Accident and Emergency Waiting Times

Debate between Chris Bryant and Stephen Dorrell

Wednesday 5th June 2013 Commons Chamber

[Mr Dorrell]

I absolutely agree with my hon. Friend. We cannot blame people in the country for not understanding the need for change in the health service if politicians never explain why that need has arisen. I quite often quote Enoch Powell—not someone who wins a consensus across the House—who as Health Minister went to the equivalent of the NHS Confederation conference, which is now under way in Liverpool, to explain the need for the change in the service model in mental health. He said in his speech that

“Hospitals are not like pyramids, built to impress some remote posterity”.

That is the case that we need to begin to explain.

[Chris Bryant]

rose—

[Mr Dorrell]

I shall give way once more.

[Chris Bryant]

I am grateful for the right hon. Gentleman’s generosity. One of the ironies is that Enoch Powell recruited a lot of doctors overseas. He would have had absolutely nothing to do with the argument advanced yesterday by one of the right hon. Gentleman’s colleagues that all the problems in A and E are to do with the arrival of migrants. If anything, we need to change immigration policy in this country, so that more doctors can come here.

[Mr Dorrell]

I have four minutes, or with two interventions, six minutes, so if the hon. Gentleman will forgive me, I shall not go off into a discussion about immigration policy.

I want to focus on the changing needs that the health service has to meet. I sometimes wonder whether people talking about rising demand on the health service and rising demand for emergency care have ever sat in a GP’s surgery. Have they noticed around them in a GP’s surgery the kind of people who present in a surgery and the conditions that bring them there—dementia, diabetes and drug and alcohol abuse? How can we expect a service that was designed to meet the needs of patients, inasmuch as it was designed at all, in the 1950s, 1960s and 1970s to meet the needs of today’s increasingly elderly and dependent patients, without rethinking the way care is delivered?

This is—I come back to my core point—a shared analysis. It is not a subject of party political debate. It is a shared analysis between the two Front Benches, and what is even more surprising is that not only is the analysis shared, but the conclusions about the right policy response are shared.

Congenital Cardiac Services for Children

Debate between Chris Bryant and Stephen Dorrell

Thursday 23rd June 2011 Commons Chamber

[Mr Stephen Dorrell (Charnwood) (Con)]

Like the right hon. Member for Oxford East (Mr Smith), I congratulate my hon. Friend the Member for Pudsey (Stuart Andrew) on introducing the motion, which is of huge importance to my constituents and to the national health service. In contributing to the debate, I wear two hats. First, I represent the village of Glenfield. Glenfield hospital is actually in the neighbouring constituency of the Opposition spokesman, the hon. Member for Leicester West (Liz Kendall), but it takes its name from the village in my constituency. Secondly, I am Chair of the Health Committee. The Committee has not approached the subject specifically, because we have been looking at a number of other matters, but we have so far published two reports on commissioning, which is precisely at the heart of today’s debate.

In a sense, I personify the conflict that every Member feels between the constituency interest and the national interest, and in this case I do so in a particularly dramatic form, as one of the surgical units involved is closely associated with my constituency. My first point is that that conflict exists for all Members. We are of course here to represent our constituents’ interests, but I argue that we are here first and foremost as Members of a national Parliament and should seek, as my hon. Friend the Member for Pudsey recognises, the right answer for all NHS patients, not simply for a particular local interest.

[Chris Bryant (Rhondda) (Lab)]

I wish to make a very small point because the right hon. Gentleman used the word “national”. Many of the services we are considering are also used by Welsh and Scottish constituents, so it is important to ensure that there is that communication between the different elements.

[Mr Dorrell]

I agree with the hon. Gentleman’s point.

My hon. Friend the Member for Pudsey said that this is not a political issue, by which he meant that it is not a party political issue. That is exactly right, but issues can be political without being party political. It is important that the House, in approaching the subject, makes it clear that the issue should ultimately be resolved according to clinical standards, not as a form of political bartering, whether party political or through the general representation of local interests.

I am in the happy situation, personifying, as I do, the conflict between local and national interests, that the specialist group has recommended a solution that accords with my constituents’ views, but I think that in approaching the subject it is important to be clear about the ladder of interest: we should approach this from the point of view of national standards for the service delivery. We of course should represent the views of our constituents, but we should be clear that the national view should come first.

Writing in The Times today, Sir Bruce Keogh, the medical director of the NHS, states:

“Intellectually, the case for change is compelling and widely accepted. Sadly, the realpolitik is that the closer we get to a solution, the more personal, professional and political interests conspire to perpetuate mediocrity and inhibit the pursuit of excellence…For too long this has been filed in the ‘too difficult’ box. Time is running out.”

Those words should ring loud in our ears as we debate the subject this afternoon.

We should recognise that the whole issue of child heart surgery has form in the history of the national health service. It is now over a decade since Sir Ian Kennedy published his review of circumstances that illustrate what can go tragically wrong when things are allowed to drift on and when real issues are not addressed. Although I am of course here as a Member representing my constituents’ interests, I think that the key priority for the House this afternoon is to support the principle that this issue must be decided in the interests of the children who are the patients and who will become the adult patients, and in a way that satisfies the key driver of the pursuit of excellence in clinical standards.

I welcome the fact that the previous Government set up the review to ensure that we addressed the issues that had been left to drift on for too long since the Bristol heart review a decade ago, and I wholeheartedly endorse the view, expressed by Sir Bruce in today’s Times, that the time to act is now.

As a local MP, I wonder what the effect is on Leicester of this drive to a decision. I have already referred to the fact that I am not in an uncomfortable position, because on page 93 the review states:

“Option 2”—

which became option A—

“is viable as it is consistently the highest scoring potential option.”

The review’s recommendation is that the process go ahead based on option A, and that is convenient from the point of view of the person arguing the case that I do, but I conclude that if anyone wants to argue for an alternative outcome, it behoves them, particularly in view of the history of this issue in the national health service, to present a coherent, whole argument for how their solution represents a better solution for the patients of those services, while reflecting, of course, the local interest of the people we are elected to represent.