Oral Answers to Questions

Dan Poulter Excerpts

Tuesday 23rd October 2012 Commons Chamber

[Mrs Mary Glindon (North Tyneside) (Lab)]

3. What his policy is on upholding national pay arrangements in the NHS.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

NHS trusts and foundation trusts have the freedom to determine the terms and conditions of the staff they employ. As the hon. Lady will be aware, the “Agenda for Change” was negotiated and brought in during 2004 by the then Secretary of State, John Reid, to agree a national framework for pay in the NHS. In general, most trusts support the agreed pay framework and the “Agenda for Change”, and they are likely to continue to use national terms, provided they remain affordable and fit for purpose.

[Mrs Glindon]

In fairness, a truly national health service demands a national pay scheme, and the British Medical Association has warned that the move to regional pay undermines the ethos of “national” in our national health service. How does the Minister intend to act on that warning?

[Dr Poulter]

I remind the hon. Lady that it was the previous Government who set up the current national pay framework in 2004, and that framework has been amended 20 times to support employers over that period. The previous Government gave foundation trusts the freedom to amend those pay terms and conditions. Regional pay does exist in the NHS. On the basis of what she has said, does the hon. Lady wish to remove the London weighting for those workers who live in London? I am sure she would not want to do that because we recognise that it is more expensive to live in certain parts of the country, and workers should be rewarded for that.

[John Pugh (Southport) (LD)]

The Lib Dem conference rejected regional pay entirely, but not the London weighting, and 25 honourable colleagues endorsed a submission to the pay review body. With that in mind, is it not odd that the south-west consortium remains part of national pay bargaining?

[Dr Poulter]

My hon. Friend makes a good point and it is important that we support national pay bargaining where we can. There is an agreement in principle, endorsed by NHS employers, that national pay bargaining is supported throughout the NHS. It was supported throughout the NHS under the previous Government, who set up the “Agenda for Change”, and during their tenure, that agenda remained fit for purpose. Twenty changes during the previous Government’s tenure benefited employees in the NHS, and rightly so. The current Government believe that we must continue to ensure that the system is fit for purpose.

[Mr Jamie Reed (Copeland) (Lab)]

It is most unusual to find the ghost of Christmas past sitting next to the invisible man. The truth is that in May this year, the Deputy Prime Minister stated:

“There is going to be no regional pay system. That is not going to happen.”

Regional pay will strip millions from local NHS services; it will hit the poorest areas of the country hardest, damage front-line NHS care, and there can be no justification for it. Will the Minister categorically rule out continuing with these ruinous proposals—yes or no?

[Dr Poulter]

The arguments presented by the hon. Gentleman are fatuous, and the previous Government endorsed regional bandings for London workers. If today he is saying that he does not agree—[Interruption.] You might learn something if you listen. If he is saying that he does not agree with London weighting for London workers, which is a form of regional pay—[Interruption.]

[Mr Speaker]

Order. The Minister is entitled to be heard.

[Dr Poulter]

If the hon. Gentleman listens, he may well learn something about what his Government did when they were in power. They endorsed the fact that in the NHS it is important to recognise that we need inducements in some parts of the country to encourage workers to work there. That is why we have central London and outer London weighting. If it was good enough under the previous Government, it should be good enough now.

[Mr Speaker]

Order. We are immensely grateful to the Minister, but we have a lot to get through and we really must press on with rather greater dispatch from now on.

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[Mr Nick Gibb (Bognor Regis and Littlehampton) (Con)]

6. What assessment he has made of the role of community hospitals in the range of local health care and hospital provision.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

My hon. Friend is right to highlight the importance of community hospitals in his constituency and elsewhere. They can provide high-quality care close to home, particularly for people with long-term conditions and the frail and elderly.

[Mr Gibb]

I am grateful to my hon. Friend for that answer. If there is a conflict between local health officials and local people as to the desirability of a community hospital, as there is in Littlehampton in relation to the Littlehampton community hospital, which most people in the town want to see rebuilt, whose views should prevail—the NHS employees or the local residents of Littlehampton?

[Dr Poulter]

I thank my hon. Friend for his question. As he is well aware, it is down to local commissioners—local doctors—in Littlehampton to decide, in consultation with local communities, what is good health care. Of course, we must not get fixated on buildings in the NHS. I know there is a local campaign to support the re-establishment of Littlehampton district hospital, and although that may be a very desirable end, there may be many other ways in which high-quality health care can be provided for his constituents closer to home.

[Graham Jones (Hyndburn) (Lab)]

From April, my local health centre will be transferred to a national property company, a quango, in Whitehall. How can local people in Hyndburn regain some influence over this health centre and its use after April?

[Dr Poulter]

Part of reorganising services and delivering good health care is about clinical leadership—I hope that is supported across the House—and local doctors, nurses and health care professionals saying what is important for their patients and what local health care priorities are. Obviously, local communities need to be engaged in that process, but what really matters is what is good for patients and delivers high-quality care for them. We need to deliver more care in the community, and in doing so we have to recognise that some of the ways we have delivered care in the past—picking up the pieces in hospitals when people are broken—need to change. We have to do more to keep people well at home and in their own communities.

[Sir Alan Beith (Berwick-upon-Tweed) (LD)]

Given that the maternity unit at Berwick infirmary has been suspended since the beginning of August for safety reasons, with births being referred to a hospital 50 miles away, will the Minister take into account the urgent need to provide the necessary clinical support for community hospitals in remote areas so that they can provide local essential services to the highest standards?

[Dr Poulter]

I thank my right hon. Friend for that question. We discussed this issue in the Adjournment debate before the autumn recess. He is a strong advocate for his local maternity services. The concern was that only 13 births take place at his local maternity unit every year, and whether staff can continue to deliver high-quality care with such a low number of births. Of course, his local providers will want to consider the rurality of the area and the potential, as outlined in the Birthplace study, of rotating staff in and out of the hospital to support his local unit.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

7. What steps he plans to take to ensure that providers of domiciliary care employ staff who are properly qualified and security checked.

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[Mr William Bain (Glasgow North East) (Lab)]

12. What recent representations he has received on regional pay in the NHS.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

I refer the hon. Gentleman to an answer I gave earlier today.

[Mr Bain]

Has the Minister had an opportunity to study the research done by the New Economics Foundation a few months ago, which reveals that fully regionalised public sector pay could strip up to £9.7 billion a year from local economies, put 110,000 jobs at risk and hit women twice as hard as men? Given that, what possible justification could this Government have for such a crazy policy?

[Dr Poulter]

Let me bring the hon. Gentleman back to planet earth for a while—[Interruption.] He should have listened to the answer I gave a little earlier about allowing for flexibility in pay frameworks. Some degree of regional pay was introduced by the previous Government in “Agenda for Change”. On principle, then, the previous Government, the hon. Gentleman and his colleagues, including the former Secretary of State, were supportive of regional pay. However, on the current negotiations and discussions, we would like to see a collaborative relationship between employers, unions and employees in the NHS at the NHS Staff Council to make sure that we maintain national pay frameworks as long as they remain fit for purpose.

[Sir Tony Baldry (Banbury) (Con)]

Why should there be an assumption that local pay will lead to lower pay in the public sector? In a constituency such as mine, where the unemployment rate is below 2%, local pay could quite possibly lead to higher pay in the public sector so that people are attracted to it.

[Dr Poulter]

My hon. Friend makes an excellent point. It was the previous Government who, through the “Agenda for Change”, gave flexibility to NHS trusts to allow some employers to pay a 30% premium in areas with workplace shortages.

[Lilian Greenwood (Nottingham South) (Lab)]

17. At a time when NHS budgets are under exceptional pressure, my constituents simply do not understand why the Government are so intent on pushing trusts to divert money away from patient care and into wasteful local pay bargaining. Is there not a risk that Nottingham’s excellent NHS hospitals and community services will be unable to recruit and retain the best staff if regional pay results in cuts to their salary scales? The Government are supportive of the idea, endorsed by the previous Government, that local pay flexibility allows additional rewards to be paid to staff in areas with workplace shortages, as my hon. Friend the Member for Banbury (Sir Tony Baldry) just made clear. The Government are supporting the unions, employers and employees, as the NHS Staff Council, in coming together to try to agree how we need to modify the “Agenda for Change” and other agreements to ensure that they remain fit for their purpose of protecting employees.

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[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

We are working with the Department for Education to introduce integrated commissioning of education, health and social care for children and young people with special educational needs and disabilities. This will ensure that children with profound multiple learning difficulties can get the care they need while at school.

[Chi Onwurah]

I recently visited Hadrian school in my constituency, which caters for children with severe learning difficulties and profound and multiple learning difficulties. I saw fantastic teachers and carers doing fantastic work with fantastic children, but I also saw in the reception classes that more children with more severe health needs were entering the school. What guarantees can the Minister offer that funding will be in place for those children in five or 10 years so that Hadrian school can plan now for their needs?

[Dr Poulter]

The hon. Lady makes a good point. We know that the Government are putting more money into the NHS. However, this not just about putting in more money, but about how we deliver care in a more joined-up way. At the moment, education works too much in its own silo and the NHS works in another. The Government’s new commissioning arrangements will follow the more joined-up approach that we need to take properly to meet the needs of children with learning disabilities in the round. That must be a good way forward in properly joining up education and health care.

[Mr Mark Spencer (Sherwood) (Con)]

T1. If he will make a statement on his departmental responsibilities.

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[Helen Jones (Warrington North) (Lab)]

T5. Before the last election, the Prime Minister promised a “bare knuckle fight” to save district general hospitals and promised that they would be enhanced. Now that we know that the board of St Helens and Knowsley hospitals is looking at a merger with Warrington and Halton to solve its problems, can the Minister give the House an unconditional assurance that no services at Warrington will be downgraded or removed, whether that merger goes ahead or not?

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

There was an option to discuss this issue at the board meeting on 29 August—not of the hon. Lady’s hospital trust but of the Halton hospital trust—because the Halton trust is looking to achieve foundation status. So I can reassure her that the services at Warrington hospital are safe.

[Mr John Redwood (Wokingham) (Con)]

T3. What is the administration overhead cost to the NHS and the Department this year and how does it compare with 2009-10?

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[Rehman Chishti (Gillingham and Rainham) (Con)]

T4. Will the Secretary of State join me in welcoming the progress that has been made to reduce mixed-sex wards and improve patient privacy at Medway Maritime hospital in my constituency?

[Dr Poulter]

My hon. Friend is absolutely right to highlight the Government’s success in reducing mixed-sex wards not just in his hospital but throughout the NHS—we inherited a very different situation from the previous Government. Medway has been a pioneer in that area and my hon. Friend is right to commend the hospital and I put on record my thanks for all that it is doing.

[Paul Goggins (Wythenshawe and Sale East) (Lab)]

T8. Will the Secretary of State take a close personal interest in the proposed changes to the NHS in Trafford? Given the uncertainty about alternative accident and emergency provision, and indeed the delays in commissioning community services, will he ensure that any final decisions are deferred so that they can be considered as part of the wider review planned for NHS services across Greater Manchester?