Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 23rd October 2012 Commons Chamber

[Mr Peter Bone (Wellingborough) (Con)]

1. What his latest estimate is of the likely cost of the NHS in 2012-13.

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

The latest estimates of NHS spending are those published in the 2012 Budget. The planned NHS spending for 2012-13 is £108.8 billion.

[Mr Bone]

The Conservative-led coalition Government are increasing spending on the NHS, unlike what Labour would do. In my constituency, we will get an urgent care centre in a few months as a result of Tory health reforms. People in Corby already have an urgent care centre as a result of Tory reforms. Does the Secretary of State agree that, while Labour talks about the NHS, Conservatives deliver on the NHS?

[Mr Hunt]

I absolutely agree with my hon. Friend. Indeed, last week we announced that waiting times are at near-record lows. The number of hospital-acquired infections continues to go down and mixed-sex wards have been virtually eliminated. I am very pleased that my hon. Friend has an urgent care centre, and am sure that Mrs Bone will appreciate it even more than he does.

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

Does the Secretary of State recognise that the Office for National Statistics survey shows that the mortality rate in north-east England is 12% higher than that in the rest of the UK? Does he recognise the need to invest in more advanced radiotherapy equipment, bearing in mind that 70 of the 212 systems will need to be replaced by 2015?

[Mr Hunt]

I would not necessarily expect the hon. Gentleman to follow announcements that are made at the Conservative party conference, but we did make the big announcement that access to radiotherapy will be transformed, making it available to everyone for whom it is clinically necessary and cost-effective. Improving mortality rates is extremely important. As I have set out, one of my key priorities is to transform the NHS so that we have the best mortality rates in Europe. I hope that that is welcome news for his constituents.

[Charlie Elphicke (Dover) (Con)]

Does my right hon. Friend agree that there will be less budget pressure on the NHS if we do better with long-term conditions, get better at integrated care and use data better to predict ill health? To that end, will he come and see the work of the Kent Health Commission on those issues?

[Mr Hunt]

I would be delighted to see the innovative things that are happening at the Kent Health Commission. Looking at how we deal with people with long-term conditions—that is 30% of the population, and the proportion is growing with the ageing population—will be a vital priority for the NHS over the coming years.

[Andy Burnham (Leigh) (Lab)]

May I welcome the Secretary of State and his new team to their positions? As the only other person to have made the jump from Culture to Health, I am sure that he will find me a constant source of useful advice.

The Secretary of State has not said much since his appointment, but he did set out his mission in The Spectator:

“I would like to be the person who safeguards Andrew Lansley’s legacy”.

Let us talk about that legacy. Just last week, the Secretary of State slipped out figures on the latest costs of NHS reorganisation. Would he care to update the House on the current estimates?

[Mr Hunt]

Let me tell the right hon. Gentleman that Andrew Lansley’s legacy is—

[Mr Speaker]

Order. The Secretary of State has been in the House for seven and a half years. I think he knows that we refer to Members by constituency, not by Christian name. It is not difficult.

[Mr Hunt]

First, may I say how delighted I am that the right hon. Gentleman and I once again have the same brief? I look forward to having a constructive relationship with him, not with total optimism, but I will try my best.

The right hon. Gentleman talked about my predecessor’s reforms and legacy. One of the finest things about my predecessor’s legacy is that he safeguarded the NHS budget—indeed, he increased it during this Parliament by £12 billion—when the right hon. Gentleman said that it would be irresponsible to increase it.

[Andy Burnham]

Look at the figures: the previous Secretary of State gave the budget a real-terms cut for two years running. Let me give the exact figures, which the Secretary of State did not give the House. The costs of the reorganisation are up by 33% or £400 million, making the total £1.6 billion and rising. And what is that money being spent on? A full £1 billion is being spent on redundancy packages for managers: 1,300 have got six-figure pay-offs and there are 173 pay-offs of more than £200,000. Scandalously, that news comes as we learn today that the number of nurse redundancies has risen to more than 6,100. Six-figure pay-outs for managers, P45s for nurses and the NHS in chaos—is that the legacy that the Secretary of State is so proud of?

[Mr Hunt]

Let us look at some of the facts. The number of clinical staff in the NHS has gone up since the coalition came to power. The right hon. Gentleman talked about the cost of the reforms, which is about £1.6 billion. Thanks to those reforms, we will save £1.5 billion every single year from 2014 and the total savings in this Parliament will be £5.5 billion. Let me remind him that he left the NHS with £73 billion of private finance initiative debt, which costs the NHS £1.6 billion every single year. That money cannot be spent on patient care. He should be ashamed of that.

[Mr Philip Hollobone (Kettering) (Con)]

Will the Secretary of State confirm that NHS spending will increase in real terms during the lifetime of this Government, and that there are no plans from anyone to close the accident and emergency department and the maternity unit at Kettering general hospital? Will he condemn those who say that the Government want to close the hospital, when nobody is going to do that at all?

[Mr Hunt]

My hon. Friend is absolutely right: that is a mendacious scare story that is being put out on the ground. Real-terms spending on the NHS has increased across the country, which has not been possible across all Government Departments. Because of that, we are able to invest more in patient care, cancer drugs, doctors and facilities across the country, and indeed in Kettering.

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

2. How many patients waited longer than half an hour in an ambulance to be transferred to accident and emergency in each year since 2009-10.

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

The Department’s records date back to 2010-11. The number of ambulance handovers delayed by longer than half an hour was 63,892 between 1 November 2010 and 24 February 2011 and 77,543 between 1 November 2011 and l March 2012.

[Tom Blenkinsop]

On 27 September, patients and paramedics were left waiting outside James Cook university hospital in Middlesbrough for two and a half hours before being handed over. Dr Clifford of the college of emergency medicine described such delays as being due to an unacceptable mismatch in demand and supply. Does the Secretary of State agree with Dr Clifford, and what steps will he take to ensure that those problems do not recur for my constituents?

[Mr Hunt]

I am extremely concerned about what happened on 27 September. I can confirm to the hon. Gentleman that all the red 1 calls on that day were met within the target time of eight minutes, but the delays were completely unacceptable. I know that the trust is taking measures to ensure that the problems are not repeated, particularly looking forward to the winter time when there is likely to be extra pressure on ambulance services. I will follow the matter very closely, and I expect the trust to come up with measures to ensure that his constituents are properly safeguarded.

[Andrew Bridgen (North West Leicestershire) (Con)]

In the summer, I spent an interesting and thought-provoking day observing the work of a crew of the East Midlands ambulance service. Can my right hon. Friend confirm that ambulance trusts across the country, including the East Midlands ambulance service, are performing well in meeting their response time targets?

[Mr Hunt]

I can absolutely confirm that. In fact, I was extremely pleased to see last week that all the standards are being met for both eight-minute category A calls— red 1 and red 2 calls—and 19-minute calls. That is as it should be, but it is no grounds for complacency. Although that is a country-wide picture, there are parts of the country where those standards are not being met in the way that we would like. We will continue to monitor the situation closely.

[Andrew Gwynne (Denton and Reddish) (Lab)]

I will be charitable to the Secretary of State, but he brushed over the figures in his answer to my hon. Friend the Member for Middlesbrough South and East Cleveland (Tom Blenkinsop). I have got the actual figures through a freedom of information request. They show that under this Government, 100,000 additional patients are being left waiting in ambulances outside accident and emergency departments for more than half an hour when they need urgent treatment—a totally unacceptable situation. What more evidence does the Secretary of State need of the chaos engulfing the national health service under his Government? It shows that the focus has slipped off patient care and that our accident and emergency units are struggling to cope.

[Mr Hunt]

The hon. Gentleman speaks as though the problem of ambulance waits never happened for 13 years under Labour, but he knows that we actually had some appalling problems, with ambulances circling hospitals because hospitals did not want to breach their four-hour A and E wait targets. We are tackling the problem, and as I mentioned, if he looks at the figures published last week he will see that we are meeting the standards for ambulance waits that his party’s Government put in place. However, we are not complacent, and we are monitoring the figures closely. Particularly with the winter coming up, we want to ensure that the ambulance service performs exactly as the British public would want.

[Mr James Gray (North Wiltshire) (Con)]

Many ambulance trusts are indeed doing extremely well, as the Secretary of State indicated. Does he agree that that is at least partly due to localism in the ambulance service, which may be undermined if, for example, the Great Western ambulance service becomes an amalgamated regional service? Now it has been announced that the call centre in Devizes will be closed in favour of one in Bristol. Does he agree that there is at least a risk that the local service for people in Wiltshire will be reduced if such regionalisation is allowed?

[Mr Hunt]

I agree with my hon. Friend that the purpose of the changes that the coalition Government have brought to the NHS is to tap into local innovation, ideas and ambitions to transform services, and it is important that no changes undermine that. He should take comfort from the fact that my predecessor introduced clear tests for any major reconfigurations, including that they should be strongly supported by local doctors, that the public should be involved in any consultation, that the changes should improve patient choice and that there should be clear evidence of benefits to patients. I hope that that gives him and his constituents some reassurance.

[Mrs Mary Glindon (North Tyneside) (Lab)]

3. What his policy is on upholding national pay arrangements in the NHS.

--- Later in debate ---

[Christopher Pincher (Tamworth) (Con)]

5. What steps the Government are taking to help people cope with conditions such as diabetes and asthma.

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

We are working on an outcomes strategy for long-term conditions such as diabetes and asthma structured around six shared goals, early diagnosis, integrated care, promoting independence, and steps to support those with long-term conditions to live as well as possible.

[Christopher Pincher]

Given that type 1 diabetes in under-fives is growing at 5% each year, what can my right hon. Friend do with the innovative Secretary of State for Education to ensure that nursery and primary school staff have the right skills and knowledge to ensure that they can help young children to cope with type 1?

[Mr Hunt]

The answer is that we are doing quite a lot—a good booklet, “Managing Medicines in Schools and Early Years Settings”, goes around schools, and there are other resources for schools—but we need to do more. We will be announcing a diabetes action plan, a long-term conditions outcomes strategy and a cardiovascular disease outcomes strategy, which will go further to address the issues that my hon. Friend raises.

[Keith Vaz (Leicester East) (Lab)]

I declare my interest as someone who has type 2 diabetes and welcome what the Secretary of State says. However, according to the latest report, another 700,000 people will contract the disease by 2020, and 80% of amputations are avoidable. Could he ensure that this very important subject is on the agenda of local clinical commissioning groups?

[Mr Hunt]

I certainly can. The number of diabetes sufferers overall will go up from about 3.7 million, which is already 5% of the population, to 4.4 million. We need to do a lot better in how we look after people with long-term conditions if the NHS is to be sustainable. We can also do a lot to transfer the individual care of people who have diabetes through things such as technology, which I will look into carefully.

[Mr Stephen Dorrell (Charnwood) (Con)]

Does my right hon. Friend agree that the effective delivery of care to people with long-term conditions relies on breaking down the silos within the health service, and between the health service, social care and social housing? Will he encourage the new health and wellbeing boards to follow through that agenda with a serious purpose?

[Mr Hunt]

My right hon. Friend is absolutely right. By 2018, nearly 3 million people will have not one but three long-term conditions. All too often, the system treats them on a disease or condition basis, and not as a human being who needs an integrated care plan. That is the route to lower costs, but it is also the route to transformed care.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

The Public Accounts Committee has heard that, of 20 trusts that needed to improve their diabetes care, only three took the accepted help. How will the Secretary of State ensure that care through health providers meets the grand targets he has set for himself?

[Mr Hunt]

The hon. Lady is absolutely right to point out that the consistency of provision is not good, but we will be publishing a diabetes action plan that will try to ensure more consistent provision throughout the NHS. We also need to raise our sights as to what is possible, because as I have mentioned, a third of the population have long-term conditions, and we can do much better at helping people to live with those conditions in a way that promotes their independence.

--- Later in debate ---

[Mary Macleod (Brentford and Isleworth) (Con)]

9. What steps the Government are taking to improve care for people with dementia.

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

Tackling dementia—particularly the shockingly low diagnosis rates—is a key priority for me and the Prime Minister.

[Mary Macleod]

I welcome the Government’s steps to support carers and the work they have done, especially on the £400 million to give carers’ breaks from their important responsibilities. Will my right hon. Friend explain what is being done to increase awareness and understanding of carers’ health care needs?

[Mr Hunt]

My hon. Friend is right to highlight this point. In the draft Care and Support Bill, local authorities will be required to meet the eligible needs of carers. That is a particular concern with dementia, because, all too often, someone looking after a partner with dementia gets to a tipping point where there is no alternative to residential care, but, if we can give them better support, they will have a better chance of remaining at home, which, in the vast majority of cases, is where they want to be.

[Kate Green (Stretford and Urmston) (Lab)]

Many elderly people with dementia remain trapped in hospital, because there is not adequate provision in the community for them to be looked after at home. How does the Secretary of State intend funds to be extracted from hospitals to be spent in the community, particularly at a time when local authority funding cuts mean that many of the voluntary agencies providing that support are actually losing posts in my borough?

[Mr Hunt]

The hon. Lady is right to highlight this growing issue. One million people will have dementia by 2020, so we have to take it very seriously. It is not an either/or situation, though, because about 25% of patients in hospitals have dementia, and hospitals would like them placed in the community or at home, where they can be better looked after. This is one of those examples where, under the new reforms, we need much greater integration of services to ensure that those people are treated in the way they need to be.

[Mark Durkan (Foyle) (SDLP)]

10. What recent progress he has made on improving early diagnosis of pancreatic cancer.

--- Later in debate ---

[Mr Mark Spencer (Sherwood) (Con)]

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

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

It is my privilege to serve as Health Secretary responsible for the national health service. I have identified four priority areas where I hope over the next two years to make the most progress. They are improving mortality rates for the major killer diseases so that we are among the best in Europe, which we are not at the moment; improving the way we look after people with long-term conditions such as diabetes and asthma; improving the way we deal with dementia, both as a national health service and as a society; and, perhaps most important of all, transforming the attitude to care throughout the NHS and social care systems so that the quality of care is seen to be as important as the quality of treatment.

[Mr Spencer]

What assistance can the Secretary of State give to the newly appointed chairman of the Sherwood Forest Hospitals Trust as he begins to wrestle with the private finance initiative signed under the previous Government and attempts to find repayments in excess of £40 million a year?

[Mr Hunt]

The first thing I would say to my hon. Friend about Sherwood Forest is that I know everyone in the House will join me in saying that our hearts go out to the families of the women who were misdiagnosed for breast cancer. We expect the local NHS to come up with a serious package of measures to make sure that that kind of thing cannot happen again.

My hon. Friend is right to talk about PFI. We inherited an appalling scandal. In order to tackle the PFI debts of just seven institutions, we are having to put aside £1.5 billion over the next 25 years, but we are working with all institutions to deal with this appalling debt overhang.

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

We know that the Secretary of State’s views on abortion do not have a religious basis, so does he care to share with the House the scientific evidence to support his view that abortion time limits should come all the way down to 12 weeks?

[Mr Hunt]

Four years ago I voted with my conscience, as I am sure she voted with hers, but I did so as a Back-Bench Member of Parliament and we have made it clear that it is not the policy of the Government to change the abortion law. My job as Health Secretary is to implement the elected will of the House, which voted in 2008 not to reduce the abortion time limits.

[Annette Brooke (Mid Dorset and North Poole) (LD)]

T2. What steps is the Department taking to tackle the growing incidence of drug-resistant cases of TB, which increased by more than a quarter in the past year?

--- Later in debate ---

[Mr John Redwood (Wokingham) (Con)]

T3. What is the administration overhead cost to the NHS and the Department this year and how does it compare with 2009-10?

[Mr Jeremy Hunt]

I will get back to my right hon. Friend with the exact details, but the impact of the reforms that the Government have introduced will cut administration costs by a third across the whole NHS, leading to net savings of £4 billion during this Parliament.

[Jack Dromey (Birmingham, Erdington) (Lab)]

T7. Last Wednesday, the Prime Minister told the House that Kettering hospital was safe. The following day—Thursday—evidence in a document leaked to the Corby Telegraph said that 515 of the 658 beds in the hospital could be lost. Will the Secretary of State ask the Prime Minister to come before the House to put right the statement he made to the House, but will the people of Corby not conclude that whatever the Prime Minister says, the national health service will never be safe in Tory hands?

[Mr Hunt]

What a disgraceful comment. We do not need the Prime Minister to come before the House because I can tell the hon. Gentleman that Kettering hospital is safe, and that it is totally irresponsible scaremongering by the Labour party in the run-up to a by-election to suggest anything else.

[Rehman Chishti (Gillingham and Rainham) (Con)]

T4. Will the Secretary of State join me in welcoming the progress that has been made to reduce mixed-sex wards and improve patient privacy at Medway Maritime hospital in my constituency?

[Paul Goggins (Wythenshawe and Sale East) (Lab)]

T8. Will the Secretary of State take a close personal interest in the proposed changes to the NHS in Trafford? Given the uncertainty about alternative accident and emergency provision, and indeed the delays in commissioning community services, will he ensure that any final decisions are deferred so that they can be considered as part of the wider review planned for NHS services across Greater Manchester?

[Mr Jeremy Hunt]

I should like to reassure the right hon. Gentleman that I take a close personal interest in all reconfigurations because they tend to end up on my desk. In this case, I encourage him to take part in the consultation for Trafford general, which will go on until the end of the month, but I remind him that the Government have put in place four important tests for any major reconfiguration. We must be satisfied that those tests are passed before we approve any reconfiguration, and those include the support of local doctors.

[Nick de Bois (Enfield North) (Con)]

T6. As breast cancer action month comes to an end, recent research by Breast Cancer Campaign has shown that 76% of women would like more information about breast cancer signs and symptoms. What steps are the Government taking to encourage early diagnosis of breast cancer?

[John Healey (Wentworth and Dearne) (Lab)]

Since his promotion, the Secretary of State has said little and, I assume, read a lot. Did his starter pack include details of the Prime Minister’s promise:

“This year, and the year after, and the year after that, the money going into the NHS will actually increase in real terms.”?

Did it include Treasury figures that show there has been a real terms cut each year since the election? What is he saying to NHS staff and patients who see the cuts and see the Prime Minister’s big NHS promise being broken?

[Mr Jeremy Hunt]

May I just remind the right hon. Gentleman that there has been a real terms increase in NHS spending? That contrasts rather starkly with what was said by the Health Secretary under the previous Government. He said it would be irresponsible to increase health spending in this Parliament. We ignored that advice and NHS patients are benefiting.

[John Stevenson (Carlisle) (Con)]

T9. The food labelling consultation closed in August. Could the Minister indicate when the Government response is likely to be issued and confirm that the Government will not bring in unnecessary burdens on the food industry over and above those set out in European regulation?

[Mr Andy Slaughter (Hammersmith) (Lab)]

The excellent children’s heart surgery unit at the Royal Brompton hospital will be pleased that a full review has been announced. Why does it have to report within four months, including the Christmas period, and why were previous referrals by both Brompton and Leeds refused? Will the review be full and impartial or not?

[Mr Jeremy Hunt]

It will be a totally impartial and very thorough review. This is an extremely important decision, and that is why I asked the Independent Reconfiguration Panel to take the time that it needs to do the review properly; that is the least that the hon. Gentleman’s constituents would want.

[Andrew George (St Ives) (LD)]

In order to get the Health and Social Care Act 2012 through this House, the Government gave explicit assurances that private companies could not cherry-pick the easiest procedures and patients, yet a recent letter from David Flory, the deputy chief executive of the NHS, back-pedals on the Government’s position, and shows that the Government are dependent purely on guidance. What can the Government do to put a bit of backbone back into that important policy?

[Mr Hunt]

May I reassure my hon. Friend that we are absolutely committed to the “no cherry-picking” provisions of the Act? We think that we have found the right way to achieve that in the NHS, and I will write to him to explain exactly how we will do that.

[Valerie Vaz (Walsall South) (Lab)]

Given the apparent increase in spending in the NHS and the £4 billion surplus, will the Secretary of State look at lifting the pay restraint for lower-paid workers, to increase morale and boost productivity?

[Mr Hunt]

The £12 billion increase in spending on the NHS under this Government, which the right hon. Member for Leigh (Andy Burnham) thought was irresponsible, means that we will be able to do a lot more for patients, but there is also rising demand. If we do not have that pay restraint, we will not be able to meet the needs of an ageing population.

[Justin Tomlinson (North Swindon) (Con)]

What specific consideration is being given to matching the annual growth funding uplift to actual changes in population? That is essential to my constituency, which has high population growth.

[Nick Smith (Blaenau Gwent) (Lab)]

The Public Accounts Committee says that 11 of the 144 foundation trusts across England are now in serious financial difficulty. What contingency funding is in place for those trusts, to protect patients?

[Mr Jeremy Hunt]

We have a clearly set out programme for all those trusts, to make sure that they get back to the proper financial controls and proper governance structures that they need. We do not want to get into the business of bailing them out; we want them to stand on their own two feet. That is the vision of the Health and Social Care (Community Health and Standards) Act 2003, passed by the hon. Gentleman’s party when it was in government.

[David Tredinnick (Bosworth) (Con)]

Will my right hon. Friend extend the scope of personal budgets? They help not only patients, giving them wider choice, but carers, allowing them to leave their post.

--- Later in debate ---

[Mel Stride (Central Devon) (Con)]

My right hon. Friend will know that in this country, over 1,000 people a year die as a consequence of asthma. We have one of the highest prevalences of asthma in the world. Will he outline to the House what action we will take to get those mortality rates down?

[Mr Jeremy Hunt]

We are doing a lot of work on the outcomes strategy that will directly impact on asthma sufferers. As part of that work—we are as concerned as my hon. Friend is about this—we are looking at every single asthma death in a 12-month period, starting from this February, to try to understand better the causes of mortality, because we need to make very rapid progress.