(7 years, 8 months ago)
Commons Chamber(7 years, 11 months ago)
Commons ChamberI am happy to look personally at the case that my hon. Friend talks about. I think he speaks for all patients and families who have suffered tragedies when he says that the only thing people want is for lessons to be learned. A more challenging issue is that staff sometimes do not feel empowered to speak out in such situations, and they worry about the consequences. A number of trusts have an outstanding learning culture that is really supportive of staff, but that is not the case everywhere. One of the big lessons from today is that we must work out how to spread that positive culture across the NHS.
On 10 December last year, I asked:
“Is the Secretary of State satisfied that families seeking truth and justice for their loved ones are having to rely on pro bono lawyers for advice and representation, and on crowdsourcing to get legal advice?”
He said:
“It should never come down to lawyers.”—[Official Report, 10 December 2015; Vol. 603, c. 1147.]
Sadly, we all know that, on occasion, it will come down to lawyers getting involved. Will any of the recommendations from the CQC cover such eventualities?
It is a difficult one, because access to lawyers is a matter for the Ministry of Justice. I am not trying to duck the issue, but my responsibility, in what we are trying to do today, is to try to make sure that families do not feel as though they need to go to lawyers, because the NHS is open and transparent enough. With the values of people in the NHS, I think that ought to be achievable. I am happy to look at the case that she raises, and to bring it up with my colleague the Lord Chancellor.
(8 years, 2 months ago)
Commons ChamberIn the light of the ongoing dispute and concerns about patient safety, has the Secretary of State given any consideration to the idea of compulsory independent arbitration, binding on both sides, to settle disputes where patient safety and public safety is in dispute? Will he look at that?
(8 years, 4 months ago)
Commons ChamberI am absolutely prepared to give that assurance and I thank my hon. Friend for his comments. He is right. We can look at MTAS and such changes. We can go even further back and look at the introduction of the European working time directive—strange to bring that up in the current context—and the shift system, which sensibly reduced some of the crazy hours that junior doctors were being asked to work, but unfortunately at the same time got rid of the “old firm” system which gave junior doctors a sense of collegiality, meant that there was a consultant whom they knew and related to, and made their training a lot more rewarding and satisfying. That was disrupted when we introduced the shift system and the maximum hours limits. We need to think about—and we are doing some very important work on this—how we could recreate some of that sense of collegiality, which is particularly missing for junior doctors in the first two years of their training, before they have joined a specialty.
With morale among junior doctors at rock bottom, and Hull having an historic problem with recruitment and retention, what particular initiatives is the Secretary of State going to use to allow the health service in Hull to have the number of doctors that we need to function properly and provide the high-quality care that we all want to see?
There is one very good doctor in the Hull A&E department, and that is Dr Ellen McCourt, who has taken over as leader of the junior doctors committee—at least, I imagine she is very good; I have been very impressed every time I have met her. There are particular pressures at Hull, and as the hon. Lady knows we have had management changes. So far we have not seen the improvement in performance that we would like. I am aware that there are big issues with the infrastructure— the physical buildings. We will continue to work with the NHS locally and with the trust to try to improve the situation. She is right to bring it to my attention.
(8 years, 7 months ago)
Commons ChamberI absolutely give my hon. Friend that commitment. He is absolutely right to say that professionals should not withdraw emergency care in pursuance of a pay dispute. It is totally and utterly inappropriate. It is not just me saying that; it is what very experienced doctors such as Professor Bruce Keogh are saying. This is the wrong way to go about this dispute. In the end, the public recognise a simple truth: you cannot choose which day of the week you get ill. If we are to have the best health service in the world, we need to reflect that in the medical cover we provide at the weekends as well as during the week.
I have previously raised with the Secretary of State the problems with recruitment and retention in Hull and East Yorkshire. I would like an undertaking from him. If he moves forward with the imposition of the new contract and evidence comes to light that retention and recruitment are going to be difficult, will he stop the imposition and think again?
We are constantly monitoring what will happen with the new contract, and we want to make sure that we get it absolutely right. If the hon. Lady makes such a plea to me, she should also talk to the BMA and say that the way to make sure we implement this contract correctly is to sit down with the Government and talk about how to make it successful, rather than to refuse to talk to us, which is what is happening at Hull Royal infirmary and many other hospitals.
(8 years, 9 months ago)
Commons ChamberThe biggest threat to morale for doctors is not being able to deliver the care that they came into the profession to deliver. That is why we are sorting out a proper seven-day NHS, particularly for junior doctors who work in A&E departments at weekends, where they often do not have the support they would get during the week and do not have as many consultants around as there would normally be. That is what we are trying to put right. I appreciate that it is very difficult when the counter-party in the dispute does not want to negotiate, but in the end Governments have to decide what is right for patients and what is right for the service, as well as what is right for doctors.
Hull has traditionally struggled to recruit doctors in specialties such as A&E, general practice and psychiatry. I am concerned about the royal colleges’ warning that the imposition of the contract will have a detrimental effect on staff morale and staff retention in the NHS. Will this not make things even more difficult for areas such as Hull, which struggle to recruit in the first place?
We want more doctors and more nurses in the NHS, but in the end, if we are putting extra money in to recruit these extra doctors and nurses, it is fair to the public who are paying for their salaries to have reforms that mean their care gets better. That will apply to the hon. Lady’s constituents in Hull, who want a seven-day NHS, just as my constituents in Surrey do.
(8 years, 10 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I am grateful to my hon. Friend for raising that issue, which has not been raised so far this afternoon. He is right. We have a pressing global need—not just a UK need—to reduce the inappropriate prescribing of antibiotics. That is why training of clinicians is so important. In the case of sepsis, not only is the prescribing of antibiotics appropriate but it is essential and it is essential to do it quickly. We need to make sure that, as we train GPs to reduce their prescribing of antibiotics so that we do not develop the resistance to antibiotics that could be so disastrous for global health, they do not avoid prescribing them when they are absolutely essential.
The Health Secretary said that NHS 111 was a victim of its own success. I agree with what my right hon. Friend the Member for Exeter (Mr Bradshaw) said, which is that it is used because it is so difficult to see a doctor. On 2 January, the Hull Daily Mail reported that Hull Royal Infirmary was telling people not to come to A and E but to use services such as NHS 111. In the light of the findings of this investigation, which have national implications, does the Secretary of State agree that there should be more clinicians at NHS 111?
I do agree that we need more clinicians in primary care. We also need to invest in secondary care, which is why the hon. Lady has a new A&E centre opening in Hull, which I am sure she welcomes. We need more clinicians in primary care so that we can deal with these issues more quickly, before people need hospital care and to spot conditions such as sepsis. This Government are investing £10 billion in the NHS annually in real terms in order to step up the improvement in the services that we offer.
(8 years, 11 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
My hon. Friend is absolutely right. That is why Professor Sir Bruce Keogh is developing a methodology to help us understand the number of avoidable deaths and the reporting culture at a trust level. We have a good methodology for understanding the number of avoidable deaths on a national level. The Hogan and Black analysis says that about 3.6% of deaths have a 50% or more chance of being avoidable. However, we will not get real local action until we localise it, and that is the next step.
Is the Secretary of State satisfied that families seeking truth and justice for their loved ones are having to rely on pro bono lawyers for advice and representation, and on crowdsourcing to get legal advice?
I am afraid that that probably does happen. We all, in all parts of the House, passionately believe in and support the NHS. It should never come down to lawyers. When there is a problem, we need a culture where the NHS is totally open and as keen as the families are themselves to understand what happened, whether it could be avoided, and what lessons can be learned. If nothing else, that is the big lesson that we need to make sure we act on as a result of today’s leaked report.
(9 years, 4 months ago)
Commons ChamberWe do need more doctors and more nurses. We saw an increase of about 8,000 nurses and 10,000 doctors in the previous Parliament. We will need more for the simple reason that we will have 1 million more over-70s by the end of this Parliament. That said, the NHS is admired in the other countries my hon. Friend talks about for our models of care, which are sometimes less hospital-centric and therefore inherently more efficient than what happens in some other systems. The learning should go both ways.
My question is about whistleblowers. I want to know whether the Secretary of State is really satisfied that the fit and proper person test for managers is working, when it allows a chief executive who bullies and mismanaged, as happened in Hull, as the Secretary of State knows, to move with the help of the Trust Development Authority to another job as a chief executive, paying £170,000, and yet the whistleblower has to fight for her rights. When the fit and proper person test was invoked, the TDA investigated and the new trust, unsurprisingly, said that that chief executive was okay. I do not think that that is independent, transparent or in the spirit of Francis.
I recognise that the hon. Lady has legitimate concerns about the way that the whistleblower, who I think is one of her constituents or is near to her constituency, was treated. I have, as she requested, looked into that very carefully. She will understand that it would not be right or proper for me to comment on an individual case. She knows that, as a result of requests by her and fellow MPs, I looked into whether due process was followed in the case that she mentioned. All I will say is that bullying behaviour should not happen anywhere in the NHS. That is a very important part of the culture change that I want to see.