Junior Doctors Contract

Clive Efford Excerpts

Monday 30th November 2015 Commons Chamber

[Mr Hunt]

I would like to reassure categorically those doctors that that is not the intention of the changes we are making. We have made it clear that we will protect the pay of anyone working within the legal contracted hours, and in fact three quarters of junior doctors will see their pay rise as a result of these changes. We want to deliver safer care. If we are able to go ahead with the negotiations with the BMA that I hope we can in the coming weeks, I hope we will be able to put in place very strong safeguards that all sides agree will reassure my hon. Friend’s constituents.

[Clive Efford (Eltham) (Lab)]

The Secretary of State has to accept his responsibility in bringing about the cancellation of operations, because if he had been prepared to go to ACAS at the outset, all this would have been avoided. Does he accept that he is going to have to change his attitude towards negotiating with these junior doctors if we are to get the satisfactory outcome that we all want?

[Mr Hunt]

My attitude is very straightforward: I need to do the things that will make patients in the NHS safer, and I want to negotiate reasonably with anyone where there is a contractual issue that needs to be resolved. I think that the Government’s position has been reasonable. The vast majority of doctors will see their pay go up, and the pay for everyone else working legal contracted hours will be protected. This is a very reasonable offer that does a better job for patients, but it has been difficult to get through to the BMA. I urge the hon. Gentleman to talk to his friends at the BMA and to urge them to be reasonable and talk to the Government, whereby we could have avoided some of the problems.

Junior Doctors Contract

Clive Efford Excerpts

Friday 20th November 2015 Commons Chamber

[Alistair Burt]

My hon. Friend puts it very well. The people of Bury, Tottington and Ramsbottom have long experience of very good health services provided by excellent family doctors, as well as through good secondary medical care, not just in their own constituency but around and about. They will find it surprising that, with the guarantees given by the Secretary of State and mentioned by my hon. Friend, anyone should be contemplating strike action. Equally, they will find it incomprehensible that anyone from any political party is giving that strike action any support.

[Clive Efford (Eltham) (Lab)]

The Minister has just told us that the Secretary of State is across the road in his office and cannot be bothered to come here to account for an unprecedented strike by junior doctors in our national health service. That is an absolute disgrace! The Prime Minister has said that this is his miners’ strike. The doctors are prepared to go to arbitration. The public will know that if this strike goes ahead it will be because the Government will not go to arbitration. It will be the fault of the Secretary of State and the Prime Minister.

[Alistair Burt]

I think it is of primary importance for the Secretary of State to work on contingency plans this morning to make sure that we are all safe should there be a strike. That is the task he has been given by the action that has been taken. At the same time, he has repeated that he is open to negotiations to deal with the dispute. Rather than expressing anger, the hon. Gentleman should be expressing concern that a contract that makes an unsafe situation for doctors safer is not being backed more readily by those on the Opposition Front Bench, who should also be rejecting strike action.

A&E Services

Clive Efford Excerpts

Wednesday 24th June 2015 Commons Chamber

[Mr Reed]

The hon. Gentleman has made that point on the Floor of the House on many occasions, and he has been a constant voice with regard to the hospital services used by his constituents. That was a decision made by clinicians in the area, and he will recognise that. He will recognise also how much the framework has changed and how much more difficult the Government have made it for communities such as his to have their say on health reconfiguration.

[Clive Efford (Eltham) (Lab)]

My hon. Friend is absolutely right. The point is not that there should never be any change in our national health service. When clinicians plan it and put it forward to improve services, we are right to support it. The difference is that the Conservative-led Government came in and attempted to close A&Es from the centre, such as Lewisham A&E, which they were going to close. They said they would not close Sidcup A&E, but they closed it within months of entering government. That is the difference: the Government dictated the closures, not local clinicians.

[Mr Reed]

My hon. Friend is absolutely right. The lesson that the Prime Minister and Secretary of State drew from those episodes was, “When you get beaten in the courts, change the law”—a completely different approach from that of the previous Labour Government.

--- Later in debate ---

[Ben Gummer]

I am sure that the shadow Minister has come to the House without reading the speech in which my right hon. Friend the Secretary of State directly addressed the issues caused, in some trusts, largely by agency spending, which took place because of the chronic understaffing created by the previous Government, and put right by us. That led in part to the catastrophe at Mid Staffs. The shadow Minister has not read my right hon. Friend’s comments about limiting the salaries of highly paid managers in the NHS, or his comments about cutting consultancy pay. It is precisely that kind of action—including enabling chief executives of NHS trusts to control their budgets—that this Government are taking to ensure that, nationally and locally, we are living within our means.

[Clive Efford]

The Minister says that the Government responded to Mid Staffs. Will he give us a guarantee that there will be no removal of the minimum staffing requirement that came in on the back of the Mid Staffs report?

[Ben Gummer]

I can guarantee that to the hon. Gentleman. On minimum staffing, it was in response to the Francis inquiry that this Government, in their previous incarnation, set the Care Quality Commission a specific target of doing something about minimum staffing. That did not happen before then. He understands that relationship between safe care and money. I just wish that he was able to explain it to his colleagues on the Front Bench, because if they went to the Salford Royal hospital, they would see how, through instigating safer care, it is saving £5 billion a year. It is by combining quality and efficiency that we get the double benefit of better care for patients and better returns for the taxpayer.

Mental Health and Well-being of Londoners

Clive Efford Excerpts

Thursday 12th February 2015 Commons Chamber

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

I beg to move,

That this House has considered mental health and wellbeing of Londoners.

First, I would like to thank the Backbench Business Committee for giving me the opportunity to raise the important question of the mental health and well-being of Londoners. Mental health touches all classes and cultures in London. In consequence, it is important not just that it be viewed within the paradigm of health care but that we understand that all elements of London’s socio-economic development are deeply rooted in the well-being of our city’s residents. Unless we start seriously to tackle what I believe to be a rapidly unravelling crisis of service provision for mental illness, we will begin to see dire ramifications surfacing in all aspects of society, including education, family stability and public order.

As the House will be aware, I have thrown my hat into the ring to be Labour’s candidate for London Mayor. If anything, this has sharpened my interest in these matters. Fundamentally, however, my interest in this subject derives from the fact that my mother was a nurse, and in the latter half of her career, she was a dedicated mental health nurse. I saw the mental health system through her eyes—the problems, the challenges—but above all I saw that she loved her job and that she genuinely loved the people she nursed. Through her, I have always had an instinctive idea that people with mental health issues are human beings, too, and deserving of our love and care.

For three years, I was privileged to be shadow public health Minister, and I was able to meet and learn from many dedicated workers in both the public and voluntary sectors in the mental health field. The sad truth is that mental health provision has long been chronically underfunded, and now, during a time of unprecedented demand, the concern is that spending might be falling dramatically in real terms.

[Clive Efford (Eltham) (Lab)]

On the point that funding might be falling, we in London also face the problem that the cost of living is growing. Many people working in public services such as mental health nurses and workers in mental health care are often low-paid in comparison to others. People who come to see me are having difficulty finding places in London and some services are finding it difficult to recruit staff, which has a knock-on impact on the standard of services. I wonder whether my hon. Friend would comment on that.

[Ms Abbott]

I very much agree with my hon. Friend. As he says, there are cost of living issues. Then there are spiralling housing costs. Health care in London has some of the biggest turnover and some of the highest vacancy levels of any health care provision in the country. The pressures of the cost of living crisis and the housing crisis are making it increasingly difficult to provide permanent staff to meet the health care needs in general and the mental health needs of Londoners.

I shall focus in my speech on the cost to London of the mental health crisis and the importance of parity of esteem between mental and physical health, about which Members on both sides of the House have spoken. It is important to stress it, because we are nowhere near parity of esteem when it comes to the questions of finance and resources. I also want to talk about the mental health and well-being of London’s lesbian, gay, bisexual and transgender community, and about the growing crisis of mental illness among our children, adolescents and young adults. I shall also deal with something not often spoken about—mental health issues in our black and minority ethnic communities in London.

It is important, because mental health is sometimes a marginalised issue, to talk about the huge cost of the mental health challenges to London. Recent figures indicate that almost a million adults of working age in London—15.8% of the adult population—are affected by common mental disorders such as anxiety and depression. I was in the House about 18 months ago when Members of all parties bravely talked about their own experience of depression and how they felt a stigma and found it very difficult to get treatment.

It is estimated that 7% of London’s population have an eating disorder, that one in 20 adults has a personality disorder; that 1% of Londoners are registered with their GP as having a psychotic disorder such as schizophrenia, bipolar and other psychoses; and that nearly half of Londoners are anxious. London has the UK’s highest proportion of people with high levels of anxiety. In addition, almost a third of Londoners report low levels of happiness, which must clearly be exacerbated by the cost of living issues we have mentioned. The number of Londoners reporting low levels of happiness is well over 2.5 million. We London MPs see many of them in our surgeries week after week.

In basic economic terms, almost £7.5 billion is spent each year addressing mental health issues in London, while according to the Greater London Authority, the wider health, social and economic impact of mental illness costs the capital an estimated £26 billion. In social care costs alone, London boroughs spend around £550 million a year treating mental disorder, and another £960 million each year on benefits to support people with mental ill health. There are some concerns about the changes in welfare and the—

Francis Report: Update and Response

Clive Efford Excerpts

Wednesday 11th February 2015 Commons Chamber

[Mr Hunt]

I thank my hon. Friend, whom I know has thought extremely hard about this issue. Indeed, we talked yesterday about getting the fit and proper persons test to work properly. It is still in the early stages, so it is difficult to assess whether it is having the impact we want. We certainly hope it will have some impact. There is an unfairness about the fact that a clinician as a chief executive of a hospital is accountable to the GMC as a doctor, whereas a chief executive who is not a doctor is not accountable. We actually want more doctors to become chief executives. On the whole, they do a really good job, and we should give further consideration to that.

[Clive Efford (Eltham) (Lab)]

It will take a great deal to change the culture. I have spoken to a senior hospital manager who would like to express his concern about the lack of qualified nurses, forcing him to advertise posts abroad. I have spoken to two A and E nurses who are concerned about the critical situations occurring at their unit every day. One of them has become an agency nurse so she can limit the number of hours she is forced to work. Then there is an ambulance worker who is concerned about the 12-hour shift and the lack of time he is given to clean his ambulance between dealing with patients. They would all like to come forward to express their concerns, but they do not feel that anyone above them would listen. What can the Secretary of State say today to reassure those people?

[Mr Hunt]

I can say that we are consulting on making a big change that would mean they would have someone independent in their organisations to whom they could talk and raise their concerns. They could say, “I want to say this, but no one is listening to me”. That is what Sir Robert Francis calls “freedom to speak up” guardians, whom he wants in every organisation. It is what Helene Donnelly is championing in her work. That is the way forward to address those concerns.

NHS Major Incidents

Clive Efford Excerpts

Wednesday 28th January 2015 Commons Chamber

[Mr Hunt]

It was not raised by NHS England on Monday because I did not know about this local guidance, as I had absolutely nothing to do with it.

[Clive Efford (Eltham) (Lab)]

Can the Secretary of State explain why in the incident response plan from NHS England there is an entire paragraph headed “Politics” under the principles for considering an escalation response? In the House on 7 January he said:

“The decision to declare a major incident is taken locally—there is no national definition”—[Official Report, 7 January 2015; Vol. 590, c. 273.]

However, the guidance issued in the middle of January says that major incidents

“should be agreed...with the Director on call for NHS England”.

If it is not political, the Secretary of State owes the House an explanation of NHS England’s involvement and the meaning of that paragraph.

[Mr Hunt]

The hon. Gentleman has quoted selectively; he has not quoted the whole guidance. If he looks at the whole guidance, he will see that it clearly states that a responsible trust, before it declares a major incident, which is its decision, must make sure that there is not going to be a negative impact on the rest of the economy, because patients must always come first. He is also not saying what Dame Barbara Hakin said this morning —that none of this guidance was anything to do with Ministers.

National Health Service

Clive Efford Excerpts

Wednesday 21st January 2015 Commons Chamber

[David T. C. Davies]

I checked the Order Paper this morning, and no one had tabled a question about the NHS in Wales.

The shadow Secretary of State for Health, the right hon. Member for Leigh (Andy Burnham), said earlier that he was not responsible for Wales, but the reality is that there are 20,000 patients in England who are registered with Welsh GPs and who have their health care provided in Wales. The right hon. Gentleman is, to some extent, responsible for the poor level of service that those people are currently receiving.

[Clive Efford (Eltham) (Lab)]

Will the hon. Gentleman give way?

[David T. C. Davies]

I am happy to give way, but I have to say that Opposition Members have used up rather more of their allocation than Members on this side.

[Clive Efford]

The hon. Gentleman seems to be talking about records. This Government came in with no mandate whatever and planned to close nine of the 31 accident and emergency departments across London. What state does he think the A and E service in London would be in if his Government had been successful in every case? They were prevented from achieving their aim by public campaigns, including the one in Lewisham, in my part of London.

[David T. C. Davies]

I am absolutely certain that the A and E situation in England would be far better under this Government than it is in Wales, where, according to the House of Commons Library report, 13% of patients in major departments wait more than four hours in A and E. That is approximately double the percentage recorded by major departments in England. The question of ambulances has been raised several times today. Wales has the worst ambulance response rate in the United Kingdom, with around 55% arriving within eight minutes, compared with more than 70% in England.

The shadow Secretary of State talked about privatisation, but it was the Labour Government who, quite rightly, started using the private sector to improve the national health service. I have here a quote from the Labour Secretary of State in 2002; I will not mention his name. He said of the private sector that

“we intend to use it when it can bring expertise or resources to help improve services.”—[Official Report, 26 February 2002; Vol. 380, c. 547.]

We have carried on doing the same thing. A few years later, a different Health Secretary said:

“The NHS has always made use of the private sector and will continue to do so”.—[Official Report, 25 October 2005; Vol. 438, c. 163.]

She also promised that, the following year, patients would be able to choose from any health care provider—NHS or independent sector—that met NHS standards.

It was Labour’s policy in government to use the private sector. There is nothing wrong with that, but it is totally ridiculous for Labour Members now to pretend that the Conservatives are trying to privatise the NHS. That is a big lie: we will never, ever privatise the NHS, but we are quite happy to use the private sector when it can provide a better service, just as the Labour Government did. The last word on this came in 2005, when Professor Allyson Pollock wrote a damning book about the privatisation of the national health service. She was criticising the Labour Government.

A and E (Major Incidents)

Clive Efford Excerpts

Wednesday 7th January 2015 Commons Chamber

[Clive Efford (Eltham) (Lab)]

Is it not true that this Government set out with a plan to close nine out of 31 A and Es in London, including the one at Lewisham, as directed specifically from the Secretary of State’s office? Does he regret that? What state does he think the A and E services in south-east London would be in if he had been successful, in the face of public opposition, in closing that A and E?

[Mr Hunt]

First, as the hon. Gentleman knows perfectly well, there were never any plans to close that A and E, and he should desist from scaremongering about what was happening at Lewisham hospital. He should also remember that when this Government came into office—[Interruption.] The plans—

[Clive Efford]

You idiot—it went to court!

[Mr Speaker]

Order. First of all, it is unseemly to squawk, and I think it would be accurate to say that what I heard was a squawk. I am not sure if there is a verb “to squawk”, but there was a squawking sound. What is worse, it was unparliamentary language, and I believe that the hon. Gentleman used a word that he will now wish to withdraw.

[Clive Efford]

I withdraw it unreservedly, Mr Speaker, but the public out there will draw their own conclusions.

[Mr Speaker]

I am grateful to the hon. Gentleman for his withdrawal and I note what he says.

NHS (Five Year Forward View)

Clive Efford Excerpts

Monday 1st December 2014 Commons Chamber

[Mr Hunt]

Yes, I will. I have to say to the House that the importance of being better at tackling sepsis was brought home to me personally by two moving meetings with Scott Morrish, the father of Sam Morrish, who was from the west country—perhaps near my hon. Friend’s constituency. His son’s tragic death from sepsis was avoidable, so this is an absolute priority for me in the next couple of months.

[Clive Efford (Eltham) (Lab)]

Two weeks ago, the Secretary of State could not muster enough Conservative MPs in this House to defend the Health and Social Care Act 2012, particularly those elements of it that have allowed competition regulators into the NHS to second-guess decisions of local commissioners. If he wants to save money in the NHS, he can do away with that element of the 2012 Act and stop money being diverted from patients to pay for lawyers and accountants to oversee a tendering process that is wasting money.

[Mr Hunt]

If we stopped the NHS using the private sector, which seems to be Labour’s direction of travel, 330,000 people every year would have to wait longer to have their hips or knees replaced. We will make decisions on the basis of what is right for patients, and not of ideology.

Oral Answers to Questions

Clive Efford Excerpts

Tuesday 25th November 2014 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for his comments. I was quite amused to see that I have a future career as an estate agent, along with the Prime Minister, when our hopefully long careers in politics are over, but the point is that this is scaremongering and it is wrong to scaremonger about something as important as the NHS. To suggest that the NHS is being privatised is fiction. What is not fiction is Labour’s legacy of poor care.

[Clive Efford (Eltham) (Lab)]

The Secretary of State’s definition of “harm” is not the definition that Labour Members have. My Bill, which was passed overwhelmingly on Friday, would require the Secretary of State to bring the matter back to this House should TTIP apply to the NHS in any way whatsoever. Will he support my Bill going into Committee without delay, so that we can discuss the detail and answer the questions he has?

[Mr Hunt]

No, I will not support the hon. Gentleman’s Bill.