Oral Answers to Questions

Debate between Jeremy Hunt and Derek Twigg

Tuesday 19th December 2023 Commons Chamber

[Jeremy Hunt]

What I can confirm is that, as a result of the measures I took in the autumn statement, it will be lower at the end of the scorecard period than it would otherwise have been, and a lot lower than it would be under any Labour Government.

[Derek Twigg (Halton) (Lab)]

May I ask the Chancellor how many middle-income taxpayers have been paying the higher rate of tax since 2019?

[Jeremy Hunt]

I am happy to write to the hon. Gentleman with the exact numbers, but for people on low incomes—people being paid the lowest legally payable wage—their post-tax real income has gone up by 30% since 2010, because the Conservative party believes in making work pay.

Oral Answers to Questions

Debate between Jeremy Hunt and Derek Twigg

Tuesday 2nd April 2019 Commons Chamber

[Mr Hunt]

My hon. Friend is right. I think it is fair to say that there has been some hesitation in the past in our embracing the issue of persecution of Christians—whether from a misguided concern about our history and the role of missionaries, I do not know—but now is the time when we have to put all that behind us and say that freedom of religious belief is an essential and indivisible part of freedom, full stop. The UK should always be on the right side of that issue.

[Derek Twigg (Halton) (Lab)]

Christians are among the most persecuted believers in the world, and clearly we have to do more to help. I welcome what the Foreign Secretary has said about the work that he has commissioned. Are Christian women not often doubly persecuted, for both their religion and their gender? That needs looking at very closely as well; there needs to be more work around the world with Governments to tackle that problem.

[Mr Hunt]

The hon. Gentleman is absolutely right. I would widen the point even further, and say that women from all religions, not just Christian religions, are double victims. Where there is persecution of any religion, often women come off worst. I think the most inspiring example of courage in the face of that persecution is Nadia Murad, the recent Nobel peace prize winner, a Yazidi campaigner who suffered absolutely horrifically but is an inspiration to persecuted women all over the world.

Breast Cancer Screening

Debate between Jeremy Hunt and Derek Twigg

Wednesday 2nd May 2018 Commons Chamber

[Mr Hunt]

That is a good point, and we will get in touch with all the cancer charities that we think are going to be affected by what has happened and make sure they have the support they need.

[Derek Twigg (Halton) (Lab)]

When did the Secretary of State or the Minister with direct responsibility for screening last ask their officials about the accuracy of the screening programme and the robustness of the checks and assurances in place to ensure it was working properly and efficiently? When, before January this year, did he last ask his officials that?

[Mr Hunt]

I will have to get back to the hon. Gentleman with a detailed answer to that question. Ministers were informed of this issue in March, and we are responsible, as Ministers, for the effective functioning of that system—in the way all Ministers have responsibility for their various areas—so one of the questions we need to ask is whether the right escalation procedures and checks and balances were in place so that Ministers could be informed if there was likely to be a problem.

Oral Answers to Questions

Debate between Jeremy Hunt and Derek Twigg

Tuesday 20th March 2018 Commons Chamber

[Mr Hunt]

My hon. Friend always speaks very thoughtfully on this matter, and it is important, because social care issues will continue for decades ahead unless we find a solution and both parties will have to deal with this issue in government. In truth, both parties have made things worse by politicking in the past, whether by discussion about a death tax in 2009 or a dementia tax in 2017.

[Derek Twigg (Halton) (Lab)]

I have received a document from my local authority sent out by Cheshire and Merseyside NHS which tells it that it should be looking at there being a minimum of one choice of place for people coming out of hospital into a care home, and if that cannot be met it should be looking at transitional placements. So it will have to ask people who are frail and elderly to go into transitional placements, and that will cost more money. How are people going to be able to cope with this? At the end of the day, the problem is simply this: there is not enough money; there is not enough money to pay for good quality staff; and there are not enough places. The Government should be ashamed of themselves.

[Mr Hunt]

It is the hon. Gentleman’s party that should be ashamed of itself for leaving us with the financial crisis 10 years ago that has created such huge pressure in both the health and social care systems. Yes, in 2010 there were some cuts in the social care system, but that has changed now and over this Parliament the budget is going up, with £9.4 billion of additional resources, which is an 8.6% increase in real terms. We need to go further, however, which is why we have a Green Paper.

Oral Answers to Questions

Debate between Jeremy Hunt and Derek Twigg

Tuesday 4th July 2017 Commons Chamber

[Mr Hunt]

The hon. Lady happens to work in an NHS hospital in which there has been a big increase in the number of nurses. Across the country, there are actually 13,000 more nurses working on our wards than there were in 2010, but she is right: we need more nurses and nursing staff, and that is why we are expanding the number of nurse associates. This year we are, for the first time, opening up an apprenticeship route into nursing, which means that people from non-traditional backgrounds—particularly band 3 healthcare assistants—will find it much easier to get into nursing. That is how we will expand the workforce.

[Derek Twigg (Halton) (Lab)]

According to the latest NHS indicators published by the House of Commons Library last week, the number of GPs is estimated to have fallen over the past 12 months, and the figures for March 2017 are expected to show a further fall. Why is that?

[Mr Hunt]

We have had a big increase in the number of medical students choosing to go into general practice, but we have also had an increase in the number of GPs retiring early. That is a problem that we are urgently addressing.

Oral Answers to Questions

Debate between Jeremy Hunt and Derek Twigg

Tuesday 21st March 2017 Commons Chamber

[Mr Hunt]

My hon. Friend’s ingenuity in bringing these issues up in question after question never ceases to amaze me. As he knows, we recognise that the pressure in primary care cannot just be borne by general practice, but we must always follow the science as to where we get our help from.

[Derek Twigg (Halton) (Lab)]

Only recently, a surgery has been closed down in the borough of Halton. There is a clear shortage of GPs. Despite the efforts of the clinical commissioning group to try to find replacements, that has not happened. How will merging CCGs help, and can the Secretary of State rule out any merger between Warrington and Halton?

[Mr Hunt]

This is something on which we take guidance from what local CCGs say. There are times when the CCGs feel that their scale is not big enough to have the impact they want.

[Derek Twigg]

You set them up.

[Mr Hunt]

The hon. Gentleman says from a sedentary position that we set up the CCGs. I remind him that CCGs came together without central prescription as to what their size should be, but we will always listen to the advice we get on the ground if people want to change their size.

NHS and Social Care Funding

Debate between Jeremy Hunt and Derek Twigg

Wednesday 11th January 2017 Commons Chamber

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

I beg to move an amendment, to leave out from “House” in line 1 to the end and add:

“commends NHS staff for their hard work in ensuring record numbers of patients are being seen in A&E; supports and endorses the target for 95 per cent of patients using A&E to be seen and discharged or admitted within four hours; welcomes the Government's support for the Five Year Forward View, the NHS's own plan to reduce pressure on hospitals by expanding community provision; notes that improvements to 111 and ensuring evening and weekend access to GPs, already covering 17 million people, will further help to relieve that pressure; and believes that funding for the NHS and social care is underpinned by the maintenance of a strong economy, which under this administration is now the fastest growing in the G7.”

I thank the shadow Health Secretary for bringing this afternoon’s debate to the House. He is right to draw attention to the pressures in the NHS, but, regrettably, I will have to spend much of my time correcting some totally inaccurate assertions that he has made, and that is a shame. This is an important debate for our constituents—for his and for mine—and for the NHS. The country deserves a proper debate, but that is difficult when we are given misinformation at a time when the NHS is under sustained pressure.

I am also very pleased to see the Leader of the Opposition in his place. I think that he has become rather a fan of my parliamentary appearances—[Interruption.] It is a Jeremy thing, he says—if only. I wish to address one part of my speech to him, because it is an area of policy for which he is perhaps more personally responsible.

Winter is always challenging period, and I want to repeat the thanks of the shadow Health Secretary and the thanks that I gave on Monday to NHS staff. According to NHS Improvement, on the Tuesday after Christmas the NHS had its busiest day ever. Earlier in December, it treated a record number of patients within four hours. Overall, as the Prime Minister said this morning, we are seeing 2,500 more patients within the four-hour standard every single day compared with what happened in 2010. As we discussed on Monday, the NHS made record numbers of preparations for this winter, because it is always a difficult time, including having 3,000 more nurses and 1,600 more doctors in full-time employment.

Let me address what the shadow Health Secretary said with regard to Worcestershire. I met colleagues from Worcestershire on Monday. A huge number of actions are now being taken, but we must say right up front that it is totally unacceptable for anyone to wait 35 hours on a trolley and that we expect the hospital to ensure that that does not happen again. There are plans in place to open additional bed capacity this week. We have already had capacity made available by Worcester Community Trust to support the flow. The trust has deployed its chief operating officer on the task of facilitating discharges. The trust is in special measures, so we have a big management change, and a new chief executive will be starting later on in the spring.

What is wrong with what the shadow Health Secretary has just said is the suggestion that winter problems are entirely unusual. As my right hon. and learned Friend the Member for Rushcliffe (Mr Clarke) said, the NHS had difficult winters in 1999, 2008, and 2009. He remembers difficult winters from his time as Health Secretary, but there are things that are different today. One of them is that, compared with six years ago, we have 340,000 more over-80s, many of whom are highly vulnerable or have dementia. We know that when people of that age go to an A&E at this time of year, there is an 80% chance that they will be admitted to hospital.

[Derek Twigg]

The Secretary of State talks about correcting the points that have been made so that the House has the right information. May I repeat the question that I asked him on Monday? What are the latest figures—he should have them up to this week—for the number of people who could be discharged but have to remain in hospital because there is no community support available for them? Can he give us that figure now? He said that he would write to me, but he must know that figure now.

[Mr Hunt]

Last year, on average, it involved around 7,000 beds, which is far too many. That is why the Secretary of State for Communities and Local Government announced in December a new package of support worth around £400 million—

[Derek Twigg]

rose—

[Mr Hunt]

Let me answer the hon. Gentleman’s question. I said that I would write to him, and I will do so. He may have noticed that there are other issues that we are dealing with, which is why I may not have had time to sign the letter. The £400 million extra for local authorities over the next two years will make a significant difference and he should recognise that.

--- Later in debate ---

[Mr Hunt]

I will give way, but first I want to make some progress.

I want to talk about something else that is different in our A&E departments today compared with six years ago. Although we are sticking to the four-hour target, we also insist on much higher standards of safety and quality.

On Monday, I congratulated Labour on the introduction of the four-hour target—I support it—but we should also remember that four years after that standard was introduced, we started to see some horrific problems at Mid Staffs, many of which were in the A&E department. Some were caused because people thought they would be fired if they missed the target. Robert Francis said that the failures at Mid Staffs were

“in part the consequence of allowing a focus on reaching national access targets.”

Therefore, although we retain targets, we will not allow them to be followed slavishly in a way that damages patient care.

[Derek Twigg]

Will the Secretary of State give way?

[Mr Hunt]

I have already given way to the hon. Gentleman. There are many other Members who want to intervene.

That is why we have a new inspection regime that makes it harder to cut corners in the way that used to happen when beds were not being washed, there was poor infection control and ambulances were being used as waiting rooms.

Mental Health and NHS Performance

Debate between Jeremy Hunt and Derek Twigg

Monday 9th January 2017 Commons Chamber

[Mr Hunt]

While I do not agree with moving to a social insurance model, I have some sympathy with what my hon. Friend has said about the broader issue of resourcing healthcare. If there are to be a million more over-65s in the next five years, we shall have to find a way to continue to invest more in our health and social care systems over the decades ahead. We are doing that this year in providing an extra £3.8 billion, and Governments will need to continue to do it in the coming decades.

My hon. Friend has rightly highlighted a specific problem. I do not have a solution to it now, but I want him to know that I understand that, in rural areas, people can wait too long for ambulances. Our system of targets gives ambulance services an incentive to prioritise the calls to which they can respond quickly in nearby towns, but I shall look into the issue.

[Derek Twigg (Halton) (Lab)]

The Secretary of State tells us that he has a plan and a strategy, so I assume that he is on top of all the facts, but will he assure us that he understands the scale of the problem by answering this question? As of the latest count this week, how many hospital beds were being blocked by people who could not be discharged because no facilities for their care were available in the community?

Oral Answers to Questions

Debate between Jeremy Hunt and Derek Twigg

Tuesday 20th December 2016 Commons Chamber

[Mr Hunt]

No one fights harder and more eloquently than my hon. Friend for the needs of the people of Stafford. I always look with concern at proposals to change emergency services given the huge pressures that exist, so I shall happily look at the plan as he suggests.

[Derek Twigg (Halton) (Lab)]

21. The problem is not just winter pressures but pressures all year round. The Secretary of State will no doubt tell me that the Government have now allowed councils to increase the precept to allow councils to fund it better, but the fact is that that is not enough money. There is no strategy. Does anyone outside the Department—those in the Department might not either—believe that the Government has a strategy for social care?

[Mr Hunt]

All I would do is urge the hon. Gentleman to listen to what the Prime Minister said at this Dispatch Box last week. She said that we recognise the short-term pressures—indeed, the Communities Secretary came up with a package of £900 million extra over the next couple of years—but that we also need a long-term sustainable solution, on which the Government are working hard.

CQC: NHS Deaths Review

Debate between Jeremy Hunt and Derek Twigg

Tuesday 13th December 2016 Commons Chamber

[Mr Hunt]

I am happy to do so. We will lay down in regulations in the House that the information must be published for all trusts on a quarterly basis. I draw my hon. Friend’s attention to what I said in the statement, which is that it is not legitimate to compare the numbers in different trusts, because trusts will have different levels of reporting. In fact, our better trusts may actually have higher levels of reported avoidable deaths because they are better at picking up these things.

[Derek Twigg (Halton) (Lab)]

One of the recommendations says:

“Greater clarity is needed to support agencies working together to investigate deaths and to identify improvements needed across services and commissioning.”

How is that going to happen?

[Mr Hunt]

This is a very complex issue, but it is a very important one, particularly for people with learning disabilities who are users of the services of multiple organisations. The National Quality Board will put together guidance before the end of March, so that we can roll this out across the whole NHS during next year.

NHS Funding

Debate between Jeremy Hunt and Derek Twigg

Monday 31st October 2016 Commons Chamber

[Mr Speaker]

I would like to conclude these exchanges by 4.30 pm because there is other pressing business. If people take a long time, they are preventing their colleagues from contributing. I am sorry, but it is as simple as that.

[Derek Twigg (Halton) (Lab)]

Does the Secretary of State believe that there is a need for additional funding for adult social care over and above that which has been already allocated?

[Mr Hunt]

We are putting extra money into adult social care, and local authorities have the ability to increase their funding to adult social care through the new precept. In an ideal world, everyone would like more money to go into the NHS and social care system, but Government Members know that those systems are powered by a strong economy and that we can increase our budget only at a rate that the economy can afford. The past six years show that if we take care of the economy, we can increase the NHS and social care budget, and that is what we are doing.

Oral Answers to Questions

Debate between Jeremy Hunt and Derek Twigg

Tuesday 11th October 2016 Commons Chamber

[Derek Twigg (Halton) (Lab)]

The problem is that many trusts are still in a financial mess and have a deficit. If hospitals and the wider health service are to solve that, they need more funding, and councils, too, need funding for care. What is the Secretary of State doing to fight for more funding for his Department to ensure that we deal with those problems properly?

[Mr Hunt]

The hon. Gentleman will have noticed that in last year’s spending review the NHS got the biggest funding increase of any Government Department. We have committed to the NHS’s own plan, which asks for £10 billion more a year during the course of this Parliament in real terms. However, I do not disagree that there are still very real financial pressures in the NHS and particularly in the social care system. The trusts that are delivering the highest standards of care are those with the lowest deficits. Delivering unsafe care is one of the most expensive things people can do, which is why this is an important agenda.

Oral Answers to Questions

Debate between Jeremy Hunt and Derek Twigg

Tuesday 9th February 2016 Commons Chamber

[Derek Twigg (Halton) (Lab)]

5. What proportion of hospital trusts are in deficit?

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

Trusts reported a net deficit of £1.6 billion for the first half of this financial year, with 75% of trusts reporting a deficit, which is why, last week, we launched the Carter efficiency programme in which Lord Carter confirmed that hospitals can save £5 billion annually by making sensible improvements to procurement and staff rostering.

[Derek Twigg]

Almost every acute trust will be in deficit in the coming year, including Warrington and Halton Hospitals NHS Foundation Trust and Whiston and St Helens hospitals, which cover my constituency. The fact is that the Government have been slow in dealing with one of the causes of the deficit, which is the employment of great numbers of agency staff. They also want to cut the tariff, which is based on efficiency savings, leaving hospitals such as Whiston and St Helens, which are among the most efficient in the country, struggling to make greater efficiencies. Will the Secretary of State look at that matter again?

Oral Answers to Questions

Debate between Jeremy Hunt and Derek Twigg

Tuesday 24th February 2015 Commons Chamber

[Derek Twigg (Halton) (Lab)]

On the early detection of cancer, will the Secretary of State consider putting more resources into socially deprived areas such as Halton where the incidence of cancer is higher?

[Mr Hunt]

We are putting more resources into Halton. In fact, we are putting more resources into the NHS across the country. We are carrying out 21,000 more diagnostic tests, including cancer tests, every year compared with four years ago, and I hope that that is something the hon. Gentleman will welcome.

Francis Report: Update and Response

Debate between Jeremy Hunt and Derek Twigg

Wednesday 11th February 2015 Commons Chamber

[Mr Hunt]

It is very important that everyone uses the right figures. What has happened at Basildon hospital is an inspiration to other trusts in special measures. In just a few months, it moved from being in special measures to being rated “good” by the CQC. The trust has an inspiring new chief executive, Clare Panniker, who really does listen to staff. I have been there and been told by staff how they feel that they are being listened to. We all have an obligation to make sure that the right information goes out to local communities, so that they understand where things really are getting better.

[Derek Twigg (Halton) (Lab)]

Most, if not all, hospitals are very concerned about next year’s proposed 3.8% efficiency saving. They fear that it will have an impact on access to and quality of services, and hence on patient safety. In the spirit of the openness and transparency that we now want to see, may I ask whether the Secretary of State was aware of those concerns, and whether, if he was not, he will find out why?

[Mr Hunt]

I am glad to note that this is rapidly becoming one of the most open and transparent exchanges of questions and answers we have had in the Chamber. I am, of course, aware of trusts which say that they will find it difficult to meet stretching efficiency targets, but I would say to them that if they look at some of the safest hospitals in the world—such as Salford Royal in England and Virginia Mason in Seattle—they will find that they have the lowest costs. It is not a choice between cost and safety; better safety leads to lower cost.

A and E (Major Incidents)

Debate between Jeremy Hunt and Derek Twigg

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

I am aware of the problems at Addenbrooke’s. Indeed, the main issue, as my hon. Friend rightly says, is delayed discharges relating to care. The chief executive is running the command and control system and working with the local authority to facilitate the discharges that are necessary and to de-escalate the situation. The hospital has £2.2 million for its winter pressures support and 185 more doctors than four years ago.

[Derek Twigg (Halton) (Lab)]

The national health service in my constituency is under immense pressure, as are the adult services. It has been known for some months now that the number of acutely ill people coming into hospital has been growing. Has the Secretary of State investigated the reasons for that significant increase, which I am hearing about from the chief executives of the hospitals? If he has, what are those reasons? Is it to do with access to primary care, or problems with adult social services? Will he tell the House now?

[Mr Hunt]

We have looked into that matter in huge detail. There are probably three broad factors that are behind the increase in demand. One is the ageing population. There are 350,000 more people over the age of 75 than four years ago. The point is that if someone of that age goes into A and E in the winter, there is an 80% chance they will be admitted to hospital and quite a large chance they will stay in hospital for some time. The second factor is changing consumer expectation among younger people who want faster health care—[Interruption.] That is what Professor Keith Willett, the director of emergency care at NHS England, said, and Opposition Members should listen to what our clinical leaders are saying. The third factor is a refusal by NHS trusts to do what they were pressurised to do in the past, which is to cut corners to hit targets.

NHS (Five Year Forward View)

Debate between Jeremy Hunt and Derek Twigg

Monday 1st December 2014 Commons Chamber

[Mr Hunt]

No one campaigns more for first aid than my hon. Friend. I would certainly encourage all schools to teach first aid, as I think it is a very important skill and we should consider that as part of the prevention agenda. There is also a broader point, which is that we can do a lot with the Department for Education on this agenda.

[Derek Twigg (Halton) (Lab)]

In my constituency, people are increasingly finding it difficult to access GPs and the local hospital, Warrington and Halton, is in deficit and is missing its A and E targets. I therefore have a simple question for the Secretary of State. How many additional GPs will this money find, over and above the number of GPs who are in post today?

[Mr Hunt]

It takes seven years to train a GP, so the long-term solution is to train an additional 5,000 GPs, which is what the Government have decided to do and have announced. While they come on stream, this additional money will fund up to 20,000 additional posts, a number of which will be in the community.

Oral Answers to Questions

Debate between Jeremy Hunt and Derek Twigg

Tuesday 21st October 2014 Commons Chamber

[Derek Twigg (Halton) (Lab)]

We have a shortage of GPs in Halton. Constituents tell me it is more difficult to get an appointment, and in recent months, two GPs have told me that there are major problems with GP services in Halton and the country as a whole. Despite what the Secretary of State says about increased numbers of GPs, that is not happening in Halton. What is he doing to address the problem, particularly in areas of great deprivation, such as Halton?

[Mr Hunt]

There is pressure throughout the NHS because there are nearly 1 million more over-65s than there were four years ago, which puts pressure on GPs, as it does on any department or hospital providing elective care. However, this is not just about getting an appointment; it is also about ensuring that GPs have personal responsibility for the patients on their list and are accountable for the care of some of the most vulnerable people. We have brought back named GPs with personal responsibility for over-75s, and I hope the hon. Gentleman welcomes our going further and bringing it back for everyone.

Special Measures Regime

Debate between Jeremy Hunt and Derek Twigg

Wednesday 16th July 2014 Commons Chamber

[Mr Hunt]

We absolutely do need to do that. Dementia care is an area where there needs to be lots more work and innovation. There is huge variation and even some very caring places could try new ideas. There are some very interesting ideas about dementia care in Holland, too. I absolutely welcome that work.

[Derek Twigg (Halton) (Lab)]

Does the Secretary of State think that standards could be improved further by having minimum levels of staffing in care homes, and does he think that more can and should be done to improve pay and rewards for care workers?

[Mr Hunt]

We have recommended levels of staffing, but in the NHS we have decided not to have minimum levels of staffing. We were worried that that would be seen as a hurdle where, once achieved, nothing more would need to be done about staffing levels. The real issue about staffing levels and mandating numbers from the centre is that care needs change on a daily basis depending on how complex the needs are of the patients in a particular ward or home. That is why it is difficult to do it from the centre. We want to make sure that everywhere has the right numbers of staff. That is why I hope the hon. Gentleman welcomes the fact that we have so many more nurses.

Patient Safety

Debate between Jeremy Hunt and Derek Twigg

Tuesday 24th June 2014 Commons Chamber

[Mr Hunt]

I would be delighted to do that. Incredible hard work by doctors, nurses and health care assistants on the front line of my hon. Friend’s local hospital has meant that the trust has come out of special measures, which the whole House should celebrate. Indeed, it was helped in that by Salford Royal, and one of the most encouraging things about the new special measures regime is that we are pairing up hospitals in difficulty with other hospitals that have a better record, and we are getting tremendous results.

[Derek Twigg (Halton) (Lab)]

Clinical commissioning groups commission services in hospitals. What discussions has the Secretary of State had with CCGs to ensure that when they commission services they particularly look to ensure transparency and that patient safety is the highest priority in their discussions?

[Mr Hunt]

We have a lot of discussions, and the hon. Gentleman is right: the commissioning of care is vital and we need CCGs to play their part. We have many discussions with NHS England about how to do that, and we will be considering how we can make CCGs more publicly accountable for their record in those areas.

Oral Answers to Questions

Debate between Jeremy Hunt and Derek Twigg

Tuesday 1st April 2014 Commons Chamber

[Mr Hunt]

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

[Derek Twigg (Halton) (Lab)]

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

[Mr Hunt]

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

Urgent and Emergency Care Review

Debate between Jeremy Hunt and Derek Twigg

Tuesday 12th November 2013 Commons Chamber

[Mr Hunt]

I pay tribute to my hon. Friend for raising both publicly and privately his concerns about the hospital provision that his constituents face. We shall of course make sure that there is a proper review before any service changes are made. I hope that he will be reassured by the big change that happened this year with the introduction of an independent chief inspector of hospitals, who is going round the country rooting out poor care, not sweeping it under the carpet, as happened so often under the Labour Government.

[Derek Twigg (Halton) (Lab)]

Does the Secretary of State regret the loss of 6,000 nursing jobs since the last election?

[Mr Hunt]

The number of hospital nurses has gone up since the election, and as a result of the changes in the Francis report—the hon. Gentleman’s party refused to have a public inquiry many, many times—I hope that the NHS will recruit many more nurses.

Accident and Emergency Departments

Debate between Jeremy Hunt and Derek Twigg

Tuesday 10th September 2013 Commons Chamber

[Mr Hunt]

A number of things have contributed to these changes, one of which is that we have not succeeded, as an NHS or as a Parliament, in getting the way in which we do reconfigurations right: they do not command the confidence of the public and people are not satisfied that there are alternatives that they can trust or that good alternatives will be put in place when a change is proposed. We need to learn the lessons from what happened in my hon. Friend’s constituency.

[Derek Twigg (Halton) (Lab)]

Since 2010 the new Whiston hospital has seen an increase of 25% in emergency demand, but it has not been funded for it. I met the chief executive and vice-chair of the governing board last Friday and asked them whether they would be able to guarantee a safe service if that level of activity continues with the winter pressures, and they said that they might not. Will the Secretary of State urgently look at the situation at Whiston and come up with some solutions?

[Mr Hunt]

I hope that when the hon. Gentleman looks at today’s announcement it will reassure him that we are addressing not just the immediate pressures in the most difficult areas, but the underlying pressures. That 25% increase at Whiston—I pay tribute to the staff in its A and E department, who will no doubt be working extremely hard to cope with it—has come about because we have not had better alternatives to A and E and because departments have often found it difficult to discharge people from hospital into the community, which has further increased the pressure on them. What we have announced in the past few months and today will make a real difference to alleviating those pressures.

Managing Risk in the NHS

Debate between Jeremy Hunt and Derek Twigg

Wednesday 17th July 2013 Commons Chamber

[Mr Hunt]

It is funny how the Labour party decided to make the NHS its main campaigning issue for the past three years, yet the moment people start to scrutinise its own record on the NHS it says the NHS is being used as a political football. What does that say about Labour’s approach to the NHS?

I want to consider the specifics of the motion before looking at the wider issue of risk. The motion mentions the Francis inquiry. One of this Government’s first acts on coming to power was to set up the full public inquiry into Mid Staffs that families had been denied by the right hon. Gentleman’s Government for too long. We are implementing it, and fast. That is why a new chief inspector of hospitals started work yesterday, just five months after the report was published. [Interruption.] The right hon. Gentleman says that a chief inspector of hospitals is not in the report, but how are we going to make sure that the report’s recommendations are implemented throughout all 266 NHS trusts? That will be done because we will have independent inspection of hospitals, which has not been done before because the situation was so undermined by the previous Government. That is how we are going to make sure that Francis actually happens.

We intend to implement the spirit of everything that Robert Francis proposed, even if the details may vary in places from his 290 recommendations. Francis himself endorsed that approach when that he said that the Government have indicated their

“determination to make positive changes to the culture of the NHS, in part by adopting some of my recommendations and in part through other initiatives.”

Francis talked about five themes, so let us look at the progress being made on them. First, on information and transparency, yesterday showed that this Government are determined to root out, once and for all, an NHS culture of solving problems behind closed doors. This is about not just the decision to hold a public inquiry into Mid Staffs, which the right hon. Member for Leigh and his colleagues rejected doing 81 times, but the Keogh review, which reported yesterday that 14 hospital trusts have excess mortality rates. This is the first time the NHS has ever conducted such a review. We have also published individual surgeon outcomes—the first country in the world to do so across an entire health system. The independent rating of hospitals will start this autumn, so for the first time people will know how good their local hospital is, just as they do for their local school.

Francis also mentioned standards. The new chief inspector of hospitals—a position that Labour still refuses to support—began work yesterday. In Professor Sir Mike Richards, we have a new whistleblower-in-chief whose sole job is to drive up standards and root out poor care. He will be supported by a team of expert inspectors, in stark contrast to the generalist inspection model set out by the right hon. Gentleman’s Government in 2009. That is plain common sense. We have put it right. The work of the inspectors will be informed by the independent review of hospital safety that is being conducted by Professor Don Berwick, who will advise on how to embed a culture of patient safety throughout the NHS. He will report back later this summer.

[Derek Twigg]

Yesterday, when I asked the Secretary of State whether mortality had fallen before 2010, his answer was:

“According to Professor Jarman…it has been falling slightly.”—[Official Report, 16 July 2013; Vol. 566, c. 944.]

The Keogh report states that it had fallen by 30% over 10 years. Figures from the House of Commons Library, which were sourced from the NHS, show that there has been a significant fall in deaths within 30 days of non-elective hospital procedures. Will he correct the record?

--- Later in debate ---

[Mr Hunt]

I am afraid that that intervention sums up where the spin is happening. The 14 hospitals were investigated by Professor Keogh because they had excess mortality rates. The Labour party thinks that that started in 2010, but it goes right back to 2005 in those hospitals and earlier than that in many of them. That is the ugly truth that Labour refuses to confront: 14 hospitals had high mortality rates for years and years, and Labour did nothing to sort it out.

The Francis report—

[Derek Twigg]

Will the Secretary of State give way?

[Mr Hunt]

I am going to make some progress. The Francis report also talked about leadership.

Hospital Mortality Rates

Debate between Jeremy Hunt and Derek Twigg

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

This is the problem. [Interruption.] This is the denial we are getting from the Labour party; it is denying any responsibility for these deep-seated problems in some of our hospitals. As Health Secretary, I intend to do exactly as my hon. Friend describes. In order to try to measure the progress we are making, we will this year for the first time be asking every NHS in-patient whether they would recommend the quality of care that they received to a friend or a member of their family, because in the end that is what this is all about.

[Derek Twigg (Halton) (Lab)]

In May 2010, had mortality rates been falling in NHS hospitals?

[Mr Hunt]

According to Professor Jarman on the radio this morning, the answer is that it has been falling slightly.

Health Services (North-West)

Debate between Jeremy Hunt and Derek Twigg

Thursday 11th July 2013 Commons Chamber

[Mr Hunt]

My hon. Friend makes two important points. I explicitly said that we will not proceed with any of these changes until neighbouring hospitals have been consistently meeting their A and E standards and any necessary changes have been put in place so that we can be sure that they will improve care for patients. That is really important if we are going to maintain confidence.

On my hon. Friend’s point about urban versus rural, part of the underlying reason for these changes is that we need to get more care out of big hospitals, which are often in urban areas, and into the community—into settings near people’s homes. That is very important for rural communities where there are often large concentrations of older people. Today’s decision will mean an additional investment in those community services. As we look at the big changes we need to make in the NHS, we will need to make more decisions that allow more to be invested in out-of-hospital care if we are to prevent the illnesses that ultimately put so much pressure on our A and E departments.

[Derek Twigg (Halton) (Lab)]

Is any consideration being given within the Secretary of State’s Department or NHS England to reconfiguring the A and E services between St Helens and Whiston hospitals and Warrington and Halton hospitals? He might not be aware that the chief executive of Warrington and Halton hospitals and the chair of its trust board recently told me and my hon. Friend the Member for Warrington North (Helen Jones) that they think they will run out of money in about 18 months’ time such are the pressures that they have at the moment. Will the Secretary of State investigate this and tell me whether any consideration of that reconfiguration is taking place?

[Mr Hunt]

With regard to pressures on A and E, we are working very hard with A and Es across the country to make sure that they learn the lessons from what happened last winter and are properly prepared for this winter. Those discussions will include the A and E departments that serve his constituents. He will know that any decisions about service changes or reconfigurations are a matter for the local NHS; they come to me only if they are referred to me following a formal proposal by a local health overview and scrutiny committee, and that has not happened in this case.

Regional Pay (NHS)

Debate between Jeremy Hunt and Derek Twigg

Wednesday 7th November 2012 Commons Chamber

[Derek Twigg (Halton) (Lab)]

One way in which the Secretary of State can express his thanks is by ruling out regional pay. Will he tell us now whether he will do so, because it is a major concern for my constituents, who have written to me in their dozens over the past two or three weeks?

[Mr Hunt]

I am coming on to say exactly what the Government’s approach to regional pay is, so I will address the hon. Gentleman’s comments.

Mental Health Act 1983

Debate between Jeremy Hunt and Derek Twigg

Monday 29th October 2012 Commons Chamber

[Mr Hunt]

My understanding is exactly the same as that of my right hon. Friend. The key point is that this was a technical irregularity, but we do not believe that any patient has been sectioned, detained or hospitalised who would not have been if the correct procedures had not been followed. It is none the less very serious that this technical breach happened; that is why, as well as correcting the technical breach and providing absolute clarity, we are conducting this review to make sure that we do everything we can to avoid anything similar happening again—even under completely different structures than the SHAs.

[Derek Twigg (Halton) (Lab)]

I do not necessarily disagree with anything the Secretary of State said, but I noted that he used the term “we believe”, which means that it is not simply factual at this point that no one has been detained who should not have been. It would be worth the Secretary of State addressing the reverse position: does he believe that no one who should have been detained has been released and then gone on to commit a serious offence?

[Mr Hunt]

As a result of the technical irregularities that we have identified and put right, I do not believe that what the hon. Gentleman describes has happened. Let me explain that when I say “we believe”, it reflects the advice we have had that there are good arguments on why the detentions were and are lawful, but that is not to say that those arguments cannot be challenged or that a court would necessarily agree with us. That is why it is necessary to take this unusual step of introducing emergency legislation.

Leveson Inquiry

Debate between Jeremy Hunt and Derek Twigg

Wednesday 25th April 2012 Commons Chamber

[Mr Hunt]

My hon. and learned Friend makes an excellent point. Let me remind him of what Lord Justice Leveson said this morning. He said, “I do not seek to constrain Parliament, but it seems to me that the better course is to allow this inquiry to proceed.”

[Derek Twigg (Halton) (Lab)]

It seems strange that the Secretary of State brings a special adviser into the centre of Government on a very commercially difficult contract or situation, and does not know what he is doing. But may I ask the Secretary of State a very simple question: why did the permanent secretary decide that the contact point would be a special adviser and not a civil servant?

[Mr Hunt]

Adam Smith was a part of the process that was authorised by the permanent secretary. But he was not the only point of contact—there were many, but he was one of the points of contact. You need to do that. [Hon. Members: “Why?”] Well, we set up a process that was approved by the permanent secretary, and we also put in place many safeguards to make sure that my decisions were taken objectively, and seen to be taken objectively. I have to say to the hon. Gentleman that there is no evidence whatsoever, looking at my actual decisions, that any of those conversations had any influence on them whatsoever.

Oral Answers to Questions

Debate between Jeremy Hunt and Derek Twigg

Thursday 15th December 2011 Commons Chamber

[Mr Hunt]

I congratulate the Royal Liverpool golf club, and I would be delighted to attend—diary permitting. I agree with my hon. Friend that sport is a massive driver for tourism. Two million people come to this country every year to watch or play sport. I hope that sport in Liverpool will be helped by this week’s announcement of a new local TV station for Liverpool, on which I am sure my hon. Friend will be an early honoured guest.

[Derek Twigg (Halton) (Lab)]

What is the Secretary of State doing to support the tourism industry to attract more people to smaller conurbations like Halton, which has the excellent Norton Priory museum and the Catalyst science centre, which is currently struggling. What is he doing to attract more people to the, shall we say, less obvious tourist areas?

Hillsborough Disaster

Debate between Jeremy Hunt and Derek Twigg

Monday 17th October 2011 Commons Chamber

[Derek Twigg (Halton) (Lab)]

Let me first say a big thank you to my right hon. Friend the Member for Leigh (Andy Burnham). I was at the 20th anniversary commemoration service at Anfield, and I know that that was a very emotional occasion for my right hon. Friend. I think that he felt the rawness tenfold—knowing how the families, Liverpool fans and others felt about an injustice that has continued for over 22 years—and I think that he did well to get through his speech and deliver his message on that day. I want to record my thanks for what he did, along with my hon. Friend the Member for Garston and Halewood (Maria Eagle). As I have said, it was an emotional occasion. There were 30,000 people in the stadium that day. I have been going to such commemoration services for many years, but that occasion demonstrated the depth of support for the families, and for the securing of the truth and justice that we all seek.

I was present at the Hillsborough disaster. I drove to the ground that day with three friends. As was recalled by my hon. Friend the Member for Liverpool, Walton (Steve Rotheram), it was a beautiful sunny day, and we were looking forward to a good match—one of many good matches that we had seen as Liverpool supporters. One could never have imagined how the event would end. As we approached the stadium we sensed that something was wrong, and indeed the chaos had already started outside the Leppings Lane end. We witnessed mounting chaos around the turnstiles. When we eventually managed to pass through them, our tickets were not checked. There was no organisation and no policing. As I have said, it was complete chaos.

I watched the disaster. I was in the north stand, and my three friends were at the Leppings Lane end. I felt somewhat let down because I did not have a ticket for Leppings Lane. I would normally stand up in the Liverpool Kop, but for some reason I had ended up with a stand ticket, which meant sitting down, and I felt that I had lost out. Of course I did not know what was about to happen, and I did not know what had happened to my three friends in Leppings Lane until some time later.

As I have said, I watched the whole horror of the disaster unfold in front of me. It was obvious well before 3 pm that pens 3 and 4, the middle pens, were full, but on either side of them the stand was empty. I will not go into the details, because we have been through them back in 1998 and since, but it beggars belief that the police and those responsible could not see what was happening. It had to be seen to be believed. Then, of course, we saw the disaster unfold.

The horror of that day will always live with me, but I did not lose my life, and nor did anyone personally known to me. The families, however, are in a completely different position. I recognise the dignified and determined way in which they have pursued their fight for justice, in spite of the terrible slur perpetrated by the police, with the help of certain sections of the press, in blaming Liverpool supporters for the disaster. Those families have my deepest respect. It is their love for their loved ones, and their burning desire to put a wrong right, that have kept them going for 22 years. Imagine 22 years of fighting this! It is quite unbelievable—but they still have the energy and drive to see this through. One person could not be here tonight. He said that he was tired and would not be here: he wanted to save his energy, so that he could see the conclusion of the campaign and see that justice was done.

Imagine finding out that your loved one had died in that terrible disaster, or been badly injured, and reading or hearing shortly afterwards that that person and his fellow supporters were being blamed for it. It is almost unimaginable that, notwithstanding the grief and trauma that those families were going through, those reports should unfold in the next few days. As has been said, several newspapers were involved, but I think that a headline in The Sun caused the most distress and upset. It is difficult for those who were not personally affected to appreciate the impact of that headline. The fact that police officers were involved as well was disgraceful. The distress caused by all that cannot be overstated.

As my right hon. Friend the Member for Leigh said, the 3.15 pm cut-off point is crucial, because nothing that happened after that time was taken into consideration. We know that people were alive then, and, as my right hon. Friend made clear, that is an issue for some of the families. It was an unbelievable decision. Dozens of ambulances were not allowed into the stadium, and it was also unbelievable that that was allowed to happen. As my hon. Friend the Member for Liverpool, Walton pointed out, it was Liverpool supporters who led the rescue mission, if I can call it that, carrying bodies and injured people away from Leppings Lane outside the ground.

I welcomed the Home Secretary’s statement about the independent panel. There was some discussion about the establishment of the panel, and there was a good deal of mistrust among the families because of all that had happened previously, but they went along with the process and became involved in detailed negotiations with the Government. I was asked by Liverpool and Merseyside Members of Parliament to represent them in those negotiations, which required considerable hard work. The panel’s primary aim is to ensure the recording and orderly release of the documents, which—this is crucial—must be shown to the families first. However, as my right hon. Friend the Member for Leigh knows, we managed to ensure that the production of a report was included in the agreement. That report will be crucial to the process of putting the truth in the public domain, and enhancing our understanding of the events and information relating to the disaster.

I welcome the Prime Minister’s unequivocal commitment to full disclosure, but will the Minister confirm that it will include the advice on which the Director of Public Prosecutions based his decision not to prosecute any senior police officers? Will it also include the reasons for moving an experienced match commander, Chief Superintendent Mole, a few weeks before the semi-final and replacing him with Chief Superintendent David Duckenfield, who was relatively inexperienced in the policing of football matches?

I think it important for Ministers, and the Government generally, to tread carefully, because there have been some problems. I know that what the Secretary of State for Culture, Olympics, Media and Sport said about hooliganism was taken out of context, but the fact remains that it caused a great deal of distress to the families. Moreover, last week’s debacle involving the hon. Member for Christchurch (Mr Chope) almost scuppered tonight’s debate. We need careful planning and thinking about how this matter should be dealt with from now on.

[The Secretary of State for Culture, Olympics, Media and Sport (Mr Jeremy Hunt)]

As the hon. Gentleman has referred to comments that I made, may I take this opportunity to apologise to the House—as I have to the families—for those comments? What I said was sloppily worded, it caused great offence, and I hugely regret it. The families were incredibly generous in accepting the apology that I made to them.

[Derek Twigg]

I know that the Secretary of State did not mean his remarks in the sense in which they were portrayed. I gave that example, along with last week’s, to emphasise that all this must be dealt with sensitively. The families have been through so much, and sometimes things have been wrongly said, have not been done or have been glibly avoided.

I want to put on record my thanks to the people of Sheffield. What lives with me is the memory of queues of supporters outside residents’ houses—and I mean queues: not two or three people, but 10, 20 or 30—who were allowed to use those residents’ telephones to let their families know that they were OK, and were given cups of tea. That was tremendous. The contribution and support of the people of Sheffield should be on record, and is one of the images that live with me to this day as I recall walking back from the ground. We want justice for the 96, and we want to make sure that all this information is released and that the families can see it first; that is crucial. We also want the Government to consider very carefully the report that will be produced, and to respond in a positive way that ensures that the families know both that everything possible has been done to get the information out and that their fight has not been in vain.

Oral Answers to Questions

Debate between Jeremy Hunt and Derek Twigg

Monday 26th July 2010 Commons Chamber

[Mr Hunt]

My hon. Friend makes an important point. I have already had a meeting with Lord Young to discuss how we can look at the burden of health and safety regulation on volunteering in general. A particular concern is the rule that requires two people to take children to sporting activities in minibuses. We are worried that that is putting off schools taking people to sports events in other places. My hon. Friend is absolutely right, and we are looking at that matter carefully.

[Derek Twigg (Halton) (Lab)]

I am sure that the Front-Bench team will agree that it is important to increase participation in sport at school, and that playing fields have an important role in that. During the review of capital expenditure on education, was the Secretary of State consulted on the proposal to review the regulations relating to school playing fields? If he was consulted, what did he say? If he was not consulted, why not?

[Mr Hunt]

We are working closely with the Department for Education on a number of projects to do with school sport. In particular, we want to ensure that proper protections are in place for school playing fields. That was a failing of the previous Conservative Government and of the previous Labour Government, and we want to put it right.