National Health Service

Derek Twigg Excerpts

Wednesday 21st January 2015 Commons Chamber

[Andy Burnham]

What we can see is that this decline began when the Government made the monumental misjudgment of bringing forward a top-down reorganisation that should never have happened, that nobody voted for, and that took 1.5 million eyes off the ball in the NHS. The Government should have been looking at the front line and maintaining standards there, instead of which they looked backwards, and focused on the reorganisation and the jobs merry-go-round that then carried on. It is really disgraceful that they did that and plunged the NHS into the chaos that it is today.

[Derek Twigg (Halton) (Lab)]

Last Friday evening, I spent time at Whiston A and E talking to doctors and nurses, who do an unbelievable job. I heard about the problem of getting elderly people back into the community when they have undergone treatment. There were also issues around recruiting and retaining nurses and the tariff there, but there does not seem to be any answer coming from the Government.

[Andy Burnham]

My hon. Friend describes the problems well. I know the hospital because I have been there with him. He is right that older people are becoming trapped in hospital. The support is not there for them in their own homes, and nursing home places are not available. I will come back to that theme in a moment.

Oral Answers to Questions

Derek Twigg Excerpts

Tuesday 13th January 2015 Commons Chamber

[Norman Lamb]

I understand that about 22% of callers do get to speak to a clinician and, as I have already said, we are seeking to develop the service so that there are more referrals to an appropriate clinician. Let me again repeat the fact that the performances of A and E, ambulances and people waiting for hospital are considerably better in England than they are in Wales, and the Opposition need to recognise that.

[Derek Twigg (Halton) (Lab)]

12. What recent assessment he has made of the reasons for increased attendances at A and E departments in 2014.

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

A range of factors is contributing to increased attendances. The ageing population means that, by the end of this Parliament, there will be nearly 1 million more over-65s than at the start. The urgent and emergency care review cited pressure on GP appointments and availability or awareness of alternatives as factors that might affect A and E attendances.

[Derek Twigg]

NHS Providers, which represents 94% of NHS foundation trusts, says that national tariff proposals that have forced hospital trusts to find efficiencies of 3.8% are excessive and, taken with other cost pressures, undeliverable. It will take £1.2 billion out of budgets from front-line NHS services. Do the Secretary of State and his Ministers understand the implications of that proposal, and will they act to stop it given the pressures on the NHS, especially on A and E departments?

[Norman Lamb]

The Nicholson challenge, which was published in the last year of the Labour Government, recognised that the whole system had to deliver efficiency savings, and I think that everyone understands that. But the answer to all of this is a significant shift of emphasis towards preventing ill health and preventing crises from occurring. Under the better care fund the NHS and the care system are for the first time being properly joined together.

A and E (Major Incidents)

Derek Twigg Excerpts

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

I am aware of the problems at Addenbrooke’s. Indeed, the main issue, as my hon. Friend rightly says, is delayed discharges relating to care. The chief executive is running the command and control system and working with the local authority to facilitate the discharges that are necessary and to de-escalate the situation. The hospital has £2.2 million for its winter pressures support and 185 more doctors than four years ago.

[Derek Twigg (Halton) (Lab)]

The national health service in my constituency is under immense pressure, as are the adult services. It has been known for some months now that the number of acutely ill people coming into hospital has been growing. Has the Secretary of State investigated the reasons for that significant increase, which I am hearing about from the chief executives of the hospitals? If he has, what are those reasons? Is it to do with access to primary care, or problems with adult social services? Will he tell the House now?

[Mr Hunt]

We have looked into that matter in huge detail. There are probably three broad factors that are behind the increase in demand. One is the ageing population. There are 350,000 more people over the age of 75 than four years ago. The point is that if someone of that age goes into A and E in the winter, there is an 80% chance they will be admitted to hospital and quite a large chance they will stay in hospital for some time. The second factor is changing consumer expectation among younger people who want faster health care—[Interruption.] That is what Professor Keith Willett, the director of emergency care at NHS England, said, and Opposition Members should listen to what our clinical leaders are saying. The third factor is a refusal by NHS trusts to do what they were pressurised to do in the past, which is to cut corners to hit targets.

NHS (Five Year Forward View)

Derek Twigg Excerpts

Monday 1st December 2014 Commons Chamber

[Mr Hunt]

No one campaigns more for first aid than my hon. Friend. I would certainly encourage all schools to teach first aid, as I think it is a very important skill and we should consider that as part of the prevention agenda. There is also a broader point, which is that we can do a lot with the Department for Education on this agenda.

[Derek Twigg (Halton) (Lab)]

In my constituency, people are increasingly finding it difficult to access GPs and the local hospital, Warrington and Halton, is in deficit and is missing its A and E targets. I therefore have a simple question for the Secretary of State. How many additional GPs will this money find, over and above the number of GPs who are in post today?

[Mr Hunt]

It takes seven years to train a GP, so the long-term solution is to train an additional 5,000 GPs, which is what the Government have decided to do and have announced. While they come on stream, this additional money will fund up to 20,000 additional posts, a number of which will be in the community.

Oral Answers to Questions

Derek Twigg Excerpts

Tuesday 21st October 2014 Commons Chamber

[Derek Twigg (Halton) (Lab)]

We have a shortage of GPs in Halton. Constituents tell me it is more difficult to get an appointment, and in recent months, two GPs have told me that there are major problems with GP services in Halton and the country as a whole. Despite what the Secretary of State says about increased numbers of GPs, that is not happening in Halton. What is he doing to address the problem, particularly in areas of great deprivation, such as Halton?

[Mr Hunt]

There is pressure throughout the NHS because there are nearly 1 million more over-65s than there were four years ago, which puts pressure on GPs, as it does on any department or hospital providing elective care. However, this is not just about getting an appointment; it is also about ensuring that GPs have personal responsibility for the patients on their list and are accountable for the care of some of the most vulnerable people. We have brought back named GPs with personal responsibility for over-75s, and I hope the hon. Gentleman welcomes our going further and bringing it back for everyone.

Special Measures Regime

Derek Twigg Excerpts

Wednesday 16th July 2014 Commons Chamber

[Mr Hunt]

We absolutely do need to do that. Dementia care is an area where there needs to be lots more work and innovation. There is huge variation and even some very caring places could try new ideas. There are some very interesting ideas about dementia care in Holland, too. I absolutely welcome that work.

[Derek Twigg (Halton) (Lab)]

Does the Secretary of State think that standards could be improved further by having minimum levels of staffing in care homes, and does he think that more can and should be done to improve pay and rewards for care workers?

[Mr Hunt]

We have recommended levels of staffing, but in the NHS we have decided not to have minimum levels of staffing. We were worried that that would be seen as a hurdle where, once achieved, nothing more would need to be done about staffing levels. The real issue about staffing levels and mandating numbers from the centre is that care needs change on a daily basis depending on how complex the needs are of the patients in a particular ward or home. That is why it is difficult to do it from the centre. We want to make sure that everywhere has the right numbers of staff. That is why I hope the hon. Gentleman welcomes the fact that we have so many more nurses.

Patient Safety

Derek Twigg Excerpts

Tuesday 24th June 2014 Commons Chamber

[Mr Hunt]

I would be delighted to do that. Incredible hard work by doctors, nurses and health care assistants on the front line of my hon. Friend’s local hospital has meant that the trust has come out of special measures, which the whole House should celebrate. Indeed, it was helped in that by Salford Royal, and one of the most encouraging things about the new special measures regime is that we are pairing up hospitals in difficulty with other hospitals that have a better record, and we are getting tremendous results.

[Derek Twigg (Halton) (Lab)]

Clinical commissioning groups commission services in hospitals. What discussions has the Secretary of State had with CCGs to ensure that when they commission services they particularly look to ensure transparency and that patient safety is the highest priority in their discussions?

[Mr Hunt]

We have a lot of discussions, and the hon. Gentleman is right: the commissioning of care is vital and we need CCGs to play their part. We have many discussions with NHS England about how to do that, and we will be considering how we can make CCGs more publicly accountable for their record in those areas.

Oral Answers to Questions

Derek Twigg Excerpts

Tuesday 1st April 2014 Commons Chamber

[Mr Hunt]

I am happy to congratulate the trust on its excellent work. It is worth reflecting on how well the NHS did this winter. Despite constant attempts by the Opposition to talk up a crisis, we hit the target for A and E in more weeks than was the case when the right hon. Member for Leigh (Andy Burnham) was in office, and 2,000 additional people were seen within four hours every single day.

[Derek Twigg (Halton) (Lab)]

Part of the problem with people being admitted and readmitted to hospitals involves access to their GPs. What is the Secretary of State doing to ensure that elderly people across the board have access to their GP, so as to prevent their admission or readmission to hospital?

[Mr Hunt]

The hon. Gentleman is absolutely right. If we are going to deal with the pressures in A and E, we need to have a massive improvement in primary care access. There has been historical under-investment in primary care, going back over many years, and we need to change that. One of the ways in which we want to do that is to reintroduce GPs taking personal responsibility for the most vulnerable older people, and today’s changes will help us to move towards that.

Urgent and Emergency Care Review

Derek Twigg Excerpts

Tuesday 12th November 2013 Commons Chamber

[Mr Hunt]

I pay tribute to my hon. Friend for raising both publicly and privately his concerns about the hospital provision that his constituents face. We shall of course make sure that there is a proper review before any service changes are made. I hope that he will be reassured by the big change that happened this year with the introduction of an independent chief inspector of hospitals, who is going round the country rooting out poor care, not sweeping it under the carpet, as happened so often under the Labour Government.

[Derek Twigg (Halton) (Lab)]

Does the Secretary of State regret the loss of 6,000 nursing jobs since the last election?

[Mr Hunt]

The number of hospital nurses has gone up since the election, and as a result of the changes in the Francis report—the hon. Gentleman’s party refused to have a public inquiry many, many times—I hope that the NHS will recruit many more nurses.

Accident and Emergency Departments

Derek Twigg Excerpts

Tuesday 10th September 2013 Commons Chamber

[Mr Hunt]

A number of things have contributed to these changes, one of which is that we have not succeeded, as an NHS or as a Parliament, in getting the way in which we do reconfigurations right: they do not command the confidence of the public and people are not satisfied that there are alternatives that they can trust or that good alternatives will be put in place when a change is proposed. We need to learn the lessons from what happened in my hon. Friend’s constituency.

[Derek Twigg (Halton) (Lab)]

Since 2010 the new Whiston hospital has seen an increase of 25% in emergency demand, but it has not been funded for it. I met the chief executive and vice-chair of the governing board last Friday and asked them whether they would be able to guarantee a safe service if that level of activity continues with the winter pressures, and they said that they might not. Will the Secretary of State urgently look at the situation at Whiston and come up with some solutions?

[Mr Hunt]

I hope that when the hon. Gentleman looks at today’s announcement it will reassure him that we are addressing not just the immediate pressures in the most difficult areas, but the underlying pressures. That 25% increase at Whiston—I pay tribute to the staff in its A and E department, who will no doubt be working extremely hard to cope with it—has come about because we have not had better alternatives to A and E and because departments have often found it difficult to discharge people from hospital into the community, which has further increased the pressure on them. What we have announced in the past few months and today will make a real difference to alleviating those pressures.