Infection Prevention and Control

George Howarth Excerpts

Tuesday 15th May 2018 Westminster Hall

[Jim Shannon]

The hon. Gentleman is absolutely right; we have got to get it right in our own hospitals and across the NHS and the whole United Kingdom of Great Britain and Northern Ireland, and then we can look further afield to other countries. He reminds me that last year I had occasion to be in hospital three times for various operations. I never had any infections. I had nothing but the best care. The surgeon’s knife went in the right direction and removed what had to removed. It was important to do that. The important thing is that we have hospitals and an NHS that are excellent. When the NHS works well, it is the best in the world, but sometimes we need to think about things.

The cost of infections to the NHS includes the immediate costs of treating patients in hospital, bed-blocking and so on. There are also issues with hospital capacity, which has reached 100% in some cases. The World Health Organisation estimates that 50% to 70% of hospital-acquired infections are transmitted by hands, so improving hand hygiene must play a central role in any strategy to reduce hospital infections. It would be remiss of me not to note the work carried out by the Secretary of State to improve patient safety in the NHS—let us give credit where credit is due. In November 2016, there was a commitment to halve gram-negative infections by 2020. The Secretary of State announced he would appoint a new national infection prevention lead, Dr Ruth May. Both are important steps in bringing down infection rates and show a commitment to do so.

Given that 50% to 70% of hospital infections are transmitted by hands, I was encouraged to see alongside those measures a commitment for the NHS to publish staff hand hygiene indicators for the first time. If hand hygiene is done—it should be, and perhaps there are indications of places where it has not been—then publishing hand hygiene indicators will allow benchmarking between hospitals and help drive up standards of hand hygiene. If we can have a system that can help drive hand hygiene, we should have it. Perhaps the Minister can respond to that point in his summing up.

The policy should not be implemented by weighing or counting cartridges used in hospital hand sanitiser dispensers. If it is done by the number of cartridges used, we might be under the impression that things are going the right way, but there has to be a wee bit more to it than that. Without factoring in patient bed numbers and staffing levels, the information is, I gently say, somewhat meaningless in showing hand hygiene compliance levels. The intention is right, but other factors need to be looked at.

The Secretary of State is a strong proponent of the use of reasonable technology in the NHS. Like me, he believes it has the power to radically change how we deliver care. Electronic monitoring technology can monitor hand hygiene to deliver real-time, accurate data to drive behavioural change. We want to see behavioural change where staff are not as active on hand hygiene as they should be.

Electronic monitoring is an innovative practice that is used internationally. Studies from a hospital in the US have shown that following the adoption of the technology, hand hygiene compliance improved by 30%. If we use that methodology, hopefully we can replicate what has happened in the US and reduce infections. That 30% increase corresponded with a 29% decrease in the number of MRSA infections, saving that one hospital more than $400,000. Here in the UK, electronic monitoring is being piloted at a number of hospital trusts in what the Care Quality Commission describes as “outstanding” and “innovative” practice. It goes back to what my hon. Friend the Member for Upper Bann (David Simpson) said in his intervention: where we see good things happening, we should be doing those things across the whole United Kingdom. My hon. Friend the Member for East Londonderry (Mr Campbell) also referred to that.

If the results from the US are replicated here in the UK—they can be—the national adoption of electronic monitoring technology could see 30,000 fewer infections, saving the NHS more than £93 million. More importantly, it would mean less infection, fewer people staying in hospital and fewer deaths. Dr Ruth May, the national infection prevention lead, said that,

“the collection, publication and intelligent use of data…will ensure organisations improve infection control and help…poor performers get the support they need”.

Those are very wise words. While I welcome the announcement of the hand hygiene indicator policy, it appears that progress on its implementation has stalled. I suppose that is the point I am coming to and the reason for this debate. The Department of Health and Social Care has missed its own deadline to publish the data by the end of 2017. Data is so important in drawing up a strategy, policy and vision of how we can address the issue.

We have been collecting mandatory data on the number of healthcare-associated infections, such as MRSA and Clostridium difficile, since 2004. When hand hygiene is so critical to reducing the number of healthcare-associated infections, it is difficult to see why it has taken more than 14 years to publish data on staff hand hygiene—data that we are yet to see. I find that incredible. I spoke to the Minister last night, so he knew I would raise this issue. The key issue for me is how we use the data we have to make a policy and a strategy from which we can all benefit. To mark World Hand Hygiene Day, the World Health Organisation is calling on Health Ministries worldwide to make hand hygiene a marker of care quality. If we do that right, we will be going in the right direction.

Will the Minister consider making hand hygiene a national marker of care quality? Will he, on behalf of the Secretary of State, outline who is responsible for the implementation of the policy? Will he set out a clear timeline for the collection and publication of this data, which is critical to driving up hand hygiene standards in hospitals? Someone walking through the door of any hospital will always first notice the smell. They will probably notice the warmth of the hospital, because it is there to care for patients and those who are ill. They will also see nurses running about with their gloves on. Hand hygiene is important for them, but we need to drive it a wee bit harder from the ministerial point of view and the local hospital point of view, to ensure that it happens.

Publishing data on hand hygiene compliance is a simple first step in improving hand hygiene, which is essential to raising standards of infection prevention and control in the NHS. It will save lives and money, and we cannot afford further delay. The UK and the NHS have been at the forefront of worldwide infection prevention and control strategies since the early 2000s. While a good deal of progress has been made since then—we welcome that progress, some of which has been significant—there is much work to be done to realise the Secretary of State’s ambition: that the NHS will be the safest health service in the world. We should strive to be the best. In many cases, we are the best, but we can certainly do better. The role of good hand hygiene in reducing hospital-acquired infections and improving patient safety cannot be overstated. We must also acknowledge that the current method of direct observation in monitoring hand hygiene in hospitals is no longer fit for purpose, and that technology can and should play a role in changing behaviours.

I look to the Minister for his response. I thank all Members for taking the time to come to Westminster Hall on a Tuesday morning to make a contribution. We look forward to those contributions.

[Mr George Howarth (in the Chair)]

I do not propose setting a time limit on speeches. It might be helpful by way of guidance to suggest that if everyone speaks for no more than 10 minutes, it should be possible to accommodate everyone who has indicated that they want to speak.

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[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Howarth. I congratulate the hon. Member for Strangford (Jim Shannon) on securing this extremely important debate and on his insightful contribution. He has a reputation for being one of the most prolific Members of this House, both here and in the main Chamber. He has pursued this issue assiduously during his time here, and his comments made clear his commitment to improving patient safety. His contribution was wide-ranging and fecund, and he highlighted the good timing of the debate, given that 5 May is World Hand Hygiene Day. There is a particular focus this year on sepsis, to which a number of hon. Members referred. We should reflect seriously on the staggering figures they mentioned: there are 30 million infections worldwide a year and 44,000 deaths in this country, and we could save between 5 million and 8 million lives a year through greater awareness and control. We all want to tackle sepsis very seriously.

The hon. Gentleman was right to say that there will not be any political disagreement today, as we all want the very best outcomes in this area. He was right that good progress has been made, particularly over a longer period, but it could be argued that we have plateaued. The infection rate remains too high. I am sure that we all agree that the figure of 6.4% across the NHS is far too high. He talked about the human and financial cost—he mentioned the figure of £1 billion. He made the fair point that this has downstream effects, as beds are occupied unnecessarily. It is always regrettable if any patient is in a bed because of something avoidable, particularly given that the number of beds across the NHS is at an historic low.

I was pleased to hear from the hon. Member for Morley and Outwood (Andrea Jenkyns). She has spoken on a number of occasions about this important subject, and she spoke again about the personal tragedy of her father’s death. She has been a consistent and vigorous campaigner on the issue since she came to this place. This is the first time I have heard in such detail the appalling circumstances surrounding her father’s death and the basic hygiene breaches that took place. I doubt that any member of the public, let alone any trained medical professional, would consider what happened there to be acceptable. That highlights the difficulties we sometimes face in tackling these issues.

The hon. Member for Amber Valley (Nigel Mills) made a considered and thoughtful speech about a wide range of issues. He referred to the World Health Organisation’s figures, which suggest that about half of the associated deaths in this country are preventable. He was right to say that in no other area would we be prepared not to tackle such a figure with great vigour. I agree with him that staff are not deliberately flouting hygiene standards, but the pressure of work sometimes means that standards slip. From the vacancy rates referred to by the Scottish National party spokesperson, the hon. Member for Central Ayrshire (Dr Whitford), and from regular staff surveys, we know how much pressure staff are under in the NHS. The hon. Member for Strangford highlighted accurately the difficulties with the existing audit processes and how they are not necessarily the best. He summarised perfectly the false comfort that we derive from the belief in 100% compliance rates. We know from what we have heard today that when audits are not taking place, compliance is considerably less than 100%.

The hon. Member for Moray (Douglas Ross) had clearly done a lot of important and excellent research to come up with all those statistics across a whole range of environments. He showed that there is no uniform picture in tackling infection control and suggested that the condition of the buildings might sometimes be an impediment to best practice. He rightly said that that is an area where many things can be learned from across the border, or indeed across the world—best practice should be disseminated.

The hon. Member for North East Derbyshire (Lee Rowley) talked about the need to reduce hospital admissions as one way of reducing infection rates. He mentioned anaemia in particular: apparently 4 million people have an iron deficiency and anaemia is the fourth most common cause of admission. He also mentioned sepsis and the possible gap in understanding or focus in the NHS, although we have heard today that a lot of awareness-raising is going on in that area.

It has been almost two and a half years since we last discussed this issue—January 2016—so today’s debate provides us with a useful opportunity to take stock of progress. We heard about a number of recent positive initiatives but, as the hon. Member for Strangford said, levels of healthcare-acquired infections remain stubbornly high, and in some cases they are increasing. Reductions in the rates of MRSA and C. diff are welcome, but the increase in MSSA and E. coli over the past five years is worrying. Furthermore, about one in every 16 patients will still acquire an infection while being cared for by the NHS in England, and every one of those infections requires additional NHS resources and, more importantly, leads to great patient discomfort and reduces patient safety.

According to the most recent figures from Public Health England, the fatality rate is 28.1% for MRSA cases, 19.7% for MSSA, 14.7% for E. coli and 15.1% for C. diff. We cannot overstate the seriousness of acquiring one of those infections. Furthermore, the Department of Health and Social Care reported recently that, sadly, E.coli infections led to the death of more than 5,500 patients in 2015, at an estimated cost to the NHS of £2.3 billion. The impact on patients and their families is devastating, while the growing threat of antimicrobial resistance adds to the significance of the issue.

In the US and Europe alone, antimicrobial-resistant infections are estimated to cause more than 50,000 deaths a year, and that figure is projected to increase significantly, as we have heard. A report by the World Health Organisation states that resistance is frequent among bacteria isolated in healthcare facilities, with antibiotic-resistant bacteria causing over half of all surgical site infections. We cannot overstate the importance of tackling the issue.

Healthcare of course carries inherent risks, and even if we were to take every possible preventative step, it would still be possible to acquire an infection. However, as I mentioned last time we discussed the matter, it has been estimated that about 30% of infections could be avoided by better application of existing knowledge and good practice. Much of that improvement could be realised through improved hand hygiene practices. Although we have known that for decades, the method of monitoring hand hygiene in hospitals remains outdated, inaccurate and, as we heard from the hon. Member for Morley and Outwood, flawed.

The monitoring method relies on direct observation by nurses, which leads to compliance rates being overstated and takes up hours of nursing time when staff on the wards are already overstretched. Staff naturally wash their hands much more frequently when being observed directly, which results in clearly overstated compliance rates of 90% to 100%. Academic research has found that typical compliance is actually between 18% and 40%. The international best practice to which the hon. Member for Strangford referred demonstrates that electronic monitoring of hand hygiene can decrease the risk of infection by 22%, which would not only save the NHS money, but save lives. We therefore welcomed the November 2016 commitment by the Secretary of State that staff hand hygiene indicators would be published for the first time by the end of 2017. However, as we heard, that deadline has elapsed and we seem to be no nearer to seeing implementation. Will the Minister tell us when we can expect to see the detail of that long-overdue improvement?

On 19 March, in a written response, the Minister mentioned that Public Health England had carried out some initial analysis with the available data, but that the data was incomplete, so it does not truly reflect hand gel usage. I accept that it might not provide an accurate representation of the NHS as a whole, but will the Minister set out what the analysis that he has received has found, and whether any of that information might be useful in the interim until the full dataset is available? Two ongoing pilots into the use of electronic monitoring technology within the NHS have also been mentioned. Has he made any assessment of those pilots? What plans do the Government have to look at universalising good practice, if it is shown to be as effective as early reports suggest?

As with any type of infection, healthcare-acquired infections can trigger sepsis, particularly in people who are already at risk—for example, those with chronic illnesses such as diabetes, or those who are immuno- compromised, such as those receiving chemotherapy. The majority of cases do not derive from a hospital setting, but with 150,000 cases a year and 44,000 deaths, many of them preventable, sepsis is a critical safety issue for the NHS. The challenge is to recognise it in its early stages, before multiple organ failure sets in, and to implement rapid treatment. If it is left untreated for hours, the chances of death increase rapidly. Sepsis in its early stages is often dismissed as something less serious, so I ask the Minister to advise us on what processes are in place to monitor patients at risk from sepsis. What steps will he take to ensure that treatment is started without delay?

In conclusion, around the world and in this country we spend vast sums of money on researching innovations to tackle illnesses and improve our welfare, but tackling hospital-acquired infections better would potentially put us in a position to prevent thousands of unnecessary deaths each year through the most basic of steps and the dissemination of best practice.

[Mr George Howarth (in the Chair)]

Before I call the Minister to respond to the debate, I remind him gently that it is customary to leave a short period at the end of the debate for the mover of the motion to wind up.

Privatisation of NHS Services

George Howarth Excerpts

Monday 23rd April 2018 Westminster Hall

[Mike Hill]

I am glad that my hon. Friend mentioned such issues, and dementia in particular—mental health care needs to be looked at for investment.

[Mr George Howarth (Knowsley) (Lab)]

Will my hon. Friend give way? I know he has just said, “One more time”, but perhaps he will make it two.

[Mike Hill]

I am on my last two paragraphs, but I will give way to my right hon. Friend.

[Mr Howarth]

I am grateful to my hon. Friend. He has made a powerful case for how it is wrong in principle to privatise the national health service, and he has alluded to comparisons with the social care sector. Is not one of the major risks the fact that private sector provision sometimes fails—the business fails—so there is a complete and, in the short term, irreplaceable loss of capacity in the healthcare categories catered for by such a company?

[Mike Hill]

I cannot disagree with such a well made point.

The impact of austerity has been a double-edged sword, according to the union Unison. On one hand, less money can be made from the NHS, so some firms have shrunk away. On the other hand, the NHS has opted increasingly for short-term fixes as it struggles with insufficient funding, and that has created opportunities for the private sector. For example, the Carter review includes the threat that hospitals that cannot make sufficient savings in their support services or pathology functions might have to use outsourcing instead. Most recently, the development of wholly owned subsidiary companies has brought a whole new set of fears for the NHS, and for health staff in particular.

The old fears from the 1980s and 1990s are beginning to resurface. When we add social care into the mix, those fears multiply. The NHS is one of our proudest achievements, and we need to protect it, not privatise it. To do so, we need to revoke section 75 of the Health and Social Care Act.

Autism

George Howarth Excerpts

Thursday 29th March 2018 Commons Chamber

[Dame Cheryl Gillan]

That is a common theme for parents who face this continuous battle. That is why we need to provide assistance. Every Member must know which routes they can take to provide as much assistance as possible.

[Mr George Howarth (Knowsley) (Lab)]

Will the right hon. Lady give way?

[Dame Cheryl Gillan]

This will probably be the last intervention, I am afraid.

[Mr Howarth]

I am grateful. I hesitate to intervene on the right hon. Lady because she is making a powerful point, but before she moves on to employment, will she agree that any new system has to take account of the frustration that parents feel as they attempt to get appropriate support for their children? In some cases, that frustration is overpowering.

[Dame Cheryl Gillan]

I agree entirely. The right hon. Gentleman shows that there is great understanding of the issue on both sides of the House.

Some 60% of employers worry about getting support for an autistic employee wrong, and 60% of do not know who to ask for advice or support about employing an autistic person. Given the huge success of the Government’s Access to Work programme, it is a real shame that there is not better awareness of it among employers. I want to hear about that from Front Benchers. The NAS recommends that we ensure that Jobcentre Plus staff, work coaches and disability employment advisers all receive training in how to deal with autistic people.

 Orkambi and Cystic Fibrosis

George Howarth Excerpts

Monday 19th March 2018 Westminster Hall

[Bim Afolami (Hitchin and Harpenden) (Con)]

It is a pleasure to serve under your chairmanship, Mr Evans. It is also a pleasure to be in this debate. I commend my hon. Friend the Member for Sutton and Cheam (Paul Scully). As has been said, the number of Members of Parliament here for a Westminster Hall debate is extraordinary, and shows how much Members and constituents care about this.

I will be brief because it is important that Members have a chance to make their contributions. Cystic fibrosis is the most common inherited genetic disease in the UK. We have already heard that Orkambi has been praised as being important and effective by NICE.

I am thinking about two of my constituents: Matthew Dixon-Dyer, who suffers from the disease himself, and Karen Murphy, whose son suffers from the disease. They urged me to speak in this debate. They did not just want me to urge the Minister to take charge of the negotiations with Vertex, or at least to press NHS England much harder to come to a resolution with Vertex. Nor was it to do with just cystic fibrosis or this drug. It is important that the cost-benefit analysis that NICE uses reflects chronic conditions, which drugs such as Orkambi deal with, more broadly, rather than just dealing with acute conditions, which it was typically designed for.

Like my hon. Friend the Member for Hornchurch and Upminster (Julia Lopez), I ask the Government to build the greater cost to the NHS later into the cost-benefit analysis. As we have heard from many Members, individuals may have to be in hospital for weeks on end as a result of the reduction in lung capacity. Karen Murphy’s son was in hospital for 16 weeks. I do not know what the costs of that were.

[Mr George Howarth (Knowsley) (Lab)]

The hon. Gentleman is making a very powerful point. Does he agree that, while we need processes to evaluate new drugs, sometimes the system does not work, which is why we have Ministers and such debates?

[Bim Afolami]

Yes, sometimes systems do not work and, as I said, I believe that in this case the Minister should get involved, but we also need to look at the processes. Members of Parliament cannot come to the House and demand action for every single drug. We need to build in better processes for NICE so that when there is a drug such as Orkambi, which deals with a chronic condition and can make a significant difference to people’s lives, the Government, Members of Parliament, this country and our society can act in the right way.

Diabetes

George Howarth Excerpts

Monday 26th February 2018 Commons Chamber

[Liz McInnes]

The hon. Gentleman makes an important point. I will talk about the technologies that are available for the treatment of diabetes and about education and information, so I hope I will answer his question later in my speech.

The hon. Gentleman emphasises the point that I was going to make, which is that it is really important that we listen to the voices of those living with diabetes. The charity Diabetes UK recently published a report entitled “The Future of Diabetes”, based on a consultation with more than 9,000 affected people. Those people said that, as well as a need for a better understanding and awareness of diabetes, there are a number of ways in which diabetes care can be improved.

In 2016 the Care Quality Commission produced a report entitled “My diabetes, my care”, based on a survey of a smaller number of people, but it came to very much the same conclusions. People living with diabetes want more support for their emotional and psychological health. The effect of varying blood sugar levels on mood and the relentless need to manage the condition can affect mental health.

[Mr George Howarth (Knowsley) (Lab)]

I am grateful to my hon. Friend for giving way; she has been very generous. Is she aware that some young type 1 diabetics manipulate their insulin to get rapid weight loss, and that they struggle to get treatment because on the one hand, they need psychological support, and on the other, they need advice from diabetologists? Does she agree that, if we started to bring all those different support services under one roof, it would make the route to dealing with young people who have that problem much easier?

[Liz McInnes]

My right hon. Friend makes a very important point. In the APPG on diabetes, we have discussed the issue of young diabetics self-medicating with insulin to keep their weight down. That emphasises the point I was going to make, which is that all healthcare professionals should receive training so that they can routinely support emotional and mental health and, importantly, know when to refer to specialist support.

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[Steve Brine]

That would be very interesting—if the hon. Lady did that, I would be grateful. We are working hard to improve diabetes services. The Government are strongly committed to taking action to prevent diabetes and to treat it more effectively. The Government’s mandate to NHS England for 2017-18 includes an objective for NHS England to

“lead a step change in the NHS in preventing ill health and supporting people to live healthier lives.”

[Mr Howarth]

The Minister will be aware that an algorithm exists whereby it is possible to create an artificial pancreas, and that the Juvenile Diabetes Research Foundation is heavily involved in research at the University of Cambridge to bring that concept to a workable proposition. Will he give a commitment that the Government will fully support that work so that we can end up with something that will help type 1 diabetics to monitor their condition?

[Steve Brine]

I will not give a commitment at the Dispatch Box, but I know the JDRF well. I have supported it in my constituency through various events, including the Alresford music festival, which I am sure the right hon. Gentleman is familiar with. I will take a look at what he said and if he wants to chat to me offline about that, I would be very happy to do so.

The diabetes prevention programme has been mentioned. Wherever possible, the aim is to prevent type 2 diabetes from developing in those most at risk. I am proud to say that NHS England, Public Health England, for which I am responsible, and Diabetes UK have had some success working on the NHS diabetes prevention programme—the first such programme that we have delivered at scale nationwide. I know that a lot of other countries are looking at what we are doing.

The programme is putting in place support for behavioural change in people who have been identified by their GP, or through the NHS health check, as being at high risk of developing diabetes. Individuals can then get tailored, personalised help to reduce their risk of developing the condition, including bespoke exercise programmes and education on healthy eating and lifestyle. It is incredibly positive.

I am aware of the time, so I will move on to treatment and care programmes. After successfully securing significant new investment in diabetes through the spending review, NHS England has developed a diabetes treatment and care programme, which is aimed at reducing variation and improving outcomes for people living with diabetes. As part of that, NHS England will invest £42 million in proposals from individual CCGs, collaborations and sustainability and transformation partnerships to improve the treatment and care of people with diabetes.

Woodlands Hospice, Aintree

George Howarth Excerpts

Wednesday 7th February 2018 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)]

I thank the hon. Member for Liverpool, Walton (Dan Carden) for the way in which he has approached this debate. I commend him on making an excellent speech, as he could not have been better at articulating the positive contribution that hospices make. I do not think there was anything in his speech with which I disagreed, which is quite unusual.

I was struck by the hon. Gentleman’s description of hospices as places where people go to live. When I visit hospices, I am struck by the very real efforts that their staff go to to make them comforting places. It can be a more difficult time for the loved ones than it is for the person who is ending their life, but they really are comforting places, and the hon. Gentleman is right to pay tribute to all the staff who work in them.

The hon. Gentleman powerfully praised the efforts of his own hospice, Woodlands, which is clearly providing an excellent service. I am grateful that he has given me the opportunity to address some of the concerns and make it clear how much we value the contribution that hospices make to the NHS.

It is testament to the excellence of our hospice sector that last October’s “State of Care” report by the Care Quality Commission showed that 70% of hospices are rated as good and 25% as outstanding. Those figures are higher than for any other secondary care service, which illustrates the significance of hospices’ contribution. Woodlands Hospice received a good rating in the CQC report. Like the hon. Gentleman, I congratulate its hard-working staff and volunteers on ensuring that patients get the personalised care and support that they need.

NHS England has advised that Liverpool clinical commissioning group, which is the main commissioner for the hospice—I hear what the hon. Gentleman says about there being more than one CCG, which probably adds to the strain on the hospice with regard to long-term funding—provides £900,000 of funding a year. Sefton also provides £240,000 per year, which brings the total amount provided to the hospice to over £1 million a year. As the hon. Gentleman outlined, the CCGs of Liverpool, South Sefton and Knowsley are in the process of reviewing their end-of-life care provision. They are taking into account population need, service demand, and all providers of that care, including Woodlands Hospice.

I am sure that the hon. Gentleman welcomes, as I do, the attention that local healthcare planners are giving to this important area of care. I suggest that the commissioners should pay close attention to what the hon. Gentleman and his colleagues have said tonight, speaking on behalf of their communities, about the value they place on this service. I hope that the commissioners will also take note of my comments when I say that the hospice sector, and this particular hospice, are making a very real contribution to people at the end of their life.

I know that many Members have hospices in their constituencies that they support and champion, so I thought that it might be helpful if I set out the broader position on hospice funding. As the hon. Gentleman outlined, the sector is characterised by strong voluntary contributions and philanthropic activity, which is to be celebrated.

We have 223 registered independent hospices and small number of public hospices that are run internally by NHS trusts. Around three quarters of hospices provide adult services, with the remainder caring for children and young people. The hospice movement was established from charitable and philanthropic donations, so the vast majority of hospices rely heavily on charitable income for the lion’s share of their budgets, but they do receive some statutory funding from CCGs and the Government for providing local services. As the hon. Gentleman suggested, the statutory funding varies from place to place for a wide number of reasons—he highlighted deprivation as one of them—but adult hospices receive an average of 30% of their overall funding from the NHS.

Funding remains a local decision, which I think is right, and the hon. Gentleman will be aware that we take deprivation into account when making our allocations to CCGs. He referred to long-term funding stability and the importance of knowing how much the Government will provide, and I will reflect on that important point. It would be good practice to give as much certainty as possible, which is a principle of our health funding more generally, so that will bear examination.

[Mr George Howarth (Knowsley) (Lab)]

I am grateful that the Minister has committed to reflect on the thoughts of my hon. Friend the Member for Liverpool, Walton (Dan Carden) about a national framework, but the difficulty in having locally determined support from CCGs is that that will inevitably vary from place to place. Some CCGs are under much more financial pressure than others, which is why it is important that we have some kind of national framework.

[Jackie Doyle-Price]

I would not want to depart from the principle that this is for local decision makers, but that is not to say we do not make clear our expectations about what CCGs should be delivering as we develop our national policies on end of life, and support for hospices forms part of that. Given the number of people who pass away in hospices and the care that they receive, we would encourage CCGs to carefully consider the extent to which they support hospices.

In addition to NHS funding for locally commissioned services, children’s hospices receive £11 million through the children’s hospice grant, which is awarded annually and administered by the NHS. Children’s hospices tend to receive smaller amounts of statutory funding because of how they have developed and the services that they provide. Unlike adult hospices, which tend to be more focused on end-of-life care services, children’s hospices can provide support for much of a child’s life, and that can involve not only more clinical care, but much more support for families.

It is worth highlighting the point made by the hon. Member for Liverpool, Walton that philanthropic support does not just mean money. I pay tribute to all those involved in volunteering in hospices. That is a fantastic example of how communities come together to bring out the best in people, so I thank everyone involved in that work.

Members may be reassured to hear that, to improve commissioning arrangements, NHS England is making a new palliative care pricing system available in April. That should help local areas to plan services, and it will also encourage more consistency and, perhaps, transparency in how much CCGs are supporting the sector.

While hospices are, of course, an important feature of end-of-life care provision in this country, it is important to see them within the wider context of our ambitions for such care. As the hon. Gentleman mentioned, the Government have published the end-of-life care choice commitment, which is designed to transform end-of-life care, and the hospice sector is an important partner in that process. We are determined to significantly improve patient choice by enabling more people to die in the place of their choice, be that at home, in a hospice, in a care home or in hospital. Our commitment is to set out the further action that we will take to deliver high-quality, personalised end-of-life care for everyone, including by delivering advance care planning and ensuring that we have the necessary conversations earlier. I draw Members’ attention to the reference to hospice care at home, which is a significant aspect of the programme. We need to make sure that more people are aware of what their options are, and we need to encourage innovation in end-of-life care. In collaboration with partners from the voluntary sector, including key hospice and end-of-life charities, the Government and NHS England have been working to make sure that the quality and availability of end-of-life care services continue to improve and that our end-of-life care commitment is delivered.

As I have already mentioned, the Government believe it is right that CCGs have the autonomy to shape local services according to local need, but it is important that we do more to provide commissioners with the tools, evidence, support and guidance to demonstrate the benefits of delivering our vision for end-of-life care. A crucial part of that is strengthening the provision of end-of-life care services outside hospital and in the community so that people can make the choice of where they wish to end their life.

To deliver this, we are working with sustainability and transformation partnerships so that there is tailored information to assess where we need further investment, commissioning and intervention. NHS England is also a member of the national palliative and end-of-life care partnership, which is made up of charities and organisations from across the health and care system that have together developed a framework for improving end-of-life care at a local level. More guidance will be published through that body soon.

NHS England has also commissioned Hospice UK to undertake an evaluation of the cost-effectiveness of hospice-led interventions in the community. I fully anticipate that could be a good news in support of the hon. Gentleman’s arguments. Although many such care models exist across England, there is poor data on what are the most effective approaches, which makes it rather more difficult for CCGs to confidently commission such services. The project will examine hospice-led initiatives that appear to be having a positive impact on where people are cared for, as well as on where they die. The Department and NHS England will pay close attention to the findings when they are made available, which should be next month.

We fully acknowledge that more needs to be done if we are to meet our ambition to reduce variations in end-of-life care and to ensure that the system works effectively to support more people to die in the place of their choice. However, I am confident that through NHS England’s programme board for end-of-life care, with all key system partners and stakeholders, including the hospice sector, we have the best opportunity to continue delivering the progress in end-of-life care that we all want, however and wherever it is provided. I cannot emphasise enough that hospices are central to our commitment. Local commissioners will wish to reflect on all the comments that were made in this evening’s debate when they come to make their allocations, and I wish Woodlands Hospice every success in the future.

Question put and agreed to.

Hormone Pregnancy Tests

George Howarth Excerpts

Thursday 14th December 2017 Commons Chamber

[Sir Mike Penning]

I completely agree with my hon. Friend. One thing that has surprised me is that although, on average, every single MP will have a victim of Primodos in their constituency, many of the victims think that what happened was their fault and that they are on their own. In the fantastic documentary on Sky, people came forward to say, “I have been affected by this, but I thought that I was on my own. I thought that I was the only one.”

[Mr George Howarth (Knowsley) (Lab)]

rose—

[Sir Mike Penning]

Another point was that the inquiry should be conducted fairly and independently. Members should consider that for a few seconds and take a look at who was on the committee while I take an intervention from the right hon. Gentleman.

[Mr Howarth]

The right hon. Gentleman is making a very powerful case. Given that the inquiry/review has now been very much discredited—it has certainly been rejected by all of those who have suffered—does he agree, as I am sure he will, that the way forward is set out in his motion, which calls for a

“Statutory Inquiry under the Inquiries Act 2005 to review the evidence on a possible association with hormone pregnancy tests on pregnancies and to consider the regulatory failures of the Committee on Safety of Medicines.”?

[Sir Mike Penning]

I praise the Clerks who helped me to draft the motion. I was very angry when we started drafting it, after reading the report, but they helped me get it into some kind of parliamentary language.

An inquiry has to be independent and judge-led, and it has be able to subpoena people to give evidence before it on oath, so that we can get to the absolute truth. It also has to look at the regulatory system that was in place at the time. I am afraid that the Department of Health cannot hide behind this report. To me, that is vital.

Let us look again at the point about the inquiry being fair and independent. One of the ways we thought it could be independent and fair was to have an expert witness who was not part of the campaign, but whom everybody massively respected. For those of us who have been involved in the thalidomide campaign over the years, it was a really positive thing when we heard that Nick Dobrik’s name would be put forward.

Interestingly enough, although Nick was there as an expert witness, he was not asked to play a part in drawing up the conclusions in any shape or form. In fact, he was asked to leave the room. Nick was very surprised—actually, he was gobsmacked—when, in good faith, the Minister and then the Prime Minister said that Nick Dobrik had fully endorsed the conclusions of the report. I know now that the Minister and the Prime Minister know—I have met the Prime Minister, and Nick has done an interview with Sky today—that he categorically does not endorse the conclusions of the report. It was fundamentally wrong for anyone to advise the Prime Minister or the Minister that he did. He does not blame the Prime Minister; I do not think I blame the Prime Minister. As a former Minister—I know that there are former Ministers on the Opposition Benches—I know that we take advice from our officials and they tell us what the situation is. In good faith, the Minister at the urgent question, and the Prime Minister at Prime Minister’s questions, said that Nick endorsed the conclusions.

On behalf of Nick, who cannot defend himself in this Chamber, I would like whoever gave that advice to the Minister and the Prime Minister to formally apologise to Nick Dobrik. He is a fantastic campaigner not only for the Thalidomide Trust, but for all injustices, especially within the pharmaceutical area. The victims do not feel that the inquiry was fair and independent at all. They should have trust and confidence.

The most important thing is that the inquiry was asked to find a “possible” association—not “causal”, but “possible”. I and other members of the all-party group asked the experts from the panel why, after taking the word “inquiry” out, the remit was changed again, because “causal” is very difficult to prove. They said that they followed the science, but they were supposed to follow their remit and do what they were told. If they felt that they could not do that based on the evidence in front of them, fine. They could have gone back to the Minister and the victims and explained that. Instead, we had the farcical situation of the group looking for something when they knew full well—it is clearly in the documents—that they could not reach the conclusion that there was a causal link.

Interestingly enough, the group also could not come to the conclusion that there was not a causal link, because the evidence was not there for either conclusion. As I said during the exchanges on the urgent question, an injustice has taken place. Natural justice is the reason we are sent here. We defend our constituents when the system has come down against them and caused such horrific, horrible things to happen to them, so we need to address that injustice.

Capital Funding: New Hospital in Harlow

George Howarth Excerpts

Wednesday 18th October 2017 Westminster Hall

[Robert Halfon]

My hon. Friend has set up the all-party parliamentary group on new towns, of which she is the chair and I am pleased to be vice-chairman. We set it up because we have many of the same problems. Our towns were built at the same time and we have the same issues, whether it is to do with our hospitals or regenerating housing and our high streets. I thank her for the work she does on this and the way she represents her new town and her constituents in Telford.

As I was about to say, the hospital secured £1.95 million of emergency department capital funding in April this year, allowing significant building works to support the department’s work, including the expansion of the medical assessments base. That is coupled with an A&E-focused recruitment drive to take advantage of the new facilities.

That leads me on to staff recruitment and retention. While Harlow hospital now has 27 more doctors and 35 more nurses than in 2010, the vacancy rate in recruitment is a perpetual worry. The nurse vacancy rate for September stood at 25%. Staff vacancy rates were picked up in the CQC report in 2016, in which inspectors found that

“staff shortages meant that wards were struggling to cope with the numbers of patients and that staff were moved from one ward to cover staff shortages on others.”

The proximity of Princess Alexandra Hospital to London plays a major role and, although pay weighting is a factor, I have been told by the hospital leadership and Harlow Council’s chief executive, Malcolm Morley, who is in Parliament today, that career development is significant. Princess Alexandra Hospital must compete with Barts and University College Hospital in specialist training and career development. The retention support programme established career clinics and clear career pathways, but there is only so much that the hospital can do to compete with the huge investment and facilities at London hospitals. Harlow needs to be able recruit and retain staff. Recruitment is related partly to the future of the hospital itself and partly to the staff’s ability to develop their careers in Harlow. Of course, both factors relate to the hospital’s infrastructure.

I have tried to make sure that our NHS in Harlow is a top priority for the Government, and I have had many meetings with the Health Secretary and the hospitals Minister. I am pleased to say that they have visited our hospital a number of times, most recently in May, when the Health Secretary visited the Princess Alexandra Hospital to speak to the hospital leadership team about Harlow’s case for a new hospital. He spoke of

“the exciting proposals which are coming together to invest capital in upgrading these facilities, including the option of a brand new hospital.”

He also stated:

“These proposals are at an early stage but upgrading services on this important site will be a priority for a Conservative government”.

Following capital funding announcements for sustainability and transformation partnerships in July, I was informed that

“Princess Alexandra Hospital is still a real priority”

for the Department of Health

“and work is ongoing to take it forward”,

and that the Government are “on hand” to carry on helping to get the Princess Alexandra bid together. Given that the Health Secretary said that Princess Alexandra Hospital is a priority case, will the Minister say what the current budget is for capital funding and how it will be allocated to new hospitals, such as Harlow?

In autumn 2016, the Secretary of State requested that the PAH board, the local clinical commissioning group and local authority partners progress a strategic outline case. After considering a number of options,

“the SOC concluded that a new hospital on a green field site, potentially as part of a broader health campus, to be the most affordable solution for the local system”—

note the expression “most affordable”—

“and the solution that would deliver most benefit to our population.”

The health campus would bring together all the services required to ensure that healthcare in Harlow is fit for the 21st century: emergency and GP services, physio, social care, a new ambulance hub, a centre for nursing and healthcare training.

Having recently met the chief executive of the East of England Ambulance Service, I know that there has been a significant increase in the number of calls from critical patients who need a fast response. Harlow has four new ambulances but the development of a top-class ambulance hub would allow huge improvements in that area. The health campus could also act as a centre for degree apprenticeships in nursing and healthcare, bringing specialist training to the eastern region. It could build on strong links between the Princess Alexandra Hospital and Harlow College and capitalise on the new Anglia Ruskin MedTech innovation centre at the Harlow enterprise zone.

The health campus proposal has been supported by West Essex CCG, the East and North Hertfordshire CCG and the Hertfordshire and West Essex STP, which brings together 13 local bodies and hospital trusts. A joint letter has been signed by more than 10 councils, including Harlow Council, Epping Forest District Council, Essex County Council and the Greater London Authority.

Despite recognition from local authorities and Ministers alike, some NHS England officials—I stress the word “some”—suggest that a refurbishment would be more fitting than the development of a brand-new hospital, due to capital funding constraints. That solution is the equivalent of an Elastoplast—a short-term option that will do nothing to solve real, long-term problems.

Given the support from the Government and key organisations, we need to be sure that plans for a new hospital are not obstructed. Will the Minister give an assurance that NHS England and NHS Improvement will work positively with public, private and voluntary sector partners to progress the plans? A rapid strategic solution is needed, rather than a short-term fix.

The cost of the new campus model would be between £280 million and £490 million, depending on the type and preferred method of funding. The hospital leadership is looking at all the options to maximise public sector investment and bring together the public, private and voluntary sectors. Private investment will not involve any kind of private finance initiative contract. Instead, the leadership will focus on how the private sector works with the NHS and how the development can generate revenue flows through social care, for example. The development also raises the potential development of housing as a source of income and private investment. These are decisions for the future. When the PAH leadership looks at private investment, it will consider supported housing and similar options.

Moreover, Public Health England’s move to Harlow will create a world-class health science hub. Without exaggeration, once Public Health England has completed its move, Harlow will be the health science capital of the world, Atlanta aside. We must ensure that the Princess Alexandra Hospital is an important partner that benefits from and adds to that success. The creation of a health campus is vital not only for Harlow but for the surrounding area. The infrastructure of the campus would be fundamental to the vitality of the community and the economy of the entire region that the Princess Alexandra serves.

I have visited the Princess Alexandra Hospital many times. I defy the Minister to find more professional and dedicated staff, doctors and nurses. They work day and night to look after the people of Harlow and the surrounding area. I have seen the incredible work in A&E, intensive care and the maternity and children’s units. That is why I know that PAH staff are second to none. However, their professionalism and hard work will go to waste unless our hospital is fit for purpose. I know that the Secretary of State recognises that, given his numerous visits to the hospital and what he has said since. I know that the Minister himself recognises that, given his visit to the hospital this time last year. I know that all the key local authorities, neighbouring MPs and trusts are supportive. I urge the Minister to do everything possible to ensure that Harlow has a hospital that is fit for the 21st century.

[Mr George Howarth (in the Chair)]

Before I call Mark Prisk, he needs to be aware that adequate time must be allowed for the Minister to respond. If he does not appear to be finishing his speech in a timely manner, as I am sure he will, I will intervene to bring in the Minister.

Autism Diagnosis

George Howarth Excerpts

Wednesday 13th September 2017 Westminster Hall

[Norman Lamb (North Norfolk) (LD)]

Does the hon. Gentleman agree that NICE needs to look at reviewing its guidance? It is not just about the first appointment. There is a risk that there is gaming of the system. People get their first appointment, but then it is stretched out to three and a half years, as we know. Getting the diagnosis is the critical thing.

[Mr George Howarth (in the Chair)]

Order. Before I call Bambos Charalambous, I should say that those seeking to make a speech in the debate may consider it unnecessary to make an intervention, enabling those who for one reason or another cannot make a speech to make a short intervention. I say that in an advisory sense; it is up to the hon. Gentleman whether he accepts any interventions. As they glance around the Chamber, Members will become aware that it will be difficult to get everyone in.

[Bambos Charalambous (Enfield, Southgate) (Lab)]

The right hon. Member for North Norfolk (Norman Lamb) makes a good point about the need for proper assessment of when the final diagnosis is actually made. It may not be at the first appointment; more than one appointment may be needed before the final diagnosis is established. It is absolutely vital that these diagnoses are made as soon as possible.

--- Later in debate ---

[Bambos Charalambous]

My hon. Friend makes an excellent point. Sometimes the behaviours for autism in women and girls are not picked up as much as they are in boys, because they do not always display the behaviours that would lead someone to detect autism. I wish her constituent well for the future.

The lengthy delay in diagnosis can lead not only to the development of further secondary conditions to autism, but will invariably end up costing the NHS more money for more GP appointments, emergency admissions and reliance on mental health services at a time of crisis. In addition, delayed diagnosis has a disproportionate effect on women. Girls are often diagnosed late as they do not always display the same classic behaviour associated with autism as boys do.

How can the situation be remedied? I urge the Minister to consider implementing three things. First, we need to ensure that the NHS collects and publishes data for each NHS trust or CCG from the date that a child is referred to them until the date of diagnosis. At present there is no such requirement, so such a database should be cemented in the NHS accountability frameworks and should be held by the CCGs in their improvement and assurance frameworks. CCGs and the NHS trusts should be measured by how they perform on referrals and diagnoses.

Secondly, we need more investment in the NHS. To miss a standard set by NICE by more than three years leads me to believe that the Government are not really trying hard enough when it comes to ensuring that the children are seen and properly diagnosed within a timely period. It is scandalous that children’s futures are put at risk in such a way. Although the Minister may say that the three months is only a guideline and not mandatory, I believe the guideline should be strictly adhered to. The guidance is there for a reason.

We also need more specialist units to deal with diagnosing autism. We have in recent months heard some bold promises from the Government about funding for mental health, but we have yet to see any sign of firm action. We need investment in the NHS and we need it now.

Finally, we need to ensure that the improved record- keeping of autism diagnosis helps to identify where there are gaps, and that work can begin to tackle the health inequalities we face. I wish to thank the National Autistic Society and Autistica, and also the House of Commons Library for its excellent briefings on this matter. I await the Minister’s response.

[Mr George Howarth (in the Chair)]

Order. Before I call the next speaker, I should point out that many people wish to contribute, so there will be a time limit of three minutes starting from when the next speaker sits down. I apologise for that, but it is the only way we can try to get everybody in. Even then, it is unlikely that everybody who is down to speak will be called.

--- Later in debate ---

[Several hon. Members rose—]

[Mr George Howarth (in the Chair)]

Order. It might be helpful to announce that the three Front Benchers have generously agreed to cut their speeches to give us an additional six minutes. I will therefore be calling the Front Benchers from 10.36 am. Do the maths and try to accommodate all of your colleagues.

--- Later in debate ---

[Several hon. Members rose—]

[Mr George Howarth (in the Chair)]

Order. I will be calling the Front-Bench Members at 10.36 am. I call Jim Shannon.

--- Later in debate ---

[Jackie Doyle-Price]

I hear the hon. Gentleman’s point, but the wraparound support and care will do more than any finite target time. I am happy to look at that.

We are running short of time and I really need to give the hon. Member for Enfield, Southgate time to respond. We have had a very constructive discussion today, and I look forward to engaging with all hon. Members on these issues.

[Mr George Howarth (in the Chair)]

Before the hon. Gentleman responds, may I thank all Members who contributed today, and particularly those on the Front Benches? It was very difficult to get everybody in, but we managed it in the end—certainly all those who had applied to speak. I call Bambos Charalambous to respond.

Contaminated Blood

George Howarth Excerpts

Tuesday 25th April 2017 Commons Chamber

[Andy Burnham]

It is a total disgrace. Absolutely there must be full, fair compensation now. I say to the Government, do not delay; do what Ireland and other countries have done. They should do that now. They raised expectations and they should do it. We would all support it.

Mrs Bullock, whom I mentioned, is reduced to sending begging letters. She has had to sell the family home and move away from everything. She is sending begging letters to the Skipton Fund for a stair-lift. She is not well herself now. How can that be right? We are making a woman who has lost everything send begging letters for a stair-lift, as she tries to cope on her own because her husband is no longer there. On the point about medical treatment, I understand that Mr Bullock may have been refused a liver transplant because his notes said that he was an alcoholic. There is injustice upon injustice here. It is absolutely scandalous. I hope the House now understands why, as I said at the beginning, I could not live with myself if I left this place without telling it directly what I know to be true.

[Mr George Howarth (Knowsley) (Lab)]

My right hon. Friend is making a powerful case that there was a systematic cover-up. By joining together the dots in the way that he has, a picture seems to emerge that needs to be examined further. Even if he is wrong and what we are confronted with is systemic administrative and medical failures, the argument for immediate compensation for all the people affected is so powerful that the Government need to look at it urgently and, if possible, say something sensible about it today.

[Andy Burnham]

Absolutely; I could not agree more. It is downright immoral to make these people carry on begging in the way they have been forced to do. The Government raised their hopes; they should deliver on the former Prime Minister’s promise and do what my right hon. Friend has just described.

The story is becoming clear, is it not? Warnings from the United States were ignored. There was a wish to drive on with these new products from the Oxford haemophilia centre: “We’ll just push them out there to find out the results before we really know whether there is infectivity.” Problems started to happen and perhaps there was the idea, “Oh no, the Government might be exposed to litigation. Let’s not have it in people’s notes so that a story does not build about how there has been negligence and people might have a compensation claim.” That is the story I have got; I do not know what anybody else thinks. Worse, for some people, they said, “Don’t just destroy their notes; falsify their notes.” That is the story. We need to find out whether it is true or not. In my view, these are criminal acts. They did not just happen by chance. A major injustice has happened here.

In making this speech tonight, I think of our late, great friend Paul Goggins, who I miss every single day. He did so much to advance the cause of justice for those who suffered. I also think of his constituents, Fred and Eleanor Bates, and of the promises I made to act for them in Paul’s name. In a 2013 debate like this one just before he died, Paul made an impassioned call for:

“A serious Government-backed inquiry…with access to all the remaining records and the power finally to get to the truth of what happened and why.”—[Official Report, 29 October 2013; Vol. 569, c. 201WH.]

His demand was as undeniable then as it is now, yet it pains me that, in the four years since then, this House has not moved it forward at all. If that continues to be the case after what I have said tonight, I am afraid that this Parliament will be complicit in the cover-up.

In reply to the demand of my hon. Friend the Member for Kingston upon Hull North for an inquiry in a letter she wrote in October 2016, the Prime Minister said:

“the relevant documents have been published on the Department of Health and the National Archives websites and it is unlikely that a public inquiry would provide further information.”

In my view, that is a highly debatable statement. I do not think that a Prime Minister who has a good track record in helping to secure justice for those to whom it has been denied should have put her name to such a letter, which was probably drafted by the Department of Health. I remember exactly the same thing being said to me by those who opposed the setting up of the Hillsborough independent panel. “Everything is out there, it’s already known,” is what they always say. If the Prime Minister is confident in her assertion—I say this to the Minister—then rather than just publishing the documents the Government have selected as relevant, why not publish all the Government-held documents so that we can all decide whether her claim is true? On the basis of the evidence I have presented tonight, I believe it would be quite wrong for this House to resist that call.

To be clear, I am not calling for a lengthy public inquiry; I am calling for a Hillsborough-style disclosure process, overseen by an independent panel, which can review all documents held by government, NHS and private bodies. Just as with Hillsborough, the panel process should be able to view documents withheld under secrecy protections and make the necessary connections between documents held locally and nationally. It should then produce a report on the extent to which the disclosure of those documents tells a new story about what has happened.

So tonight I issue a direct challenge not just to the Government but to all parties in this House, including to my own Labour Front Bench and the Scottish National party: do the right thing and put a commitment in your election manifestos to set up this Hillsborough-style inquiry into contaminated blood. That, in my view, would be the most effective way to get as quickly as possible to the full truth and the whole story, as it was, effectively and efficiently, with Hillsborough.

I want to be very clear tonight with the Minister and with the House. If the newly elected Government after the general election fail to set up the process I describe, I will refer my dossier of cases to the police and I will request a criminal investigation into these shameful acts of cover-up against innocent people. I say to the Minister that the choice is hers. People are asking me why I do not just go straight to the police with the evidence I have, and I owe them an explanation. It is my view that the individual crimes I have outlined tonight are part of a more systematic cover-up and can only be understood as a part of that. If we refer them piecemeal to the police, they may struggle to put together the bigger picture of what lies behind the falsified medical records. That, in turn, may delay truth and justice. If the Government will not act, however, I believe a police investigation is the correct next step and that is what I will request. I cannot keep this information in my possession and not do something with it.

As we know, time is not on the victims’ side, so I will set a deadline. If the Government do not set up a Hillsborough-style inquiry by the time the House rises for the summer recess, I will refer my evidence to the police and request that investigation.

--- Later in debate ---

[Nicola Blackwood]

Of course, that was only part of the picture, because further documents have been disclosed. The Department has published all relevant information that it holds on blood safety, in line with the Freedom of Information Act 2000. All papers that are available for the period between 1970 and 1985, amounting to more than 5,500 documents, have been published on the Department of Health website, as the Prime Minister said in her letter to the right hon. Gentleman. In addition, more than 200 files of documents covering the period between 1986 and 1995 are available to the public through the National Archives. Of course, papers from more than 30 years ago are already a matter of public record.

We are also aware of six documents among those published on the Department’s website that are currently being withheld under the Freedom of Information Act, either on the grounds that they contain only personal information and nothing relevant to the issue of blood safety, or on the grounds that they hold legally privileged material that still has the potential for future litigation. A further 206 files containing documents covering the period between 1986 and 1995 have been published on the National Archives website and are available to the public. We cannot provide a figure for the number of individual documents that have been withheld from those files, but if documents have been withheld, the files will hold an indication of that which will be visible to the public. Files that contain only some information that is unsuitable for publication will have been redacted.

[Mr George Howarth]

My right hon. Friend the Member for Leigh (Andy Burnham) made a direct comparison between this case and the Hillsborough scandal. Following Hillsborough, there was the Taylor report, which was produced hurriedly but was actually useful. There was then the Stuart-Smith inquiry. Between the two, there were all the coroner’s inquests. It was not until the process that my right hon. Friend described, involving an independent panel that was able to look at all the documents—as an independent panel would be able to do in this case—that the truth finally emerged. The Minister ought to accept that that process is the best way to get at the truth. She cannot guarantee that everything that has gone on so far has got at the truth.

[Nicola Blackwood]

The right hon. Gentleman has made a good point. However, given the release of Government papers that has already taken place and the numerous statements made about the issue by Ministers in both Houses, it is hard to understand how an independent panel would add to current knowledge about how infections happened, or the steps taken to deal with the problem. As with a public inquiry, the Government believe at this point that setting up such a panel would detract from the work that we are doing to support sufferers and their families without providing any tangible benefit.