Oral Answers to Questions

Greg Mulholland Excerpts

Tuesday 13th January 2015 Commons Chamber

[Mr Hunt]

We have allocated £8.84 million to South Gloucestershire’s strategic resilience group, and that is employing more doctors, nurses and hospital and community staff, and providing more than 100 beds.

[Greg Mulholland (Leeds North West) (LD)]

All the talk about appointments concentrates on GPs and A and E, but does not seem to focus on pharmacies, which have a hugely important role to play, considering how many years pharmacists train for. My constituent Mr. Dhand of the Headingley pharmacy is undertaking a pilot to see how many people could and should have gone to a pharmacy rather than to a GP. Would Ministers support that?

[Dr Poulter]

I very much welcome what the hon. Gentleman’s constituent is doing locally. For many patients the pharmacy is often the first point of contact with the NHS, so the more we can do as a Government to support local pharmacists in delivering community services, the better.

Oral Answers to Questions

Greg Mulholland Excerpts

Tuesday 25th November 2014 Commons Chamber

[Mr Hunt]

We are not rationing services. In fact, we are doing 1 million more operations every year than were done under the previous Government. I will tell the right hon. Gentleman why that financial pressure exists: we have an ageing population, with nearly 1 million more over-65s than four years ago, and huge pressure to deliver good care in the wake of the Francis report. The NHS will be supported if we have a strong economy that can fund real-terms increases in health spending—something that never happens if the deficit is forgotten.

[Greg Mulholland (Leeds North West) (LD)]

My constituent, six-year-old Sam Brown, is one of 100 people with the rare disease Morquio. His family live in a state of anxiety because they do not know whether the drug Vimizim will be approved for further use on 15 December. Will a Minister please meet me and Katy and Simon, Sam’s parents, to give Sam the Christmas present he needs and to keep Sam smiling?

[The Parliamentary Under-Secretary of State for Health (George Freeman)]

I would be delighted to meet my hon. Friend and his constituents to review that very important issue.

Oral Answers to Questions

Greg Mulholland Excerpts

Tuesday 21st October 2014 Commons Chamber

[George Freeman]

Yes, I absolutely sympathise: I understand how important this is to local patients and their parents. As my hon. Friend knows, NHS England’s review of children’s heart surgery goes back a very long way—to the Bristol royal infirmary issues in the 1980s—and I know that Leeds and Newcastle Members are actively engaged on it. I can say that there is no immediate threat to any congenital heart surgery unit. NHS England has held a drop-in session with all MPs, and I encourage Members to make representations to the consultation on the national review.

[Greg Mulholland (Leeds North West) (LD)]

The reality is that NHS England has made a mess of this. I hope that it will finally apologise when the third stage of the review is published. On the process that we have now, will my hon. Friend confirm that it is an open and fair process that will allow all units, including Leeds, to reach the important standards that we want for all our units?

[George Freeman]

My hon. Friend makes an important point. This is a matter for NHS England to deal with. I have made inquiries to ensure that the process is being followed as it should be. As I say, there is no immediate threat. The issues around the provision of congenital heart disease services are not limited to Leeds. NHS England is conducting a nationwide review of congenital heart services, which will look at the whole of life care pathways available across the country. The truth is that congenital heart diseases are often very serious illnesses affecting life expectancy and quality of life for patients, who will expect NHS England to put in place the very highest quality care and service available.

Oral Answers to Questions

Greg Mulholland Excerpts

Tuesday 15th July 2014 Commons Chamber

[Mr Hunt]

I do not know what the charter says, but I am happy to have a look at it. I agree with the hon. Lady’s sentiments. The important change we need to make is to understand that it is a false economy not to look after people who are vulnerable—those who need help washing, getting out of bed and feeding every day. Scrimping on such care is incredibly dangerous: it costs the NHS more, but most of all it means that those people are not treated with the dignity and respect that they should be.

[Greg Mulholland (Leeds North West) (LD)]

A recent Age UK report shows that older people are many times more likely to be moved multiple times in hospital, and that there is an attitude that they should not be using up hospital beds. What does my right hon. Friend suggest to tackle the problem, for example through improved guidance?

[Mr Hunt]

The attitude to which my hon. Friend refers is totally unacceptable. It is not specifically an NHS problem; we need to change the way of thinking across our society. In particular, I worry about people with dementia who are sometimes in hospital wards where they are not able to speak up for themselves. That is why we have introduced probably the toughest inspection regime of any hospital system anywhere in the world, and I hope it will make a real difference.

Care Quality Commission (Morecambe Bay Hospitals)

Greg Mulholland Excerpts

Wednesday 19th June 2013 Commons Chamber

[Mr Hunt]

We have not talked very much about care homes during these questions, but anyone who saw the horrific “Panorama” programme earlier this week on the BBC will know that there are some appalling problems in some of our care homes. We need that same independent, rigorous inspection in care homes as well. That is why, alongside the chief inspector of hospitals, we are appointing a chief inspector of social care who will once again—it is a great shame that we stopped doing this—rate care homes on the quality of care that they give and speak without fear or favour, so that we can reassure my hon. Friend and his constituents.

[Greg Mulholland (Leeds North West) (LD)]

Last week and this week, the Secretary of State has made bold and helpful statements in the interests of NHS accountability, and I commend him for doing that, but does he accept that we have a real problem in the structure of democratic accountability in the NHS? As he knows, there has been great leadership, including from some of his Back Benchers, and will he commission a review now so that we can all have confidence that there is a proper democratic structure of accountability to oversee all parts of the NHS?

[Mr Hunt]

I thank the hon. Gentleman for his comments, and I hope that he will bear with me as the profound changes that we are introducing this year are rolled out. The most important element of democratic accountability is making sure that the public have the same information as the experts, so that they know whether their local hospital, GP surgery and care home are doing well. That is one of the biggest imbalances and that is why I am putting a lot of emphasis on the new chief inspectors, who will have the status, authority and resources to make those judgments, so that the public know what sometimes only the system has known. Then we will help to address some of the issues that he raised.

Children’s Heart Surgery

Greg Mulholland Excerpts

Wednesday 12th June 2013 Commons Chamber

[Mr Hunt]

The independent review says that the knock-on effects on adult heart surgery, and the interrelationship between the two, need to be considered. There are always knock-on effects of a service reconfiguration. Within reason, one must consider them, but one must also bear in mind what the right hon. Member for Leigh said: one must ensure that one does not overcomplicate the reviews. If we consider every single knock-on effect of every single change, the danger is that we end up not being able to change anything at all, which on this occasion would be an abdication of our important responsibilities.

[Greg Mulholland (Leeds North West) (LD)]

I have called consistently for leadership and accountability. I believe that we have had those things today, and I thank the Secretary of State and his colleagues in the Department for that. I have said consistently that there was something wrong with the decision-making process. We were right, whereas those who told us that we should be quiet and ignore the serious flaws, clear bias and utter lack of transparency were wrong. May we have a full investigation into the clear maladministration in the course of the review? Will the Secretary of State assure the House that lessons will be learned, which is key, and that those conflicted people who have let children down and wasted taxpayers’ money will play no part in any further review in the NHS?

[Mr Hunt]

I can confirm that a thorough process of learning the lessons will happen. As I said earlier, we must learn big lessons about the time it takes to make very important service changes in the NHS, not just in children’s heart surgery but in many other areas. We need to learn those lessons. The person who was responsible for the JCPCT, Sir Neil McKay, is no longer responsible and has retired from the NHS. We need to look at everyone who was involved in the process and see where the right calls were and were not made. If we do not, we will never be able to make important changes in the NHS—and we have a big responsibility to make those changes.

Oral Answers to Questions

Greg Mulholland Excerpts

Tuesday 11th June 2013 Commons Chamber

[Mr Hunt]

The right hon. Gentleman will understand that I cannot prejudge the decision that I will take on reflection, having read the Independent Reconfiguration Panel report, so this morning I cannot give him an answer as to what will happen. However, I can reassure families in Yorkshire, and throughout the country, that where there are safety concerns, we will take them very seriously indeed and investigate them promptly, and where there are difficult reconfiguration debates to be had, we will not duck them, but in all cases, the interests of patients—patient safety and reducing mortality—must be our primary concern.

[Greg Mulholland (Leeds North West) (LD)]

18. There seems to have been little reliable evidence for the suspension of services at Leeds, but rather for the safe and sustainable review itself. Will the Secretary of State now do what NHS England has so far refused to do to the Independent Reconfiguration Panel, despite the recommendation of the health and overview scrutiny committee in Yorkshire, and finally publish all the official e-mails between the Joint Committee of Primary Care Trusts and the National Specialised Commissioning Team between 2008 and 2013, so that he can finally learn the truth about the review and what has gone so wrong with it?

Oral Answers to Questions

Greg Mulholland Excerpts

Tuesday 16th April 2013 Commons Chamber

[Dr Poulter]

I commend the right hon. Gentleman’s work in raising the profile of diabetes. A lot of the Government’s work is focused on the importance of improving public health in this country and in particular on obesity, and if we are to tackle that we have to deal with diabetes. As a key part of that, we are now giving 40% of the public health money to local authorities to do exactly what he has just described: to focus money in the right places to tackle cardiovascular disease in those communities that most need it, particularly in inner-city areas.

[Greg Mulholland (Leeds North West) (LD)]

The role of local authorities in scrutinising NHS decisions is now even more important, yet the joint health overview and scrutiny committee of Yorkshire and Humber councils was consistently denied a number of important documents, which was one reason the High Court ruled that the decision taken in the Safe and Sustainable review was unlawful. This is now in tatters. Will the Minister now confirm whether he will instruct NHS England not to appeal the High Court decision?

[Dr Poulter]

Surely the validity of evidence is a matter for the court. I am sure my hon. Friend would recognise that there has to be a distinction between what we do here in Parliament and what is done in the courts. If NHS England would like to appeal the decision and if it thinks there are good grounds to do that, it must do that. The decision will then ultimately be made in the courts, on the basis of how valid that appeal is.

Heart Surgery (Leeds)

Greg Mulholland Excerpts

Monday 15th April 2013 Commons Chamber

[Mr Hunt]

I thank the right hon. Gentleman for the constructive conversation we had on Good Friday about what I entirely agree is an extremely difficult issue for the families and for the staff at the LGI. My intention is to try to resolve the matter as quickly as possible. I obviously cannot comment on what view I will take while legal proceedings are under way and while I wait for advice from the IRP, but I agree with him about the uncertainty, which I would like to resolve as quickly as possible. He would want me to be guided by what is in the best interests of his constituents and people across the country who need children’s heart surgery.

[Greg Mulholland (Leeds North West) (LD)]

I, too, thank the Secretary of State for his private phone call to me, but we should have heard from him on this fiasco before today in response to an urgent question. I have to say that his response has simply not been good enough, considering what has happened. To correct one thing that he said, it was not with the agreement of the LGI that services were suspended. Clearly, Sir Bruce Keogh marched into the LGI at 8 o’clock in the morning and said that if surgery was not suspended, people would be sacked. That was no way to behave even if the data were accurate, but Sir Bruce has now backtracked and admitted the data passed to him by his friend Sir Roger Boyle were not accurate.

The decision to close children’s heart surgery in a safe unit, which is what we now know Leeds always was, puts children at greater risk. To make a decision of that nature that is incorrect is simply unacceptable. Will the Secretary of State do what is now clearly necessary and have a full investigation of this fiasco, including the conduct, judgment and motivations of senior NHS officials involved?

[Mr Hunt]

I simply say to the hon. Gentleman that if, as he has alleged consistently in the media, this was some kind of political ploy linked to Safe and Sustainable, we would not have reopened children’s heart surgery in Leeds on 10 April as we did. I spoke to him at the time and told him that it was my hope that operations would be able to resume as soon as possible and that we would get to the bottom of the data to find that the concerns were unnecessary because the unit was safe. In the end, that is what happened.

It would have been utterly irresponsible for Professor Sir Bruce Keogh, in view of the evidence he was faced with—including incomplete data that the hospital had not supplied in the way that it should have done—not to ask the hospital to suspend surgery. That would have been taking a risk with the lives of the hon. Gentleman’s constituents and the people of Leeds in a way that would have been wholly inappropriate. The NHS needs to move in a totally different direction on patient safety, and this is a good example of the NHS medical director behaving promptly and properly in exactly the way he should.

Leeds Children’s Heart Surgery Unit

Greg Mulholland Excerpts

Tuesday 30th October 2012 Westminster Hall

[Greg Mulholland (Leeds North West) (LD)]

I congratulate my neighbour, my hon. Friend the Member for Pudsey (Stuart Andrew), on everything that he has done and on securing this debate. It is also good to have four other parliamentary neighbours here, as well as many other colleagues from our region. That speaks for itself.

I put on record my regret that we have still not had a full and proper debate on the Floor of the House of Commons. Six minutes is not enough for me or other hon. Members to state our serious technical concerns about a deeply flawed process, and I do not believe that this debate should be seen as a substitute. However, I thank the Minister and her colleagues for doing the right thing in listening and correctly, considering the huge concerns, referring the decision to the Independent Configuration Panel. That is clearly essential. I am pleased that she and her colleagues did so, considering the outrageous protestations from the Joint Committee of Primary Care Trusts and, I am afraid, from other organisations trying to stop the process and prevent what is clearly essential democratic scrutiny. That in itself is a matter that should be taken further. It is a disgraceful thing for any body involved in the decision to seek to do.

Briefly, in the time that I have, I will raise with the Minister the slight concern also mentioned by the joint health overview and scrutiny committee for Yorkshire and the Humber. We want an assurance—today is a good opportunity—that the terms of reference for the Independent Reconfiguration Panel will not be restrictive. Otherwise, there is a danger that it could simply repeat the same deeply flawed assessment process that my hon. Friend the Member for Pudsey eloquently described. Will the Minister ensure that that is not the case, and that the IRP can properly and fully consider the decision?

We have all heard what a blow the decision has been to the wonderful staff who work at the unit and, most importantly, to the families and children involved, as well as to people in the region and beyond who rely on the unit or could do so in future. We must be clear on this point, which I want the Minister to take away. Of course we have all heard the stories of the awful situation in which families and children have found themselves. Each and every one is heart-rending, and they deserve to be listened to. However, we must also accept that the same stories would apply to any of the units in the review, so that is not the point. The point is a cold, hard one: by the review’s own criteria for bigger and smaller units, the JCPCT has made an absurd decision in favouring the closure of Leeds.

The JCPCT has demonstrated a clear bias all the way through. I am sorry to have to say it, but the JCPCT’s decision was clearly a stitch-up. If it had followed its criteria properly and gone through the process following the criteria set down by the previous Government, it could not have failed to argue, given the troubled times and all the other things that we have heard about, that Leeds must be a fully functioning bigger unit, yet it has not. I believe that investigations are still needed.

It is utterly disgraceful how the JCPCT and others have sought to avoid proper scrutiny. To back up what my hon. Friend the Member for Pudsey said, the JCPCT has continued to refuse to provide all the information requested of it by the body charged in the health service to scrutinise it. That is not only disgraceful but quite sinister, and I ask the Minister to look into it properly. If the JCPCT will not release its reports and minutes properly under the Freedom of Information Act, it must say why, but it simply has not done so. I pay tribute to Councillor Illingworth, his predecessor and the body of councillors for all the good work that they have done. They are being refused the information that they need to do their job. That is not acceptable, and I want it to be taken up properly with the JCPCT.

The other issue that has not been raised so far—none of us wants to repeat what has been said—and that I want to bring to the Minister’s attention is the absolute nonsense that despite the geography of the whole country, the Yorkhill unit was not included. There is already a flow of cross-border patients from the north of England to Scotland and the other way around. It is somewhat ironic that Sir Ian Kennedy, who chaired the Safe and Sustainable review panel in England and Wales, also separately commissioned a review by NHS Scotland of Yorkhill. He said:

“The panel had significant concerns about important aspects of the service in the surgical unit...Of most concern was a lack of leadership and coherent team working. Also of concern was a sense that the provision of paediatric intensive care may be unsafe if critical staffing problems are not addressed.”

He concluded:

“The panel was of the view that urgent remedial action is required in PICU to prevent care from becoming unsafe.”

I have to say to the Minister that it is nonsensical as well as dangerous for Yorkhill not to be included in the Safe and Sustainable review. If it had been, the only logical conclusion would have been to keep the Leeds unit open, and to allow the patients in the north of England and south of Scotland to choose between Leeds and Glasgow.

There is a concern about the whole review itself. The Scottish Government—we accept that there is devolution—have now decided that the Glasgow unit does not have to comply with the magical 400 cases per year, but that three surgeons performing 300 operations is enough to be safe.

I am sorry about the time, but as I have made clear, I object to the fact that we have not had a proper debate so far on this serious matter. I will be as brief as I can.

It is simply not acceptable to have one rule for children in Scotland—to say that it is safe to have 300 units—and to say to the people of Leeds that we have to close a perfectly safe unit on the basis of a number that has been dreamt up in Whitehall. That is inconsistent. Yes, there is devolution and we may even have independence, but even then we would still have people crossing the border to access surgery.

This simply does not make sense. It is dishonest. I am afraid to say that the Little Hearts Matter charity has been quite dishonest, on the one hand saying that Safe and Sustainable is the right way forward, and on the other saying that it is okay for Yorkhill to carry on performing only 300 operations per year. That simply does not make sense.

My final question to the Minister is one that has not been answered. If Leeds does close, will we be told how much it will cost to close it? It will cost an awful lot to close and to reconfigure the services. We have not had that figure yet. If we do get it, I think people will be even more angry about the decision to close a much-needed, perfectly safe and excellent children’s heart surgery unit.