NHS Major Incidents

Debate between Jeremy Hunt and Paul Burstow

Wednesday 28th January 2015 Commons Chamber

[Mr Hunt]

I can reassure the hon. Lady that we have provided a huge amount of extra money to deal with the problems in the wake of what happened at the former Mid Staffs Trust. We are continuing to give every support we can to Walsall and Stoke and other trusts. We have more doctors and more nurses and major changes are happening. The problem in Mid Staffs went on for four long years, and we do not want to wait that time before sorting out the problems.

[Paul Burstow (Sutton and Cheam) (LD)]

Clearly, patient safety must be paramount. We must ensure that any guidance supports the ambition that exists on both sides of this House for a more integrated system that takes into account the capacity across the whole service. Does the Secretary of State agree that what we also need is clarity and certainty over how the NHS and social care will be funded over the life of the next Parliament so that we realise the ambition and potential of the Care Act 2014 and we deliver Simon Stevens’s NHS plan?

[Mr Hunt]

I totally agree with the right hon. Gentleman. I am sure, too, that he will agree with me that the best way to give the NHS certainty over funding in the future and the increase in funding that it needs to implement the five-year forward view is a strong economy, and it is only this Government who are able to deliver that.

Oral Answers to Questions

Debate between Jeremy Hunt and Paul Burstow

Tuesday 13th January 2015 Commons Chamber

[Mr Hunt]

I am sorry, but this says it all about the Labour party’s campaign. It talks about savage cuts to social care and then the shadow Chancellor says he is not going to do anything to reverse them. It really has to be consistent. On the walk-in centre, Labour Members were saying earlier today that they want GPs present in every A and E department and that is exactly what has happened at Salford Royal. The walk-in centre was closed so that GP services could be moved closer to the A and E at that hospital. Perhaps the hon. Lady should talk to Sir David Dalton, her local chief executive, who will tell her why this is doing a better job for her constituents.

[Paul Burstow (Sutton and Cheam) (LD)]

The Secretary of State is absolutely right to highlight the success of the coalition in delivering a better economy, which is allowing us to invest £2 billion from April this year. Will he address the point put to him about the importance of social care, and seriously consider investing some of that £2 billion in social care, not just in our health care system.

[Mr Hunt]

May I reassure my right hon. Friend by saying that I agree with him? I want to pay tribute to him for campaigning on this issue for some time, both in office and out of office. The truth is that there is a strong link between what happens in the social care system and what happens in the NHS. This year, we are putting £1.1 billion of support from the NHS into the social care budget. Next year, that increases by another £2 billion. We need to recognise that these two systems need to be brought together as one system—and with the better care fund, that is what is happening.

A and E (Major Incidents)

Debate between Jeremy Hunt and Paul Burstow

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

I agree entirely with the right hon. Lady. The better care fund is a first step, but it is only a first step. It is happening from this April, but we have the NHS England five-year forward view, which is the long-term plan to improve community care. I agree that Salford Royal is an excellent hospital. It had £3.5 million to help it deal with winter pressures this year, but it is also a good example of how integrated care between the acute trust and local community services can make a real difference, and it is delivering some of the safest care in the country.

[Paul Burstow (Sutton and Cheam) (LD)]

May I pay tribute to the accident and emergency staff at my local hospital, St Helier, whom I met on Monday? One thing they made clear to me is that although there is no single cause of the pressures on A and E at the moment and there is therefore no single solution, they want certainty about the long-term plans for NHS funding. Although the down payment of £2 billion announced in the autumn statement was very welcome, will the Secretary of State say whether the Government or any Government in whom he might participate in the future will deliver the additional £8 billion necessary to secure the closing of the funding gap that Simon Stevens identified?

[Mr Hunt]

When we did the autumn statement last year, we asked Simon Stevens and NHS England how much they needed for their plan next year and they told us it was about £2 billion, so we made that commitment. We also said that that was a down payment on delivering the entire plan, not a one-off payment. I agree about the importance of long-term certainty over funding, but the most important thing in that regard is to have a strong economy that can deliver the money that will support our NHS. It is only Government Members who have shown that they are capable of delivering that strong economy rather than the instability that would come from disastrous economic policies.

A and E and Ambulance Services

Debate between Jeremy Hunt and Paul Burstow

Thursday 18th December 2014 Commons Chamber

[Mr Hunt]

The hon. Gentleman is absolutely right to make that point. There has been a lot of support for the NHS today from Liberal Democrats. If they are ever considering which is the best partner to back the NHS at any hypothetical time in the future, they should know that there is only one party that can provide the strong economy to fund a strong NHS.

[Paul Burstow]

My compliments of the season to you, Mr Speaker.

May I draw attention to the fact that people with mental health problems have double the attendance rates in accident and emergency departments compared with the general population? Given that fact, is it not strange that successive Governments have not invested in the evidence? If we invest in liaison psychiatry, we can reduce the numbers needing to go to A and E and give them better results as well. Is it not time that this Government did that and did it even more than they are planning to do?

[Mr Hunt]

Yes, my right hon. Friend is absolutely right. I can reassure him that we are investing more in liaison psychiatry both this year and next year. The Minister of State, my right hon. Friend the Member for North Norfolk (Norman Lamb), has particularly championed that, as it is a very good way in which to reduce pressure on A and E departments.

NHS (Five Year Forward View)

Debate between Jeremy Hunt and Paul Burstow

Monday 1st December 2014 Commons Chamber

[Mr Hunt]

I am always happy to confirm that a Guardian story is wrong. Let me tell the hon. Gentleman that there was no plan to downgrade the majority of A and Es. The plan is to invest in A and Es—to continue with broadly the same number of A and Es as we currently have but to recognise that some of them will need to specialise in different things. We will stick to that plan—it is a good one.

[Paul Burstow (Sutton and Cheam) (LD)]

I very much welcome the statement and, in particular, the Secretary of State’s ambition that Britain should become the best place in the world to grow old in. Given that home care is an essential part of maintaining frail older people and enabling them to remain in their own homes, and given that well-paid, well-trained and well-motivated home care staff enable people to stay in their own homes and families to juggle work with caring responsibilities, will he direct some of the extra £2 billion to the better care fund, so that it goes directly into social care so that these services can actually be provided?

[Mr Hunt]

First, I agree with the point that my right hon. Friend is making: home care is going to become an increasingly important part of what the NHS and social care systems deliver. I want them to deliver it in an integrated, joined-up way, and £200 million of the £1.7 billion going to the NHS front line is to help develop new models of care. I think that improved home care could be a very real way we do that.

Five Year Forward View

Debate between Jeremy Hunt and Paul Burstow

Thursday 23rd October 2014 Commons Chamber

[Mr Hunt]

I welcome the hon. Lady to her place. This report says something with which this Government very strongly agree, which is that we need to reverse the shift that there has been over many decades of investment away from community care towards hospital care. It is really important that we focus on the role of GPs. We do not want to force all GPs to become employees of hospitals, but we would like to back them, so we have brought back personal responsibility for GPs for every single NHS patient as an important first step in that direction.

[Paul Burstow (Sutton and Cheam) (LD)]

This is an important report, which must not turn into another political football. We should focus on what it says and make that the basis for a real debate about our NHS. There are 23 references in this report to mental health. Parity of esteem is an established idea, but it has not yet been incorporated into NHS practice, so we still have further to go. Does the Secretary of State agree that another area in which we need to go further is perinatal mental health, where the cost to society, to mothers and to generations runs into billions? If the NHS could do a bit more in that regard, it would make a big difference.

[Mr Hunt]

My right hon. Friend is absolutely right. We know that perinatal mental health problems have a big impact on the child as well as on the mother. This report says that we must stop looking at conditions such as mental health as separate to physical health conditions. We need to look at people’s whole condition in the round. If we start to do that, we will make the NHS sustainable by making the kind of investments that will bring down the overall cost of treatments. Putting mental health centre-stage in that approach will be an important part of our strategy.

Special Measures Regime

Debate between Jeremy Hunt and Paul Burstow

Wednesday 16th July 2014 Commons Chamber

[Mr Hunt]

The right hon. Gentleman makes some important points. I will start with the point that provides a broader lesson for the NHS. Not taking our foot off the gas is really important. This is the start of a very long journey. I said last year that it would take about three years to turn around a hospital where the wrong culture has become entrenched.

I pay tribute to the leadership at East Lancashire Hospitals NHS Trust. The CQC report said that the staff on the front line now feel more supported, more empowered to take decisions and more able to raise concerns. If there is one thing that we have learned, it is that successful hospitals make it easy for their staff to speak out and support them in speaking out. The hospitals with problems are the ones where people feel bullied and intimidated when they speak out. I am delighted with the progress that has been made.

In respect of finances, this is a challenging time for finances across the NHS. I simply say that, as I am sure the leadership of the right hon. Gentleman’s trust recognise, the most expensive thing of all is delivering poor care. The most important way of saving money is ensuring that the care that is delivered is safe.

[Paul Burstow (Sutton and Cheam) (LD)]

I very much welcome the changes the Secretary of State has announced on social care inspections. However, standards and enforcement alone are not sufficient. Does he agree that we need to look at the support that is provided to organisations so that they can change before they get to a point of crisis? If so, will he look at the work of My Home Life, which runs programmes to transform the lives of people in care homes and improve their quality of life by working with staff in a different way? I commend that work and hope that he looks at it.

[Mr Hunt]

I am happy to do that. I agree with the right hon. Gentleman. I would like to see a lot more innovation. Even in the best care homes, which deliver good care by today’s standards, there is room for much more innovation and imagination in seeing how we can make people’s last years ones that they really enjoy. I have seen some amazing dementia care homes that break the mould. I am very happy to look at the work of that organisation. I am sure that there is a lot we can all learn.

Oral Answers to Questions

Debate between Jeremy Hunt and Paul Burstow

Tuesday 15th July 2014 Commons Chamber

[Paul Burstow (Sutton and Cheam) (LD)]

14. What the timetable is for publication of a successor to the current national dementia strategy.

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

Dementia is one of the most important issues we face at the moment and we are having detailed discussions with stakeholders about the best way to ensure that the very successful Prime Minister’s challenge on dementia continues into the next Parliament.

[Paul Burstow]

I am grateful for that answer and have no doubt that the continuation of the challenge is very important, but both the Prime Minister and the Secretary of State have told the House from the Dispatch Box that there will be a successor to the national dementia strategy. My question was very straightforward. Is there a timetable for delivering that strategy, given that the current strategy ends this year?

[Mr Hunt]

I should clarify for my right hon. Friend that the Prime Minister’s challenge was a successor to the national dementia strategy. The Prime Minister’s challenge finishes at the end of this Parliament and that is why we are having discussions about what should succeed it, because we all have an interest in ensuring that we maintain the tremendous momentum of the past few years.

--- Later in debate ---

[Mr Hunt]

I am happy to do so, because the service that he describes—I have not seen the details—sounds totally unacceptable.

[Paul Burstow (Sutton and Cheam) (LD)]

T9. Given that last year, more than 7,500 people with a mental health crisis found themselves in police cells rather than anywhere appropriate such as a hospital, given that 263 of those people were children and young people, and given that they stayed for 10 and a half hours in a police cell, is it not time that we took the evidence of street triage, which we know works, and rolled it out across the country?

Oral Answers to Questions

Debate between Jeremy Hunt and Paul Burstow

Tuesday 25th February 2014 Commons Chamber

[Mr Hunt]

I can assure the right hon. Lady that this Prime Minister is here to stay. Indeed, I can also reassure her that the national dementia strategy is here to stay. As she has announced that she is stepping down at the end of this Parliament, may I thank her for her campaigning on dementia, which, I think, came from a family connection with the issue? She has attended many of my dementia meetings and the G8 dementia summit. She has made a really important contribution, and I thank her for that.

[Paul Burstow (Sutton and Cheam) (LD)]

May I follow up on the question that the right hon. Lady has just asked? The Secretary of State has said that the national strategy is here to stay and that is very welcome, but the national strategy was drafted with the intention that it would expire this year. It would be useful if he now indicated the intention to refresh and update it so that we have a clear road map for at least the next decade.

[Mr Hunt]

I know that my right hon. Friend showed great interest in this issue when he was in my Department. When I say that the strategy is here to stay, I mean that it is here to be refreshed and updated. We are subscribing to some big new ambitions, including that by the time of the next election two thirds of people with dementia will be diagnosed and have a proper care plan and support for them and their families. That is a big improvement on the 39% of people who were diagnosed when we came to office. There is much work to do, but I assure him that we are absolutely committed to delivering.

Oral Answers to Questions

Debate between Jeremy Hunt and Paul Burstow

Tuesday 14th January 2014 Commons Chamber

[Mr Hunt]

We are very conscious of that, which is why we introduced the triple lock on pensions and protected pensioners from the brunt of the cuts that this Government, sadly, have had to make to deal with the deficit we inherited.

[Paul Burstow (Sutton and Cheam) (LD)]

Dementia is the disease that people over the age of 50 say they fear the most and it is one of the biggest challenges for our society and for our health and social care systems. One of the ways to meet that challenge is through research, and the coalition Government is to be commended for the doubling of spending on research into dementia by 2015. However, it will take another decade, until 2025, for this Government or a future one to double it again. Will he reconsider that? Surely there needs to be greater ambition and greater pace to deliver the cures, the solutions and the prevention we need.

[Mr Hunt]

I commend my right hon. Friend for his work on dementia when he was working at the Department of Health. We are doing our bit as a country but we will not be able to do it on our own. Dementia is an incredibly difficult disease to crack, which is why, in December, the Prime Minister hosted a G8 summit to encourage other leading countries to increase their investment in dementia. We secured a commitment that they would significantly increase that investment and we want to encourage the private sector to do the same.

Mid Staffordshire NHS Foundation Trust

Debate between Jeremy Hunt and Paul Burstow

Tuesday 19th November 2013 Commons Chamber

[Mr Hunt]

I do not have the results in front of me, but I am happy to supply them. I want to take up the right hon. Gentleman’s point about avoidable deaths, because one of the changes we want to make today is to avoid the temptation, when there is an avoidable death, for people on the front line to say that it was unavoidable. We are trying to create the structures that make it easy for people to speak out if they think that a death was avoidable and to ensure that they are encouraged to do so.

[Paul Burstow (Sutton and Cheam) (LD)]

I very much welcome the introduction of a statutory duty of candour, which the Minister of State, my hon. Friend the Member for North Norfolk (Norman Lamb), wrote into our 2010 manifesto. May I ask the Secretary of State about his plans to prosecute if the fundamental standards are breached, which is an important step with regard to corporate criminal accountability? In drafting those standards, will he ensure that advice is sought from the Director of Public Prosecutions, the Health and Safety Executive and others to ensure that the wording is clear and fit for purpose so that when a prosecution takes place there is no hiding behind the language in those fundamental standards?

[Mr Hunt]

We will absolutely do that. We are in the process of a very big consultation to ensure that we get the definitions of the fundamental standards absolutely right, but we also want to try to create a culture that means we do not get to that point in the first place. One of the problems we had with the current system is that the definition of success for a hospital tended to be about meeting waiting time targets and financial balance, rather than caring for patients properly. We want to re-engineer the system through the new inspection regime so that a hospital cannot be good or outstanding unless it is delivering good or outstanding care.

Urgent and Emergency Care Review

Debate between Jeremy Hunt and Paul Burstow

Tuesday 12th November 2013 Commons Chamber

[Mr Hunt]

Perhaps the right hon. Gentleman might like to hear what the British Medical Association said yesterday about walk-in centres. The BMA is not known for its support of Government policies, but it said that urgent care centres

“were often opened in places with little patient demand…The result has been a lot of money being spent on these facilities with some now closing because commissioners have found there is not sufficient demand”.

That is the problem we are sorting out.

[Paul Burstow (Sutton and Cheam) (LD)]

One long-term cause of pressures in our A and E departments is the lack of parity of esteem between physical and mental health. Does the Secretary of State agree that it is unacceptable that two thirds of people experiencing a mental health crisis do not get access within four hours to a psychiatric assessment? Was it not a failure of the previous Government not to set access standards for people with mental health problems? Is it not time, as the mandate does today, to deliver just that?

[Mr Hunt]

My right hon. Friend is absolutely right about that. We do need parity of esteem between mental and physical health. The situation puts particular pressure on A and E departments, including the one closest to this House, at St Thomas’s hospital, where people said that the biggest single worry they have and the biggest single thing that makes it difficult for them to meet their targets is the lack of quick access to psychiatric services. We are looking at this matter and he is right to highlight it.

Changes to Health Services in London

Debate between Jeremy Hunt and Paul Burstow

Wednesday 30th October 2013 Commons Chamber

[Mr Speaker]

Order. I should just say to the House, almost as a courtesy, that I am prioritising London Members. However, non-London Members should take heart. If they exercise their knee muscles they may have an opportunity in due course.

[Paul Burstow (Sutton and Cheam) (LD)]

The hon. Member for Hackney North and Stoke Newington (Ms Abbott) was absolutely spot on in her question to the Secretary of State, not least with regard to variability and accessibility of GP services. A few months ago, I asked him whether he would make it a requirement for plans to expand out-of-hospital care to be in place before hospital changes occur. Can I take it from his statement that it is his intention that, when recommendations from the Independent Reconfiguration Panel are before him, he will require plans to build capability for community health services and primary care services to be in place before they go ahead?

[Mr Hunt]

The right hon. Gentleman campaigns assiduously for his constituents. I recognise that there are worries about potential changes in his constituency, an issue he often raises. Yes, we must ensure, if there are transitions or changes, that proper plans are in place to ensure they can be made safely. If he reads the report, he will derive a great deal of comfort from the stress the IRP puts on the necessity of having proper alternative provision in place before any changes are made.

Oral Answers to Questions

Debate between Jeremy Hunt and Paul Burstow

Tuesday 11th June 2013 Commons Chamber

[Mr Hunt]

We do have a strategic approach, but we also have some very important safeguards that any big change in approach has to go through before it is implemented. That is why I asked for a report from the Independent Reconfiguration Panel on the plans for north-west London, and I will consider that report very carefully before I make any decision.

[Paul Burstow (Sutton and Cheam) (LD)]

When considering issues relating to A and E closures, particularly the proposed closure of the A and E department at St Helier hospital, which serves my constituents, will the Secretary of State ensure that those who propose such plans make sure that there is also a costed plan for developing out-of-hospital care, which is an essential prerequisite for any changes to acute services?

[Mr Hunt]

I agree with my right hon. Friend on this issue. It is extremely important that all these plans take a holistic view both locally and nationally. That is why, in looking at how to resolve the A and E issues we have faced and the severe pressures last winter, we are looking not just at what happens inside A and E departments, but at primary care alternatives and the integration of social care services, which are all equally important.

Mid Staffordshire NHS Foundation Trust

Debate between Jeremy Hunt and Paul Burstow

Tuesday 26th March 2013 Commons Chamber

[Mr Hunt]

Yes, it will be, as it will to providers in the social care sector.

[Paul Burstow (Sutton and Cheam) (LD)]

Can the Secretary of State confirm that it is his intention that the statutory duty of candour—and the introduction of a ratings system—will apply to home care and care homes, not just NHS providers?

[Mr Hunt]

Yes, I can confirm that. My hon. Friend is right, because part of the big change that we need is to see a big increase in provision of domiciliary care, and an increase in the standard of that care.

Social Care Funding

Debate between Jeremy Hunt and Paul Burstow

Monday 11th February 2013 Commons Chamber

[Mr Hunt]

I am making the announcement today, so we have to give the financial services industry some time to respond to the proposal. However, the indications are encouraging, and I think that we will all see, in plenty of time for the 2017 start of this plan, what products are available. There may be separate products, but it may also be something that becomes part of people’s pension planning. In the same way that people decide what arrangements they want in their pension for an annuity and for a lump sum payment, payment towards these costs up to the level of the cap may become another part of the pension plan. We need to let the pension and insurance industries have the time to respond and to come up with these plans.

[Paul Burstow (Sutton and Cheam) (LD)]

Does my right hon. Friend agree that, in evaluating these proposals, the public need to understand the nasty little secret at the heart of social care in this country, which is that we have among the harshest of means tests and that that leads to people facing catastrophic costs? Will he also ensure, in making these reforms, that he provides the Joint Committee examining the draft Care and Support Bill with all the necessary details of how this will be implemented?

[Mr Hunt]

I would be happy to do that and I am grateful to the right hon. Gentleman’s Committee for its work to date on pre-legislative scrutiny. He will understand why I was not able to go into details when we met to discuss the Bill last week. He is absolutely right: dealing with that threshold is one of the most important things and I am sure we will benefit from good scrutiny, as we have done to date.

Oral Answers to Questions

Debate between Jeremy Hunt and Paul Burstow

Tuesday 15th January 2013 Commons Chamber

[Mr Hunt]

I think that the hon. Lady might perhaps read Lord Leveson’s conclusions before she starts hurling about allegations, many of which came from her side of the House, that were later shown to be totally false. With respect to the decision on Lewisham hospital, I thought that we had a very useful meeting last night with the south London MPs who are directly affected. She understands that the process put into law by her party and her Government means that I cannot reopen the entire consultation and start seeing some groups without seeing all groups that are affected. That is why I am limiting the discussions I have with colleagues, but I think that that is the right thing to do.

[Paul Burstow (Sutton and Cheam) (LD)]

The evidence is compelling that improved access to talking therapies for children and adults makes a huge difference to their mental health. Will the Minister therefore assure me and the House that the NHS Commissioning Board will have the necessary dedicated teams to ensure that the adult improving access to psychological therapies—IAPT—programme is delivered and that the new children’s programme is, too?

NHS Commissioning Board (Mandate)

Debate between Jeremy Hunt and Paul Burstow

Tuesday 13th November 2012 Commons Chamber

[Mr Hunt]

The approach the reforms take is this: when there are inequalities in treatment, and when one hospital is particularly good at certain operations and another hospital is not as good, the best way to drive up performance is to make that information available in a way that has never happened before. More than anything, peer review drives the NHS. A very important part of the programme will be to roll out plans similar to those we have rolled out for cardiothoracic surgery, for which a performance comparison by consultant team, not just by hospital, has led to a dramatic improvement in survival rates from heart operations. We need to roll that out across many other disciplines. We also need to be able to compare local GP-led group with local GP-led group, and local authority with local authority. That will be a far more effective way of driving change than the old top-down way. That was tried under different Governments many times and in many ways, but it was never as successful as it was meant to be.

[Paul Burstow (Sutton and Cheam) (LD)]

I welcome the statement, and particularly the actions that are being taken to deliver parity of esteem between physical and mental health, and to drive improvements on dementia. Those two things are linked by the common frustration of family carers, who feel that their voices are not always heard or understood within the NHS, and that there is too much variation in this country when it comes to identifying carers and ensuring that they get access to the breaks they so often need. Can the Secretary of State assure us that the mandate will ensure that people who need breaks get them before they have a breakdown?

[Mr Hunt]

I thank my right hon. Friend for the work he did at the Department, which is widely recognised on both sides of the House. He is right to talk about the critical role of carers. We have spoken a lot today about dementia. Dementia puts huge pressure on partners of the people affected. Very often, because we do not give the support we need to give at an early stage, people with dementia end up having to go to residential homes, whereas with that support, they would be able to stay at home happily for much longer. It is a critical issue. I hope he will be pleased to see in the section on long-term conditions explicit mention of the role of carers. We will follow the matter closely as the NHS Board implements at a local level the support he mentions.