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?