want to work in the NHS have the opportunity to do so. That is why it is important that we widen and open the avenues into working in the NHS, as the hon. Member for Bristol South suggested, over the next few years, in order to meet the challenge to which the hon. Member for Strangford alluded.

I want to quickly run through the other issues raised by my hon. Friend the Member for Hendon. On master vendors, he has a specific issue regarding some constituents with whom he has been dealing, but I understand that master vendors are managed under a series of arrangements with the Crown Commercial Service. Officials will meet with that organisation soon to discuss the overall issues around master vendors. It is for individual trusts to make such purchasing decisions, but I understand the issue he has raised and the terms in which he put it, and I will ensure that it is investigated properly.

My hon. Friend identified two areas involving agencies and fraud. Fraud is of course unacceptable, and the NHS has quite good systems for identifying it. Given the scale of the NHS, I find it surprising—it is entirely to the credit of those who work in the NHS—that fraud makes up such a tiny proportion of the excessive costs in the NHS.

On the revalidation of locum doctors, for which the General Medical Council is responsible, some doctors find it difficult to gather all the required supporting information needed for revalidation due to the peripatetic nature of the work. To help with that, specific guidance is available for both the doctors and their employers via NHS England and NHS Employers. Locum doctors are part of a larger issue about agency spend and foreign workers working in the NHS. I imagine that the three organisations will come together in the next few years to produce a more stable situation.

[Mr James Gray in the Chair]

Let me turn to the remaining points of the hon. Member for Bristol South. On the stability of the system, I hope and anticipate that one product of the general election is that the system will be broadly stable over the next five years. We intend to continue with the current structure of the NHS. There will be some small changes, such as that identified by my right hon. Friend the Secretary of State last week concerning the NHS Trust Development Authority and Monitor, but we are broadly content with how the system is set up. We must now proceed to ensure that it works.

The shadow Minister made a point about structures and fragmentation. There will always be a genuine dilemma here, because one can approach any system and say that change can be achieved by altering structures, but changing structures can lead to the same outcome. That has been the story of the NHS since its inception. It would be a mistake to think—the hon. Member for Bristol South and the shadow Minister were not suggesting this—that a structural change would somehow produce the outcomes that we all want. The priority is to ensure that the system’s wiring works correctly—that everyone’s interests are aligned and that the incentives are correct—so that people want to sit around the table and come to a considered decision, which can too often not be the case when there is an adversarial relationship between providers, producers and purchasers. That is why I hope that the system’s stability over the next five years will allow us to focus on the significant challenges mentioned by the shadow Minister.

[Andrew Gwynne]

When discussing competition rules, we often talk of public versus private, but two public parts of the NHS can also compete. Another NHS trust might have the tender for providing a service in another area and an integrated care organisation might want to bring that back in-house.

[Ben Gummer]

Absolutely. There are examples of that all over the country, but there are also examples of people working together in what might be considered competitive situations, so it is about ensuring that we copy the best and delete the worst.

Before I turn to the shadow Minister’s comments, I want to reflect on the contribution of the hon. Member for Angus (Mike Weir). The SNP spokesperson on health, the hon. Member for Central Ayrshire (Dr Whitford), has used a constructive tone in the Chamber so far, bringing some of her expert experiences as a clinician and also the experiences from Scotland. It is nice to be able to sit here and hear the experiences of people in Northern Ireland and in Scotland, and it would have been nice to have heard from Wales in this debate. Indeed, we do not yet properly learn from the best in Scotland, which would be all to our good, let alone the best in America or India.

The £22 billion in savings is an estimate not from the King’s Fund but from NHS England. It formed part of its plan, devised at the end of last year and some years in the making, which identified £30 billion of additional money that needs to be put into the service over the next five years. It stated that £22 billion could be generated internally—that was Simon Stevens’ estimate—which leaves an £8 billion shortfall. That is what we are pledged to provide. None the less, he, like everyone in the Chamber, has correctly seen that £22 billion is a large number and one that will take a great deal of intellectual and moral work to deliver. I welcome the tone with which everyone has approached this challenge in the debate.

[Mike Weir]

The reference to the King’s Fund was to make the point that it said that this was a tall order, as I think the Minister himself is admitting.

[Ben Gummer]

It is not a tall order, but it is a challenging one. Whoever was sitting in my place, from whatever party, would be facing a similar challenge, no matter how the needs over the next five years were framed. The challenge must be addressed, and it is better addressed if we all come together to do so.

The hon. Gentleman touched on pharmaceutical savings, which I have not yet addressed, and Lord Carter’s comments on them. Lord Carter will make more detailed recommendations later in the year, but the hon. Gentleman is absolutely right that there is much to be done to ensure that we save money on the provision and purchasing of drugs and by not wasting them. Lord Carter is looking at that, and the service is already implementing his initial recommendations.

New drugs are a problem faced by health services across the world. Indeed, it is a profound challenge, because the new drugs coming online are of an expense that has never been experienced in health systems before. They are also for increasingly small numbers of patients, precisely because they are personalised, which drives up the cost even further. That is why the Under-Secretary of State for Life Sciences, my hon. Friend the Member for Mid Norfolk (George Freeman), is bringing forward his accelerated access review and doing some exciting work, trying to use the muscle of the NHS—our ability to be an research lab, effectively—for those developing new drugs, so that we can use the NHS to drive costs down and provide patients with treatments earlier and more cheaply. There is a win-win there, but it requires a fundamental change in the system, which at the moment is not working.

Finally, I turn to the comments of the shadow Minister, mindful of the need to give my hon. Friend the Member for Hendon time to wrap up. I thank the hon. Member for Denton and Reddish for his kind welcome; it was good of him to say that. I hope that over the next couple of years we will be able to thrash out some of these difficult issues in the manner in which he has begun the process. If we do so, we will come to a better understanding of what is needed in our national health service.

The hon. Gentleman asked a number of questions, such as where the £8 billion is coming from. I believe it is coming from general taxation—my right hon. Friend the Chancellor will be providing greater details of that in the Budget next week. The hon. Gentleman also asked where the £22 billion was coming from. NHS England has devised the plan. It is NHS England’s plan to implement, and it will provide further detail about the £22 billion shortly. It will be an evolving plan that will necessarily change over the five years. NHS England is confident that it is achievable, but it will take some incredible heavy lifting by all of us and, dare I say it, the dropping of political shibboleths throughout the House—if one can drop a shibboleth; I am not sure.

The hon. Gentleman raised the issue of provider deficits, which is a problem across the system. He will know that there was a similar issue towards the end of the Labour Administration—in CCGs, rather than in hospitals. It does not necessarily require more money; it requires getting a grip on where the problem is. We have started that with announcements on agency spending. Many trusts in the country are doing well financially. Not surprisingly, they are often the trusts that are also delivering good care, because—to return to the comments of the hon. Member for Bristol South—if the care is right, the money flows from it. That is why Lord Carter’s review and a concentration on care quality will, we hope, produce the savings that we need, not just at this immediate moment to address provider deficits, but to achieve the £22 billion.

The hon. Member for Denton and Reddish also mentioned sales reps and procurement. I absolutely agree that the subject is covered in the report from Lord Carter. The numbers of product lines certainly should come down. I am not sure that the NHS, before having greater responsibility for purchasing, was any better at buying, but we need to be better at it. Procurement is a science. It is not one that I pretend to know a great deal about, but I know that in the end we will always end up in not quite the right place, because we might centralise too much, which takes away decision-making from the trust responsible. That is why we have to get the balance right.

On the cost of competition, the hon. Gentleman quoted a figure of £100 million. However, I understand that the costs of the reorganisation have been outweighed by the benefits, to the tune of about £1.5 billion annually. I think we all agree across the House on the producer-provider split. There will always be a degree of competition in the NHS; it is about getting the balance right between competition and collaboration.

In the last 30 seconds, let me touch on sub-acute services. The hon. Gentleman made his most pointed—and fair—remarks about the need to integrate social care with the NHS. The Government’s contention is that creating a new national structure for health and social care does not produce the end that we all want to see. That is why we want to see local solutions—we believe a good one is already emerging in Manchester—across the country, which will suit different areas according to their needs. In the end, we come back to money. We all know that money will be tight in local government. Our aim over the next few years is to ensure that as much of the resources that we can put into local government are going towards social care. That is the essence of the better care fund, which lies at the heart of what we are doing on integration over the next five years. I know the hon. Gentleman will want to comment on that as we proceed on those lines.

I thank all Members who have spoken in what has been an invigorating debate from which I have learnt a great deal. I again thank my hon. Friend the Member for Hendon for raising these important issues.

A&E Services

Ben Gummer Excerpts

Wednesday 24th June 2015 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

May I take this opportunity to congratulate you on your election, Madam Deputy Speaker? It is a great pleasure to speak for the first time with you in the Chair. You will have noted that the subject for debate on the Order Paper is A&E services—an important matter that everyone in this House cares much about. You will also have noted that there are several proposers of the motion, including the Leader of the Opposition, the shadow Secretary of State and the shadow Minister for care and older people. My first question is why, on this important issue, which the Opposition seem to think is critical to their programme for the NHS, the shadow Secretary of State for Health cannot be here to make the argument himself. Further, we understand that the shadow Minister for care will not be wrapping up the debate.

[Mr Jamie Reed]

I can tell the Minister where they are not: they are not hiding behind trees, and they are not meeting Rupert Murdoch in an underground car park.

[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.

[Ben Gummer]

It is a matter of importance, Madam Deputy Speaker, because in this episode of “Health Handbags”, we have been given an insight into the crisis within the Labour party and Labour Members’ inability to understand what the priorities are for the NHS and for the country.

If the NHS and A&E services are of such importance to the Labour party, one would expect the shadow Secretary of State—

[Robert Flello]

On a point of order, Madam Deputy Speaker.

[Ben Gummer]

rose—

[Madam Deputy Speaker (Natascha Engel)]

Order. If the Minister could sit down for a moment, I will take the point of order, which I imagine is very similar to the previous one. It would be nice if we could move the debate on, as there are several maiden speeches waiting to be taken. It is an important subject and I would like to move on, rather than get bogged down in this. I will take the point of order, and then I hope we will move on.

[Madam Deputy Speaker (Natascha Engel)]

Thank you very much. It is the person in the Chair’s decision whether something is within scope or not. I did not take the Minister’s response to my decision as a challenge to the Chair; I merely wanted to point out that it would be nice to get on with the debate and to allow other hon. Members to speak, especially new Members who wish to make their maiden speech. If the Minister could move on, we would all be very grateful.

[Ben Gummer]

With pleasure, Madam Deputy Speaker.

In the absence of the shadow Secretary of State, I shall channel him, which is something I enjoy doing. I like the right hon. Member for Leigh (Andy Burnham); he is a man who often—sometimes; a few times—speaks some sense. Just before the last election, he said that after the election,

“we need to come together, and then allow the NHS to get on with the job of building 21st-century services”.

What I do not understand about the motion that he and other Opposition Members have put before the House is that, far from coming together and trying to build consensus on the future of the NHS, what they are seeking to do—once again—is reproduce the golden oldies of criticism that they put before the country before the last election, and that were so roundly rejected.

That comment was about after the election. What I do not understand is what the shadow Secretary of State felt was the purpose of leading a campaign so politicising the NHS before the election. I, like so many others, had a leaflet through my letterbox saying that there were 24 hours to save the NHS—

[Madam Deputy Speaker (Natascha Engel)]

Order. We are straying into the general election, which has passed, and away from what is on the Order Paper, which is a debate on A&E services. If the Minister could stay on that subject, I would be enormously grateful.

[Ben Gummer]

With pleasure, Madam Deputy Speaker. The point is that we were warned that there were 24 hours to save the NHS, yet it is still there, and the A&E crisis, which is named at the top—

[Several hon. Members]

rose—

--- Later in debate ---

[Madam Deputy Speaker (Natascha Engel)]

Order. If the Minister could resume his seat, we are beginning to stray into the realms of challenging the Chair’s decision. We do not have much time and I do not want to take any more points of order on this one subject, so if he could stick to the subject on the Order Paper and let us move on, I would be very grateful to him.

[Ben Gummer]

I apologise, Madam Deputy Speaker.

The motion is about A&E services, and I would like to talk about the progress that the NHS has made in the past five years. Far from the picture painted today by the hon. Member for Copeland (Mr Reed) and Members who intervened during his speech, the NHS is treating more people than ever before, it is treating more people in A&E than ever before and it is treating more people at a higher rate of satisfaction than ever before, and the result of that is that patient outcomes—something we did not hear much about from the shadow Minister—have improved. We are treating more people to a higher standard.

[John Redwood]

Is it not the case that the excellent policy of seven-days-a-week GP services means an expansion in the amount of GP services, which will provide welcome relief from the pressures on A&E, which will add to the good work being done in hospitals?

[Ben Gummer]

That is precisely the sort of policy on which we will seek consensus in the months and years ahead. There is a choice for Opposition Members. I know there are many new Members who wish to make their maiden speech in this debate, and I would just say to them that the choice is this: to come together to try to model better care within the NHS and better outcomes for patients, or to seek division.

[Helen Hayes (Dulwich and West Norwood) (Lab)]

I want to raise a point of substance that affects my constituents. There are young people in my constituency who would love to train as nurses and work in the NHS, but by cutting the number of training places in London by 25%, the Government have made that much harder. At the same time, when I last spoke to the recently retired chief executive of King’s College Hospital NHS Foundation Trust, he told me that he was recruiting nurses in the Philippines, because there are not enough nurses—

[Madam Deputy Speaker (Natascha Engel)]

Order. When the Chair is on her feet, Members sit. I have said before that interventions need to be very short and kept to a minimum. That was too long.

[Ben Gummer]

The shadow Secretary of State cut the number of training places for nurses; it was increased under the last Government and is now at a record level.

We were on the subject of performance, which is at the heart of the motion. The shadow Minister can speak warm words about the workforce, but he failed to congratulate them on their exceptional performance under unprecedented pressures. At no point in his speech did he acknowledge the real increase in pressure on A&E services in the NHS. Some 3,000 additional patients a day are being seen, treated and discharged in accordance with the 95% target; that is being delivered by NHS staff across the service. He fails to point out the places where we have seen remarkable successes. He fails to give the example of Barking, Havering and Redbridge University Hospitals NHS Trust, which saw a 16% improvement in A&E performance times in the last year. That is front-line staff delivering better outcomes as a result of changes made by the Secretary of State over the past five years.

[Mr Jamie Reed]

I am grateful to the Minister for giving way, but he gives an absolutely fictional account of my remarks to the House. If he is so confident in his description of what is happening in the health service, can he explain why a comedy document produced by the Conservative research department says:

“New polling by Conservative peer Lord Ashcroft found that 47 per cent of voters believe Labour has the best approach to the health service while just 29 per cent picked the Tories”?

[Ben Gummer]

As Madam Deputy Speaker pointed out, we have just had an election, and the voters’ voice on the NHS was loud and clear. There is a simple point to make about the performance of this nation’s NHS: an independent think-tank—one of the most respected in the field—has rated it the best performing national health service in the world. It is better than that of Scotland, Northern Ireland or Labour-run Wales. A&E, as measured by countries across the world, performs no better in any country than in this. If we wish to go to international comparisons, the shadow Minister would do well to accept the extraordinary work that NHS staff are already delivering to make this the best health service in the world.

[Mr Reed]

I wish the Minister was right. I genuinely wish ours was the best A&E provision in the world. However, I have to draw his attention to an article in the International Business Times in January this year. When a journalist contacted the Department of Health to learn the basis for that claim by the Secretary of State, they were told that there was

“no concrete research on which Hunt had made the statement”.

This is a complete fabrication. Will the Minister set the record straight?

[Ben Gummer]

The shadow Minister should know that we in this country perform best of all countries that measure A&E, and that is the only way that we can judge this. The trouble is that by talking down that remarkable fact, all we do is denigrate the work of the people who deliver that every day.

I move on to the financial performance of the NHS, the second point that the shadow Minister raised, which lies at the heart of his motion. Let me set the financial context. [Interruption.] While Opposition Members are giggling, they might like to remember that they went into the last election not willing to commit to the NHS’s own plan for the next five years. Only one major party pledged to give the NHS the funding that it requested for the next five years: the Conservative party. The history on delivery is clear: we are talking about an additional £12.9 billion of cash in the last five years; a contribution of £2 billion this financial year, and a further £8 billion to fulfil the five-year plan. That is the financial background to this debate—a background that the Opposition refused to match at the last election. Money on its own does not get to the root of the problem, which I am afraid is not recognised in the motion, namely the relationship between quality, standards and money.

[Byron Davies (Gower) (Con)]

Does the Minister agree that it would probably do the shadow Minister and other Opposition Front Benchers a great deal of good to move down to Wales, where there has been an 8% cut in the budget? Wales has not met A&E targets since 2008.

[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.

[Clive Efford]

The Minister says that the Government responded to Mid Staffs. Will he give us a guarantee that there will be no removal of the minimum staffing requirement that came in on the back of the Mid Staffs report?

[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—

[Ben Gummer]

I give way to my hon. Friend.

[Tom Pursglove]

Under the coalition Government, a new urgent care centre opened in Corby, which is providing an excellent service for my constituents. That is in addition to the service in Kettering. Does the Minister agree that it is important that care is not only accessible, but as local as possible?

[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.

[Heidi Alexander (Lewisham East) (Lab)]

The Minister is talking about the financial context. My worry is that a lot of NHS managers in London talk about a Lewisham-sized hole in the NHS budget in south-east London. We stopped the Secretary of State closing Lewisham’s A&E last time. Can the Minister promise me today that he will not be coming back to Lewisham for another go?

--- Later in debate ---

[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.

[Mr David Burrowes (Enfield, Southgate) (Con)]

I welcome the focus on integration, particularly in relation to social care. Enfield suffers from historical underfunding, with a lack of fairness in relation to the growing deprivation and age profile. We have made great progress, but we need to make more to ensure that there are winners, such as Enfield. That may lead to other parts of London, and inner London, being losers, but let us take these decisions now and make funding fairer, particularly in relation to social care.

[Ben Gummer]

My hon. Friend is right. Again, he highlights a local solution to a serious problem, and one that will not reflect what is needed in other parts of the country. That is why it is so important that we concentrate the additional money that we are providing on local solutions rather than on a top-down reorganisation.

The shadow Minister spoke about primary care. He does not seem to have listened to my right hon. Friend’s latest announcements on the new deal for GPs to increase the workforce, support new buildings for GPs, and improve access through local innovation. We are trying to reduce the pressures that we understand are on GPs and that go back many years, not helped by the GP contract signed by his Labour predecessors. We have a choice in government about whether we declare an ambition—the ambition on primary care declared by Labour at the last election was, the Royal College of GPs said, an

“ill-thought out, knee-jerk response”—

or we can try to do something about it, listen to concerns, and remodel care so that it helps patients. That is what the Government have done. My right hon. Friend has spoken about it, and the work is being carried on by the Minister with responsibility for primary care, my right hon. Friend the Member for North East Bedfordshire (Alistair Burt).

[Dr Murrison]

Will my hon. Friend give way?

[Ben Gummer]

I am not going to take any more interventions, if my hon. Friend does not mind, because I want to cover the additional issues raised by the shadow Minister. Before I do so, I would like to know whether the shadow Minister agrees with our target for 5,000 additional GPs, which can be afforded only because of the £8 billion that we have committed to the NHS—a commitment that, again, he has been unable to sign up to.

[Mr Jamie Reed]

The Minister has touched repeatedly on issues of finance. He has not given an accurate reflection of the Labour party’s position going into the general election with regard to NHS funding. Let me ask him again: will he explain how the £22 billion of efficiency savings is going to be made, and will he give a guarantee that it will not affect hospital services, A&E services, staff numbers, or any front-line services in any community in this country?

[Ben Gummer]

I find it difficult to have to repeat to the hon. Gentleman, as I have to the shadow Secretary of State on a previous occasion, that this is a plan by NHS England. It is a plan that we supported before the election and afterwards, and a plan that the Opposition failed to support. The details of the plan have been worked out by NHS England and will be revealed in due course. Our part of the deal is that we provide the money that it has requested, which is £8 billion. We will see the plan as it is revealed by NHS England. It is an ambitious plan but one that we will fund from our side of the bargain.

The shadow Minister reveals in his comments and in the motion to which he has put his name that his motives are not pure. He speaks about the reporting targets for A&E departments around the country, but does not mention that the decision to change the reporting standard was made not by the Government but on the basis of a recommendation made by Professor Sir Bruce Keogh, who did so as part of a general review of reporting standards. When the shadow Minister talks about reporting standards, he does not mention that we are bringing those for cancer waiting times forward from a quarterly to a monthly basis, which I would hope he would have welcomed.

The shadow Minister does not mention that, for the first time, we are introducing mental health waiting times, as well as putting into the NHS constitution parity of esteem, which was not in the original constitution written and instituted by the shadow Secretary of State. Those are two matters of vital concern to our constituents which we are correcting on the recommendation of Professor Sir Bruce Keogh. Nor does the shadow Minister mention that Sir Bruce recommends that the A&E targets are brought on to a monthly reporting basis so that they can have clinical parity with all other standards and produce a better quality of statistical reporting.

In this debate, the shadow Minister finds himself on the wrong side of the clinical evidence given by Sir Bruce; the Patients Association, which welcomed the change; and the Royal College of Emergency Medicine, which said:

“The move from weekly to monthly reporting better reflects meaningful trends and will in fact increase the validity of this key metric, by reducing the effect of short term and unforeseeable events”.

The Nuffield Trust said that

“the replacement of weekly A&E figures with a monthly publication of indicators for many targets should help us understand changes in performance in a more meaningful way”.

The hon. Gentleman is on the wrong side of clinicians, academics, the Patients Association and the Royal College of Emergency Medicine—and on the wrong side of the argument.

The reason why is that the hon. Gentleman has made a choice. I appeal to the new Opposition Members who are sitting behind him: they can go through the next five years, motion by motion, vote by vote, opposing everything that is done on the basis of clinical evidence, just for the purpose of making political gain. If they do that, I, in turn, will remind the Opposition of the scandal of mixed-sex wards; the scandal of the highest hospital infection rate in the developed world; the scandal of a doubled pay bill for managers; the scandal of Morecambe Bay; the scandal of Mid Staffs; and the scandal of some of the worst cancer outcomes in the world. I will remind them of those every time they seek to oppose us for political reasons. The choice is theirs—or they can take the other tack and try to listen to clinicians, to be constructive and to de-weaponise the NHS.

I will seek to do what the shadow Secretary of State claimed to want to do, which is to come together and allow the NHS to get on with the job of building 21st-century services. However, if the Opposition make the wrong choice, all they will do is confirm in the minds of the British people that they put politics before the NHS, and that for the Labour party, the party comes first—always—whereas for Conservative Members, the NHS and patients always come first.

NHS Success Regime

Ben Gummer Excerpts

Thursday 4th June 2015 Commons Chamber

[Hon. Members]

Where is he?

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

I welcome the success regime, details of which were published by Monitor yesterday. The purpose of the success regime is to improve health and care services for patients in local health and care systems that are struggling with financial or quality problems. It will build on the improvements made through the special measures regime, recognising that some of the underlying reasons may result from intrinsic structural problems in the local health economy. This will therefore make sure issues are addressed in the region, not just in one organisation.

The regime is designed to make improvements in some of the most challenged health and care economies. The first sites to enter the regime—North Cumbria, Essex and North East and West Devon—are facing some of the most significant challenges in England. They have been selected based on data such as quality metrics, financial performance and other qualitative information.

Unlike under previous interventions, this success regime will look at the whole health and care economy: providers, such as hospital trusts, service commissioners, clinical commissioning groups and local authorities will be central to the discussions. It will be supported by three national NHS bodies, whereas existing interventions tend to be delivered by individual organisations and to concentrate on one part of a health economy—for example, the commissioning assurance framework led by NHS England that concentrates solely on commissioners, or special measures led by NHS England, the Trust Development Authority or Monitor, which focuses on providers.

Together, Monitor, TDA and NHS England, with local commissioners, patients, their representatives such as Healthwatch England and health and wellbeing boards will aim to address systemic issues. The national bodies will provide support all the way through to implementation, with a focus on supporting and developing local leadership through the process.

[Andy Burnham]

As we have just heard, this announcement has far-reaching implications for people in Essex, Cumbria and Devon. It was being finalised on Tuesday, when the House was engaged in a full day’s debate on the national health service, yet there was not one single mention of it during the debate. What are we to make of that, and why was the Secretary of State not here to make this announcement to the House? Why does he think that it is always more important to make announcements in television studios or to outside conferences than to Members of Parliament in the House of Commons? That is not acceptable. People in Cumbria, Essex and Devon will be worried about what the Minister has just said, and what it means for health services in their areas.

First things first. Can the Minister confirm that services in those areas are safe and sustainable? Are there enough staff, and will work be undertaken immediately to deal with staff shortages? Are plans being drawn up to close A and E departments, or other services, as part of this process? Could it mean mergers between organisations, and job losses?

We welcome action that means taking a broader view of challenged health economies—indeed, my hon. Friend the Member for Copeland (Mr Reed) has long called for such action—but what will the new regime mean for local NHS bodies? Will it be possible for NHS England to overrule them? The House will recall the last occasion on which the Secretary of State tried to take sweeping powers to close health services over the heads of local people in south London. It did not end well; indeed, it ended with his being defeated in the High Court. Can the Minister assure us that patients will be consulted before any changes go ahead?

Is not the fact that NHS is taking drastic powers over whole swathes of the NHS in three counties a sign of the failure of the Government’s plans for local commissioning, and evidence of five years of failure of Tory health policies? Is it not evidence that care failures are more likely, not less likely, on the Tories’ watch?

This is no way to run a health service, and no way to treat Parliament. The Minister, along with the Secretary of State, is trying to shift the blame for things that have gone wrong in the NHS on their watch—for problems that are of their making. We will not let the Secretary of State do that. He should have been here to do Members who are affected by this announcement the courtesy of giving them answers, and I ask his junior Minister to relay that to him directly after the debate.

[Ben Gummer]

The shadow Secretary of State has spoken at length—in his answer to his urgent question—about NHS bodies. He has spoken about local commissioners, about NHS England and about the Department of Health, but Members will have noted that there was one group of people about whom he did not speak, and that was patients. It is extraordinary that, once again, he has come here to speak, again and again, about structures—about the NHS and its bodies, about jobs, about providers and about deliverers—but not about the people who are being failed at local level, namely patients in Essex, west and north-east Devon and north Cumbria.

Let me deal with the right hon. Gentleman’s points in detail. First, he made accusations about television studios. I think it is a bit of a cheek to make such claims—and I should tell the House that the Secretary of State will very shortly be addressing the NHS Confederation.

[Andy Burnham]

So that is more important than this?

[Ben Gummer]

The urgent question was submitted this morning.

Coming from a shadow Secretary of State who is, one might suspect, using urgent questions and the subject of the NHS not to address issues relating to the quality of care, but for his own political reasons—as he always has—this was a shameless attack. It reflected rather badly on the right hon. Gentleman himself, rather than reflecting on the cause that he should seek to pursue: the better care of patients, which lies at the heart of what NHS England is attempting to do. If he had read what Simon Stevens said when he announced the plans yesterday to the NHS Confederation, he would have noted that they are being drawn up, co-ordinated and, in part, led by local commissioners rather than—as was the case before—by monolithic centralised bodies headed by bureaucrats. This process is being led, locally, by clinicians, who are being supported and helped by NHS England and professional regulators.

The right hon. Gentleman asked about staff shortages. I am surprised that he mentions that, given that he was in part the author of the staff shortages that hobbled the NHS at the end of the previous Administration and that led in part to the problems at Mid Staffordshire that we have been seeking to address. Only this Government, in their previous incarnation, promised to correct that situation, in part through our pledges on GP numbers over the next five years.

The right hon. Gentleman asked about plans for accident and emergency departments and about job losses. I would say to him that it is different this time. These plans are being drawn up by local commissioners, who are now beginning the process of working out how to improve their local health economy. This is not a plan that will be devised centrally in Whitehall, imposed on local areas and announced as a done deal for local people. I know that that is what the right hon. Gentleman is used to, but in this instance it is a genuine conversation between local patients and local commissioners with the aim of improving their local health economies, and it will be supported by national bodies.

The right hon. Gentleman asked about south London and about consultation. I was a candidate in a constituency that had a solution imposed on it, during his tenure as Minister for Health, without any decent consultation. That proposal was eventually thrown out. The previous Government never consulted local people properly when he was in control, but we have changed that. These local plans will involve local people, patient bodies and health and wellbeing boards from the outset.

The shadow Secretary of State asked about the powers of NHS England, about localisation and about the co-ordination of local services. I ask him once again to go back and read Simon Stevens’s speech. He will see how things have changed. This is not about decisions being made by politicians in Whitehall. I dare say that the right hon. Gentleman does not know the solution to the problems in the local health economies in Devon, Essex and Cumbria—

[Mr Jamie Reed (Copeland) (Lab)]

I do.

[Ben Gummer]

I am so glad that the shadow Minister is such an augur of knowledge. I will tell him who knows the solution: it is the patients and the local clinicians. They will provide the answers and make the changes. We want patient care to be improved for local people to provide excellence in the local NHS—excellence delivered and excellence for patients—and we were supported at the general election in that mission to create a world-class NHS.

[Several hon. Members]

rose—

[Dr Sarah Wollaston (Totnes) (Con)]

I welcome the additional support for struggling health economies, even if it is a classic example of NHS newspeak to call it a success regime. Will the Minister reassure the House that, in looking at a wider approach to health economies, he will also look at the funding formulae for health and for social care, which do not adequately take into consideration the impact of age or rurality?

[Ben Gummer]

I thank my hon. Friend for her typically gracious welcome for the proposals. She understands why this matter requires a whole-system approach at local level. I can confirm that the NHS will be studying every single aspect of the local health economy and all that that entails.

[Mr Ben Bradshaw (Exeter) (Lab)]

Is it not disgraceful that in the health debate on the Gracious Speech two days ago the Secretary of State had nothing to say about the financial crisis affecting the NHS and refused to answer my questions about his plans for Devon, and that this announcement was made to the media yesterday with no details of how it is going to affect patient care or the quality of services in my area? The Minister is very keen on quoting Simon Stevens, but Mr Stevens told BBC Radio Devon this morning that this chaos was a direct result of the fragmentation following this Government’s reorganisation of the health service. When is the Minister going to admit that that reorganisation was a disaster, and when are the Government going to get a grip on the spiralling financial crisis in our NHS?

[Ben Gummer]

I heard the right hon. Gentleman’s comments during the debate on the Queen’s Speech, and I know that he has taken a keen and detailed interest in the problems in his local health economy. I know also that he has been very careful and keen to include local commissioners and those who understand what is happening on the ground. That is why I had hoped he would be pleased about the introduction of the success regime, which will build on the financial consultations and discussions that have been going on, will involve local commissioners and, importantly, will provide the back-up of national regulators and NHS England. I did not hear the comments of Simon Stevens on local radio but I did read his speech, in which he made the opposite point to the one that the right hon. Gentleman suggested. The reforms that were brought in, far from being as the right hon. Gentleman characterised them, have saved £1.5 billion in this year, in addition to the £5 billion previously—money that is being invested in care in his constituency.

[Mr Simon Burns (Chelmsford) (Con)]

I am grateful to the Minister for the statement. How will my constituents in mid-Essex and the local health economy in mid-Essex see the results of what is going to be done under this regime? Can he assure me that it will examine the funding formula for health care per head of the population in mid-Essex, which has historically been skewed away from mid-Essex towards other parts of the country?

[Ben Gummer]

My right hon. Friend will be aware of the hospitals in Essex that have been placed in special measures. He will also be aware that focusing on one or several particular institutions is not sufficient to sort out the problems in the wider local health economy. That is why the success regime is being brought in—to try and deal with those systemic issues. Once the success regime has been concluded, I hope that his constituents will rapidly see an improvement in the service that they receive and that they deserve, wherever they are in the county.

On his second point about funding per head, he will know that NHS England has already started to look at that and, in some instances, address it. I have the same problem in my constituency in Suffolk, and it needs sorting out in the medium term across the country.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

The Minister talks about consulting commissioning groups locally, but why is he not willing to listen to groups of doctors across the country who talk about the point I made on Tuesday—fragmentation? We need integration. Local authorities are having their budget taken away, which means cuts to social care. Social care companies are one thread away from bankruptcy. We need to fund both sides of that, yet we are running round looking at structure. We need to move and look at outcomes. I have heard the Minister talk about “Five Year Forward View”. In Scotland we are already doing that as part of 2020 Vision: look at the patients, as the Minister says.

[Ben Gummer]

I take this opportunity to congratulate the hon. Lady on her entry into the House and on her maiden speech, which I enjoyed listening to in the Queen’s Speech debate. In England we are addressing the issues surrounding social care and its integration with the health service. That is why we have introduced the £5 billion better care fund. Under the success regime, far from looking at structure, we are trying to see how we can better link up services. That is why local councils will be a key partner at the table in the discussions.

[John Stevenson (Carlisle) (Con)]

I welcome the announcement, which I see as an opportunity to review the whole health economy in north Cumbria. It is a chance to review the strengths and weaknesses of health care and patient care in and around Carlisle and north Cumbria. However, will the Minister confirm that this will not hinder other developments, such as the acquisition of the Cumberland infirmary by Northumbria NHS Trust?

[Ben Gummer]

It is such a pleasure to see my hon. Friend return to the House. I know that he has been a tireless campaigner for the people of Carlisle. The success regime, as I said in answer to previous questions, will look at every single part of the local health economy, and every single partner in those discussions will be locally based or national regulators and NHS England.

[Sue Hayman (Workington) (Lab)]

I am desperately concerned about the state of our health services in west and north Cumbria, as are many of my constituents. Many people told me during the election that they want their services delivered as close to where they live—as close to home—as is possible. That is challenging in west Cumbria. I hope that the success regime recognises that, and that we stop talking and consulting and actually have action to deliver the services where people live. That is challenging because of recruitment, and those issues need to be taken into account. I would like the Minister’s assurance that that will be part of the success regime, because without it there will be no success.

[Ben Gummer]

I welcome the hon. Lady to her seat. She is right in much of what she says, and the entire purpose of the success regime is to take action, rather than just to keep on publishing PowerPoint presentations. We will be addressing every single part of the failures in her local health economies, and that may well include recruitment.

[Sir Alan Haselhurst (Saffron Walden) (Con)]

If a major feature of the success regime is ensuring that there is adequate care in the community, so that people who no longer need to be in acute beds can be released safely and comfortably and to the assurance of their relatives and family, is that not something to be welcomed?

[Ben Gummer]

I thank my right hon. Friend for that, and he has got to the nub of the point in a way that the shadow Secretary of State did not. This is about patient care and the excellence we expect from it. That is precisely why I agree with him that success regimes will be successful only if we ensure that we are improving patient care, and that might well include improving access to care at a local level.

[Heidi Alexander (Lewisham East) (Lab)]

I am confused: the NHS success regime is not about success—it is about failure. Will the Minister confirm that services in the areas affected are delivering safe care? Should patients be worried?

[Ben Gummer]

The hon. Lady should not be confused because the success regime is indeed dealing with local failure and we intend to turn it into a success. That is the point of what we are doing. We have made these decisions where the NHS has assessed areas as having quality and financial problems. We intend to address them rather than just talk about them, which is why I am so glad that this will be locally led, finding local solutions to local problems.

[Mr Gary Streeter (South West Devon) (Con)]

This intervention affects every one of my constituents, and if it improves their patient care of course I welcome it. The Minister has done extremely well from the Dispatch Box in one of his earliest outings, but can he tell us the timescale of this intervention and how we will measure whether or not it has been a success?

[Ben Gummer]

I thank my hon. Friend for his kind comments. He should be aware that success regimes will begin imminently, but we have no set timescale for them yet, because that will be determined by the plan drawn up in the initial stages by local commissioners. Again, that goes to the root of what we are trying to do; this is going to be a plan led by local clinicians, commissioners and providers, in order to provide a local solution.

[Derek Twigg (Halton) (Lab)]

There are real concerns in the north-west generally about deficits and problems with patient care and safety if those deficits continue. Let me ask the Minister a specific question on the issue before us today: who will have the final say in these areas? Will it be commissioners or will it be NHS England? If it is the commissioners, will they be able to call for more funding, and will the Government meet that?

[Ben Gummer]

The hon. Gentleman should know that the success regime will be co-ordinated by local commissioners, supported by NHS England, the TDA and Monitor. They will come together with a plan, which will then be implemented. The only way these success regimes will work is if they are owned by everyone who makes decisions locally. [Interruption.]

[Stephen Metcalfe (South Basildon and East Thurrock) (Con)]

I welcome this announcement. As my hon. Friend will know, Basildon hospital has been making good progress in improving patient care, but that has been at a cost. This regime will allow it not to have to choose between balancing the books and providing a safe environment. Can he confirm that patients and the public will be involved at every stage of this process, so that they can suggest any changes that may be necessary to achieve the success we are after?

[Ben Gummer]

They will not just be involved; they will be central to the discussions. The jeers and taunts from Opposition Front Benchers give the game away: they expect a decision to be made centrally—that is what they want. That is the only way they think. Conservative Members believe that local people should be central to that decision and that we should fix the whole local health economy, as opposed to trying to deal with individual trusts as they encounter problems.

[Diana Johnson (Kingston upon Hull North) (Lab)]

Will the Minister explain how the problem of chief executives who are not performing properly will be dealt with under this regime? Let me give him an example. Under the coalition Government’s watch the chief executive at Hull, who was disastrous, was moved to Harlow where he is now earning £170,000 a year. He had the help of the TDA in that move and left a disastrous situation in Hull.

[Ben Gummer]

I was not aware of that situation and would very much like to talk to the hon. Lady about it afterwards. If the facts she states are true, that is indeed wrong. The whole point of the success regime is to get away from the idea of being able to change one chief executive or commissioner in one provider in a challenged health economy while expecting to see a change to the whole system. We are trying to correct the system so that local care for local people is improved.

[Johnny Mercer (Plymouth, Moor View) (Con)]

If this intervention improves healthcare for my constituents, I will welcome it very much. However, will my hon. Friend clarify the impact on Derriford hospital in my constituency and whether the intervention will put any new management into our hospital?

[Ben Gummer]

I thank my hon. Friend for his question and welcome him to this place. To repeat the answer I have given several times so far—[Interruption.] Those on the Opposition Front Bench say that I do not know, but I must explain to them once again that this is not about a Minister sitting in Whitehall making a decision having never visited an area. That is what the right hon. Member for Leigh (Andy Burnham) did when he tried to destroy local services in my constituency and other places in Suffolk. This is different. It is about trying to fix problems in these challenged local health economies, which in some places have been present not for months or years but for decades. We are trying to ensure that the decisions are corrected and made by the local commissioners and clinicians.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

Ministers will be aware of the plight of the Barts Health NHS Trust, which is in special measures. Part of its problem is the weight of the interest on its private finance initiative, a new Labour policy that I did not support. It is having to pay that back at £500,000 a month. Surely a success regime for Barts and other hospitals burdened with PFI debt would be a serious attempt to renegotiate those PFI agreements.

[Ben Gummer]

I am so glad that the hon. Lady welcomes the success regime and the potential it might have. I spoke to one of her colleagues the other day about the troubled hospitals that she mentioned and I was about to invite her in to have a discussion about them, as we must try to find out what the core issues are with Barts Health NHS Trust. She raises an interesting point about PFI, however. One reason we are struggling in some cases, and why we have struggled over the past five years to provide the funding within the NHS that it requires, is the enormous NHS PFI debt that was loaded on to it by the previous Government and that has cost it billions of pounds over the past 10 years.

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

I thank my hon. Friend for his very thoughtful comments and replies. Does he recognise that one of the problems for the Devon clinical commissioning group is that it covers a large rural community and also Plymouth, the largest conurbation west of Bristol? We need to find a way in which this can all work to ensure that the city of Plymouth gets looked after and that levels of deprivation and so on are considered.

[Ben Gummer]

My hon. Friend makes the point better than I did. How do we sort these problems out using the local knowledge that he has just demonstrated rather than having a Minister in Whitehall with a map thinking that he or she can make the decision themselves? The success regime seeks to harness that local knowledge and the local solutions.

[Helen Hayes (Dulwich and West Norwood) (Lab)]

It is simply not acceptable that an announcement of this magnitude should have been made without first being debated in this House. As I understand it, the success regime applies to a number of areas of the country but not to London. My local hospital, King’s College hospital, has a deficit well in excess of £40 million. It is nigh on impossible in parts of the constituency to see a GP when people need to. We have a crisis in the NHS across the country. What is the comprehensive plan to address that? We need that rather than a piecemeal intervention in only parts of the country.

[Ben Gummer]

I welcome the hon. Lady to her place. She will not know that there was an Adjournment debate at the end of the last Parliament on precisely this issue. I invite her to seek such a debate if she wishes to discuss local issues with me or other Ministers. The success regime has been devised by Simon Stevens and NHS England. It will be clinically led, fulfilling our desire to see the NHS led by doctors, not Whitehall bureaucrats.

[Will Quince (Colchester) (Con)]

I welcome the announcement. Colchester general hospital is in special measures. One of the biggest issues facing our hospital is the recruitment of nursing staff. Will my hon. Friend give an assurance that county-wide recruitment will be included as part of the success regime?

[Ben Gummer]

Every single aspect that is troubling local health economies, including recruitment, I understand, will be within the scope of success regimes.

[Bill Esterson (Sefton Central) (Lab)]

Having listened to the Minister’s answers, it seems to me that patients have every right to be worried about whether care is safe in the NHS. Does he not realise that, unless the Government reverse the cuts in social care, the problems in patient care will not be resolved anywhere in the NHS—not just in the areas covered by the so-called success regimes?

[Ben Gummer]

May I gently remind the hon. Gentleman that this Government and their predecessor changed the culture of trying to suppress bad news, whether on care or money, and instead tried to understand what was best for patients, even when that meant facing up to difficult decisions? That is precisely what NHS England is doing with the success regime, and that is why we are addressing seriously challenged local health economies, rather than pretending that there is not a problem, which I am afraid was the attitude of the Labour Front-Bench spokesman when he was in power.

[Several hon. Members]

rose—

[Mr Kenneth Clarke (Rushcliffe) (Con)]

At this crucial mid-point, thank you very much, Mr Speaker, for that unusual way of calling me.

Does my hon. Friend the Minister recall that the whole purpose of introducing the purchaser-provider divide many years ago, which was developed by the Labour party and is now known as local commissioning, was to concentrate on patient care, patient outcomes and local priorities? Will he therefore, with this welcome announcement, continue to stick by NHS England, allow it to do that, and resist the blandishments of the shadow Health Secretary, who seems to pine for the days of centralised bureaucracy and is still feebly trying to weaponise the NHS for party political purposes?

[Ben Gummer]

It gives me particular pleasure to respond to my right hon. and learned Friend. He was an exceptional Secretary of State for Health because he understood the centrality of local decisions by patients and their doctors and commissioners. I confirm that we will continue to allow local commissioners to make the decisions, rather than try to wrest power back from them to Whitehall, which is precisely what the shadow Secretary of State did when he was Secretary of State.

[Melanie Onn (Great Grimsby) (Lab)]

Is not the fact that these drastic steps have been taken a sign that care problems are becoming more likely under this Government and not less?

[Ben Gummer]

I welcome the hon. Lady to her place. I only hope that she does not have the same contempt for her constituents that her predecessor seems to have expressed. It is interesting how it all comes out afterwards. I repeat to the hon. Lady that the decisions will be made locally by local people and local commissioners in response to local problems, and where they arise we will seek to address them.

[Helen Whately (Faversham and Mid Kent) (Con)]

I have heard that trusts in my constituency were potential candidates for this regime. Will the Minister please make it clear that, unlike some previous oversight regimes, this regime will enable local health care organisations to work together to solve their problems and will involve not just scrutiny but more support?

[Ben Gummer]

I thank my hon. Friend for her question. I am delighted to see her in her place. She has experience and expertise in this area. She will know that elsewhere in the country, before 2010, local commissioners, doctors and providers often came up with good solutions, but then strategic health authorities would come in with a completely different answer and override all of them. That is what we are seeking to avoid.

[Mr David Anderson (Blaydon) (Lab)]

The Minister is right that patients are key to this, but so are the people who deliver hands-on services. He has mentioned the role of clinicians a number of times, but what about the voice of care workers, nurses and other people on the front line? Will they be listened to, and will their representative bodies, such as trade unions and colleges, be listened to, or will they be completely and utterly ignored, as was the case with the Health and Social Care Bill?

[Ben Gummer]

I am glad that the hon. Gentleman has made that point. The success regime will not work unless every single part of the local health economy contributes to it, including the vital component of local care workers.

[Sir Peter Bottomley (Worthing West) (Con)]

The early stages of these exchanges would have been better had the Opposition asked how the Government will respond to the deficiencies shown in the Care Quality Commission report. I recommend that all Members read the article in The Guardian today by Diane Taylor and Denis Campbell, which sets out the problems that this is tackling. Will my hon. Friend ensure that those areas where there are no major problems, such as Coastal West Sussex, are given support and not overlooked, and that resources are not taken away from them, because they are as under-resourced as others?

[Ben Gummer]

This is not about moving resources around the country. I must say that I differ with my hon. Friend on his views about the CQC. It was a complete basket case when the Government came to power in 2010, but it has since been turned around and is now providing exceptional inspection regimes, which is changing the whole nature of safety and quality in the NHS. I hope that it will continue to improve.

[Geraint Davies (Swansea West) (Lab/Co-op)]

The Minister says that there are systemic issues in Devon, Cumbria and Essex. Did the National Audit Office confirm that, and did he know that before the election? Why did he not reveal his hand then to say that he would intervene in one or more of those areas, or is he simply playing politics with patients’ lives?

[Ben Gummer]

The hon. Gentleman should know that there have been issues in those areas not just for months and years, but sometimes for decades. We have sought in the first instance to deal with problems with providers, which is why in two of the areas we have hospitals in special measures, or formerly in special measures. We are now seeking to fix the problems in the wider local health economy, led by local people. We are getting on with that, rather than just talking about it, which is what happened before.

[Mr David Nuttall (Bury North) (Con)]

If the success regime is extended to other parts of the country, what will be the impact on the proposed devolution of healthcare to Greater Manchester?

[Ben Gummer]

I do not at this stage anticipate—I have received no indication from NHS England—that the success regime will be extended in any way. I repeat that this is a particular intervention by local people, in co-ordination with NHS bodies, to fix local NHS problems. It they arise elsewhere in the country, I am sure that local people will want to look at them too.

[Karin Smyth (Bristol South) (Lab)]

I congratulate the Minister on what is possibly the fastest reorganisation the NHS has ever seen. Which of those local organisations is in charge, and who will be accountable for deciding what constitutes success?

[Ben Gummer]

I welcome the hon. Lady to her place. We are now repeating discussions we had in the previous Parliament, because I am afraid that the Labour party still does not understand that these decisions are not being directed from Whitehall. I know that is uncomfortable for them, because what they want to do is pull a lever and hope that something happens at the other end, but that does not work. The only way to get success is by having local clinicians, supported by national bodies, providing the solutions that local people deserve.

[Mr Peter Bone (Wellingborough) (Con)]

In North Northamptonshire we had a problem with the A&E at Kettering hospital. Local commissioners and three hon. Members—my hon. Friends the Members for Kettering (Mr Hollobone) and for Corby (Tom Pursglove) and I—all worked together to produce a plan, which the Minister has taken up. That is a precursor to the success regime, and it shows that local commissioners, local hospitals and MPs can solve problems by working together. Will the Minister continue to look on that favourably?

[Ben Gummer]

The care of my hon. Friend’s constituents, including Mrs Bone, is always a prime consideration. He has shown what Opposition Front Benchers should understand, which is that working across parties, as he did in his part of the world, can bring about co-ordination and success. I only wish that those on the Opposition Front Bench, on what should be a clean slate, would do the same.

[Dr Tania Mathias (Twickenham) (Con)]

Is the success regime a 21st-century way of improving the NHS? If so, may I ask the Minister always to seek to improve the NHS, which has to be constantly moving and improving for the sake of every patient? Will he, like the Secretary of State, visit Teddington memorial hospital in my constituency, where a local initiative has vastly improved our out-of-hours service?

[Ben Gummer]

I welcome my hon. Friend to her seat. I hope to make a whole series of visits soon and I will certainly talk to her about her hospital. She will have noted that the very first speech given by my right hon. Friend the Prime Minister was about the NHS. That reaffirms our commitment to the NHS. We were the only major party to commit to the NHS’s own plan for success over the next five years. That is why the Conservative party, to be frank, is the only one that can now be called the party of the NHS—[Interruption.]

[Jeremy Lefroy (Stafford) (Con)]

Will my hon. Friend confirm—[Interruption.]

[Jeremy Lefroy]

Thank you, Mr Speaker. Will my hon. Friend confirm that at the heart of the success regime will be the provisions of the Health and Social Care (Safety and Quality) Act 2015 on integration and quality?

[Ben Gummer]

It must have been a great pleasure for my hon. Friend to have taken personal possession of the 2015 Act, which he helped steer through Parliament and piloted himself. It is a significant contribution to the cause of patient safety, which lies at the heart of the Government’s vision for the NHS.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

I congratulate my hon. Friend on his obvious grip on complex material. To what extent will the success regime take account of Kate Barker’s report on health and social care, recently published by the King’s Fund?

[Ben Gummer]

I thank my hon. Friend for his kind comments. The success regime is locally based but must take into account the developing national opinion on the integration of health and social care. However, those can be properly integrated only on the basis of local considerations; this is not something that we can design from the centre, as some would wish.

[Fiona Bruce (Congleton) (Con)]

I thank the Minister for confirming that the Health and Social Care (Safety and Quality) Act 2015 will be at the forefront of the minds of those implementing these plans. The 2015 Act was passed by the House in the very last days of the last Parliament. Does not the fact that the Opposition have asked this urgent question today show that they have already forgotten the central tenet of the Act: that patient care and safety will be at the forefront of everything that the Government do?

[Ben Gummer]

I repeat to my hon. Friend the observation that I made earlier: it is interesting that in his opening contribution, the right hon. Member for Leigh did not make a single statement about patients and their centrality to what we are trying to do. The NHS has devised its own plan for its own success over the next five years, and the safety and care of patients lie at the heart of it. Only one party is supporting that plan, and that is why the Conservatives are the only party backing the NHS.

[Mr Philip Hollobone (Kettering) (Con)]

I congratulate my hon. Friend on his response to the urgent question and the new Government on acting so swiftly. Having listened to the exchanges across the Floor of the House today, I think it would be particularly sensible and grown up for Her Majesty’s Government, first, to admit that there are geographical parts of our NHS that are not working as well as they might and, secondly, to seek local holistic solutions to put them right as soon as possible.

[Ben Gummer]

As so often, my hon. Friend is on the money. He has described exactly what NHS England is trying to achieve with the success regime.

[David Morris (Morecambe and Lunesdale) (Con)]

Thank you for calling me, Mr Speaker; my knee is giving way.

Would my hon. Friend like to come to Morecambe bay to see an excellent initiative run by Dr Alex Gaw called Better Care Together which is a pointer for the success regime? I should also say that, according to Labour, the NHS is always in crisis—but it never says what from, unless it is hospital closures that do not exist.

[Ben Gummer]

My hon. Friend has a particular local experience of a failing hospital, and I welcome him back to his seat. I hope to come to Morecambe bay at some point soon and I look forward to seeing with him the local initiatives that he has mentioned.

Health Services in Staffordshire

Ben Gummer Excerpts

Wednesday 3rd June 2015 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

It is a great pleasure to serve in this, your first Adjournment debate of the new Parliament, Madam Deputy Speaker. I am delighted that you have found your seat again. It is a great pleasure, too, to respond to my hon. Friend the Member for Stafford (Jeremy Lefroy), who has been a model for many of us in the 2010 intake in his advocacy of local health issues. He was rightly recognised for so doing in the election, and I am delighted that he, like so many of my hon. Friends, was returned with such a considerable mandate as a result of his hard work. I congratulate him, too, on securing this important Adjournment debate, which continues the battle he has fought on behalf of his constituents over the last Parliament.

Let me say first that the initial meetings I have had in my new position have in large part centred on the issues raised as a result, both directly and indirectly, of the terrible events that befell the Mid Staffordshire trust. My hon. Friend’s bringing of this Adjournment debate is timely in that sense.

I shall first address some of the specific issues my hon. Friend raised about the procurements recently spoken about in the press before moving on to deal with the more general issues. None of this has been particularly helped by some of the comments in the local media. Looking at the CCG’s proposals to improve the organisation of cancer and end-of-life services, which my hon. Friend raised first, I would like to announce to him and the House today that a public-private consortium led by two NHS trusts is now the sole remaining bidder and is in the final stages of talks with the CCG to manage the cancer care pathway. This is an innovative model. I know my hon. Friend has some reservations about it, but it is the first of its kind and it should greatly help to improve and develop services for patients. It is one of the outcomes we wanted to see from the changes in his county, so that health excellence emerges out of the terrible events that occurred. I know we share a common position on that.

Four CCGs are in the process of procuring this consortium to act as a service integrator for the wide range of organisations in the area providing cancer care and to improve the journey of patients in the county and their experience of the care they receive. Dialogue will now continue.

My hon. Friend asked about the role of advisers, consultants and the associated costs. I cannot give him the details now, but I will ensure that they are provided to him. I will ensure also that all officials, including those in the CCG, have the discussion about the role of consultants and advisers in order to satisfy him—or not—on that matter.

Let me now deal with some more general points about the health economy in which my hon. Friend’s constituency sits. It is challenged, and it has been challenged for a long time. Last year, Staffordshire was identified as one of the 11 most challenged local health economies in England. The healthcare organisations in those areas need intensive support to ensure that, as a minimum, services are clinically and financially sustainable over the next five years.

Many of the problems faced by Staffordshire have lain unaddressed for years. Recruitment and retention problems are not unique to the county—other parts of the country experience them as well—but, as my hon. Friend will know, they contributed to the dreadful events on which he has become an expert. Change is needed, not just in the hospitals but in the local health economy as a whole.

As my hon. Friend has already explained, the county hospital in Stafford is now part of the new University Hospitals of North Midlands NHS Trust—in alliance with services in Stoke—but that in itself is not enough to ensure that patients get a better service. That is about much more than a change of management. A solution often used by the NHS involves concentrating services on a single site, so that professional skills are maximised and patients receive much better care.

Although there is a need to reorganise, reorganisation is not just a switch of management location; services themselves must change. That process must be led by local clinicians, working in a partnership between hospital and community, and taking the views of patients into account. The eventual structure cannot be imposed from the outside, nor can there be a “one size fits all” answer. Stafford’s geography, population distribution, transport links and distance to nearby towns and cities, for example, are all relevant to a decision on how services should be set up. Any solution must take account of those factors, as well as others such as disease prevalence and age profile, which are, perhaps, more obviously health-related.

[Sir William Cash]

Will my hon. Friend give way?

[Ben Gummer]

I will, briefly.

[Sir William Cash]

Let me—briefly—remind my hon. Friend that people in the deep rural parts of my constituency are served by the county hospital and the University Hospitals of North Midlands NHS Trust. It is important to ensure that, when there is a lack of easy communication on the motorway, they too are specially looked after.

[Ben Gummer]

That is precisely the point that I made to the clinical commissioning groups when I spoke to them yesterday. I appreciate its importance, and not just on the basis of my own experience of representing an urban seat in a largely rural county.

My hon. Friend the Member for Stafford raised the issue of community beds. I need not advise him to exercise caution when it comes to believing everything that he reads in the press. However, there will be consultation about any changes that do take place, and I know that the Trust Development Authority and the commissioners will work together to ensure that they take place in a coherent fashion. Following my forthcoming meeting with chief executives and the TDA commissioners, I shall be happy to meet my hon. Friend and others to discuss changes in services if that will help to allay his concerns.

I have had detailed discussions with commissioners and NHS England about haematology and oncology services. Although there was a thought that they had been mentioned in original documents, I must say that I, too, found such mentions to be lacking. I am afraid problems of that kind are often encountered in the NHS, and that, in the past, consultations have not been as full or as pertinent as they should have been. I have asked the NHS again to consult specifically on those services, and also to engage in a full and proper consultation with patients and local groups. The same will apply to any other services that may come into question. I take my hon. Friend’s point about the need for a list of services, and I will pass it on to the CCGs, because I think it is important.

[Jeremy Lefroy]

I am most grateful to the Minister. It is very good news that there will be proper, extra consultation. As I said earlier, last week I visited a patient whom I know, and saw the excellent service that is currently being provided. It would be a real loss—more than that, a tragedy—were that service to be moved.

[Ben Gummer]

I stress that it is not for me to design the outcome of that consultation, because the whole point of what we are trying to do is to allow clinicians to make that decision, but they must consult properly. The same pertains for A&E. My right hon. Friend the Secretary of State has said that round-the-clock A&E services—I know he has made this point specifically to my hon. Friend—could return to Stafford if clinically safe to do so.

There is a need for quality services to be delivered immediately, however, and that is why I am concerned also about the situation at Stoke, where issues clearly need to be addressed in the immediate term. I wrote yesterday to the chief executive of the University Hospitals of North Midlands NHS Trust to arrange a meeting with him, local commissioners and the TDA to see what can be done immediately to help improve the emergency services at Stoke. I will of course speak to my hon. Friend following that meeting to bring him up to date on the conclusions of that discussion.

I also understand from the local NHS that the plans are resilient and will deliver better services, and that the work is being led by CCGs and local authority commissioners. They are redesigning the Staffordshire health and social care economy to ensure that patients enjoy the benefits of a safe, high-quality and financially sound service in the long term. That is their assurance to me. My job, and my hon. Friend’s, is to ensure that they fulfil their promise.

My hon. Friend brought up two separate issues more generally about agency nurses and consultants, and he will have seen the announcements made by my right hon. Friend the Secretary of State yesterday and today about them. Both go to the heart of the matter my hon. Friend raised and demonstrate how we in this Government are prepared to move rapidly on the matters facing the NHS in the early days of this Parliament to ensure that we can deliver the excellence in healthcare that we know our constituents deserve and wish for.

The Minister for Community and Social Care, sitting beside me, has heard my hon. Friend’s comments on GP numbers. That is a challenge throughout England and in my constituency, and one that we hope to address in part by the 5,000 additional general practitioners whom we hope to recruit in the next five years. We will, however, bring forward a range of measures to ensure that general practice not only survives but flourishes in the years to come.

In conclusion, I thank once again my hon. Friend for bringing so carefully and diligently these important matters to the House’s attention. It has allowed us to explore some of the wider issues facing the national health service. I hope I have provided him with a few points of consolation and also reassurance on how the Government and local health commissioners will proceed with the matters that he has raised. If he has any further complaints, problems, wishes or desires about his local health service, he should come to me. That invitation extends to his colleagues in the county of Staffordshire as well.

Question put and agreed to.

Oral Answers to Questions

Ben Gummer Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Mr Ronnie Campbell (Blyth Valley) (Lab)]

11. When he expects NHS England to reach a decision on access to Translarna for the treatment of Duchenne muscular dystrophy; and if he will make a statement.

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

NHS England is considering the interim commissioning position for Translarna as part of its wider prioritisation process for funding in 2015-16 and expects to come to a decision by the end of this month. Translarna has also been referred for evaluation by the National Institute for Health and Care Excellence’s highly specialised technologies programme. Draft NICE guidance will be available later this year, with final guidance expected in February 2016.

[Caroline Nokes]

I thank the Minister for that response and welcome him to his place. Yesterday my constituent Jules Geary came to see me regarding her son Jagger, who suffers from Duchenne muscular dystrophy. Jagger had been approved for Translarna treatment but then suddenly found that it had been withdrawn at the last moment. Like many other boys, he is now waiting, not knowing when a treatment that will prolong his mobility will be forthcoming. Will my hon. Friend meet me, Jules and Muscular Dystrophy UK to discuss how this process can be streamlined so that other children do not have to wait this long?

[Ben Gummer]

Muscular dystrophy is a terrible, debilitating illness and my sympathies go out to Jagger and his family. My hon. Friend will be aware that families and their representatives will be going to Downing Street on 10 June to make their representations on this matter. The Minister for Life Sciences has introduced an accelerated access review precisely because of the concerns that my hon. Friend has raised, and I know that he will welcome representations once it has been completed.

[Mr Ronnie Campbell]

Is the Minister aware of the case of my constituent, little George Pegg? At one time he could not walk, but this drug has made his life 100% better and he can now walk. Why are we dithering? This has been going on for at least a year, so why don’t you get off that backside of yours and get it approved?

[Mr Speaker]

Order. May I just exhort Members to have some regard to considerations of taste? This is a new Minister. I call Minister Gummer.

[Ben Gummer]

I thank the hon. Gentleman for his question. In relation to posteriors, it is good to see his in its rightful place. I have heard of his constituent’s case, which is as distressing as that of Jagger and of all those suffering from Duchenne muscular dystrophy. It is a terrible disease that causes lasting pain to the sufferers and their families. That is precisely why we are pushing hard for a decision from NHS England by the end of this month—it could not have come as quick as he had hoped—and for interim NICE guidance by the end of this year. I am pushing officials to move as quickly as they can on this.

[Greg Mulholland (Leeds North West) (LD)]

The reality is that NHS England has failed to respond to letters or to turn up for meetings, and it has behaved in an utterly unaccountable manner in regard not only to Translarna but to Vimizim, which is used to treat Morquio syndrome. We have still not had confirmation that an interim decision will be made on 25 June, but we are now being told that there will be a decision from NICE on 5 June. Will Ministers finally get a grip on this and give the families affected by these various conditions some sense of when they might get the treatment that could improve their quality of life?

[Ben Gummer]

I am sorry to hear that the hon. Gentleman has had that experience with NHS England. My hon. Friend the Minister for Life Sciences will want to speak to him about that; if it is the case, it is clearly unacceptable. As the hon. Gentleman will have heard from my previous answer, we are hoping to get quick decisions from NHS England on the interim commissioning guidance this month, and I am pushing hard for a decision from NICE as soon as possible this year, so that we can get interim guidance from it.

[Jeremy Lefroy (Stafford) (Con)]

3. What progress he has made on the implementation of the trust special administrators’ proposals following the dissolution of Mid Staffordshire NHS Foundation Trust.

--- Later in debate ---

[Ms Margaret Ritchie (South Down) (SDLP)]

6. What recent discussions his Department has had with the Royal College of Emergency Medicine on the recruitment of additional middle-grade doctors for NHS hospitals.

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

The Secretary of State meets the Royal College of Emergency Medicine on a regular basis. The number of middle-grade emergency medicine doctors has increased by 24% since May 2010. Health Education England is working with the RCEM further to strengthen the workforce to ensure that patients receive high quality care.

[Ms Ritchie]

I thank the Minister for his response, but I disagree with him. There is a shortage of middle-grade accident and emergency doctors. When will the next recruitment of such doctors take place in the Indian subcontinent and elsewhere and have all the Home Office regulations and impediments been resolved to allow the recruitment to take place?

[Ben Gummer]

I should make it clear first that, for the hon. Lady’s constituents, we have no say over the control of the health service in Northern Ireland. We have seen an increase of 24% in middle-grade doctors in the English health service and, as I have said, we have seen an increase in all doctors in emergency medicine of 25%. That is a considerable increase in an area that has been difficult to recruit to for a very long time. The Government made a difference in our previous incarnation and we will continue to do so.

[David Tredinnick (Bosworth) (Con)]

I welcome my hon. Friend to his place and wish him well. Is he aware that when the Select Committee on Health considered emergency care and took evidence from the Royal College of Emergency Medicine in the last Parliament it was clear that there was a perception among doctors that this was not as attractive as other specialties and that that is a serious problem? What is he going to do about it?

[Ben Gummer]

I thank my hon. Friend for bringing that to my attention. I was not aware of it and it is certainly something I shall consider. There are several specialties in the NHS where this is a problem and I shall be addressing that as I review the workforce in the years to come.

[Ms Gisela Stuart (Birmingham, Edgbaston) (Lab)]

Of course the Minister knows that his problem is not just recruitment; it is also retention. In that context, is he planning to make greater use of physicians’ assistants?

[Ben Gummer]

Yes.

[Neil Carmichael (Stroud) (Con)]

7. What steps he is taking to increase access to GPs’ surgeries.

--- Later in debate ---

[Christopher Pincher (Tamworth) (Con)]

T5. Burton hospital trust and the Heart of England foundation trust are discussing how they can make better use of the facilities at the Sir Robert Peel hospital. Will colleagues on the Treasury Bench encourage both trusts to make better use of the facilities, provide new facilities and services at the hospital, and make sure that local people are properly consulted?

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

It is a particular pleasure to see my hon. Friend returned to the House. He will be aware that local commissioning decisions are the responsibility of local commissioners, which is something that this Government will continue, as per our reforms in the last Government. I am making it expressly clear to NHS England that I expect consultations to be full and proper and to engage everyone in the local community.

[Ian Lavery (Wansbeck) (Lab)]

T4. The Secretary of State has admitted this morning that under his watch the NHS and the taxpayer have been ripped off to the tune of somewhere in the region of £1.8 billion for temporary workers and £3.3 billion for agency workers. How many fully qualified NHS nurses could have been employed with that type of finance?

--- Later in debate ---

[Andrea Jenkyns (Morley and Outwood) (Con)]

T7. The rate of hospital-acquired infections improved dramatically and halved in the last Parliament. Having lost my own father to a hospital-acquired infection, I am fully aware of the challenges we face. Will the Secretary of State look into ensuring that surgical site infections are included in all future statistics? In doing so, we can work on eradicating them, as they are a common way to catch an infection.

[Ben Gummer]

May I, too, welcome my hon. Friend to her seat. I was aware of the tragic death of her father, so she will be pleased to know that we are already collating information on SSIs resulting from orthopaedic surgery. That is done by Public Health England and the information is available from NHS England as a set of statistics. We are looking at what else we can do to include indicators on SSIs for other procedures.

[John Pugh (Southport) (LD)]

T10. May I invite Ministers to comment on the recent statement by the Academy of Medical Royal Colleges that the Government’s anti-obesity strategy is“failing to have a significant impact”and that there is a“huge crisis waiting to happen”?

A and E (Major Incidents)

Ben Gummer Excerpts

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

If the hon. Gentleman feels strongly about that he might want to talk to the shadow Chancellor, who this week publicly ruled out any extra funding for social care.

[Ben Gummer (Ipswich) (Con)]

I was at Ipswich hospital this morning to talk to the senior clinical team. They have exceeded their targets in A and E—it is the fifth best performing hospital in the country—and they have done so because of their work. Will the Secretary of State congratulate them, and does he regret the politicking that undermines their incredible efforts in the service of my constituents?

[Mr Hunt]

The services that the Ipswich team have been delivering are absolutely brilliant, and I congratulate them. I thank my hon. Friend for his support for their work, which I know is so important for the people of Ipswich.