Autumn Statement

Debate between Jeremy Hunt and Meg Hillier

Wednesday 22nd November 2023 Commons Chamber

[Jeremy Hunt]

I thank my right hon. Friend. I had extensive discussions with him in the run-up to the statement, including many discussions about the self-employed. Indeed, it was partly his advocacy of the role of the self-employed that made me so enthusiastic about making the national insurance changes that I was able to make.

I hear what my right hon. Friend says about IR35. We took our decision partly because of concerns about avoidance, but I am happy to look at that again. As for the VAT threshold, many other colleagues have made the same point. We do have the highest threshold in any major European country, and, indeed, any G7 country, but there is always this issue of the cliff edge, and my right hon. Friend is right to draw my attention to it.

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

Can the Chancellor confirm that living standards will drop by 3% in the next year?

[Jeremy Hunt]

What I can confirm to the hon. Lady is that a year ago they were predicted to fall by 3.7%, and now the OBR says that they will increase this year by 2.5%.

Oral Answers to Questions

Debate between Jeremy Hunt and Meg Hillier

Tuesday 21st March 2023 Commons Chamber

[Jeremy Hunt]

I thank my right hon. Friend for asking that question, and for all the work she has done in the Department for Work and Pensions on economic inactivity. As she knows, there is an ongoing statutory Government review of the state pension age, and that review will need to carefully balance important factors, including fiscal sustainability, the economic context, the latest life expectancy data, and fairness to both pensioners and taxpayers.

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

One of the key ways to promote economic activity is to make sure that people have a stable, affordable roof over their head. Only last week a constituent visited me who cannot earn enough to be able to afford to rent privately in London, so he is restricted in how much he can work. Surely, if the Chancellor believes in growth, he must see the common sense in investing in social housing?

[Jeremy Hunt]

I do, but I also point out to the hon. Lady that we took a range of other measures in the Budget that will help such people, including increasing the help that we give them to find appropriate work, and helping those who have a long-term sickness or disability to get the support they need to get back into work. Doing all those things will make a big difference.

Autumn Statement

Debate between Jeremy Hunt and Meg Hillier

Thursday 17th November 2022 Commons Chamber

[Jeremy Hunt]

I thank my right hon. Friend for the tremendous support she gave to science and innovation when she was Prime Minister. That is very much something we want to build on as we go forward. We are looking at all the taxes around R&D relief, which we want to encourage. There has been a certain amount of abuse, but we particularly want to encourage use of the relief among small companies, which can often be the most innovative, so I will take away her comments and maybe talk to her separately about what can be done better.

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

The Chancellor has unveiled large numbers —or numbers that seem large—but let us be clear: that £3.3 billion a year is not even Osbornesque funding for the NHS. It is not enough to keep the NHS standing still. Will he level with us and tell us what percentage of the NHS budget that is?

[Jeremy Hunt]

I actually remember the Parliament from 2010 to 2015 because I was Health Secretary for quite a big chunk of it. I apologise to the hon. Lady, given the important role she plays in this House, for not being able to do that kind of maths in my head, but I can tell her that in that period, the NHS budget went up by 0.1% a year, and this is a lot more than that.

NHS Shared Business Services

Debate between Jeremy Hunt and Meg Hillier

Tuesday 27th June 2017 Commons Chamber

[Mr Hunt]

I can absolutely confirm that.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

I am pleased that the Secretary of State at least acknowledges that this was incompetent but, crucially, does this not run deeper? Problems were first raised in January 2014, and then again internally by an administrator in June 2015. He found out, as Secretary of State for Health, only in March last year, and the Public Accounts Committee found out and was able to look at this only in September, because information was released on the final day that Parliament sat last summer. He talks about transparency, but does he not think there are deeper lessons to be learned here not only about transparency but about how the NHS supports whistleblowers?

[Mr Hunt]

There are two big lessons that we need to learn. First, why did the company have no internal systems in place to deal with the fact that from 2011 the mail was building up into a backlog? According to the NAO report, the situation was not escalated to the chief executive’s level until the end of 2015. That is wholly unacceptable. Secondly, it is also unacceptable that we did not have the assurance systems in place that would have allowed us to know that a backlog was building up. That is why it is so important that lessons are learned.

Oral Answers to Questions

Debate between Jeremy Hunt and Meg Hillier

Tuesday 7th February 2017 Commons Chamber

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

T7. Last year, hospital trusts were urged by Department of Health officials to raid their capital budgets to cover resource funding. Does the Secretary of State think that is a good way forward, and what instructions is he giving officials this year?

[Mr Hunt]

I recognise that it is not a sustainable position to have to do that. Pressures on the frontline meant that it had to happen, but we do need to invest for the future and I agree with the hon. Lady that capital budgets are very important.

Oral Answers to Questions

Debate between Jeremy Hunt and Meg Hillier

Tuesday 15th November 2016 Commons Chamber

[Mr Hunt]

May I commend my hon. Friend for his great persistence in flying the flag for homeopathic medicine? While we must always follow the science in the way we spend our money on medicines, as I know he agrees, he is right to highlight the threat of antibiotic resistance and the need to be open to every possible way of reducing it.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

Today I publish my first annual report as Chair of the Public Accounts Committee, in which I conclude that there is a sustainability crisis in the funding of the NHS. Surely the Secretary of State will agree—he has made some comments in the media that suggest he is becoming aware of this—that he will need to lobby the Chancellor for a better settlement in the autumn statement. Will he update the House on his negotiations?

[Mr Hunt]

I am sorry to disappoint the hon. Lady but I do not update the House on Government discussions which happen in the run-up to every Budget and autumn statement. What I would say to the hon. Lady is that I am not someone who believes that the financial pressures that undoubtedly exist in the NHS and social care system threaten the fundamental model of the NHS. What they remind us all of is that what we need in this country is a strong economy that will allow us to continue funding the NHS and social care systems as we cope with the pressures of an elderly population. That, for me, is the most important challenge—the economic challenge that will allow us to fund the NHS.

Junior Doctors: Industrial Action

Debate between Jeremy Hunt and Meg Hillier

Monday 5th September 2016 Commons Chamber

[Mr Hunt]

I have a stunning new ministerial team, two of whom I am pleased to see here today, but I wish to take this moment to say how much I enjoyed working with my right hon. Friend last year. Then, as now, his advice and thoughts are very wise. The Government have made 107 concessions, and the BMA might like to think what signal it sends if that many concessions are made, an agreed deal is reached with the union leadership and the reaction then is for the most extreme strike in history to be called. What encouragement will that give to other Ministers to be moderate and reasonable in their negotiations with unions? The position being taken is preposterous and many other choices could have been made when dealing with losing the ballot, but he is right in what he says.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

A lack of workforce planning and weak financial management have led to staff shortages, which have been a major contributor to this dispute. The Department of Health accounts and NHS England accounts, which came out on 21 July, underlined that weakness in financial planning, with the Comptroller and Auditor General saying clearly that he had real concerns about the future sustainability of NHS funding. We have, however, heard the Secretary of State say again today that the £10 billion available is to solve the issue about the seven-day NHS, but we have also heard that money promised for many other things by the head of NHS England. Does the Secretary of State really have a plan for the financial sustainability of the NHS? If so, what is it?

[Mr Hunt]

We do and we are implementing it. I know that the hon. Lady has looked at this in great detail, and I simply say, in broad terms, that following the tragedy of what happened at Mid Staffs the NHS was very honest about how some of the poor care there was happening in other places and NHS trusts decided that they needed to have more staff in their hospital wards. The poor workforce planning that she talked about, which goes back many decades in the NHS, meant that the result was an explosion in the use of agency staff, the cost of which rose to more than £3.5 billion in the last financial year, which has put huge pressure on finances. The lesson that we must take away, not just for the junior doctors’ strike, but for financial sustainability, is that we need to be better at workforce planning and training up the number of doctors and nurses that we need.

Oral Answers to Questions

Debate between Jeremy Hunt and Meg Hillier

Tuesday 10th May 2016 Commons Chamber

[Mr Hunt]

I think the hon. Gentleman is right that we have historically not trained enough staff to work in the NHS and been over-optimistic about the staff needs. That is why, in this Parliament, we will be training over 11,000 more doctors as a result of the spending review, and 40,000 more nurses.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

In the Public Accounts Committee, which I sit on with the hon. Member for Southport (John Pugh), we have repeatedly come to this question about agency staffing. The key thing is, as he says, that the establishment level for acute hospitals is always under par, because the budget set from the centre is never enough to meet it. Will the Secretary of State go and take a serious look at this issue, and stop this myth that it is just down to the rates paid? That is part of the problem, but it is not the main problem.

[Mr Hunt]

Perhaps I can give the hon. Lady some comfort. I recognise that there is a big mountain to move, but the changes we made last year were not just about changing the rates paid to agencies. They were also about capping the amounts agencies can pay their own staff, because we think it is incredibly divisive inside hospitals to have two nurses doing exactly the same work, but one being paid dramatically more than the other. We are also capping the total amount hospitals can spend on agency staff. The result is that the monthly spend on agency staff is now falling and we are on track to reduce the agency bill by about £1 billion in this Parliament.

A and E (Major Incidents)

Debate between Jeremy Hunt and Meg Hillier

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

There are two things. First, as I am sure the hon. Lady does, I take every opportunity to praise the work being done by staff through a very difficult and challenging period. Secondly, the practical way in which we can most help them is to try to recruit more staff where we possibly can, and to make sure that resources are not a barrier to recruiting more staff. We have about 5,000 more nurses in hospitals compared with 12 months ago, and that has made a difference.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

The Secretary of State stood up and said that he takes personal responsibility for everything that happens in the NHS. Given that his Government undertook a costly and time-consuming reorganisation, does he now regret that people took their eye off the ball in relation to the highly predictable population shifts that have led to the pressure on A and E?

[Mr Hunt]

I am afraid that that is an example of the politicisation of the NHS that people find so distressing. Those reforms were not enacted in Wales, which is run by the hon. Lady’s party, and A and E performance there is significantly worse. It does not make any logical sense to blame A and E performance on those reforms.

A and E and Ambulance Services

Debate between Jeremy Hunt and Meg Hillier

Thursday 18th December 2014 Commons Chamber

[Mr Hunt]

My hon. Friend is right. The NHS wants to know that it has a Government who have a long-term plan for the NHS, who are prepared to fund that plan and who have thought about the long-term solutions. Better access to GPs is one of the key things, as is access to a GP who actually knows about the patient and their condition. Sadly, we lost named GPs following the changes to the GP contract in 2004, but I am proud to say that, from next April, we will be bringing them back.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

The Secretary of State has accused Opposition Members of political scaremongering. Perhaps I should refer him to the Public Accounts Committee’s report on out-of-hours services, which showed cost-shunting to the ambulance service by out-of-hours providers, and to our recent hearing on A and E, which revealed an incredible waste of public money and a lack of joined-up thinking. That is not scaremongering; those are facts from the National Audit Office being interpreted by Members from all parties.

[Mr Hunt]

Yes, and those are the facts that we are acting on with our winter plans. We are trying to reduce the amount of money spent on locum staff and to increase flow going into and out of A and E departments. There is a huge amount of practical things that can be done. I have absolutely no problem with dealing with constructive suggestions from both sides of the House on how we can help A and E departments to get through a difficult winter. It is unacceptable, however, constantly to turn this issue into a political football, when everyone knows that the pressures of an ageing population are making life very difficult for NHS staff and that those staff have a Government who are doing everything they can to support them.

Oral Answers to Questions

Debate between Jeremy Hunt and Meg Hillier

Tuesday 21st October 2014 Commons Chamber

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

The Secretary of State makes great play of protecting the NHS budget, but NHS England, the Nuffield Trust and his hon. Friend the Chair of the Health Committee all agree that it needs another £30 billion investment, so how can he tell people that the NHS is safe under his watch?

[Mr Jeremy Hunt]

We have not just protected the NHS budget, but increased it in real terms, which I think is a huge achievement given the state of the economy we inherited. [Interruption.] I simply say to the hon. Lady that the way to protect and secure NHS funding for the future is by making sure that there is a strong economy to pay for it. That is the single most important thing of all.

Urgent and Emergency Care Review

Debate between Jeremy Hunt and Meg Hillier

Tuesday 12th November 2013 Commons Chamber

[Mr Hunt]

We have put in an additional £2 billion—that makes a total of £3.8 billion being invested to support the social care budget. That is significant because it is recurring expenditure. We have shown our commitment by continuing to support the social care system through this Parliament. The trouble with underspends is that they depend on how many resources we have in any particular year. It is therefore much harder to invest off the back of them.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

The Secretary of State has spoken about the importance of continuing care from one’s own GP to limit admissions to A and E, yet in Hackney, when GPs tried to take over and run the out-of-hours service, the commissioners were paralysed by the fear of legal challenge and, rather than putting patients’ interests first, put the rich lawyers’ interests first.

[Mr Hunt]

If I may say so, it was the Government whom the hon. Lady supported who removed the responsibility for out-of-hours care from GPs. I welcome and want to help any GPs who want to take it back.

Accident and Emergency Departments

Debate between Jeremy Hunt and Meg Hillier

Tuesday 10th September 2013 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. I am astonished that the Labour party seeks to defend those changes to the GP contract, which got rid of named GPs, removed responsibility for out-of-hours services from them and broke the personal responsibility that the best GPs always wanted to feel for the people on their list. In fact, many brave practices refused to go along with those contract changes and continue to have named GPs. There is clear evidence that people who have named GPs use hospital services less. If we are going to give older people the right care, we need to undo those damaging changes.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

The Secretary of State has spoken confidently about how his changes will make a difference in the short term, but over the weekend the BBC revealed that A and E departments are, on average, 10% understaffed and that one trust in London is 75 nurses down. Despite what he has announced today, how can he be sure that those vacancies can be filled?

[Mr Hunt]

The hon. Lady is right that there are staff shortages, and it is not because trusts do not want to employ people; it is because it is difficult to find people to fill all those vacancies. Those are some of the longer-term problems that we will have to address when looking at how to make working in A and E more attractive. There are a number of things we can do in the short term to alleviate the pressure, such as putting GPs on the front desks at A and E departments so that people can get help, ensuring that the social care system is open seven days a week so that people can be discharged on Saturdays and Sundays, and extending consultant cover late into the evenings and at weekends, when A and E departments are busiest. I think that it is right that we do those things straight away while trying to address the longer-term problems.

Oral Answers to Questions

Debate between Jeremy Hunt and Meg Hillier

Tuesday 16th July 2013 Commons Chamber

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

Since 2010, thousands of NHS staff have left the NHS with big, fat redundancy cheques, only to go through the revolving door and get new jobs in the NHS, often months later. Will the Secretary of State tell us how much has been spent on redundancy payments and whether he regrets that waste of NHS money?

[Mr Jeremy Hunt]

The hon. Lady asks that question as if that kind of thing never happened under Labour. The answer is that it is not acceptable, which is why we are changing the rules to ensure that people cannot get payoffs and then walk straight into another NHS job. The other answer is that the reorganisation that she criticises means that we have put more money on the front line, including for 6,000 more doctors, which I think was the right thing to do.

A and E Departments

Debate between Jeremy Hunt and Meg Hillier

Tuesday 21st May 2013 Commons Chamber

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

The Secretary of State seems to have decided that changing GP out-of-hours services is part of the solution to the A and E crisis. In the Public Accounts Committee a few weeks ago, we heard from clinical commissioning groups that they fear a single tender just to GPs because of the threat of legal action. We have seen that played out in Hackney, where GPs have been knocked back by the clinical commissioning group. When will the right hon. Gentleman get a grip on his Department and let the CCGs have the freedom to commission local GPs rather than fear the legal action that prevents them from doing so?

[Mr Hunt]

I want them to have that freedom, but they are operating under the same constraints as primary care trusts, which means having to abide by European procurement law. It is the Labour party that is against any changes in our relationship with the European Union.

Oral Answers to Questions

Debate between Jeremy Hunt and Meg Hillier

Tuesday 16th April 2013 Commons Chamber

[Mr Jeremy Hunt]

I would be absolutely delighted to do that. I had an excellent visit to Kettering hospital that was hosted by my hon. Friend, and I saw at first hand just how hard people are working in tough circumstances, with big increases in A and E admissions causing a great deal of pressure throughout the hospital. One had a sense at the hospital that there was a mission to turn things around and make things better, and a management team who were totally committed to doing that. I congratulate them and all the front-line staff who are doing such an important job for the people of Kettering.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

A year ago, GPs in Hackney bid to run the out-of-hours services. Earlier this year, they were told that it had to be tendered because the board was fearful of legal challenge from private health companies. Who is running the NHS—the Secretary of State or the private health company lawyers?

Oral Answers to Questions

Debate between Jeremy Hunt and Meg Hillier

Tuesday 15th January 2013 Commons Chamber

[Mr Hunt]

NHS funds are independently decided by the NHS Commissioning Board, and I know that is a key concern of the board. I visited Kettering hospital, so I know that it is a very busy hospital coping well in difficult circumstances.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

Penalties on readmission rates were introduced to improve clinical practice, but patients suffering from sickle cell and thalassaemia in my constituency and elsewhere cause hospitals to be fined for readmission, even though it is often in the patient’s best clinical interest. Will the Minister once again reconsider exempting sickle cell and thalassaemia from the penalty?

Oral Answers to Questions

Debate between Jeremy Hunt and Meg Hillier

Tuesday 23rd October 2012 Commons Chamber

[Mr Hunt]

My right hon. Friend is absolutely right. By 2018, nearly 3 million people will have not one but three long-term conditions. All too often, the system treats them on a disease or condition basis, and not as a human being who needs an integrated care plan. That is the route to lower costs, but it is also the route to transformed care.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

The Public Accounts Committee has heard that, of 20 trusts that needed to improve their diabetes care, only three took the accepted help. How will the Secretary of State ensure that care through health providers meets the grand targets he has set for himself?

[Mr Hunt]

The hon. Lady is absolutely right to point out that the consistency of provision is not good, but we will be publishing a diabetes action plan that will try to ensure more consistent provision throughout the NHS. We also need to raise our sights as to what is possible, because as I have mentioned, a third of the population have long-term conditions, and we can do much better at helping people to live with those conditions in a way that promotes their independence.

Oral Answers to Questions

Debate between Jeremy Hunt and Meg Hillier

Monday 21st June 2010 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for his question. We are looking at the independent analysis of precisely the factors that he mentions. We have a strong desire not to do anything that would restrict investment in grass-roots sport, and we will announce a decision by July.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

We have heard a bit about the legacy for sport in the Olympics, but in my constituency we are seeking the legacy of skills post-2012. What discussions is the Secretary of State having with other Departments, because decisions taken by his Department now could have a major impact on the legacy delivered by others after 2012?