Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 19th November 2024 Commons Chamber

[Wes Streeting]

I, too, pay tribute to Norman and to family carers like him, who play such a vital role supporting loved ones. Through the carer’s allowance uplift in the Budget, the Chancellor announced the largest increase to the weekly earnings limit since the introduction of carer’s allowance in 1976. As well as that investment, we will have a 10-year plan for social care, and I see the care workforce, care providers and family carers as all being important partners in building that plan.

[Jeremy Hunt (Godalming and Ash) (Con)]

I welcome the Secretary of State’s plans to reform the NHS, but may I caution against the idea that the answer is to fire more incompetent managers? The problem is not bad management: it is micromanagement from the centre that sees hospitals managed with more than 100 targets by NHS England, making ours one of the most micromanaged healthcare systems in the world. Will the Secretary of State’s plans allow managers more autonomy, helping them to innovate, save money and improve care for patients?

[Wes Streeting]

I am happy to confirm that it is my view that, when there are too many targets and everything is being measured, nothing ends up being measured. We need to give more freedom and autonomy to good leaders, including clinical leaders and managers in the NHS who are coming up with some of the best productivity gains in the system. That is why we have announced new support for, and investment in, the college of leadership for both clinical and executive leaders in the NHS. I would be delighted to meet the right hon. Gentleman to discuss those issues. He was a great Chair of the Health and Social Care Select Committee, but back in July, we saw a great example of how we can improve things by sacking bad managers.

Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 19th July 2022 Commons Chamber

[Mr Speaker]

I call the Chairman of the Health and Social Care Committee, Jeremy Hunt.

[Jeremy Hunt (South West Surrey) (Con)]

May I recommend some scintillating summer reading to the Secretary of State: the study of 4.5 million patients that showed that people who see the same GP over a long period are 30% less likely to go to hospital and 25% less likely to die? Will he, after reading that, consider changing the GP contract to get rid of the micromanagement, and replace it with what doctors and patients want, which is the ability to have a long-term relationship?

[Steve Barclay]

I think my right hon. Friend knows me well enough to know that I will have a close interest in reading anything over the summer that is data driven. He highlights an extremely important issue. Just yesterday, I met with Andrea and Simon Brady, whose daughter tragically died of cancer at the age of 27. One of the key concerns that they raised with me was the lack of consistency when it came to the GP that Jessica went to see, and the fact that she kept seeing different people, and there was not continuity of care. Specific cases that I am looking into speak to this issue, and I am happy to look at the data that my right hon. Friend can share.

Ambulance Pressures

Jeremy Hunt Excerpts

Monday 18th July 2022 Commons Chamber

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call the Chair of the Health and Social Care Committee, Jeremy Hunt.

[Jeremy Hunt (South West Surrey) (Con)]

I congratulate my right hon. Friend on taking up his post as Health Secretary. Since no one ever thanks you for doing that job, I thank him for doing this tough job. I am delighted that someone with ministerial experience in the Department of Health, who therefore knows what he is talking about from the outset, is doing the job. I welcome his saying in his statement that the ambulance service is under pressure not just because of the heatwave. Does he agree that one of the main reasons for that pressure is that hospitals find it difficult to discharge patients who are fit to discharge into the social care system, and that it is financial madness to look after someone in a hospital at £300 a day when the social care system can often do it at £50 a day? Will he, in his new role, finish the job and put in place a 10-year plan for the social care system and the funding for local authorities needed to go with it?

Draft Mental Health Bill

Jeremy Hunt Excerpts

Monday 27th June 2022 Commons Chamber

[Mr Speaker]

I call the Chair of the Health and Social Care Committee.

[Jeremy Hunt (South West Surrey) (Con)]

I commend my right hon. Friend’s courage in talking about his family’s tragedy, which is one of the most difficult things to do in politics. I also thank my right hon. Friend the Member for Maidenhead (Mrs May) for her commitment to mental health, which is unparalleled among any Prime Minister I have known in this place; it made an enormous difference to me when I was Health Secretary.

I support wholeheartedly what the Health Secretary has said today. I hope that he does not mind my saying that in one instance it does not go far enough: there are still 2,000 people with autism and learning disabilities in secure institutions, effectively incarcerated, even though they would be better off in the community. It is a human rights scandal. As part of the remedy, would he consider changing the rules on sectioning so that, after a short period, anyone who wanted to keep someone in a secure unit would have to reapply for sectioning every week or two, so pressure is put on the system to find a better solution?

[Sajid Javid]

We are determined to reduce the number of people with learning disabilities and autism who are in mental health hospitals. As part of those plans, we will shortly publish the cross-Government “Building the right support” plan to drive progress; I will have more to say about that shortly. I listened carefully to my right hon. Friend’s suggestion and would be happy to meet him to discuss it further.

Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 14th June 2022 Commons Chamber

[Mr Speaker]

I call the Chair of the Select Committee, Jeremy Hunt.

[Jeremy Hunt (South West Surrey) (Con)]

Has the Secretary of State read the study in the British Journal of General Practice that says that people who see the same GP over many years are 30% less likely to go to hospital, 30% less likely to need out-of-hours care and 25% less likely to die? If he has, will he consider changing the GP contract to restore individual patient lists and reverse the change of two decades ago so that everyone has their own family doctor?

[Sajid Javid]

I have not read that review, but now that my right hon. Friend has mentioned it I will certainly take a look at it. He raises an important point about access to GPs. He is right to say that many people would want to see the same GP again and again—that would be their preference. One can see how that may lead to better clinical outcomes, but I hope he will respect the fact that others do not mind if they do not see the same GP and just want rapid access. It is important that we get the right balance.

Health and Social Care Leadership Review

Jeremy Hunt Excerpts

Wednesday 8th June 2022 Commons Chamber

[Mr Speaker]

I call the Chair of the Select Committee, Jeremy Hunt.

[Jeremy Hunt (South West Surrey) (Con)]

I thank the Health Secretary for this excellent report and commend Sir Gordon Messenger and Dame Linda Pollard for all their work in putting it together. It has some very important recommendations. People who run hospitals are doing one of the most difficult jobs in Britain today, and anything we can do to give them better support in their careers will help all of us.

Does my right hon. Friend agree that the elephant in the room is that one thing that makes their job most difficult: we have more national targets in the NHS than any other health system anywhere in the world? That means not only that there is a risk of patients turning into numbers, but that we remove the autonomy from managers to show the leadership that Sir Gordon is advocating in this report. So as my right hon. Friend implements the recommendations, will he look at the role of national targets in the NHS and whether we need to simplify and reduce them?

[Sajid Javid]

I thank my right hon. Friend for his support of the report. Of course he speaks with incredible experience. He is right to raise the issue of the importance of targets, and sometimes targets can have unintended consequences. The report does talk a bit about the importance of that issue. I can assure him that as we make changes and work with our colleagues in the NHS to make reforms, we will certainly be taking that into account.

North East Ambulance Service

Jeremy Hunt Excerpts

Monday 23rd May 2022 Commons Chamber

[Mr Speaker]

I call the Chair of the Health and Social Care Committee.

[Jeremy Hunt (South West Surrey) (Con)]

I thank the Minister, who is a practising nurse, for her profound commitment to patient safety. What happened to Peter Coates, Quinn Evie Beadle and others was a terrible tragedy for them and their families. No doubt the paramedics made mistakes, but everyone makes mistakes in the course of their work. What is unforgivable is the cover-up by the North East Ambulance Service, and the fact that we made the families go through such hell to get to the truth.

At the heart of this is that we still make it far too difficult for everyone involved in such cases to distinguish between ordinary human error and gross negligence, with the result that the organisations responsible for people’s care default to a defensive, covering-up position. Will the Minister take this up with the Ministry of Justice to ensure much clearer delineation between the ordinary human errors that we all make and gross negligence, which is never forgivable?

[Maria Caulfield]

I thank my right hon. Friend for making those points. Several safety measures were started when he was Secretary of State for Health, including the duty of candour. There is supposed to be a culture in place where, if mistakes happen, the health service is open and honest about that. The Healthcare Safety Investigation Branch was introduced. There is independent investigation. Anyone can report concerns to that body and an investigation will take place. There is the early notification system in maternity, where if mistakes or incidents happen the process is first and foremost to say that to relatives and family and to start a lessons-learned process. The patient safety commissioner is to be appointed shortly. We are doing everything we can not just to improve patient safety, but to improve openness and learning within the system to change the culture within the NHS.

Health and Care Bill

Jeremy Hunt Excerpts

Consideration of Lords amendments
Monday 25th April 2022 Commons Chamber

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call the Chair of the Select Committee, Jeremy Hunt.

[Jeremy Hunt (South West Surrey) (Con)]

Thank you, Madam Deputy Speaker. I rise to speak in support of Lords amendment 29B. Even though I believe the Government will reject it today and this may be the last time this House can debate it, I will try to make my comments with the customary courtesy that the Minister for Health attributed to me just now, with his customary courtesy. He said that this amendment was unnecessary, but I wish to ask the House: what precisely is unnecessary about an amendment that simply requires independent, regular estimates of the numbers of doctors and nurses we should be training? What could drive the Government to want to vote down such a harmless amendment, not once, not twice, but, including today, three times? I will tell the House why the Government are going to vote this amendment down. They will do so because they know that any such independent estimate would conclude that we need to be training more doctors and nurses. Why on earth would we not want to train more doctors and nurses, if we looked objectively at the challenges facing the NHS today? We last debated this on the day the Ockenden report was published in Parliament. That report talked about more than 200 babies’ lives that would probably have been saved with better care. The key recommendation in that report was for 2,000 more midwives and 500 more obstetricians, and that would not have been necessary had this amendment been in place. We can put this right.

I immensely respect the work done by the Minister for Health and the Secretary of State, and I am grateful for their engagement, but I say to them, from the bottom of my heart, that not training enough doctors and nurses is a false economy. It costs patients’ lives, it costs taxpayers’ money, it demoralises the workforce and it lets down the people who are waiting for their NHS operation. The Health Minister’s argument is that we will have 50,000 more nurses by the end of this Parliament and we are training more doctors than ever, but today’s report by the King’s Fund shows that that is a hollow claim, because even though we are on track for our 50,000 nurses, the number of vacancies is still not going down. In other words, more nurses does not mean enough nurses, and we can never know what enough is unless we are honest enough to ask ourselves the hard questions.

The lesson of Mid Staffs, Morecambe Bay, Southern Health and Telford is that the first step in dealing with poor care is to be honest about the issue. We now have in the NHS a workforce issue of enormous proportions, which is why Lords amendment 29 is supported by every NHS leader, every royal college, every health think-tank, every union and more than 100 NHS organisations in total. I am afraid that, by voting down a simple request for independent estimates of the number of doctors and nurses we should be training, the Government are actively choosing to sweep the problem under the carpet. I say to Ministers, who have listened to my arguments genuinely and in good faith, that NHS and care staff deserve better after two years of the pandemic, and the people waiting for their NHS operations deserve better, too.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call the SNP spokesperson.

Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 19th April 2022 Commons Chamber

[Mr Speaker]

I call the Chair of the Select Committee, Jeremy Hunt.

[Jeremy Hunt (South West Surrey) (Con)]

The Secretary of State will have read the scandal exposed in The Sunday Times this weekend that six babies are born every month after being exposed to sodium valproate, which has been known for many years to cause disabilities. Last year the Government consulted on putting warning labels on valproate. Is it not time to go much further and ban the prescription of sodium valproate to epileptic pregnant mothers?

[Sajid Javid]

My right hon. Friend is right to raise this, and many of us will have seen the recent reports, especially from the families affected. It is right that we reconsider this and make sure that sodium valproate, and any other medicine, is given only in the clinically appropriate setting.

Health and Care Bill

Jeremy Hunt Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Jeremy Hunt (South West Surrey) (Con)]

Will the Minister give way?

[Edward Argar]

I wanted to make a little progress, but I will give way to the Chair of the Select Committee.

[Jeremy Hunt]

Could the Minister possibly just tell me whether there is a single NHS organisation that is not supporting Lords amendment 29, which the Government are planning to reject?

[Edward Argar]

I may regret giving way to my right hon. Friend. I do not often say that, but perhaps I do now. I believe that this is about striking an appropriate balance in workforce planning and understanding supply and demand. I believe that the approach we have adopted as a Government, with the commission and the subsequent commission from the Secretary of State, is the right one. We are working closely with all NHS organisations from NHS England down, and I am sure that we will continue that collaborative work and that they will recognise the value being added by these commissions.

--- Later in debate ---

[Geraint Davies]

It is, of course, 125 years since the birth of Aneurin Bevan, who famously said:

“Illness is…a misfortune the cost of which should be shared by the community”.

That cost, as the right hon. Member for Chingford and Woodford Green (Sir Iain Duncan Smith) said, should not be borne by the victims of genocide, abuse or slavery, so I support amendment 48 and, indeed, amendments (a) and (b).

I am the trade rapporteur of the Council of Europe in respect of safeguarding human rights, democracy and the rule of law. I very much hope that where there is abuse or slave labour, we pursue filtering out such imports from procurement in general. Curing illness should not be at the cost of creating illness and harm abroad.

Obviously we need security of supply. We have seen China use embargoes and trade sanctions against Australian wine and Lithuanian products, or whatever, so we need a safe supply, much of it home-grown, for when we face such a problem or a pandemic. I put it to the Minister that we need to look much more at generating production and procurement in the public sector. It is no good going to the pub landlord of the right hon. Member for West Suffolk (Matt Hancock) to get expensive PPE. We need both value for money and ethical sourcing.

Some of the proposals for integrated care boards involve corporations that have a vested interest. If we remove competitive tendering, waiting lists and costs would both go up. It is critical that we get value for money.

Looking at what happened in Wales during the pandemic, we find that the cost of PPE was, in fact, half the cost of PPE in England. The £1.1 billion given to Wales for test and trace was a Barnett consequential, but we spent only half of that, £533 million, because we used public sector procurement and production effectively.

Through a combination of ethical procurement and public sector provision, we can keep the light of the health service shining, we can keep the faith and we can build a stronger, more successful and cost-effective health service.

[Jeremy Hunt]

Like the shadow Health Secretary, I rise to speak in support of amendment 29, which the Government plan to vote down. This wholly innocuous amendment simply asks them to publish, every two years, independent projections of the number of doctors and nurses we should be training. The Government are rejecting the amendment because they think it would compel them to train more doctors, which is true, but it ignores the fact that this is the best way to reduce the £6.2 billion locum bill that is currently devastating the NHS budget.

The shadow Health Secretary was very generous to me, and I return the compliment by saying that I think he is doing an excellent job. I hope he remains shadow Health Secretary for many years.

I ask the House, in the nicest possible way, to reject the compromises proposed by the excellent Minister. The Government are publishing a 15-year framework, but he knows and we know that it will simply detail the number of doctors that the Government think they can afford, not the number of doctors we actually need. In the past—even last year—when the NHS has tried to publish the number of doctors it thinks it needs, it has been stopped by the Government. Why is there this reluctance to publish the number of doctors we are going to need in 15 years’ time, given that 97% of hospital bosses say that staff shortages are having an impact on the quality of care they are giving and there are 110,000 vacancies? The answer is simple: it is because the Government know we are not training enough right now. What message does it send to young doctors, newly qualified midwives and newly qualified nurses, who are incredibly stressed and pressured by the situation on the frontline, if we are saying to them, “Look, it is really tough now, but we are not even prepared to train enough doctors, nurses and midwives for the future to relieve that stress and pressure later on in your career”?

[Steve Brine]

I will support my right hon. Friend in standing up for Lords amendment 29, because when I look back to our time together at the Department, when we published the long-term plan and when I published the cancer plan, I know that the thing that undermined us most of all was when the stakeholders came back and said, “Where’s the people plan that goes alongside it?” Because we could not answer that, we were always playing catch-up. This Lords amendment sets that train back on the right track.

[Jeremy Hunt]

I thank my hon. Friend for that comment. He was an excellent cancer Minister. In our time, the biggest pressure was funding, but now people say that the biggest pressure is workforce. It is devastating for morale to refuse to address this issue at a time such as this. Any Government who care about the long-term future of the NHS have an absolute responsibility to make sure that we are training enough doctors and nurses for the future. Any Government who care about value for money for taxpayers should welcome a measure that will help us control a locum and agency budget that has got massively out of control. That is why opposing Lords amendment 29 makes no sense either for the Department of Health and Social Care or for the Treasury. This is why it is supported by more than 100 health organisations; every royal college and every health think tank; people in all parts of this House; many peers in the other place, including Lord Stevens, who used to run the NHS; and—this is the point I wish to conclude with—by thousands of thousands of doctors and nurses on the frontline.

[Sir Roger Gale (North Thanet) (Con)]

Is it not the case that what my right hon. Friend is proposing is custom and practice in very many developed countries already?

[Jeremy Hunt]

It is absolutely the case. We need something like this because, as I know—I will do my self-reflection now—when a Health Secretary negotiates a spending settlement with the Chancellor, the number of doctors they are going to have in 10 or 15 years’ time is quite low down their list of priorities because they are thinking about immediate pressures. So we need something that deals with that market failure. I did set up five new medical schools and was proud to do so, but I do not know whether that was enough. That is why we need something to make sure that we never have to worry, whoever the Government and the Health Secretary are, that this fundamental thing that is vital for the future of the NHS for all of us is always properly looked after.

Let me conclude by remembering what we were discussing this morning in the Ockenden review. We talked about the agonies faced by families. We did not talk enough about the agonies faced by doctors, midwives and nurses who find themselves responsible for the death of a child—it is psychologically incredibly devastating for them. We need to be able to look them in the eye and say, “The No. 1 thing in the Ockenden review that came out was that staffing shortfalls can make a difference. We understand that.” They know and we know that there is no silver bullet; this cannot be solved overnight. It takes seven years to train a doctor, 10 years to train a GP and three or four years to train a nurse or a midwife. No one is expecting a solution tomorrow, but we do at least have a responsibility to look each and every one of those people, who worked so hard for us in the pandemic, in the eye and say, “We do not have a solution right away but we really and truly are training enough for the future.”

[Daisy Cooper (St Albans) (LD)]

The Minister made a valiant effort to dissuade some of us from supporting Lords amendment 29—the workforce amendment—but I suspect he knows he is not kidding anybody.

We have learned today that public satisfaction with the NHS is at its lowest level since 1997. We should not underestimate the blow that that news will deliver to the health and care workers who turn up, do an amazing job, and go above and beyond every single day. To say that that news is dispiriting is an understatement. It is important that those workers know that the public, and every Member of this House, loves our NHS; it is just that we want it to work a bit better. It is hardly surprising that people’s biggest frustrations are waiting times, a lack of proper funding and staff shortages. Those things are the fault not of health and care workers but of this Tory Government, who are driving our health and care services into the ground.

Cancer Research UK says that without the workforce amendment the Bill will fail to address the biggest barrier to the achievement of world-class cancer outcomes in the UK: the staffing shortages and pressures. The King’s Fund has said that the health and care workforce crisis will be the key rate-limiting factor in the reduction of the NHS elective care backlog. The workforce amendment may not be a silver bullet, but it is the closest thing to one, which makes it all the more frustrating that the Government will not accept it. As I suspect the Minister knows, the Government’s objections just do not stand up to scrutiny.

As the right hon. Member for South West Surrey (Jeremy Hunt) said, framework 15 simply sets out the number of staff the Government think they can afford, rather than the number of staff we actually need. I urge the Minister to think about what message that sends to my constituent, who is a newly qualified midwife. She wrote to me just a couple of months ago and said:

“I am extremely concerned about the crisis in maternity care. This isn’t caused by Covid-19—the systemic failings have been crippling the service for a generation—but the pandemic has made a bad situation worse.”

She said:

“I am being harmed, my clients are being harmed. Staff are being harmed. For every 30 newly qualified midwives, 29 are leaving. Parents are reporting bullying and coercion. Threats are being used to ensure compliance. Unnecessary medical interventions are at epidemic levels. Trauma—amongst parents and midwives—is rife.”

She said that “concerns are being missed” and interventions “made too late”, and that the reason was “staffing problems.” If that is not a wake-up call, I do not know what is.

I wish briefly to express my concern about the powers the Bill will give the Secretary of State. At best, the change will create a bureaucratic nightmare; at worst, it will lead to meddling and the politicisation of the day-to-day running of the NHS. The Government have tried to argue that the pandemic showed the need for Ministers to have more powers, but we know that during the pandemic the Secretary of State had powers over PPE and test and trace, both of which issues were handled extremely badly. The NHS’s operational independence is critical, but it will be undone by the introduction of the Henry VIII powers in the Bill, so Liberal Democrats will oppose them.

Finally, I congratulate the right hon. Member for Chingford and Woodford Green (Sir Iain Duncan Smith) on his impassioned speech. I agree with him wholeheartedly that we have a duty as a nation and as a society to ensure that the goods used in our publicly owned NHS are not tainted by modern slavery or linked to the behaviours that may lead to genocide.