NHS Annual Report and Care Objectives

Bob Blackman Excerpts

Wednesday 4th July 2012 Commons Chamber

[Mr Lansley]

I reiterate to the hon. Gentleman and to the House that the purpose of reports across the NHS is not to isolate individual conditions and to report on all of them, because if we attempted to do so the resulting document would be not the size of the one before me, but 10 times that. The object is to improve outcomes across the board.

Let me make two points. First, one thing that the NHS did achieve last year involved 528,000 people having access to talking—psychological—therapies, and that in itself should substantially reduce dependence on medication for depression. Secondly, and I think importantly, of the 22 overall objectives established in the NHS Commissioning Board’s draft mandate, the ninth is about making mental health as important as physical health—creating a parity of esteem between the two. The measure is in the Health and Social Care Act 2012, it is being carried through into the objectives of the NHS Commissioning Board and it will, in itself, be important when carried through into practice.

[Bob Blackman (Harrow East) (Con)]

I warmly welcome the improvements in screening, diagnostics and treatment for those suffering from cancer, but patient outcomes are wildly different. For some, 10% of treatment will be successful, for others, 85% will be, and this means that we need more research to highlight which drugs and treatments should be introduced. May I make a bid for part of the surplus to be directed to the expensive equipment that is required to make such research happen, so that treatment and outcomes can be improved?

[Mr Lansley]

My hon. Friend makes a very important point, and I was happy to announce earlier this year that in response to the report by Professor Sir John Bell and his colleagues we will now put resources behind the establishment of genetic testing centres throughout the NHS, which will enable us to undertake what is known as stratified medicine. This means that, by identifying when medicines have particular benefits for patients with certain genetic characteristics or phenotypes, we will be able to target such treatments, as we will be much more certain of their effectiveness and be able to reduce, as my hon. Friend rightly says, the many cases in which medicines are prescribed but turn out not to be effective in a particular patient’s circumstances.

Health Transition Risk Register

Bob Blackman Excerpts

Thursday 10th May 2012 Commons Chamber

[Mr Lansley]

I will repeat what my noble Friend Earl Howe said: we have every intention of publishing the risk register, but will do so when it is no longer directly relevant to the formulation and development of policy.

[Bob Blackman (Harrow East) (Con)]

Having been involved in the production of risk registers for many years, I know that they are pertinent to the point in time at which they are produced and require free thinking by those who put them together. There must then be a mitigation strategy to prevent the risks from ever happening. The key issue is this: what does my right hon. Friend think would happen to the policy advisers who put together risk registers for Ministers if these highly sensitive documents were put in the public domain?

[Mr Lansley]

I am grateful to my hon. Friend. To be absolutely clear, some risk registers are designed to be published. For example, strategic health authorities publish risk registers, and have done for a period of time, because they are designed to be published. The way in which the Labour party used the risk registers published by strategic health authorities, I think at the last Health questions, amply demonstrated that not only are they open to misrepresentation and misuse, but that the Labour party is very keen to misuse and misrepresent them. Even more so would it misrepresent and abuse the information in risk registers that were designed for the frank expression of advice if they were published. I do not need to speculate further in reply to my hon. Friend, because Lord O’Donnell, the former Cabinet Secretary, made it very clear that we would end up with bland, anodyne documents that did not serve the management purpose for which they were created.

Cigarette Packaging

Bob Blackman Excerpts

Tuesday 17th April 2012 Commons Chamber

[Mr Robinson]

I am grateful for that intervention. I do not think by any measure that I could be thought to be suggesting that plain packaging is going to be a magic wand to deal with counterfeiting in itself. It is not, so I agree that it will not be enough in itself. The point I am making—it seems obvious to me—is that the extent to which measures are failing at the moment clearly shows that prevalence is increasing and will increase further unless we get effective action by Government agencies. This is where the Minister has a key role to play in the Department. I shall try to prompt local government in Coventry and the west midlands to get active in this respect, but the Minister has an overriding responsibility to deal with the problem for the whole country, as it is indeed a major problem.

[Bob Blackman (Harrow East) (Con)]

I am grateful to the hon. Gentleman for giving way; he is making a powerful case, with which I completely agree. Does he agree that one problem is that the industry has gone about deliberately marketing its products to young people in the form of lipsticks, CD covers, thins and other ways that attract young people to take up smoking, which they can then never cure?

[Mr Robinson]

I agree entirely with the hon. Gentleman, and I am very pleased to say so. He mentions some of the advertising gimmicks and marketing subterfuges to which the industry has stooped. The evidence that this is achieving success lies in the fact that two thirds of those currently smoking started when they were younger than 18. That is why we have to deal with this matter and take measures to deal more effectively with the counterfeiting problem.

Breast Implants

Bob Blackman Excerpts

Wednesday 11th January 2012 Commons Chamber

[Mr Lansley]

Of course, as the hon. Lady knows, we have been thinking hard about precisely this issue. The NHS Future Forum made further recommendations to us only yesterday about achieving access for patients to their own records by 2015 across the NHS. The NHS should keep records, but the patients themselves should have access to them. We will pursue that issue in the NHS, although frankly, I am not in a position to mandate that in the private sector. However, any patient would be well advised to say, “Why can’t I hold my own record from a private provider?”

[Bob Blackman (Harrow East) (Con)]

I welcome the Secretary of State’s statement, but PIP is not the sole supplier of breast implants across the industry. What assurances has he received from the industry that no other company has embarked on the practice of using non-medical grade silicon in its breast implants, so that women who have had such implants can feel safe?

[Mr Lansley]

I have no evidence of such behaviour on the part of other companies. My hon. Friend is right: PIP is only one of a number of suppliers, and in this country probably only one in seven breast implants were PIP implants. Other countries have looked at this, and across Europe the regulatory process should ensure the scrutiny of these implants, including proper testing. The European review must look at whether that surveillance, including unannounced inspections and appropriate testing, gives us the assurance we are looking for.

Hinchingbrooke Hospital

Bob Blackman Excerpts

Thursday 10th November 2011 Commons Chamber

[Mr Burns]

My hon. Friend makes a valuable point from a sedentary position. The driving force behind the arrangement and the key criterion for Circle is the need to turn the hospital around, with regard to its quality and standard of care and its finances. The challenge for Circle is to eliminate completely the £39 million historical deficit over the 10-year period and put the day-to-day running costs of the hospital on a firm footing. I am confident that, within the framework of the agreement, that offers the best change to turn the hospital around.

[Bob Blackman (Harrow East) (Con)]

I congratulate my hon. Friend on exploiting the position presented by the Opposition. Given that this is a one-off, as he has said, what is the future for the other 20 hospitals that are in a desperate financial state? Is this a blueprint for the future and can we look forward to other partnership arrangements coming forward?

[Mr Burns]

I am grateful to my hon. Friend for the opportunity to put on the record the way forward for those 20 hospitals. This is not a blueprint or model to be used by other hospitals. It is on the statute book, as the hon. Member for Leicester West (Liz Kendall) knows. Where there are problems with the 20 hospitals that are seeking foundation trust status, the SHAs, departmental officials and the trusts themselves are looking at them. They have all published TFAs in the past six weeks or so with their intention for the way forward. I think that I am right in saying that for all of them there is a variety of options that range from a stand-alone FT bid to a possible merger or acquisition with another FT or trust. There are no TFAs for a franchise arrangement. As I have said before, this is a first and, as of now, unique model.

National Health Service

Bob Blackman Excerpts

Wednesday 26th October 2011 Commons Chamber

[Andy Burnham]

My right hon. Friend makes an incredibly important point. Make no mistake: if the Bill passes, the NHS will never be the same again. The Bill will unpick the fabric of a public national health care system—a planned system—and turn it into a free-for-all, as he says. Indeed, it is unbelievable to see a letter in The Guardian today from senior Liberal Democrats—many of whom made the same argument a few weeks ago as my right hon. Friend—now saying that, because of a few tweaks to the Secretary of State’s powers, the time has come to abandon all their concerns about the provisions. That is a ridiculous statement to make. If they still have concerns about competition and privatisation, they should have the courage of their convictions and stand up against the Bill, instead of writing sanctimonious letters to The Guardian.

Grip has been lost; the NHS is drifting. However, the Government cannot say that they were not warned. Sir David Nicholson, the chief executive of the NHS, told the Public Accounts Committee that the reorganisation had increased the scale of the financial challenge:

“I’ll not sit here and tell you that the risks have not gone up. They have. The risks of delivering the totality of…the efficiency savings that we need over the next four years have gone up because of the big changes that are going on in the NHS as a whole.”

This has been a lost year in the NHS—a crucial year, when it needed to face up to the financial challenge—but things are not getting better. We face months of further uncertainty, as the Secretary of State battles on with his complicated and unwanted Bill. Four-hundred and ninety pages, 70-page letters to peers, amendments made on the hoof: it is a total mess. The NHS deserves better than this. Even the man the Secretary of State brought in to run his new NHS Commissioning Board describes his Bill as “completely unintelligible,” and went on to say:

“It is going to be messy as we go through a very complex transitional programme.”

And this from the Secretary of State’s friends.

The harsh truth is that the Secretary of State has comprehensively failed to build the consensus he needs behind his Bill. GPs do not want it; nurses do not want it; midwives do not want it; patients do not want it. I say to the Prime Minister and the Health Secretary today: stop digging in. Drop this Bill. If they do, my offer still stands, as our motion makes clear. We will work with the Secretary of State to reform NHS commissioning, giving GPs and other clinicians a bigger role. That can be achieved without legislation and a major structural upheaval of the entire NHS. It can be done through existing legal structures, giving immediate stability and saving millions.

We make our offer again today, as it is time for all politicians to put the NHS first. It is slipping backwards, and the warning signs are there for all to see. Waiting lists and waiting times are getting longer, with a 48% rise in the last year in the numbers of patients waiting more than 18 weeks. When patients are waiting longer, it is unforgivable that £2 billion to £3 billion has been set aside to pay for the costs of reorganisation. It is also unforgivable that £850 million is being spent on making people redundant who will end up being re-employed elsewhere in the system, in the new clinical commissioning groups.

We are witnessing a return to the bad old days of waiting longer or paying to go private. This is just a glimpse of the future. If the Bill passes, the NHS will never be the same again. We have all seen the adverts on television for the health lottery. Is this the right hon. Gentleman’s early marketing and his new brand name for our NHS?

[Bob Blackman (Harrow East) (Con)]

Does the right hon. Gentleman not accept that one of the severe problems that the national health service is facing came about on his watch, when primary care trusts were allowed to build up huge deficits without making the economies and efficiencies that should have been made at that time, rather than on this Government’s watch?

[Andy Burnham]

I have never said that the NHS was perfect, or that there were no challenges during our time in government. But let me tell the hon. Gentleman what happened when the NHS was facing those deficits in 2006 and 2007. We took a grip at the centre and we brought those trusts back into financial balance, through hard work. There was a turnaround team in the Department, and we made sure that those difficulties were tackled at root. I do not see the same grip in the national health service right now. I see drift and lack of focus, and I see huge distraction as a result of this unwanted Bill.

--- Later in debate ---

[Paul Farrelly]

rose—

[Bob Blackman]

rose—

[Mr Lansley]

The second reason the House should reject the motion is that it fails to pay tribute to the hard-working staff of the NHS. I participated in many debates such as this when I was shadow Secretary of State and I thought that they provided an incredibly good opportunity for Members to raise issues relating to their own constituencies. I hope that that happens in this debate, as it is important. Every one of us has in our constituencies thousands of committed and hard-working NHS staff who want to know that we recognise it. I do not see any of that in the motion.

Oral Answers to Questions

Bob Blackman Excerpts

Tuesday 12th July 2011 Commons Chamber

[Paul Burstow]

If the hon. Lady had read on, she would have found that £700 million of the £1 billion is to be found not through cuts in services, but through efficiency savings, for example through the use of telecare, which significantly reduces costs, and investment in reablement services, which save resources and help people to get back on their feet. That is all in the report that she is waving around. When it comes to investment, the Government have already made clear their commitment through the spending review, and are investing, by the end of this Parliament in 2014-15, an additional £2 billion—something that her party did not do when in government.

[Bob Blackman (Harrow East) (Con)]

The extra money being given to adult social care should be good news, but in Harrow, the council, which is Labour-run, has applied the £2.1 million additional funding to redundancies in general areas, rather than passing it on to the weak and the vulnerable. Will my hon. Friend take action to ensure that the new money provided by the Government reaches the people who need it?

[Paul Burstow]

I am absolutely determined to make sure that the additional resources that the NHS is transferring to social care deliver real benefits for people who need social care services, protect services, and allow local authorities to make the right decisions about how they continue to support not just investment in prevention, but those most in need.

Oral Answers to Questions

Bob Blackman Excerpts

Tuesday 8th March 2011 Commons Chamber

[Mr Lansley]

My hon. Friend will know that through the plans set out in the Health and Social Care Bill the commissioning of those services will be the responsibility respectively of the NHS commissioning board and local authorities. Through local authorities, and as part of our public health responsibilities, we will be looking to promote good sexual health and high-quality support for people who need assistance with reproduction.

[Bob Blackman (Harrow East) (Con)]

My right hon. Friend has referred to the ring-fencing of the money that is going to be given to local authorities. Will he advise the House how long he expects that ring-fencing to last? Is it until such time as local authorities can be trusted to spend the money on public health?

Public Health White Paper

Bob Blackman Excerpts

Tuesday 30th November 2010 Commons Chamber

[Mr Lansley]

My hon. Friend makes a very important point, and that was not all that happened. On the money available to primary care trusts for what is termed the healthy living programme, there is no correlation between how much trusts spend relative to health deprivation, so in places with the poorest health outcomes trusts on average do not spend any more on discretionary health improvement activity. That is why our proposed health premium is so important. The places with the poorest health outcomes will clearly have the money they need to undertake specifically preventive work to raise health outcomes.

[Bob Blackman (Harrow East) (Con)]

I warmly welcome the proposals to transfer public health to local authorities and, indeed, the ring-fencing, but will my right hon. Friend clarify how we will enforce the spending of that money on public health, so that there are no blurred edges and local authorities cannot fund their other services from within that ring-fencing?

[Mr Lansley]

I bow to my hon. Friend in his understanding of local government. My experience and understanding of local government is such that I know that the people involved are very concerned about improving health in their communities, and these resources will be available for that. Those people will not only be accountable to the people who elect them but accountable through the incentive mechanism of the health premium for the delivery of improving outcomes in the reduction of health inequalities. They will have an in-built incentive in the funding system to use those resources to deliver the outcomes that are collectively agreed, co-produced with local government. If they do not do so—if they spend the money elsewhere—they will not see the increase in resources that would otherwise flow.

NHS White Paper

Bob Blackman Excerpts

Monday 12th July 2010 Commons Chamber

[Mr Lansley]

Ah! That was one of the Opposition Whips’ handout questions, wasn’t it? I will tell the hon. Gentleman that actually, patients are more likely to get their treatment more quickly. Let me give him an example. Patients with rheumatoid arthritis need rapid treatment, but they were losing out and suffering as a consequence of the 18-week target, because hospitals were hitting 18 weeks, but not providing the care needed by those patients in the light of their conditions. We must focus on what is in the best interests of patients, not on what is in the best interests of political grandstanding.

[Bob Blackman (Harrow East) (Con)]

The Secretary of State’s announcement will be warmly welcomed in my constituency. On Friday, I went to see a group practice of 12 GPs who are totally frustrated by the local PCT. They are concerned that when the reforms are introduced, they will also be frustrated by the GP consortiums. Will my right hon. Friend give me some assurances on how the GP consortiums will be formed? What will happen if some GPs disagree with how a consortium is set up?

[Mr Lansley]

I can tell my hon. Friend that I am looking to GPs in a locality to create GP commissioning consortiums that represent an area. They must decide on the geography of that and make proposals. It will not be possible for GPs simply to say, “This is nothing to do with us,” because in future, we must expect GPs, who are senior professionals in public service and paid appropriately, to be responsible not only for the care of the individual patient in front of them, but collectively for the quality of care provided to their population at large.