Oral Answers to Questions

Debate between Jeremy Hunt and Tim Farron
Tuesday 19th March 2024

(8 months, 1 week ago)

Commons Chamber
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Jeremy Hunt Portrait Jeremy Hunt
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No one knows more about high-end TV than my hon. Friend. Whoever said that politics is showbusiness for ugly people was absolutely wrong in his case. I will take away what he says and consider high-end television as a potential future Budget measure.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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The Chancellor will be aware of the award-winning film “The Windermere Children”, which talks about the legacy of those Jewish children who survived the death camps in central Europe and made a new life for themselves on the banks of Lake Windermere at Troutbeck Bridge. For the last several years, there has been an ongoing exhibition on their legacy at Windermere library, and now we look to build a lasting memorial alongside a rebuilt Lakes School at Troutbeck Bridge.

Will the Chancellor be interested in meeting the families of the Windermere children, and those behind the new build and the provision of a new lasting memorial to their legacy, at Windermere at some point in the foreseeable future?

Oral Answers to Questions

Debate between Jeremy Hunt and Tim Farron
Tuesday 14th November 2023

(1 year ago)

Commons Chamber
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Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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There is encouraging news in that the Pension Insurance Corporation has recently announced that it is going to invest in helping to support the building of 1,200 new affordable homes in this city. Does the Chancellor agree that pension funds could be a very important source of capital for developing social rented housing around the country—Eden Housing Association, South Lakes Housing, and Westmorland and Furness Council, for example? Will he look at the rules and bring in greater incentives for pension investment funds to invest in affordable housing across the country?

Jeremy Hunt Portrait Jeremy Hunt
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We are already working on proposals in that very area. Broadly speaking, we have one of the most robust and resilient pension fund sectors in the world, but we are doing a lot of work to remove the barriers to investing back into the UK. Things such as affordable housing, infrastructure and our growth businesses are areas of great potential.

Oral Answers to Questions

Debate between Jeremy Hunt and Tim Farron
Tuesday 20th June 2023

(1 year, 5 months ago)

Commons Chamber
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Jeremy Hunt Portrait Jeremy Hunt
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That is a fair point. I thank my hon. Friend for the fact that Newbury is a hotbed of technology businesses, with Roc Technologies, Stryker, Edwards Lifesciences and a range of other businesses that she gives a lot of support to. I will write to her listing all those things and I will make sure that it is available on the website of the Department for Science, Innovation and Technology.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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The tech sector in rural Cumbria depends on reliable broadband. Communities in Warcop, Sandford, Coupland Beck, Blea Tarn and Ormside in Westmorland have signed up to the community interest company and volunteer group B4RN to provide a gigabit connection for just £33 a month, but the communities have been suddenly designated a low priority area, which means that their vouchers have been removed, putting the whole project at risk. Will the Chancellor commit to supporting those communities, residents and businesses to ensure that they get the vouchers that they were initially promised?

Jeremy Hunt Portrait Jeremy Hunt
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I will happily look into what has happened. We strongly support all rural areas having access to gigabyte broadband, as an important part of our policy. We have made a lot of progress on that. I will look into detail of what is happening in the hon. Gentleman’s area and get back to him.

Economic Update

Debate between Jeremy Hunt and Tim Farron
Monday 17th October 2022

(2 years, 1 month ago)

Commons Chamber
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Jeremy Hunt Portrait Jeremy Hunt
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I hear my hon. Friend. The hospitality industry is incredibly important to our economy. I have two things to say. As he knows, we are reviewing the whole structure of alcohol duties, and as part of that process we will be keeping the levels of duty under constant review.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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We have had many U-turns, but there is one that the Chancellor has not made that is massively relevant to Cumbria and other rural communities. The cut in stamp duty will help nearly nobody who can currently not afford a home to be able to afford one. What it will do is add fuel to the fire of a second home ownership and Airbnb disaster in areas such as the lakes and the dales. Does he understand the damage that excessive second home ownership and Airbnb do to communities such as mine and other parts of the country? Will he think again and do something to support our communities and stop the housing catastrophe?

Jeremy Hunt Portrait Jeremy Hunt
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I entirely understand the concerns about second home ownership, and the Government have been looking at that policy in enormous detail over recent months. However, I gently say to the hon. Member that it would be wrong to be dismissive of the concerns of young people desperately trying to get onto the housing ladder, and the help that we are giving them with the stamp duty reforms will make a significant difference.

NHS Staff Pay

Debate between Jeremy Hunt and Tim Farron
Wednesday 21st March 2018

(6 years, 8 months ago)

Commons Chamber
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Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.

Each Urgent Question requires a Government Minister to give a response on the debate topic.

This information is provided by Parallel Parliament and does not comprise part of the offical record

Jeremy Hunt Portrait Mr Hunt
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I am happy to do that and to congratulate the staff at my right hon. Friend’s hospital, which he has long championed and whose pressures and needs he has highlighted assiduously. To come out of special measures is a huge achievement. I have recorded a video message, but I am happy to say in the House how proud we all are of what the staff have achieved. I also recognise the capital issues at the hospital and the fact that the building is not fit for purpose.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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The minimum amount that nurses in south Cumbria will have lost since the pay freeze is £4,306. Given that the average house price in my constituency is 10 times the value of the average nurse’s salary, Members will understand the huge impact that there has been on retention and recruitment. The rise is therefore deserved, welcome and overdue, but without a long-term plan for funding health and social care, this announcement will not be trusted, so does the Secretary of State not agree that we need a new deal to refresh Beveridge’s vision for the 21st century, and should we not be prepared to be honest with the British people and say that this will involve a modest but clear increase in taxation?

Jeremy Hunt Portrait Mr Hunt
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I disagree that the deal will not be believed—it is a concrete deal. NHS staff still have to vote for it, but the Government have committed to significant rises in pay. I agree, however, that we will need to find the best way of getting more money into the NHS and social care system as we face the pressures of an ageing population.

Oral Answers to Questions

Debate between Jeremy Hunt and Tim Farron
Tuesday 20th March 2018

(6 years, 8 months ago)

Commons Chamber
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John Bercow Portrait Mr Speaker
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Not only was the hon. Lady present in Speaker’s House this morning, but her sister and distinguished speech and language therapist Rosalind Pow was present as well, so we had two doses of Pow in the course of a breakfast meeting. It was an unforgettable experience for all concerned.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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I cannot compete with that, Mr Speaker. Back in November, I wrote to the Secretary of State about the increased service charges on GP practices. Ambleside surgery in my constituency, which serves an increasingly ageing population, faces a huge increase of £25,000—more than double—and the staff there fear they cannot keep the surgery going long term with that kind of increase. A ministerial written response in November did not mention Ambleside once, so will the Secretary of State commit now to intervening directly to guarantee that Ambleside will not have to pay this unjustified additional £25,000 a year?

Jeremy Hunt Portrait Mr Hunt
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I will re-look at the issue and the response that the hon. Gentleman was given. The issue is that there is unevenness and unfairness in the rates charged to GPs whose surgeries belong to NHS Property Services. We are trying to make this fair across the country, but we also want to make sure that no GP surgeries close.

Oral Answers to Questions

Debate between Jeremy Hunt and Tim Farron
Tuesday 6th February 2018

(6 years, 9 months ago)

Commons Chamber
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Jeremy Hunt Portrait Mr Hunt
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We are absolutely going to do that. We have a big programme of expansion in perinatal health support, because there is a lot of evidence that pressures on mothers around the time of birth transmit to their children and can leave lasting damage.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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Specialist mental health crisis care for young people in south Cumbria is available only between the hours of 9 and 5 from Monday to Friday. Does the Secretary of State agree that in the light of the Care Quality Commission’s recent damning report of the partnership trust, that is not acceptable? Will he join me in asking the Morecambe Bay CCG to ensure that there is out-of-hours and weekend care for all people?

Jeremy Hunt Portrait Mr Hunt
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I am happy to look into that issue. The hon. Gentleman’s colleague, the right hon. Member for North Norfolk (Norman Lamb), did a huge amount to set up crisis care provision around the country. We need to build on that for the simple reason that, if we are to have parity of esteem, people need to be able to get help in a mental health crisis, just as they are if something goes wrong with their physical health.

Oral Answers to Questions

Debate between Jeremy Hunt and Tim Farron
Tuesday 14th November 2017

(7 years ago)

Commons Chamber
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Jeremy Hunt Portrait Mr Hunt
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I congratulate my hon. Friend on becoming Chair of the Liaison Committee. Of course, I am always happy to meet her, and the issue that she has raised is very important. Our figures show that the number of nursing home beds, as distinct from the number of nursing homes, is broadly stable. There is real pressure in the market, however, and there are real issues about market failure in some parts of the country, so I am more than happy to talk to her about that.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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The south Cumbria area is one of the few places in England where patients who need even the least complex radiotherapy treatment must travel for longer than the maximum 45 minutes recommended by the National Radiotherapy Advisory Group. In NHS England’s consultation, which will close on 18 December, will the Secretary of State make sure that access to radiotherapy within 45 minutes is a key criterion in allocating resources so that Westmorland general can be given its much-needed satellite radiotherapy unit?

Oral Answers to Questions

Debate between Jeremy Hunt and Tim Farron
Tuesday 10th October 2017

(7 years, 1 month ago)

Commons Chamber
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Jeremy Hunt Portrait Mr Hunt
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My hon. Friend is absolutely right. I am aware of the report that she talks about. We know that half of mental health conditions become established before the age of 14, which is why early intervention is so important. In July, I announced an expansion in the mental health workforce—another 21,000 posts. A number of those will be in children’s mental health, to address the issues she raises.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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The Secretary of State may know that because of a reduction in the number of mental health clinicians in Cumbria, the Cumbria Partnership NHS Foundation Trust has now chosen to end consultant psychiatric call-out care from 8 pm to 9 am. It would have started last week, but it is going to start in the next two or three weeks. That means, as I am sure he is aware, that it will not be possible to section people under the Mental Health Acts between those hours unless they are within an NHS facility. People in police stations, people in care homes and people at A&E departments will not be—

Tim Farron Portrait Tim Farron
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The question is: does the Secretary of State agree that that is not an appropriate use of resources, and will he provide the resources that are needed?

Jeremy Hunt Portrait Mr Hunt
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The hon. Gentleman raises a very serious issue. I will not go into it in detail now, but I will certainly look into it closely and get back to him, if I may. Obviously it is very important.

Oral Answers to Questions

Debate between Jeremy Hunt and Tim Farron
Tuesday 4th July 2017

(7 years, 4 months ago)

Commons Chamber
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Jeremy Hunt Portrait Mr Hunt
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I was concerned about the general laughter following that comment, Mr Speaker.

I am delighted that my hon. Friend’s father was treated so well, and I very much enjoyed my visit to the hospital recently. She is right: where there are changes in the patterns of training, we need to be very careful to ensure that they do not interrupt the delivery of local services in a disadvantageous way.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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The boundaries of the sustainability and transformation partnerships are bound to cause concern about the future of A&E and other acute departments given the nature of them. My area, south Cumbria—relatively sparsely populated and rural—is lumped in with Lancashire, which is largely urban. Will the Secretary of State confirm that the voices of rural communities will not be dwarfed by those of the larger urban ones, and in this week, as we celebrate the 25th anniversary of Westmorland general hospital, will he give guarantees that it will not be closed and will indeed not receive any downgrading as a result of the STP process?

Jeremy Hunt Portrait Mr Hunt
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Westmorland general hospital has a very important future in the NHS and I am happy to give the hon. Gentleman that assurance. I do not think he should be concerned about STP footprints covering both rural and urban areas. However, where there is an issue in his constituency, and many others, it is the response times for ambulances in the most remote areas, and we are looking at that.

Oral Answers to Questions

Debate between Jeremy Hunt and Tim Farron
Tuesday 5th January 2016

(8 years, 10 months ago)

Commons Chamber
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Jeremy Hunt Portrait Mr Hunt
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The inquiry has only just started, but I thank my hon. Friend for her interest in it. The important conclusion that we have drawn from what happened at Southern Health is that this issue is much broader than one trust. We are not as good as we need to be at investigating unexpected mortality in the NHS. Southern Health is perhaps an extreme example, but the problem is much more widespread. A cultural change is needed, and we are determined to do something about it.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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Will the Secretary of State undertake to support Morecambe Bay, the other hospital trust in Cumbria, as it moves out of special measures, by confirming the commitment made by the coalition Government to underwrite the capital costs of a radiotherapy unit at Westmorland general hospital and to support the uplift in tariff needed to sustain that unit?

Jeremy Hunt Portrait Mr Hunt
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I will happily look into that. I cannot give the hon. Gentleman the answer now, but we would want to do everything we can to support that trust. It has been through a very difficult time and has made huge progress. We want to help it on its way.

Maternity Services (Morecambe Bay)

Debate between Jeremy Hunt and Tim Farron
Tuesday 3rd March 2015

(9 years, 8 months ago)

Commons Chamber
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Jeremy Hunt Portrait Mr Hunt
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I do not know the answer to the last question because we have received the report only very recently, but we will do this work as soon as possible. Indeed, if we have cross-party support, it may be that we can expedite the process. The hon. Gentleman worked very closely with James Titcombe and is absolutely right to talk about the seriousness of what happened. As with the Francis report, however, I would caution against the idea that this problem will be solved if a few more nurses are struck off. We need accountability—that is incredibly important—and where there is wrongdoing, people must be fully held to account. The big lesson is the lack of openness, transparency and trust. It is quite possible that the reason some people did not speak out about poor care is that they were frightened of the consequences of doing so. They thought they would not be listened to. Other industries, such as the nuclear industry in which James Titcombe worked or the airline industry, have managed to create a culture of trust where people on the front line who make mistakes feel able to speak out and be supported if they do so. That is the most important lesson we need to learn from today’s report.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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I, too, want to the thank the Secretary of State and the shadow Secretary of State for their entirely appropriate contributions, both the statement and the response, on this immensely sensitive and deeply personally upsetting series of circumstances. I want especially to pay tribute to the families who lost loved ones as a result of what Dr Kirkup referred to as

“serious failures of clinical care”.

He refers to the report as a damning indictment.

The dignity and determination of parents such as James Titcombe and Carl Hendrickson have led to this awful truth being laid bare today. Those parents are an inspiration to me, and they should be to all of us. I want to pick up on one point in particular that was raised during the Secretary of State’s statement. Dr Kirkup expresses disquiet that the NHS and the parliamentary ombudsman chose not even to investigate what has now been shown to be the needless deaths of at least 11 babies and at least one mother. May I press the Secretary of State to go further than he has in his statement and do everything in his power to ensure that the watchdog for patients is not a lapdog for senior managers? Patients need a powerful, effective independent investigator who listens to those who grieve, like the Morecambe Bay families, and not one who dismisses them without even an investigation.

Jeremy Hunt Portrait Mr Hunt
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My hon. Friend is absolutely right. There were, clearly, very serious flaws in the way the Parliamentary and Health Service Ombudsman operated, particularly in the case of Joshua Titcombe. My hon. Friend will know that the PHSO is accountable to this House through the Public Administration Committee, and not through the Government and the Department of Health. The Public Administration Committee is considering this issue in a great deal of detail to see what lessons need to be learned. I think one of the issues is the level of expertise within the PHSO and, with the greatest of respect, a certain lack of confidence in its ability to understand when there has been a clinical failure. I think everyone agrees that one of the things we need to do is to ensure that it can draw on medical expertise. It needs to make sure that its culture is as open and transparent as the culture it would like to see inside the NHS.

Oral Answers to Questions

Debate between Jeremy Hunt and Tim Farron
Tuesday 13th January 2015

(9 years, 10 months ago)

Commons Chamber
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Jeremy Hunt Portrait Mr Hunt
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Let me tell the hon. Lady what we are doing—[Interruption.] This is what I think is so shocking: Labour Members are not actually interested in what is happening to avoid precisely the kind of things that the hon. Lady mentioned. We are putting £4.6 million of extra support into the North West ambulance service this winter, and that money is being used to employ more paramedics, to train people so that they can see and treat patients on the spot, and to help more people on the phone so that they do not need an ambulance. The hon. Lady should perhaps have listened to the earlier question, because where Labour is running the ambulance services, results are even worse.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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Does the Secretary of State agree that the rules for commissioning ambulance services need to be looked at again to ensure that ambulances serving rural areas such as South Lakeland which do not have an acute centre of their own and therefore export their ambulances further afield need to be compensated with additional ambulances to take account of the fact that so many of our vehicles are out of county most of the time?

Jeremy Hunt Portrait Mr Hunt
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My hon. Friend makes an important point about the way targets are set up. It is possible for ambulance services to hit their targets while not delivering a satisfactory service to the most rural areas, and we have discussed that issue a number of times. Because we are in the middle of a challenging winter, we do not think that now is the right time to review the issue, but he should rest assured that we are keeping it under review.

Oral Answers to Questions

Debate between Jeremy Hunt and Tim Farron
Tuesday 21st October 2014

(10 years, 1 month ago)

Commons Chamber
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Jeremy Hunt Portrait Mr Jeremy Hunt
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I am very happy to pay tribute to Eilish Hoole, to the many cancer campaigners and to the many people who have survived cancer and put their lives back together again. There is still a huge job to do in getting earlier diagnosis. I think there is agreement across the House about the need for much earlier cancer diagnosis, particularly for ovarian cancer, which makes a huge difference. I know that we would all like to pay tribute to her work.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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NHS England has identified south Cumbria as one of just three places in England where travel times to receive radiotherapy are unacceptably and debilitatingly long. Will the Secretary of State meet me and NHS England to talk about how Kendal hospital can be the place for a new radiotherapy centre this autumn?

Health Services (North-West)

Debate between Jeremy Hunt and Tim Farron
Thursday 11th July 2013

(11 years, 4 months ago)

Commons Chamber
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John Bercow Portrait Mr Speaker
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Order. I thank the Secretary of State for his courtesy. I know the right hon. Gentleman well, and I know that he would not seek for one moment to mislead the House. He was trying candidly to respond to the right hon. Member for Blackburn (Mr Straw). For the avoidance of doubt, let us be absolutely clear. I can quite accept that the Secretary of State requested, within the Government machine, permission to make a statement today. However, the House will wish to be aware that I myself was aware of the request to make a statement only this morning. Let us be clear about that.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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There is a strong clinical case for the concentration of vascular services in Cumbria and Lancashire at three sites, but is it not ludicrous that the three that have been chosen are so geographically located that one is virtually on the Scottish border, then there is a gap of almost 100 miles, and then there are two that are nine miles apart? Does not that leave south Cumbria and north Lancashire dangerously under-provided for? Given the current difficulties, shall we say, at Morecambe Bay, does not robbing Morecambe Bay of those skills and that expertise make a difficult situation potentially even worse?

Jeremy Hunt Portrait Mr Hunt
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I know that my hon. Friend has campaigned, rightly, to represent the concerns of his constituents about the extra travel that they will have to undertake. I would like to reassure him that we considered that issue very carefully. The Independent Reconfiguration Panel recognises that travel is a consideration, but also believes that for his constituents, even for the people who have to travel further, there will be better clinical outcomes for specialist vascular surgery. We are not talking about routine surgery, diagnosis or rehabilitation work but about conditions such as aneurysms and carotid artery disease which require specialist care. Patients can get much better help if that is concentrated in specialist centres.

As to why those particular centres were chosen, it was a genuinely difficult decision. There is a bigger concentration of population in the south of the region and there is also more social deprivation and more unmet need. I know it was a difficult decision, but it was decided that that would be best for the 2.8 million people in the area and also better for my hon. Friend’s constituents.

Care Quality Commission (Morecambe Bay Hospitals)

Debate between Jeremy Hunt and Tim Farron
Wednesday 19th June 2013

(11 years, 5 months ago)

Commons Chamber
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Jeremy Hunt Portrait Mr Hunt
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First, may I say I agree with what the hon. Gentleman says, and commend him on his work with his constituents and local families who have suffered so terribly from what happened? He is absolutely right to say we have created a system that is a nightmare for families who identify problems, and the real problem is a lack of clarity as to where the buck stops: where the buck stops in terms of the decision to say that a hospital is safe or not safe, and where the buck stops in terms of sorting out a problem when it is identified. Those are the areas where we are putting through big changes this year, as a result of the Francis report.

I completely understand why the issue of whether there is a continuing cover-up is a concern. All I can say is that I have total confidence in the new leadership of the CQC. They are on the side of the public. They understand that the CQC’s job is to be the nation’s whistleblower-in-chief. They absolutely get that, but changing the culture in the broader NHS takes more than the appointment of two new individuals at the CQC; it takes a complete change in the leadership so that people on the front line always feel supported if they want to raise safety concerns. That is a much bigger job. I do not want to pretend that we are going to be able to solve it overnight, but that is the big change we have to make.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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My constituents can be forgiven for wondering whether, when the watchdog chooses to muzzle itself, it is time to put it to sleep. The report shows that the CQC discovered the truth about the deaths of babies at Furness General, but chose to suppress the truth, and to seek to subvert the Freedom of Information Act—and this morning I have asked the police to investigate that point.

Grieving families like the Titcombes deserve to know who made these decisions, so will the Secretary of State agree to ensure the removal of anonymity for those guilty of putting institutional convenience ahead of the lives of mothers and babies?

I completely agree with my right hon. Friend about backing those on the front line, but we have a culpable ex-chief executive of the trust on a £200,000 payout while the excellent nurses and doctors in the trust are struggling under immense pressure, so will he agree to work with me and all colleagues across Morecambe Bay to help the trust recover, which includes agreeing not to now demand that the trust make £25 million-worth of savings by March, as that would further threaten the pursuit of patient safety?

Jeremy Hunt Portrait Mr Hunt
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I agree with much of what my hon. Friend says. He is absolutely right that accountability for what went wrong is crucial in this. I know that the CQC wanted to publish the report in full today, including the names of the individuals involved, but was given legal advice that it would be against the law to do so. However, the CQC is keen to have maximum transparency as soon as possible and is looking into how it can make sure that happens. There should be no anonymity, no hiding place, no opportunity to get off scot-free for anyone at all who was responsible for this. This is the problem we have to address in the NHS: all too often, people are not held accountable for what went wrong. However, the system also bears responsibility. This is not just about bad apples and how we root them out more quickly; it is also about creating a system that brings out the best in people—that plays to the decent instincts that got people to join the NHS in the first place, rather than making them think that targets at any cost matter more than the care and dignity of the patients in their trust.

Oral Answers to Questions

Debate between Jeremy Hunt and Tim Farron
Tuesday 15th January 2013

(11 years, 10 months ago)

Commons Chamber
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Jeremy Hunt Portrait Mr Hunt
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We believe in the clinical networks, including the network for cardiovascular disease. We have increased the funding for those networks by 27%. However, we want them to include mental health and maternity services. We think that it would be wrong to do what the Labour party wants, which is to concentrate that funding on cardiovascular disease and cancer, and deprive of the clear benefits of such networks the 700,000 women who give birth on the NHS every year and the nearly 1 million people who will be diagnosed with dementia.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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Given that the majority of vascular interventions are acute in nature, following trauma or cardiac episodes, is it not reckless for NHS Lancashire and NHS Cumbria to be talking about moving vascular services away from the Morecambe bay area, meaning that people from the south lakes and north Cumbria will have to travel as far as Preston, Blackburn or Carlisle to receive treatment? Will the Secretary of State meet me, other local MPs and local consultants to discuss how we can put the matter right for local people?

Jeremy Hunt Portrait Mr Hunt
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We are very keen to ensure that all reconfigurations of services have strong local, clinical support. We are making good progress in this area. There is always a trade-off between access, which I recognise is extremely important in a rural constituency such as the hon. Gentleman’s, and the centralisation of services, which sometimes leads to better clinical outcomes. I am happy to arrange for him to meet me or one of my colleagues to discuss his concerns in more detail.