Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 10th June 2014 Commons Chamber

[Mr Robin Walker (Worcester) (Con)]

1. What recent assessment he has made of the role of the Prime Minister’s challenge fund in improving access to GP services.

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

Mr Speaker, it is a pleasure to see you again so soon.

The Prime Minister’s challenge fund will be rolled out over 1,100 of the 8,300 GP surgeries in the country. It will improve access out of hours, at weekends and electronically, and it will benefit up to 7.5 million people.

[Mr Walker]

I am glad that this Government, unlike the previous one, whose disastrous contract negotiations led to a decline in GP access, is making sure that out-of-hours care is as widely available as possible. Will the Secretary of State assure me that he will do whatever he can to ensure that places, such as Worcester, that have not yet been reached by the challenge fund will also see the benefits of this approach?

[Mr Hunt]

My hon. Friend is right to say that some bad changes were made. What will most benefit his constituents, whether or not they are part of the initial tranche of the Prime Minister’s challenge fund, is the reintroduction of named GPs for the over-75s. For people with complex long-term conditions, continuity of care is extremely important, and every single one of his constituents aged 75 or over will now get a named GP.

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

We are very pleased in Old Trafford to have secured funding for 80 extra care beds for one of the most deprived parts of my community. We also hope to be able to bring health care services, including GP surgeries, on to the same sites, but we are experiencing difficulty in unblocking funding via the NHS area team. Will the Secretary of State meet me to discuss this issue and how we might be able to move forward?

[Mr Hunt]

Yes, I would be more than happy to meet the hon. Lady and see what I can do to help her to improve health care in her area.

[Jessica Lee (Erewash) (Con)]

I thank my right hon. Friend the Secretary of State for his recent visit to Erewash. He has kindly offered to come back another time. We welcome the Prime Minister’s challenge fund being allocated to Erewash. May I reassure my right hon. Friend that our excellent GPs are working very hard to make sure that services and support are appropriately allocated in our community?

[Mr Hunt]

I thank my hon. Friend for her work to promote good health care in her area. I very much enjoyed meeting her local GPs. I was disappointed that it was only for about five minutes. I very much hope to go back and have a proper discussion. They were very enthusiastic about the Prime Minister’s challenge fund, and are making some very innovative changes.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

May I push the Secretary of State on this matter? What my constituents want is to be able to get to see a GP when they really need one; they do not want to turn up in A and E just because they cannot get an appointment for a week. Is not poor management of GP surgeries—poor management from top to bottom—at the heart of this problem?

[Mr Hunt]

Actually, I agree with the hon. Gentleman. I think that we do have a problem. We have some fantastically good GP surgeries and some brilliant GPs, but we have not in the past had structures in place to make sure that we deal quickly with underperforming GP surgeries and, indeed, underperforming GPs. We need to have much more transparency of data so that we can see where the problems are. We have introduced a rigorous new inspection regime, with a new chief inspector of general practice, and I hope that that will go some way to addressing the issues he raises.

[Andy Burnham (Leigh) (Lab)]

People ringing their surgery this morning only to be told that no appointments are available for days will be listening to the Secretary of State’s answers today and thinking that he is living in a different world. People’s real experience is that it is getting harder and harder to get a GP appointment under this Government, but for some it could get much worse. I recently visited a practice in east London that faces closure in October because of this Health Secretary’s changes to GP funding. NHS England says that 97 other practices are in the same position, affecting thousands of patients. Will he today give a guarantee that no practice will have to close?

[Mr Hunt]

Let us address this issue head on. The right hon. Gentleman knows perfectly well that it is totally wrong to have a system in which two neighbouring GP practices can be paid different sums of money for doing the same amount of work. We must have an equitable funding formula for GP practices, which is why we are phasing out the minimum practice income guarantee. That is a sensible decision. We are also taking measures to ensure that we do not affect patient care in the process. Of course we are looking at the individual cases carefully, but I am sure that he would agree that we have to fund GP practices equitably.

[Graeme Morrice (Livingston) (Lab)]

2. If he will commission a review of the safety of polypropylene transvaginal mesh implants.

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[Ms Margaret Ritchie (South Down) (SDLP)]

5. If he will meet the chair of the College of Emergency Medicine to discuss A and E units.

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

I met the chair of the College of Emergency Medicine four times in the last six months and I will meet him again next week.

[Ms Ritchie]

I thank the Secretary of State for his answer. Will he tell the House what progress has been made by Health Education England, along with the College of Emergency Medicine, to recruit trainee doctors from India in an attempt to address the serious staffing shortages in emergency medicines departments? Will he work with Ministers from other devolved regions to address the serious shortage in A and E doctors, which is having an impact on waiting lists in hospitals the length and breadth of the UK?

[Mr Hunt]

The hon. Lady is right that operational pressures on A and E are happening throughout the United Kingdom. We have made good progress in recruiting 50 A and E doctors to help relieve pressure this year in A and E departments, but that is a short-term measure. The long-term issue is to get more doctors going into A and E from training, and we are looking at contract structures and at what we can do with training schedules to make that more attractive. We will certainly work with colleagues in devolved Administrations and tell them what we have learned.

[Chloe Smith (Norwich North) (Con)]

I welcome the fact that waiting times have halved under this Government, but the Norwich walk-in centre should stay in its city centre location to continue to move people away from A and E when they do not need to go there. Will the Secretary of State meet me to discuss urgent and primary care provision in Norwich?

[Mr Hunt]

I would be delighted to meet my hon. Friend, and she is right to say that the long-term solution to pressures in A and E is to find alternatives in out-of-hospital care that are easy for people to find. That means improving GP access and any other alternatives, and I am sure we can find a good solution in Norwich.

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

There is not one person in my constituency who does not want to see the accident and emergency unit stay open. If this is made clear in any consultation, will the Secretary of State commit today to scrapping the callous closure proposals?

[Mr Hunt]

As the hon. Lady knows, local service changes are the responsibility of the local NHS, but when they get referred to me, through local authorities, I will never take a decision that is against the interests of patients, including her constituents. Were such a proposal to come to me, I would indeed listen to any representations that she makes.

[David Tredinnick (Bosworth) (Con)]

Does my right hon. Friend agree that a critical problem that A and E units will face in the future is antibiotic resistance? Is he aware that the Science and Technology Committee, of which I am a member, has been looking at this issue, and it also interests the Health Committee, of which I am also a member? Can he assure me that he is talking to the Prime Minister about how to stimulate new antibiotic research, and will he also remember that nature has its own remedies, such as tea tree oil?

[Mr Hunt]

My hon. Friend is right about the seriousness of the issue of antimicrobial resistance. Some 25,000 people die in Europe every year as a result of the failure of antibiotics—more than die in road traffic accidents. I raised the issue at the World Health Assembly and I have discussed it closely with the Prime Minister.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

The Health Secretary will be aware that the chair of Morecambe Bay trust has stood down today, ahead of what is expected to be another critical report from the Care Quality Commission about services. What guarantees can the Health Secretary give the worried people who are served by the Furness general hospital that its A and E department will be protected and the vital national industries that depend on its services will continue to be able to rely on them?

[Mr Hunt]

First, I thank the hon. Gentleman for the work that he does locally, in particular with people such as James Titcombe, who has campaigned extensively to improve the quality of care at Morecambe Bay. I assure the hon. Gentleman that whatever the problems are at Morecambe Bay, we will be transparent and open, and we will make sure that we deal with them promptly. That is why we have had these independent inquiries. We will look closely at what the report says and make sure that we act quickly.

[Liz Kendall (Leicester West) (Lab)]

The College of Emergency Medicine says that the use of agency doctors has become endemic in the NHS, and that hospitals are increasingly relying on more expensive agency nurses, just as Labour warned when jobs and training places were cut. It is clear that NHS finances are going backwards under this Government. Will the Minister now confirm Monitor’s latest figures, which show that annual spending on agency staff in foundation trusts has soared to £1.4 billion, a staggering 150% higher than trusts planned at the beginning of the year, and will he explain how that makes any financial sense?

[Mr Hunt]

Let us look at why the number of agency nurses has increased. It is because trusts have responded to the Francis report, published just over a year ago, and are seeking to end the shocking under-staffing of wards that was endemic under the last Labour Government. Of course we want people to recruit full-time nurses on proper contracts, and that is happening. That is why we have 3,000 more nurses—not agency nurses, but proper full-time nurses on proper NHS contracts—than when the hon. Lady’s Government were in power, and we will continue to make progress.

[Mr Philip Hollobone (Kettering) (Con)]

6. What recent assessment he has made of the performance of the A and E department at Kettering general hospital.

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

rose—

[Mr Speaker]

Go ahead.

[Mr Hunt]

Thank you, Mr Speaker. I like to wait until you give me the word.

[Mr Speaker]

If the Secretary of State needs encouragement I am happy to give it to him.

[Mr Hunt]

I am most grateful for any encouragement I can get.

The NHS needs to change its culture to be much more open to whistleblowers. That is why we have banned gagging orders in contracts and funded a whistleblowing helpline and website, and why we are working with brave whistleblowers, such as Helene Donnelly from Mid Staffs, to reform the training of NHS clinicians to make it easier.

[Michael Fabricant]

I am grateful for that answer. About 10 years ago, two people, a nurse and a consultant surgeon from the same hospital, came to my surgery and showed me evidence of filth—mouse droppings—in even consulting rooms and the operating theatre. They were frightened to leave the documentation with me, because they thought they would be sacked if it was found that they were the whistleblowers. Will they now have the assurance that they could give me or others evidence without fear of retribution?

[Mr Hunt]

I hope so, but I want to be honest with the House. It takes time to change a culture, and that is the big change we have to make. Whistleblowers are now coming forward from Coventry, Cambridge, Ealing and all over the country. That is why I am afraid that I profoundly disagree with the shadow Health Secretary, who said that the lessons of the Francis report were about a local failure. This is about a systemic problem and we have to change it across the NHS.

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

Given there are so many emerging cases of whistleblowers—both current and historic—being treated with injustice, a precedent will not be set for accountability until these injustices are actually faced. Will the Secretary of State set up a truth and reconciliation committee to look at historic and current cases so that accountability becomes a reality?

[Mr Hunt]

First, I commend my hon. Friend for her campaigning on this issue in the House and on the Health Committee. We have not done everything we need to do to change the culture within the NHS, and we are looking at what more needs to be done to get a culture change profound enough to make it easier for people to speak out. This is not just about whistleblowing. If it is whistleblowing, we have failed because it means that someone has had to go to the press or outside their organisation when they were worried. We need an NHS where people within their own organisation are listened to when they have concerns, and we are looking at what we need to do to take that forward.

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

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

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

Almost a year ago, following the Keogh report, we put 11 NHS trusts into special measures, the first time such a large number of trusts have been put into special measures. Yesterday I was pleased to report to the House that the first trust, Basildon, has come out of special measures. I am pleased to tell the House today that across all the trusts in special measures, an additional 1,202 nurses and an additional 118 doctors have been recruited. The programme is making good progress, and the whole House will want to commend the efforts of all the staff in those hospitals on the tremendous efforts they are making.

[Mr Baron]

I join the Secretary of State in commending the management and all the staff of Basildon hospital for their excellent work and a great team effort. The hospital is now no doubt on an upward trajectory. I should like to raise with him the matter of the human papilloma virus vaccination programme for young women. It has been a success, and there is mounting evidence that is should be extended to young men. Will the Government now look into the feasibility of doing that?

[Mr Hunt]

My hon. Friend is right, and I am grateful to him for mentioning how proud we are of the HPV vaccination programme for girls and women. It is one of the best in the world, and we are getting an 86% take-up rate among eligible 12 to 13-year-old girls. He is also right to say that we now need to look at whether the programme should be extended to men and boys. A decision was taken at the time that it did not need to be, but we are now reviewing that decision. We will shortly be getting advice from the Joint Committee on Vaccination and Immunisation—which, as he will know, gives us independent advice on these matters—and we will take its advice seriously.

[Andy Burnham (Leigh) (Lab)]

I am sure that, like me, the Secretary of State will have been shocked to the core by the serious case review into the Orchid View care home. It spoke of institutionalised abuse and of residents dying of sheer neglect. This is just the latest case of appalling abuse in care homes, following that of Winterbourne View and the recent “Panorama” programme on Oban House. People are asking how many more times we must see abuse of this kind in our care homes before we take decisive action to stop it. Will the Secretary of State give serious consideration to the central finding of yesterday’s review, which was that the same principles of patient safety that apply in the NHS should now be applied to the care home sector?

[Mr Hunt]

I thank the right hon. Gentleman for that question. He is absolutely right to suggest that the lessons of Francis need to be applied to the care home sector, to general practice and to all out-of-hospital care every bit as much as they are applied to NHS hospitals. That is why we have legislated in the Care Act 2014 not only for a chief inspector of general practice but for a chief inspector of adult social care, Andrea Sutcliffe, who has made an excellent start. She is going around all the care homes, and she is bringing back the rigorous Ofsted-style analysis that was unfortunately taken away by the last Government. That will mean that we have proper transparency in standards. Going back to an earlier question from my hon. Friend the Member for Lichfield (Michael Fabricant), we also need to do more to help whistleblowers working in care homes. Because there are so many care homes, we cannot depend solely on the inspectors to get this right. We have also introduced the ability to prosecute offenders, which did not exist before.

[Mr Nigel Evans (Ribble Valley) (Con)]

T3. The fears of the people of the Ribble valley that the old Clitheroe hospital would be closed and not replaced were allayed when the new hospital was built. It recently opened with 32 in-patient beds, radiology, diagnostics and other facilities. Will the Secretary of State come to Clitheroe to have a look at this brand-spanking-new hospital, which is being welcomed by the local community, and to say thank you to the staff there for all they do? If he does so, I promise to take him for a pint of healthy real ale afterwards in the Campaign for Real Ale pub of the year in Pendleton in the Ribble valley, to celebrate the opening of the new hospital.

[Mr Speaker]

What a generous fellow the hon. Gentleman is!

[Mr Hunt]

Well, I must say that that sounds like a pretty irresistible offer, and I will give it careful consideration. Local community hospitals have an important role to play in our NHS because of the high standard of compassionate care that they deliver, and because they are easy for relatives to get to. I am delighted to see my hon. Friend campaigning for his local hospital, and delighted that it is doing so well.

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

T2. A Birmingham trust has recently announced that it will be possible to cut 1,000 beds across the city by setting a maximum stay of seven days for most patients. Not surprisingly, this has caused some alarm. Are Ministers aware of that proposal? What guidance, if any, can they offer in regard to such proposals?

[Jesse Norman (Hereford and South Herefordshire) (Con)]

T5. Like other rural communities, Herefordshire has long suffered from chronic underfunding in health care. Does the Secretary of State share my view that setting clinical commissioning group allocations should be an evidence-based process that takes into account factors including sparsity and old age? Also, will he ignore the calls from the shadow Health Secretary, who was seeking to cut the previous NHS allocations in areas such as Herefordshire?

[Mr Jeremy Hunt]

I agree with my hon. Friend that it has to be done on the basis of evidence. Part of that is an important change that the Government have made, which the Labour party criticised a great deal. We have depoliticised the process by giving it to NHS England, where it is decided at arm’s length from Ministers on the basis of need. It is challenging to do it fairly. There are some historical imbalances, and we have to do what we can to address them, but we have to do it in a way that is fair and is not tarnished by party politics.

[Alex Cunningham (Stockton North) (Lab)]

T4. Health inequality on Teesside is a major issue, but the Government axed plans for our new hospital four years ago. I am told that Ministers now accept that a new hospital to replace the two hospitals at North Tees and Hartlepool is the right way forward. When will they remove the barriers to the project and give the support that is needed?

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[Mr Andy Slaughter (Hammersmith) (Lab)]

T10. Last October the Secretary of State said that Hammersmith accident and emergency would be closed when it was safe to do so. Imperial proposes to close it on 10 September, when on its own admission there is insufficient capacity at St Mary’s and it is not safe to do so. Will he keep his promise and ensure that Hammersmith A and E does not close, especially when there is not sufficient capacity in the system?

[Mr Jeremy Hunt]

I keep my promises, but may I point out to the hon. Gentleman that the way in which he has campaigned on those issues has been totally irresponsible? He put out leaflets in the local election campaign saying that Charing Cross hospital would be demolished. He failed to mention that it was going to be rebuilt as a brand-new hospital with an A and E department. I hope that he will not be invited to it when it is reopened unless he apologises to his constituents for the way he has presented this issue.

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[David Rutley (Macclesfield) (Con)]

T8. Following the recent speech by the new NHS England chief executive Simon Stevens about the important role of local hospitals, can my right hon. Friend confirm that district general hospitals such as Macclesfield will continue to play a vital role in delivering local health services in the years to come?

[Mr Jeremy Hunt]

I can confirm that. What my hon. Friend said was profoundly important. There is not an automatic link between size and quality. We know that for certain types of treatment, there is huge benefit in centralising services, as has happened for stroke services in London, but other services can be delivered extremely well at smaller units, and we will continue to support those.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

The Minister has just talked rather piously about spending NHS money on front-line services, but the NHS is spending £300,000 on a university secondment for a staff member who has left. How does he justify that sort of abuse?

[Mr Hunt]

I just point out to the hon. Lady that in the Queen’s Speech we made it clear that we are cracking down on inappropriate payments to people who leave the NHS, many of which are the result of contracts set up by her Government.

[Ian Swales (Redcar) (LD)]

T9. My constituent, Beth Charlton, recently lost her father to pancreatic cancer and notes that patients have only a 3% chance of surviving five years. That is much lower than the survival rates for other cancers and has not improved in 40 years. Will the Minister invest more in early detection and diagnosis of this silent killer?

[Mr Dennis Skinner (Bolsover) (Lab)]

In the last hour I have heard the Secretary of State and his Ministers complain about the problems with A and Es; I have heard them talk about the problems with GPs; now we hear that they have lost control of care of the elderly. Instead of continuing to blame the last Labour Government of four years ago, why does the right hon. Gentleman not admit that the NHS is not safe in his hands? Let us have an election and get a Labour Government.

[Mr Jeremy Hunt]

Because we are making the NHS safe. We are taking action to deal with the issues that the hon. Gentleman’s Government swept under the carpet. The NHS is getting safer and more compassionate. It is delivering more care to more people than ever happened under the Labour Government. We are proud of our record on the NHS, and we will not make the NHS better by pretending that problems do not exist when they do.

[Sir Andrew Stunell (Hazel Grove) (LD)]

Stockport Mind reports that it takes on average 12 months to receive the first appointment for cognitive behavioural therapy after diagnosis. What action can be taken to improve that standard in Greater Manchester?

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

As he heralds an era of transparency, can the Secretary of State update us on what steps he has taken to ensure that private providers in the NHS are every bit as transparent and accountable as public ones?

[Mr Jeremy Hunt]

I think they absolutely should be, and the changes that we introduced in the Care Act 2014 relating to the transparency of the inspection regimes apply to private providers supplying services to the NHS just as they do to NHS providers. Let us be absolutely clear: poor care is poor, whether it happens in the public sector or the private sector, and we must clamp down on it wherever it happens.

[Bill Esterson (Sefton Central) (Lab)]

The Minister said that he was dealing with the chronic shortage of staff who help vulnerable children and young people, who cannot get access to mental health services. Will he tell us when there will be enough staff delivering those services to that important group?