Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 1st April 2014 Commons Chamber

[Andrew Selous (South West Bedfordshire) (Con)]

1. What steps he is taking to improve compassionate care in the NHS.

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

The Government have made it a key priority to restore a culture of compassionate care throughout our NHS. Ten thousand nurses and midwives will have taken part in a new leadership programme that champions patient-focused compassionate care. Pilots are testing whether all nurses should spend time on the wards prior to a nursing degree.

[Andrew Selous]

Will the Secretary of State join me in congratulating NHS staff, who are shifting the priorities of the NHS culture towards compassionate care and away from a tick-box culture? Does he agree with Robert Francis, who says that compassionate care very often saves money?

[Mr Hunt]

My hon. Friend is absolutely right. Last week I was in one of the safest hospitals in the world, Virginia Mason hospital in Seattle, which has cut litigation claims by three quarters since it introduced safer care. We have fantastic hospitals in this country too, such as Salford Royal. The truth is that safer care is better value for money: it means that more money can be spent on the front line, not on litigation.

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

The Secretary of State is not showing much compassion towards hard-working NHS staff, who have a 1% pay rise. One year on from the top-down reforms, what does he think of the survey showing that 69% of front-line staff think his reforms are damaging patient care?

[Mr Hunt]

The most damaging thing for patient care would be a pay award, which the hon. Gentleman sounds like his is supporting, that would mean the potential loss of 6,000 nursing jobs from our front line. That would be incredibly bad for patients and incredibly bad for nurses. All nurses are getting a minimum 1% rise. That is the right thing to do. That is supported by the shadow Chancellor but not, apparently, by the shadow Health Secretary.

[Nadhim Zahawi (Stratford-on-Avon) (Con)]

20. In a report published by the King’s Fund last month, South Warwickshire NHS Foundation Trust was highlighted as a leading example of compassionate care for the frail elderly. Will the Secretary of State join me in congratulating the trust’s staff on the move away from tick-box targets, and visit the trust to see this new emergency care model in practice?

[Mr Hunt]

I much enjoyed a recent dinner where I had the chance to meet a consultant from South Warwickshire NHS Foundation Trust. One of the discussions I remember having with him was how inside the NHS the definition of success for a hospital was in the past too narrowly focused on targets and financial balance, and not enough on patient safety, compassionate care and clinical outcomes. He, and many other people in the NHS, welcome the change that this Government have made in the past year to change that balance.

[Helen Jones (Warrington North) (Lab)]

Does the Secretary of State agree that compassionate care begins with being able to see a GP? In areas such as mine, GP appointments are increasingly hard to get. In fact, one practice has had its contract rescinded because of its failures. Does he now regret scrapping the target allowing patients to see a GP within 48 hours?

[Mr Hunt]

I am interested and rather astonished that the hon. Lady dares to mention the words “GP” and “contract” in the same sentence. It was Labour’s GP contract changes in 2004 that made it disastrously more difficult for people to see their GP and destroyed the link between patients and doctors by getting rid of named GPs. She will be pleased to know that from today we are reintroducing named GPs for the over-75s, which is big step forward in making it easier for people to see their GP.

[Andrew George (St Ives) (LD)]

Although the Secretary of State says that he is getting rid of tick-box targets, new targets are being introduced, including hourly ward rounding for nurses and the introduction of a requirement for nurses to undertake a year as a care assistant. Would it not be better to depend on the professionalism of the nursing profession?

[Mr Hunt]

That is exactly what we are doing. There is no target to introduce hourly rounding, but there is very good evidence from the hospitals that have it, such as Salford Royal, that it results in the buzzer going off less often, calmer wards and problems being nipped in the bud. People are given food and water before they feel the need to ask for it and we end up with much better and safer care. That is something the hon. Gentleman should welcome. We certainly want to work with the nursing profession to ensure we deliver that.

[Mr David Crausby (Bolton North East) (Lab)]

2. What his most recent estimate is of the cost to the public purse of reorganisation in the NHS.

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

According to official figures, the new structure set up by the Health and Social Care Act 2012 will save £5.5 billion in this Parliament and £1.5 billion every year after that, all of which will be reinvested in front-line care.

[Mr Crausby]

Given that he promised in 2010 that there would be no top-down reorganisation of the NHS, how can the Secretary of State justify spending billions of pounds on top-down reorganisation on the day on which Simon Stevens, the new chief executive of NHS England, has warned that the NHS is facing the biggest

“budget crunch in its 66-year history”?

[Mr Hunt]

As Simon Stevens is starting today, I think that this is a good moment to welcome him to his post. He is an outstanding individual, and I know that we all wish him well in what will be a challenging but incredibly important job.

As for the reorganisation, the official figures make it clear that it is saving more than £1 billion every year during the present Parliament—money that is being reinvested in the provision of 1,600 more nurses, 1,700 more midwives, 1,800 more health visitors and nearly 8,000 more doctors than we had under Labour. I am afraid that that shows that Labour has not learned the lessons of Mid Staffs. Labour Members still want to turn the clock back and spend all that money on administration.

[Mr Simon Burns (Chelmsford) (Con)]

Does my right hon. Friend agree that savings that have been made through greater effectiveness and efficiency, and that can be ploughed back into patient care, should be warmly welcomed? Does he not think that such action is far preferable to the bizarre suggestion by a former Labour Health Minister that people should be charged £10 a month to visit their GPs, which would compromise Nye Bevan’s founding principle of a free health service?

[Mr Hunt]

I do think that that is a bizarre suggestion. Given our ageing population, we need to make it easier rather than harder for people to see their GPs. I also think it bizarre of the Opposition to set their face against the reforms that my right hon. Friend helped to pilot through the House. Because money has gone to the front line, 800,000 more operations are being performed in the NHS year in, year out than were performed under Labour. We are putting money where it is needed, with doctors and nurses.

[David Wright (Telford) (Lab)]

Will the Secretary of State give us more details about the amount of money that was spent on consultants during the top-down reorganisation? Would that money not have been better spent on nursing?

[Mr Hunt]

I will happily give the hon. Gentleman the figures, but if he is shocked by the amount that was spent on consultancy, he will be even more horrified to learn that it was vastly greater under the last Labour Government. We are paring that down precisely because we want money to be spent on the front line.

[Caroline Dinenage (Gosport) (Con)]

Does the Secretary of State share my hope that the Government’s joint commitment to increasing NHS spending and dealing with the legacy of private finance initiative debt will help areas such as Gosport, which is living under the umbrella of a huge PFI hospital that was approved under the last Government and is sucking up most of the NHS budget?

[Mr Hunt]

PFI debt is costing the NHS more than £1 billion every year. In some cases that money was well spent, but it was often very poorly spent. My hon. Friend is absolutely right: we want the money to be spent on front-line care, which is why we have drawn a line under the appalling deals negotiated by the last Government. We are spending money where it should be spent, in order to help patients.

[Andy Burnham (Leigh) (Lab)]

It is a year to the day since the Government’s reorganisation took effect, and now that the dust has settled, we can see the full scale of its folly. There are 163 more NHS organisations than there were before, four times more managers are being paid the very highest salaries than the Government planned for, and 4,000 staff received redundancy payments only to be rehired by the new organisations that the Government had created. Is not the reason why the NHS is the only public service that cannot honour a 1% pay increase for its hard-working staff the fact that these Ministers lost control of their own reorganisation, and it has now wasted billions of pounds?

[Mr Hunt]

I think that the right hon. Gentleman needs to look at the figures. The reorganisation, which he opposed through thick and thin, means that the NHS is spending less on administration and bureaucracy. If he questions that, may I ask how he thinks we found the money to pay for 8,000 more doctors and 15,000 more clinicians, if it was not by getting rid of primary care trusts and strategic health authorities? That is why there are now 2.5 million more diagnostic tests and 4 million more out-patient appointments every year. We are doing more for patients than was ever done when the right hon. Gentleman was Secretary of State.

[Andy Burnham]

I know that it is April fool’s day, and the Secretary of State certainly seems to be getting into the spirit of it with that answer, but his fantasy figures will be laughed at by anyone who works in the NHS. It is not just in relation to bureaucracy that the Government have broken promises. They said that the reorganisation would improve patient care, but 70% of NHS staff say that it has got worse. The first full year of the reorganised NHS has been the worst year for a decade in A and E. It is harder to get a GP appointment than it was before, and cancer patients are waiting longer to start treatment. Is it not now clear that the Government’s reorganisation has been a disaster on every level for patients and taxpayers who never voted for it, and who were promised that it would never happen?

[Mr Hunt]

I will tell the right hon. Gentleman what is not an April fool—the appalling care at Mid Staffs on his watch. If he is talking about how the NHS is doing, perhaps, for once, Labour Members should look at what patients are saying. I know that it is difficult, but if we look at what patients say, we see that since the election, there has been a 5% increase in those who think that their NHS care is safe, and a 10% increase in those who think that they will be treated with dignity and respect in the NHS under the coalition. We are proud of that, because we are putting patients before politics, which the right hon. Gentleman never does.

[Mr John Spellar (Warley) (Lab)]

3. How many staff have been made redundant and subsequently re-employed by NHS organisations since May 2010.

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[Karen Lumley (Redditch) (Con)]

5. What progress he has made on improving out-of-hospital care for frail elderly people.

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

Under the new GP contract, which starts today, we will ensure progressively that everyone over the age of 75 has a named GP responsible for delivering proactive care for our most vulnerable older citizens. The new contract will help to restore the personal relationship between doctor and patient that was destroyed in 2004 when named GPs were abolished.

[Karen Lumley]

Will my right hon. Friend congratulate Worcestershire Acute Hospitals NHS Trust, which has used some of its winter pressure money this year to buy beds in a nursing home in order to free up much-needed hospital beds? Does he agree that that model enables elderly people to be cared for in their community when they no longer need urgent treatment?

[Mr Hunt]

I am happy to congratulate the trust on its excellent work. It is worth reflecting on how well the NHS did this winter. Despite constant attempts by the Opposition to talk up a crisis, we hit the target for A and E in more weeks than was the case when the right hon. Member for Leigh (Andy Burnham) was in office, and 2,000 additional people were seen within four hours every single day.

[Derek Twigg (Halton) (Lab)]

Part of the problem with people being admitted and readmitted to hospitals involves access to their GPs. What is the Secretary of State doing to ensure that elderly people across the board have access to their GP, so as to prevent their admission or readmission to hospital?

[Mr Hunt]

The hon. Gentleman is absolutely right. If we are going to deal with the pressures in A and E, we need to have a massive improvement in primary care access. There has been historical under-investment in primary care, going back over many years, and we need to change that. One of the ways in which we want to do that is to reintroduce GPs taking personal responsibility for the most vulnerable older people, and today’s changes will help us to move towards that.

[Lorely Burt (Solihull) (LD)]

In my constituency the success of virtual wards has decreased the need for hospital beds. That is welcome, but dementia sufferers, who sometimes need hospital treatment and specialist care to mitigate the additional confusion and anxiety that they experience, do need specialist care within a hospital. Our local dementia unit is under threat of closure. Does the Secretary of State agree that it should not be closed and that that is a wrong decision?

[Mr Hunt]

I do not know the details of that particular case, but I am happy to look into it. I would say that a quarter of our hospital in-patients have dementia, and it is incredibly important that hospitals continue with a revolution in the way they look after people with dementia. There are some fantastic examples of that around the country, and I want to give them every support and encouragement.

[Mr Jamie Reed (Copeland) (Lab)]

GP access is a crucial element of out-of-hospital care, and the British Medical Association today said that the damage caused by this Government to the NHS has been “profound and intense”. Last week, the Royal College of General Practitioners said that more than a quarter of us now wait more than a week for an appointment with our family doctor. Within days of taking office, Ministers axed Labour’s guarantee of an appointment within 48 hours and took away the funding for evening and weekend opening. Under this Government, has it not got harder and harder to get an appointment with a GP? Let us have an honest, grown-up answer.

[Mr Hunt]

The honest factual answer is that we got rid of that target because when it was in place the number of people actually being able to see their GP within 48 hours was falling, so it was not working. I am afraid that this is the same old Labour problem: thinking that the solution to every problem in the NHS is another target. That is exactly what led to Mid Staffs and exactly what we will not allow to happen.

[Mr Dominic Raab (Esher and Walton) (Con)]

6. What steps he is taking to reduce the time taken to diagnose brain tumours in children.

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

Last week, I launched a campaign to save up to 6,000 lives by halving avoidable harm and avoidable death in the NHS. I am inviting all NHS trusts to sign up to safety, by putting together their own plans, with support provided by NHS England, Monitor, the NHS Trust Development Authority and the NHS Litigation Authority. Learning from hospitals with the best safety records anywhere in the world, such as Virginia Mason in Seattle and Salford Royal here in England, we have a once-in-a-generation opportunity to put behind us the tragedy of Mid Staffs and make the NHS the safest health care system in the world.

[Mr Bradshaw]

People in Exeter and Devon with mental illness are now waiting more than two years for treatment. This is totally unacceptable and will, if it has not already, lead to the loss of lives. The Minister has repeated today his criticism of NHS England’s decision to cut funding for mental health, but as the shadow Minister reminded him, he is not a passive observer; he is the Minister responsible. What will he do about it?

[Mr Hunt]

The reason we are not passive observers is that we have made some substantial improvements in mental health provision since coming to office, including legislating for parity of esteem, which is precisely why the right hon. Gentleman feels able to ask that question. There are 55,000 more people every year getting a dementia diagnosis and nearly 80,000 people going on to psychological therapies. Lots has been done, but there is lots more to do, and we will continue to do everything we need to until we get that parity of esteem.

[Mr David Heath (Somerton and Frome) (LD)]

T3. The whole House will have been appalled by evidence from the Winterbourne View case and others of inappropriate methods of controlling patients. Will the Minister now take action to ensure that restraint is only ever used as a last resort, whether in care homes, hospitals or mental health units?

[Liz Kendall (Leicester West) (Lab)]

The Government’s damaging reorganisation has weakened the grip on NHS finances. Figures slipped out the day after the Budget show that NHS hospitals are in deficit for the first time in eight years, hospital trust deficits are three times higher than they were a year ago and twice as many foundation trusts are in the red. Will the Secretary of State now commit to publishing the final year-end figures for all hospitals in one annual account so that the House can hold him to account for his mismanagement of public money?

[Mr Jeremy Hunt]

It is financially challenging for the NHS, but we will not lose control of NHS finances, as happened under Patricia Hewitt. I remind the hon. Lady that for nine of Labour’s 13 years in office the NHS trusts sector as a whole was in deficit. We are getting a grip of those problems. We will publish the figures she wants, but the reason it has been particularly challenging this year is that hospitals have responded to the Francis report and hired 3,500 additional nurses to ensure that we have proper care on our wards.

[Chris Heaton-Harris (Daventry) (Con)]

T5. What progress is being made on ensuring that selective dorsal rhizotomy is available to children with cerebral palsy who need that life-changing operation?

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

T2. How does the Minister respond to a warning from the UK’s top cancer doctors that the planned closure of 18 specialist centres for treating the victims of brain cancer is putting patients’ lives at risk by delaying treatment? It is clearly at odds with the Prime Minister’s assurance about improving access. Those top brain surgeons say that it is appalling. Will the Secretary of State stop it and engage in a proper and meaningful review?

[Mr Jeremy Hunt]

The review the hon. Gentleman refers to is a consultation by NHS England to ensure that we commission specialist services better. There has been a 23% increase in the number of cancer sufferers getting treatment under this Government. We want to improve on that record even more, which means having sensible discussions on how to improve specialised commissioning, and that is what is going on.

[Bob Blackman (Harrow East) (Con)]

T6. In 2010 the Chancellor specifically set aside funding for the rebuilding of the Royal National Orthopaedic hospital in my constituency. The site has planning permission. Will my hon. Friend update the House on progress so that we see work on the ground before 2015?

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[David Tredinnick (Bosworth) (Con)]

In his travels to the People’s Republic of China, what has my right hon. Friend the Secretary of State learned about the integration of western medicine with traditional Chinese medicine?

[Mr Jeremy Hunt]

What I have learned is that the most important thing is to follow the scientific evidence. Where there is good evidence for the impact of Chinese medicine, we should look at that, but where there is not, we should not spend NHS money on it.

[Mr Dave Watts (St Helens North) (Lab)]

T7. How is the Government’s pledge to get hospitals operating on a seven-day basis going? Many GP commissioners are refusing to provide the funding for hospitals to provide that service.

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[Andy McDonald (Middlesbrough) (Lab)]

T8. The Health Secretary talks about Welsh patients flocking to the English NHS, but is he aware that the number of English patients going to Welsh hospitals has increased by more than 10% since 2010? Does that mean that the English NHS is in crisis?

[Mr Jeremy Hunt]

Unfortunately, a third of Welsh patients do not get things such as urgent scans within six weeks, compared with just 1% of patients in England. The Welsh NHS is struggling badly. I urge Labour, if it is to be consistent, to work closely with its colleagues in Cardiff to give a better standard of care to people in Wales, because they deserve a good NHS as well.

[Mr Douglas Carswell (Clacton) (Con)]

There is due to be a consultation on the future of maternity units at Clacton and Harwich hospitals. Last week, however, the management team at the already troubled Colchester trust decided to shut the units anyway. That has caused great anger and concern locally. Will my hon. Friend write to the board to ensure that it does not prejudice the outcome of the consultation and that decisions are made on the basis of fact, not muddled management?

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[Jenny Chapman (Darlington) (Lab)]

Who is responsible for the disgraceful increase in the numbers of people across the country waiting hours in pain and indignity for an ambulance?

[Mr Jeremy Hunt]

We have 1.2 million more people going to A and Es every year. The ambulance service has, on the whole, been doing a good job, but there have been areas where there are problems. We need to change our attitude towards the capabilities of ambulance services, particularly the ability of paramedics to treat people on the spot, and we are driving through that change.

[Mr Stewart Jackson (Peterborough) (Con)]

In the absence of a definitive policy decision on the fortification of basic foodstuffs with folic acid, what steps are Ministers taking to encourage women of child-bearing age to take folic acid to reduce the incidence of neural tube defects such as spina bifida and hydrocephalus?

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

The Francis report highlighted the importance of ward sisters in properly managing wards, so why has the number of band 8 nurses in the north-east fallen by 87 since the general election?

[Mr Jeremy Hunt]

The number of nurses overall is up by 1,600 since the general election. Let me be absolutely clear that I do not believe in a system where the Secretary of State is micro-managing precisely how many nurses there are in every ward in every hospital in the country. Because we have protected funding that Labour wanted to cut, there are more doctors and more nurses than there were when it was in government.

[Mr Philip Hollobone (Kettering) (Con)]

Ten babies a day are born at Kettering general hospital. May I welcome the recent award of £400,000 of NHS modernisation funds to the hospital’s 33-bed maternity unit and urge the Minister to encourage NHS England to prioritise areas of high population growth such as Kettering for future funding?

[Bill Esterson (Sefton Central) (Lab)]

I cannot speak highly enough of the staff at Southport hospital who cared for me when I spent three days there as a patient last month. They told me that GPs now routinely send older patients straight to A and E because their funding has been cut and that community services are no longer in place to support people in their own homes, which is all leading to a crisis at A and E. Is not the sad reality that what is happening at Southport is being repeated up and down the country as a result of the Government’s disastrous reorganisation and cuts to front-line services?

[Mr Jeremy Hunt]

I am very pleased about the excellent treatment that the hon. Gentleman received. The problems that the nurses talked about are exactly why, from today, we are reintroducing named GPs for everyone aged 75 or over to bring back the kind of personal care and personal responsibility for patients that I am afraid was so sadly abolished previously.

[Several hon. Members]

rose—