(13 years, 7 months ago)
Commons ChamberIf my hon. Friend will forgive me, I will give way again a little later, but first I want to make a couple of further points.
The House knows of my commitment to the NHS; Opposition Members know of that, too. They know that I have not spent seven and a half years as shadow Secretary and Secretary of State to see the NHS undermined, fragmented or privatised. They know that that was never my intention; it is not my intention. Before the last election, we were absolutely clear that we would protect the NHS, but we are doing more than just protecting it; we are strengthening it. We are enabling clinicians to lead a more integrated, responsive, accountable NHS—not fragmented, not privatised, not based on access to insurance, and not compromising quality for price—and, equally, an NHS that is not run by a top-down, unaccountable bureaucracy, but that is locally led and locally accountable.
As the right hon. Member for Wentworth and Dearne admitted, this is a comprehensive, consistent and coherent vision, and it is an evolution of the better policies of the last 20 years. It was the last Labour Government who introduced patient choice; we will extend it and give patients the information they need to make it work. It was the last Labour Government who introduced practice-based commissioning; we will make it real, with health professionals designing integrated pathways of care with decision-making responsibilities. It was the last Labour Government who introduced foundation trusts; we will deliver on their broken promise to take all NHS trusts to foundation status. It was the last Labour Government who introduced payment by results, but left it half baked, distorting services and hindering joined-up care; we will change it so that it genuinely supports the best care for patients. Of course, it was the last Labour Government who brought the independent sector and competition into the NHS, but we will not follow their lead by giving the independent and private sector providers the opportunity to cherry-pick services and by giving them financial advantages over NHS providers.
Will the Secretary of State confirm that the meeting patients needs programme put forward by the previous Government, which closed down many accident and emergency units and many children’s wards, will not happen again under this new regime? Will he confirm that that is because local people and local GPs will be consulted first, as opposed to having the programme driven through with no support and no consultation, as under the previous Government?
I completely understand and agree with my hon. Friend. I thought it was outrageous for the shadow Secretary of State to say, “Oh, they promised a moratorium and now some closures are taking place.” Why? Because we were left what were, in effect, faits accomplis by the previous Government and it was impossible to change them. [Interruption.] My hon. Friend the Member for Maidstone and The Weald (Mrs Grant) would feel the same as my hon. Friend the Member for Burnley (Gordon Birtwistle).
(13 years, 8 months ago)
Commons ChamberThe right hon. Lady must know that we continue to have a record number of midwives in training, and that the number of midwives in the health service has continued to increase since the election. In the financial year that is just starting, the number of commissions for training will continue to be at a record level.
The Secretary of State is aware that under the Labour Government, accident and emergency and children’s services were transferred from Burnley to Blackburn. The transfer was opposed by the majority of GPs and 95% of the local community. It was supported only by the bureaucrats in the PCT and the SHA and by prima donna consultants. Will the Secretary of State confirm that under his new proposals that will never happen again and that such decisions will be taken only following full consultation and agreement with GPs and local communities, rather than being driven through as they were by the previous Government?
I am grateful to my hon. Friend. In Burnley and other places—I think not least of Maidstone—decisions were made in the past, under a Labour Government, that clearly did not meet the tests that we now apply, which are about public engagement, the support of the local authority, engagement with general practices leading commissioning, the clinical case and the responsiveness to patient choice. Those tests will be met in future. As we go through the painful process of examining how they are applied to the situations that we have inherited, on occasion we can say things to help colleagues, but sometimes we cannot.
(13 years, 10 months ago)
Commons ChamberThe College of Emergency Medicine recently stated that if a hospital A and E unit is to be downgraded to an urgent care centre, the nearest A and E unit should be no more than 12 miles away. Will the Secretary of State revisit the cases of A and E units that were recently downgraded by the previous Government to urgent care centres when the nearest A and E unit is more than 12 miles away?
Yes. My hon. Friend makes a very important point. I promise I will discuss with John Heyworth of the College of Emergency Medicine precisely the point that my hon. Friend has raised. The College of Emergency Medicine says that it does not recognise what an urgent care centre is. From its point of view, hospitals should either have an emergency department or an A and E or they should not. If they do not, it is very important to be clear that they do not. I feel that we need to be much clearer about the nature of the service provided in A and E departments and the distinction between that and the service provided in minor injury or minor illness centres.
(14 years ago)
Commons ChamberWhat I said to the shadow Secretary of State was entirely accurate.
Does the Secretary of State agree that the abolition of unelected quangos such as primary care trusts and strategic health authorities will bring an end to the decisions they are taking to remove services from local hospitals against the wishes of GPs and local residents?
The reforms we propose will bring far greater accountability not only through local authorities but through patient choice and through front-line clinicians being able to commission services.
Let me also tell my hon. Friend that I have today referred to the independent reconfiguration panel, for initial appraisal, the question referred to me by Lancashire county council about the children’s ward at Burnley hospital.
(14 years, 1 month ago)
Commons ChamberI am afraid that I have to correct the hon. Gentleman. We are not withdrawing specialist top-up payments; the Department has acted on the basis of a review conducted by the university of York which was initiated by the Opposition Front Bench team’s predecessors when they were in government. They set up a review on specialist top-ups which said that the payments should go down from 78% to 25%, not that they should be withdrawn completely. We are reviewing that outcome with the specialist children’s hospitals and a meeting is taking place today to consider whether the review’s conclusions were accurate and applicable.
Does the Minister agree with me and the 1999 Shields report that children’s accident and emergency, paediatrics and maternity units should be kept together in one hospital? Will he postpone the move of the Burnley children’s ward to Blackburn until the new GP commissioners are installed and can make an informed decision?
Yes, I entirely understand my hon. Friend’s point and we have discussed this at Burnley. I feel strongly—indeed, I know—that we must continue to apply the tests that I have set out for such issues of configuration, including that they will deliver improving clinical outcomes, be safe for patients and, as he rightly says, reflect the commissioning intentions of local GPs representing local patients.
(14 years, 3 months ago)
Commons Chamber14. What steps his Department takes to ensure that local NHS trusts observe its guidelines on reconfigurations involving transfer of facilities from one hospital to another.
Commissioners should ensure that current and future reconfigurations demonstrate evidence of compliance with the four criteria that I announced in May. That should be a rigorous process, involving GPs and other local clinicians, local authorities, patients and the public, as set out in guidance. For current schemes, the local assessment should be concluded by 31 October this year.
Is my right hon. Friend aware that East Lancashire Hospitals NHS Trust is breaching his guidelines by transferring a children’s ward from Burnley to Blackburn without the approval of local GPs and the local council or the support of the local population? Will he please intervene?
My hon. Friend and I have had a conversation in Burnley about emergency and children’s services at Burnley hospital. I was not aware of the position that he has just described, but I will ensure that any reconfigurations that have taken place in the past and are still being reviewed, or that are currently being proposed or acted on, comply with the criteria that I set out in May, and I will write to him.