(7 years, 1 month ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
(Urgent Question): To ask the Secretary of State for Health if he will make a statement on the responsibility for establishing an inquiry into the contaminated blood scandal.
I begin by adding my personal apology to those who have previously spoken in this House about the tragedy of contaminated blood, and by reiterating that the Government recognise the terrible impact contaminated blood has had on many thousands of lives.
The Government recognise that previous inquiries into the events that led to thousands of people being infected with HIV and/or hepatitis C through NHS-supplied blood or blood products did not go far enough. That is why, on Tuesday 11 July 2017, the Prime Minister committed to establishing a further inquiry so that the causes of this tragedy can be fully understood.
Once established, we want the inquiry to be fully independent. Before it is established, however, there is a need to define its scope and format so that terms of reference may be set by the relevant Secretary of State. Given the tragedy’s impact on so many lives, it is vital that we get this right and that we get it right from the start. I am aware of the concerns that have been raised this week by those affected, by campaign groups and by Members of this House. Indeed, I spoke to the hon. Member for Kingston upon Hull North (Diana Johnson) on Tuesday about this very issue.
I reassure the House that the Government have as yet made no final decisions on the scope and format of an inquiry, or on its leadership. I have newly taken on this policy area, and I am keen to make sure that all those affected are given an opportunity to give us their thoughts and opinions. I understand it is normal practice for public inquiries to be sponsored by the relevant Department. However, we are keen to listen to the concerns that have been raised and ensure that they are addressed, which is why we are in discussions with the Cabinet Office and colleagues across Government to ensure that this inquiry does its job, and does it well, under appropriate leadership.
That is why an early consultative meeting was scheduled for today, hosted at the Cabinet Office, and the Secretary of State and Ministers hope to understand further the important views of those affected on the shape and establishment of an inquiry. This is the first of several meetings that the Government would like to offer over the coming weeks. I strongly encourage anyone affected to give us their views. Our door is open to anyone who wants to discuss the inquiry or raise any concerns they may have.
It is important to note that, whatever arrangements are agreed for this independent inquiry, safeguards will be put in place to ensure independence—for instance, by ensuring that the secretary to the inquiry has never worked at the Department of Health or any of its agencies. I reiterate that we are absolutely committed to a thorough and transparent inquiry, and we want to establish the best format and remit. That is why we want to hear as many opinions as possible, and we will work with those affected and Members of this House to do so.
Thank you for granting this urgent question, Mr Speaker.
Although I welcome last week’s announcement of an inquiry into the contaminated blood scandal, the vast majority of people affected by this scandal, their families, campaign groups and legal representatives, plus many cross-party parliamentarians, are, like me, dismayed to see the Department of Health leading on the establishment of this inquiry. The Department of Health, an implicated party at the heart of so much that has gone wrong over the past 45 years, must have no role in how this inquiry is established—in my view, it is akin to asking South Yorkshire police to lead an inquiry into the Hillsborough disaster. I regret that the Government have not been able to understand that putting the Department of Health in charge at this time immediately undermines their excellent decision to call a public inquiry last week. In consequence, contaminated blood campaigners boycotted a meeting organised by the Department of Health at 10 am today in protest. Another Department must surely now take over the responsibility for consulting on the remit of this inquiry.
I am pleased that the Government acknowledge the overwhelming and unanimous opposition to the Department of Health consulting on the inquiry, including from more than 250 campaigners and 10 campaign groups, the Haemophilia Society, and the law firms Collins Law and Leigh Day, which together represent 716 claimants. Nevertheless, the Minister needs to address two questions urgently. Why, on Tuesday 18 July, did the Department of Health call a meeting for 10 am today, with just two days’ notice, in central London, and at a time that is most difficult, inconvenient and expensive for people affected to attend? When I spoke to the Minister, she told me that the Government plan to update the House by September and get the inquiry up and running as soon as possible. That had not been made clear to campaigners or MPs, and I wondered why.
I still believe that the case is even more pressing for another Department to take over the work of establishing this inquiry now. That Department must then have a true and meaningful consultation with everyone affected, so that they can be fully involved and have confidence in this public inquiry.
As I mentioned, no firm view has been taken as to which Department will run the inquiry, but as the Minister with responsibility for this area the House would consider it amiss if I were not having meetings and discussions with those affected about the inquiry’s remit. When the Minister of State, my hon. Friend the Member for Ludlow (Mr Dunne), made the statement to the House about the inquiry, we made it clear that we wanted to progress as soon as possible. The Secretary of State called this meeting because we want to hear directly from the victims about what they want from the inquiry. We are very much in listening mode. A decision has not yet been taken as to which Department will run the inquiry but ultimately, as a Minister, I am accountable to Parliament for what happens in the Department of Health in those areas for which I have responsibility, and I want to be leading from the front, having those discussions.
I thank the Minister for saying that no decision has yet been taken about which Department will run the inquiry. Does she agree that perception is as important as reality in this matter, and therefore will she gain from this occasion a mindfulness of the weight placed by hon. Members, on both sides of the House, on the idea that the inquiry perhaps would be perceived to be more objective if some other Department took the lead?
I say to my right hon. Friend, and I have repeated this in other discussions as well, that the Cabinet Office is very closely involved in this, and this opportunity has given me the time to make that clear to the House. The Government are listening; we want to consult as widely as possible. No decision has yet been taken, but the Cabinet Office is closely involved in all the consultation we are currently having.
It is disappointing that we are here again today, so soon after last week’s announcement. A week ago, this House united in agreement to finally facilitate justice for those tragically affected by this scandal. Yet, as we have heard, in recent days Ministers have reneged on last week’s promises and run roughshod over the affected community.
The Minister of State may shake his head, but that is how the community feel; we have spoken to them. There are three key questions that the Under-Secretary before us this morning must answer, and I hope she will be more forthcoming with much-needed answers than she was to my hon. Friend the Member for Kingston upon Hull North (Diana Johnson).
Understandably, the community have deeply held suspicions when it comes to the Department of Health, so why are Ministers ignoring these concerns and the demands to facilitate an inquiry through another Department, such as the Ministry of Justice? This concern has been well documented in the letter to the Prime Minister by my hon. Friend, the Haemophilia Society, the 10 campaign groups and the law firms Collins Law and Leigh Day. Why does the Minister think the Government can so easily disregard all these people?
Events over the past few days have shown that last week’s promise to consult, engage and listen to the community was simply warm words. The audacious move to hold a roundtable meeting this morning with so little notice to potential attendees from throughout the UK has hindered many from being involved in the process of setting up the inquiry. Will Ministers explain why the meeting was held at such short notice? Who did they plan to invite so that the meeting was properly consultative? In the end, who was scheduled to attend following the mass boycott by many of those invited, who felt that the offer of a meeting was a slap in the face?
It is important that the inquiry is held sooner rather than later, but not at the risk of jeopardising justice. Will the Minister publicly outline, now, the timetable for the inquiry? Do the Government intend to initiate the inquiry in September? If so, why has that not been made public? Why is it that we must bring Ministers to the House again to make this clear? Does that not go against everything we were promised last week? The Minister must remember the promises made just last week and ensure that consultation is central to the whole process; otherwise, the Government will fail this community, who must have the justice they so rightly deserve.
It is in taking forward the consultation that we are delivering on the commitments made last week. We made it clear then that we wanted to get the inquiry going as soon as possible because, frankly, these people have waited long enough for answers. We have not ignored the concerns expressed by many about the role of the Department of Health in the inquiry. I repeat: no decision has yet been made and the Cabinet Office is closely involved in taking the matter forward.
As for the complaints about the short notice of the meeting organised by the Secretary of State this week, it is because we want to hear directly from the people affected as soon as possible that such a meeting was arranged before the House rises for recess. This is just the start. We want there to be good, effective dialogue because, as the hon. Member for Washington and Sunderland West (Mrs Hodgson) and the rest of the House will appreciate, it is important that we all inspire confidence in this process. Given the cross-party support we had when the inquiry was announced, it is disappointing that we are now getting bogged down in the process.
Like others in the Chamber, I welcomed the Prime Minister’s announcement last week of a public inquiry. I am encouraged by what the Minister is telling us this morning. One of my constituents who was affected has raised the issue of which Department should take the lead in the inquiry. Will my hon. Friend the Minister confirm what role victims, families and campaigners will play? How can they best engage with her and the Department at this stage?
We obviously want to hear from as many of the affected people as possible, and we will reflect on their representations. If they want to be very clear and blunt about the role of the Department of Health, we need to hear those representations so that we can make the best decision about who takes forward the inquiry.
I thank the hon. Member for Kingston upon Hull North (Diana Johnson) for asking this urgent question and pay tribute to her for continuously pushing on this important subject to ensure that we get justice for those so tragically affected. The inquiry must get the right answers, and it must command the confidence of those affected. Will the Minister confirm when a decision will be made as to which Department will lead on the establishment of the inquiry? Does she think it is right for the Department of Health to lead it? Will she confirm that the inquiry will include the families and victims, so that it is sensitive to what they want to know? Will the Government ensure that the inquiry will have to look at all matters, including documents, patient records and things that were altered and hidden, and that the things hidden behind public interest barriers will be opened up, so that light can be shed on this matter, as was the case with Hillsborough?
To be clear, the Department of Health is the sponsoring Department for the inquiry, which will be entirely independent. It is yet to be determined who will oversee it. Clearly, having made the statement and expressed our intention to hold an inquiry, we need to consult to make sure that that inquiry reflects on and answers the hon. Gentleman’s questions. Central to that will be the need for it to be seen to be transparent, open and fully independent. Once it is established, the inquiry will be entirely removed from the Department of Health. That should be enough to inspire confidence, provided we get the consultation right so that we get the remit right.
Two of my constituents who were affected by this terrible tragedy have already contacted me with concerns about the Department of Health’s involvement in the inquiry. This is a unique situation, especially with respect to the time it has taken to bring forward the inquiry, and credit should go to the Government for announcing it. Nevertheless, it is incredibly important that justice is seen to be done, so will the Minister consult members of the all-party group on haemophilia and contaminated blood with regard to who she determines are the right people to oversee the scope of the inquiry?
I am keen to hear from all Members of the House and members of the public on how they feel the inquiry should be taken forward. That is the spirit in which we are embarking on this consultation.
I welcome the Government’s decision to hold this inquiry in response to the campaign led by my hon. Friend the Member for Kingston upon Hull North (Diana Johnson). I know that the Health Minister is acting in good faith, but over many years Department of Health officials have advised there is no need for the inquiry and no problem at the heart of the issue. Will she recognise that because of that it would have much greater credibility for many of those who have campaigned on this issue if the sponsoring Department were another Department—be it the Ministry of Justice or the Cabinet Office—if all the staff did not come from the Health Department, and if one of the other Departments could be involved in the consultation, the establishment and the remit. This is no criticism of her—I know she takes this very seriously—but I advise her to hand this one over to another Department and let them run with it instead.
I understand the right hon. Lady’s point and I repeat that the Cabinet Office is closely involved with this at this stage. I think she would consider it most remiss of me were I not to take a close interest as this consultation is taken forward. I cannot say this enough: it is essential that the way in which the inquiry is established inspires confidence in the people affected, and that is what we are trying to achieve through the consultation. As I say, we want to hear from them and we are completely open-minded as to which Department takes responsibility. For now, I want to have those conversations because I want to understand their concerns with what has happened with the Department of Health. As a Minister, I need to give that challenge.
The letter from the hon. Member for Kingston upon Hull North (Diana Johnson) started by expressing gratitude to the Government for the progress made so far. That would have been welcome decades ago, but it is right to acknowledge it now. The letter included three practical points that it put perhaps slightly better than the shadow Minister. The machinery of government cannot work overnight normally and the questions and answers today will help the Government and the Prime Minister decide whether the right solution is, as has been suggested, having another Department or the Cabinet Office take on the consultation with the Department of Health helping as far as it can. The one point for the Department of Health now is whether it can guarantee the third point in the hon. Lady’s letter, which is that no records will be destroyed and that they will all be available to the inquiry.
I can certainly give my hon. Friend that commitment. Let me reiterate that we have made many documents available in public, all published, and I can give him every assurance that nothing will be destroyed. Having now taken the decision to hold an inquiry, we must get it right. I am happy to hear from hon. Members at any time if they have any specific concerns about whether they think evidence is being withheld, so that I can satisfy myself that that is not the case.
This is not a matter of challenging the Minister’s personal integrity; that is not in doubt. What is in doubt is the wisdom of the decision to have a Department that is majorly implicated in the concerns about what happened in the past involved at any point in the consultation and in taking the inquiry forward. I hope that before we go into recess an urgent statement can be rushed out advising that the Cabinet Office or the Ministry of Justice will now lead, not only on the outline of the inquiry but on the consultation. Then we can have trust from those who have been involved.
It is quite without precedent at this stage—so shortly after announcing an inquiry—for such a decision to be made. It is normal practice for the sponsoring Department to embark on the consultation, and I repeat that the Cabinet Office is closely involved from the perspective of propriety and ethics and the Department of Health is not working alone.
I warmly welcome the fact that the inquiry is now happening, and that the Government made the decision to undertake it, given the decades that have gone past since this issue first came up and the scandal occurred. Will the Minister reassure the victims that, in terms of any judicial involvement, which is almost certain in this case, the identity of the judge concerned will be selected by the Lord Chief Justice, and not by any Government Department?
That would be the normal procedure, so yes, I can give that commitment.
Will the Secretary of State assure us that, in the responsibility of this inquiry, there are real powers, which will enable the inquiry to ensure that it has proper access to all the witnesses and documents necessary? That will be vital to developing a just settlement for all those affected and their families. Can we also have an assurance that a fair financial system will be in place to support them, because this could take some time?
We are really looking to settle that question in this consultation. One decision that needs to be taken is exactly what shape the inquiry should take. Clearly, we would normally do this through a statutory inquiry, which would have the powers to which the hon. Lady referred, but equally, Members of the House have made representations that we should have a Hillsborough-style inquiry, which, by definition, would be more fleet of foot. One reason why we are pushing forward with this consultation is to get exactly that feedback, so that we put together an inquiry that inspires confidence among those who have been campaigning for this for so long.
Far from being negative, the Government should be applauded for their very swift action—recently, not in the past. They are listening and have already committed extra compensation, sorted out the complex system that we had before, and announced an inquiry. Can the Minister give an assurance, particularly to my constituents, that the right Department will be chosen, because we do have to give them confidence that we will not all be here again discussing this? We have the chance to sort it out now.
The purpose of the consultation is to allow people to make their points about which Department should be chosen to oversee the inquiry, and then we will respond accordingly. All I can say is: please encourage people to participate in this consultation.
If the consultation with interest groups unanimously says that the inquiry should be held by another Department, will the Minister respect that view?
We need to understand exactly what the concerns are and we will only achieve that through dialogue. I can reiterate that we are here to listen to those concerns. Now that we have decided to go ahead with the inquiry, I want to make sure that we get it right.
May I put on record how pleased I am, for my constituents and their families, about the commitment to hold this inquiry? I thank the Minister for listening to me on this yesterday. Does she agree that it is only by listening to those most affected that we can finally get the answers that the victims and their families are seeking?
We can only gain from having dialogue. It is in that spirit that we want to have as many conversations with those people affected as possible. It is disappointing that this morning’s meeting was not attended, but I hope that, in the future, we will have some meaningful dialogue.
May I ask the Minister to reflect on the fact that it is not reasonable to ask campaign groups from Scotland to attend a meeting at two days’ notice? May I also point out that there is a distinct legal system in Scotland? Has there been any thought about that or any discussions with Scottish campaign groups and/or the Scottish Government?
As I have said, that was the first of what I hope will be many conversations. Arrangements were made for the campaign groups in Scotland to dial into the meeting, so that they could participate. I have already started discussions with the Scottish Government about how this inquiry will play out and affect the position in Scotland. I am pleased to say that we are having those discussions in a spirit of healthy co-operation. In particular, we are looking at how we can make use of what has already been gone through with the Penrose inquiry. We will continue to have dialogue, and we are very sensitive to those issues.
At the weekend, I saw my constituent, Sue Wathen, whose case I raised in the debate last week. She was delighted with the Government’s commitment. The one issue that she particularly wants to see considered is that of access to appropriate treatments for victims. For most victims, that is the most important issue. Will my hon. Friend feed that back?
My hon. Friend makes a good point. That is exactly the sort of thing we need to hear from this consultation when we are setting the scope, and clearly access to treatment is very important. I encourage him to ask his constituent to write in and make those points.
I think there is a consensus across the House, because everyone has made the point very clearly that they do not have confidence in the Department of Health running the inquiry. I expect an announcement from the Minister soon. If the Cabinet Office is appointed, it does have a track record of taking rather a long time with inquiries, so quite often that is used to kick things into the long grass. Can she assure us that it will be a speedy but thorough inquiry?
The speed at which the inquiry reports will be determined by the chairman, because it will be independent—that is the point. At the moment the Department of Health is leading on conversations, but the inquiry will be independent; it will not be run by the Department of Health.
Health is a devolved matter, so can the Minister give the House a commitment that there will be maximum co-operation with all the devolved institutions across the UK?
I can give the hon. Gentleman that commitment. I have already discussed this with the Welsh Minister. It is a UK-wide inquiry and health is a devolved matter, so obviously we will need to work closely to ensure that we all respond to what the inquiry finds.
I thank the Minister for her statement and commend the hon. Member for Kingston upon Hull North (Diana Johnson) for her tenacity on this issue. Although only last December the Northern Ireland Health Minister allocated funding for contaminated blood victims to put us on a par with compensation paid on the UK mainland, it is essential that any UK investigation includes the Northern Ireland victims—I am speaking on their behalf—so that it is not done on an England-and-Wales-only basis. Can she confirm that that will be the case?
I can reassure the hon. Gentleman that we are very sensitive to the facts as they apply to Northern Ireland, and we will by all means ensure that the requisite dialogue takes place so that we can deal with it sensitively.
(7 years, 1 month ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship, Ms Buck. I thank all Members who have participated in this debate. Organ donation has been such an established practice in the NHS for quite some years that we often forget about it. The way that everyone has brought the subject to life today, with references to their own stories and experiences, has reminded all of us how important it is. Perhaps it is time this subject had some renewed focus, if only to raise awareness and encourage people to opt in, whether or not we ultimately introduce an opt-out system.
I pay tribute to the hon. Member for Barnsley Central (Dan Jarvis). He could not have done a better service to his constituents Joe Dale and Max Johnson in the way he expressed his argument with considerable persuasion. Perhaps through him, I could send my good wishes to Joe Dale’s family. I hope they get some comfort from the fact that Joe lives on by giving life to others. As we know, one organ donor can save or transform up to nine lives. What better legacy can we have than for other people to live on? We, as Members of Parliament, could perhaps be more proactive in giving that message, as we breathe life into this much neglected subject.
I am told that we last considered organ donation on the Floor of the House in 2014. This opportunity to discuss it is very welcome, and we will have many more opportunities, given the confirmation from the hon. Member for Coventry North West (Mr Robinson) that he will use his private Member’s Bill to push this issue forward. I am sure it will get a good airing.
The hon. Member for Washington and Sunderland West (Mrs Hodgson) presented tests at the end of her speech for what we should bear in mind when deciding what to do in this space. I think we should do all those things, in any case, as we talk about kidney donation. The key has to be public awareness and ensuring that medical professionals do their bit to encourage people to participate in organ donation. We must also engage with community groups where there is a specific problem. That is my biggest priority.
I want to say a bit more about the context. Obviously, we want to encourage as many people as possible to make clear their intention to donate after death and to have that conversation with their families. That is often where the decision is made. Medical professionals need the requisite training to have these sensitive conversations.
As the hon. Member for Barnsley Central mentioned, not many people understand the system of organ donation. We can all sign up to be on the donor register, but not all of us will be in a position for our organs to be used. Quite often, organs can be used after an unexpected and traumatic death, and it is very difficult for any medical professional to have a conversation with the family about what should happen to the deceased’s organs. We need to have a lot more understanding and be a lot more willing to make it clear to our loved ones that we would want our organs to be donated if we were ever unfortunately in that position.
I must pay tribute to all those in the national health service who work in this area. Their determination and commitment makes donation and transplantation possible. Although we still need more transplants, we have seen a significant increase in donations in the UK. We saw 1,413 donors giving 3,712 transplants in the last year, which illustrates how many lives can be saved by one successful approach to donation.
It is incredible that, as NHS Blood and Transplant told us only this week, more than 50,000 people are now alive thanks to organ donation and transplantation. The first transplants took place in my lifetime, and they were seen as revolutionary. One reason we have not given this subject as much attention is that donations now tend to be seen as commonplace.
There is much to celebrate, but there is also much more to do, not least because 457 people died last year while on the active transplant waiting list. That ignores the 875 people who were removed from the list because they had become too ill to receive a transplant. Many of those will have died shortly afterwards. At any one time some 6,500 people are on the waiting list, and again, although waiting times are declining, we cannot be complacent. We need to make sure that those people have hope that, when they are on the list, they have a realistic chance of receiving a transplant.
Our biggest challenge is black, Asian and minority ethnic donors, for two reasons. First, black and Asian people are more at risk of illnesses that may require a transplant, such as high blood pressure and diabetes, and secondly, the consent rate for those communities is half that of the white population. The same is true for blood, so we need many more blood donors from the black community. There is a constant need for that because of the prevalence of sickle cell anaemia, but we know that only 1% of the nation’s blood donors are black. So we need to do much more not only in organ donation but in blood donation.
There is some encouraging news. Last year, more than 6.4% of all deceased donors were from black and Asian communities. That is a significant increase, so the direction of travel is positive, but we need to do much more. Average waiting times for kidney transplants have fallen for everyone, and that rise in donations from black and Asian communities has meant that the biggest fall in waiting times is for black and Asian patients—down from four years to two and a half over the past seven years. The direction of travel is good, but we need to do more, because people from black and Asian communities still wait at least six months longer than white patients. That problem needs to be tackled, because recipients are matched according to blood and tissue types, which differ across ethnic groups.
As we set out in our manifesto, we are determined to target that audience, and we welcome the involvement of all hon. Members in that. We are looking at other partner agencies, and we are working with the National Black, Asian and Minority Ethnic Transplant Alliance. However, many other groups need to be engaged, not least to tackle misplaced cultural concerns about donation. It is not incompatible with Christian beliefs to bequeath one’s organs, and we need to make sure that that message gets out loud and clear by engaging with all community leaders in this space.
We have heard some persuasive arguments on opt-outs and why we should move towards an opt-out system, and I certainly understand the thinking behind that proposal. To add my personal experience of this, my constituent Patricia Carroll regularly lobbies me on the subject. Her daughter Natalie suffered from anorexia and diabetes, and died awaiting a kidney and pancreas transplant. Patricia tried to donate her own kidney to Natalie but was not a match. Following Natalie’s death, she decided to become a live donor. Last year—I think it was around Christmas—she gave a kidney to a 22-year-old young man called Joe who had been on dialysis for three or four years.
What Patricia has done for that family—it is the family, not just the individual—has transformed their lives. I again pay tribute to all live donors. That is an incredibly altruistic thing to do when recognising the impact it can have on the donor’s own health. It is amazing, particularly when there are donors who have absolutely no personal relationship with the beneficiary of their organ. Patricia will be watching with interest to see what I have to say about this.
There are obvious attractions to opt-outs as a tool; anything that will increase the pool of available organs will obviously be attractive. However, opt-outs on their own are not a panacea, and the references to what we can learn from Spain are significant. The issue is about what is wrapped around that. Specifically, it is not just about public understanding and public awareness of why we need donation and what it means, but about how the medical profession deals with it.
The crucial point that affects donation is the conversation in the room between medical professionals and bereaved families. We have seen examples of families refusing consent because they are not convinced that their relatives wanted to donate and it feels safer to say no. Equally, we have seen that being overruled. We find that the highest rates of donation are achieved when we have specially trained nurses who have that conversation with the family in a sensitive way. When such conversations take place, rates of donation go up significantly. Those conversations are critical. If we look at the experience of Spain, we see that that injection of medical advice achieved the step change in donation rates, over and above having an opt-out system.
None the less, we are interested to see the experience in Wales. We are certainly prepared to consider that, and obviously we need to consider it sooner than we might have intended, given the private Member’s Bill, but opt-out will never be a silver bullet to achieve more donation. We are committed to ensuring that we do whatever we can to increase donation. Our strategy, “Taking Organ Transplantation to 2020”, contained the ambitious targets that the hon. Member for Barnsley Central mentioned. Although we have not actually achieved the 70% that we are aiming for, the direction of travel is positive. The fact that more than 23.5 million people have opted in to donate their organs is quite an achievement, although I am not complacent. To give credit where credit is due, the NHS and everybody involved have achieved a great deal in achieving those figures.
The key thing is the availability of specialist nurses. We must ensure that organ donation is embedded as a normal consideration of end-of-life care, where that is available. We have looked at developing a new organ donor register that makes it easier for people to opt in. We are trying to make available as many opportunities as possible for people to do that, for example when people sign up for a new driving licence. In any interaction with Government, we need to give people that option, because where it is a positive choice, it is more likely to be effective.
We all agree about the need to raise awareness on the mainland and across the whole United Kingdom of Great Britain and Northern Ireland. When it comes to raising awareness—I presume the Minister will do so imminently—will she engage with the Northern Ireland Assembly, provided that it is still going, and with Scotland and Wales to ensure that we have a UK-wide programme of awareness to get people on the register?
The hon. Gentleman makes an excellent point. He might have seen that I am wearing a pin, which is a nice pink heart that says, “Yes”. That campaign is being run by NHSBT to highlight the need for people to offer to be a donor. If people are prepared to do it, they should wear this nice pin. We need to use any number of the tools at our disposal, and we need to be a lot more imaginative about the ones we use. I look forward to seeing him with his nice pink heart.
I should conclude my remarks to allow the hon. Member for Barnsley Central an opportunity to respond to the debate. I think that we are all united in the outcome we are trying to achieve, which is to encourage more people to be willing to donate their organs to achieve more transplants. With regard to the tools we employ to achieve that, we will look at opt-out and consider whether that would do anything, but in the meantime we are prioritising engagement with black and minority ethnic communities. We will continue to invest in specialised nursing to have those very sensitive conversations, because they need to happen. We will look at what more we can do to encourage more families to be willing to give consent at the time it needs to be given. I thank everyone for contributing to the debate.
(7 years, 1 month ago)
Written StatementsMy hon. Friend the Parliamentary Under-Secretary of State for Health (Lord O’Shaughnessy) has made the following written statement in the House of Lords:
I am today publishing the Government response to the public consultation on the National Data Guardian for Health and Care’s (NDG) and Care Quality Commission’s (CQC) data security reviews. A copy of the response is available at:
https://www.gov.uk/government/consultations/new-data-security-standards-for-health-and-social-care
Boosting cyber resilience, improving the response to data and cyber incidents and providing clarity on the handling of personal data remain an urgent priority for the health and care sector.
Following consultation which closed on 7 July 2016, the Government accept the recommendations from the two independent data security reviews published in 2016.
Through the consultation, we heard broad support for Dame Fiona Caldicott’s recommended data security standards and opt-out model, alongside a clear message that we need to carefully think through and approach all elements of implementation. Other key themes in the responses to the consultation related to the need to build public trust through providing clarity and communicating clearly with the public and professionals.
The global WannaCry ransomware attack in May 2017, which affected many other countries’ services as well as our own health and care system, has reaffirmed the potential for data and cyber incidents to impact directly on patient care, as well as the need for our health and care system to act decisively to minimise the impact on essential frontline services.
The Government response includes wide-ranging plans to strengthen organisations across the NHS and social care against the threat of global cyber-attacks.
The immediate and longer-term actions are centred on ensuring local organisations are implementing the 10 data security standards proposed in the NDG review, supported by the national cyber support services provided by NHS Digital, backed up by clear contractual obligations, and by assurance and regulatory action.
Investment in data and cyber security will be boosted above £50 million and will include a new £21 million capital fund which will increase the cyber resilience of major trauma sites.
NHS Digital is already supporting local organisations by broadcasting alerts about cyber threats, providing a hotline for dealing with incidents, sharing best practice across the health and care system and carrying out on-site assessments to mitigate against cyber-attacks.
The NHS contract now requires NHS organisations to implement and adopt data security standards as recommended by the independent NDG for Health and Care.
Chief executives will also be held to account for standards that are being implemented and maintained and this will be assessed during inspections by the Care Quality Commission from September this year.
The Government’s response also includes steps to give patients and the public more access to, and control over, their personal data while building confidence in the importance of secure data to provide better individual care and treatment, as well as supporting research and planning across the health system.
As the chief medical officer’s recent report on genomics showed, better use of data and technology has the power to improve health outcomes, deliver better patient experience, transform the quality of care patients receive and support improvements across the health and social care system—now and in the future. Staff and patients will benefit from reduced bureaucracy, freeing up more time for patient care, and leading to more accurate diagnoses and more personalised treatment.
I want to thank Dame Fiona Caldicott, her team and the Care Quality Commission for their important and considered reviews and recommendations, which can be found at:
https://www.gov.uk/government/publications/review-of-data-security-consent-and-opt-outs
http://www.cqc.org.uk/publications/themed-work/safe-data-safe-care
Attachments can be viewed online at:
http://www.parliament.uk/business/publications/written-questions-answers-statements/written-statement/Commons/2017-07-12/HCWS40/
[HCWS40]
(7 years, 1 month ago)
Commons Chamber8. What progress is being made on improving end-of-life care.
In July 2016 the Government published “Our commitment to you for end of life care”. This set out what everyone should expect from their care at the end of life and the actions we are taking to make high quality and personalisation in care a reality for everyone. By 2020 we want to significantly improve patient choice, including ensuring an increase in the number of people able to die in the place of their choice, including at home.
I thank the Minister for her reply, and it is welcome news that there is such a focus on end-of-life care. Will she meet me to discuss the Access to Palliative Care Bill presented in the other place, to look at how we can improve access to palliative care across the whole of the UK?
I will be delighted to meet my hon. Friend, who is a committed and passionate campaigner in this area. I am keen to explore anything that improves care and choice for all patients at the end of their life.
22. Croydon’s NHS, including end-of-life care, has been funded below the London average every year since the Conservatives first came into government. That is leading to the closure of services in Croydon that are available elsewhere, and to longer waiting times for GPs or the A&E in Croydon. When will Croydon’s funding be brought up to the London average?
The amount of resource that is dedicated locally is a matter for clinical commissioning groups, and we continue to make sure that funding is fair. I suggest the hon. Gentleman takes that up with his CCG.
9. What guidance he provides to clinical commissioning groups on decision-making processes to improve healthcare provision.
14. What plans he has to improve the integration of mental health services for young people and adults.
We are investing a record £1.4 billion in children’s mental health services. The transition from children’s services to adult services can cause distress, so NHS England has prioritised transitions when offering financial incentives for improvements. We will consider that in the forthcoming Green Paper.
I thank the Minister for that answer. There is a growing crisis in young people’s mental health in Plymouth and the far south-west. Despite 75% of mental health problems starting before the age of 18, only 8% of funding is allocated to young people. Will the Minister consider ring-fencing that young people’s mental health spending so that the funding gets to where it is needed?
The hon. Gentleman makes a good point. We have to balance the need to give CCGs the flexibility to dedicate funding and prioritise in their own way. We have been told by mental health professionals that the targets for physical health are more rigorous than those for mental health. We need to keep that under review, but we have imposed additional targets, which are being met.
I commend the Government for their work on mental health over the past few years, but when the Department of Health publishes its Green Paper, jointly with the Department for Education, may I urge the Minister to focus on the evidence of what works for young people and children, which is rigorous early intervention, often with enduring psychotherapeutic interventions? Can she reassure me that the Green Paper will look at evidence on what actually works for young people?
I can give my hon. Friend that assurance. Indeed, the Care Quality Commission is undertaking a thematic review to see what works. He is right to identify early intervention as key but, as the hon. Member for Plymouth, Sutton and Devonport (Luke Pollard) highlighted, there is a need to consider the transition as well.
Thank you for the encouragement, Mr Speaker.
I have been alerted to an online posting yesterday on the social network Nextdoor by the father of a teenager who suffered awful trauma witnessing the horror at Grenfell Tower. He was after therapy for his daughter. Clearly there is an absolute need to ensure that everyone who may be in need knows how to get such therapy. What are the Government doing to ensure that everyone does know? Also, what are they doing to ensure that there is sufficient funding locally so that mental health services can provide for what will clearly be ongoing needs?
I thank the right hon. Gentleman for his question. I would be grateful to receive more details so that we can make sure that such support is going where it is needed. I advise him that, certainly in the case of the too-frequent disasters that we have had recently, we have been relying on more intervention on the ground. In our work on mental health first aid we are prioritising exactly those areas.
15. What steps are being taken to ensure that NHS Improvement provides timely and effective support to health communities to deliver consistently high-quality care.
T3. Would a Minister be willing to meet the all-party group on blood donation after it has been reconvened next week and would they be able to provide an update on the work of the Advisory Committee on the Safety of Blood, Tissues and Organs in respect of lifting or easing the deferral period for gay men who want to donate blood?
I would be happy to agree to such a meeting, and I know this issue has support on both sides of the House.
T8. Last week I met doctors and nurses at the Friarage, an excellent small hospital serving a rural population spread over 1,000 square miles. Will my right hon. Friend urge South Tees Hospitals NHS Foundation Trust to do everything it can to ensure the continued provision of emergency care clinicians and anaesthetists at this vital local hospital?
I know that Ministers share my passion for ensuring that a bereavement suite is attached to every maternity unit in the country. What steps can the Government take to make that a reality?
I congratulate my hon. Friend on his dedicated work. The Government understand the importance of bereaved parents having a dedicated place where they can be cared for and not hear other babies crying. We have funded better bereavement spaces in nearly 40 hospitals and continue to work with Sands—the stillbirth and neonatal death charity—to see what more we can do to improve provision.
It is always quite interesting to study the habits of colleagues. The hon. Member for Feltham and Heston (Seema Malhotra) has perambulated from one side of the Chamber to the other; nevertheless, she is here and I suppose we should hear her. No? The hon. Lady had a question on the Order Paper. Your opportunity is now—get in there!
(9 years, 6 months ago)
Commons ChamberI agree that unions have an important role, but this should not have to be about unions. Regardless of whether a hospital has unions, people should be able to contact someone independent if they feel that their concerns about poor care are not being listened to, and that person should be enthusiastic about listening to what they say.
This morning I was contacted about a patient at Basildon hospital who was suffering from Parkinson’s disease and who, on asking for assistance to go to the toilet, was told by nurses that they were too busy, so he had to use his pad. He was left in some distress, and suffering from nappy rash. Does my right hon. Friend agree that, when we are developing a patient-centred culture in the NHS, such behaviour should not be tolerated?
I do agree, and I have had many discussions with my hon. Friend about how local health care services can be improved. It shows real courage to raise a concern about patient care at one’s own local hospital. Basildon is a fantastic hospital—it is very well run, and it has really turned a corner—but that does not mean it is perfect, as I am sure its chief executive would be the first to accept. It is possible to have a sensible debate about improving care while being honest about the problems. That is the big change we need to make, and my hon. Friend has given us an example.
(9 years, 11 months ago)
Commons ChamberI beg to move,
That this House welcomes the Government’s guidance that hospital car parking charges should be fair and proportionate; notes that some hospitals are still charging patients and their visitors excessive fees of up to £500 per week; further notes that the charity Bliss has said that parents with premature babies are having to pay on average £32 per week; further notes that for many patients it is essential that they travel to hospital by car; believes that such charges affect vulnerable patients at a very difficult time; and urges the Government to consider ways in which hospital car parking fees can be reduced.
I am extremely pleased to be able to open the debate and I am grateful to the Backbench Business Committee for making time to discuss this important issue, which has been impacting on so many constituents up and down the country. Before I go into my arguments, I must pay tribute to the work of my hon. Friend the Member for Harlow (Robert Halfon), who has done so much to highlight this issue and many others that directly impact on ordinary hard-working people. It is incumbent on all of us in the House, when people’s loved ones are ill or they themselves require hospital treatment, to ensure that the national health service makes the conditions appropriate for them to access the treatment that they need, and car parking charges get very much in the way of that. I reiterate that I thank my hon. Friend for his efforts to push this matter up the political agenda.
Hospital car parking charges have largely been abolished in Scotland and Wales, but that is not the case in England where 79% of hospitals continue to charge, often at punitive rates. For so many of our constituents driving to hospital is not a choice; it is essential. Many of them are undergoing treatment which means that travel by public transport is simply not an option, particularly when they have to be accompanied by members of their family. Members of their family will also wish to visit them if they have a prolonged stay, and they, too, should not be faced with punitive car parking charges. To put it simply, hospital car parking charges are a tax on NHS treatment.
I congratulate my hon. Friend on procuring this debate, and I congratulate my hon. Friend the Member for Harlow (Robert Halfon) on his leadership of the campaign. Does my hon. Friend the Member for Thurrock (Jackie Doyle-Price) agree that at the root of this—I come from Hereford, where hospital parking charges are reportedly some of the highest in the country—is a private finance initiative contract in many cases, which it is often almost impossible for the hospital in question to control? Therefore, there must be wider action to control PFI costs alongside hospitals to support the people whom we are trying to help.
My hon. Friend is quite right. He has done much to highlight some of the PFI contracts, the long-term consequences of which we are now having to deal with, where the contractors may have been rather more savvy in negotiating a deal that suits them rather than the patients. We must remember that the NHS should serve the interests of patients, not the providers of any contracts or services within it. I wholeheartedly agree with my hon. Friend and I hope that the Minister will consider what more can be done to challenge some of the contracts.
I congratulate the hon. Lady and the hon. Member for Harlow (Robert Halfon) on securing the debate. I think that my hon. Friend the Member for Coventry South (Mr Cunningham) was also involved in that.
The hon. Member for Hereford and South Herefordshire (Jesse Norman) touched on the heart of the problem. I was an ex-Paymaster General when the Coventry bid was pushed through as a PFI project. We have a magnificent new hospital, but people’s impression of it is not how good the facility is, but how high the car parking charges are, necessitated, unfortunately, by the PFI contract. Does the hon. Lady agree that the key point to put to the Treasury is that these PFI contracts are often too onerous to be sustained by the normal income that the NHS can expect a hospital to generate, and, in particular, the car parking fees built into that are too high?
Order. I remind Members that about 37 Back Benchers want to speak in three debates that must finish at 10 o’clock, and we must also take the Front-Bench speakers and the proposers. We need interventions to be short, pithy and to the point, and Members must be disciplined if everybody who wishes to speak is to be able to do so. Time is of the essence.
The hon. Gentleman reiterates the point made by my hon. Friend the Member for Hereford and South Herefordshire (Jesse Norman). We have all learned a lot of lessons from poorly negotiated PFI contracts. It is worth noting that in Scotland and Wales, the movement to get rid of NHS car parking charges has not been limited by those contracts, and there are ways to see those contracts through.
My friend and neighbour, the hon. Member for Hereford and South Herefordshire (Jesse Norman), has already touched on the shocking situation that we have in Herefordshire, but it is made worse by the county council putting double yellow lines almost everywhere in the city. Ambulances do have to get through, but could not more be done by local authorities to ease the burden on patients?
Absolutely. It is always a good idea for public bodies to be more co-ordinated in how they approach such matters. No hospital acts in isolation, and car parking charges are often a function of how expensive local car parking is.
I welcome the recent announcement by the Department of Health to strengthen the guidelines given to NHS trusts on the implementation of car parking charges. They include the important provision that relatives of people who are seriously ill or in hospital for a long period should also be entitled to discounted or free parking. The guidelines are clear and welcome, but they do not go far enough. It is important that the House sends a clear message to the management of NHS trusts throughout the country that punitive car parking charges are wrong and will not be tolerated.
I congratulate the hon. Member for Harlow (Robert Halfon) on securing the debate; I assisted—if that is the right word—him in that. Does the hon. Lady agree that although car parking charges are far too high for a number of groups of people—my hon. Friend the Member for Coventry North West (Mr Robinson) and I have been campaigning for years in Coventry to get them reduced—it would take the muscle of the Secretary of State to help here, because not all car parking charges are based on PFI. There are hospitals that do not have a PFI, but those charges are built into their budgets.
The hon. Gentleman makes a good point. It is crucial for the Secretary of State to give clear and robust messages about what he expects from NHS trusts. This Secretary of State has probably done more in his period of office to put the patients at the heart of the NHS. We are talking about a rebalancing of the relationship between the patient and the provider. It is simply not appropriate for NHS trusts to decide their car parking charges without considering the impact that those will have on the welfare of patients.
This debate has been part of a campaign initiated by the Opposition on rip-off Britain, and I congratulate the hon. Lady and the hon. Member for Harlow (Robert Halfon) on getting a debate on one aspect of that. I totally welcome the Secretary of State’s guidance on this matter, but we know from our local areas that some hospital trusts will gently put two fingers up to what the Secretary of State says. I very much hope that when the Minister replies he will say what plan B is for those hospitals that continue to charge excessively those who need to continue to visit their relatives in hospital.
I humbly suggest to the right hon. Gentleman, who is not backward in coming forward in expressing his views, that it is up to us in this House to challenge the leadership of our trusts where we think they are being unfair with their car parking charges. Quite frankly, we should be prepared to make lots of noise about that when it occurs.
I would like to make a little more progress.
The guidance confirms that it is up to local trusts to decide how much and whether they charge for parking but that charges should be proportionate and concessions available. I think we have all seen many examples where charging policy could in no way be described as fair or proportionate. I make particular reference to London hospitals. The Royal Free hospital charges a staggering £72 a day. My constituency is just outside London, but when some of my constituents need to access specialist treatment they are sent to London hospitals. They travel some distance and the fact that they then have to pay punitive charges to access treatment is simply not acceptable.
On the ability of trusts to make their own concessions, I want to shed a glimmer of light on an example in my own Heart of England NHS Foundation Trust. It is possible for relatives to buy 20 visit passes for £10, no matter how long they stay. All they need to do is obtain a signature from the ward sister. There are compassionate ways of treating families who need to make regular and sometimes long visits to hospital.
My hon. Friend highlights exactly the kind of initiative that we in this House would expect the local management of trusts to undertake. On having a fair charging policy, we should not have simple flat fees and expect all patients and visitors to pay them. We should be thinking about the best possible opportunities to enable patients to get better when they are being visited by their families and to access treatment without being worried about parking charges.
Does my hon. Friend agree that NHS managers could learn from private providers, which in my constituency of Redditch provide two hours’ parking for £1.20, whereas my local hospital trust charges £3?
My hon. Friend has put a very important point on the record. It illustrates again that when management thinks about patients rather than managing the accounts, it can come up with solutions that are good for the patient.
We have all had many representations from individual patients about the costs they have incurred personally. We have also heard from pressure groups. In particular, Macmillan has highlighted that cancer sufferers have found parking charges to be a very costly element of their treatment, adding significantly to the financial strain for people who are going through prolonged periods of treatment. As I have said, some of them are losing considerable amounts of earnings during that process. We need to be making it easier for them to get better and overcome their debilitating illness.
I congratulate my hon. Friends the Members for Thurrock (Jackie Doyle-Price) and for Harlow (Robert Halfon) on securing this debate. Of course, it is patients and their families who are the main people affected by this particular issue, but does my hon. Friend the Member for Thurrock agree that surely it is wrong that NHS staff, who do such an amazing job in all our hospitals, are in many cases, particularly in my area, required to pay for the parking in the area where they work, thereby reducing their own salary?
My hon. Friend raises a very important point. One objection to our campaign on parking charges is that somehow the money would be taken away from health care, but I do not believe that is the case at all. He mentions staff. In order to get the best conditions for care, we need to make it easier for people to go out and work, and access to cheap parking is very much a part of that.
I would like to make a little more progress.
These charges are a tax on the sick. They hit patients and their families when they are at their most vulnerable. It is incumbent on hospital trusts and us in this House to make sure that we create the conditions for patients to have the support to aid their recovery. Simply levying high parking charges will not aid their recovery. We all know that receiving visitors will help. We should be making it easier for them to visit their loved ones.
I appreciate the hon. Lady’s giving way in this very interesting and extremely worthwhile debate. Does she share my concern that, in seeking to get profits from car parks, the issue raised by the hon. Member for Hexham (Guy Opperman) about staff being sidelined or being asked to pay more is a problem? We certainly have that problem in Derriford, where staff are now finding it very difficult to park anywhere, if at all.
Absolutely. This comes back to the issue of challenging trusts as to whether the car parking charges are fair. We have had push-back from a number of trust managers who say that it costs money to operate and maintain the car parks, partly because of some of the PFI contracts that have been mentioned. It is simply not good enough, however, for hospital trusts to pass on costs to staff and vulnerable patients when they need to be more challenging about how they manage their finances and not simply take from the patients. Nor is it enough for trusts to argue that charges are reasonable for their area. That is like writing an open cheque and allowing London hospitals to levy extremely high charges. It simply is not good enough. There is, in effect, a parking lottery in the NHS, with some patients able to access health care without any charge for parking their car, while others pay extremely handsomely for the privilege. I find that scenario completely incompatible with an NHS that should be free at the point of use.
I was shocked to discover that 74% of hospitals make more than £500,000 a year from their car parks, and even more shocked that more than 40% raise more than £1 million. I recognise that there are many reservations about the removal of car parking charges because of the amount of revenue received, but I do not buy it: I think there is lots more that hospital trusts can do to replenish any gaps that might occur in their revenue as a result of removing car parking charges.
I want to refer to my own local trust of Basildon in that regard. Some will know that Basildon has a very troubled history. It was one of the hospitals that went into special measures following the inquiry into Mid Staffordshire and it has had very high death rates. In the past year, however, since a change of leadership in the hospital trust, it has made massive advances, and it was the first to come out of special measures.
One of the things that the new chief executive has done is to recruit 200 new nurses, and in doing so she has managed to cut the pay bill because she is no longer relying on agency staff. We can all find other ways of replenishing the money that might be lost as a result of reducing car parking charges—not least, I might add, through some patients getting better quicker because they will get more visits from their families. That makes perfect sense to me.
I thank my hon. Friend for giving way and for facilitating this very important debate. One area she has not yet touched on is the impact on built-up areas such as the one surrounding Eastbourne district general hospital. The car parking charges at the DGH are really quite high, so instead of using the car park people are parking around and about, which is making it very difficult for residents. If it is done badly, it is bad for residents—
Order. Short means not many words. A large number of Members are waiting to speak. The hon. Member for Thurrock (Jackie Doyle-Price) has now been on her feet for 17 minutes. This is going to be a severely curtailed debate and Members will get only a minute or two unless we can start making some progress. Remember that interventions must be short if there are to be any more. I wonder whether the hon. Lady would consider, in respect to her colleagues who wish to speak, drawing her remarks to a close.
Thank you, Madam Deputy Speaker—I certainly will. My hon. Friend the Member for Eastbourne (Stephen Lloyd) makes a very good point. I would also add that money could still be made by reducing car parking charges but enforcing action against those who should not be using the car park.
In deference to you, Madam Deputy Speaker, I shall make my comments briefer and move to a close so that other Members can speak, but I just want to reiterate this final point. The NHS is supposed to be free at the point of use, but it is not when patients who have to drive are paying through the nose. Hospital car parking charges are a tax on the sick. We should send a strong message to the managers of all hospitals that we expect them to take steps to reduce this financial penalty on the most vulnerable in our society.
I thank all Members who have participated in this debate, which, in displaying zero tolerance for punitive car parking charges, has been a rare show of unanimity. When the House reaches a consensus on such issues, it is all the more powerful.
I would like the Minister to take away the message that some examples of very bad practice have been highlighted, as well as some examples of good practice. That must be disseminated, to show exactly what we will not tolerate. Perhaps we should look more at naming and shaming trusts that are not stepping up to the plate and not doing the best for their patients. At its heart, this issue is about the relationship between patients and providers, and whether the latter are doing everything they can to put the interests of patients first. We must continue to apply pressure to ensure that they do exactly that.
Question put and agreed to.
Resolved,
That this House welcomes the Government’s guidance that hospital car parking charges should be fair and proportionate; notes that some hospitals are still charging patients and their visitors excessive fees of up to £500 per week; further notes that the charity Bliss has said that parents with premature babies are having to pay on average £32 per week; further notes that for many patients it is essential that they travel to hospital by car; believes that such charges affect vulnerable patients at a very difficult time; and urges the Government to consider ways in which hospital car parking fees can be reduced.
(10 years, 2 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
What I will take responsibility for is agreeing to a public inquiry into what happened at Mid Staffs—something rejected by the Labour party—that has woken up the whole NHS to the need for safe staffing in all our wards. We are implementing the report and that will indeed be reflected in the nurse training numbers going forward.
Basildon and Thurrock hospital was the first to exit the special measures regime after a number of years of failure. It did so because the leadership embraced what happened, was willing to learn the lessons from what went wrong and went out of its way to fix them. Far from being a naming, shaming and blaming culture, is it not the truth that my right hon. Friend is strengthening the culture of accountability in the NHS, which is as it should be?
Yes, and I would like to thank my hon. Friend for her superb work in supporting Basildon and Thurrock hospital through a very difficult period. I think that the chief executive there, Clare Panniker, is an exemplary one. She wrote an article in The Guardian pointing out that it is incredibly painful for trusts when they go into special measures, that it causes a lot of pressure in the local media, but that it also means that change can be made much more quickly when an urgency to solve these problems, many of which have been around for years and years, is created. I commend the staff of that hospital not just for coming out of special measures but for being rated “good” by the chief inspector of hospitals—a fantastic achievement.
(10 years, 2 months ago)
Commons ChamberThe decision to place 11 trusts into special measures last summer was not taken lightly, but we can see today that it was the right decision. Across the whole NHS, the number of people who think they would be safe in an NHS hospital is as high as it has ever been, the number of people who think that people are treated with dignity and respect has risen by six percentage points over the year and the number of people who think that people are treated with compassion has gone up by eight percentage points. This Government have introduced new chief inspectors of hospitals, general practice and adult social care to oversee the toughest, most transparent and most independent rating system of any country anywhere. We have improved accountability with a statutory duty of candour, and we are supporting staff by publishing ward-level nurse staffing levels for every trust.
I thank my right hon. Friend for giving way. I am sorry that his congratulations to Basildon hospital were so dreadfully interrupted earlier, because its journey since 2009, when real deficiencies were highlighted, to where we are now with the special measures being lifted is, as he has said, real testament to the leadership of the hospital’s new management and the commitment of the staff. I thank him for the impetus that he has given that process, because it is only by admitting when things go wrong that we can put them right; that is the difference between the Government and the Opposition.
I congratulate my hon. Friend for her work campaigning for higher standards at her local hospital, and I agree with her. Why is it that interventions to do with improving safety and compassionate care are coming only from Government Members and that the Opposition are not interested? I just challenge Labour Members on whether they are really on the right side of the big changes that need to happen in our NHS.
I have reflected on the comments of the hon. Member for Mitcham and Morden (Siobhain McDonagh) and I really must tackle head-on the belief that because there is no Bill on the NHS, that is a weakness. The reality is that the NHS does not need more legislation. What it needs is good leadership and good performance management so that it delivers what we want it to deliver for our constituents. We will not improve the care of patients by sitting on these Benches and pontificating and giving the benefit of our experience. What we need to do is empower real practitioners to actually deliver change.
May I inform the hon. Lady that many of my constituents in Mitcham and Morden believe the withdrawal of clause 119 from the Care Bill would have done a lot for their NHS?
I cannot agree with the hon. Lady. The important thing is that Government Members make it clear to the NHS that we expect it to put the interests of patients at its heart. I want again to draw attention to what has happened in Basildon and Thurrock university hospitals trust because it is perhaps the best example of the profound change we have had in NHS culture over the last five years. We now have a Government, and leaders within the NHS, who are finally prepared to face up to what is going wrong and to deal with it, rather than to cover up, be complacent and say, “We’re no worse than anyone else.”
I have to say that it has been a turbulent journey for those of us involved in Basildon hospital over those five years. The shadow Health Secretary, who is not in his place, will recall coming to this House in 2009, at the same time as he spoke about Mid Staffordshire, to highlight exactly what was going wrong at Basildon. Since then I have had a number of conversations with senior managers in which I was told, “Well, we’re no worse than anyone else. You’ll find this everywhere.” That was not good enough, but after two and a half years of not making any progress at all, Members of this House had very robust discussions with Monitor and said, “This needs proper intervention.” That led to a complete change in the leadership. A new board was appointed that was more inclined to give challenge where it was due. We had a leadership team that put stronger emphasis on good clinical leadership, and a chief executive was appointed who was determined to make sure that Basildon hospital delivered the standards of care that all patients deserve. What we have had is cultural change, and cultural change comes from leadership; it does not come from legislation. As I have said in many contexts, any organisation is a creature of the person at its top, so when we get good leadership in individual hospitals we get a step change in performance.
I also wish to pay tribute to the Secretary of State for the continued emphasis he places on patients, because when the head of the NHS—the person operationally responsible here in Parliament for performance—is articulating that, it will spread the cultural change which will deliver the real change in performance. I pay tribute to Clare Panniker, Basildon hospital’s current chief executive, who has delivered this significant change in the 18 months she has been in post. She has taken Basildon from being one of the worst performing hospitals to a position where it is coming out of special measures. She has been ably supported by the chairman of the trust, who has also been prepared to give a robust challenge and to stand behind her when she was doing so. Most of all, I wish to pay tribute to all the staff at Basildon. It has not been easy for them—it has not been good for their morale to see in the newspapers regular reports of the latest horror story of poor care within the trust—but they have reacted to the cultural change that Clare Panniker has brought. They have bought into it and given good, honest feedback, and I no longer get whistleblowing letters from staff about the latest incident. They have procedures to act on things and the management then implement that change. It says a lot about the commitment of the staff in that hospital that they have bought into that process and delivered us to where we are now. We all need to learn that sunlight is indeed the best disinfectant. It is not good enough to pretend that there is not a problem when there so clearly is, and it is important that we continue to put patients at the heart of the NHS. Only by doing that will we be able to ensure that the incidents witnessed at Mid Staffs and Basildon will become a thing of the past.
I wish to turn my attention to another issue that was not mentioned in the Queen’s Speech but which is on the Government’s legislative timetable for the coming year: the plan to introduce standardised packaging for tobacco products. I have to say to the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb) that it is a very bad idea. I fully support the policy objectives of tackling tobacco consumption and, in particular, of dissuading and preventing children from ever taking up smoking, but I have worries that this tool is not effective and that its unintended consequences may bring about worse health outcomes than doing nothing at all. Sir Cyril Chantler is said to have examined that as part of his review, but I am not persuaded of the evidence. In particular, I believe that introducing standardised packaging will worsen the public health outcomes if unregulated illicit tobacco products replace the regulated ones. We all know how toxic regulated cigarettes are, but when unregulated products enter the market the health outcomes will be very much worse.
Sir Cyril Chantler has concluded that Her Majesty’s Revenue and Customs has been very effective in tackling contraband and illicit tobacco, and he has cited figures going back to 2001. Although they show an improvement, the nature of the problem has changed over that period. European Union enlargement took place during that time and there was an immediate rise in the amount of illicit tobacco, but that has been tackled, mainly through co-operation with tobacco manufacturers. That illicit tobacco was also a legal product, whereas the illicit tobacco coming into this country today is not from Europe and it is not from regulated markets; it tends to be made in places such as China and Indonesia. Some of these products are extremely nasty, with tobacco rolled with whatever is available and containing high levels of tar. I commend The Sun for the exposé it ran last week in which an illicit producer from Indonesia explained just how toxic some of his products are and how standardised packaging will help him make money by reducing the costs of production.
The Government’s own inquiry showed that there would not be an increase in the amount of illicit tobacco traded in this country. Does the hon. Lady not trust her own Ministers and the report they commissioned?
I was quoting that report and challenging its conclusions, which are based on a flawed analysis of the market—that is what I have been trying to explain. No, I do not trust that report. It is superficial and it has been put together with a particular agenda. As I say, it will lead to unintended consequences which will be very bad for public health.
My constituency contains Tilbury docks and the Purfleet ferry terminal. Despite the best efforts of Border Force, Essex police and the port of Tilbury, these products are getting through. Despite large seizures every week, Border Force does not believe that it is getting even 10% of the illicit product that is coming into the marketplace. It is estimated that one in three cigarettes smoked in London are illicit, and a good proportion of them will come through the ports in my constituency. Standardised packs will inevitably reduce costs for illicit manufacturers, who will be able to produce the product without differentiation in brand. I believe this proposal is a charter for a lot of very nasty people to make a lot of money, and if they do, the health outcomes we wish to see will not be achieved.
Let us be frank: we are talking about packets of cigarettes sold from holdalls behind pubs for a couple of pounds. Children do not start smoking by walking into their newsagents and picking a branded product; they are introduced to smoking via that holdall, at the back of the bike sheds or at the back of pubs. When cigarettes become that cheap, because of the proliferation of illicit products in the market, these children will be smoking some very nasty things. I ask Ministers to think again, because this is not the best tool for achieving a reduction in smoking and there will be unintended consequences for public health. I ask this Minister to sit down with Border Force and understand just how difficult the fight is that it is waging against serious organised crime and smuggling.
(10 years, 4 months ago)
Commons ChamberI thank my hon. Friend for his comments and support. He speaks from a position of knowledge, which is always a good position from which to speak. Sir Cyril and his team visited Australia, and hon. Members can find reflections on the Australian experience to date in the report. We are proceeding on our own timetable, not waiting for the end of Australian litigation on this subject.
My hon. Friend has made many references to Sir Cyril’s conclusions on illicit tobacco, but what conversations did she have with Her Majesty’s Revenue and Customs and the UK Border Force before making this statement? At the port of Tilbury in my constituency, we are waging a war against tobacco smuggling, and my fear is that standardised packaging will make beating it in that war even more difficult.
In the course of policy making, HMRC’s views have very much been sought and taken into account, and it will certainly be part of the final consultation. It is fair to put on the record the fact that HMRC has had considerable success in fighting smuggling over recent years. I of course acknowledge my hon. Friend’s concerns, but I urge her to read the report and to understand the connections between price and illicit tobacco, and to read what Sir Cyril says about the information gleaned from Australia and from our own experience.
(11 years, 1 month ago)
Commons ChamberBereaved families in Thurrock have had their pain compounded by how the Basildon and Thurrock trust has investigated complaints and incidents. Does my right hon. Friend agree that the way in which hospitals investigate such incidents is an important aspect of the transparency and accountability agenda?
It is, and this year we will be introducing in law a duty of candour that will make it a criminal offence for boards not to be honest, not only with families if patients have been harmed, but with the system, which is extremely important. Salford Royal hospital has one of the most successful safety records in the country, and it has achieved that by creating an atmosphere of trust so that front-line staff are not afraid to speak out about the problems that they encounter, however junior they are. It takes outstanding leadership to get that right, and part of the turning point that we require today is an understanding of what is involved in such leadership, which we need in many more places.