Mental Health and NHS Performance

Debate between Jeremy Hunt and Kevin Foster

Monday 9th January 2017 Commons Chamber

[Mr Hunt]

In the hon. Gentleman’s long list of statistics, what he was not prepared to say is that people wait twice as long for a hip replacement in Wales, more than double the proportion of the population is on a waiting list for NHS care—that is one in seven people in Wales, compared with one in 15 in England—and those in Wales are 40 times more likely than those in England to be waiting too long for a diagnostic test result.

[Kevin Foster (Torbay) (Con)]

Torbay, like many other places, has been under pressure owing to the demographics of an ageing population in the bay area, but does the Secretary of State agree that it is encouraging to hear of work being done in places such as the Chelston Hall practice, which I visited on Friday, to make sure doctors can be available on the day for those who need them and people are sent on to specialists who can help them better, such as a physiotherapist, rather than just taking up vital GP appointments?

[Mr Hunt]

Yes, indeed, and I congratulate all the NHS and social care staff in Torbay on doing a fantastic job. I also congratulate them on the pioneering work they have done on health and social care integration, which has made a huge difference to my hon. Friend’s constituents.

CQC: NHS Deaths Review

Debate between Jeremy Hunt and Kevin Foster

Tuesday 13th December 2016 Commons Chamber

[Mr Hunt]

There are a number of barriers, one of which is time. Staff feel very pressured for time. I strongly argue that it is a false economy not to allow time for lessons to be learned, because tragedies, when they happen, take up a huge amount of time. From a management and leadership point of view, we have to make sure that doctors and nurses are given the time for reflective learning as part of what they do.

Another thing is the management culture. If people feel that the management of their trust are open and listening, they are more likely to be open and listening themselves. If they feel that there is a hire-and-fire culture, they are less likely to take that approach. There are a number of lessons.

[Kevin Foster (Torbay) (Con)]

Given the case of three-year-old Sam Morrish, who died at Torbay hospital in 2010, and the conclusions of the Parliamentary and Health Service Ombudsman that many investigations into avoidable deaths were not fit for purpose, I welcome the statement. I also welcome the spirit of openness that will follow in relation to these extremely difficult issues. We are, ultimately, all mortal. Although I think it is absolutely right that we will not be setting targets, will the Secretary of State reassure me about the ongoing monitoring we will undertake and the proactive work we will do with trusts to reduce the number of such incidents?

[Mr Hunt]

As my hon. Friend knows, I have met the parents of Sam Morrish—Scott and Sue Morrish—on a number of occasions. They described how when their son died, all the shutters came down. I met them only a few months after I became Health Secretary, and that engraved itself on my memory because it was so awful to hear about what they were doing.

My hon. Friend raises a rather sensitive issue, which I tried to talk about in my statement. I expect, as a result of the changes, the number of reported avoidable deaths to increase. If that happens, I do not think that it will necessarily mean that patient care is suffering. We have to be very careful, in this House and with our local newspapers, to say that if trusts start to report an increased number of avoidable deaths, it might mean that they have a more transparent culture and are being more open. Their standards about what is expected and what is unexpected may start to change as they realise that things could have been done to prevent a death that they might previously have described as expected. We have a duty, as Members, to encourage responsible reporting of this new openness, and that, in turn, will help staff.

Health Service Medical Supplies (Costs) Bill

Debate between Jeremy Hunt and Kevin Foster

2nd reading: House of Commons & Programme motion: House of Commons
Monday 24th October 2016 Commons Chamber

[Mr Hunt]

I am happy to give that reassurance. As I said, this industry contributes £56 billion to the UK economy, with tens of thousands of jobs. When the Prime Minister talks about where she sees our competitive advantage, she talks, first, about financial services, and life sciences is the very next industry she mentions. I completely agree with right my hon. Friend about its incredible importance, not just to this country but to the future of humanity. That is why we seek in this Bill to establish a fair relationship between the NHS, which we have to represent as we are funding it through the tax system, and the pharmaceutical industry. It is also fair to say that there have been times when some pharmaceutical companies’ practices have been disappointing, and because we want to make sure that that does not happen and that we can continue with a harmonious and productive relationship we are proposing this Bill to the House.

[Kevin Foster (Torbay) (Con)]

We agree that this is not about profit controls—about having a fair return for investment made—but about tackling an emerging business model that could almost be seen as profiteering.

[Mr Hunt]

My hon. Friend is right about that. The nice way of putting it is that we are closing a loophole. If one were being less polite, one might say that it is a shame we are having to do that. None the less, it is important to do what we are proposing to the House.

We recognise that it has been some time since the Government consulted on the options, and I wish to reassure hon. Members and those companies in the statutory scheme that we will consult further on the implementation of a payment mechanism in the statutory scheme, including the level of the payment mechanism, before the regulations come into force. We estimate that 17 companies would be affected by the introduction of a payment mechanism, with the 166 companies that are currently members of the PPRS not being affected. Our proposals would save health services across the UK an estimated £90 million per year.

The second key element of this Bill amends the 2006 Act to strengthen the Government’s powers to set prices of medicines where companies charge unreasonably high prices for unbranded generic medicines. We rely on competition in the market to keep the prices of these drugs down. That generally works well and has, in combination with high levels of generic prescribing, led to significant savings. However, we are aware of some instances where there is no competition to keep prices down, and companies have raised their prices to what looks like an unreasonable and unjustifiable level. As highlighted by the investigation conducted by The Times earlier this year, there are companies that appear to have made it their business model to purchase off-patent medicines for which there are no competitor products. They then exploit a monopoly position to raise prices. We cannot allow this practice to continue unchallenged. My Department has been working closely with the Competition and Markets Authority to alert it to any cases where there may be market abuse and provide evidence to support this, but we also need to tackle it within our framework for controlling the cost of medicines and close the loophole of de-branding medicines. Although the Government’s existing powers allow us to control the price of any health service medicine, they do not allow controls to be placed on unbranded generic medicines where companies are members of the voluntary PPRS scheme. Today, most companies have a mixed portfolio of branded medicines and unbranded generic medicines. For that reason, all the manufacturers of the unbranded generic medicines mentioned in the investigation by The Times are able to use their PPRS membership to avoid government control of their prices.

It should be said that that practice is not widespread, but a handful of companies appear to be exploiting our freedom of pricing for unbranded generic medicines where there is no competition in the market, leaving the NHS with no choice but to purchase the medicine at grossly inflated prices or to transfer patients to other medicines that are not always suitable. Alongside the Government, many in the industry would also like to see this inappropriate behaviour stamped out.

Oral Answers to Questions

Debate between Jeremy Hunt and Kevin Foster

Tuesday 11th October 2016 Commons Chamber

[Mr Hunt]

I do not recognise the picture the hon. Lady paints about opposition to STPs. We need to ensure we have good plans that will deliver better care for NHS patients by bringing together and integrating the health and social care system, and improving the quality of out-of-hospital plans. While we are in a period where those plans have not been published there will obviously be a degree of uncertainty, which we will do everything we can to alleviate, but she is right to say that these plans are very important for the future of the NHS. The process has our full support.

[Kevin Foster (Torbay) (Con)]

The Secretary of State will be aware of the concern in my constituency about the future of Paignton hospital, which prompted hundreds to turn up to a recent meeting. Does he agree with me that it is vital the clinical commissioning group, in publishing its plans, does not just publish what it will remove but the details of what it will replace them with?

Junior Doctors: Industrial Action

Debate between Jeremy Hunt and Kevin Foster

Monday 5th September 2016 Commons Chamber

[Mr Hunt]

I was nervous mentioning the fact that the Government have made 107 concessions when I saw that my hon. Friend might be in the Chamber because I knew that, for him, that would be 107 too many. His broader point is absolutely spot on. The working terms and conditions for Saturdays for junior doctors in this new contract are better than they are for nurses, police officers, fire officers and for those in many other parts of the economy. That is why I think it is a fair deal that everyone should recognise and welcome.

[Kevin Foster (Torbay) (Con)]

I know that the Secretary of State will agree that what sums up this dispute is that, under the existing contract unless the new one is brought in, we could be treated by a doctor working their 91st hour in a week. Does he agree that it is absolutely bizarre to see this level of strike action called when even the BMA’s own council was so divided over whether to support it?

[Mr Hunt]

That is absolutely right. What my hon. Friend is alluding to is the fact that, in the new contract, we are reducing the maximum hours that any doctor can be asked to work in any one week from 91 hours to 72 hours. There are all sorts of other safeguards that benefit safety. He is right. This should not be happening, and I urge the BMA to reconsider.

Junior Doctors Contracts

Debate between Jeremy Hunt and Kevin Foster

Monday 25th April 2016 Commons Chamber

[Mr Hunt]

My hon. Friend speaks wisely, as ever, on this. The fact is that we have moved a very long way to meet one of the BMA’s biggest concerns: that there should still be premium pay on Saturdays. For doctors who work regularly at weekends this is a very good deal—better than that for pretty much anyone else in the public sector. That is why we think that the reasonable thing to do would have been to accept the deal and not to call these wholly unnecessary strikes.

[Kevin Foster (Torbay) (Con)]

I know my right hon. Friend will agree that a dispute over pay cannot justify a threat to withdraw emergency cover. Will he confirm that after the new contract comes in no doctor will be treating patients while working their 91st hour in the same week, and that he will be looking at the availability not just of junior doctors but of other support services that are needed to deliver the seven-day services we have pledged to provide?

[Mr Hunt]

Absolutely. My hon. Friend is quite right to point out that the seven-day NHS vision is not just about junior doctors but about support services for junior doctors that will make the provision of care to their patients at weekends not just better for those patients but much more rewarding for them. It is immensely frustrating for doctors not to be able to get diagnostic tests back quickly because it is the weekend. We want to sort out all those problems. That will be better for doctors and better for patients.

NHS Reform

Debate between Jeremy Hunt and Kevin Foster

Thursday 16th July 2015 Commons Chamber

[Mr Hunt]

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.

[Kevin Foster (Torbay) (Con)]

In Torbay, there are a number of concerns about access to primary care, due to issues of recruitment and retention of GPs. Recognising the comment that the Secretary of State made earlier in response to my hon. Friend the Member for Totnes (Dr Wollaston), how does the Secretary of State see his statement today helping to improve this situation?

[Mr Hunt]

We have some fantastic primary care in Torbay. I remember visiting my hon. Friend during the election campaign and going to a hospice run by an absolutely inspirational lady. We need to build on those traditions, and modern technology offers us an opportunity to go even further. In the end, this is about having a less hospital-centric system and prevention rather than cure, and our great tradition of general practice will be our strongest asset in that change.