A&E Services

Debate between Ben Gummer and Jamie Reed

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.

--- Later in debate ---

[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.

--- Later in debate ---

[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

Debate between Ben Gummer and Jamie Reed

Thursday 4th June 2015 Commons Chamber

[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.