Oral Answers to Questions Debate
Full Debate: Read Full DebateJeremy Hunt
Main Page: Jeremy Hunt (Conservative - Godalming and Ash)Department Debates - View all Jeremy Hunt's debates with the Department of Health and Social Care
(10 years, 6 months ago)
Commons Chamber1. What progress he has made on improving out-of-hospital care for the frail and elderly.
We will ensure that everyone over the age of 75 has a named GP, responsible for delivering proactive care for our most vulnerable older people in the best traditions of family doctors. Through our £3.8 billion better care fund, we are also merging the health and social care systems to provide more joined-up health and social care.
I welcome the steps that my right hon. Friend is taking to improve and enhance the quality of care for the elderly. Given that east Cheshire has one of the fastest-growing ageing populations in the UK, will he tell the House what specific steps he is taking to improve out-of-hospital care in and around Macclesfield? Furthermore, does he agree that it is vital that appropriate funding is in place to take care of the elderly and most vulnerable patients?
May I congratulate my hon. Friend on the campaigning work he does in his constituency on health matters? I commend the Eastern Cheshire clinical commissioning group for its “Caring Together” programme and for the fact that Cheshire was selected as one of the 14 integrated care pioneers. I hope that it will blaze a trail in joining up the barriers that have bedevilled our health and social care system for too long, so that his constituents are not pushed from pillar to post because of arguments about budgets and people can be discharged on time. I think his area is blazing a trail.
The national dementia strategy has been fundamental in improving care for many frail and elderly people with dementia living in the community. The strategy is due to expire in April—in two months’ time. Will the Secretary of State give a commitment to the House now that the national dementia strategy will be renewed? I understand that we have the Prime Minister’s dementia challenge, but, like many of us, Prime Ministers come and go. We need a strategy and not simply the Prime Minister’s challenge.
I can assure the right hon. Lady that this Prime Minister is here to stay. Indeed, I can also reassure her that the national dementia strategy is here to stay. As she has announced that she is stepping down at the end of this Parliament, may I thank her for her campaigning on dementia, which, I think, came from a family connection with the issue? She has attended many of my dementia meetings and the G8 dementia summit. She has made a really important contribution, and I thank her for that.
May I follow up on the question that the right hon. Lady has just asked? The Secretary of State has said that the national strategy is here to stay and that is very welcome, but the national strategy was drafted with the intention that it would expire this year. It would be useful if he now indicated the intention to refresh and update it so that we have a clear road map for at least the next decade.
I know that my right hon. Friend showed great interest in this issue when he was in my Department. When I say that the strategy is here to stay, I mean that it is here to be refreshed and updated. We are subscribing to some big new ambitions, including that by the time of the next election two thirds of people with dementia will be diagnosed and have a proper care plan and support for them and their families. That is a big improvement on the 39% of people who were diagnosed when we came to office. There is much work to do, but I assure him that we are absolutely committed to delivering.
Some hospitals are making a virtue out of quick discharge for their stroke victims. Is the Secretary of State convinced that elderly stroke victims, perhaps those without people to advocate on their behalf, are getting appropriate care and that their care and rehabilitation are not being scrimped on or rationed?
No, I am not convinced. We need to do much better when it comes to the discharge of vulnerable older people, especially when they leave hospital not cured and still with a long-term condition. They may be recovering from a stroke or dementia or any other condition. We need to have much better links between hospitals and GPs and to have named accountable GPs in the communities looking after those very people.
I was disappointed with the allocation of funding by NHS England for care around the country because it did not reflect the demands of the elderly population. People in my constituency have to do a 200-mile round trip to receive support such as cardiac care. Will the Secretary of State ask it to think again for future years?
My hon. Friend is right to campaign hard on that issue. I agree that the funding formula does not always do justice to people, especially those in sparsely populated rural areas. I know that NHS England is trying to do what it can to move to a more equitable funding formula, but it is not something that can be done overnight. I encourage her to keep pressing on that issue.
Welcome back, Mr Speaker. Easy access to GPs is a key part of out-of-hospital care for elderly and frail people. Days after the election, the Prime Minister scrapped Labour’s guarantee that gave patients a GP appointment within two working days, and took away funding that kept thousands of surgeries open in the evenings and at weekends. Now the Royal College of General Practitioners is warning that 34 million patients will fail to get an appointment. Will the Secretary of State listen to the Patients Association, bring back the 48-hour appointment guarantee and help older people to see their doctor when needed?
The reason that we got rid of that guarantee was that the number of people who were able to see a GP within 48 hours was falling in the last year in which the target was in place. It was not working, and that is why the British Medical Association and the Royal College of General Practitioners were against it. In the same survey that the hon. Gentleman quoted, the RCGP said it estimated that there had been a 10% increase in the number of GP appointments compared with when his Government were in office.
2. What recent steps he has taken to improve maternity care.
People can opt out of the care.data programme through their GP surgery. Depending on the surgery, that may well be done online or by telephone.
Is the Secretary of State aware that the Government’s handling of the scheme has been shambolic from the very start and that their failure to communicate is nowhere better illustrated than in Pulse, the GP’s magazine, in which an article states that only 15% of members of the public surveyed knew that they had the right to opt out? What will he do to restore public confidence in a scheme that could be very beneficial?
It is a pleasure—I think for the first time—to take a question from someone who might be one of my constituents in Godalming. However, I do not agree with the hon. Gentleman that the process has been shambolic. The programme has been in place for 25 years, so it is important to understand that this big public debate is happening because this Government did something that the previous Government did not do: we said that if we are going to use anonymised data for the benefit of scientific discovery in the NHS, people should have the right to opt out. We introduced that right and sent a leaflet to every house in the country, and it is important that we have the debate—[Interruption.] The right hon. Member for Leigh (Andy Burnham) complains, but he did not want to give people the right to opt out when he was Health Secretary.
The Secretary of State will be aware of the report in The Daily Telegraph setting out how hospital episode statistics data were sold to insurance companies, which were able to match that information with credit ratings data. Nothing will undermine this valuable project more than a belief that data will be sold to insurance companies, so will he set out the way in which he will investigate how that sale was allowed to happen and categorically reassure the House that there will be no sale of care data to insurance companies?
My hon. Friend is absolutely right to raise that issue and I am happy to give that assurance. That incident is one of the reasons why we set up the Health and Social Care Information Centre through the Health and Social Care Act 2012, in the teeth of opposition from the Labour party. Following the establishment of the centre, the guidelines in place mean that such a thing could not happen. She is also right that it is important that we reassure the public because, let us not forget, it was this important programme that identified the link between thalidomide and birth defects, that identified that there was no link between MMR and autism, and that helped to identify the link between smoking and cancer, so it is vital that we get this right.
20. Virtually everyone wants to improve patient care in the NHS, so why not scrap the underhand way in which the care.data programme has progressed so far, and instead provide a diverse choice of ways to opt in, limit the use of medical data to the NHS and keep the public’s personal information out of the hands of the private sector?
May I gently tell the hon. Gentleman that the reason why we are having the debate is that this Government decided that people should be able to opt out from having their anonymised data used for the purposes of scientific research, which the previous Labour Government refused to do? When they extended the programme to out-patient data in 2003 and to A and E data in 2008, at no point did they give people the right to opt out. We have introduced that right, which is why we are having the debate.
There are of course huge benefits from using properly anonymised data for research, but it is difficult to anonymise the data properly and, given how the scheme has progressed so far, there is a huge risk to public confidence. Will the Secretary of State use the current pause to work with the Information Commissioner to ensure that the data are properly anonymised and that people can have confidence in how their data will be used and how they can opt out?
I will do that, and NHS England was absolutely right to have a pause so that we ensure that we give people such reassurance—[Interruption.] When we had a pause before, the result was the very good Health and Social Care Act, which is doing good things for patients throughout the NHS. This programme is too important to get wrong, and while I think that there is understanding on both sides of the House about the benefits of using anonymised data properly, the process must be carried out in a way that reassures the public.
When he was appointed, the Health Secretary declared it his personal mission to have a “data revolution” in the NHS, but what he has presided over is a spectacular collapse in public confidence in the use of patient data. The only revolution he has created is a growing public revolt against his care.data scheme. Coming after his NHS 111 shambles and the court humiliation over Lewisham hospital, it cements a reputation for incompetence. When was he first warned about problems with care.data and what action did he take?
The shadow Secretary of State searches for NHS crises with about as much success as George Bush searching for weapons of mass destruction. My first contact with that programme, when I was told about it, was to decide to do something that he never did as Health Secretary: to say that every single NHS patient should have a right to opt out of having their data used in anonymised scientific research. I think that was the right thing to do. Of course we are having a difficult debate, but its purpose is to carry the public with us so that we can go on to make important scientific discoveries.
Again, the right hon. Gentleman never takes responsibility—it is always somebody else’s fault. Even by this Government’s standards, this is a master-class in incompetence. First, we have this useless glossy leaflet. He said that it has gone to every home, but that is not true, because homes that have opted out of junk mail have not received it. Many people report that they still have not had it through their letterbox. Secondly, when people cannot even get through to their GP practice on the phone, as we heard earlier, or get an appointment, he has made it almost impossible to opt out of the scheme. Has this cavalier approach not built an impression that the Government are taking patient confidentiality for granted in trying to force through the scheme, increasing public mistrust and putting the important scheme at risk?
It is intriguing that the shadow Secretary of State has chosen not to talk about a winter crisis, because it has not happened, despite the fact that he predicted it time after time. Let me tell him what was cavalier: the previous Labour Government’s refusal to give patients a right to opt out of giving their data to this programme, even though it was going on for their whole time in office. We believe that we should have a data revolution, but to do that we need to carry the public with us, which is why we need to have this important debate and give people the reassurance they deserve.
6. What recent assessment he has made of the number of available mental health crisis beds for young people in England.
12. What recent meetings he has had with representatives of the private health care sector.
In the past three months, I have had two meetings with private sector health care providers, both in China, helping them to win export orders. In the same period, I have had 20 meetings with traditional NHS providers.
Private health companies with strong links to the Conservative party have been awarded contracts to run NHS services worth about £1.5 billion, which surely raises serious questions about the level of influence of Conservative donors on health policy. In the interests of transparency, will the Secretary of State commit to publishing a list of private health care companies that have made donations to the Conservative party?
The difference between donors to the Conservative party and donors to the Labour party is that our donors do not write our policies. While we are talking about private sector health care providers, I remind the hon. Gentleman of what an unnamed shadow Cabinet Minister told The Independent last week:
“We all remember when Andy was Health Secretary and happily contracting out bits of the NHS to the private sector… You have to ask yourself what’s changed.”
The NHS diagnostic centre in Wycombe, which is operated by the private sector, does a fantastic job. Will the Secretary of State join me in congratulating and thanking Opposition Members for all that they did to extend private and independent provision in the NHS?
I am happy to do that. My hon. Friend may be interested to know that in the last four years of the last Government, private sector contracts in the NHS doubled—something that this Government have not been able to match. It is important to look at the facts before we start any hares running with respect to privatisation.
T1. If he will make a statement on his departmental responsibilities.
I would like to thank Public Health England and the NHS emergency services for their extraordinary work during the recent floods, and say that this House is proud of their dedication and commitment to help those in great need. Since the previous Health questions, we have also had the first anniversary of the Francis report on Mid Staffs. As a result, I am proud that the Government have taken significant steps to restore compassionate care to all parts of our NHS, with a regulator now free from political interference, failing hospitals being turned round, and more nurses, midwives and health visitors in our NHS than at any time since 1948.
The family of my eight-year-old constituent Ben Foy have been fighting for more than two years for the funding of sodium oxybate—a drug that his doctors feel could help him cope with narcolepsy and cataplexy. This is a particularly distressing condition for Ben and his family, but sadly, after all this time there is still complete confusion as to who has responsibility for Ben’s commissioning request. Will the Secretary of State look into the matter and clear up that confusion?
I reassure my hon. Friend that I have looked into Ben Foy’s case, and NHS England has confirmed that it is responsible for commissioning his care. The particular drug that my hon. Friend mentioned is not recommended by the manufacturer for use by children and adolescents, but I am happy to arrange for him to meet NHS England and get to the bottom of the issue.
I want to return to care.data—an important scheme that needs to be saved from the incompetence of this clownish coalition. The Secretary of State said earlier that I was in search of a crisis, but now I will offer him a solution. If the Government work with us to introduce a series of tough new safeguards to protect patients, we will work with the Secretary of State to help rescue this failing plan. Those safeguards include tougher penalties for the misuse of data, Secretary of State sign-off on any application to access data, full transparency on organisations granted access, and new opt-out arrangements by phone or online. Will he meet me to discuss changes to the Care Bill to put that important scheme back on track?
The right hon. Gentleman has still not addressed the fundamental question of why he did not introduce an opt-out for the use of personal data, which this Government are doing. We have taken more steps than his Government ever did, and we will continue to work hard to ensure that this important scheme goes ahead. The right hon. Gentleman should know better.
T2. There is great unmet need among older people in our communities, particularly for dementia care and support. In Portsmouth we are holding a community summit to join up local agencies to meet that unmet need. Will the Minister meet me to discuss what central Government can do to ensure that advice on additional funding streams is clearly and readily available?
T4. Further to the answer given earlier to my hon. Friend the Member for Wansbeck (Ian Lavery), the lobbyist John Murray and an organisation funded by large pharmaceutical companies led a consultation and co-wrote a report for NHS England on the future of commissioning for £12 billion of NHS services. Will the Secretary of State tell the House whether it is now Government policy to have lobbyists and big drug companies drafting reports that directly influence the commissioning of NHS services?
Let me say this to the hon. Lady: we have very clear rules, and for people who are involved in industry and have a self-interest we have important protections to ensure there is no conflict of interest. Let us be clear: the private sector has an important role to play in the NHS, but it grew far faster under the previous Government than it has done under this one. We are not going to take any lessons about being in hock to the private sector.
T3. As the NHS comes through another winter, when it has delivered an outstanding service to more patients than ever before, how does my right hon. Friend assess the damage done by the unfounded scaremongering talk of crisis by the Opposition and some parts of the media?
My hon. Friend is absolutely right. I encourage those on the Opposition Front Bench in particular to talk to a few people in A and E and ask whether they think they have been supportive, in a very difficult winter, by whipping up all these scare stories when, in fact, because of their hard work, we are seeing 2,000 more people every single day in less than four hours than when the shadow Secretary of State was Health Secretary. A and E is performing better than ever.
T5. There are nearly 500 UK-trained medical practitioners now working in Australia, of whom 6% never return owing to the better conditions available there. What steps will the Secretary of State and his ministerial team take to ensure that we retain those qualifying in emergency medicine this year, to keep local A and E departments open in Britain and Northern Ireland?
T10. The village of Melling has grown in recent years, yet its surgery hours have been cut drastically. Elderly and disabled residents now face a four-hour round trip by public transport to see their doctor. How can cuts in surgery hours, like those in my constituency, be justified if the Government are serious about having a first-class NHS?
We absolutely want to make primary care more accessible and that is why we are introducing named GPs for everyone aged 75 or more from April. This is a significant and important reversal of, I think, a mistake that everyone now agrees was made in 2004 when named GPs were abolished. Its purpose is to make GPs more accessible to the people who need them the most.
T9. The father of one of my constituents passed away at the weekend, one of 8,700 people who are diagnosed with pancreatic cancer each year in the UK, of whom only 3% will survive beyond five years. That survival rate has not changed in over 40 years. Will my right hon. Friend update the House as to what the Government are doing to improve patient outcomes for those with pancreatic cancer?
The Manchester Evening News recently highlighted the enormous pressures faced by Wythenshawe accident and emergency after the downgrading of Trafford accident and emergency. Will the Secretary of State meet me to discuss this and to tell me when Wythenshawe will receive the extra funds that it has been promised?
I welcome the hon. Gentleman to the House and congratulate him on representing in his constituency a fantastic hospital; I have been to Wythenshawe hospital and it is superb. Some big changes are happening in the Greater Manchester area that will lead to that part of the country having some of the best NHS care in the country. Obviously there is a difficult transition in A and E services between Trafford and Wythenshawe, and I am happy to meet him to discuss it further.
Does my right hon. Friend agree that it is unacceptable that investigations into failures in hospital services take so very long? There has recently been one in my constituency: a very sad and badly handled case connected with mental health. Does my right hon. Friend agree that the authorities need to provide answers very promptly to families who are left completely beleaguered by such behaviour?
I absolutely agree with my right hon. Friend. One of the tragedies that the Francis report helped us to uncover was that so many failings had been allowed to persist for so long: in the case of Mid Staffs, between 2005 and 2009. We owe it to families to be much quicker, which is why there is now a time limit on the failure regime: hospitals must be turned around within a fixed period of time or go into administration. Otherwise, we will not have safe hospitals in our areas.
The Minister earlier told the House that 1,500 new midwives had come on stream since the Government started, but, of course, the Government promised that there would be 3,000 delivered by 2015. Midwives are very good at delivery; how good is the Department?
Last year I spent a busy and informative day with the East Midlands ambulance service on the road. It was clear speaking to those professionals that a large proportion of individuals taken to A and E would be better served by going to their GP or by accessing other services. However, the ambulance service felt completely disempowered to advise or even to refuse to take anyone to A and E who requested it.
That is one of the things we need to be much better at—linking up the services offered by ambulance services. I would add that pharmacies have a big role to play in this, as one in 11 or 12 A and E appointments could be dealt with at a pharmacy. My hon. Friend is absolutely right that this is something we need to do better.
A hugely expensive review of A and E services is going on in Telford, the Wrekin and Shropshire. The Secretary of State was in Telford a couple of weeks ago but did not have the courtesy to let me know. Will he say whether we will retain full 24-hour, seven-day-a-week services at Telford and whether there will be downgrade of our A and E?
First, I apologise to the hon. Gentleman if my office did not let him know that I was visiting, an oversight for which I take responsibility. I had a good visit to the Redwoods, a superb mental health in-patient unit where I learned a great deal. I am not aware of any plans to change or downgrade his A and E.