BMA (Contract Negotiations)

David Amess Excerpts

Monday 21st March 2016 Westminster Hall

[Sir David Amess (in the Chair)]

I call Helen Jones to move the motion.

[Helen Jones (Warrington North) (Lab)]

Thank you, Mr Amess. It is a great pleasure to serve under your chairmanship. I beg to move,

That this House has considered e-petition 121262 relating to contract negotiations with the BMA.

This is one of a number of petitions on the website about the junior doctors’ dispute, including the perennial favourite “Consider a vote of No Confidence in Jeremy Hunt”. We have chosen this one for debate because it was begun after the Government’s decision to impose the contract, and therefore relates to the position that we are in now.

It takes a lot to make doctors go on strike; their nature and their years of training mean they are inclined to stay with their patients. So, when facing the first doctors’ strike in 40 years, it is fair to ask how we reached this position and what can be done to resolve it. I am sorry to say that I think most of the blame lies with the Secretary of State and the atmosphere that he has created. In saying that, I want to make it clear that I do not think the current contract is perfect by any means. It is too complicated, and it throws up some anomalies in pay. However, it has proved impossible to negotiate changes to that contract properly, due to the atmosphere of mistrust and suspicion that has been created by some of the comments made by the Secretary of State.

That atmosphere goes back some years, but it reached its lowest point in July last year, when the Secretary of State said that the NHS had a “Monday to Friday culture”. I have read since that he has never actually visited a hospital at the weekend. If that is true, perhaps he should, because he would find that many staff are working. So incensed were they at the idea that they did not work weekends that they took to posting pictures on Twitter with the hashtag “#ImInWorkJeremy”.

The Secretary of State then went further by telling doctors to “get real”. I think that people who make life-and-death decisions every day, care for terribly sick patients, work with emergencies in accident and emergency while putting up with drunks and insults, work in special care baby units, and care for frail, elderly, often confused people know what reality is. They do so in a national health service under huge pressure. Much of the equipment is now out of date and there is a repairs backlog worth £4.3 billion, but the capital moneys available were cut by £1.1 billion in the Budget. Doctors are working with out-of-date scanners and computers that crash, and because the Government see all support staff as inessential bureaucrats, doctors are mopping their own operating theatres or doing data input that any competent clerk could do. I think that they know the reality of what they face. To be told that by someone whose gilded path to ministerial office went through Charterhouse, Oxford and management consultancy is beyond parody.

The Secretary of State, again, had to say more than that. He looked at weekend death rates, and jumped to the conclusion that they were caused by staffing levels. He said clearly:

“Around 6,000 people lose their lives every year because we do not have a proper seven-day service”.

He later used the figure of 11,000. Again, he said that was

“because we do not staff our hospitals properly at weekends.”—[Official Report, 13 October 2015; Vol. 600, c. 151.]

I will spend a few minutes on the research quoted by the Secretary of State, because it does not actually prove that at all. The research paper that reached the conclusion that there were 11,000 extra deaths considered admissions from Friday to Monday, not just at the weekend, and considered death rates within 30 days of admission. Anyone who designs research will say that it is almost impossible to allow for all the things that could happen in 30 days. The researchers themselves did not draw the conclusion drawn by the Secretary of State. What they said was:

“It is not possible to ascertain the extent to which these excess deaths may be preventable; to assume that they are avoidable would be rash and misleading.”

In fact, being rash and misleading is exactly what the Secretary of State was doing.

--- Later in debate ---

[Helen Jones]

No, I am not going to withdraw that remark. [Interruption.]

[Sir David Amess (in the Chair)]

Order.

[Helen Jones]

And she said they were endangering patient safety. It is that attitude among Government Members that is preventing a solution to the dispute. There are constant attempts to stigmatise staff and to accuse them of things that they have not done and are not doing. The Minister, for example, says that junior doctors are misled about their contract by the BMA. That is patronising, because it implies that they are not able to look at the evidence and judge for themselves. We have heard no attempt from the Minister to outline the Government’s plan B if some doctors leave and do not sign the contract. Well, I am not surprised that the Government do not have a plan B because they do not even appear to have a plan A.

I appeal to the Government to change course and to take steps to get the BMA and junior doctors’ representatives back round the table so that the dispute can be sorted out for the benefit of patients and for the benefit of the whole NHS. If they do not do that, we are really heading towards serious problems in the future.

Question put and agreed to.

Resolved,

That this House has considered e-petition 121262 relating to contract negotiations with the BMA.

Bowel Cancer Screening Age

David Amess Excerpts

Tuesday 8th March 2016 Westminster Hall

[Caroline Ansell]

Indeed, there is a lot of positivity. Lauren brings that positivity: she wants not only to reduce the screening ages, but to advance awareness of bowel cancer across the piece. I know that she is particularly concerned about those who are at risk and are already carrying the condition in their 20s and their 30s. So much more needs to be done, and that includes us talking about our symptoms and taking that forward. As we have heard, there is a good prognosis if we can strike out for that early intervention.

[Sir David Amess (Southend West) (Con)]

On that positive note, my mother had a scare at 90. She ended up with a colostomy and she is shortly to be 104. There are good outcomes. Does my hon. Friend share my disappointment that the national average for take-up is 58%? In Southend, it is 52%. Our excellent Minister will be keen to ensure that there is a much higher take-up rate.

[Caroline Ansell]

Indeed. I am looking forward to hearing more from the Minister about the excellent work the Government are doing. I know that they have plans and prospects for hitting that low take-up. I fear that that low take-up might be a very British sort of thing, and we need to break through that if we are to strive to see the same survival rates as some of our European counterparts.

On early diagnosis, those diagnosed with stage 1 bowel cancer have a 97% chance of survival, which is hugely positive. That compares with a chance of survival of just 7% when the cancer is more advanced. Early diagnosis not only provides patients with a much better chance of survival, but would cost the NHS far less, saving an estimated £34 million according to the charity Beating Bowel Cancer. That is because treatment for the earlier stages of cancer is often less intensive and invasive than treatment for more advanced diseases.

Sadly we also know that we are lagging behind other countries on survival rates. A 2013 study for the London School of Hygiene and Tropical Medicine, which was part-funded by the European Commission, found that in Britain we diagnose bowel cancer later than other countries, while our survival rate overall for bowel cancer was only 51.8%. That is lower than the European average of 57% and lower than Germany’s survival rate of 62%. That is not where we want to be. I am looking forward to hearing from the Minister about her Department’s sterling work, but my question today is: could the age of screening be revisited? Is there scope to further personalise and target testing in those younger years?

Epilepsy

David Amess Excerpts

Thursday 26th February 2015 Commons Chamber

[Sir David Amess (Southend West) (Con)]

The whole House was moved by the speech of my hon. Friend the Member for Wycombe (Steve Baker). The pain of losing a child under such circumstances is unimaginable.

My hon. Friend the Member for South Thanet (Laura Sandys) started her speech by beating herself up because she did not feel that she had done enough to raise the profile of epilepsy. Nothing could be further from the truth. She has done a magnificent job, and she made my day with her invitation to colleagues to come up with ideas about how she should break the law as an epileptic. When she gets back to her room later, she will find that she is inundated with suggestions. I, like others, am very sorry that she has chosen not to stand in the next election. I hope to God that she is replaced by someone with the good common sense and judgment that she has shown throughout her time as a Member.

Epilepsy is a potentially life-threatening neurological condition, as other speakers have said. It affects the lives of nearly 500,000 people in England alone. It can reduce life expectancy by up to 10 years and can leave people unfit to work, as we have heard. Among other consequences, epilepsy affects children’s performance at school owing to seizures. Nearly half of the number of deaths from epilepsy can be avoided. In the constituency that I represent, there are an estimated 865 people suffering from epilepsy. This figure increases to 13,600 for the county of Essex.

What are the local CCGs doing to assist people with epilepsy in the area that I represent? I am afraid to tell the House that the answer is not enough. Clinical commissioning groups have a very important role to play. They have a strategic influence and make commissioning decisions that impact on the lives of an average of 2,370 epilepsy sufferers in each CCG area. I have recently been in contact with Epilepsy Action which—I agree with others—is doing a wonderful job in raising awareness of the problems faced by people with epilepsy. I was shocked to hear that my local Southend CCG has no plans to produce a written needs assessment of the health and social care needs of people with neurological conditions; has no plans to produce a written needs assessment of the health and social care needs of people with epilepsy; has not identified neurology or epilepsy as an improvement and saving opportunity; has not identified neurology as a priority for the local health and wellbeing board; and has not appointed a clinical lead for neurology. That is simply not good enough.

Southend West has a higher than average number of people with epilepsy, because of its high age profile. The correct ratio for specialised epilepsy nurses to patients is 1:300. The specialist nurse at Southend hospital is currently looking after more than 1,000 patients, which is absolutely ridiculous. That has to change. More specialist epilepsy nurse posts must be created before any improvements can be felt by my local residents. I fully accept that it is a country-wide problem, but it is very frustrating that most CCGs do not understand the needs of people with epilepsy.

I am in regular contact with the South East Essex Epilepsy Support Group, which is superbly led by its chairman, Mrs Diane Blake-Lawson. It is a wonderful source of information and support for epilepsy sufferers in the area I represent. I hear about all sorts of obstacles faced by people with epilepsy. Very often local residents are diagnosed and then they and their families are left without any medical guidance or support, and we heard a little about that earlier. I was particularly upset to hear that Southend hospital has on a number of occasions refused MRI scans and other medical examinations.

I have received complaints regarding the prescription of generic drugs, despite evidence suggesting that their use leads to an increased risk of seizures. Even more alarmingly, I was informed that the latest drugs are not made available to patients, as older and less effective drugs are cheaper to use. That is just not acceptable. Local residents often get caught up in a confusing situation where the hospital says that they should speak to their GPs first, but once they contact their GPs there seems to be a reluctance to give any advice and they are told to turn to neurologists instead. There is clearly a lack of GP training in epilepsy.

Nationally, only 20% of people with epilepsy who are referred to see a specialist are seen within the NICE-recommended waiting time. Even worse, there is an 18% gap in the treatment of epilepsy, meaning that 18% of people with epilepsy who could attain seizure-freedom experience seizures unnecessarily due to a lack of appropriate treatment.

I want to touch on the issue of benefits, which the right hon. Member for Knowsley (Mr Howarth) also raised, because a number of people are adversely affected by the present situation. As we all know, the process of claiming benefits can be lengthy and stressful, which in turn can aggravate the psychological symptoms as well as the frequency and severity of seizures. What I am most concerned about is the ability of benefit medical assessors—they are rarely doctors—to recognise and appreciate the severity of epilepsy.

In conclusion, I think that there is a role for the Government to play. We need more funds to be invested in medical research to ensure that more people with epilepsy can access effective treatments. Southend residents suffering from epilepsy should not be denied access to the various treatment I mentioned earlier. For too long epilepsy has been forgotten when it comes to funding and the variety of treatments available. It is time for the Government to hold CCGs to account to ensure that due gravity is given to this very serious condition. As my hon. Friend the Member for South Thanet passes the baton to the hon. Member for Walsall South (Valerie Vaz), I hope that in the next Parliament, whoever forms the next Government, we will do our very best to provide the best possible treatment for those who suffer from epilepsy.

Blood Safety (Variant Creutzfeldt-Jakob Disease)

David Amess Excerpts

Thursday 29th January 2015 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

It is a pleasure to serve under your chairmanship, Sir David. Sadly, I have been left with less time than any of the other hon. Members who have spoken in the debate to respond to the questions put to me, but I will do my best.

[Sir David Amess (in the Chair)]

Order. The debate goes on until 4.30 pm.

[Jane Ellison]

Marvellous. My mistake. In that case, I have plenty of time.

In case there is anything I cannot cover in my remarks, I should point out that we have already committed to write to the Committee with a further update before the end of the Session. There are issues where we will have more to report, and I will focus on a couple of specifics today.

Let me start by thanking the Committee for the opportunity to look at the issue again. May I also apologise for the fact that I am holding my notes so far away from me? I have left my glasses at home.

NHS Specialised Services

David Amess Excerpts

Thursday 15th January 2015 Westminster Hall

Motion made, and Question proposed, That the sitting be now adjourned.—(Damian Hinds.)

[Sir David Amess (in the Chair)]

Our subject for debate is the national commissioning of NHS specialised services. There is clearly great interest in the debate and I am sure colleagues can work out how much time is at our disposal. Obviously, I want to call everyone who would like to speak.

--- Later in debate ---

[Kelvin Hopkins (Luton North) (Lab)]

I, too, congratulate you on your knighthood, Sir David, which is well deserved. It is a pleasure to serve under your chairmanship. I also congratulate the hon. Member for St Austell and Newquay (Stephen Gilbert) on launching and promoting this very important debate.

I want to speak up for robot-assisted surgery, which should be the subject of national commissioning and should not be localised. The case for it is very powerful indeed. Some 500,000 robot-assisted surgical procedures took place in the world in 2013, and 5,000 of those were in Britain—but 5,000 is quite a small number when compared with the total number of operations across the whole field of health during a year. These operations are very specialised; a small number of very specialised surgeons do them. Clearly, such surgery is wholly inappropriate for local decision making, local funding and local commissioning. My hon. Friend the Member for Bristol East (Kerry McCarthy) made the point very strongly: these operations should be part of a national service, where we can get economies of scale and a focus on centres of quality and expertise.

The operations are used, among other things, to treat patients with prostate cancer, kidney cancer and bladder cancer and, to a lesser extent, in the areas of colorectal surgery and gynaecology. Having seen some of the operations on film, I know how incredibly precise and difficult they are and what miracles can be worked by robotic surgery. It cannot be done by human beings: however brilliant a surgeon is and however delicate their hands are, they cannot be as precise as a robot. Robots will increasingly become part of the way we operate on human beings more broadly.

My reason for being so interested in this issue is personal. Over the last four years, I have been invited to speak, briefly, at an international symposium on surgical robotics at the Royal Geographical Society. It has been led by my noble Friend Lord Darzi, of another place. As we all know, he is a gifted and brilliant surgeon himself. I make a brief address at the beginning—not because I am a medic myself or know anything about these things, but because my late father was Professor Harold Hopkins FRS. He was a gifted scientist who designed the first successful optical endoscopes. Flexible fibre optics were his, as were rod lens cystoscopes and all the endoscopes that followed from them.

If anyone has ever had a colonoscopy or a gastroscopy—or, indeed, had their bladder inspected through the urethra—they will have had one of those instruments poked inside them. I have experienced more than one of them, but fortunately I was in perfect health, so I was pleased about that. I also had the unusual experience of seeing the first ever clear picture of bladder cancer; my father showed it to me when the first endoscope was used to take it. It was an historic moment.

The point I want to make is how important it is that these procedures are promoted within the national health service, because Britain must be at the forefront of this technology. We have brilliant surgeons and brilliant designers and scientists designing these things, but when my father first invented his cystoscopes, his endoscopes, he could not get them produced in Britain. Eventually, he met a man called Storz in Germany, who manufactured the endoscopes and made millions of pounds from them.

The Deutsches Museum in Bonn has a case devoted to those instruments in a part of the museum for foreigners who have made a contribution to the German economy. It could all have been done in Britain, but it was not. I fear that if we do not keep funding this cutting-edge technology—“cutting” is perhaps an unfortunate word—we will lose our position in the world at the head of all these developments. It is so important for Britain, as an economy, that we sustain these things, but they will not be sustained if we have penny-pinching local commissioning, which will undermine the procedures and their availability.

These are very serious concerns. Sadly, my father died of prostate cancer himself some 20 years ago. There is a hereditary component in prostate cancer, so I have a personal interest in making sure that all these operations are available and that we have the best possible technologies to deal with the disease.

A recent front-page report in The Guardian or The Independent—I forget which—showed that prostate cancer treatment varies enormously from area to area, and death rates are higher in some areas than in others because some treatments are not available nationally. Some treatments, such as implanting into the prostate small radiation-generating components that kill off cancer cells, are not available to all sufferers, and they should be.

There are all sorts of reasons for national commissioning to ensure consistency of provision across the country and that people do not die unnecessarily of dreadful diseases. There is a powerful case in many other fields for national rather than local commissioning. We are talking not about hip replacements and tonsillectomies, but about very specialised operations, sometimes for rare diseases and conditions, using technology that is not available in every area. There should be national centres for such things.

That is my case, although I could speak at much greater length. I want to finish on the question of funding for the health service. There has been a lot of press comment and alarm about the state of the health service, and quite rightly so. I do not speak for my Front-Bench team—I only wish I did, and from time to time I try to persuade them that I should—but I believe that NHS spending must be increased. We spend at least 2% less of GDP on health than do the French or the Germans, and 2% of GDP is the equivalent of approximately £60 million per constituency. I would like to see an extra £60 million spent on health in Luton North, as I would in Luton South and in every other constituency. That would simply match the current situation in Germany and France.

The NHS does a wonderful job and is incredibly efficient, despite what people say. It has a high level of productivity, although that is being damaged by fragmentation and creeping privatisation. It is a remarkable organisation, envied across the world. It is still, in many ways, the best health provision in the world, but it is in danger from underfunding. I want us at least to match what the French and Germans do, especially as our economy is now evidently stronger than theirs.

There is a possibility of spending more. The population regularly indicate in polls that for certain areas, particularly health, they would be prepared to pay a little more tax to make sure that they are safe. I look forward to the next Labour Government, who should be in office in the next few weeks. We will then be able to move forward and properly fund the NHS.

[Sir David Amess (in the Chair)]

I call Mr Mark Tami, who, as it turns out, has plenty of time at his disposal.

Mental Health Services (South-East Essex)

David Amess Excerpts

Wednesday 5th March 2014 Westminster Hall

[Mr David Amess (Southend West) (Con)]

I make this speech in sorrow and anger—in sorrow because as a result of the South Essex Partnership University NHS Foundation Trust, SEPT, my constituents are suffering, and in anger because I am a parliamentarian who takes his job extremely seriously and I have simply not been listened to.

In this very place on 1 March 2001—13 years ago—I made a speech outlining in graphic terms how disgracefully the mental health services that look after people with problems in Southend were run. I see no purpose in having Adjournment debates if when Members of Parliament raise an issue, Ministers say that they are glad it has been raised and then it gathers dust. Let me make it clear that I will not remain silent on this issue until something is done. The Minister is a Liberal, and will understand me well. Liberals like to dig themselves into their constituencies and have a high profile. That is what I did in Basildon and in Southend West. I know my area better than the Minister, the Care Quality Commission, Monitor, the civil servants and the trustees and directors of SEPT. I really do know what the service is like. I will be making a presentation to the House about the organisation. It will be horrified when it has a private meeting and reads what I have to say about it and how it will be reported. Let me use new Labour terms: the organisation is not fit for purpose. Let me then use terms that the Minister might respond to: there are lessons to be learnt.

Then there is the issue of governance. I can remember only too clearly the then Labour Minister listening to what I was sharing with the House, but absolutely nothing was done about it and people suffered. Under the Labour Government of 13 years, the organisation did extremely well under its previous chief executive. I will outline all sorts of honours that he received—he did extremely well.

Thinking about my old constituency of Basildon, when Sir John Major visited Basildon hospital, it was a first-class hospital. I am very proud to say that; it is where all my five children were born. We use local health services. I do not have private health care; I use the national health service. The previous Labour Prime Minister visited Basildon hospital just before the election on a public relations exercise, and the media reported how marvellous everything was. In the past three years, as the Minister knows, an inspection was done of the hospital. What went on with that fabulous hospital breaks my heart. Fortunately, new management is in there and it has been turned round in a remarkable fashion. It has perhaps the finest cardiac unit in the country, so I cannot speak highly enough of Basildon hospital now. I am only sharing that with the House because a public relations exercise can mislead in a graphic way.

What am I after in this debate, so we do not lose sight of what is happening? What went on is totally wrong; the previous chief executive was on his huge salary and all those personal things happened with the trust that we, the residents, had been paying for. It is absolutely outrageous that the governing body, whose duty is for governance of the organisation, then appointed the deputy, who has been with the organisation since 2005. What is so wrong about the organisation is the management. That is why they are not going to like what I shall say, but it is absolutely disgraceful.

Since I have been a Member of Parliament, I have observed how little power Ministers have these days. It was under Tony Blair’s Government that gradually powers seeped away, so I absolutely accept that the Minister is limited in what he can do. I have had meetings with Monitor and the Care Quality Commission—my hobby horse is that, for the life of me, I do not know why we have two organisations, one of which is in Wellington house, very close to the health service—and when I challenged them on these issues and on all the complaints, they were completely lost, so it is very frustrating.

When I first became a Member of Parliament, I could get things done. I saved Basildon A and E with just two days to go—there is a long list of things. Now we pass things to Ministers. It may take four weeks, eight weeks or 12 months for the civil service to produce a letter that is topped and tailed, and at the end of it all, it is a complete waste of time. I will not have that with this issue, because the mental health service is the Cinderella service of the country, as we all know. I applaud what the Government are doing with all their notices on the tube, as has been pointed out to me, and the way in which they are trying to turn round, in real terms, the way people see others who are suffering from mental health issues such as depression, so they are seen in a better light. However, I am not holding my breath that the Government will take action on this matter. Frankly, I think it has to be done through people power.

When I first became a Member of Parliament, I never saw as many people with mental health problems as I do now. They are growing in number. Whether it is depression or all sorts of matters, the numbers are definitely increasing. I really feel for my constituents who have a loved one with a mental health problem—not just through drug or alcohol abuse, but a real mental health problem—and then they have to go through the sectioning process, which is not easy. Of course, that process involves the police, and that is another subject as well, but what I want from the mental health service that looks after people in Southend is some honesty. Is it that they can no longer cope or that they do not know what they are doing? I am sick to death with my constituents’ endless list of complaints about mental health services. They are not part of the nanny state, wanting to dump their problem on to the state; they are in complete anguish about what it is like to get someone sectioned.

Of course, there is then the nightmare that when someone is sectioned, people are told, “Well, we can’t talk to you directly because the person being sectioned has a number of rights,” yet when they are released, the families, who can often be aged, have to cope with these very difficult circumstances. Sadly, I say to the Minister that all the figures seem to show that the number of people with mental health problems is growing.

According to figures provided by SEPT, in 2004 there were 184 complaints. There was no record of any of the complaints being upheld. I would have thought that someone, somewhere in Government, when I complained about it, would have said “How on earth can that happen?” In 2012-13, under an enlarged organisation, which of course seems to be an excuse, 434 complaints were made against the service. Of those, 243 were upheld, so more than half the complaints were upheld. We do not have the time to go into the details of the stress caused by raising a complaint and the length of time it takes to deal with it. Those figures in themselves should have set alarm bells ringing in the Department of Health, but I do not think that has happened.

My question today is: why on earth has this service, which in the early 2000s was already in a shocking state of affairs, been allowed to continue in that fashion? Why did no one intervene when I raised it in this Chamber in 2001? It really is not good enough, frankly, that nothing has been done. What makes matters worse is that the organisation is rewarded for failure.

Many people in the organisation, and there will be lines to take on the matter, were not there on the journey I have been on. After 31 years, I have a real picture, but I go back to the appointment of the present chairman, who has been with the organisation since 2005. In 2010, 118 employees earned more than £60,000. That was up from 99 in 2009. More recently, in light of the numbers of complaints that I have just quoted, in March 2013, 161 staff earned more than £70,000, 49 of whom earned between £100,000 and £150,000. That is absolutely crazy—50 earning between £100,000 and £150,000.

It gets worse, however. Although complaints to the trust were increasing exponentially, SEPT staff were rewarded with higher salaries—rewarded being the norm. In 2009, while many ordinary people were suffering from the worst effects of the global recession, the salary of the chief executive of SEPT rose from £170,000 to £200,000, and then it became much higher than that. That is absolute madness, and it is all in Hansard. This is supposed to be the mother of Parliaments, which runs the country. I have complained about this time after time and yet nothing at all has happened. It is an absolute disgrace that my words of caution have been ignored about this matter. Apparently, the salaries were justified

“to recognise the trust’s exceptional performance”.

Well, that is a joke if ever there is a “Tick the box” exercise. The constituents and whistleblowers who have contacted me would certainly question it.

Following my Christmas pre-recess Adjournment debate, in which I raised this issue, I was informed by a Minister that the CQC currently has no concerns about SEPT’s services in Southend. Well, that is a laugh in itself, frankly. No concerns? What on earth has it been doing? It is absolutely ridiculous. I do not necessarily dispute whether the inspections of these services were carried out rigorously enough, but what I would dispute is that a recent inspection, in September 2013, when I started to make a fuss about this again, found no overarching concerns for any of the “four essential standards”, one of them being “complaints”. Surely the increased number of complaints in the past 10 years is evidence enough to suggest that we should question an inspection that declares that there is no cause for concern at all. Surely I should be listened to, as a local representative. I have been there longer than all these other people; I have 31 years’ experience.

Perhaps the CQC is not missing something, but in 2010 a whistleblower, who was a practising doctor for the service, claimed that the previous chief executive of the service would often circulate e-mails to encourage staff members to “talk up the service”. That actually happened when inspectors came to visit. Nothing at all was done about the people who were responsible for governance. In fact, according to the whistleblower, internal surveys that were meant to help the service to improve itself would often be loaded to ensure that a negative response could not be input into the questionnaire, so the service was either “excellent”, “very good” or “quite good”. And we, the mother of all Parliaments, have, as power has seeped away, allowed all this to happen. What is the good of elected Members of Parliament if we have become so impotent?

I recognise the motivation behind what the Care Quality Commission does to ensure that the health services across the country are serving the interests of patients, but I cannot help but feel that the inspectors are missing something or being misled by staff at SEPT, who have in the past been reported as ensuring that patients are on their “best behaviour” when an inspection takes place. I think that it is important to link that with the statistics that I referred to; the numbers of complaints have increased. How the CQC does not consider that to be not only incredibly concerning for patients and their relatives but very suspicious is alarming. That said, I welcome the recent report on Bedford hospital.

I talked in the Christmas Adjournment debate about the previous chief executive, Patrick Geoghegan, who left in September, and his history. I have mentioned in this debate the very large salary increase. I do not have time to go into how he described himself as a doctor. I have my own view as to what a doctor is. I will leave it to others to reflect on him. But I think that it is curious how that chief executive went from the modest role of a hospital porter when I was Member of Parliament for Basildon to become one of the highest paid chief executives in the whole country, and the mother of Parliaments has done absolutely nothing about this disgrace. We have just had heads down and a rule of silence: “This is the line to take, Minister, and let’s just get on with it.” Well, I am certainly not going to remain silent about it. For example, in 2009, under Labour, Mr Geoghegan received the NHS leader of the year award, beating 700 other candidates, and he was rewarded with a huge pay increase.

One of the most consistent complaints that I receive is with regard to the number of locum staff that the service employs. There is evidence to suggest that agency staff often work two jobs and, as a result, will turn up late for shifts.

In 2008, an independent inquiry criticised the staff turnaround rate after a murder was committed by the schizophrenic Gary Roberts. There was a report on that. I am rushing through this because I have so much to say. John Vesey, former chairman of SEPT for six years, has told me that there was a problem getting staff when he was there and he knew of extra money being offered to prospective psychiatrists on the side. He said that the directors—this is coming from the former chairman—

“lied through their teeth about this”

when it was brought up at a board meeting. In 2007, the trust was still facing staff shortages, and the board discussed the issue but concluded that the shortages had no detrimental effect on the quality of care. What an absolute joke. And the trust went on ignoring things.

In response to a freedom of information request that I put in to the trust in September 2013, I was told that £600,000 was spent on promoting this organisation. That was three times the salary that Mr Geoghegan was receiving at the time. We could have employed a number of hospital consultants for that. The uses of the public relations techniques are an absolute disgrace

Sharon Tattoo, a constituent of mine, became a whistleblower. I want briefly to talk about two issues now. John Vesey, while chairman of Thameside mental health service as it was then called, recalled how he was forced to dismiss a member of the board by the regional chairman after he was threatened with dismissal if he did not dismiss that individual from his post. That example of bullying is absolutely typical of SEPT, and the corruption does not end there. There was a particular incident in which Mr Vesey, in response to a large and elaborate party that had been held for his birthday, approached the director responsible for finance and inquired how the party had been paid for. The response unnerved Mr Vesey: the money had come from funds donated by what the then finance director called “grateful patients”.

Sharon Tattoo worked for SEPT. She became aware of what she saw to be the misuse of funds by the leadership. She told Mr Vesey, the chairman, about the funding being redirected. The chief executive then warned her that if she were to raise these issues with the chairman, his job would be at risk, and she was advised that she should refrain from making further complaints. I could go on and on about what happened.

Mr Geoghegan left in September, but what on earth was going on with the board when it replaced Mr Geoghegan with his deputy, Sally Morris, who had been there since 2005? I have looked at the present board members and where they come from. It is now a much larger organisation. But what on earth has Lorraine Cabel been doing, as the chairman of the trust, in overseeing all this? I think that what has been happening is an absolute disgrace; and all the time, my constituents have been suffering as a result of this poor care.

For instance, there is a young girl who is now in Rochford hospital as a result of having suicidal thoughts. She recently escaped, with another patient, from a ward, and the staff apparently allowed that escape to happen. I want to ask how the staff on duty at the time, bearing in mind that these patients have fragile minds, allowed two patients to escape from a secure unit. What has happened is absolutely disgraceful.

I want to end my speech by paying tribute to the work of one of my constituents, Cheryl Higgins, who in 1999 recognised how poor the health services were in my constituency and, supported by John Barber, set up Trust Links to address the gap in mental health services. That organisation is still flourishing today.

I say to the Minister that I am not going to let this matter drop—I am really not. I am very, very angry about the way I have been ignored on this issue. I have no doubt that there will be a line to take and that I will be told, “All is well.” It is not well. This is a very expensive service, and it seems to me that we want a complete clean sweep of the management. That is what I am asking the Minister to achieve. Mental health services have always been the Cinderella service. When the Government whom I support came to power, under one of our colleagues who was then a Minister, a pledge was given that it would no longer be the Cinderella service and it was going to be front line now. From what is happening in my own area, I am not at all satisfied that the organisation that is in charge is fit for purpose. I will not shut up until I get some real action on the matter.

[The Minister of State, Department of Health (Norman Lamb)]

It is clear from the contribution of my hon. Friend the Member for Southend West (Mr Amess) how strongly he feels about the matter, and I absolutely respect that. I am not interested in any line to take from the Government. I have a speech here, but I want to address directly what my hon. Friend has had to say. I share his passion for trying to improve mental health services. That is something that I feel strongly about. I never like the idea of sweeping failures of service under the carpet. He has raised some serious concerns, although he did not have time today to go into the detail of all the things that he wanted to raise, and I would be keen to meet him to discuss those issues further.

I want to say a word about what I am trying to do in mental health. I agree that it has always been the Cinderella service, and there is what I would describe as an institutional bias against mental health in the NHS, which manifests itself in all sorts of ways. The spotlight is not on standards in mental health as it is in other areas of the health service. When the Government responded to the Francis report on Mid Staffordshire, we made it clear that addressing the concerns he raised about culture in the NHS was just as important in mental health as it was in any other part of the health service. If my hon. Friend reads the Government response to Francis, he will see that that is the case.

One of the ways in which we have responded to Francis is substantially to change how the Care Quality Commission goes about its work. My hon. Friend sought to make the case—by putting it in such a way, I do not suggest that he is wrong; I am not in a position to judge —that there is a massive gap between what he knows about a local service and what the regulators say about it. I know from my own part of the world, Norfolk, that when one raises acute concerns about, for example, the ambulance service, the response is often that everything is fine even though we know that it is not. We must try to ensure that inspectors and regulators reach a clear and accurate view of the quality of services.

The inspection regime that we are introducing, first in acute hospitals but soon in mental health trusts as well, is much more rigorous than anything that has gone before. One of the things that the previous Government did in 2008 was to remove specialist teams of inspectors, so that everyone in the CQC became a generalist. They might one week inspect a dental practice, a GP practice, an acute hospital and perhaps a mental health trust. That is no good; we must have people who know what they are looking for. It is also critical to involve clinicians and service users, who may well have an insight that others will never achieve. The CQC has appointed a deputy chief inspector who is in charge of the inspection regime for mental health, and I urge my hon. Friend to contact him directly to raise the concerns that he has expressed. At the end of the inspection process, mental health trusts will be rated so that the public has a much better view of the quality of a service in their local area.

Regulation on its own does not change culture; I absolutely get that. There must be carrot and stick. We must do things to change the culture within organisations as well as seeking to secure good standards through regulation. Regulation and inspection are a critical part of the overall picture, however, and we must have confidence in the inspection regime.

Everything that has emerged from the CQC’s work under the new leadership of David Behan and David Prior—a former colleague of my hon. Friend’s whom I happened to beat in North Norfolk to give him the opportunity to become the chair of the CQC—shows that they understand about compassionate care and high standards of care. We will shine a spotlight on mental health services and other parts of the health service in a way that has not happened before. I think that that will be of some value.

[Mr Amess]

Does the Minister understand how frustrating the whole thing is for me? The previous chief executive, Patrick Geoghegan, was in an unusual relationship, which I will not enlarge on, with someone who was first installed in a property in my constituency—there was a dispute about that—and later became a top-earning member of the board. With all this due diligence and inspection, how on earth was that allowed? What has happened is absolutely crazy, and I will need quite a bit of convincing, whoever the Minister introduces me to. It seems to be only when we air things publicly in Parliament that there is any interest—“Yes, Minister. Let’s get a brief ready.” I am not going to let the matter drop because my constituents deserve better than they are getting at the moment.

[Norman Lamb]

I hope that my hon. Friend recognises that I have sought to address his concerns directly, rather than reading from a pre-prepared speech. I share his concern about levels of pay in the upper echelons of the NHS, and I believe that that must be addressed.

On a more positive note, in the short time that I have available let me mention some of the positive things that we are doing. In January, we launched a document called “Closing the gap”, which directly addresses the fact that mental health services always fall behind physical health services. We have stated publicly, and we have put into legislation, that there should be parity of esteem and equality between mental and physical health services. The document identifies 25 areas in mental health services in which essential change is needed. One example is the widespread use of face-down restraint. Such restraint is not acceptable or necessary in a modern mental health service, and many areas have demonstrated how to create positive regimes without the use of such a barbaric approach.

Oral Answers to Questions

David Amess Excerpts

Tuesday 11th June 2013 Commons Chamber

[Mr Hunt]

I recognise that my hon. Friend has campaigned on that issue a great deal, and I have great sympathy, because areas with high age profiles do have much greater needs for the NHS. That obviously must be weighted against things like social deprivation, which also have an impact. It is right for these things to be decided independently, which they are. The question is how we get closest to those independent allocations, and I know that that is preoccupying NHS England at the moment.

[Mr David Amess (Southend West) (Con)]

2. What steps his Department is taking to ensure consistent and continuous provision of pre-natal and post-natal care.

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

The Government are committed to improving continuity of care during pregnancy and the post-natal period. To give women the personalised care that they deserve, we have increased the number of midwives by nearly 1,400 and the number of health visitors by more than 1,000 since May 2010. In addition, there are a record 5,000 midwives in training.

[Mr Amess]

Will my hon. Friend visit Southend university hospital, and tell residents at first hand what steps the Government are taking to ensure that post-natal care meets clinical guidance and the Government’s aspirations to ensure that the maternity experience is continuous, with patients having one dedicated midwife?

[Dr Poulter]

I would be delighted to visit my hon. Friend’s constituency. He has been a tremendous advocate for maternity services, both nationally and in his constituency, in his time in the House. As I am sure that he has realised, if we want a genuinely personalised maternity service, we need to ask women about their experiences of care. That is why the Government are introducing a friends and family test in maternity from October this year.

Oral Answers to Questions

David Amess Excerpts

Tuesday 15th January 2013 Commons Chamber

[Norman Lamb]

I take extremely seriously the point that the hon. Lady makes. It seems to make more sense to be part of a comprehensive, integrated sexual health strategy, which the Government are planning and which will be published very soon. Services tend to be delivered together in the same units, so it makes sense to have a single strategy to deal with all those issues.

[Mr David Amess (Southend West) (Con)]

T10. In the light of widespread representations from constituents about the proposals for the centralisation of pathology services, will my right hon. Friend the Secretary of State consider the clinical concerns very carefully before any such changes are sanctioned?

[Dr Poulter]

I thank my hon. Friend for that question and he is right to highlight the fact that any decisions about service reconfigurations must be clinically led, as was outlined in the Government’s tests for any service reconfiguration.

Oral Answers to Questions

David Amess Excerpts

Tuesday 27th November 2012 Commons Chamber

[Dr Poulter]

It is worth putting it on the record that it was the previous Labour Government who introduced foundation trusts in 2003 and set them free from direct accountability to Ministers. That includes the ability to set their own pay, terms and conditions. It was Labour that removed the power of the Secretary of State to direct foundation trusts, and it is Labour, not the Government, that needs to decide whether it supports the legislation that it put in place in government. We endorse national pay frameworks and will do all that we can to preserve them.

[Mr David Amess (Southend West) (Con)]

13. What recent representations he has received on strategies to support patients with osteoporosis.

[The Minister of State, Department of Health (Norman Lamb)]

The Department of Health has received no recent representations on strategies to support patients with osteoporosis. From April this year, osteoporosis was included in the quality and outcomes framework, giving GP practices financial incentives for diagnosing and treating osteoporosis in their patients.

[Mr Amess]

Does the Minister welcome the new Falls and Fractures Alliance that will hold its first board meeting next month? It has been set up specifically to reduce admissions to hospitals resulting from falls, fall-related injuries or hip fractures in the over 65s.

[Norman Lamb]

I very much welcome the establishment of the alliance, and I applaud the work of the National Osteoporosis Society, Age UK, and the all-party group of which I think the hon. Gentleman is a member. We know that if we follow the evidence, we can substantially reduce the number of falls and fractures, thereby increasing health and well-being and reducing the cost to the system.

Induced Abortion

David Amess Excerpts

Wednesday 31st October 2012 Westminster Hall

[Mr David Amess (Southend West) (Con)]

I congratulate my hon. Friend the Member for Mid Bedfordshire (Nadine Dorries) on securing the debate. My hon. Friend the Member for Stone (Mr Cash) has left the Chamber, but for a moment I felt like a thorn between two roses, because the three of us have 90 years’ service in the House, and we have been active on this issue since we became MPs. One reaches a point of having heard all the arguments, and having to agree to disagree with colleagues. Some debates have been pleasant, and some have been very unpleasant.

There is something different about this debate. I cannot recall a Secretary of State for Health commenting on this issue as the present one has. I happen to agree with him, and I congratulate him on speaking out. I also congratulate my right hon. Friends the Home Secretary and the Secretary of State for Culture, Media and Sport on what they said, and the Prime Minister. I am advised that 14 members of the Cabinet now take a similar view to mine, which has never before happened during my time. Things have changed considerably since 1990, so I welcome the opportunity that my hon. Friend the Member for Mid Bedfordshire has given us to discuss these matters.

I want to speak about counselling for women who seek a termination. About £60 million is spent on funding that operation, and there is an element of self-interest. In south-east Essex, 695 consultations produced 624 abortions, and 71 women—10.2% of the total—opted to continue with their pregnancy.

I am worried about the pre-signing of consent forms for abortion. The Daily Telegraph carried out an undercover operation, and in January the Care Quality Commission identified evidence during inspection of a private clinic of HSA1 forms being pre-signed by one doctor. What action are the Government taking on those two matters?

Many years ago I introduced a ten-minute rule Bill on sex selection. There was some merriment in the House at the time, but I stood my ground. It is disappointing that I have been proved right, because in February an undercover investigation by The Daily Telegraph revealed that in some places in the UK it was possible to obtain an abortion on gender grounds. I also understand the point being made by hon. Members that if we reduce the limit from 24 weeks to 20, we are talking about very small numbers. However, hon. Members could then say, “If the numbers are very small, what is the problem with reducing it to 20 weeks?”

I was once Edwina Currie’s Parliamentary Private Secretary. At that time, which was a long time ago, I was a little concerned about the influence of officials—in fact, I was shocked, as I had expected them to be rather even-handed on this matter. Of course, as it was so long ago, I am sure that they have all retired. However, I would like to know what action the Government have taken against doctors who were found to have broken the Abortion Act 1967 by pre-signing forms. What action has been taken in the 14 national health service trusts identified to ensure that the pre-signing of forms does not happen again?