(10 years, 5 months ago)
Commons ChamberI congratulate my hon. Friend on securing this really important debate. The point she is making reflects the concerns of a few of my constituents who have contacted me. A couple wrote to me and said:
“No one associated with the unit can understand the decisions being taken at a time when the incidence of eating disorders is increasing. Our daughter relies on the excellent treatment and support provided by the dedicated team at the RVI’s unit. We have no doubt that her own health and those of others would suffer if this service was withdrawn.”
My hon. Friend makes an excellent point. Again, the testimony of those most intimately involved speaks to the excellence of the unit and the concern of people in Tyneside.
(10 years, 7 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
My hon. Friend is absolutely right. The CQC needs to build a reputation so that everyone has confidence in its ability always to represent the patient’s interests. I believe that the CQC’s leadership understand that mission and are well on the way to achieving it, but it will not happen overnight.
I have seen wonderful examples of residential care in my constituency, but I have also had concerns raised with me about staffing levels and zero-hours contracts in other care homes. There is no one-size-fits-all solution, and transparency is key, so what are the Government doing to enhance and protect the vital role of employees who blow the whistle on poor standards of care?
The hon. Lady is absolutely right to recognise that there is great care out there, and we should applaud care workers who deliver fantastic care. I was at an awards dinner recently at which individual care workers were given awards for providing great care. Celebrating great care is incredibly important in changing the culture of the sector.
The Government took steps to fund a helpline that had previously been only for health workers and extended it to social care, so that anyone can seek advice about what to do if they want to whistleblow. The culture must be that anyone feels able to blow the whistle and get things done, and the CQC must respond effectively when that happens.
(10 years, 10 months ago)
Commons ChamberI fear my hon. Friend is absolutely right. I know Warrington hospital well and the pressures that have been on it, and I agree that ambulance response times have increased across the country because so many ambulances have been held in queues outside A and E, unable to hand over patients to A and E staff because it is full. That has left large swathes of the country—particularly in rural areas—without adequate ambulance cover, and very serious incidents have taken place across the country, not least in the Minister’s area of Norfolk where people have not received ambulances on time. That is the consequence of the pressure on A and E not being addressed, and it is threatening to drag down the rest of the NHS.
My right hon. Friend is making an incredibly powerful speech that goes to the very heart of our NHS and the staff who work in it. North East Ambulance Service is one of the highest performing services in the country and reaches 80% of most seriously ill or injured patients within eight minutes. Last week, however, it had to hold an emergency summit because staff morale is at an all-time low. Assaults on staff are increasing dramatically, and the stress and pressure of waiting outside A and E to admit patients is having a deeply damaging impact on the wider NHS. Does my right hon. Friend agree that that is not what the Prime Minister meant when he said that the NHS was safe in his hands?
My hon. Friend’s point was also made powerfully by ambulance staff at an A and E summit held by the shadow Front-Bench team in Parliament before Christmas when a paramedic spoke of the phenomenon she has just described. He mentioned an occasion when staff were at the door of A and E waiting to hand over a patient to A and E staff, when the patient had a heart attack. The staff did not know what to do and had to go back to the ambulance to try to stabilise the patient. Those sorts of joining points or disconnects in the system are leading to real pressure on staff who do not know what to do in those difficult circumstances. The system is in danger of being overwhelmed, and the pressure on staff must be addressed urgently.
(11 years, 6 months ago)
Commons ChamberTwo years ago, almost to the day, we debated the issue in the House. I said at the time, and reiterate today, that the issue must be resolved as quickly as possible to end the damaging delay and uncertainty, and to secure the safety of children and the best clinical care for them. The Secretary of State has given a variety of reassurances, but I would like to hear a cast-iron reassurance, for my constituents, that in any future decision, clinical expertise and care will be paramount, and that this will be resolved as quickly as possible.
(11 years, 8 months ago)
Commons ChamberI shall be meeting the relevant Home Office Minister today to discuss that very issue, but let me repeat that, far from being a counterfeiter’s dream, the packets produced in Australia would clearly be a nightmare here. A variety of colours, watermarks and holograms, and all manner of other things, can be attached to them, which is why they are described as “standardised” rather than “plain”.
20. This decision is taking too long, and those who care about the impact of smoking on children are at a loss to understand why. Given the U-turn on minimum alcohol pricing, the delaying of the sexual health strategy and, now, the stalling on standardised packaging, I must ask whether the Government have simply given up on public health.
I congratulate my hon. Friend on her campaigning on this. There must be full accountability for what went wrong in that ambulance trust. It is absolutely a top priority for me and my Ministers, two of whom represent Norfolk and Suffolk, to sort out what is happening in the trust, and that is why very decisive action has been taken.
T7. Further to the question from my hon. Friend the Member for Newcastle upon Tyne Central (Chi Onwurah), several of my constituents with desperately ill relatives are very angry about the Government referring to NICE a decision on the use of eculizumab. The continuing delay is risking lives and also means that people have several invasive treatments that could well cost more. To save space in the Minister’s diary, may I add a request to join the meeting with my hon. Friend to talk about how this dangerous delay is causing very great distress to many constituents?
The hon. Lady raises a very important point, and I would be delighted for her to join the meeting rather than my having another one.
(12 years, 1 month ago)
Commons ChamberI did not have a question on this.
(12 years, 9 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Barrell. One had only to listen to how Dr Sam Barrell and her colleagues in the Baywide clinical commissioning group in my hon. Friend’s constituency are providing clinical leadership in south Devon and Torbay to be absolutely clear that the Bill is right to give them that responsibility and that they will use it extremely well.
If the Deputy Prime Minister’s letter agreed with the Secretary of State, as the Secretary of State has confirmed today, can he explain why the Minister of State, Department of Health, the right hon. Member for Chelmsford, said on Radio 4 yesterday that there would be no further changes to the Government’s Bill?
My right hon. Friend and I are very clear that, as I explained—really quite carefully, I thought—it is customary in another place for some of the issues that have been debated to be reflected in amendments on Report, and that is what will happen.
(12 years, 9 months ago)
Commons ChamberMy inbox and postbag, like those of my colleagues, have been flooded with e-mails and letters calling for the publication of the risk register. Without it, MPs will be voting on changes to the NHS without knowing the full facts. I am overwhelmed, although not surprised, by the concerns of my constituents. I want to use today as an opportunity to express those concerns.
One key issue that I feel has not received enough attention to date is the level of risk posed to children by the proposed NHS reforms. Concerns about that have been expressed by more than 150 paediatricians, who have called on the Government to scrap the Health and Social Care Bill. First, they quite rightly question the Government’s assertion that this top-down reorganisation is even necessary. More importantly, however, they say:
“We believe that the bill will undermine choice, quality, safety, equity, and integration of care for children and their families.”
My colleagues have already described the shameful saga of the release of the risk register, so I will not go any further into that. However, we should be grateful for the interim insight given by NHS London’s assessment of the risks of reorganisation, which makes for grim reading. By virtue of the fact that the Government are refusing to publish the risk register, I can only be concerned about what the national picture must be. In addition to the risk of all patients receiving “sub-optimal care”, the London assessment refers to the risks to safeguarding children, the “dilution of expertise”, and
“weaknesses in information sharing systems and processes,”
and says:
“The consequences of this may be preventable harm to children”.
There is clearly a fundamental problem with the reforms when it comes to child protection. In order to safeguard children effectively from abuse and neglect, various agencies need to communicate and work together. However, the result of the NHS reforms will be to substitute co-operation for competition, to the detriment of good safeguarding and, ultimately, to the children whom it is supposed to protect. Each month we see a higher incidence of children being neglected by their parents and taken into care. In that context, and against the backdrop of significant cuts to children’s services, the Government should not be focusing their energies on unnecessary reorganisation that could increase risks to an already vulnerable group.
The Government’s policy is completely confused in this area. The Department for Education is aware of the need and expresses support for providing early help to vulnerable children and families. We should be focusing on training midwives to identify vulnerable families before a child is born, getting them the support they need if they are at risk. The NHS London risk report, however, has expressed grave concerns about the capacity of maternity services and the capability of the work force—as a direct result of the proposed reforms. Similarly, general practitioners—a first port of call for many families—have a key role to play in identifying and reporting risks of abuse. This is hampered where, as shown in the London risk report, the reforms will render their performance variable and, in some cases, poor.
In the words of the 154 paediatricians who wrote to The Lancet last week, the safeguarding of children
“will become even more difficult when services are put out to competitive tender and organisations compete instead of co-operate. Children who are vulnerable, neglected or abused will inevitably slip through the net…The bill will be detrimental to the goal of integrating care for the most vulnerable children across health, education, social care and the criminal justice systems in order to deliver good outcomes”.
It defies belief that the Government are insisting on pursuing reforms that have been assessed as potentially and needlessly resulting in harm to children. How, faced with that, can the Government continue with this folly?
Even in the face of the public’s reaction to the Bill, we have seen more than 150,000 signatures on the “Drop the Bill” petition, while hundreds of my own constituents have contacted me on this issue. My constituents and others up and down the country highlight the Government’s lack of transparency and accountability on this matter. The Information Commissioner has said that there is a strong public interest in disclosure of the information. An important point is being made about the risk register, which reveals that the Government have abandoned principles of proper governance on this matter.
Time and again we have heard the Government promising openness and transparency in government and in the NHS—the Prime Minister, the Deputy Prime Minister, the Health Secretary and others have extolled those virtues—but as the refusal to publish the register shows, those statements are nothing but platitudes. How can the Government claim transparency when they kept key critics of the Bill out of their meeting on Monday? It is a joke. The Government must publish the risk register, allowing proper and informed debate. We owe it to the people of this country who treasure our NHS—and we owe it especially to our vulnerable children.
(13 years, 5 months ago)
Commons ChamberMy hon. Friend is absolutely right. At the heart of this, we know that additional resources have to be brought to bear and that given the financial circumstances we face, we also know that this will have to be a partnership between taxpayers, families and individuals—it cannot simply be handing costs over to the state. Although Andrew Dilnot makes no specific recommendations about how to pay for his proposals, he is very clear that even if it were to be through a tax mechanism, he believes it should come from an existing tax and should bear particularly on the same groups of older people rather than be a further intergenerational transfer from working age adults. What that immediately points to is the necessity of engaging fully with some of the stakeholder groups such as Age UK and others and of engaging properly with the public so that before we embark on this major reform, they can feel confident that they understand those trade-offs and precisely how these costs are to be met.
The increased availability of care at home is to be welcomed, but it also poses increased challenges for safeguarding vulnerable adults. Given that personal budgets can be spent on unregistered and therefore unregulated care providers, what steps will the Secretary of State take to ensure that taxpayers money can be spent only on good quality and safe care provision where the rights of care workers are also fully respected?
The hon. Lady makes a number of important points. As the Minister of State, my hon. Friend the Member for Sutton and Cheam, made clear recently, one purpose of legislation in due course will be to put the safeguarding on a statutory basis, which is important. Working with the CQC, we must ensure that in domiciliary care as well as in residential care homes, mechanisms are in place that enable us to assess the quality of care and get feedback from residents. The social care outcomes framework must be developed in a way that captures an understanding of the experience of care users, their families and supporters.
(13 years, 5 months ago)
Commons ChamberThat the children’s heart unit at Newcastle’s Freeman hospital is cherished across the north-east is undisputed. One has only to read the coverage of the Newcastle Evening Chronicle “Keep Our Children’s Heart Unit” campaign in recent months to appreciate just how the unit has changed the lives of countless young people and families over the past decades.
Indeed, because of the pioneering work of the children’s heart unit at the Freeman, it is recognised nationally and internationally as a centre of excellence, with particular strength in quality and outcomes. The unit has also had significant investment over recent years. It is the only unit in the country able to offer all forms of heart treatment, regardless of age, under one roof, and the Freeman is recognised as having led the way in the UK in providing end-stage heart failure treatment for children.
As my right hon. Friend the Member for Newcastle upon Tyne East (Mr Brown) said, the Freeman famously and bravely performed the UK’s first successful baby heart transplant in 1987. It has performed more than 200 child heart transplants overall, and was recently the first hospital in the world to enable a young child to survive for four months with an artificial heart, while the baby’s own heart recovered.
The quality of the work carried out at the Freeman means that young patients and their families travel to Newcastle for treatment not just from the west of Cumbria or north Yorkshire, but from as far afield as Scotland, Northern Ireland and even the Republic of Ireland.
For those reasons, I believe that the children’s heart unit at the Freeman is well-placed to continue providing its excellent, world-leading cardiac surgery services for children. Three of the four options put forward by the Safe and Sustainable review propose that that should be the case. However, I have concerns about attempts to move the debate away from the key issue at hand: ensuring that congenital cardiac services provided to children in England and Wales continue to be high quality, and therefore safe, and sustainable and deliverable. That was the intention of the Safe and Sustainable review.
I do not think any hon. Members who are fighting to save their local units are trying to move the debate away from that. I shall quote what health professionals from the North Lincolnshire and Goole NHS Foundation Trust say:
“In summary, we believe the babies, children and families of northern Lincolnshire would be largely disadvantaged…knowingly relocating a well run and safe service without providing additional advantage to our families is questionable and unnecessary.”
We are not moving the debate away from the clinical issues at all.
The hon. Gentleman has put his thoughts and concerns issue on the record.
I mentioned the intentions of the Safe and Sustainable review, which was instigated by national parent groups, NHS clinicians and their professional associations. Those intentions must be the primary drivers in deciding the final outcome of the review.
I am equally concerned at suggestions that the decision and outcome of the review should be stalled, or that the remit should be altered. I am not alone in expressing such concerns. The Children’s Heart Foundation argues that that would leave
“the door wide open for another Bristol Baby tragedy”.
Meanwhile, the charity Little Hearts Matter believes that the Safe and Sustainable service reconfiguration offers—
No, I will not.
Little Hearts Matter says:
“The Safe and Sustainable Service reconfiguration offers a monumental opportunity to ensure that every child with a heart problem has access to the best heart surgery service that this country can offer—a gold standard service.”
I urge anyone in a position of influence, including hon. Members, to support that step forward, and not to halt the process because of personal bias.
A number of hon. Members are concerned about the co-location of children’s services. However, it is important to note that during the development of the £100 million new Great North Children’s hospital at the Freeman’s sister hospital, the Royal Victoria infirmary, a deliberate decision was made to retain children’s heart services at the Freeman, aligned with the world-renowned adult heart services there.
Services that simply did not exist 20 years ago have created a new generation of adults needing care, and the service at the Freeman allows for a seamless transition into adulthood. Of course, services at the Great North Children’s hospital are available to the Freeman in a matter of minutes—throughout the review process, they have been recognised as though they are on the same site.
In conclusion, I am not asking those who will make the final decision to give special treatment to the children’s heart unit at the Freeman, or indeed to the people of Newcastle and the north-east. I am all too aware how difficult this process has been for all children’s heart units under consideration. Each is valued and each has a great story to tell. However, I am asking that the decision is made on the grounds of clinical excellence and the quality of services that are currently provided, and on those grounds alone. I urge that a decision on the future of children’s congenital cardiac services is not put off or prolonged, because the safety of babies and children in need of heart surgery should be paramount in this debate.