Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 7th July 2015 Commons Chamber

[Bridget Phillipson (Houghton and Sunderland South) (Lab)]

2. What recent estimate he has made of the proportion of patients who waited for at least one week for a GP appointment in the past 12 months.

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

While we do not record the proportion of patients waiting a week for their GP appointment, the latest GP patient survey results show that 85% of patients reported that they were able to get an appointment to see or speak to someone, and only a very small percentage ended up not speaking to or seeing someone.

[Bridget Phillipson]

Unfortunately, many of my constituents would not recognise the picture that the Secretary of State seeks to paint. The British Medical Association recently said that waits of one to two weeks were becoming the norm for patients. Why is it becoming harder, on his watch, to get a GP appointment?

[Mr Hunt]

If I may gently say so, the under-investment in general practice has been going on for decades, according to the BMA and the Royal College of GPs. We have announced that we are putting that right with our plans to recruit 5,000 more GPs during this Parliament. That is the biggest increase in the number of GPs in the history of the NHS, with £1 billion going to upgrade GP and primary care premises, and 18 million people by the end of this financial year benefiting from evening and weekend appointments. That is a big, positive change, and I hope the hon. Lady would welcome it.

[David Tredinnick (Bosworth) (Con)]

Has my right hon. Friend had a chance to read the report by the Professional Standards Authority for Health and Social Care, which says that pressure would be taken off doctors and nurses if greater use were made of the 63,000 practitioners that it regulates on 17 separate registers covering 25 occupations? Will he look at the report and write to me?

[Mr Hunt]

I am very happy to do that. My hon. Friend is right to point out that the solution to the problem is not just about expanding the number of appointments offered by GPs, although we are doing that; it is also about looking at the very important role that pharmacists and other allied health professionals have to play in out-of-hospital care.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

The Secretary of State mentions recruiting 5,000 extra GPs, but I note in a recent speech that that was downgraded from a guarantee to a maximum. With 10% of trainee posts unfilled and the BMA’s recent survey suggesting that a third of GPs will leave in the next five years, is that not going to be difficult? Has the Secretary of State had any consultation with the BMA and the royal college to ask why they are leaving?

[Mr Hunt]

It will be difficult. The commitment has never been downgraded: we always said that we needed about 10,000 more primary care staff, about half of whom we expected to be GPs. We have had extensive discussions about the issues surrounding general practice, such as burn-out, the contractual conditions and bureaucracy. We are looking at all of those things. The commitment is to increase the number of GPs by about 5,000 during the course of the Parliament, and that is a very important part of our plan to renew NHS care arrangements.

[Dr Whitford]

I assume the Secretary of State is aware that two of the pilot sites for the seven-day, 8 till 8 working—one in north Yorkshire and the other in County Durham—have abandoned the project owing to poor uptake by patients, with only 50% of appointments used on a Saturday and only 12% on a Sunday. Given that they found that it had a detrimental effect on recruiting cover for out-of-hours GP urgent services, does not he feel that this needs a rethink and that consultation with the profession and looking at cover would be of most benefit?

[Mr Hunt]

The hon. Lady is presenting only a partial picture. In Slough there are about 900 more appointments every week as a result of the initiative for evening and weekend appointments. Birmingham has dramatically reduced the number of no-shows and Watford has reduced A&E attendance measurably. Some really exciting things have happened, but of course we will continue to consult the profession to make sure that the programme works.

[Johnny Mercer (Plymouth, Moor View) (Con)]

Radical and innovative steps were taken in Plymouth this April to integrate not only front-line health and social care services in the city, but all the council and clinical commissioning group resources into a single fund. Will my right hon. Friend describe how the success regime in the Plymouth and Devon area will build on those achievements?

[Mr Hunt]

Absolutely; I had the pleasure and privilege of visiting Plymouth during the election campaign to see some of the radical changes being offered in community care. There is huge enthusiasm for transforming the situation in Devon. It is a very challenged economy, but by bringing together the health and social care system and by putting more resources into primary and out-of-hospital care we will be able to give a better service to my hon. Friend’s constituents, which I know he will welcome.

[Andy Burnham (Leigh) (Lab)]

Ten years ago, this great city lived through one of the darkest days in its history. Our thoughts today are with all those who were affected and we pay tribute to the heroic staff of London’s NHS, who did so much to help them.

The latest GP patient survey is important for the simple reason that it covers the first full year of the Government’s GP access challenge fund. The results do not make good reading for the Secretary of State. The percentage of patients dissatisfied with their surgery’s opening hours has increased and patients found it harder to get appointments last year than the year before. Will the Secretary of State admit that his policies are simply not working and that GP services are getting worse on his watch?

[Mr Hunt]

First, I echo the right hon. Gentleman’s comments about the extraordinary bravery of the emergency services, particularly the London Ambulance Service, in response to the terrible tragedy of 7/7.

I do not accept the picture the right hon. Gentleman paints of general practice. The Prime Minister’s challenge fund has been extremely successful: by the end of this year, 18 million people will be benefiting from the opportunity to have evening, weekend and Skype appointments with their GP. We have also announced the biggest increase in the number of GPs in the history of the NHS. The Labour party left us with a GP contract that ripped the heart out of general practice by removing responsibility for evening and weekend care and by getting rid of personal responsibility by GPs for their patients. The right hon. Gentleman should show a little contrition and modesty about Labour’s mistakes.

[Andy Burnham]

People who have been ringing surgeries this morning unable to get appointments will not be convinced by what they have just heard. The truth is that the disarray in the Secretary of State’s primary care policy goes much deeper. Not only has he made it harder for people to get a convenient appointment, but he now wants to charge people who miss the appointments they are able to get. We all want to reduce waste, but there are many reasons why people do not turn up, including family emergencies. That is presumably why No. 10 slapped him down. He will have worried people, so for the avoidance of doubt, will he today confirm that he will not return to that idea in this Parliament?

[Mr Hunt]

There are no plans to charge people who have missed appointments. That is precisely the sort of scaremongering that the British public rejected at the last election. The right hon. Gentleman put the NHS on the ballot paper, and the country voted Conservative; he might want to think about the lessons from that. Missed appointments cost the NHS £1 billion a year. We want that money to be spent on doctors and nurses. Labour spent billions on wasted IT contracts and the private finance initiative, and did not spend enough on front-line staff. We are putting that right.

[Harry Harpham (Sheffield, Brightside and Hillsborough) (Lab)]

3. What steps he is taking to ensure that clinical commissioning groups routinely fund cough-assist machines for people with muscle-wasting conditions when a clinical need has been identified.

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[Heather Wheeler (South Derbyshire) (Con)]

10. What progress the Government have made on improving safety in hospitals in special measures.

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

The 21 hospitals that have been put into special measures under the new inspection regime have recruited 458 more doctors and 1,012 more nurses, and all of them have made good progress, including the Medway and Burton hospitals.

[Rehman Chishti]

I thank the Secretary of State for the support that he has given Medway Maritime hospital. Will he welcome the appointment of a chief quality officer at Medway hospital? It is one of only two trusts to have done that, and it is helping to improve safety and bring Medway out of special measures. Will he join me in paying tribute to the brilliant staff at Medway hospital, who are working day and night to turn things around?

[Mr Hunt]

I do pay tribute to them, and I welcome Dr Trisha Bain to that post. Ten years ago, that hospital had one of the worst mortality rates in the country. Since then, it has recruited nearly 100 more doctors and 83 more nurses, and has teamed up with Guy’s and St Thomas’. There is a culture of transparency and honesty about failings and a rigorous focus on improvement that were not there before. I hope that the whole House will welcome that change in culture.

[Heather Wheeler]

My local hospital, Queen’s hospital in Burton, has worked closely with Monitor to improve while it has been in special measures. Does the Secretary of State agree that, although spending four nights in ward 7 was not the best way for me to start the general election campaign, all the staff should be congratulated on the way they have approached the need to improve?

[Mr Hunt]

I am sorry that my hon. Friend had to go to hospital at the start of the election campaign, but I congratulate her on being probably the only Member of the House to have launched their campaign from an NHS hospital ward. I trust that all the nurses voted for her as a result.

Inexplicably, the trust that my hon. Friend talked about was made a foundation trust in 2008, despite a number of problems that were not recognised. Since then, it has made dramatic improvements in its care, with more doctors and more nurses. I am delighted that it is on track to deliver better care.

[Valerie Vaz (Walsall South) (Lab)]

How many of the hospitals in special measures have implemented recommendation 13 of the final Francis report on fundamental standards?

[Mr Hunt]

I would expect that all trusts have done so. If they have not, they will not come out of special measures. That is the benefit of a rigorous, independent inspection regime. Seven trusts have come out of special measures. I hope that the others will come out in due course, but that is not a decision for me; rightly, it is a decision for the chief inspector of hospitals.

[Sue Hayman (Workington) (Lab)]

The NHS in my constituency has moved beyond special measures into the success regime. Will the Secretary of State consider innovative models of care, because my constituency is very different from others and the trust will not achieve success without looking at how it can deliver safety in different ways?

[Mr Hunt]

The hon. Lady is absolutely right. The big change that we need in the NHS is to move away from the dependence on hospital care as the only way to deliver safe, effective care. That is why we put £200 million into the vanguard programme last year, which is looking at such models. I hope that the success regime will hasten the innovation in her area.

[Amanda Milling (Cannock Chase) (Con)]

20. Now that the Mid Staffs trust board has been dissolved, will my right hon. Friend advise me on which is the appropriate body to deal with historic complaints against the previous trust, not only to provide answers for patients and family members, but to ensure that lessons are learned to improve patient safety?

[Mr Hunt]

In the first instance, patients who are concerned about safety should contact the trust concerned, even though it is a different trust legally from the one that was there before. The CQC is there to ensure that any lessons about the safety of care are disseminated throughout the NHS. That is an important part of the transparency culture that we are introducing.

[Matthew Pennycook (Greenwich and Woolwich) (Lab)]

6. What progress the Government have made on achieving parity of esteem for physical and mental health services.

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[Margaret Greenwood (Wirral West) (Lab)]

8. Whether he expects that the efficiency savings identified in NHS England’s most recent “Five Year Forward View” will entail a reduction in staff numbers.

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

The “Five Year Forward View” is about meeting increasing demand through new models of care, not cutting staff numbers. In fact, we are planning an additional 10,000 staff in primary and community settings, including around 5,000 doctors.

[Margaret Greenwood]

The Secretary of State will be aware that Sir Robert Francis specifically recommended that the National Institute for Health and Care Excellence provide guidance on safe staffing levels because it is independent and can establish guidance based on the needs of patients. The Government’s decision to suspend that work and transfer responsibility to NHS England has been met with criticism from patients’ groups right across the NHS. Will the Secretary of State please explain why he thinks NHS England is better placed than NICE to carry out that vital work?

[Mr Hunt]

The important thing is that that work happens. NICE did a very good job in delivering safe staffing guidance for acute wards. It is important to recognise that that guidance was interpreted as being about simply getting numbers into wards, but the amount of time that doctors and nurses have with patients is as important. The work will continue and we are proud of the fact that we are dealing with the issue of badly staffed wards. We will continue to make progress.

[Dr Sarah Wollaston (Totnes) (Con)]

In trying to reduce waste as part of the drive for efficiency savings identified in the “Five Year Forward View”, the Secretary of State spoke recently about the possibility of putting a price label on high-value items in prescriptions alongside a label saying that they are paid for by the taxpayer. Will he reassure the House that such a measure would be carefully piloted and evaluated first, so that we can avoid any unintended consequences for those who might consider discontinuing very important medication?

[Mr Hunt]

We will look at all the evidence. The evidence we have seen from other countries is very encouraging. Apart from ensuring that NHS patients and the public understand the cost of NHS care, one of the main reasons why we want to do that is to improve adherence to drug regimes by making people understand just how expensive the drugs are that they have been prescribed. We will of course look at all the international evidence.

[Mr Nicholas Brown (Newcastle upon Tyne East) (Lab)]

16. NHS England consulted in the last Parliament not just once but twice on downgrading the economic deprivation part of the funding formula, which would have had the effect of taking some £230 million per year out of the primary care budget for the north-east and Cumbria. Will the Secretary of State give the House a commitment—we got one from the Minister in the last Parliament—that he will not downgrade the economic deprivation part of the funding formula?

[Mr Hunt]

I give an absolute commitment that economic deprivation will be a very important part of the funding formula, but the right hon. Gentleman will appreciate that things such as the number of older people in a particular area is as important in determining levels of funding. We are committed to reducing health inequalities, but that also means making sure that similar levels of care are available in similar parts of the country. That has not always been the case.

[David T. C. Davies (Monmouth) (Con)]

Does my right hon. Friend agree that the efficiency savings our Government are introducing have led to the lower waiting lists and the better access to cancer drugs for patients in England that are the envy of my patients in Wales? What can I tell them about how we can get greater access and better standards in Wales while the NHS in Wales is run by Labour?

[Mr Hunt]

My hon. Friend can tell them that when Labour Members opposed the Health and Social Care Act 2012, we were doing the right thing for patients, with 18,000 fewer managers, 9,000 more doctors and 8,500 more nurses, whereas the Labour party was posturing. We can see the results of that posturing in Wales, where more people wait for A&E, more people wait for their cancer operation, and 10 times more people are waiting for any kind of operation.

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

The Secretary of State talks about having similar levels of care, but we do not have similar levels of safe staffing around the country. Peter Carter has said about the decision on NICE:

“If staffing levels are not based on evidence there is a danger they will be based on cost.”

Is my hon. Friend the Member for Wirral West (Margaret Greenwood) not right? NHS England should reverse that decision and let the independent body be the judge of safe staffing levels.

[Mr Hunt]

I gently say to the hon. Lady that we will not take any lessons in safe staffing from the party that left us with the tragedy of Mid Staffs. We have recruited 8,000 more nurses into our hospitals because we have learned the lessons of the Francis report. The important lesson in the report is that it is not simply about the number of nurses; it is about the culture in hospitals and making sure that nurses are supported to give the best care. We want to learn those lessons as well.

[Mr Peter Bone (Wellingborough) (Con)]

In reference to the “Five Year Forward View”, the Secretary of State talked about new modes of working. A very simple thing that could be done is for women’s smear test results to refer to the fact that it is not a test for ovarian cancer, and to then list the symptoms of that cancer. That would not cost any money, but it would save lives.

[Mr Hunt]

I am very happy to look into that. The general direction of travel my hon. Friend is talking about is right. We need to empower patients. We need patients to become expert patients, so that they take responsibility for their own healthcare. That means giving them much more information to help them to make the right decisions.

[Liz Kendall (Leicester West) (Lab)]

The Secretary of State is trying to avoid the question asked by my hon. Friend the Member for Wirral West (Margaret Greenwood). It was a key recommendation of the Francis review into Mid Staffs that safe staffing guidelines should be drawn up independently from Government and NHS managers to make sure people are confident that they are based on what is best for patients, not budgets. Why has he gone against Francis? What was wrong with what NICE was doing? He has published no new criteria for NHS England and no process or timetable for action. Will he now commit to doing that, so that patients, staff and Members of this House can be confident that this is not just a cover for cuts?

[Mr Hunt]

We will not take any lessons from the Labour party about what needs to be learned from Mid Staffs. Labour Members should be ashamed of the state of hospital care they left behind. There are 8,000 more nurses in our hospitals as a result of the changes that this Government have made. They should welcome that, not criticise it.

[Helen Jones (Warrington North) (Lab)]

9. What recent discussions he has had with NHS England on the future of district general hospitals; and if he will make a statement.

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[Rachael Maskell (York Central) (Lab/Co-op)]

12. What changes in funding he plans to make to address the NHS funding shortfall forecast in NHS England’s most recent “Five Year Forward View”.

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

We have committed to providing additional funding to the NHS of at least £8 billion by 2020-21, over and above inflation. This is in line with the funding identified in the NHS England “Five Year Forward View” and in addition to the £2 billion extra for NHS front-line services this year.

[Rachael Maskell]

With trust deficits reaching £822 million at the end of the last financial year, commissioners, chief executives and NHS professionals are saying that it is impossible to achieve £22 billion of efficiency savings without cutting services, staff numbers or staff pay or even stripping out the market. Which will the Secretary of State choose?

[Mr Hunt]

Of course, it will be very challenging to find those savings, but I gently remind the hon. Lady that Labour’s manifesto at the last election promised £5 billion a year less for the NHS than we promised, and that was because of our confidence in a strong economy, which is what the NHS needs.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

The five-year forward plan will need to deal with the outstanding issue of the contaminated blood scandal, as a result of which one of my constituents suffered devastating consequences, including having to take the terrible decision to terminate their unborn child. When might we expect a statement and final resolution on this matter?

[Mr Hunt]

I thank my hon. Friend for raising this issue. It was a terrible tragedy—I had constituents who died—and I can confirm that we will be meeting the commitments made by the Prime Minister to bring forward a solution very shortly.

[Mr Jamie Reed (Copeland) (Lab)]

The House will have seen that the pitch is being carefully rolled by the Secretary of State today for future service closures around the country. Last week, a former care Minister was reported as saying that the £22 billion of efficiency savings the Government had signed up to were “virtually impossible” to achieve and that everyone knew it. Given that he is one of the few people to have seen the detail of the efficiency savings, this does not fill anybody with confidence. Will the Secretary of State now commit to publishing the details of the efficiency savings so that Members, the public at large, patient groups and medical professionals can have a proper and open debate about what it means?

[Mr Hunt]

We will of course publish how we are going to make these efficiency savings. We have already started with a crackdown on agency spend and a crackdown on consultancy spend, and with the work that Lord Carter, a Labour peer, has done to improve hospital procurement and rostering.

Let me gently say to the hon. Gentleman, however, that he went into the election promising £2.5 billion more for the NHS—£5.5 billion less than we did—and most of that was from the mansion tax that Labour now says was a bad idea. So there would have been nearly £8 billion more of efficiency savings under Labour’s plans than under this Government’s plans, and he should recognise the progress we are making.

[Bill Esterson (Sefton Central) (Lab)]

13. What recent assessment he has made of the implications for his policies of guidance from the chief medical officer on the consumption of alcohol by pregnant women.

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[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

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

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

The Government’s priority for the NHS this Parliament is to put Mid Staffs behind us by transforming the NHS into the safest healthcare system in the world, and in particular, through seven-day hospital care so that we end the tragedy of up to 6,000 lives lost because people do not have access to consultants or diagnostics at weekends. It means recognition that safer care costs less, not more, which is why we are cracking down on expensive agency staff who cannot give the continuity of care that is best for patients.

[Vicky Foxcroft]

Almost two years ago, Lewisham took the Secretary of State to court over the closure of Lewisham A&E and maternity services—and won. In the light of the new report, “Our Healthier South East London”, can the Secretary of State promise me that any further shake-up of the NHS in south-east London will not involve the closure of services at Lewisham Hospital?

[Mr Hunt]

What I can assure the hon. Lady is that we inherited deep-seated problems in the old South London Healthcare Trust and we have dealt with them. We have more doctors and nurses looking after her constituents, and care is getting better as a result of the difficult decisions we have taken.

[Maria Caulfield (Lewes) (Con)]

T2. Part of my constituency is served by Eastbourne District General Hospital, which is run by East Sussex Healthcare NHS Trust. The trust was recently deemed “inadequate” by the Care Quality Commission. Residents are obviously concerned, and both East Sussex County Council and Polegate Town Council have gone on record as saying that they have lost confidence in the hospital’s management. Will the Minister look into the matter urgently, in order to reassure my constituents?

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

We have heard a number of fair questions from Opposition Members, and, I am afraid, nothing but woeful and inadequate answers from Ministers so far. Let me try again by asking the Secretary of State about GPs. As we have already heard, before the election he promised that there would be an additional 5,000 GPs by 2020. However, now that the election is over, he says that that promise requires “some flexibility”, and he was similarly evasive in an earlier answer. Given that there is, in the words of the Government’s own taskforce, a “GP work force crisis”, will the Secretary of State now clear things up? By 2020, will there be 5,000 extra GPs—on today’s figures—as he promised, or is this yet another example of the Conservatives not being straight with people on the NHS?

[Mr Jeremy Hunt]

I think that those were woeful and inadequate questions. What I said after the election was exactly the same as what I said before the election, which was that a number—[Interruption.] Yes, we will have about 5,000 more GPs by the end of the Parliament, which is just what I said before the election. I said that a total of 10,000 more people would be working in primary care. I also said before the election that the woeful problems in general practice would be dealt with only if we unpicked the terrible mistakes made by Labour in the GP contract. That is why this year we are bringing back named GPs for every single NHS patient.

[Mr Christopher Chope (Christchurch) (Con)]

T4. Does the Secretary of State accept the verdict of the Competition Commission, which decided recently that it would be against the interests of patients for Royal Bournemouth General Hospital and Poole Hospital to merge? The clinical commissioning group has responded by saying that one of the hospitals will have to give up all its services.

[Mr Hunt]

I think that we must respect the independent view of the Competition and Markets Authority, but I also think that there are lessons to be learned by the NHS more generally from the way in which that process was conducted. There will have to be changes on the ground if we are to give patients the care that they need in the very constrained financial circumstances in which we operate.

[Paul Blomfield (Sheffield Central) (Lab)]

T3. In March this year I had a very useful meeting involving Devonshire Green & Hanover Medical Centres in my constituency and the then Under-Secretary of State, the hon. Member for Central Suffolk and North Ipswich (Dr Poulter), who recognised the threat posed to practices that serve patients with complex, demanding, and therefore costly needs by the withdrawal of the minimum practice income guarantee. The hon. Gentleman promised to follow up that meeting, but since then we have heard nothing. Will the Secretary of State guarantee that no practice will close as a result of the withdrawal of MPIG, and what will he do to ensure that that is the case?

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[Richard Burgon (Leeds East) (Lab)]

T8. Millions of people are worried about the privatisation of our national health service, so it is a real concern that the health sector remains part of the negotiations on the Transatlantic Trade and Investment Partnership. Tomorrow the European Parliament votes on TTIP, but the European Commission has already said it will not remove health from those negotiations, so can the Government confirm that they will defend the NHS and support the removal of health and other public services from future TTIP negotiations?

[Mr Jeremy Hunt]

Really, the Labour party has got to stop this scaremongering that it did so much of, and to so little effect, at the election. Privatisation is not happening, but I will tell the hon. Gentleman what is happening: at his hospital, 85 more doctors in the last five years, 185 more nurses, 7,700 more operations, 20,000 more people being seen within four hours at A&E—progress in the NHS with a strong economy.

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[Helen Whately (Faversham and Mid Kent) (Con)]

In the last Parliament we made great strides using transparency to drive improvement in the quality of patient care. Does my right hon. Friend agree that we can and should go further, particularly on the transparency of performance in primary and community care?

[Mr Jeremy Hunt]

My hon. Friend is absolutely right and has great experience in this area. We are now having a lot of transparency at an institutional level, but individual doctors and nurses in primary and secondary care are still finding it too hard to speak out if they have concerns. Getting that culture right has to be a big priority for this Parliament.

[Mr Speaker]

Emulating Strangford brevity, perhaps, I call Mr Greg Mulholland.

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[Mr Peter Bone (Wellingborough) (Con)]

Does the Secretary of State agree that hospital parking charges are unfair?

[Mr Hunt]

They cause a lot of grief to many people, which is why we have issued new guidance that tells people to take particular trouble for people who have to visit hospitals on a regular basis.

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

Will the Secretary of State outline when compensation will be made available to those who were infected by contaminated blood products in the 1970s and 1980s?

[Mr Hunt]

The hon. Lady is right to draw attention to this tragedy, and we will be bringing our plans forward to the House shortly.

[Jason McCartney (Colne Valley) (Con)]

When will the Secretary of State be making a full statement in response to the Penrose inquiry into those affected by contaminated blood?

[Mr Hunt]

As I have just said, we will bring our plans to the House very shortly.

[Mr Speaker]

Last but not least, Mr Barry Sheerman.