Mid Staffordshire NHS Foundation Trust

Edward Leigh Excerpts

Tuesday 26th March 2013 Commons Chamber

[Mr Hunt]

We are piloting the scheme to ensure that we do not end up discriminating against nurses for financial reasons. We want to attract the best people into the profession, whatever their financial background.

[Mr Edward Leigh (Gainsborough) (Con)]

Every time there is a scandal, the response of the British political establishment is to load more controls, accountability and bureaucracy on professionals, yet every nurse and doctor I meet is fed up with what already happens. As a result of the reforms, will the Secretary of State assure us that we will now trust professionals to get on with the job they love?

[Mr Hunt]

I agree with those sentiments strongly. In parallel to this process and these changes, I have asked the NHS Confederation to recommend how we can reduce the bureaucratic burden on hospital front-line staff by a third, precisely because I want to avoid the issues that my hon. Friend mentions. This is about freeing up time for people at the front line, and one way is to have an inspection system in which everyone has confidence. Once there is the confidence that problems will be identified, it becomes much easier, as has happened in the education system, to give more freedom to people on the front line.

Liverpool Care Pathway

Edward Leigh Excerpts

Tuesday 8th January 2013 Westminster Hall

[Mr Edward Leigh (Gainsborough) (Con)]

I am glad to have this opportunity and I thank my hon. Friend the Member for Montgomeryshire (Glyn Davies) for raising this important subject. We all know that the Liverpool care pathway was devised with the best of intentions. I assure my hon. Friend the Member for Banbury (Sir Tony Baldry) that none of us wants to end or take away palliative care. We all want to relieve pain and we all want people to die with dignity, but there are serious concerns about the Liverpool care pathway and that is why this debate is so important. Those concerns have been expressed by physicians. It was physicians—ethicists—who started this debate, not the newspapers. The newspapers did not start the ball rolling and we should be aware of that. Professor Peter Millard, emeritus professor of geriatrics at the university of London, and Dr Peter Hargreaves, palliative care consultant at St Luke’s cancer centre in Guildford, have warned of the risk of “backdoor euthanasia”—their words—and that economic factors are being included when treatment is considered. We must be aware of these concerns, which were originally expressed by clinicians. However, I believe that it is one of the chief duties of those of us in this House who are not clinicians to speak up in defence of the vulnerable, the voiceless and those who are sometimes forgotten.

It is simply unacceptable that vulnerable people, including the poor, the elderly and those who do not have close friends and family to look after them, come to a premature death—an unnecessarily early death. As my hon. Friend the Member for Congleton (Fiona Bruce) and others have said, in numerous cases, even friends and family caring for a loved one have not been informed that they have been put on the LCP. May I say that my hon. Friend’s speech was a wonderful speech? It drew on her personal experience and was one of the most moving speeches that I have heard in this place over many years.

I sat with my best friend, Piers Merchant, as he was dying; he was a former MP and my hon. Friend the Member for Banbury (Sir Tony Baldry) will remember him well. I saw the morphine being pumped through his body. I am sure that he died early—perhaps a few hours or even a few days early, I do not know—from the morphine. Those of us who loved him wanted him to be cared for properly, but we also did not want him, or any of our loved ones, to be put on an irreversible path to death where that was avoidable.

I welcome the statement by the Department of Health that it

“has consistently made clear that care provision, including for people at the end of life, should be based on need.”

But the question that we need to ask in this debate is this: how are the Department’s intentions implemented on the front line of medicine and hospital care? No doubt there is wonderful care being given in many hospices, but is that gold standard being replicated in all our hospitals?

It is undoubtedly true that the LCP has led to the premature death—it may not be premature by much, but it is still a premature death—of as many as 130,000 hospital patients each year. This is a vital issue that we must address in this House; with 450,000 hospital deaths in Britain each year, that figure of 130,000 is about 29% of the total number of hospital deaths. In fact, this is a frightfully serious issue.

[Robert Flello]

Will the hon. Gentleman give way?

[Mr Leigh]

Does the hon. Gentleman mind if I do not give way? I just want to make my speech and give my hon. Friend the Member for Plymouth, Sutton and Devonport (Oliver Colvile) a chance to speak too.

Professor Pullicino, who was quoted earlier, has himself personally intervened to have a patient taken off the LCP who went on to be successfully treated. So, despite the fact that we must listen to clinicians, it is simply impossible to determine satisfactorily that a patient has hours or days left to live, which is one of the worrying flaws of the LCP.

In November, an independent inquiry into the LCP was announced, and I welcome that announcement. My hon. Friend the Minister is doing his job extremely well in this regard, and we respect him as somebody who will genuinely try to get to the truth. He himself has said that there have been too many cases of patients dying on the pathway while their families were not informed, so he is quite right to zero in on that issue. He has said, “This is simply unacceptable.” I echo those words and I hope that he will repeat them when he winds up the debate.

Of course there are people who speak on both sides of this issue, but I believe that any inquiry must be conducted by a suitable variety of individuals and not just by supporters of the LCP. It is not good enough to state, as the Department of Health sometimes does, that the LCP is not euthanasia. It might not be euthanasia and, of course, if it is implemented properly it is not euthanasia. However, it has become obvious to many people that the LCP can be employed, and indeed has been employed, in cases that are highly questionable.

I say to those who have spoken today that what worries me is this: why is it that the average time to death on the LCP is 33 hours? An identical figure for average time to death was found in two consecutive national audits that were conducted two years apart. In the view of many people, that shows that the LCP has a machine-like efficiency in producing death within 33 hours, and that is why some people say that the LCP is in effect a “lethal care pathway”. Statistics suggest that fewer than 5% of patients put on the LCP are taken off it. Why only 5%? There is something wrong here, and the inquiry needs to get to the bottom of it.

I believe that we should appoint a member of the judiciary rather than a medical expert, to carry out the inquiry. Of course, they will have medical advisers, but we should appoint a member of the judiciary rather than just a medical expert to lead the inquiry, so that they can look at this complicated issue with a fresh perspective and a judicial mind.

Thank you for calling me to speak, Mr Weir. In conclusion, I believe that we have a duty to instil confidence in each of the citizens and residents of this country that they live in a society that believes in their inviolable dignity as human beings, and that takes the necessary steps to ensure that they are cared for and looked after when they are ill, especially in the closing moments of their life.

Induced Abortion

Edward Leigh Excerpts

Wednesday 31st October 2012 Westminster Hall

[Mr Edward Leigh (Gainsborough) (Con)]

Thank you for calling me to speak, Mr Crausby. People often say that such debates are very emotional, but it is nice that our debate this morning has been calm. I hope I will be very calm too; my wife always says to me that I must be less emotional when I speak, so I shall give a boring little speech that tries to deal with some facts and surveys. I hope that there will not be a lot of controversy about what I say.

According to the most recent figures for this country, one in five pregnancies ends in abortion. Whatever one’s views about pro-life or right-to-choose issues, I am sure that most people would regret that. In 2011, there were almost 290,000 abortions; that is 572 abortions every day. As we all know, United Kingdom law allows abortion up to 24 weeks, or until full term if the baby is disabled with a “serious handicap” or the mother’s life is threatened. In 2011, only 0.02% of abortions carried out in England and Wales were because of a risk to the mother’s life. Meanwhile, abortions carried out on the grounds of foetal handicap constituted a mere 1.2% of the total number of abortions. Even so, abortions on those grounds are often undertaken even when the handicap in question is undoubtedly curable. Many will recall the noble work of the Church of England vicar, Joanna Jepson, who highlighted that abortions were being carried out on babies with cleft palates on the grounds of foetal handicap.

Since 1929, British law on abortion has, for better or worse, linked the legality of abortion with the viability of the child to survive outside the womb. The Human Fertilisation and Embryology Act 1990 reduced the upper time limit on abortions set by the 1967 Act from 28 weeks to 24. The arguments employed in the parliamentary debates of the time recognised that and highlighted the issue of viability. Since the passing of the 1990 Act, significant improvements have undoubtedly been made to neonatal care, increasing the ability of prematurely born children to survive. Figures from 2005 show that 52 babies born earlier than 24 weeks have survived. In the specialist neonatal unit at London’s University College hospital, five of the seven infants born at 22 weeks between 1996 and 2000 survived, as did nearly half those born at 23 weeks.

Our French and continental neighbours have been mentioned today, and in France, abortion on demand is legal up to only 12 weeks. As we have heard from the hon. Member for Feltham and Heston (Seema Malhotra), 91% of abortions take place before 12 weeks. I do not think that it is a massive attack on women’s right to choose if we therefore try and focus the debate on late abortions. We are talking about a relatively small number, but we are also discussing human life, and even one human life is important.

In France, abortions are only allowed after 12 weeks if two physicians certify that it is being done to prevent grave, permanent injury to the physical or mental health of the pregnant woman, or because there is a risk to the pregnant woman’s life, or if the child in question will suffer from a particularly severe illness recognised as incurable. That law was reinforced in 1994, when French law-makers required that multidisciplinary diagnostic centres decide which birth defects are severe enough to allow for abortion after the 12-week limit.

[Fiona Mactaggart (Slough) (Lab)]

Is the hon. Gentleman aware of a study of late abortions in Britain? A number of those abortions seem to be as a result of difficulties that women have had getting abortions earlier. If we had abortion on demand up to 12 weeks, as France does but we do not, perhaps the result would be a greater number of earlier abortions in this country.

[Mr Leigh]

We can certainly debate that point. I should have thought that the law is that we have abortion on demand, but if the hon. Lady believes that some women feel they are under pressure not to have abortions before 12 weeks, we can discuss that matter. I thought, however, that we were focusing on late abortions today, which I should have thought we regret all around the Chamber.

A lot of European countries that are viewed as much more liberal than we are have time limits on abortions that are many weeks less than in Great Britain. The UK’s 24-week upper limit is double that of most European countries. Sixteen of 27 EU countries have a gestational limit of 12 weeks or lower; thus attempts to stir a reduction of the upper time limit as controversial have very little ground to stand on when we compare our laws with those of our European neighbours, as we often do in many other areas. A 2005 survey revealed that more than three quarters of women in the United Kingdom are in favour of reducing the time limit on abortions. A 2007 survey, commissioned by Marie Stopes International, found that 65% of GPs would welcome a reduction.

The number of abortions performed in Britain is now four times higher than in 1969, the first full year that abortion was available under the 1967 Act. G.K. Chesterton wrote:

“Men do not differ much about what things they will call evils; they differ enormously about what evils they will call excusable”.

For those of us who are abortion opponents, like my hon. Friends, our views are known, and they can be dismissed. I hope, however, that even the most fervent supporters of legal abortion recognise that abortion is not desirable, even if they find it excusable. Anything that we can do to prevent late abortions is surely desirable for our country.

Regardless of the obvious moral debate, there is a compelling medical case for wanting to reduce the number of abortions. The Royal College of Psychiatrists has recognised that abortion can damage a woman’s mental health. Studies have discovered that women who have had abortions are almost twice as likely to suffer from mental health problems, three times as likely to have major depression, and six times as likely to commit suicide as mothers who do not have an abortion—

[Mr David Crausby (in the Chair)]

Order.

Cancer Treatments

Edward Leigh Excerpts

Tuesday 19th June 2012 Westminster Hall

[Mr Edward Leigh (in the Chair)]

Order. I know that the hon. Lady will wish to leave time for the Minister to reply. The debate must finish at 12.30 pm.

[Liz Kendall]

I am about to sit down, Mr Leigh. The Minister will know that the Opposition have put forward proposals for social care to be free at the end of life, to avoid the awful situation in which families have to fill out means-test forms and might struggle to get the care package that they need at that crucial time—the end of their loved one’s life. There is evidence that such a proposal would be cost-neutral, as it would reduce the number of more expensive bed days spent in hospital. Survival rates are absolutely critical, but we must not forget other issues, such as the quality of the patient experience and end-of-life care.

NHS Risk Register

Edward Leigh Excerpts

Wednesday 22nd February 2012 Commons Chamber

[Mr Lansley]

I do not know about the debate being bad-tempered, Mr Deputy Speaker, but we at least have jokers in the House.

The shadow Secretary of State is out on his own. I will be kind to him and say that at least opposition is coming naturally to him. Whatever we propose, he opposes it, even to the extent of directly contradicting what he and his colleagues said in government. His contribution today was another shameless example. We have seen this before. The last Opposition day debate on this subject was a travesty of his previous views about the role of the private sector, the need for the private finance initiative and the role of competition in the NHS that he espoused in government. He has done a U-turn on those matters and now holds the polar opposite views from those that he held before. That may be a luxury of opposition and he may enjoy it for the moment—actually, I am not sure that he did enjoy it that much—but that kind of inconsistency will keep him in opposition for a very long time.

The shadow Secretary of State spoke for about 50 minutes and I heard not a word of appreciation for the staff of the NHS. We are asking the staff of the NHS to live in financially challenging times, but it is not mission impossible. He said that saving money in the NHS was mission impossible. That is certainly how the Labour party treated it in government. Spending money was about the only thing that it seemed to be capable of doing, but it never spent it well. We are asking the staff of the NHS to save and to reinvest, and to improve performance at the same time.

Did I hear one scintilla of appreciation from the shadow Secretary of State for what NHS staff are doing, or for the fact that we have the lowest number of hospital-acquired infections on record and the lowest ever numbers of patients waiting more than six months and more than one year for treatment? I did not. I put it on record again that whether we compare May 2010 with December 2011, during which time the number of patients waiting more than a year for treatment more than halved, or December 2010 with December 2011, in which time it went down from more than 14,000 to nearly 9,000, the number has gone down. For the shadow Secretary of State to stand at the Dispatch Box and say that it has doubled, which is transparently wrong, is a misrepresentation to the House and a travesty to the staff of the service. He ought to come to the Dispatch Box and withdraw it.

[Mr Edward Leigh (Gainsborough) (Con)]

Of course the views of staff are desperately important, but this is our NHS, and what is really important is the outcome for patients. It is because of the catastrophic decline in productivity that I say to my right hon. Friend that we urge him to keep going, with no more watering down of the Bill. His parliamentary party is 120% behind him.

[Mr Lansley]

My hon. Friend is absolutely right, and when he was Chair of the Public Accounts Committee he constantly told the last Government that they should do something to ensure rising productivity in the NHS. He was not alone in that.

Care of the Dying

Edward Leigh Excerpts

Tuesday 17th January 2012 Westminster Hall

[Mr Edward Leigh (Gainsborough) (Con)]

There is no doubt in my mind that, if we allow assisted dying, it will eventually become encouraged exit. G. K. Chesterton wrote that, when orthodoxy becomes voluntary, it will be prohibited, and we could be on a dangerous, slippery slope. One of the witnesses to the Falconer inquiry said:

“I think we can only go for terminal illness at the moment, so this doesn’t actually apply to the people who are probably about to go into care homes. But, you know, baby steps.”

That is a chilling statement.

There is a lot I could say about this issue, but time is short. We all know that it is virtually impossible to predict how long someone has to live—we know that even from the famous case of the Lockerbie bomber. We also know how people suffer from depression in their last months of life. We know what has gone on in Oregon and in the Netherlands, where 8% of all deaths are the result of euthanasia. We also know about the experience in the Northern Territory, in Australia.

However, I just want to make one simple point, and I apologise, because I suppose it is a moral point. I visited St Andrew’s hospice with my hon. Friend the Member for Cleethorpes (Martin Vickers). To us, this is a moral issue; we believe that the body is simply the mirror of the soul, and however old, crippled or useless someone might seem to society—our society seems to be dominated by the worship of youth and beauty—they are of immense value to society and should be sustained by society to the very end of their lives.

Health and Social Care (Re-committed) Bill

Edward Leigh Excerpts

Wednesday 7th September 2011 Commons Chamber

[Nadine Dorries]

No, I will carry on for a bit longer.

I want to talk about the difference between consultation and counselling. I doubt very much whether the constituents of the hon. Member for Streatham had counselling; I think they probably had consultation. There is a big difference. Every woman who turns up at an abortion clinic has a consultation, but that is about the medical process—the side effects and what is going to happen. Every e-mail that we receive from women on this subject involves a consultation. This is how the law stands today; my hon. Friend the Member for Broxtowe (Anna Soubry) might want to listen to this, as most of the way through she has been nodding in agreement with the adverse comments.

When a woman turns up at an abortion clinic, the clinic does not offer counselling. It does offer consultation, but the woman has to ask for counselling; it is not offered. She has to ask—or the doctor in the clinic has to see that a woman is in a particular position, or be alarmed enough by her state to offer counselling. I want to make the point very clear: counselling is not offered, but has to be asked for. [Interruption.] Someone says from a sedentary position that it is, but if it is, the centre is operating outside the guidelines, because counselling is not offered.

[Mr Edward Leigh (Gainsborough) (Con)]

I am sure that many abortion providers do their level best to give advice, but that is not the point being made. Surely in any field of endeavour it is not appropriate for the provider of a service to give the so-called independent advice. That is the key point—and, frankly, the only point.

[Nadine Dorries]

As I have said to many people, I will come on to the financial situation and the reasons for it.

To recap, the amendment proposes that abortion clinics make an offer of counselling, which they do not make because under the guidelines they have no provision to make it—the woman has to ask for it.

Last week, The British Journal of Psychiatry reported that women who abort are twice as likely to suffer from mental health problems.

NHS Future Forum

Edward Leigh Excerpts

Tuesday 14th June 2011 Commons Chamber

[Mr Lansley]

I hope that my colleagues would support me in saying that I have support from colleagues right across the coalition, because the coalition Government are supporting the NHS in enabling it to deliver improving services. That is what it is all about.

[Mr Edward Leigh (Gainsborough) (Con)]

It is appropriate that I am last, because I come at this from a different direction from everybody else. Given that no extra cash is available—we know that—how will the watering down of Monitor’s duty to promote core competition help to deliver the efficiency gains that are the future of the NHS? How will the Secretary of State now achieve that?

[Mr Lansley]

I say three things to my hon. Friend. First, let us be clear that there is £11.5 billion of additional cash available to the NHS over the course of this Parliament—but we have to use it better and deliver greater quality and effectiveness. The job of the commissioners and Monitor together is to deliver that—partly through tariff development in ensuring that they get those efficiencies by the price that they set, based on benchmark-to-best practice prices, but also through using their commissioning strength to design services. We all know that if we simply said every year to the NHS, “You must save money by cutting the price of what is paid to you”, its response would be to cut services, cut staffing or cut quality. In fact, achieving greater quality and effectiveness is about the redesign of clinical services—the transfer of services into the community and keeping people well at home rather than through emergency admissions to hospital. It is about clinical leadership and clinical redesign, and that is what these proposals will bring to the forefront.

Future of the NHS

Edward Leigh Excerpts

Monday 9th May 2011 Commons Chamber

[Mr Lansley]

I give way to my hon. Friend the Member for Gainsborough (Mr Leigh), the former Chairman of the Public Accounts Committee.

[Mr Edward Leigh (Gainsborough) (Con)]

Sadly, despite massive increases in funding over 15 years, there has been an undoubted catastrophic decline in NHS productivity. Does my right hon. Friend accept that many of us on the Government Benches feel that if we are to save the NHS there is no alternative to more co-operation with the private sector, and that he should stick to his guns?

[Mr Lansley]

My right hon. Friend made that point when he chaired the Public Accounts Committee, and it should silence Labour Members, because the Public Accounts Committee has said exactly the same thing since the election under the chairmanship of the right hon. Member for Barking (Margaret Hodge)—that productivity in the NHS declined consistently under Labour.

Let me make clear that if we are going to make—[Interruption.]

NHS Reorganisation

Edward Leigh Excerpts

Wednesday 16th March 2011 Commons Chamber

[Mr Lansley]

The right hon. Gentleman was not satisfied with his first speech, so he had to have a go at a second one. He did not answer any of my questions. The Labour party said in its manifesto that it would use the private and voluntary sectors alongside NHS providers. The reason for that was simple: having the NHS as the preferred provider meant that the patient could be let down time after time before another quality provider could be permitted. We are going to allow competition on quality, but the quality has to be there. Patients will get the best possible service from whoever is best placed to provide that care.

Our changes are being seen across the country already.

[Mr Edward Leigh (Gainsborough) (Con)]

This party political ding-dong is great fun, but what worries me is that we have an ageing population, there are rightly more and more expensive techniques, and the taxpayer cannot put any more money in. Who is going to save the NHS if there is no co-operation with the private sector?