Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 17th November 2015 Commons Chamber

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

By 2020, all patients admitted to hospital in an emergency will have access to the same level of consultant assessment and diagnostic tests, whichever day of the week they are admitted.

[Michael Tomlinson]

With mortality rates at weekends suggesting that there is an increased risk of dying, does the Secretary of State recognise the importance for Dorset of getting right the proposal for a new emergency hospital in the Poole and Bournemouth area and ensuring that there are specialist consultants 24/7?

[Mr Hunt]

I thank my hon. Friend for raising that issue, which is incredibly important for his constituents and for Dorset as a whole. I know that the Under-Secretary of State for Health, my hon. Friend the Member for Ipswich (Ben Gummer), who has responsibility for hospitals, will be going there very soon. The clinical standard says that anyone admitted to hospital in an emergency should be assessed by a consultant within 14 hours. Across every day of the week and all specialties, that happens in only one in eight of our hospitals. That is why it is so important to get this right.

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

Bootham Park mental health hospital and York’s place of safety shut with four working days’ notice, so York no longer has a seven-day service, nor even a one-day service in our hospital. That would have been totally avoidable if one NHS body had overarching responsibility for patient safety. Will the Secretary of State agree to meet me and to have an independent inquiry so that mental health patients are not put at serious risk again and we can have a full seven-day service before 2020?

[Mr Hunt]

Obviously, I am very concerned to hear what the hon. Lady says. I know that my right hon. Friend the Minister of State has been looking at this issue and is very willing to talk to her about it. Alternative provision has been made, but she is right to make sure that her constituents have access to urgent and emergency care seven days a week.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

Does my right hon. Friend agree that full hospital services does not mean full services in every hospital, and that if we are to achieve our ambition of driving down excess weekend deaths, we will have to look again at concentrating services in regional and sub-regional centres, and, in addition, make sure that we network properly among smaller hospitals, where they exist?

[Mr Hunt]

My hon. Friend speaks very wisely on this issue. Yes, this is not about making sure that every hospital is providing every service seven days a week. It is about making sure that in an urgent or emergency situation, people can access the care they need and that, for example, high dependency patients are reviewed twice a day, even at the weekends, by consultants. That happens across all specialties in one in 20 of our hospitals, which is why it is so important to get this right.

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

What assessment has the Department made of the impact of reduced accident and emergency hours, and what effect will that have on the implementation of a seven-day work plan?

[Mr Hunt]

I am not quite sure I understand what the hon. Lady is referring to. We are not reducing A and E hours; we are investing. We have nearly 2,000 more consultants in our A and E departments than five years ago and we need to support strong A and E departments as much as possible.

[Andrea Jenkyns (Morley and Outwood) (Con)]

Over the weekend we learned of the close links between the leadership of the British Medical Association and the Labour party. It seems that the BMA is more interested in pushing its own political agenda than in securing the best deal for its members. Can my right hon. Friend assure me that he will hold his nerve and deliver the seven-day NHS that will make the NHS safer for our patients?

[Mr Hunt]

I can absolutely give my hon. Friend that assurance. This is essential for the constituents of all hon. Members, whichever side of the House they sit on, and this Government will always stand on the side of patients. The weekend mortality rates are not acceptable. That is why we are doing something about them.

[Daniel Zeichner (Cambridge) (Lab)]

Given the acute pressures on the national health service, we are a long way from the vision that the Secretary of State wants to achieve. I met the Indian Workers Association this morning. Thousands and thousands of care workers of Indian origin are trained nurses and could be in our NHS, but the bar for the language test has been set so high that they are excluded. Will the Secretary of State look again at the test?

[Mr Hunt]

I commend the extraordinary contribution made by NHS front-line workers of Indian origin. I have met the Indian doctors association, the British Association of Physicians of Indian Origin, and have had many discussions on that front. It is very important, however, that people speak good English if they are providing care in the NHS. There are real issues for clinical safety when the standard of English is not high enough. We have a lot of fantastic support from immigrants who do a great job on the NHS frontline, but good English is an absolute pre-requisite.

[Maggie Throup (Erewash) (Con)]

3. What steps the Government are taking to improve diagnostic testing in primary care.

--- Later in debate ---

[Caroline Lucas (Brighton, Pavilion) (Green)]

9. What plans he has to introduce a new contract for junior doctors.

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

Junior doctors are the backbone of the NHS. It is highly regrettable that their union has let them down by refusing to negotiate a new contract that will be fairer for doctors and safer for patients, and deliver the truly seven-day services we all want.

[Oliver Colvile]

I thank my right hon. Friend for that answer, but has he had an opportunity to speak to medical schools about the new contract for junior doctors, especially the Peninsula medical school in my Plymouth, Sutton and Devonport constituency?

[Mr Hunt]

NHS Employers has regular discussions with the Medical Schools Council, which represents the Peninsula medical school. Although the training of doctors is not the specific contractual dispute that is in the headlines, it is something on which we could make significant improvements. We want to use this opportunity to work with medical schools and the royal colleges to see whether we can bring back some of the continuity of training that used to be such an important feature of junior doctors’ training.

[Caroline Lucas]

The person who has let down junior doctors is none other than the Secretary of State. Does he recognise how insulting it is to those doctors to imply that they are not already working seven days? Crucially, will he listen to the professionals—junior doctors and their senior counterparts who support them—and drop his threat to impose the contract so that meaningful talks can take place?

[Mr Hunt]

What exactly would the hon. Lady say to her constituents who are not receiving the standard of care that they need seven days a week, and will she stand side-by-side with them, or with a union that has misrepresented the Government’s position? We have been clear that there are no preconditions to any talks, except that if we fail to make progress on the crucial issue of seven-day reform, we of course reserve the right to implement a manifesto commitment. That must be the way forward, and I urge the British Medical Association to come and negotiate rather than grandstand, so that we get the right answer for everyone.

[Dr Sarah Wollaston (Totnes) (Con)]

I am deeply concerned about the impact on patient care caused by the proposed three days of industrial action, including two days of a full walk-out. Will the Secretary of State say what advance preparations are taking place to ensure patient safety? Will he reassure the House that there are no preconditions that will act as barriers and to which the BMA has to agree before negotiations can take place?

[Mr Hunt]

I absolutely give my hon. Friend that reassurance. There are no preconditions, and this morning I wrote again to the BMA to reiterate that point. Of course, if we fail to make progress we have to implement our manifesto commitments, but we are willing to talk about absolutely everything. I agree strongly with my hon. Friend that it will be difficult to avoid harm to patients during those three days of industrial action. Delaying a cancer clinic might mean that someone gets a later diagnosis than they should get, and a hip operation might be delayed when someone is in a great deal of pain. It will be hard to avoid such things impacting on patients, and I urge the BMA to listen to the royal colleges—and many others—and call off the strike.

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

It is 40 years since the last junior doctor strike—before I even started medical school. Given the ballot tomorrow, does the Secretary of State regret the antagonistic approach that he took before the summer towards senior and junior doctors? Should he instead have worked with them and not threatened to impose a contract so as to reach a stronger emergency seven-day service?

[Mr Hunt]

I do not know what the hon. Lady thinks is antagonistic about holding reasonable discussions with doctors for three years to try to solve the problem of seven-day care. Those discussions ended with the BMA, after two and a half years, walking away from negotiations last October. We made a manifesto commitment to have a seven-day NHS and to do the right thing for patients, and we simply asked the BMA to sit round the table and talk to us about it. I am confident that we can find a solution.

[Dr Whitford]

Claiming in July that senior doctors do not work outside 9 to 5 was perhaps felt to be antagonistic. Contrary to the figures quoted by the hon. Member for Dudley North (Ian Austin) last Monday, A&E figures for NHS England are 5% below those in Scotland. With such disappointing figures before we even get into winter or face a work-to-rule, and in the presence of eye-watering deficits, how does the Secretary of State plan to support hospital trusts through the winter?

[Mr Hunt]

I urge the hon. Lady to correct for the record her wholly untrue statement that I ever said that doctors do not work outside 9 to 5. That is exactly the kind of inflammatory comment that makes the current situation a whole lot worse than it needs to be. I have always recognised the work that doctors do at weekends, but I also recognise that we have three times less medical cover at weekends, which means that mortality rates are higher than they should be. On A&E performance, we are taking extensive measures to ensure that the NHS is prepared for winter. It will be a tough winter, but unnecessary and wholly avoidable industrial action by the BMA will make it worse.

[Sir Simon Burns (Chelmsford) (Con)]

17. Does my right hon. Friend agree that the failed attempt by the BMA to get an injunction against the General Medical Council to stop it issuing guidance on how doctors should behave responsibly towards patients if there were to be a strike undermines the BMA’s claim that it is putting patient safety first? Will he assure the House that the BMA will have no veto on a seven-day NHS? That was a Conservative party manifesto commitment and it is what the vast majority of people in this country want.

[Mr Hunt]

My right hon. Friend championed the cause of patients when he was a Health Minister, and we must continue to do the right thing for patients, which is also the right thing for doctors. It is wholly inexplicable that the BMA should try to gag the GMC and stop it issuing guidance to doctors about their professional responsibilities. Whatever the disagreements over the contract, the most important thing is to keep patients safe.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I am sure that both sides of the House genuinely appreciate the excellent work done by all staff in our NHS, which at a time of unprecedented strain relies more than ever on the goodwill of its employees to keep going. We have to support and value our staff, not criticise them and provoke them when there is disagreement. Calling junior doctors militant is not the way to end a dispute, and we have heard more of the same rhetoric this morning. Industrial action is always a last resort when negotiations have failed. Does the Secretary of State accept any responsibility for that failure?

[Mr Hunt]

I accept total responsibility for doing the right thing to save patients’ lives. I have to say that I think that any holder of this office would be doing wholly the wrong thing if they were to try to brush under the carpet six academic studies that we have had in the last five years that say we have higher mortality rates at weekends than we should expect. This Government are on the side of patients and we will do something about that.

[Philip Davies (Shipley) (Con)]

10. If he will take steps to reduce the number of children born with genetic problems due to marriages between first cousins.

--- Later in debate ---

[Kate Hollern (Blackburn) (Lab)]

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

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

On Friday, I announced an ambitious plan to halve the rates of maternal deaths, neonatal harm and injury and still births by 2030 by learning from best practice in this and other countries. Following the tragic events in Paris, I know the House would also like my reassurance that we regularly review and stress test the NHS’s preparedness for responding rapidly to terrorist attacks. I have written to Madame Marisol Touraine, my French counterpart, to offer our solidarity and support. Vive la France!

[Kate Hollern]

Just after the election, the Health Secretary called childhood obesity a national scandal and made tackling health inequalities one of his key priorities. How will a flat-rate cut in the public health grant across all authorities, regardless of specific health challenges, as well as a further projected cut, under the reformulation, of £3 million in my constituency, help him to achieve his mission?

[Mr Hunt]

I gently say to the hon. Lady that we have to find efficiencies in every part of the NHS, and we are asking the public health world to find the same efficiencies as hospitals, GP surgeries and other parts of the NHS, but that should not be at the expense of services. I completely agree with her about childhood obesity, on which we will announce some important plans shortly.

[Mr Speaker]

Forgive me colleagues, but what we need at Topical Questions is short inquiries, without preamble, if we are to make progress. Let us be led in this exercise by Fiona Bruce.

--- Later in debate ---

[Heidi Alexander (Lewisham East) (Lab)]

On Sunday, independent experts, the King’s Fund, the Nuffield Trust and the Health Foundation, had this to say about the coming winter:

“Expect the inevitable: more people dying on lengthening waiting lists; more older people living unwell, unsupported and in misery; and a crisis in Accident and Emergency.”

Are they all wrong?

[Mr Hunt]

They are right about the pressures on the NHS, which is why we are investing £5.5 billion more into it than Labour promised. Those pressures will be made a lot worse by the forthcoming strike, so will the hon. Lady clear something up once and for all: does she condemn the strike—yes or no?

[Heidi Alexander]

Let us be clear: if junior doctors vote for industrial action, one person will be to blame, and that person is the Health Secretary.

The Health Secretary does not want to admit that NHS funding is not keeping pace with demand and that over the last five years, his Government’s deep cuts to social care have left the NHS bleeding. Will he guarantee that every penny of the money his Department had set aside for implementing the now-postponed cap on care costs will go directly into funding social care?

[Mr Hunt]

That is the difference: the hon. Lady follows the unions; I lead the NHS. When Labour had a big choice whether to support vulnerable patients who desperately need better weekend care, they chose political expediency—and the whole country noticed.

--- Later in debate ---

[Ruth Cadbury (Brentford and Isleworth) (Lab)]

T2. I strongly associate myself and my colleagues with the remarks of the Secretary of State about the atrocities in France this weekend. What assessment has the right hon. Gentleman made of the impact of housing problems on the difficult task of recruiting and retaining clinical staff, particularly nurses in London and London’s NHS?

[Mr Hunt]

I do think it is a serious problem. People find it hard to live near to the hospital at which they work, particularly where housing is very expensive. This is an issue that we are looking at closely.

[Julian Sturdy (York Outer) (Con)]

T8. Can the Secretary of State assure me that the NHS funding review that is currently under way will deliver a fairer formula for my constituents and many others across York and North Yorkshire by putting age and rurality—some of the biggest drivers of health costs—at the heart of this long overdue review?

[Margaret Greenwood (Wirral West) (Lab)]

T4. Can the Health Secretary explain how cutting £200 million from public health budgets is consistent with the emphasis on prevention and public health as set out in the five-year forward view?

[Mr Hunt]

I have already explained that, but I hope the hon. Lady will understand that we also need the Labour party to explain why it is committed to £5.5 billion less for the NHS over this Parliament than this Conservative Government, on the back of a strong economy that her party has never been able to deliver.

[Mrs Flick Drummond (Portsmouth South) (Con)]

T9. Some of our GP surgeries are finding it difficult to attract new GPs. What plans do the Government have to train new GPs and encourage them to work in areas where it is difficult to recruit?

--- Later in debate ---

[Heidi Allen (South Cambridgeshire) (Con)]

For the avoidance of doubt, will the Secretary of State please repeat again that he will enter into completely open-minded, non-preconditional negotiations with the British Medical Association? The public need to see that we are approaching this matter with an open mind.

[Mr Hunt]

I am happy to confirm that we are willing to talk about absolutely anything with the BMA to avoid a dispute that would be very damaging to patients. We do, of course, reserve the right to implement our manifesto commitment to seven-day reforms if we fail to make progress in the negotiations, but at this time, in the interests of patients, the right thing to do is sit round the table and talk rather than refusing to negotiate and going ahead with the strikes.

[Simon Danczuk (Rochdale) (Lab)]

T7. Rochdale infirmary now has fantastic dementia provision which really meets the needs of local people. Will the Secretary of State observe the good practice there, and look into how it could be shared more widely?

[Mr Hunt]

I shall be happy to do that. We have made great progress in tackling dementia, and there are some very good examples all over the country, but we can still do a lot better. We now need to concentrate not just on dementia diagnosis, but on the quality of the care that we give people when they have been given such a diagnosis.

--- Later in debate ---

[Norman Lamb (North Norfolk) (LD)]

Is the Secretary of State doing everything he can to ensure that we secure extra dedicated investment in mental health in the spending review? He will know that introducing the access rights that everyone else already enjoys requires hard cash. I am sure he will agree that we must end the outrageous discrimination against those who suffer from mental ill health.

[Mr Hunt]

I congratulate the right hon. Gentleman on his timing, given that the Prime Minister is now present. I assure him that we are committed to putting extra resources into the NHS, and to ensuring that we increase the proportion of those resources that go into mental health. I also congratulate the right hon. Gentleman on the mental health award that he received last week, which was extremely well deserved.