NHS Sustainability and Transformation Plans

Helen Whately Excerpts

Wednesday 14th September 2016 Commons Chamber

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

I beg to move,

That this House notes with concern that NHS Sustainability and Transformation Plans are expected to lead to significant cuts or changes to frontline services; believes that the process agreed by the Government in December 2015 lacks transparency and the timeline announced by NHS England is insufficient to finalise such a major restructure of the NHS; further believes that the timetable does not allow for adequate public or Parliamentary engagement in the formulation of the plans; and calls on the Government to publish the Plans and to provide an adequate consultation period for the public and practitioners to respond.

I am glad to open this debate on the NHS sustainability and transformation plans. As the whole House knows, the NHS has a special place in the affections of our constituents. No other public service engages with us all when we are at our most vulnerable—in birth, death and illness—and the public and NHS staff are increasingly aware that the NHS is under severe financial pressure, a matter I will return to.

In that context of financial pressure and concern about the availability of services, the sustainability and transformation plans are arousing concern. They sound anodyne and managerial, and there is undoubtedly a case for bringing health and social care stakeholders together to improve planning and co-ordination. But the concern is that, in reality, the plans will be used to force through cuts and close hospitals, will make it harder for patients to access face-to-face consultations with their GPs, and, above all, will open the door to more privatisation. It tells the public how little the Secretary of State cares about their concerns that he is not in the Chamber to listen or respond to this debate. We know that recently he has missed all seven recent meetings of the NHS board. The public are entitled to ask how much he cares about their very real concerns.

[Helen Whately (Faversham and Mid Kent) (Con)]

The hon. Lady mentioned cuts, but this Government are putting more money into the national health service—an extra £10 billion a year. The Labour party had no intention of making that sort of financial commitment to the NHS, as we saw in its failure to do so before the last election.

[Ms Abbott]

The NHS was never better funded than under the last Labour Government and the public know that. That is why they trust us with the NHS.

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[Helen Whately (Faversham and Mid Kent) (Con)]

I welcome the new ministerial team to their places. I also welcome the shadow Secretary of State, the hon. Member for Hackney North and Stoke Newington (Ms Abbott), but may we have a more constructive debate about healthcare in future? She should not talk about cuts. She knows perfectly well that this Government will be putting an extra £10 billion a year into the NHS by 2020. That is not a cut. That is £10 billion extra of taxpayers’ money. Will she please not mislead people by talking about cuts? As she well knows, her party did not commit to spending anything like that on the NHS.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

I do not think that an hon. Member would try to mislead another. That is not a word that we would use.

[Helen Whately]

My apologies, Mr Deputy Speaker. I did not mean to use that word. The hon. Lady mentioned the £22 billion shortfall set out in the “Five Year Forward View” analysis, so will she clarify whether her party is now planning to make that up? If so, where will it find the money from? That was not entirely clear in her comments.

I will move on, because I sincerely believe we need a far more constructive debate about the real challenges the NHS faces and how to improve the care it provides to our constituents. The NHS is under pressure—no one here is denying that. I know it as well as anyone, as my grandmother spent five of the last six months of her life recently in hospital, and if the system had been better she would not have been there and would have had a much better end to her life. We know that people are living longer, with multiple conditions: about 70% of NHS spending goes on dealing with long-term conditions. The treatments available have increased vastly and are therefore more expensive than they were in the past, and patients expect far more of the NHS.

The NHS should not constantly be criticised, as is so often the case, as it is seriously rising to the challenge. It is performing thousands more operations, with thousands more patients being seen every day. In addition, in response to what happened at Mid Staffs and other such incidents, tens of thousands more doctors and nurses are working in the NHS. Skilled staff do not come about overnight; training takes years. A lot is therefore being done also to address the pressures on the NHS workforce. None of that should be overlooked, although it is also costly.

I ask us all to focus on talking about how the NHS rises to the challenges it faces, doing so in a financially sustainable way. We do not have a blank sheet of paper for this; the “Five Year Forward View” was published in 2014. As you may well know, Mr Deputy Speaker, I have previously asked questions about what was happening to drive forward that review at the pace and scale needed. The STPs are a vital part of the process, as across the country they are about putting the five year forward view into practice. They are doing that in an important way, looking at the place and the whole population, bringing together a diversity of organisations across the NHS and involving local authorities. We are talking about organisations that are rarely in the same room. In Kent, organisations have come together where previously people have literally not spoken together—chief executives have not previously been in the same room together. This is really important. The STPs are also putting public health at the core of the future plans for health and care across the region, and they are looking not just at treatment but at how the population can be healthier and how we can reduce health inequalities.

Finally, I urge all colleagues to do what I am trying to do, which is make sure that the STP in their area rises to the challenges and delivers the care that we all want for our patients in future.

Junior Doctors Contract

Helen Whately Excerpts

Wednesday 6th July 2016 Commons Chamber

[Mr Hunt]

Let me tell the hon. Lady the words that Dr Malawana actually said:

“I will happily state that I think this is a good deal.”

He talked about junior doctors benefiting from

“massively strengthened areas of safety precautions…equalities improvements, improvements to whistleblowing protection and appropriate pay for unsocial hours.”

He thought this deal was a big step forward. As I said, if I thought that there was any prospect of further negotiations leading to a consensus that could get the support of the BMA membership, that is what I would be doing, but my honest assessment of the situation—given that the people who most strongly opposed the Government recommended accepting this deal and still they were not listened to—is that there is no such prospect, and I therefore need to take the difficult decision that I have taken this afternoon.

[Helen Whately (Faversham and Mid Kent) (Con)]

There has been a negotiation, the Secretary of State has listened to the concerns of junior doctors, we now have a better contract, and we heard today that there will a phased introduction of it. Does my right hon. Friend agree that junior doctors now need to move forward and that they should take up the offer to be involved in work to improve the experience of junior doctors in training? We know that junior doctors do not feel valued. They should feel valued. They need to play their part in making sure that they are valued.

[Mr Hunt]

My hon. Friend is right to say that. One of the things that is clear to me is that the reason that the May deal is better than the deal that we were going to introduce in February is because of the involvement of the BMA and the BMA leaders in telling us the concerns of junior doctors at the coalface, and the specific niggles and annoyances, many of which we were able to sort out very straightforwardly. I strongly hope that junior doctors will remain in all the discussions that we have, so that we try to get even better solutions.

Junior Doctors Contract

Helen Whately Excerpts

Thursday 19th May 2016 Commons Chamber

[Mr Hunt]

I reassure the hon. Gentleman that we are in constant touch with the devolved regions and countries to make sure that they know the changes that we are making, and to share any learning that we have from the processes that we have been through, so we will certainly do that. Across the country, we are doing everything we can to catch up with the backlog of operations, procedures and out-patient appointments—all the things that have been affected by the industrial relations dispute. Trusts will always prioritise the areas where clinical need is the greatest, but I know that that work is ongoing across the country.

[Helen Whately (Faversham and Mid Kent) (Con)]

I very much welcome the agreement that has been reached. We know that the Secretary of State recognises the importance of having a happy and well-motivated workforce, and this contract addresses many of the causes of unhappiness for junior doctors. It is particularly good to hear the points made today about addressing the problems of couples who are both junior doctors. However, there is clearly more to do, as has been acknowledged, especially on the reasons why junior doctors feel unsupported and often not valued by their employers. My right hon. Friend commissioned Professor Sue Bailey to carry out a review of the underlying problems experienced by junior doctors during training. Will he advise us whether the review will now proceed?

[Mr Hunt]

The request from the BMA was to find a new way of proceeding with that very important work, and that is what we will do. We will do so with the input of Professor Bailey, because she has a very important contribution to make. My hon. Friend is absolutely right to say that, as well as more flexible working for people with family commitments, the big issue for many junior doctors is the way in which the training process happens. In particular, the issue is about the way that continuity of training has been undermined by the new shift system—we need that system for reasons of patient safety—and that often means that someone is given advice by a different consultant on different aspects of care from one day to the next, which is frustrating. We will look at all those issues with Professor Bailey, Health Education England and the BMA to see whether we can find a better way forward.

Oral Answers to Questions

Helen Whately Excerpts

Tuesday 10th May 2016 Commons Chamber

[Alistair Burt]

It is absolutely essential that workers are paid the national minimum wage, and for care workers that includes travel. The Department has been very clear in that regard. Extra money is being provided to local authorities to pay for social care, as we know, but matters are tight—I am well aware of that. We are looking to providers and local authority providers to meet their statutory obligations to ensure that hard-pressed care workers have the financial support they need to do their vital job.

[Helen Whately (Faversham and Mid Kent) (Con)]

14. What progress his Department has made on delivery of the NHS five year forward view.

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

We are making good progress in implementing the five year forward view, including £133 million invested in new models of care and 18 million people benefiting from extended GP access.

[Helen Whately]

It is estimated that a third of patients in acute hospitals could be better treated elsewhere, for instance at home, and in east Kent our vanguard aims to address this with new models of care, but it is early days. Will my right hon. Friend advise us of what he is doing to drive progress on new models of care, bringing together health and social care so that more people are cared for in the right place?

[Mr Hunt]

My hon. Friend is absolutely right to draw attention to what is, in a way, the most fundamental point of the five year forward view, which is getting care to people earlier to help them live healthily and happily at home. Perhaps the most significant announcement we have had in the past few weeks has been the extra £2.6 billion a year that will be invested by the end of the Parliament in general practice. That is a 14% increase that will allow us to recruit many more GPs and, I hope, dramatically improve care for her constituents and others.

NHS Bursaries

Helen Whately Excerpts

Wednesday 4th May 2016 Commons Chamber

[Heidi Alexander]

I have already given way to the hon. Gentleman, and I want to make some progress.

These changes will effectively charge students for working in the NHS. Of course, longer term times and clinical placements also make it harder for these students to get a part-time job to supplement their income in the way many other students do. It is not just the course that makes healthcare students unique; they are much more likely to be women, much more likely to be mature students, much more likely to have children and more likely to be from BME backgrounds.

Many nursing students have already completed one degree and turn to nursing in their late 20s or early 30s—indeed, the average age of a student nurse is 28. When I think of my own friends who are nurses and midwives, I find that three out of four took the decision to re-train, having done a different first degree.

The Minister probably moves in different circles from me, but I can tell him that if he wants a dose of reality, my friends would, I am sure, be more than happy to oblige. I understand that he may not have experienced the conversations that I had in my working-class family about the pluses and minuses of racking up debts to get a degree, but I can tell him that for many nurses, under his proposals, that consideration will be all too real. Does he not realise that for the one in five healthcare students with children, the fear of debt is greater than it is for carefree, privately educated history students bound for Cambridge? My concern about these proposals is that we ultimately end up with those best placed to pay becoming nurses and midwives rather than those best placed to care. That brings me on to why these proposals are bad for patients.

[Helen Whately (Faversham and Mid Kent) (Con)]

I think we are all agreed on the need for more nurses; the question is how we fund them. Will the hon. Lady tell us how much money she would take away from front-line NHS care in order to fund the expansion of nursing places that the country needs?

[Heidi Alexander]

We set out at the last election our clearly costed plans for how to recruit additional nurses, doctors and care staff to the NHS.

The NHS should have a workforce that reflects the population it serves—just as this place should, too. The mental health sector in particular relies on mature students and the additional life experience they bring to what is a very demanding environment.

A few months ago, I met Marina, a young woman who has not had an easy life, but who is now on a mission to become a mental health nurse. When Marina says that she thinks some of the people best placed to care for others are those who have experienced hardships themselves, I think she has a point; and when she says she would not have been able to start her training without the bursary, I believe her. Why is the Minister so convinced that the NHS can do without people like Marina in the future? Why does he think they should pay to train, and why will he not consider other options for increasing student numbers?

The quality of training that student nurses, midwives and other allied health professionals receive will also depend on the quality of their clinical placements. Government Ministers claim these changes could deliver up to 10,000 extra places over the course of this Parliament, so can they set out what capacity hospitals and other providers have to accommodate these extra students, and confirm whether Health Education England has sufficient funds set aside to fund these placements? Will the Minister be clear about how this 10,000 figure was arrived at? Is it the Government’s assessment of what the system needs, what Health Education England can afford to fund or simply a big-sounding number plucked out of the air at random?

An extra 10,000 compared with when? What is the baseline year on which we should judge the Minister’s policy? I have asked him that three times in written parliamentary questions, and each time I have not received an answer. Does he not understand that if his Department cannot even answer a simple question relating to one of its key claims about the policy, that does not exactly inspire confidence? There are so many questions that the Minister needs to answer that it is impossible to do all of them justice in a single speech.

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[Helen Whately (Faversham and Mid Kent) (Con)]

If we ask any patients about their experience in hospital, one thing they are sure to talk about is the nurses who looked after them. In doing so, they are usually talking about both nurses and healthcare assistants—in my experience, patients do not tend to make a distinction. We know that nurses have far more interaction with patients, day to day, than doctors. Nurses’ quality and time are absolutely critical to patients’ experience.

Nurses are also critical to outcomes for hospital patients. Good nursing can be the difference between life and death. We have known that since Florence Nightingale, we were reminded of it by the inquiry into Mid Staffordshire and the Francis report, and we can see it from recent research into stroke outcomes. It will be clear to anyone who has looked at how Salford Royal has such good outcomes and such a good reputation—a lot of that is because of the focus on extraordinarily high standards of nursing.

The excellent NHS that I believe we all want needs excellent nurses. It also needs enough of them. This afternoon, people have talked about how we need something in the order of perhaps 10,000 to 20,000 more nurses—the numbers range widely. We also know that we need a shift in nursing skills, as we will need more nursing care for older people and people with long-term conditions, as well as more mental health nurses.

Right now, however, there are not enough nurses in our system, and hospitals across the country have vacancies. We know that they use large numbers of agency staff, and international recruitment is important to many hospitals, including those serving my constituents in Kent. I am not confident that more of the same will solve the problems, and neither was the nursing department of a London university that I spoke to last year. It said that it needed more funding per nurse place, but recognised that asking for more money for their nurses could mean taking money from front-line care in the NHS. That was not a good answer, and the department was open to a new funding model.

Last summer, the Council of Deans of Health and Universities UK stated that the

“current funding system is no longer working for either students or universities.”

Universities have to subsidise the cost of nursing and physio degrees from other courses, and NHS-funded nursing students have less to live on than others, even though they often study longer, more intense degrees with more hours, and are therefore even less able to do other work outside their qualification. We know that we need more nurses, and that the current funding system is not working.

How should we get more nurses? Around 2008-09, when plans were being drawn up for the Centre for Workforce Intelligence, I remember hearing that the answer was better workforce planning, with lots of skilled experts doing fabulous modelling of future workforce demands. I remember being a sceptic about that then, because when we consider the history of the NHS, and systems around the world that have centralised planning for the healthcare workforce, we find that it is almost always wrong. There are periods of over-supply and of under-supply—right now, we are in a period of under-supply, with all its knock-on consequences. Doing things better and having more experts sounds great in theory, but in practice we have seen that it does not work.

A much better answer is to set universities free to offer more places to all those students who, as we have heard, want to study nursing but are currently being turned away. I hope that we will have more nursing applicants, and that that career will become even more attractive, particularly as universities work more closely with employers on what is needed, and we must consider more of the specialist skills and expertise required within nursing by our care system now and in future.

To do that we must uncouple the funding of nurse training from the NHS, and take away the constraint that every £1 spent on training an NHS nurse is £1 potentially taken from front-line care, because that puts a premium on avoiding excess nurses. That is the right direction of travel, and it is also important to increase maintenance grants for nurses so that they do not struggle with their living costs as currently happens. There should be more routes into nursing. The nurse associate role is welcome, as is the apprenticeship route so that nurses can work and train in parallel. We know that that is appealing to more mature students who need an income and who want to be more hands-on during their training, and for whom a university environment has less appeal. Having worked for some time with healthcare assistants, I would like more recognition to be given to their role and qualifications, and I recognise the opportunity to support them even more to train to become qualified nurses.

We must invest more in continuous professional development for nurses. We know that we need a more flexible workforce that can adapt to future demands, yet in times of financial pressure, the investment and time given to ongoing training are often squeezed. Let us use this opportunity to try to shift that balance, and repurpose the workforce to meet the system’s demands and needs.

I would also like more attention paid to the appeal of nursing and the experiences of nurses in work. I have heard many nurses on the frontline say, “This weekend, I’ll be on my own—I will be the only permanent nurse on this ward. I will be working alongside agency nurses who do not necessarily know this ward, and it will make this weekend really difficult.” We badly need to put an end to that. The only way to do that, alongside the ongoing work to reduce the use of agency staff, is to increase the number of nurses who have been trained to work in the NHS.

I am out of time, but to sum up I think the direction of travel is absolutely right. Let us make sure that we get the details right on how the proposals are put into practice.

World Autism Awareness Week

Helen Whately Excerpts

Thursday 28th April 2016 Commons Chamber

[Mrs Gillan]

The hon. Lady is absolutely right. I will mention some of the organisations involved at the end of my speech. Ambitious about Autism is just one of the many organisations that are trying to help people with autism into employment. I want to mention that later as well, because it is very important.

To build on the intervention on the criminal justice system by the hon. Member for Cardiff West (Kevin Brennan), I should say that I recently visited Her Majesty’s young offenders institution in Feltham to see at first hand how a deeper understanding of the issues and how some adjustments in the physical environment can help people on the spectrum. The prison recently underwent accreditation from the NAS, and the prison staff’s enthusiasm in, and dedication to, helping the young people in their charge is absolutely admirable and really wonderful to see. I very much hope that members of the all-party group will go there on a visit to see exactly what Feltham has done. Custody can be a really traumatic experience for anyone, but without specific adjustments for those with autism, it is much harder for them to engage in their own rehabilitation. Familiarising staff with autism, allowing prisoners to use communal areas at quieter times, and reducing posters and notices to prevent over-stimulation are just some of the small things that can make a significant difference to the experience of autistic prisoners in custody.

I now want to pay tribute to the Minister for prisons, the Under-Secretary of State for Justice, my hon. Friend the Member for South West Bedfordshire (Andrew Selous), who wrote to every prison in this country asking them to undertake autism accreditation. Currently, over 20 have been in touch with the NAS and its accreditation team and, alongside Feltham, four are going through the process. We want this kind of Government leadership and we want such leadership to be sustained. When I ask the Government to do more on the awareness and understanding of autism, I expect to get this type of response. Far more could be done in the criminal justice system, particular in the Courts Service.

Following the example of Feltham, the public sector can and should do much more to make sure all its services and buildings are more accessible to autistic people, so that they and their families can feel confident that they can visit public buildings and use public services in the same way as everyone else. For example, I was very pleased at the weekend to read that Asda is piloting a “quiet hour” in one of its stores in Manchester, when it will turn off escalators, screens and music for an hour to create a more comfortable shopping experience for those with autism. That is to be commended.

At this point, it would be remiss of me not to mention that Parliament is itself working, under the leadership of Mr Speaker, towards an autism access award and to make sure that autistic visitors to our place of work feel confident that they will be understood and treated well right across the board. In the light of this positive work on the parliamentary estate, I hope the Minister will meet me and representatives from the all-party group and the NAS to discuss how, together, we can build on the early successes of the “Too Much Information” campaign and ensure that all public buildings become accessible to people on the spectrum.

I want to turn to one of the biggest issues facing people with autism and their families, which is the time it takes to get a diagnosis in the first place. I can see from the nods that that rings a bell with everyone in the Chamber. Recent research suggests that, on average, adults have to wait more than two years for a diagnosis. For children, the figure stands at 3.6 years. An autism diagnosis can be life-changing, explain years of feeling different and help to unlock professional advice and support. Government guidelines say that a diagnosis should not be a barrier to putting in place the right support, but 58% of people on the spectrum have told the NAS that a diagnosis led directly to getting new or more support. How can the right support be identified without the clarity of a diagnosis?

[Helen Whately (Faversham and Mid Kent) (Con)]

It is fabulous that we are having this debate today. I want to back up my right hon. Friend on her point about the delay in diagnosis. I have spoken to many families in my constituency who have waited for months for a diagnosis for a child, while the child could and should have been receiving help for their enormous difficulties, but months if not years have been wasted. Yet we cannot even get the data about diagnosis from either the county council or the NHS. Not only are there delays, but there is a lack of transparency about waiting times for a diagnosis.

[Mrs Gillan]

Absolutely. It is clear that, despite the best intentions of the Government, getting such a diagnosis is still crucial, as my hon. Friend says.

Meningitis B Vaccine

Helen Whately Excerpts

Monday 25th April 2016 Westminster Hall

[Helen Whately (Faversham and Mid Kent) (Con)]

It is a pleasure to serve under your chairmanship, Mr Pritchard. I thank the hon. Member for Walsall North (Mr Winnick) for his powerful contribution and my hon. Friend the Member for Bath (Ben Howlett) for his comprehensive opening speech.

I want to start by paying tribute to my constituents, Neil and Jenny Burdett, who are with us this afternoon. Their two-year-old daughter, Faye, died on Valentine’s day this year after an 11-day battle against meningitis B. It is their determination that something good should come of their loss that has brought us all here today. More than 800,000 people signed the petition after they published a picture of their daughter gravely ill in hospital. They have shown incredible courage over the past few weeks and months since her death. They did not expect to receive this much attention; they just wanted to prevent other families from suffering as they have. The scale of the response to the petition shows how strongly people in this country feel about meningitis and the level of fear and concern that there is out there among parents.

I am proud that Britain was the first country in the world to vaccinate the most at-risk group of babies against meningitis B. In this debate, we should not overlook the important fact that the rest of the world is watching our vaccination programme and seeing how it fares. In the evidence sessions prior to this debate, we heard Britain’s immunisation programme described by one expert as

“the envy of the world”,

but that does not mean we cannot do more.

It feels cold-hearted to talk about cost-effectiveness, but we have to introduce that to the debate because we know that NHS resources are limited, and we must recognise that money spent on meningitis cannot be used to fight other diseases. After extensive research and the work that was done to make the case for the vaccination to be introduced, costs were included that would not normally be included in such a case for vaccination. For instance, litigation costs and health losses to family members were included. The JCVI, which makes the recommendations, concluded that it would be cost-effective to vaccinate babies up to 12 months, but not older children. If I understand it correctly, the Government are legally bound by that decision. I am sure the Minister will confirm this, but I do not know whether we can simply call for that decision to be overturned and an instant change in the programme introduced. But questions can be asked, particularly as a group is looking at the moment into how the cost-effectiveness calculation is carried out.

[Mrs Helen Grant]

Does my hon. Friend agree that we should not ignore things simply because they are hard to measure, especially in a situation such as this? Issues that have already been mentioned such as peace of mind and public preference are really important.

[Helen Whately]

I completely agree with my hon. Friend and neighbour in Maidstone. I know she has been contacted by many of her constituents about this issue. We need to ensure that the formula used to calculate whether the vaccine should be introduced includes things such as peace of mind and the level of fear about meningitis. It should also take into account the public preference for protecting children from illness.

[Catherine McKinnell]

The hon. Lady is making an important point. My understanding—I would be grateful if the Minister would clarify this in her response—is that in calculating the cost-effectiveness of the meningitis B vaccination, the JCVI has not fully considered the potential outcome for those children who contract meningitis but survive and the long-term costs for them and their families for the rest of their lives. Such costs are often borne by the state, so, along with the factors that the hon. Lady is outlining, there are other financial costs that have perhaps not been considered fully.

[Helen Whately]

I thank the hon. Lady for that comment. We may well hear from the Minister that some of those extra costs have been taken into account, but when the Select Committee took evidence a few weeks ago we heard from the Meningitis Research Foundation and others that the cost-effectiveness model tends to privilege near-term costs over long-term costs and benefits. It does not look at the long-term lifetime health impacts, positive or negative, from a person having had or not had meningitis.

That brings me to something called the discount rate, which is applied at 3.5%. I have been told that, as a result of that discount rate, the benefits of a vaccine reach zero by the time somebody is 27. People clearly live for much longer than that, so is enough account being taken of the long-term benefits of a vaccination programme when cost-effectiveness is calculated? For instance, it has been calculated that if a 1.5% discount rate were used instead of the 3.5% rate, the answer would be different and a catch-up programme for under-fives would be cost-effective. The NICE guidance states that a 1.5% discount rate can be applied if health benefits would be attained over long periods and for public health interventions. Surely vaccinations should fall under those categories?

[Mims Davies (Eastleigh) (Con)]

Given my hon. Friend’s experience in the NHS and the clear point she is making, does she think we are missing a trick if we do not listen to that argument now?

[Helen Whately]

The arguments I am putting forward should certainly be looked into, and it is timely to consider them now, because a working group is currently looking at the cost-effectiveness calculation. We need a real sense of urgency about the report on the calculation and it should be published as soon as possible. According to the conversations I have had, there seems to be uncertainty about how it is progressing and when we will be able to discuss the findings.

In the meantime, ever greater awareness of meningitis is important, particularly as it strikes so quickly. Parents need to trust their instincts if a child seems unusually ill, and it is critical for health professionals to listen to them. We have heard many tragic cases of children getting meningitis in which the parents had suspicions that their child was really sick. They have gone to hospital and seen doctors, but they have been sent home with instructions to give the child Calpol or something similar. We know that meningitis is very difficult to diagnose, but it is worrying that there is such variability in how children are treated when they turn up with potential symptoms.

[Mrs Helen Grant]

During the Select Committee’s evidence sessions it was suggested that information about the disease could be put in babies’ red books to raise parents’ awareness. Does my hon. Friend think that that is a good idea that should be considered?

[Helen Whately]

It should most certainly be considered. The Government should look into all possible avenues for raising awareness. Charities such as Meningitis Now are working very hard and have some excellent leaflets, but parents are often still not aware. I have three young children and I have worried about meningitis. I would look out for a rash, but through being involved in this petition I now know that the rash comes so late in the process that it can be too late by the time it is seen. Parents have to be ready to spot a whole host of other symptoms and, when they speak to doctors, to be really confident that they think their child is more sick than usual and that it does not feel like a case for just Calpol. Parents have an instinct. We need to encourage them to trust it, and health professionals need to encourage them to speak up about it.

I know that other colleagues want to speak, so I shall conclude my remarks. We need a much greater sense of urgency about the work on the cost-effectiveness of vaccination. Bearing in mind the points I have made about the discount rate and the value that society attributes to the life of a child, a case could be made for extending the vaccination programme to more children. Work should be done on how health professionals deal with possible cases of meningitis B. Whether or not the NICE guidance is still right, it is certainly confusing. We also need more transparency about doctors’ reactions to possible cases of meningitis B, because it is hard to see the difference in the data—we only have anecdotes about how doctors and others respond when they see a possible case.

The Government must do all they can to raise awareness. Whatever the outcome of the debate, I thank Neil and Jenny very much for all that they have done. The petition and debate have surely raised awareness of meningitis B throughout the country, which in itself will have saved lives.

[Several hon. Members rose—]

Junior Doctors Contracts

Helen Whately Excerpts

Monday 18th April 2016 Commons Chamber

[Mr Hunt]

I hope the hon. Lady understands that I am not going to go into the details of the legal cases that we are currently arguing. However, let me make it clear that the Secretary of State does have that power and that we are using it correctly, and we will argue that case very strongly in the High Court.

[Helen Whately (Faversham and Mid Kent) (Con)]

Many hundreds of operations were cancelled during the last strike. The next strike will see the unprecedented step of emergency cover being withdrawn, and many junior doctors are themselves worried about that. Does my right hon. Friend agree that it is time for the BMA’s leaders, who are calling for the strike, to heed the worries of those junior doctors and of patients, and to call it off?

[Mr Hunt]

I absolutely agree. It is entirely legitimate to disagree with the Government of the day about contract reform—we have tried to make the case as to why that reform is important—but it is wrong for patients to pay the price for that disagreement. While the NHS can cope with the withdrawal of labour for elective care, it is a much bigger deal when emergency care is withdrawn, and people throughout the NHS are extremely worried about the impact of that. Doctors should also worry about how the public will view their profession if they proceed with this wholly unnecessary step.

Junior Doctors: Industrial Action

Helen Whately Excerpts

Thursday 24th March 2016 Commons Chamber

[Ben Gummer]

The right hon. Gentleman should know that we have negotiated with the BMA for more than three years. We have a choice either to cave in, which would produce a bad contract—much like the 2000 and 2003 contracts, which we are trying to correct, because everyone agrees they are wrong—or to move forward, accepting the fact that 90% of this contract has been agreed. We believe that it is in the interests of patients and doctors to do the latter.

[Helen Whately (Faversham and Mid Kent) (Con)]

Does my hon. Friend agree that this time the BMA has gone too far, and will he join me in calling on junior doctors to reach beyond the BMA and put their patients first and the BMA leadership second? Junior doctors are the future of the NHS, and they must play their role in constructively solving this problem.

[Ben Gummer]

I agree entirely with my hon. Friend, and we need this new contract to help junior doctors to achieve a better work-life balance, so that they can maintain their studies, training and experience in a better way than is currently allowed. We must also ensure that they are not exhausted by the contract, which is what happens under the current failed contract. It is in their interest for the new contract to be introduced, and I hope that in the coming weeks they will revise their view of whether this industrial action is truly necessary.

Oral Answers to Questions

Helen Whately Excerpts

Tuesday 22nd March 2016 Commons Chamber

[Mr Hunt]

We consulted widely with NHS leaders about the terms of the new contract, and they confirmed that it was fair and reasonable. Any decision to proceed with a new contract when it is not possible to have a negotiated settlement is inevitably controversial, but we wanted to ensure that independent people thought that the terms of the contract were fair. I think we have done that, and when junior doctors see their new contracts—as they will do shortly—they will realise that we were right to say that.

[Helen Whately (Faversham and Mid Kent) (Con)]

Underlying the dispute over the junior doctors contract is a long-standing problem of morale among junior doctors, and a failure to pay enough attention to their experiences in training. I welcome the Government’s decision to launch an independent review led by Professor Dame Sue Bailey, and I ask my right hon. Friend to update the House on the progress and timing of that review.