Care Bill [Lords]

Debate between Grahame Morris and Andy Burnham

Tuesday 11th March 2014 Commons Chamber

[Andy Burnham]

The hon. Gentleman makes that argument as if there were no changes to hospitals under the previous Government. There was plenty of change, but there is a right way and a wrong way of doing things. I would argue, as I just have, that the previous way of doing things was a better way.

[Grahame M. Morris]

Will my right hon. Friend give way?

[Andy Burnham]

In a moment.

The previous Government made changes to stroke services in London just before the last election. The number of units went down from 12 to eight. That was based on a clinical case for change. We took that argument to local people and said, “Look, it will save lives if this goes through.” That is how the Department can take people with it—by building a case for changing hospital services. Clause 119 threatens to set that back, because it puts finance in the driving seat. That risks losing public trust in the case for change. That is why what we are being asked to endorse today is, in my view, fundamentally wrong.

[Grahame M. Morris]

My right hon. Friend has made his point powerfully. I was going to ask him for an example of how it is possible to make a reconfiguration that is clinically driven. He has given the example of stroke services in London. Another example is coronary services in the north-east, where an overwhelming clinical case was made by clinicians and accepted by the general public.

[Andy Burnham]

The difficult thing for me is that when I think back to some of the processes I was involved with—stroke services in London, child care and maternity services in Greater Manchester, changes to A and E across the country, Chase Farm hospital, and other places—those issues were cynically used by those on the Government Benches when they were in opposition, and it was a bare-knuckle fight to save every hospital in the land. That is what they said, whereas we made the case for change because it would improve patient safety. I would not change my tune if I was in opposition; I still believe that hospitals need to carry on changing, but as I said, I will not do that by imposing changes on local people. The right way is to explain why, and take people with us.

--- Later in debate ---

[Andy Burnham]

Given that clause 119 is a dramatic extension of the Secretary of State’s powers, as my hon. Friend is rightly saying, does he agree that it is astonishing that the Secretary of State is not in the House this afternoon to make the case in person, to ask for the powers and to justify the idea that we should entrust the future of our hospitals to him?

[Grahame M. Morris]

I am absolutely amazed. I share my right hon. Friend’s incredulity that the Secretary of State is not here. In my view, clause 119 is one power too many for a Secretary of State who apparently believes the NHS to be a 60-year-old mistake. [Interruption.] That is a direct quotation from the Secretary of State before he took office.

The Secretary of State’s increased power and Monitor’s expanded role directly contradict the Government’s earlier promise that local commissioners would no longer be subject to central diktat. That represents a reversal of the vision that was presented during the consideration of the Health and Social Care Act 2012. Clause 119 supports none of the preconditions for a legitimate reorganisation of a local health economy and will allow trust special administrators to overrule any concerned parties.

If clause 119 becomes law, the Secretary of State will be granted the power to issue directions to require foundation trusts and clinical commissioning groups to take steps that they do not want to take. Any Member who wants to prevent the Secretary of State’s axe from falling arbitrarily on their own hospitals without clinical justification should seek to remove the clause from the Bill. I therefore urge right hon. and hon. Members to support Labour’s amendment 30 and new clause 16, which is a compromise measure to ameliorate the worst aspects of clause 119.

Care Bill [Lords]

Debate between Grahame Morris and Andy Burnham

Monday 10th March 2014 Commons Chamber

[Grahame M. Morris]

That is a perfect example and an important question that the Minister and the Government should answer. If we are to ensure that we have public trust in the data and who will use them, such questions must be answered and people be given the opportunity to consider what the Government propose.

It has become clear in recent months that the public lack confidence that the implementation of the care.data scheme as currently proposed would protect the data from inappropriate use, not least because of the point that my hon. Friend has just made. I am sure she would recall that we recently had a Health Committee session on this issue—in fact, the Minister was present—and certain assurances were given, not by the Minister but by one of his officials, that companies outside the United Kingdom would not have access to such data. The thought ran through my mind that many private health companies are global in their operations.

[Andy Burnham]

To add to the theme that my hon. Friend is developing, is not one of the problems with care.data that we have had so many statements from Ministers and officials that have not in the end come to be true? At the last Health questions, the Secretary of State said that a leaflet would be sent to every home in the land to explain what was happening. That also was not true. Does my hon. Friend agree that this is bringing the whole scheme into disrepute?

[Grahame M. Morris]

My right hon. Friend has hit the nail on the head, because there has been a catalogue of mismanagement. What we need to do if we believe in the importance of such a database is to ensure that we rebuild public trust. The Government have an opportunity to do that, but it will not be a simple matter. We have to look carefully at the implications of what the Government propose and give the necessary assurances.

The assurance that the official gave to the Health Committee had a gap that a coach and horses could be driven through. Several multinational companies could get round it by establishing a subsidiary based in the UK that would have access to the data, if that were the only safeguard.

Francis Report

Debate between Grahame Morris and Andy Burnham

Wednesday 5th March 2014 Commons Chamber

[Andy Burnham]

It is no good coming all holier than thou and claiming a counsel of perfection from the Government and that all the problems arose under Labour. There was no independent regulation in the NHS under the previous Conservative Government. There were no data of the kind that the hon. Member for Mid Norfolk (George Freeman) mentioned, so that comparisons could be made. Those things were introduced by the previous Labour Government, learning the mistakes of previous failings. This has been a continuous journey in the NHS—when things go wrong, the Government of the time act to make things better. The Secretary of State would do well to remember that before he makes the kind of statements he has made today.

We welcome some of the steps that have been taken, and I want to focus on two in particular on which we have seen an important change of emphasis. First, severe cuts to front-line staffing numbers were a primary cause of what went wrong in Stafford. In the last year, there has been a temporary halt to the cuts to nursing numbers that we saw in the early years of the coalition Government. However, Monitor has warned that this is just short term, and points to further large planned job cuts of close to 7,000 nursing posts in 2014-15 and 2015-16, made worse by severe cuts to nurse training places since 2010, which have forced many trusts in England to recruit from overseas. While we welcome the change of emphasis, we will watch carefully to ensure that recent progress on staffing is not lost.

Secondly, the Secretary of State has been right to focus on the care of older people. Moves to appoint named consultants and GPs for over-75s will clearly help to improve continuity of care. Those are the first steps in the right direction, but we would argue that something much more radical is needed. I believe that the time has come for a fundamental rethink, from first principles, of the way we care for older people, and that is what our commission on whole person care, published yesterday, has begun to set out.

Today, there are quite simply too many older people in our hospitals. Many do not need to be there, but hospital is fast becoming the last resort for people who have lost support in the home—be it support by social care or by the NHS. If we continue as a country on the current path—with further severe planned cuts to social care throughout the rest of this decade—it is a plan for the ever-increasing hospitalisation of frail older people. It is no answer to the ageing society and indeed will make it much harder to address the issues that Robert Francis identifies in his report. Instead, we need a completely new approach, where we start in the home and build a truly personalised service around each individual, their family and their carers. We need an NHS for the whole person, able to see all of an individual’s needs. We need a service where the home not the hospital becomes the default setting for care and, as I will come on to explain, that is what our policy of full integration of health and care is designed to deliver.

To listen to the Secretary of State today, people would be forgiven for thinking that everything in the NHS right now is just fine, everything is being put right and there are no problems. I have to say to him that the complacency he showed in his speech is simply not justified and, in fact, very worrying. May I remind him that hospital A and Es in England have now missed his Government’s target for 32 weeks running? The last 12 months since the Francis Report was published have—taken together—been the worst year in A and E for at least a decade, with almost 1 million people waiting more than four hours. That shows that NHS services have got worse, not better, since the publication of the Francis report.

[Grahame M. Morris (Easington) (Lab)]

Does my hon. Friend also recognise the growing problems in the mental health sector, as illustrated by evidence given to the Health Committee only earlier this week? We have seen the loss of 1,700 mental health beds over the last two years.

[Andy Burnham]

My hon. Friend anticipates me, as I will come on to that subject. My point that the NHS has gone downhill is no better illustrated than by the crisis that is developing in mental health provision.

NHS

Debate between Grahame Morris and Andy Burnham

Wednesday 5th February 2014 Commons Chamber

[Andy Burnham]

No, it was your law, your Government’s law, the Health and Social Care Act 2012—the same law against which his own care Minister, the hon. Member for North Norfolk (Norman Lamb), has recently been speaking out. He recently told the King’s Fund:

“I have a problem with the OFT being involved in all of these procurement issues… I think that’s got to change… In my view I think it should be scrapped in the future… That might happen at some future date… we’ve got to look at the barriers and address them and sort them out.”

Is that just his view, or the view of the whole Government? [Interruption.] He voted to let the OFT into the NHS. Why is he now changing his tune?

The former care Minister, the right hon. Member for Sutton and Cheam (Paul Burstow), said the same:

“The one area I have my concerns about is the way”—

the 2012 Act—

“opened up the role of the OFT.”

Yes, but did we not tell him that two years ago when he voted for the Act and when his hon. Friend the Member for St Ives (Andrew George), who is sitting next to him, joined us in the Lobby to oppose it? This is exactly what we warned them about. We warned them that it would let the market run riot through the NHS, but they would not listen, and that is why we are where we are today.

It is not just Ministers who are saying it; the comments by the chair of the Care Quality Commission at the weekend show the utter confusion in Government policy on competition in the NHS:

“We need more competition…more entrants into the market from private-sector companies”.

Will the Secretary of State clarify? Is that a statement of official Government policy? Is it his policy to get more private sector companies and more competition into the NHS? Is that what he wants? If that happens, it will mean more enforced competition leading to the fragmentation of care, and it will load extra costs on to the NHS at the worst possible time.

[Grahame M. Morris (Easington) (Lab)]

My right hon. Friend is making some positive points about the privatisation of the NHS, but does he share my concern that Monitor’s board is packed with executives who have come from private health sector companies?

Accident and Emergency

Debate between Grahame Morris and Andy Burnham

Wednesday 18th December 2013 Commons Chamber

[Andy Burnham]

That is a question for the Secretary of State. How can it make sense to close so many A and E departments in the middle of an A and E crisis? This year, the facts on the ground have changed. As I have said, it has been the worst year for a decade. Any proposal to change A and E in areas such as that of my hon. Friend needs to be considered in the light of that new evidence. We need to consider whether it is safe to proceed. As the A and E sister said, it is crisis management. That is the view from the real world. In here, it is a different story. It is, “Crisis, what crisis?”

My purpose in holding this debate is to cut through the spin. I want to bring into our debate today the voices of those A and E nurses, occupational therapists, paramedics, community nurses, and NHS 111 staff and mental health professionals who came to our summit. For instance, there is the paramedic who told us of his worries about ambulance response times getting longer because ambulances are trapped at A and E; and of the time when a patient who was held a long time at the door of a busy A and E suffered a heart attack and had to be rushed back to the ambulance. Another paramedic told us about being at the scene of a serious incident in a city centre. After calling for back-up, he was joined by a private ambulance which did not appear to have adequately trained staff to take patients to hospital. A community nurse spoke of her frustration at spending an hour and a half on the phone trying to get a GP appointment for a frail patient. An A and E-based occupational therapist said that she was now regularly diagnosing dementia for the first time in older patients who had ended up in A and E. Surely we can do better than that.

[Grahame M. Morris (Easington) (Lab)]

My right hon. Friend is giving an excellent argument as to why we are in this crisis. Is it not completely predictable given the response that we have just had on the local government grant settlement? Increased pressures on the system will be felt by old people and in deprived areas.

[Andy Burnham]

I agree. The Government have made grave mistakes. I warned them—they misquote me every week—that it would be irresponsible to give increases to the NHS, which is what they were promising, if they had to ransack local government, particularly social care budgets, to pay for them. That is a false economy. It means that older people have support withdrawn from the home, and they drift towards A and E in ever greater numbers. That is what is happening today on this Secretary of State’s watch.

Care Bill [Lords]

Debate between Grahame Morris and Andy Burnham

Monday 16th December 2013 Commons Chamber

[Andy Burnham]

Just as the Government’s proposal is not the Dilnot report, it is not my national care service proposal. I had a range of different proposals, and that one has to be considered in that context.

As the Minister knows, I proposed a universal approach in which everybody would contribute on the NHS principle—I seem to remember that he and I were in some agreement about that. That was a deferred payment, but this proposal is different. The Government are talking about a universal deferred payment scheme in which people will pay from what they leave behind, but—and this is the point—it will not be available to everybody. That was the promise the Minister has broken.

[Grahame M. Morris]

My right hon. Friend is making excellent points. On deferred payments, this proposal has been presented as something new, but is it not the case that about 90% or 95% of local authorities currently offer a similar scheme?

[Andy Burnham]

They are offering a similar scheme but at the moment they are not allowed to charge interest on it. That brings me to the next part of what is wrong with these proposals. What the Health Secretary has not said today is that interest will be charged on his proposed deferred payment scheme, which is not universal because it is not available to everybody. A loan to cover the average length of stay in a care home—two and a half years—would clock up extra costs of £3,500 in interest alone. That interest would not be included in the cap but would be outside it. Again, people will not feel that what they are paying is related to a cap.

Health and Social Care Bill

Debate between Grahame Morris and Andy Burnham

Tuesday 20th March 2012 Commons Chamber

[Andy Burnham]

The hon. Gentleman should make a speech if he wants to make interventions of that length. We had a cap to protect the interests of private patients; he is getting rid of the cap, and he is going to have to explain to patients in his constituency, if waiting lists start getting longer, why that is happening. It is as simple as that. We had systems regulation, he is removing that with the Bill and we are moving to a more unregulated market, which is not what we want to see.

[Grahame M. Morris]

On a point of order, Mr Deputy Speaker. I wonder whether I might seek your advice in relation to a declaration of interest. The hon. Member for Boston and Skegness (Mark Simmonds) has made two interventions on the private patient cap and has made a declaration of interest. He is a director of Circle, a private health care company. Is it your ruling that every Member must make such a declaration if they speak during the course of this debate?

NHS (Private Sector)

Debate between Grahame Morris and Andy Burnham

Monday 16th January 2012 Commons Chamber

[Andy Burnham]

That is exactly the point. The proposal has to be seen in the context of the health system the coalition Government want to create. They want a broken-down system where one hospital is pitted against another, where there is a duty on the Secretary of State to promote the autonomy of NHS organisations, so that they are out there on their own, having to stand or fall on their merits, with a clear incentive to drive up income gained through a relaxed private patient income cap. I shall come to that point in a moment.

[Grahame M. Morris (Easington) (Lab)]

Ministers are shouting, “Choice”, but is my right hon. Friend prepared to reflect on the merits of the private sector, both in the UK and abroad, in the efficiency of the service that it delivers?

[Andy Burnham]

When the Bill was introduced, great claims were made that it would improve NHS efficiency. That was one of the reasons the Government gave for subjecting the NHS to a huge top-down reorganisation; they wanted to make the system more efficient, but they made a mistake that many people make over time. They claimed that the NHS is inherently inefficient when in fact international evidence shows the exact opposite: the NHS model is the most efficient health care system in the world. That is because control of the system is democratically accountable, and national standards can be set through bodies such as the National Institute for Health and Clinical Excellence and entitlements can be set at national level. If that control is removed, we will see the emergence of a much less efficient health care system, like the many market-based systems.

National Health Service

Debate between Grahame Morris and Andy Burnham

Wednesday 26th October 2011 Commons Chamber

[Andy Burnham]

The hon. Gentleman nods, but I am afraid that that was not the Secretary of State’s policy.

[Grahame M. Morris (Easington) (Lab)]

I compliment my right hon. Friend on how he is moving the motion. What are his views on the impact of the reduction of funding for the NHS on the front line, and on the number of hospital trusts that are breaching the 18-week target?

[Andy Burnham]

I am grateful to my hon. Friend for those words and I shall come to precisely that point, but let us be clear about this one: the Prime Minister promised a real-terms increase, but he has delivered a real-terms cut. He stands at the Dispatch Box week after week boasting about increasing health funding when he has not. All the while, NHS staff deal with the reality on the ground of his NHS cuts. Does he not realise how hopelessly out of touch he sounds? Hospitals everywhere are making severe cuts to services, closing wards, reducing A and E hours and closing overnight, making nurses redundant, and cutting training places. Last week, The Guardian revealed the random rationing that is taking place across the country. There are cuts to pay for management services, one third of neo-natal units are reducing the number of nurses, and midwife places are being cut despite the Prime Minister’s promise to recruit 3,000 more.

--- Later in debate ---

[Andy Burnham]

I said just a moment ago that I was the one who put my name to the Nicholson challenge, because that money was going to help the NHS respond to the new demands placed on it at this difficult time, so the hon. Gentleman need not lecture me about efficiency. He needs to tell me how placing a moratorium on change in the NHS helps it to respond and deliver those efficiencies. That is the contradiction of his position, and he stood for election on that policy, as did others.

[Grahame M. Morris]

rose—