Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 22nd October 2013 Commons Chamber

[Stephen Metcalfe (South Basildon and East Thurrock) (Con)]

12. What recent progress he has made on improving the performance of hospital trusts placed in special measures.

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

Significant progress has been made at all 11 trusts placed in special measures in July, including changing the chair or chief executive officer and recruiting more nurses in every single one them and partnering each of them with a high-performing hospital so that they can make rapid progress in turning things around.

[Martin Vickers]

I thank the Secretary of State for his reply. He will be aware of my constituents’ concerns about services at Diana, Princess of Wales hospital in Grimsby. There are doubts about the future of the stroke unit and high mortality rates, and there are also problems with the East Midlands ambulance service. Will the Secretary of State give an assurance that he is satisfied that progress is being made at the hospital?

[Mr Hunt]

I think good progress is being made and I commend my hon. Friend for his campaigning on the issue. The trust concerned has introduced better privacy for patients, hired 154 nurses since the Keogh report and introduced electronic vital signs reporting at the bedside—all because we are being transparent and open about problems in the NHS and not sweeping them under the carpet.

[Andrew Bridgen]

Burton hospital, which serves part of my constituency, was one of the 11 hospitals placed in special measures following the Keogh report. Will my right hon. Friend assure my constituents that the improvements needed in those hospitals will be carried out in a culture of openness and transparency rather than one of opaqueness and cover-up, which so unfortunately typified the way in which the previous Government ran the NHS?

[Mr Hunt]

I know that my hon. Friend takes a very close interest in what happens at his hospital and I think that progress is being made in turning it around. What will be of concern to my hon. Friend is that, as far back as 2005-6, Burton’s mortality rate was 30% higher than the national average—it was even higher than that at Mid Staffs—and yet the problem was not sorted out. We are sorting it out.

[John Stevenson]

As the Secretary of State is aware, North Cumbria trust is in special measures. We have on our doorstep a potential solution to our problems, namely Northumbria trust. Will the Secretary of State give me an assurance that everything possible will be done to get North Cumbria out of special measures at the earliest opportunity and, much more importantly, that every support will be given to Northumbria in is acquisition of North Cumbria?

[Mr Hunt]

I can give my hon. Friend both assurances because Northumbria has been doing a huge amount to help North Cumbria turn itself around, including installing its patient experience systems to ensure that patients are treated with the dignity and respect that they deserve. The problems have been around since 2007 and he can tell his constituents that we are finally turning them around.

[Stephen Metcalfe]

As my right hon. Friend will be aware, Basildon university hospital in my constituency is one of the 11 hospitals that were placed in special measures following the failure of the previous Government to act on the information that they had. Will he tell the House what support the new management team, in whom I have great confidence, are receiving and when my constituents can expect to see sustained, long-term improvements?

[Mr Hunt]

I reassure my hon. Friend that the trust has hired 257 more nurses since the problems emerged this year, has better A and E processes, and has been partnered with the Royal Free in London to help it make even more progress. He will be as shocked as I am that when the Care Quality Commission identified problems at that hospital the last Government sat on the report for six months. That cannot be acceptable.

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

How can NHS patients and staff have any confidence in decisions about their local services when they are taken by the Competition Commission on the overriding grounds of what is best for a competitive market and not what is best for patients? Will he learn from the failure of the merger between the Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust and the Poole Hospital NHS Foundation Trust, and take merger off the table as an option for Rotherham hospital?

[Mr Hunt]

May I reassure the right hon. Gentleman that the competition authorities make their decisions based on what is in the best interests of patients and do not hold competition as an overriding ideology? He is right that we need to work closely with those authorities to ensure that they have the expertise to take decisions in the right way and with trusts to ensure that they have the expertise to ensure that they do not stumble when they go through those processes.

[Jenny Chapman (Darlington) (Lab)]

How can the public have confidence in their health service when police officers are taking patients who are sick and injured to A and E because ambulances are backed up outside A and E and take longer than an hour to arrive?

[Mr Hunt]

I will tell the hon. Lady why the public can have confidence in their health service: compared with three years ago, on broadly the same budget, the NHS is doing 800,000 more operations year in, year out; MRSA rates have halved; and the number of people who wait for a year or longer for operations has gone down from 18,000 to fewer than 400.

[Clive Efford (Eltham) (Lab)]

Will the Secretary of State explain why we have had a summer crisis in A and E? We are all used to the emergency services being overwhelmed in winter. Given the crisis that we have had, what will he do to assist the NHS in averting a winter crisis this year, rather than just blaming everybody else?

[Mr Hunt]

The figures for September, the last month of the summer, were 95.8% in England and 90.6% in Wales. It was not coalition-controlled England that had a summer A and E crisis, but Labour-controlled Wales.

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

The Secretary of State for Health is clearly not adequately monitoring performance. If he was, he would be aware that serious problems remain across the accident and emergency departments of the trusts that were placed in special measures by Professor Sir Bruce Keogh. On his watch, the A and E performance at eight of the 11 trusts has got worse since Keogh reported, including at my hospital in Tameside. The A and E performance has got substantially worse at East Lancashire Hospitals NHS Trust, where the number of patients waiting for more than four hours has doubled since Keogh reported, and at Medway NHS Trust, where the figure has quadrupled. When will he stop all the grandstanding, cut the spin and get a grip on his A and E crisis?

[Mr Hunt]

I hope that the hon. Gentleman will be pleased that something is happening under this Government that did not happen under the Labour Government: we are putting those hospitals into special measures and sorting out the problems, including the long-term problems with A and E such as the GP contract—a disaster that was imposed on this country by the Labour Government.

[Andrew George (St Ives) (LD)]

6. What the current (a) highest, (b) lowest and (c) mean average registered nurse-to-patient ratio is on acute hospital wards.

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[Alun Cairns (Vale of Glamorgan) (Con)]

10. What steps his Department is taking to promote a culture of openness and transparency across the NHS.

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

We need to change the culture of the NHS so that where there are problems with care or safety, people feel able to speak out. The Government have banned gagging clauses, they are introducing a statutory duty of candour, and they have for the first time published surgery outcomes for 10 specialties by consultant.

[Alun Cairns]

I commend the Secretary of State for his transparency agenda, which has uncovered previously untold horrors. What more can he do to ensure that in future no Minister can ever cover up failure in the NHS?

[Mr Hunt]

I know this is difficult territory for the Labour party, but the most important thing is for regulators to feel that they can speak out about poor care without fear or favour. I am afraid that did not happen under the previous Government, so let me just—

[Mr Speaker]

Order. I told the Secretary of State privately before, and I say it publicly now, that if he intends to devote part of his answer to talking about what happened under the previous Government, he can abandon that plan now and resume his seat. I suggest he resumes his seat.

[Mr Tom Clarke (Coatbridge, Chryston and Bellshill) (Lab)]

As part of this openness and transparency, will the Government improve their relations with the police and prison services, so that we can have a clearer idea of why people with mental illnesses are spending time in police cells or being sent to prison?

[Mr Hunt]

I am pleased to tell the right hon. Gentleman that we are working closely with the police to try to ensure that some of the people held in police cells are given much faster access to mental health services. That includes a street triage pilot, which has had early and promising results.

[Charlotte Leslie (Bristol North West) (Con)]

I was informed this morning that the chair of the NHS property board has resigned. That follows the revelation last week, through parliamentary questions I asked, that the board has been raiding its capital allocation to subsidise its own revenue funding. In the interests of transparency, will the Secretary of State undertake to review and publish the recruitment and employment procedure of executive and non-executive members of the board—including civil servant Peter Coates who created the board, which oversees £3 billion-worth of assets—and conduct careful audit and scrutiny of the board’s accounts and minutes?

[Mr Hunt]

Obviously, the suggestions my hon. Friend makes are extremely serious. If she lets me have a copy of all the things she is directly concerned about, I will look into it with the greatest priority.

[Mr Jamie Reed (Copeland) (Lab)]

With regard to openness and transparency, the Secretary of State’s failure to extend the Freedom of Information Act to private providers delivering NHS services is fostering a culture of secrecy. As he forces clinical commissioning groups to tender more services to the private sector, and if he truly believes in openness and the independence of health regulators, will he follow the clear advice from Monitor and extend FOI legislation to private providers, or is he content to allow them to continue to withhold information from patients?

[Mr Hunt]

When it comes to transparency about care, there should be an absolute level playing field between private providers and NHS providers. To answer the hon. Gentleman’s question on regulators, what this Government are going to do, Mr Speaker, is ensure that the Care Quality Commission has statutory independence so that no Government can ever try to interfere with the processes of reporting poor care.

[Mrs Linda Riordan (Halifax) (Lab/Co-op)]

11. Whether he plans to close all or part of Calderdale Royal hospital’s accident and emergency ward.

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

While always paying regard to the superb job done by most doctors, we should allow no hiding place for doctors who endanger patients’ lives by irresponsible or careless behaviour, which is why we have asked the Law Commission to come up with proposals to speed up General Medical Council investigations. We are also considering a new criminal offence of wilful neglect, as recommended by Professor Don Berwick.

[Priti Patel]

The cancer diagnosis of my constituent, Mrs Julia Wild, was delayed by nine months because of a mistake by the initial doctor at her first assessment. For four years, she has been fighting for an apology, for transparency and for the doctor to acknowledge what went wrong with her case. What can Mrs Wild, and other patients in the NHS who have had similar experiences, do to ensure that their complaints are taken seriously, that these life-changing mistakes are acknowledged and that the individuals responsible are held to account?

[Mr Hunt]

My hon. Friend speaks extremely well and I fully understand her concern about Mrs Julia Wild and the care she received. I cannot second-guess the clinical judgment of the GMC, but I agree that Mrs Wild is owed an apology. If the local NHS will not give it, I will give it now. We should have spotted the advanced lobular cancer and I apologise to her that we did not.

[Chi Onwurah (Newcastle upon Tyne Central) (Lab)]

On Friday I visited Cruddas Park surgery in my constituency to see the fantastic work that doctors and staff are doing in the face of huge levels of unmet need, health inequalities and rising mental health issues. If we hold doctors to account for their mistakes, is it not right that they should be able to hold Ministers to account for taking millions of pounds out of their funding and then telling my right hon. Friend the Member for Newcastle upon Tyne East (Mr Brown) that it was nothing to do with him?

[Mr Hunt]

Doctors should be able to hold Ministers to account, as should the public. That is why they will be pleased to know that we protected the NHS budget, and did not follow the advice of the right hon. Member for Leigh (Andy Burnham), who wanted it cut from its current levels.

[Mr Crispin Blunt (Reigate) (Con)]

While we are always of course keen to hold doctors to account for their mistakes, I trust that we will be equally keen to reward them for examples of really good practice, such as those my right hon. Friend will see on Thursday when he makes his very welcome visit to the East Surrey hospital. I commend to him the work of Dr Ben Mearns and his emergency and acute team, who demonstrate good practice and also make it transparent to the rest of the national health service.

[Mr Hunt]

I am greatly looking forward to visiting my hon. Friend’s hospital on Thursday and going out on the front line. I agree that we need to celebrate success. This has been a difficult year for the NHS as we have learned to be much more transparent about problems when they exist, but one of the advantages of having a chief inspector is that his team will be able to identify and recognise outstanding practice, so that everyone will understand that, as well as some of the problems that get more attention, brilliant things are happening throughout our NHS.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

Is the Secretary of State comfortable with a surgeon such as Ian Paterson flitting between the NHS and the private sector, making the same blunders in both but being subject to different levels of accountability and his victims having access to different levels of redress?

[Mr Hunt]

As I said in response to an earlier question, the responsibility to be transparent about care should apply equally in the public and the private sector. Obviously, in the public sector we have more levers, because we are purchasing care and we can impose more conditions than it is possible to do in the private sector. The most important thing is to have a culture in which such problems come to light quickly when they happen, so that they are dealt with and not repeated.

[Mr John Baron (Basildon and Billericay) (Con)]

15. For what reasons the publication of data on one-year and five-year survival rates for all cancers within the Clinical Commissioning Group Outcomes Indicator Set has been deferred until March 2014.

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[Steve Baker (Wycombe) (Con)]

16. What steps he is taking to ensure that the NHS becomes a more patient-led organisation.

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

The big shift we need to make is to turn the NHS into a patient-led organisation. Two measures that will help that are: independent inspections by a new chief inspector that put the patient experience at their heart; and asking every NHS in-patient if they would recommend their treatment to a friend or member of their family.

[Steve Baker]

I am encouraged by that answer. Long ago, the medical establishment was held to account by what were essentially patient-led co-operatives, and today more and more voices are asking for more patient engagement. Will the Secretary of State consider a paper brought forward by Civitas and Anton Howes calling for the incremental implementation of patient-led commissioning to close this gap?

[Mr Hunt]

No one campaigns harder than my hon. Friend on the issue of putting patients first in his constituency and throughout the NHS. CCGs have a legal obligation to involve patients in decisions about services and about them personally. The ideas in the paper he mentions are interesting, and I respect them, but given that we have brand-new commissioners and inspectors going out this year, I think we should see how the current reforms work first.

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

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

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

Today we published a report demonstrating that the NHS could recover as much as £500 million from better systems to monitor and track those who should be paying for the NHS treatment and introducing new charges to certain categories of people currently exempt. This is a significant sum of money that could fund 4,000 doctors, and far from being xenophobic, as some in the Opposition have alleged, the Government believe it is right that overseas visitors who do not pay for the NHS through the tax system should make a fair contribution through charges.

[Annette Brooke]

Poole hospital, which is much loved locally and has excellent care ratings, has a financial problem relating to tariffs that must be addressed. The £5 million spent on putting a failed case for a merger between Bournemouth and Poole hospitals to the Competition Commission raises questions about processes and openness with the public. I hope the Secretary of State can make some comments today, but will he meet me and other local MPs to discuss all these issues in greater detail?

[Mr Hunt]

I am happy to do so. I want to make it clear to my hon. Friend that I am keen to ensure we have a structure inside the NHS that makes it easy for high-performing hospitals that want to work more closely together and share services to do so, if it is in the interests of patients. We need to do more work in this area.

[Andy Burnham (Leigh) (Lab)]

The Secretary of State has been in post for a year, and in that time we have got used to his style: everything is always someone else’s fault, be it lazy GPs, uncaring nurses or the last Government. And today we see more diversion tactics—now immigration is to blame. But there is an inconvenient truth that gets clearer day by day and which he cannot spin away: A and E is getting worse and worse and worse on his watch. We have had ambulance queues, a treatment tent in a car park and now police cars doubling as ambulances, with a patient dying on the backseat. The NHS stands on the brink of a dangerous winter. Will he today set out in detail what he personally is doing to avert a crisis?

[Mr Hunt]

I welcome the right hon. Gentleman back to his place. It is a great pleasure to see him there, even if it is not entirely what the Labour leader wanted.

If the right hon. Gentleman is shocked that I breached the A and E target for one quarter last year, he will want to make a full apology for the fact that he breached it for two quarters when he was Health Secretary.

[Andy Burnham]

This complacent spin is no good to the NHS. If he wants to compare records, let us do that. Under me, 98 per cent. of people were seen within four hours; under him, over 1 million people in the last year waited more than four hours in A and E—not only a winter crisis, but the first summer A and E crisis in living memory. Today it gets worse. New figures this morning show a further 450 nursing jobs have been cut, taking the total close to 6,000 under this Government. But what were they doing last night? They were voting in the Lords against safe staffing levels. Will he now listen to the experts, stop the job cuts and take immediate action to ensure that all A and Es have enough staff to provide safe care this winter?

[Mr Hunt]

We will listen to no one on the Opposition Benches when it comes to safe care for patients in the NHS. They presided over a system where whistleblowers were bullied, patients were ignored and regulators felt leaned on if they tried to speak out about poor care. That is a record to be ashamed of.

[Mark Pawsey (Rugby) (Con)]

T5. There is evidence that a nutritional meal can be a real aid to the recovery of patients, yet the Campaign for Better Hospital Food found that 82,000 hospital meals are thrown in the bin every single day. Will the Minister update the House on the steps being taken to ensure that patients receive a hot balanced meal, served at an appropriate time?

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[Toby Perkins (Chesterfield) (Lab)]

T4. My constituent Jemma Hill is 25 and suffers from chronic hip pain, for which a specialist has recommended hip arthroscopy surgery. However, she has now been told that her local clinical commissioning group does not fund such treatment. Does it not make a mockery of GP-led commissioning when a CCG will not fund the treatment recommended by a specialist to whom the GP referred my constituent in the first place?

[Mr Hunt]

I am very happy to look into that matter, because it sounds like a very deserving case. I will look into the details carefully if the hon. Gentleman gives me the relevant information.

[Jason McCartney (Colne Valley) (Con)]

T8. Does the Secretary of State agree that we need to learn from the mistakes of the Safe and Sustainable review of children’s heart surgery services and improve the forthcoming review in two ways? First, we should make the process a lot more transparent. Secondly, areas such as neo-natal, paediatric and adult intensive care unit services and transport and retrieval services should fall within the scope of the new review.

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[John Glen (Salisbury) (Con)]

T10. Dr Elizabeth Stanger, a highly respected Salisbury GP, recently questioned me about the sustainability of providing multiple treatments for complex medical problems for several generations of the same family of foreign nationals. I welcome today’s announcement, and ask the Minister to reassure me that the mechanism to recover the funds will ensure that the money goes back to the clinical commissioning group so that it can provide a benefit locally.

[Mr Hunt]

I absolutely can reassure my hon. Friend about that. The point about the new, improved system for recovering charges is that we want the money to go back to the people providing the services so that they will be able to resource them better. This is not the diversionary tactic that some have accused us this morning of introducing; £500 million could have a huge impact on the NHS front line and allow his GPs to do a much better job.

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

This evening, the joint health overview and scrutiny committee for Trafford and Manchester will meet to consider whether the preconditions for the reconfiguration of services in Trafford, including those set down by the Secretary of State, have been met. I understand that the NHS area team has already confirmed that it believes the conditions have been fulfilled, but will the Secretary of State tell me what would happen if, as seems possible, the scrutiny committee were to take a different view tonight and decide that not all the conditions had been met?

[Mr Hunt]

We will obviously respect the legal processes, but if the scrutiny committee were to take such a view tonight, we would certainly look very closely at its concerns and ensure that we had satisfied ourselves on them before proceeding.

[Duncan Hames (Chippenham) (LD)]

A written answer from the former Minister, my hon. Friend the Member for Broxtowe (Anna Soubry), to my recent parliamentary question has on this subject revealed that people living in the south-west of England are three times as likely to contract Lyme disease as those in the rest of the country, yet I have a constituent doing what he calls drug runs to the rest of Europe to access the medicines necessary to tackle his symptoms. Will the Minister meet me to discuss how we can ensure the continuing availability of treatments for Lyme disease on the NHS?

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[Miss Anne McIntosh (Thirsk and Malton) (Con)]

When the Secretary of State meets the chairman of NHS England to discuss future priorities for NHS spending, will he ensure a fair deal for rural areas by ensuring that they reflect rurality, sparsity and the number of elderly patients and that we keep the minimum income guarantee for rural GP practices?

[Mr Hunt]

I can reassure my hon. Friend, as I am meeting some Yorkshire GPs later this week who have concerns about that very issue. The most important thing about the difficult issue of the funding formula is that it should be fair. That is why under the new legislation we have given the decision to an independent body so that it is taken at arm’s length from Ministers and so that it strikes the right balance between the issues of rurality, age and social deprivation.

[Hazel Blears (Salford and Eccles) (Lab)]

The NHS, with its massive purchasing power, can make a real difference to local areas through jobs and through supply chains. Some hospital trusts are enthusiastically implementing the Public Services (Social Value) Act 2012, including Barts and King’s. Will the Minister ensure that his new procurement strategy recognises the importance of social value?

[Tim Loughton (East Worthing and Shoreham) (Con)]

The Secretary of State knows Worthing hospital well; he has rolled his sleeves up there. When I went there a few weeks ago, I was told that the average age of patients in the hospital, stripping out maternity, is 85, yet we have qualified for no winter pressures money and we have a diminishing number of community hospital beds. Will he look into this anomaly, as he well knows the specific pressures we have on the south coast?

[Mr Hunt]

I understand my hon. Friend’s concerns and I know that there is a large elderly population in Worthing. I thought it was an excellent hospital with a fantastic atmosphere when I went and did part of a shift there. The winter pressures money went to the third of A and E departments that are struggling the most, so it is probably a compliment to his hospital that it did not receive it. We felt that with limited funds we had to concentrate resources where they were going to have the most impact. I hope that he understands why we had to make that difficult decision.

[Joan Walley (Stoke-on-Trent North) (Lab)]

This week, the report of the trust special administrator in respect of Stafford hospital is being presented to Monitor. Given that the preferred option is that the University Hospital of North Staffordshire should in some way take over, will the Secretary of State urgently meet all Members of Parliament for the north Staffordshire area to ensure that health care in north Staffordshire, where we already have a deficit of £31 million with an extra £18 million set to come over, will not be destabilised?

[Mr Hunt]

We are acutely aware of those concerns. In any reconfiguration, and particularly in this one, we want to ensure that there is no instability in the local health economy. We have given the trust special administrator a little longer to come up with a plan for Stafford hospital to try to secure local agreement, so I have not had a recommendation yet and I am going to wait and see what he says.

[Several hon. Members]

rose—