Junior Doctors Contract

Christian Matheson Excerpts

Thursday 19th May 2016 Commons Chamber

[Mr Hunt]

I am happy to do that. I recognise that this was not easy for those people, because it involved changing a position that they had held for more than three years. When we looked at the details, the result that we got to was not difficult for them to sign up to because they could see that it really was better for their members, as well as better for patients. The lesson here is that the NHS faces huge challenges, and it can only be right to deal with them by sitting round the table and negotiating constructively.

[Christian Matheson (City of Chester) (Lab)]

I, too, warmly welcome the news of the agreement, and I hope that it leads to a settlement. If it is the Secretary of State’s intention to create a seven-day NHS, that will require the participation of more than the junior doctors, so does he intend to bring forward a new contract for consultants, hospital lab workers, ambulance workers, nurses or indeed ancillary workers and catering staff?

[Mr Hunt]

The hon. Gentleman is right. A seven-day NHS is not just, or not even mainly, about junior doctors, although they are a very important part of the equation. We will need a new contract for consultants and we are having constructive negotiations with them. Many other people working in the NHS are already on seven-day contracts, so there will not necessarily be a contractual change, but the hon. Gentleman is right to say that we will need, for example, diagnostic services operating across seven days so that the junior doctor who works at the weekend will be able to get the result of a test back at the weekend. Those are all part of the changes that we will introduce to make the NHS safer for patients.

Oral Answers to Questions

Christian Matheson Excerpts

Tuesday 10th May 2016 Commons Chamber

[Mr Hunt]

As ever on health matters, my hon. Friend speaks wisely. The fundamental issue is a high level of confusion about what happens to patients when they are faced with a bewildering choice about what to do when they have an urgent health need that needs resolving. They can call 111, try to get an urgent GP appointment, go to a walk-in centre, go to A&E and many other alternatives. We need to resolve that and make it simpler for patients so that they go to the right place first time. Urgent work is happening to ensure that we do that.

[Christian Matheson (City of Chester) (Lab)]

The closure of the A&E unit at Chorley and South Ribble district general hospital has ramifications across the north-west. I am informed that North West Ambulance Service has taken on three private ambulances at a cost of £70,000 each a month to provide the extra cover that is required. Does the Secretary of State accept that it is a false economy when he allows A&E units to close on his watch? He simply passes on the costs to other parts of the fractured NHS over which he presides.

[Mr Hunt]

I recognise that we have a difficult situation in Chorley and that people in that trust are working very closely together. The chief executive of the trust pointed out that the reason for the closure was that neighbouring trusts were not respecting the caps on agency staff that she was respecting. It is incredibly important that, across the NHS, we have a concerted effort to bring down the prices paid for agency staff, which I think is the root problem here. However, we are monitoring the situation closely.

NHS Bursaries

Christian Matheson Excerpts

Wednesday 4th May 2016 Commons Chamber

[Justin Madders]

I thank the hon. Gentleman for his intervention. If he is stating the facts, then I interpret them as being a poor record for the Government; that is more about the facts than about the way in which he presented them.

Let us be clear: we are talking about a debt that nurses are never likely to pay off. They will graduate with debts of between £50,000 and £60,000. Many of the mature students who take nursing as a second degree will find themselves with more than £100,000 of debt. Let me repeat that figure so that it sinks in: our country is looking down the barrel of a policy that will saddle nurses with a six-figure debt. They are not bankers or lawyers; the people who keep the NHS going will be earning just a fraction of what they earn. We already have the highest level of student debt in the English-speaking world, which is not a record we should be proud of, and these proposals will only make matters worse.

It would be an error to put nurses into the same category as other students, but I think that the Government are making that error. Student nurses’ courses take up much more of the year, meaning that they have much less opportunity than other students to work while they study. They are also required to spend 50% of the time working with patients in clinical practice, including on evening and weekend shifts. That requires a real commitment of at least 2,300 hours over the length of their course, during which they do difficult jobs at unsocial times. Now the Government are asking them to pay for the privilege of doing that. This policy is like some kind of perverse extension of workfare. Last year, there were 10,000 unfilled nurse places in London alone. Is getting people to work for free really the answer to that?

The Government really need to raise their game to improve retention among nurses. The situation has been getting steadily worse over the past few years, and nearly 9% of nurses left last year. Some might have gone to work elsewhere in the NHS, but many have left the profession altogether. Surely sorting that out would provide a more effective solution to our problems than taking a punt on an untested plan. There appears to have been no dialogue with providers, who seem unaware of the oncoming rush. Each student nurse has to be clinically assessed by a registered nurse who has done their mentoring and assessing course, but no assessment appears to have been made of the capacity for trusts to take on those extra responsibilities.

It is clear that this policy, with all its flaws, was announced with no consultation, no engagement with the sector and no evidence basis. With such a high degree of uncertainty, surely it would have been sensible to consult on the principle before embarking on the policy. But not this Government; they know best, even though they do not seem to know their own record in this area. When I asked the Minister a simple written question on how many nurses had qualified in the last five years, I received the following response:

“The Department does not hold information on the number of nurses who qualified in the last five years”.

What an absolute shambles!

Anyone would think that with such a gap in the available evidence, the Government would have gone out of their way to undertake a full consultation and to seek out evidence before announcing the policy, but no. The Royal College of Midwives, the Royal College of Nursing, the Royal College of Podiatry and the Royal College of Speech and Language Therapists are all respected institutions with years of experience and a wealth of knowledge in this area, but not one of them was asked to make a formal input into this policy before it was announced, contrary to what the Minister has said today. When he was asked, in a Westminster Hall debate on 11 January, who he had consulted, he said:

“There has been consultation with leading nursing professionals.”—[Official Report, 11 January 2016; Vol. 604, c. 237WH.]

He said nothing about the royal colleges. I hope that we shall be able to clear this up. I ask him to tell us exactly who he did consult, and to place in the Library a copy of the advice that he received following the consultation.

Let us not pretend, now that the consultation has been published, that it is a meaningful consultation on the principle or the detail of the proposals. It simply asks a few technical questions on how to implement the changes. You can have any colour you want as long as it is black. It is frankly an insult to the public, to patients and to the profession. The Government should withdraw this proposal and instead commit to a full consultation on how to improve the support available to student nurses, how to increase the number of nurses in the NHS and how to improve retention. I urge all Members who genuinely care about the future of our health service, who have concerns about the potential deterrent effect of these proposals, and who are not prepared to gamble recklessly with our nurses, to join us in the Lobby today and send a clear message to the Government that it is time to think again. I commend the motion to the House.

[Christian Matheson (City of Chester) (Lab)]

Pick that one out of the back of the net!

Junior Doctors’ Contract Negotiations

Christian Matheson Excerpts

Monday 8th February 2016 Commons Chamber

[Ben Gummer]

We do not see any particular evidence of the movement of juniors at present, but what we would most like to see for juniors is the introduction of the new contract, so that they can recognise that it will be better for their working practices than the current one. It is in everyone’s interests—not just those of juniors, but those of patients—to ensure that juniors work safe hours. That is why the new contract involves reductions in the number of consecutive nights and long days, and it is why we want to reduce, and eventually eliminate, the excessively long hours in the week.

[Christian Matheson (City of Chester) (Lab)]

I am sure that Ministers have a very clear idea of how their proposals will affect working practices, so may I ask this Minister on how many occasions last year a junior doctor worked 91 or more hours in a week?

[Ben Gummer]

We believe that last year about 500 junior doctors were operating on a band 3 payment, which equates to payments for hours of work that exceed what is specified in the working time regulations. That is a relatively small number within the NHS, but it is still significant, and for the doctors concerned, working those excessive hours is unsafe.

NHS Trusts: Finances

Christian Matheson Excerpts

Monday 1st February 2016 Commons Chamber

[Ben Gummer]

Given the hon. Gentleman’s record of statements given to his constituents, whether on housing or hospitals, I would prefer very much comments from the clinicians running Imperial College NHS Healthcare Trust, than I do his own comments about this.

[Christian Matheson (City of Chester) (Lab)]

On the one hand, the Secretary of State is suggesting that he wants a seven-day-a-week NHS, which I presume is not an empty slogan, and on the other hand Ministers are calling for headcount reductions. That suggests that we are asking fewer people in the NHS to work longer hours. Does the Minister share my concern that that is a recipe for staff overstretch and increased pressure on staff, and therefore potentially for greater failings for patients?

[Ben Gummer]

If the hon. Gentleman had not mischaracterised the situation, he might have been able to ask a more coherent question. The fact is that NHS Improvement was looking for what savings could be made in back-office functions in hospitals so that that money could be recycled into the frontline. All I can say to him is that under this party the number of clinicians has increased by 16,000 since 2010. That is a record of which we are proud and on which we will continue to build over the next few years.

Oral Answers to Questions

Christian Matheson Excerpts

Tuesday 5th January 2016 Commons Chamber

[Jane Ellison]

My hon. Friend is quite right to highlight the number of people who will be affected by such diseases. There are between 6,000 and 8,000 rare diseases. Among the things that the Government are doing that will make a really big difference to some of the institutions that he mentioned and others, and particularly to sufferers, is the 100,000 genomes project, in which the Government have invested. The creation of a network of genetic medicine centres will underpin that further development of genetic testing services. As a very large proportion of rare diseases are genetically based, we want to make significant progress with that genomic work.

[Christian Matheson (City of Chester) (Lab)]

5. What assessment he has made of the effect of changes to social care budgets on A&E attendances.

[The Parliamentary Under-Secretary of State for Life Sciences (George Freeman)]

Our health and care system is under extraordinary rising demand from an ageing society. There are a million more pensioners this year than there were at the beginning of the previous Parliament, and there will be another million by the end of this Parliament. The number of adults needing care in the next 10 years will rise from 180,000 to 264,000. That is why integration of health and care is so important, and it is why I am delighted that my right hon. Friend the Chancellor announced in the autumn statement £3.5 billion for social care by 2020 through the new adult precept and extra funding for the NHS five-year forward view.

[Christian Matheson]

In any given week at the Countess of Chester hospital, 70-plus elderly patients pitch up and cannot be discharged because care is not available elsewhere. We know that the Government broke their promise before the election to sort out funding for long-term care, and the King’s Fund recently said that the settlement to which the Minister refers will put

“even more pressure on … the NHS to pick up the pieces when there’s a breakdown in … care”.

Will the Minister now accept that that continuing neglect and those broken promises are the key cause of the crisis in our A&E departments?