Oral Answers to Questions

Debate between Jeremy Hunt and Stephen Dorrell

Tuesday 14th January 2014 Commons Chamber

[Mr Hunt]

We are very keen to make home care packages much more portable. There are problems with home care packages across the board, particularly the 15-minute slots that, frankly, are completely unacceptable. We are definitely looking at that issue and I encourage the hon. Lady to talk to the Minister responsible for care services, my hon. Friend the Member for North Norfolk (Norman Lamb), to get more details on the progress we are making.

[Mr Stephen Dorrell (Charnwood) (Con)]

Does my right hon. Friend agree that the question asked by my hon. Friend the Member for Hereford and South Herefordshire (Jesse Norman) is the most important single question facing the health and care system? Do not too many elderly people—the greatest single source of growing demand on the health and care system—experience our system not as a national health service but as a national illness service? Is not the challenge facing the system to ensure that, as people live longer, we enable them to get greater quality out of those extended life years?

[Mr Hunt]

As so often, my right hon. Friend encourages us to raise our heads above the horizon and to look forward. He is absolutely right. There will be 1 million people with dementia by 2020 and, as he knows, most of those will have other long-term conditions alongside dementia. The name of the game will be looking after people so they can live healthily at home, which will be the focus of health policy.

Oral Answers to Questions

Debate between Jeremy Hunt and Stephen Dorrell

Tuesday 26th November 2013 Commons Chamber

[Mr Hunt]

The truth is that the previous Government had 13 years to integrate the health and social care systems, but they failed. We are doing that, and we are also providing named GPs to the most vulnerable people, so that, hopefully, they do not have to go to hospital in the first place. That is doing a lot more for older people than the hon. Lady’s Government ever did.

[Mr Stephen Dorrell (Charnwood) (Con)]

Does my right hon. Friend agree that successive Governments over 30 years have talked about the importance of joining up the different bits of the health care system and joining that up with social care? Is not the difference between this Government and their predecessors that, through health and wellbeing boards, the integrated care fund, named GPs and the pioneers programme that he has announced, this Government are actually doing it, rather than just talking about it?

[Mr Hunt]

I have to pay tribute to my right hon. Friend, because he has been talking about the integration of health and social care for a lot longer than I have, and he is absolutely right. I would add to his list one other really important thing we are doing: we are making sure that whatever part of the system someone is in, doctors can access their GP medical record—with their permission—because that information is vital in showing their allergies, medical history and previous admissions. Breaking down the barriers that prevent that from happening is one of the things that has not been picked up but is in the GP contract.

Mid Staffordshire NHS Foundation Trust

Debate between Jeremy Hunt and Stephen Dorrell

Tuesday 19th November 2013 Commons Chamber

[Mr Hunt]

We have to wait and see, but we have put in place a radical, tough new Ofsted-style inspection regime. The point of that regime is not just to identify hospitals where care is unsafe, but to identify outstanding hospitals, so that hospitals in difficulty have hospitals from which they can learn, and we create a culture, just as we have in schools, where failing schools learn from outstanding schools and have a pathway to improvement. That will make a big difference. As the right hon. Gentleman knows, we now have 13 hospitals in special measures, and I am sure there will be more as the inspection process gets under way. But we will also have the great hospitals that we can learn from, which will mean that this can be a positive process for the NHS.

[Mr Stephen Dorrell (Charnwood) (Con)]

I commend my right hon. Friend for the thoughtful and thorough way in which he has conducted the reaction to the publication of the Francis inquiry. Does he agree that the most chilling finding of Francis was that professional people whose focus should have been on the needs of their patients found themselves, in Francis’s words, “doing the system’s business”? Is not the central driver of my right hon. Friend’s recommendations to ensure that never again shall we have closed institutions in a closed system where that is possible, and that the key way forward is to throw sunlight into institutions that have too often been unchallenged?

[Mr Hunt]

My right hon. Friend, as so often, speaks wisely. This is probably the boldest step towards transparency taken by any health care system anywhere in the world. We will see if he is right, but I think that he is, because sunlight is the best disinfectant. It means that problems are sorted out much more quickly, but it is sometimes an uncomfortable process. It is really important that we as a country understand that exposing poor care in one place does not mean that there is poor care everywhere and that, in fact, exposing it is the quickest way to sort it out.

Changes to Health Services in London

Debate between Jeremy Hunt and Stephen Dorrell

Wednesday 30th October 2013 Commons Chamber

[Mr Hunt]

I am afraid the right hon. Gentleman is sounding more and more desperate. Today the Government have taken a difficult decision that will improve services for patients. It was a moment for him to show that he understood the challenges facing the NHS, but that was not to be. He said that we should not proceed with the changes given winter pressures on A and Es, but he should read the document. The proposals are for more emergency care doctors, more critical care doctors, and more psychiatric liaison support that helps A and E departments, and they are supported by the medical directors of all nine trusts affected. He said that if evidence can be produced to show that the proposals will save lives, Labour will support them. What more evidence does he want? He should be shouting from the rooftops to support the proposals, but instead he is putting politics before patients.

The right hon. Gentleman mentioned A and E performance, and I am happy to tell him about that. On average a person now waits 50 minutes in A and E before they are seen; when he was Health Secretary it was 71 minutes. The number of patients seen in less than four hours every day is 57,000—nearly 2,000 more than when the right hon. Gentleman was Health Secretary. Our hospitals are performing extremely well under a great deal of pressure because we are taking difficult decisions of the kind that we are talking about today.

The right hon. Gentleman also talked about hospital closures. Again, he should read the proposals: a brand new trauma centre at St Mary’s hospital in Paddington; two brand new elective care centres at Ealing and Charing Cross; seven-day NHS care that will save lives; 24/7 obstetric care; 16 paediatric care centres. Those are big improvements in hospital care—[Interruption.] I will come on to Lewisham. I am acting to end uncertainty because I made the decision today that whatever the outcome of further discussions that the Independent Reconfiguration Panel recommends, there will remain an A and E at Ealing and Charing Cross. That is the best thing I can do for those residents.

The right hon. Gentleman mentioned Lewisham, but let us remember that the problem started because his Government saddled South London Healthcare NHS Trust with £150 million in private finance initiative costs. I judged that the right thing for patients was to sort out a problem that was diverting £1 million every week from the front line. Yes it is difficult, but I would rather lose a battle with the courts trying to do the right thing for patients than not try at all.

Finally, these are difficult decisions, but the party that really has NHS interests at heart is the one that is prepared to grip those decisions. We are gripping the problems in A and E, and in terms of hospital reconfigurations. That is why the NHS is safe in our hands and not safe in those of the Labour party.

[Mr Stephen Dorrell (Charnwood) (Con)]

Does my right hon. Friend agree that we tackle health inequalities, and improve health outcomes and access to accident and emergency departments, by facing up to the need to make difficult decisions to change the way care is delivered to keep it up to date? Does he further agree that today we have seen a Government who are prepared to face those challenges, and an Opposition spokesman who has demonstrated a determination to duck them? Who cares about the NHS?

[Mr Hunt]

I thank my right hon. Friend for that comment. He is right that this is about facing up to difficult decisions. One aspect of the proposals that is so exciting for people who want a transformation in services is that they involve employing 800 additional people for out-of-hospital care. The real way we will reduce pressure on A and E units is by ensuring that people, particularly the frail and elderly, are looked after better at home. That is what we must do. We must recognise that, fundamentally, the problems will not be solved by trying to pour in money in the way that it has always been poured in. We must rethink the model. This is a positive and ambitious programme. If the shadow Secretary of State were in my shoes, he would speak differently of the proposals, because they represent the way forward for the kind of integrated care he normally champions.

Accident and Emergency Departments

Debate between Jeremy Hunt and Stephen Dorrell

Tuesday 10th September 2013 Commons Chamber

[Mr Hunt]

In the right hon. Gentleman’s endless quest to turn the NHS into a political football, he, disappointingly, paints a picture that is a long way from reality. He talks about A and E performance. Yes, since I have been Health Secretary we have missed our target in one quarter, but when he was Health Secretary he missed it in two of the three quarters, including 14 weeks over the crucial winter period. What he does not tell the House is that this Government actually hit their A and E target for the year as a whole, whereas in Labour-controlled Wales the NHS budget has been cut and the A and E target has not been hit since 2009—he repeatedly refuses to confront that.

The right hon. Gentleman talks about the number of nurses being down. He might want to check the figures and correct the record for the House when he uses the 5,000 figure, because the fact is that the number of hospital nurses—hospitals are where A and E departments are—has gone up under this Government, as has the number of doctors, health visitors and midwives. None of that would be possible if we had cut the NHS budget by £600 million from its current levels, which is his policy.

The right hon. Gentleman then talks about the social care budget. Under his Government the number of over-80s went up by more than a quarter, yet the Labour Government cut social care funding per head. We have introduced the innovative £3.8 billion merged health and social care fund, which will transform the joined-up nature of the services that people receive.

Finally, I am afraid that Labour Members are burying their heads in the sand about the enormous damage they did when they removed named GPs for members of the public under the GP contract. Professor Keith Willett, one of the most senior doctors in the NHS and responsible for all A and E services in NHS England, has said that between 15% and 30% of the people using A and E could be using primary care instead. That is why we are announcing really important changes to the way in which the GP contract operates, in order to address this problem. When the Government come before the House with a sensible package of short-term and long-term measures, any responsible Opposition would welcome it—instead, we have had political posturing and no attempt to address the real challenges facing the NHS.

[Mr Stephen Dorrell (Charnwood) (Con)]

May I welcome the £250 million that my right hon. Friend has announced as short-term relief of the pressures in A and E departments this winter, and in particular the £10 million he has announced for Leicester’s hospitals trust? Does he agree that the way to relieve pressure in A and E departments is by recognising that the health and care system is a single system that needs to be joined up and that the announcement by the Chancellor of £3.8 billion made available from health service spending to promote better integration of health and social care is the most effective single thing we can do to relieve pressure on A and E departments?

[Mr Hunt]

As so often on these matters, my right hon. Friend speaks extremely wisely. Since April, we have been working hard to deal with the underlying pressures on A and E departments while ensuring that we have cash available for short-term measures while those longer-term measures are put in place. He is absolutely right that joined-up integrated services are critical for A and E departments, because one of the biggest problems that they mention is the difficulty in discharging people from hospital, which makes it hard for them to admit patients who need to be admitted, often in very distressed circumstances. We also need to address the longer-term IT problems that mean that A and E departments cannot access people’s medical records and the question of alternatives to A and E, particularly in the community and through enhanced GP services.

Hospital Mortality Rates

Debate between Jeremy Hunt and Stephen Dorrell

Tuesday 16th July 2013 Commons Chamber

[Mr Stephen Dorrell (Charnwood) (Con)]

Those who want to make the case for change in an organisation—and, after the Francis review, who can doubt the need for change in parts of the national health service—must first demonstrate the need for change. Does this review not build on the distinguished record of both Bruce Keogh and Sir Brian Jarman in demonstrating the need for change in parts of our national health service?

[Mr Hunt]

My right hon. Friend speaks very wisely. As I know he agrees, identifying problems publicly is incredibly difficult, but the way to ensure that those problems are dealt with is to be totally honest and transparent about them in the knowledge that they will be sorted out as a result, and that is what is happening today.

Care Quality Commission (Morecambe Bay Hospitals)

Debate between Jeremy Hunt and Stephen Dorrell

Wednesday 19th June 2013 Commons Chamber

[Mr Hunt]

My hon. Friend speaks extremely wisely, and I know that the whole House will want to say how sorry we are to hear about the personal problems he had with that trust. All the international safety studies say that if we are to transform safety culture, it has to come from better leadership. It has to come from leadership that really cares; that frees up people on the front line to raise safety concerns in a way that they do not feel will be career-threatening; that encourages them to rethink procedures to minimise the risk of harm to patients; and that encourages the open and transparent approach that has enabled hospitals such as Salford Royal to become one of the safest in the country, because of the inspirational leadership of David Dalton. That change in leadership is fundamental, but having a chief inspector who goes without fear and favour and says where we have that leadership and, more importantly, where we do not have it, will be vital to ensuring that we start to get the changes that my hon. Friend is concerned about.

[Mr Stephen Dorrell (Charnwood) (Con)]

Does my right hon. Friend agree that in the long litany in this report of events that were inexplicable and completely unacceptable, one of the most inexplicable and unacceptable things it lays bare is that at the same time as concern was being expressed to the CQC about the quality of maternity services delivered in the trust, to which the CQC did not respond, the trust itself commissioned a report into the future of maternity services and did not see fit to report the existence of the Fielding review to the regulator to which it was responsible? Will my right hon. Friend make it crystal clear that that is completely inconsistent with any concept of duty of candour for health care deliverers?

[Mr Hunt]

I could not agree more with my right hon. Friend. What happened beggars belief, and I very much agreed with his comments on that on the radio this morning. The point about duty of candour is that there will be a criminal liability for boards that do not tell patients or their families where there has been harm and that do not tell the regulator; boards will have a responsibility to be honest, open and transparent about their record. That has to be the starting point if we are going to turn this around.

Children’s Heart Surgery

Debate between Jeremy Hunt and Stephen Dorrell

Wednesday 12th June 2013 Commons Chamber

[Mr Hunt]

I thank the right hon. Gentleman for the tone of his comments and the bipartisan way in which he has approached these issues. I particularly welcome his last point. We have many debates in this House, but this is one issue where we are completely at one. If there is a difficult decision to be made that will save children’s lives, we must have the courage to take it. I am grateful for the right hon. Gentleman’s support on that.

I think that the right hon. Gentleman will also agree with me that while this issue transcends party politics, it is one from which all of us—on both sides of the House, throughout the NHS and indeed in local authorities—have things to learn. I think that the biggest issue for us all to consider is the sheer amount of time that it has taken. The original concerns about what happened in Bristol were raised in 1989. I am pleased to say that they have been dealt with, but there are broader, system-wide lessons to be learnt. It took until 2001 for Sir Ian Kennedy’s report to be completed, it took until 2008 for the Safe and Sustainable review to begin, and now, in 2013, we are having to suspend the process yet again. What has happened is not the right outcome for children, and we must all learn the lessons from that.

The right hon. Gentleman mentioned site selection. I consider that to be one of the most crucial areas in which the process was flawed. Whether we should involve adult heart services is a difficult question, but one of the key recommendations in the IRP’s report is that they should be taken into account. I think that we should pay attention to that recommendation, because the panel thought about it very carefully. The reason for its view was that the same surgeons often operate on children and on adults. Adults also have congenital heart conditions that require operations. The panel also says that if the best outcomes are to be achieved for children, services must be concentrated in teams that have four full-time surgeons, provide specialist training, and conduct research. The knock-on impact of what is happening in adult heart services is relevant.

I agree with the thrust of what the right hon. Gentleman said about mortality data, but I know that he will also understand the difficulty of publishing such data on a very small number of cases when they may not be statistically significant. That was one of the great debates that we had over the temporary suspension of services at Leeds. We must be careful not to publish data that could lead the public to make the wrong conclusions. In principle, however, transparency is the most important thing for us to bring about.

I entirely agree with the right hon. Gentleman about the timetable. I think that we must get on with this process: I do not want to delay it any more than is necessary. I have talked extensively to NHS England about how it should be approached. NHS England—along with all the stakeholders involved—needs time in which to digest the contents of the IRP report, which was published only today. I consider that the minimum period that I need to allow it to come up with the timetable is until the end of next month. I appreciate that that is six weeks, but I think that it is a sensible period. I certainly want to be able to publish an indicative timetable by then, so that people can understand how the process will continue and how we will learn the lessons.

I also agree with the right hon. Gentleman that nothing in my statement should undermine the public’s confidence in the brilliant work being done by heart surgeons all over the country for adults and children. Our heart surgery survival rates have improved so much that they are now some of the best in Europe, and we can be very proud of the work that those surgeons do, day in, day out. However, that does not mean that we cannot strive to be even better.

[Mr Stephen Dorrell (Charnwood) (Con)]

I welcome the statement, although, in a sense, I welcome it with a heavy heart. Does my right hon. Friend agree that the Safe and Sustainable process could not go ahead because it had fundamentally lost the confidence of patients and clinicians, and therefore did not form a proper basis for necessary change?

Given that it is now more than 12 years since the publication of Sir Ian Kennedy’s report, does my right hon. Friend agree that this is not a success for the NHS? Does he agree that it is a real challenge for NHS England to put a proper time frame around necessary change for these services, and then to use that as a basis for changes that we know to be needed in other specialist services in the national health service?

Oral Answers to Questions

Debate between Jeremy Hunt and Stephen Dorrell

Tuesday 11th June 2013 Commons Chamber

[Mr Stephen Dorrell (Charnwood) (Con)]

Does my right hon. Friend agree that the introduction of health and wellbeing boards represents a very welcome introduction of democratic accountability into the management of the health and care system? Does he further agree that the acid test of health and wellbeing boards will be their ability to increase the pace of integration between health and care so that the service we deliver is more closely matched to the needs of patients?

[Mr Hunt]

As is so often the case, my right hon. Friend speaks extremely wisely on this issue. Integrated services will be the big thing that transforms the service we offer vulnerable older people, which the right hon. Member for Leigh (Andy Burnham) mentioned earlier. Health and wellbeing boards will have an extremely important role to play in bringing together local authorities and clinical commissioning groups so that we have joint commissioning of services for those very vulnerable people.

A and E Departments

Debate between Jeremy Hunt and Stephen Dorrell

Tuesday 21st May 2013 Commons Chamber

[Mr Hunt]

And I would always seek to do so, Mr Speaker.

Finally, the right hon. Gentleman constantly seeks to run down the performance of the NHS. Where is the recognition of the outstanding performance of the NHS under this Government: the fact that under this Government 400,000 more operations are happening every year than under Labour; the fact that the number of people waiting for more than a year for an operation has gone down from 18,000 under Labour to fewer than 1,000 under this Government; the fact that MSRA rates have been halved; and the fact that mixed-sex wards have nearly been eliminated? We will stick up for the great achievements of our NHS and we will not allow people to run it down. However, we will also tackle problems honestly and ensure that we address crises, many of which were caused by the previous Government.

[Mr Stephen Dorrell (Charnwood) (Con)]

Does my right hon. Friend agree that patients seeking urgent care will go to that part of the health service where the lights are on, and that the failure of the Opposition, over 13 years, to create genuinely integrated emergency care is the fruit we are now harvesting?

[Mr Hunt]

As ever, my right hon. Friend speaks with great wisdom. When it comes to the frail elderly, the key is to have a system that heads off problems before they arrive so that people do not find that they end up having to be rushed into A and E in the middle of the night. That can often be the very worst place for someone with advanced dementia or any condition that makes them extremely fragile and vulnerable. We need to integrate systems properly, and that did not happen under the previous Government. One of the key work streams of the vulnerable older people’s plan will be to look at barriers to integration, particularly the barriers to joint commissioning of social care and health. We intend to make good progress on that front.

Oral Answers to Questions

Debate between Jeremy Hunt and Stephen Dorrell

Tuesday 16th April 2013 Commons Chamber

[Mr Hunt]

I agree with the hon. Gentleman. Some of the devolved Administrations, particularly Scotland, actually do better than England in regard to dementia diagnosis, and one thing that we must learn from them is the value of a properly integrated care plan. I am working closely with the Minister of State to ensure that we deliver that in England.

[Mr Stephen Dorrell (Charnwood) (Con)]

My right hon. Friend said in his answer to my hon. Friend the Member for Fylde (Mark Menzies) that certain aspects of the treatment of dementia patients had to change. Does he agree that that should include the services that are delivered to them becoming more integrated, not only between hospitals and community health care services but between social care services and social housing support, in order to provide a proper joined-up package of care for people who receive such diagnoses?

Social Care Funding

Debate between Jeremy Hunt and Stephen Dorrell

Monday 11th February 2013 Commons Chamber

[Mr Hunt]

Really! The right hon. Gentleman talked about a flawed prospectus, but what we had from the Labour Government during their 13 years in power was no prospectus whatever. This was in Labour’s manifesto in 1997, then the Government had a royal commission in 1999. There was a Green Paper in 2005, followed by the Wanless review in 2006. The problem was going to be solved in the comprehensive spending review of 2007, but then we had another Green Paper in 2009. Let us compare that with a coalition that commissioned a report the moment it came into office, said after a year that it accepted the principles of the report, and has now, just two years later, announced how it will implement it and pay for that implementation.

Let me go through some of the things that the shadow Secretary of State has said. He quoted one stakeholder, Stephen Burke, but let us look at what some of the others have been saying. The Joseph Rowntree Foundation has said that

“the cap and threshold are welcome measures, and a welcome sign that the government is taking responsibility for addressing care funding.”

Andrew Dilnot said today:

“I recognise the public finances are in a pretty tricky state and it doesn’t seem to me that”—

what the Government are proposing is—

“so different from what we wanted”.

Or we could talk about Age UK, which says it

“has always supported the principle of a cap”

and welcomes the fact that we are increasing what it describes as

“the current miserly upper means test threshold”.

A lot of stakeholders welcome today’s announcement, but recognise that we are in extremely difficult financial circumstances and that that is why we have to be responsible with public finances.

The right hon. Gentleman talked about the cap of £75,000, which is indeed higher than the upper limit proposed by Andrew Dilnot, but to describe this as only helping people on higher incomes is fundamentally to misunderstand how a cap works. First, potentially more than 70% of the £1 billion a year that this will cost the Government by the end of the next Parliament is going to socially disadvantaged families. This is a highly progressive measure, and as well as increasing the cap we are increasing the threshold above which people do not get any help, from £23,000 to £123,000—exactly the kind of thing that some of the most disadvantaged families on the lowest of incomes will benefit from most.

The right hon. Gentleman talks about the Association of British Insurers—he needs to get up to date. It describes this as

“potentially another positive step forward in tackling the challenges of an ageing society.”

[Interruption.] If he wants some more quotes, let us look at what financial services companies are saying. Aegon UK says it

“welcomes today’s announcement and the clarity it brings on state support.”

Legal & General says it is

“pleased the Government has decided to move forward with Andrew Dilnot’s proposals.”

As for local authority budgets—the shocking state of which, by the way, we inherited from the last Labour Government—the Government said in the spending review that the NHS health budget would give £7.2 billion of support for health-related needs to local authorities during the course of this Parliament.

On inheritance tax, what the right hon. Gentleman does not understand about today’s measures is that fundamentally, they are helping people to protect their inheritance from the lottery of social care costs. The randomness of someone not knowing whether they will be the one in 10 who suffers over £100,000 in care costs is eliminated by a proposal that allows everyone to plan and prepare for their own social care costs.

The right hon. Gentleman describes this as a modest plan and says we have neglected the scale of the problem. Of course, in dealing with an ageing population many other issues need to be dealt with. He talked about the problem of integration, which we are solving by devolving power to clinical commissioning groups on the front line, a reform that Labour opposed, and by integrating technology, a reform on which Labour failed. Also, Labour did nothing about dementia, leaving us with less than half the people with dementia being diagnosed. We are now tackling that problem. We saw last week the issues of treating older people with dignity and respect. We are tackling that problem—Labour left it for far too long.

The problem is not that our solution is too small, but that it was too big for Labour to solve when they were in office. When it comes to making Britain a better country to grow old in, this Government are taking action where the last Government failed.

[Mr Stephen Dorrell (Charnwood) (Con)]

Does my right hon. Friend agree with the view expressed by Tony Blair to the Labour party conference in 1997 that it should be a priority for the British Government to sort out the unfairness that prevails in our system of care for the elderly? Does he further agree with me that when our right hon. Friend the Leader of the House was Health Secretary, he set up the Dilnot commission within weeks of this Government taking office, and that the package my right hon. Friend has announced today was described today by Andrew Dilnot as being not so different from the one recommended by the commission set up by our right hon. Friend?

[Mr Hunt]

I absolutely agree with my right hon. Friend’s points; he speaks wisely, as ever. I, too, want to pay tribute to the work that my predecessor, our right hon. Friend the Leader of the House, did in laying the ground and making the big call that we needed to have the Dilnot commission, and in last year publishing the care and support White Paper, which moved this agenda much further forward than in any of the 13 years of the previous Labour Government. My right hon. Friend is also right about the fundamental randomness and unfairness. Of course, we are not saying that the Government will pay for all the social care costs we encounter—public finances could not possibly be in a state to allow that to happen. However, this provides certainty and allows people to plan, so that they can cope with the randomness and unfairness of the current system and know that it will not put their precious inheritance at risk.

South London Healthcare NHS Trust

Debate between Jeremy Hunt and Stephen Dorrell

Thursday 31st January 2013 Commons Chamber

[Mr Hunt]

The right hon. Lady talks about the risks that Sir Bruce alludes to in his analysis of the trust special administrator’s proposals. Those risks are precisely why I have not accepted the proposals in their entirety and have put in place a series of additional safeguards.

Not resolving this issue, which is effectively what the Labour party is calling for because it has put forward no alternative proposals, would carry a high degree of risk. It would mean that south London would not meet the London-wide clinical quality standards. It would mean that £1 million a week would continue to be diverted from front-line patient care into funding an unsustainable deficit. That would be bad for her constituents and those in neighbouring constituencies.

We must look at the south-east London health care economy as a whole, but the objective must be to improve the services that people receive. That is a difficult balance to get right, but I think that we have the right balance in the proposals that I have outlined this morning.

[Mr Stephen Dorrell (Charnwood) (Con)]

Does my right hon. Friend agree that the very difficult decisions that he has announced to the House reflect the application in south London of something that is needed across the health service—a willingness to address difficult issues, but led always by clinical evidence on how to deliver the best possible outcomes for the patients who rely on the service?

[Mr Hunt]

I entirely agree with my right hon. Friend. It would be totally irresponsible for me as Health Secretary to fail to take a decision that could save as many lives as I believe this decision will save. If we are to save more lives in A and E and reduce the number of maternity deaths in London, it involves taking difficult decisions. The disappointment for me is that the Labour party has chosen to jump on an Opposition bandwagon, rather than putting forward its own solution to deal with the clinical issues in south-east London. Unfortunately, the Opposition are playing to the gallery. That is not what a Government-in-waiting should be doing.

Oral Answers to Questions

Debate between Jeremy Hunt and Stephen Dorrell

Tuesday 15th January 2013 Commons Chamber

[Mr Hunt]

With respect to the hon. Lady, she cannot talk about alleged cuts in the NHS while her Front-Bench team support a policy of real cuts in the NHS budget. In the last Opposition day debate, the right hon. Member for Leigh (Andy Burnham) said that he thought it was irresponsible of the Government to increase the NHS budget in real terms. That means he wants a real cut in the NHS budget, which would make the staffing issues to which she referred much, much worse.

[Mr Stephen Dorrell (Charnwood) (Con)]

Does my right hon. Friend agree that one of the most effective things we can do to improve the patient experience of health and care is to improve the co-ordination, not just between the hospital service and community-based health services, but between the NHS and social care, and to put in place the infrastructure, including the IT infrastructure, to make that real?

[Mr Hunt]

My right hon. Friend makes an extremely important point—in fact, I will be giving a speech on this tomorrow—because, in the end, if it is not possible to see a full medical record of some of these frail elderly or heaviest users of the NHS going in and out of the system throughout the year, it is not possible to give them the integrated, joined-up care that they desperately need. This will be a very big priority for us.

NHS Commissioning Board (Mandate)

Debate between Jeremy Hunt and Stephen Dorrell

Tuesday 13th November 2012 Commons Chamber

[Mr Hunt]

The redundancies in management and administration will save the NHS £1.5 billion every year—£1.5 billion that can be spent on the front line. We should compare that with the £1.6 billion the NHS must spend every year to deal with the right hon. Gentleman’s disastrous private finance initiative policies that left the NHS with £73 billion of debt overhang.

Let us talk about clinical networks, which are extremely important. We have four clinical networks—for cardio, cancer, maternity and mental health—and they will continue. The budget that the networks are using is increasing and not decreasing under the Commissioning Board.

The right hon. Gentleman said that ambulance services in Manchester would be run by a private bus company. I am sure the House will be interested to know who the Health Minister was when the guidelines that allow private bus companies to bid to run ambulance services were drawn up. It was the right hon. Gentleman. He was in post when that happened.

The right hon. Gentleman describes the mandate as a wish list. He should tell that to the 570,000 people who have dementia, for whom Government Members want to do a better job. He should tell it to people who suffer from cancer. They have below-average European survival rates, but we want them to have the best survival rates in Europe. He should tell it to the families and carers of people who are worried about the level of care they receive in certain parts of the system.

Government Members are determined to aim high for our NHS, because we believe in it. We believe it is doing incredibly well in difficult circumstances, but it can do even better. The right hon. Gentleman should also want an ambitious NHS. Just because he did not have those ambitions when he was Health Secretary does not mean that the Government should not aim high to make our NHS the best in the world.

[Mr Stephen Dorrell (Charnwood) (Con)]

I apologise to you, Mr Speaker, and to the House for my inability to control modern technology.

Does my right hon. Friend think it striking that, when he presents the first mandate of the NHS Commissioning Board to the House of Commons, we hear a lot of synthetic rhetoric from the Opposition Front Bench, but not a single disagreement with any one of his propositions from the Dispatch Box or in the mandate? Does that not demonstrate—this has always been the Conservative case—that there is a shared commitment to the ideals of the NHS, and that the difference is our ability to deliver it effectively?

[Mr Hunt]

I hope my right hon. Friend is right that there is agreement on the goals in the mandate, because they have been drawn up after extensive consultation with the people of this country and are important priorities, particularly as we grapple with an ageing society. I agree with him that it does not the help the NHS to descend to the rhetoric we heard from the right hon. Member for Leigh (Andy Burnham). There is a very important and legitimate debate about the right way to achieve shared goals. Government Members do not believe the right way is through performance management from the Department of Health and trying to echo out every part of the system. We believe the right way is to empower local GP-led groups to make changes on the ground. That is at the heart of the reforms.

Mental Health Act 1983

Debate between Jeremy Hunt and Stephen Dorrell

Monday 29th October 2012 Commons Chamber

[Mr Hunt]

First, I thank the right hon. Gentleman for the co-operation that he has shown to me and my Department over the weekend. There are occasionally moments when issues of public safety and patient well-being transcend the normal political divides, and I greatly appreciate his co-operation on this matter.

Let me deal with the important questions that the right hon. Gentleman has asked. The issue arose when a challenge was made to the authorisation of one doctor in Yorkshire and Humberside and, in dealing with that challenge, the irregularity in the way in which all authorisations had happened became apparent. Following further investigation, we discovered that this had happened in four other SHAs. We found out about this early last week, and I was informed towards the end of last week. Immediate action was taken to ensure proper validation last week of all the doctors who are currently taking section 12 decisions under the Mental Health Act, and that was completed as of today.

We have done exhaustive checks on the other SHAs, which is part of the reason why we asked all the SHA bosses to write to Sir David Nicholson—which they have all done today—to confirm that their processes in this area are in order. We do not believe that this issue affects any patients other than the ones we have talked about, to date. However, because people move and are moved to different hospitals and places of detention, it might be happening in other parts of the country beyond the four SHAs in which the irregularities in authorisation happened.

The right hon. Gentleman will understand that it is not the practice for Governments to publish legal advice because we want to continue to be able to receive frank legal advice in the future. However, I am happy to answer any questions about the legal advice and, as he knows, I am happy for him to talk to my Department’s legal advisers to satisfy himself on the precise legal situation.

Let me move on to the really important point about the alternatives that we considered, as it is highly exceptional to bring in emergency legislation. The right hon. Gentleman will know that authorities are allowed to detain someone under the Mental Health Act for 72 hours while the correct processes are followed to section them. Although, as I mentioned, we believe we have good arguments to show why these detentions were lawful, we did not know what a court might have decided if the detentions were challenged. We could have faced literally having to redo the entire process for 4,000 to 5,000 patients within 72 hours. Given the high level of vulnerability of many of them, we could not find a means of doing that in an orderly way that protected their well-being. I received clear medical advice from the NHS medical director, Professor Sir Bruce Keogh that that would not be an appropriate course of action. We looked at the position carefully and because we were trying to explore other alternatives we did not come to the decision to introduce emergency legislation until this weekend.

I can confirm that we do not believe that this has highlighted a defect in the legislation. We are not seeking in the emergency draft Bill to change the Mental Health Act. This is purely retrospective legislation dealing with some specific procedures under that Act; it will have no impact as this goes forward.

The right hon. Gentleman is absolutely right that we must be sure to minimise the confusion as we move towards the new structures. Under them, the problem would have been resolved, with the power reverting from strategic health authorities to the Department of Health. I do not want to be complacent: if this problem happened in one area, we want to be sure that it cannot happen in others.

[Mr Stephen Dorrell (Charnwood) (Con)]

I welcome the prompt action taken by my right hon. Friend and the support he has secured from Opposition Front Benchers for putting this sensitive matter on a secure legal footing. Is not the key point the fact that no patient has been sectioned and no doctor has been authorised who would not have been sectioned or authorised under the legislation? Is not the purpose of the emergency Bill, as always with retrospective legislation, simply to put the position as Parliament intended it to be in the first place?

[Mr Hunt]

My understanding is exactly the same as that of my right hon. Friend. The key point is that this was a technical irregularity, but we do not believe that any patient has been sectioned, detained or hospitalised who would not have been if the correct procedures had not been followed. It is none the less very serious that this technical breach happened; that is why, as well as correcting the technical breach and providing absolute clarity, we are conducting this review to make sure that we do everything we can to avoid anything similar happening again—even under completely different structures than the SHAs.

Oral Answers to Questions

Debate between Jeremy Hunt and Stephen Dorrell

Tuesday 23rd October 2012 Commons Chamber

[Mr Hunt]

I certainly can. The number of diabetes sufferers overall will go up from about 3.7 million, which is already 5% of the population, to 4.4 million. We need to do a lot better in how we look after people with long-term conditions if the NHS is to be sustainable. We can also do a lot to transfer the individual care of people who have diabetes through things such as technology, which I will look into carefully.

[Mr Stephen Dorrell (Charnwood) (Con)]

Does my right hon. Friend agree that the effective delivery of care to people with long-term conditions relies on breaking down the silos within the health service, and between the health service, social care and social housing? Will he encourage the new health and wellbeing boards to follow through that agenda with a serious purpose?

[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.