Francis Report: Update and Response

Debate between Jeremy Hunt and Valerie Vaz

Wednesday 11th February 2015 Commons Chamber

[Mr Hunt]

The hon. Gentleman makes an important point, but I hope I can reassure him, because NICE has published guidelines on safe staffing levels, although they are different for different parts of a hospital: in intensive care, it is 1:1; for less severe illnesses, it is one nurse to eight patients; and in other parts of a hospital, it is one nurse to four patients. Those are all published, and I hope they will help whistleblowers in Cornwall and elsewhere.

[Valerie Vaz (Walsall South) (Lab)]

What support will the Secretary of State give to trusts to ensure that safe staffing levels are implemented, given that they might need extra resources?

[Mr Hunt]

We have protected—indeed increased—the NHS budget in real terms at the time of the biggest financial crisis since the second world war, so I think the Government have done what they can to make resources available. However, improving care is not always about money, and some hospitals manage to staff their wards safely and achieve financial balance. In fact, hospitals that practise safe care tend to be in a better financial position than ones that do not, so safe care and good finances actually go together.

NHS Major Incidents

Debate between Jeremy Hunt and Valerie Vaz

Wednesday 28th January 2015 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. I have spoken to the chief executive of the hospital, and I must say that she and her staff are doing a good job in turning around a very difficult situation. What they want is support. We have issued sensible guidance that tells hospitals that if they declare a major incident, they must take account of the impact on the rest of their local health economy. A responsible Opposition would support such guidance, and not to try to turn it into a political football.

[Valerie Vaz (Walsall South) (Lab)]

The Manor hospital had to declare a major incident due to inordinate pressure from the closure of Stafford A and E. That is not a local issue, but a national one. When will the Secretary of State provide the hospital with the extra money to absorb the closure of Stafford A and E?

[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.

Oral Answers to Questions

Debate between Jeremy Hunt and Valerie Vaz

Tuesday 13th January 2015 Commons Chamber

[Mr Hunt]

These things are decided independently by NHS England, which made the decision on the basis of which CCGs were most off their target allocation and on social deprivation and the number of older people. I remind the hon. Gentleman that there are many older and vulnerable people in the south, too, and they need a fair settlement from the NHS. That is why the decision was made.

[Valerie Vaz (Walsall South) (Lab)]

The College of Emergency Medicine says that the extra money the Secretary of State has given is not reaching A and E. What steps is he taking to ensure that the money does not stay with the CCGs, but actually goes into A and E?

[Mr Hunt]

I have had a number of discussions with the College of Emergency Medicine and what it actually says is that the system is working pretty well—[Interruption.] Well, that is what the College of Emergency Medicine says. The country’s A and E doctors welcome the fact that with the winter pressures money, there are now 800 more doctors and 4,700 more nurses, but we always want to make sure that the money is getting through as quickly as possible, so if the hon. Lady has any particular examples, I would be happy to look into them.

A and E and Ambulance Services

Debate between Jeremy Hunt and Valerie Vaz

Thursday 18th December 2014 Commons Chamber

[Mr Hunt]

I can confirm that the Government’s policy is to root out poor care wherever we find it, not to cover it up and conceal it for party political purposes.

[Valerie Vaz (Walsall South) (Lab)]

The College of Emergency Medicine gave the Secretary of State a 10-point plan in 2013. Will he say which of those 10 points he has enacted?

[Mr Hunt]

We have enacted, or started to enact, every single one of them. Some of them take a bit longer—the contracts for A and E consultants, for example, which we want to ensure are attractive enough to encourage people to want to become A and E consultants. I am pleased to say that we have made some progress on that and are now getting the recruits coming into A and E that we want to see. Other things are starting to happen this winter—more co-location of GP services at A and E front doors and better discharging procedures from hospitals. We have been working very closely with the College of Emergency Medicine, which has been a great help to us in devising these winter plans.

Oral Answers to Questions

Debate between Jeremy Hunt and Valerie Vaz

Tuesday 25th November 2014 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for raising that point. The last Labour Government did leave us with one of the lowest cancer survival rates in western Europe, which is one of the reasons why we introduced the CDF. Unfortunately, the current Labour Government in Wales are continuing with those policies, which is why 6,500 Welsh cancer patients were admitted for treatment in English hospitals last year. [Official Report, 12 January 2015, Vol. 590, c. 5-6MC.]

[Valerie Vaz (Walsall South) (Lab)]

So will the Secretary of State then publish the assessment of the CDF by the chemotherapy intelligence unit before 7 May 2015?

[Mr Hunt]

We are, on the NHS, the most transparent Government in history, and I can see no reason why we would not publish that. We are very proud of what the CDF has achieved. We are very proud that the level of cancer diagnoses has increased by more than 50% compared with what it was under the previous Labour Government, and so we are finally starting to win the battle against cancer.

Oral Answers to Questions

Debate between Jeremy Hunt and Valerie Vaz

Tuesday 21st October 2014 Commons Chamber

[Valerie Vaz (Walsall South) (Lab)]

Will the Secretary of State explain why NHS England has entered into a contract with a company based in Kent to provide GP services, when my constituents have just seen a string of locum GPs at a higher cost to the NHS?

[Mr Jeremy Hunt]

Wherever we can avoid it, we do not want to use locum GPs or nurses or agency doctors, because they are much more expensive—our spend on that is far too high—but sometimes when there are issues of patient safety we need a quick solution. That is what has happened in response to the Francis report: as well as recruiting 5,000 additional nurses on a permanent basis, we are using extra agency nurses. However, we hope to bring those numbers down.

NHS Investigations (Jimmy Savile)

Debate between Jeremy Hunt and Valerie Vaz

Thursday 26th June 2014 Commons Chamber

[Mr Hunt]

No, I am not. That is why earlier this week we asked Sir Robert Francis to do a follow-up review to his public inquiry to determine what else needs to be done to create a culture of openness and transparency in the NHS. We have come a very long way as a society in terms of our understanding, but there is more work to be done. It is also very important, as I said in my statement—I know everyone would agree with this—that we do not undermine the brilliant work done by volunteers in hospitals and that we do not create a kind of bureaucratic morass that makes it impossible for that really important work to be done. However, I know we can do better than we are at the moment and important lessons need to be learned.

[Valerie Vaz (Walsall South) (Lab)]

The Secretary of State has been very gracious in his apology given that he was not Secretary of State at the time. Might I make one further practical suggestion? Will he speak to the Prime Minister about perhaps appointing a Minister to co-ordinate all these reports across the public institutions?

[Mr Hunt]

I reassure the hon. Lady that that responsibility lies with the Home Secretary, and the Home Office has a cross-governmental committee that will bring together all the lessons from all the reports. My first priority is to ensure that we are doing everything we can to make NHS patients safe, but there are much broader lessons to be learned. That is being led by the Home Office.

Oral Answers to Questions

Debate between Jeremy Hunt and Valerie Vaz

Tuesday 26th November 2013 Commons Chamber

[Mr Hunt]

I am delighted to do that. As these are the last Health questions before Christmas, all of us would want to pay tribute to the voluntary organisations that do an extraordinary job of making sure that vulnerable older people do not get lonely over the Christmas period. It is heroic what they do—when we are with our families, they are looking after other people—and we should salute them all.

[Valerie Vaz (Walsall South) (Lab)]

22. One way to ease the pressure on the NHS is by not handing the £2.2 billion underspend back to the Treasury. Will the Secretary of State consider using it for the NHS?

[Mr Hunt]

I wish the hon. Lady had been as diligent in asking that question of Labour Ministers, who also handed back underspends to the Treasury when they were in power.

Mid Staffordshire NHS Foundation Trust

Debate between Jeremy Hunt and Valerie Vaz

Tuesday 19th November 2013 Commons Chamber

[Valerie Vaz (Walsall South) (Lab)]

The College of Emergency Medicine has consistently called for an increase in emergency doctors, because there has been a 50% shortfall over the past three years. What plans has the Secretary of State to address that concern?

[Mr Hunt]

I met the College of Emergency Medicine yesterday to discuss those issues, among others. We have 300 more doctors working in our A and E departments than we did three years ago, but the hon. Lady is absolutely right that we need more, because 1 million more people a year are going through A and E than there were in 2010. Part of the challenge is to make A and E a more attractive profession for doctors. They might work long shifts and antisocial hours, which can make it unattractive. We need to find a way of dealing with that.

Accident and Emergency Departments

Debate between Jeremy Hunt and Valerie Vaz

Tuesday 10th September 2013 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for making that point. It cannot be said enough how hard A and E staff in particular work—antisocial hours in very challenging conditions. Many hon. Members will have seen that in their local hospitals. With respect to the capital allocations, I hope that the House has a sense from today that we are looking to solve the long-term problems facing A and E departments, as well as giving immediate help for this winter and next winter, so of course we will look carefully at the business case put forward by his local hospital for capital.

[Valerie Vaz (Walsall South) (Lab)]

The Royal College of Physicians, the College of Emergency Medicine and others have already come up with a 10-point plan for what to do about emergency care. That is the professional view. When will the Secretary of State act on it?

Oral Answers to Questions

Debate between Jeremy Hunt and Valerie Vaz

Tuesday 16th July 2013 Commons Chamber

[Valerie Vaz (Walsall South) (Lab)]

4. What plans he has to implement the recommendation of the Francis report on safe staffing levels.

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

We agree with Robert Francis that there is a need for evidence-based guidance and tools to inform appropriate staffing levels. We have set out a number of recommended actions to support appropriate staffing levels in “Compassion in Practice”—the nursing, midwifery and care staff vision and strategy for England.

[Valerie Vaz]

I thank the Secretary of State for his answer, but Robert Francis said in his report that minimum safe staffing levels lead to helping patient safety. If the Secretary of State agrees with Robert Francis, why does he not implement that recommendation now?

A and E Departments

Debate between Jeremy Hunt and Valerie Vaz

Tuesday 21st May 2013 Commons Chamber

[Mr Hunt]

My hon. Friend rightly draws attention to the importance of the ambulance service, which is also feeling the pressure on A and E departments. We need to help the ambulance service to do its job better too. One thing that it always strikes me would make a huge difference to ambulance services is if staff could access the GP records of someone they were picking up on a 999 call, so that they would know that the patient was a diabetic with mild dementia and a heart condition, for instance. That kind of information can be incredibly helpful. I hope that by sorting out the IT issues with which the last Government struggled, we can help ambulance services to do that.

[Valerie Vaz (Walsall South) (Lab)]

The Select Committee on Health heard evidence today from the College of Emergency Medicine about a 50% shortfall in trainee doctors and consultants. On average, trusts—I was going to say PCTs—spend £500,000 on locums. What does the Secretary of State intend to do about that?

[Mr Hunt]

We certainly intend to address A and E departments’ recruitment issues, which I recognise are one of the causes of the pressure. Over-reliance on locum doctors is not a long-term solution to improving the performance of A and E departments either, so those are both areas that we will be looking at.

Mid Staffordshire NHS Foundation Trust

Debate between Jeremy Hunt and Valerie Vaz

Tuesday 26th March 2013 Commons Chamber

[Mr Hunt]

First, I thank my hon. Friend for his extraordinarily tireless work and for the extremely measured and mature attitude he has taken to the problems in the hospital, which is on his patch. Hon. Members on both sides of the House welcome that. He is right about the role of the royal colleges. There are some challenging suggestions in the Francis report for some of those colleges, but when we are seeking to raise standards, it is important that setting up that scorecard for the new chief inspector happens with the help of the royal colleges, whose business it is to raise standards in the NHS.

[Valerie Vaz (Walsall South) (Lab)]

I thank the Secretary of State for his statement, and we welcome the continuation of this discussion at the Health Committee. One of the recommendations of Francis was for the Secretary of State to look at the overlap between the CQC and Monitor, both of which were involved and have accepted they were part of the failings. Under the new inspection regime, will the chief inspector report to the Secretary of State or to the NHS Commissioning Board?

[Mr Hunt]

Neither. The chief inspector will report to the CQC. The hon. Lady is right that one of the problems is the overlapping roles and the confusion of roles. What we are announcing today is a significant change in the responsibilities of the CQC. It will no longer be involved in putting right problems in hospitals: its job will simply be to identify problems, so it is not compromised in its ability to be the nation’s whistleblower-in-chief. The responsibility for putting right problems will lie with Monitor, the NHS Trust Development Authority, the NHS Commissioning Board and the wider NHS system. We want to make sure that the chief inspector is unconstrained and unconflicted, when his or her team goes into hospitals, from shouting loudly if there is a problem and continuing to shout loudly until it is solved.

Oral Answers to Questions

Debate between Jeremy Hunt and Valerie Vaz

Tuesday 15th January 2013 Commons Chamber

[Mr Hunt]

My hon. Friend has mentioned the issue to me before, and I am happy to look into it in detail for her.

[Valerie Vaz (Walsall South) (Lab)]

How will the Secretary of State assess the effect of the cancer drugs fund on cancer survival rates?

[Mr Hunt]

It will be very easy to look at the number of lives saved. We will be able to see the impact of the fund, because it only started in 2010.

NHS Commissioning Board (Mandate)

Debate between Jeremy Hunt and Valerie Vaz

Tuesday 13th November 2012 Commons Chamber

[Mr Hunt]

There is something critically important in the mandate that will do that, which is that by making the NHS operationally independent we are giving commissioning responsibilities to local GP-led groups for the first time, and GPs understand the importance not just of primary care but of prevention. So I think we will see much more innovation, along with the co-operation that the NHS has with local authorities and the new health and wellbeing boards, to make sure that there is a much bigger focus on prevention than there has been in the past.

[Valerie Vaz (Walsall South) (Lab)]

Will the Secretary of State confirm that if there is an underspend in the NHS Commissioning Board financial allocation, that will stay in the NHS and not go back to the Treasury?

[Mr Hunt]

As the hon. Lady knows, we manage our finances extremely carefully but we do have underspends. We try to minimise them and there has been a real-terms growth in spending—actual money spent in the NHS, compared with Labour’s plans. In the first year of the review there was a real-terms increase and we will continue to manage NHS finances with a commitment to protecting the budget, which did not ever happen when the right hon. Member for Leigh was in post.

Oral Answers to Questions

Debate between Jeremy Hunt and Valerie Vaz

Tuesday 23rd October 2012 Commons Chamber

[Mr Hunt]

May I reassure my hon. Friend that we are absolutely committed to the “no cherry-picking” provisions of the Act? We think that we have found the right way to achieve that in the NHS, and I will write to him to explain exactly how we will do that.

[Valerie Vaz (Walsall South) (Lab)]

Given the apparent increase in spending in the NHS and the £4 billion surplus, will the Secretary of State look at lifting the pay restraint for lower-paid workers, to increase morale and boost productivity?

[Mr Hunt]

The £12 billion increase in spending on the NHS under this Government, which the right hon. Member for Leigh (Andy Burnham) thought was irresponsible, means that we will be able to do a lot more for patients, but there is also rising demand. If we do not have that pay restraint, we will not be able to meet the needs of an ageing population.