Oral Answers to Questions

Heidi Alexander Excerpts

Tuesday 13th October 2015 Commons Chamber

[Mr Hunt]

I thank my right hon. Friend for his question, and for the interest that he showed in these issues when he was a Minister.

The reality is that about we have about 200 avoidable deaths every week in our hospitals. It is the same in other countries—this is not just an NHS issue—but it is a global scandal in healthcare, and I want England and our NHS to be the first to put it right. I think that that is consistent with NHS values, and consistent with what doctors and nurses all want.

[Heidi Alexander (Lewisham East) (Lab)]

It is good of the Secretary of State to join us today. If he had been here yesterday to discuss the small issue of the £2 billion NHS deficit, he would have heard me say that I hoped we could have a mature and constructive relationship.

As has already been said, junior doctors are key to the delivery of a seven-day NHS. The Secretary of State said recently:

“I don’t want to see any junior doctor have their pay cut.”

Can he now guarantee that no junior doctor will be paid less as a result of his proposed new contract? Yes or no?

[Mr Hunt]

I welcome the hon. Lady to her post. I hope that, just occasionally, we might agree on some things, although I suspect that today may not be one of those occasions.

Let me be absolutely clear about the commitment that we have made to junior doctors. We will not cut the junior doctor pay bill, but what we do need to change are the excessive overtime rates that are paid at weekends. They give hospitals a disincentive to roster as many doctors as they need at weekends, and that leads to those 11,000 excessive deaths. Let me gently say that that was a change to the doctors’ contracts made in 2003, so for members of the Labour party to say that this is nothing to do with them is not accurate, and they should help us to sort out the problem.

[Heidi Alexander]

I think it is fair to say that junior doctors will make up their own minds about that response.

Last week I received an e-mail about a seriously ill woman who had needed to be admitted to hospital over the weekend, but had stayed at home for two days because of recent interviews given by the Department of Health that had made her think

“that the NHS was not staffed at weekends.”

Her doctor went on to say:

“This delayed her operation, put her life in danger and ultimately will have cost the NHS more”.

Does the Secretary of State feel any responsibility for that?

[Mr Hunt]

Let me give the hon. Lady the facts. According to an independent study conducted by The BMJ, there are 11,000 excess deaths because we do not staff our hospitals properly at weekends. I think it is my job, and the Government’s job, to deal with that, and to stand up for patients.

The hon. Lady talked about being constructive. There is something constructive that she can do, which is to join the Royal College of Surgeons, the Royal College of Physicians and the Royal College of Nursing, and urge members of the British Medical Association not to strike but to negotiate, which is the sensible, constructive thing to do. Will the hon. Lady tell them to do that?

NHS: Financial Performance

Heidi Alexander Excerpts

Monday 12th October 2015 Commons Chamber

[Heidi Alexander (Lewisham East) (Lab)]

(Urgent Question): To ask the Secretary of State for Health if he will make a statement on the financial performance of the NHS.

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

I thank the hon. Lady for giving me this opportunity to come to the House and make a statement on the financial performance of the NHS.

On 9 October, Monitor, the regulator of NHS foundation trusts, reported that foundation trusts ended the first three months of the financial year with an estimated net deficit of £445 million. Monitor’s publication noted that performance in the first quarter of the financial year is usually worse than it is over the rest of the year. The NHS Trust Development Authority also published that day the financial position of NHS trusts for the first quarter of 2015-16, which showed that the NHS trusts sector ended the first quarter of the year £485 million in deficit.

The financial position of the NHS is undoubtedly challenging. It is important to recognise that, despite the difficult decisions we have had to make as a result of the calamitous deficit we inherited, it is the Conservative party that has chosen to prioritise funding for the NHS. That is why we are committing an additional £10 billion over the lifetime of this Parliament, starting with £2 billion this year.

However, additional Government spending is not the only answer to the challenges faced by the NHS. The Government have taken action with our arm’s length bodies to support local organisations to make efficiency savings and reduce their deficits. In the first three months of this year NHS trusts spent £380 million on agency staff, while foundation trusts spent £515 million. That is nearly £10 million a day across the NHS. We need to reduce that spending and challenge the agencies that are charging, frankly, outrageous amounts for their staff. To that end, a package of measures, including a ceiling on the amount each trust can spend on agency nurses and mandatory central framework agreements, was announced by my right hon. Friend the Secretary of State in June.

The Government and NHS leaders have taken national action to support local leaders in managing down those deficits. I very much welcome a constructive discussion with the Opposition on where we might be able to go further in driving the efficiency savings that the NHS must find if it is to provide the exceptional standard of patient care that we all, on both sides of the House, wish to see.

[Heidi Alexander]

I thank the Minister for that response. Where possible, I hope that we can have a mature and constructive relationship. However, he should make no mistake that when responses are as poor and lacking in detail as the one we have just heard, I will provide strong and robust opposition.

Ministers are accountable to patients, and their silence on the growing black hole in NHS finances has been deeply disappointing, as is the absence of the Health Secretary today. Not a single Minister was available to be interviewed about the NHS on Friday: it is not good enough. The deficit for the first three months of this financial year was larger than the deficit for the whole of 2014-15.

So, first things first: what advice has the Minister issued to hospital chief executives and finance directors about managing these pressures? Does he honestly think it is still possible for hospitals to balance the books, maintain current services, and deliver safe patient care? Given that the figures relate to quarter 1 and we are now in quarter 3, will he provide his latest assessment of the NHS financial outlook?

There is clearly not enough money in the current budget to cover existing costs. How on earth does the Minister plan to fund more services spread over seven days? The Conservatives’ election promises of more money have yet to materialise, and now their commitment to transparency in the NHS is looking decidedly shaky. For someone who prides himself on being open, the Health Secretary has been suspiciously silent about the delayed publication of these reports. Let me quote what a senior official in Monitor said just over a week ago:

“We are being leaned on to delay them and I have a suspicion that the sensitivity would be less after the Tory party conference”.

Will the Minister say whether these allegations have been investigated? The figures were presented to the board of Monitor on 30 September, so when was he told? Was it before the Tory party conference?

It may be an inconvenient truth for the Health Secretary and his Ministers, but the public have the right to know what is going on and what the Government plan to do. People across the country depend on NHS services, and Labour Members will stand up for them.

[Ben Gummer]

First, I welcome the hon. Lady to her place. Although he is not in the Chamber, I pay tribute to her predecessor, the right hon. Member for Leigh (Andy Burnham), who occupied her position, both as shadow Secretary of State and as Secretary of State, for a considerable period. I hope we can develop our relationship as constructively as possible in the months and years ahead.

The hon. Lady rightly said that Ministers are accountable to patients. That is precisely why we will not make the same mistakes as her predecessors in trying to trade off patient care and patient safety with the finances of the NHS. That is why we have been entirely open not only about the size of the deficit but, in a manner that the previous Administration were not, the failings of care in the NHS when they occur.

The hon. Lady said that the deficit is larger than it was in the whole of last year. That is not accurate. The deficit is traditionally larger in the first quarter of any one year. [Interruption.] She questions that, but it is a statement of fact.

We took action as soon as we came into office to give providers the opportunity and ability to bear down on deficits: it was one of my right hon. Friend’s first actions in coming into government. In three specific areas—agency staff required because of our need to take urgent action following the calamitous and scandalous events at Mid Staffs, the high and excessive pay of NHS managers and consultancy spend, and NHS property—we have given trusts the ability to bear down on deficits. We expect to see the use of those new tools in the past few months bear fruit in the months to come.

The hon. Lady asked if it is possible to balance books and deliver safe patient care. I point her in the direction of the trusts that are, and have been, successfully balancing their books and providing exceptional patient care. Indeed, it has been observed not only by me and other Ministers, but by those outside the Department of Health, that the trusts that best manage their finances and the efficiency of their hospitals also tend to provide the best patient care.

The hon. Lady made an interesting statement about there clearly not being enough money, but she will be aware that the NHS itself asked for £1.7 billion in this financial year and that we responded not with £1.7 billion, but with £2 billion. We have met the NHS’s own funding requests with more than it has anticipated. For the remainder of this Parliament the NHS itself has requested £8 billion of funding, and we have pledged to give it every single billion—a pledge that was not matched by the Opposition and that they tried to undermine at the last election. They pledged to give only £2.5 billion, as opposed to the £8 billion we promised the electorate. The hon. Lady says that promises have yet to materialise, but the money that we promised, not at the last election but in the previous autumn statement, is already flowing through the system.

The hon. Lady asked specifically about the relationship and the nature of the release of the figures. I completely refute her suggestion and I am certainly looking at investigating why such comments were made. I speak for the ministerial team when I say that we did not put on pressure as she might have suggested.

Finally, the hon. Lady says that the public have a right to know what is going on. We have been completely straight, and I have been direct, about the financial challenges facing the service. The reason for those financial challenges is the extraordinarily challenging situation resulting from the demographic changes in our country. On the Government’s part, that requires making very big decisions about the transformation of the service. We best do that not by making the NHS a political plaything, but by working together to deliver precisely the plan that the NHS has delivered for this Government and that we intend to deliver for the patients and people of this country.

Oral Answers to Questions

Heidi Alexander Excerpts

Tuesday 7th July 2015 Commons Chamber

[Ben Gummer]

The strength of the NHS forward view is that it is a creation of the NHS itself, and we, as the only party to back it in full with cash, will give it the kind of support it needs to make sure it is delivered.

[Heidi Alexander (Lewisham East) (Lab)]

How many maternity wards or emergency surgery departments currently located in district general hospitals will close as a result of the Government’s seven-day NHS plans?

[Ben Gummer]

It is telling that the hon. Lady wishes to talk about wards rather than outcomes. Over the last five years, we have seen a significant increase in the number of patients treated in emergency wards, and we will continue to see an increase, and the difference is that they will operate seven days a week, rather than just five days a week, as is currently the case for many services across the NHS.

A&E Services

Heidi Alexander Excerpts

Wednesday 24th June 2015 Commons Chamber

[Ben Gummer]

I will after I have finished this comment.

It is important to put all this in the financial context. I have been through the Lobby with the shadow Minister and with many Labour Members who were in the previous Parliament. We went through the Lobby just before the election when we agreed to cuts in public expenditure in the first two years of this Parliament and the former shadow Chancellor committed the Labour party to cuts in local government spending. Difficult choices are forced on us by the catastrophe and chaos that we were left in 2010. Labour Members need to confront those difficult choices. They cannot have it both ways. They cannot, on the one hand, say that we need massive increases in payments for social care and, on the other, say that they are going to constrain public spending. The answer to that dilemma is surely to try to find a better way of integrating social care that I hope would see cross-party consensus rather than the politicking we have just seen at the Dispatch Box.

[Heidi Alexander (Lewisham East) (Lab)]

The Minister is talking about the financial context. My worry is that a lot of NHS managers in London talk about a Lewisham-sized hole in the NHS budget in south-east London. We stopped the Secretary of State closing Lewisham’s A&E last time. Can the Minister promise me today that he will not be coming back to Lewisham for another go?

NHS Success Regime

Heidi Alexander Excerpts

Thursday 4th June 2015 Commons Chamber

[Ben Gummer]

I thank my right hon. Friend for that, and he has got to the nub of the point in a way that the shadow Secretary of State did not. This is about patient care and the excellence we expect from it. That is precisely why I agree with him that success regimes will be successful only if we ensure that we are improving patient care, and that might well include improving access to care at a local level.

[Heidi Alexander (Lewisham East) (Lab)]

I am confused: the NHS success regime is not about success—it is about failure. Will the Minister confirm that services in the areas affected are delivering safe care? Should patients be worried?

[Ben Gummer]

The hon. Lady should not be confused because the success regime is indeed dealing with local failure and we intend to turn it into a success. That is the point of what we are doing. We have made these decisions where the NHS has assessed areas as having quality and financial problems. We intend to address them rather than just talk about them, which is why I am so glad that this will be locally led, finding local solutions to local problems.

Oral Answers to Questions

Heidi Alexander Excerpts

Tuesday 2nd June 2015 Commons Chamber

[The Minister for Community and Social Care (Alistair Burt)]

May I welcome my hon. Friend to his place? Among the many good reasons to go to Cornwall over the next few months will be to visit the Cornwall better care fund, which is part of the Government’s £5.3 billion better care fund, and get the opportunity to see the work of the Cornwall pioneer. Integration of social care and healthcare is extremely important, and it will be great to see it in Cornwall.

[Heidi Alexander (Lewisham East) (Lab)]

T3. For the first time in recent history, many of London’s more prestigious teaching hospitals—King’s College, University College London, Guys and St Thomas’s, and the Royal Free—are all forecasting deficit budgets. Apart from crossing his fingers and hoping the economy picks up to fund investment, what exactly is the Secretary of State going to do to tackle this problem?

[Mr Hunt]

I would not expect the hon. Lady to want to listen to me on the “Today” programme, but I have been talking a lot today about the measures, including in my topical statement. I will tell her exactly what we are doing: this week we are announcing measures to restrict the use of agency staff, which was an important, necessary short-term measure in response to what happened at Mid Staffs. We need to move beyond that. Later in the week we will be helping trusts reduce their procurement costs and taking a number of measures, so a lot is happening. There are a lot of challenges, but I know that NHS trusts can deliver.

Princess Royal University Hospital

Heidi Alexander Excerpts

Wednesday 25th March 2015 Westminster Hall

[Heidi Alexander (Lewisham East) (Lab)]

I am very grateful for the opportunity to make a short contribution today, and I congratulate my hon. Friend the Member for Lewisham West and Penge (Jim Dowd) on securing the debate. I also thank him for sharing his time with me so that I can put on record my concerns about the challenges facing the Princess Royal and other hospitals in south-east London.

When I first learnt about the Monitor investigation into the PRUH a few weeks ago, I was worried, like my hon. Friend, that we might be witnessing the start of another process that would end up with Ministers or NHS officials wanting to close Lewisham’s full A and E. I was worried because, as he has said, we have been here before. Problems in a neighbouring hospital trust, of which the PRUH was then a part, resulted in NHS bureaucrats casting around, on the look-out for ways to save money.

It is understandable that my constituents might be suspicious about the latest investigation, given their experience a few years ago with the trust special administration process, which, as we all know, had at its heart an ill-judged and illegal attempt by the Government to close services at Lewisham in order to sort out problems at the PRUH and the Queen Elizabeth hospital.

The Minister may tell us today that this process is entirely different, but it would be helpful if she could set out exactly what the process is limited to, the time scale of the process and what change could come about as a result of the investigation. Is it about giving King’s and the PRUH more money to adequately provide the services that are needed? Is it about changing leadership at the hospital or providing specific types of support? When the investigation is concluded, how will local people know what has been proposed? Will we, as local Members of Parliament, get a copy of Monitor’s full report? Could another trust special administration process be triggered?

I am keen to get answers to those questions. Although we successfully fought the Government’s proposals for Lewisham hospital last time around, the Government have since changed the law. They can now use a rushed and chaotic process to force service closures at any hospital in the country as long as they deem the neighbouring hospital trust to be failing. Given that cynical move by the Government, it is little wonder that among my constituents there is considerable anxiety that the proposals to take services away from Lewisham will rear their head again.

I tell the Minister, for the sake of clarity if nothing else, that the people of Lewisham are adamant: no matter what the problems in neighbouring hospitals are, our full accident and emergency and maternity departments are essential local services that we cannot do without. I am not saying that everything is perfect, but when there are such huge pressures on the system, such as those we saw in the winter, my constituents are right when they say to me, “Just think how much worse it would have been if they had closed Lewisham.”

There are enormous pressures on London hospitals, and the situation is getting worse. At the PRUH, according to the chief executive’s January board report, one in four people who attended the A and E there in December were not seen within four hours. The latest weekly figures for both the PRUH and Lewisham hospital show a much lower percentage of patients seen within four hours than this time three years ago. We know that the PRUH is heavily reliant on nursing agency staff because of recruitment difficulties. That has resulted in an overspend on its staffing budget. I could list other problems, but time is short.

Suffice it to say, the system is under increasing pressure, and that has happened on this Government’s watch. When I first stood to be a Member of Parliament five years ago, the NHS hardly ever came up on the doorstep. It now comes up time and again. When I get an e-mail from a constituent telling me about their elderly neighbour being left waiting hours for an ambulance to turn up, waiting hours on a trolley to be seen in A and E and then waiting hours to be given a bed, I know that something is seriously wrong with our health service.

Will the Minister give us her honest assessment of the state of hospital services in south-east London? Will she set out exactly what her Government are doing to resolve the problems and give us categorical reassurance that the latest investigation into the Princess Royal hospital is not just another attempt to come after services in Lewisham?

--- Later in debate ---

[Jane Ellison]

I have just made clear for the record what Monitor’s powers are and are not. I hope that that gives Members on both sides of the Chamber greater clarity than they had when we started. Monitor is in the process of concluding its investigation. It will announce in due course the outcome and whether it will take any further action. Key findings and any next steps will be announced by means of a press notice. Colleagues from Monitor are here in the House, and I would like to put them on notice that I expect—I am sure that they also expect this—Monitor to engage fully with local Members. Clearly, we are entering a more tricky period from that point of view, but on the other side of the election I expect there to be full engagement with local Members, particularly as the solution lies, as I think it will in other health economies that are challenged, in the whole local health economy coming together to understand how to work through the problems. That is laid out in NHS England’s “Five Year Forward View”.

[Heidi Alexander]

The Minister talks about further support that may be available to King’s and the PRUH when Monitor has concluded its investigation. Will she give some examples of the form that that support may take?

[Jane Ellison]

If it is acceptable to the hon. Lady, I will write to her to provide some clarity on that. It might be helpful, for example, for Monitor to give examples from other investigations of the sorts of things that it undertook and the changes that it requested through the formal process. I will write to her with some examples to give her a sense of that. I have sought to give a degree of reassurance to Members, and I hope that I have managed to do so.

Barts Health NHS Trust

Heidi Alexander Excerpts

Thursday 19th March 2015 Commons Chamber

[Jane Ellison]

The bullying of NHS staff who are trying to draw attention to poor care is never acceptable, and this Government have taken a lot of measures to make sure that NHS staff are protected. The trust’s chief executive has said the following about the report:

“We are very sorry for the failings identified by the CQC in some of our services at Whipps Cross and we know the Trust has a big challenge ahead.”

Part of that big challenge will be in restoring staff morale, and making sure that that culture of openness and support for staff is in place.

[Heidi Alexander (Lewisham East) (Lab)]

The placing of Barts into special measures this week confirms what many of us already know: London hospitals are under enormous pressure, some simply cannot cope and too many patients are not getting the care they deserve. In the light of that, can the Minister confirm that the recently announced Monitor investigation into the Princess Royal hospital at Farnborough will not result in another attempt by her Government to take the axe to Lewisham hospital and to services in south-east London more generally?

[Jane Ellison]

I believe we may well be addressing that issue in an Adjournment debate next week. There will be a chance to discuss it in more detail then.

Oral Answers to Questions

Heidi Alexander Excerpts

Tuesday 13th January 2015 Commons Chamber

[Norman Lamb]

Although there was a fall in life expectancy for those aged 85 in 2012, preliminary analysis shows that there was no further drop in 2013. Incidentally, let me pay tribute to the people who work in social care. The system has performed remarkably well. Statistics on delayed discharges due to social care show that the number of delayed days is almost exactly the same this year as it was in 2010—a remarkable performance.

[Heidi Alexander (Lewisham East) (Lab)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health (Mr Jeremy Hunt)]

The Chancellor agreed in the autumn statement to support NHS England’s five-year forward view with the £1.7 billion of additional funding that the NHS requested. On top of that, the Chancellor allocated £1 billion of funding to transform primary care facilities, and I am pleased to announce today that a letter will shortly be sent to every single GP practice in the country, inviting them to bid for the first tranche of that funding with the aim of supporting more GP appointments and more proactive care for the most vulnerable.

[Heidi Alexander]

Last week, one of my constituents had a fall and fractured her pubic bone. She was taken to Queen Elizabeth hospital in Woolwich because 15 ambulances were stuck in a queue outside Lewisham. She then waited 12 hours on a trolley. If the Secretary of State had got his way and been successful in his attempt to axe services at Lewisham, exactly how much longer would he have expected my constituent to wait? Is it not true that if he had got his way the A and E in Woolwich would have been totally and utterly overwhelmed?

[Mr Hunt]

No, and I can tell the hon. Lady that her constituents would be receiving far worse care had we not tackled the long-standing issues with the South London Healthcare NHS Trust, which the last Government ducked but which we have confronted and dealt with. If she looks at the performance of A and E in her area, she will see that 48,000 more people are being seen within four hours than when Labour was in power.

Health

Heidi Alexander Excerpts

Monday 27th October 2014 Ministerial Corrections

The following is an extract from Questions to the Secretary of State for Health on 21 October 2014.

[Heidi Alexander]

London ambulances are taking, on average, two minutes longer than they did three years ago to respond to the most serious call-outs. The chief executive of the service is quite open about the fact that she does not have enough staff on each shift every day. This is a service in chaos. Will the Minister be explicit about the support her Government are giving to ensure that my constituents, and Londoners, get the service they deserve?

[Jane Ellison]

This affects my constituents too, as I am also a London MP and therefore take a very close interest in it. I think it is unfair to say that the trust is in chaos. It is taking urgent steps to address the situation, including recruiting extra paramedics, increasing overtime, and reducing the number of multiple vehicles attending each call. We are working with Health Education England to increase the pool of paramedics, with 240 being trained in 2014, going up to 700 in 2018. Urgent measures are being taken to address the problem right now. I have had those assurances directly from managers in the trust whom I met very recently.

[Official Report, 21 October 2014, Vol. 586, c. 748.]

Letter of correction from Jane Ellison:

An error has been identified in the response I gave to the hon. Member for Lewisham East (Heidi Alexander) during Questions to the Secretary of State for Health.

The correct response should have been: