Melanoma

Jeremy Lefroy Excerpts

Wednesday 18th January 2012 Westminster Hall

[Pauline Latham]

I completely agree with my hon. Friend, and I will come on to some cases in a moment. It is a very important point.

As well as coming together to share our concerns, the meeting was held to create a report that was submitted to NICE in response to the appraisal consultation document, in anticipation that it would be considered ahead of the NICE technology appraisal meeting, which took place on 16 November. We have had no response so far.

When holding the meeting on advanced melanoma, I was given the opportunity to hear first hand from melanoma patients, who are desperate to receive the drug. Melanoma often strikes at the younger end of the population. More than a third of all cases of melanoma occur in people below the age of 55, and it is the second most common form of cancer in the UK for those aged between 15 and 34. What those statistics on advanced melanoma in the younger population do not show is that many people in that age group will have children and so will face a very aggressive cancer, alongside the knowledge that they face leaving behind their children and family.

The patients whom I met at the meeting all echoed a simple and profound point: they are desperate to stay alive, so that they can be with their children, husbands, wives, partners and families. Given that treatment options for the disease have not advanced for three decades, how can it be fair not to release the drug for use by those patients who could have more time with their families? One young patient—a lady aged only 30—said at the meeting:

“I need to live. I have to live for my children. I just want a few more years so that my boys will remember me.”

Richard Clifford, the founder and trustee of the Karen Clifford Skin Cancer charity—Skcin—said at the meeting that

“median overall survival time after diagnosis is six to nine months. This is tragic because people have little time to prepare themselves and their loved ones for what is inevitably going to occur.”

I could not agree more with his sentiments. There is clearly an unmet need in the treatments available, and I believe that ipilimumab has a place in today’s treatment options, which are already scarce for cases of malignant melanoma. An experienced oncologist from Leeds who has used ipilimumab echoed that view at the meeting:

“It is the first drug that can help people live longer or make them more likely to be active for a meaningful period of time.”

I add a personal plea for help: my brother died from a malignant melanoma 11 years ago this month at the age of 54, one week after his birthday, leaving his wife and two teenage children. I know how debilitating this form of cancer is and how quickly it can spread. Apart from radical surgery, he had very few options in terms of the drugs on offer. As a result of Michael’s illness and death, I see my GP regularly, and I have had several pre-cancerous areas removed before they had the chance to progress to malignancy.

[Jeremy Lefroy (Stafford) (Con)]

I congratulate my hon. Friend on raising this important issue. As someone with very fair skin, I have had to have skin removed and examined, so I understand the potential consequences and the worry that people go through. Does she agree that we need more education about the consequences for fair-skinned people and, indeed, everyone of too much exposure to the sun and the overuse of sunbeds?

[Pauline Latham]

Yes, and I thank my hon. Friend for bringing that up. Sunbeds are still a problem, particularly among young women who think that having a tan makes them look healthier.

Care of the Dying

Jeremy Lefroy Excerpts

Tuesday 17th January 2012 Westminster Hall

[Fiona Bruce (Congleton) (Con)]

I support all that has been said by those hon. Members who have spoken today. I want to touch particularly on the importance of how we can develop the excellent hospice care that already exists in our country today. Dame Cecily Saunders has been quoted. She said that the hospice movement should have three components: care, research into good care and education of professionals and the community in care and end-of-life issues. Communities today need hospices to operate at that level not just within their buildings, but outside. Fantastic care is given in hospices, but to a relatively small number of people.

In Cheshire, for example, St. Luke’s hospice, which serves my constituency, has just 14 beds, but through various initiatives, it has a far greater beneficial impact on the wider community. I should like to share some of the initiatives that St. Luke’s is developing. It has recently been invited to share those initiatives with the all-party group on dying well. To give confidence and skills to others to share well the care of family members, it has a community outreach programme, and I will refer to one of those programmes in my constituency.

The village hall in a village near Alsager opened its doors one day a week, but that is now being extended, so that those who are not within the hospice may come for day care. Nurses from the hospice spend a day at the village hall, and a group of volunteers cook lunch for the community’s elderly residents, who are often in some difficulty with their physical and mental capabilities. They can have counselling in a private room, a massage, treatments such as manicures and pedicures and engage in hobbies. I saw some wonderful art work that they had done over a period of months. They are provided with an excellent lunch, preceded by a small glass of sherry if they want it. There is much laughter and much support, and that enables the people who visit the centre not only to remain in their communities, but to have their lives enhanced and supported by the work of the hospice, augmented by a substantial number of local volunteers. In turn, those volunteers go into those people’s homes.

[Jeremy Lefroy (Stafford) (Con)]

I am grateful to my hon. Friend for describing the innovative care that hospices in our local communities provide. In my constituency, Katharine House hospice does the same. I want to draw her attention to the community lodges that the Douglas Macmillan hospice has set up in an area near her constituency. They allow families to come together and to support their loved ones in a lodge as they are dying.

[Fiona Bruce]

My hon. Friend is absolutely right. As Siobhan Horton, the director of St. Luke’s hospice said:

“Hospices need to actively transfer their enormous expertise in health and social care more broadly to ensure more benefit from high quality care”

for more people. St. Luke’s also provides education for all those in the Cheshire area who are involved in hospice work. I have visited the hospice. The ground floor contains 14 beds, and the first floor is a resource centre with a library, and advisers to inform and enable carers and professionals to extend their expertise throughout the Cheshire community and beyond. Hospices can do that excellently, because of their unique expertise, not only in this country, but throughout the world.

Another project that St. Luke’s is undertaking is to develop a public health approach to end-of-life issues, so that ageing well and dying well are part of living well. It is working with the local community to improve communication with family members who are coming to the end of their lives, to resolve outstanding issues, to reduce regrets, to open up conversations that others may be reluctant to engage in, to work with family members and to encourage the engagement of their wider community in supporting the family and individuals who are struggling to support themselves towards the end of a life in the family. The aim for all who are supported in that way is a good death. I think that we all have that aspiration: a death within the loving embrace of our family and local community. St. Luke’s is undertaking serious research into that, and I look forward to hearing more about its developing public health approach to end-of-life issues.

I want to touch on the work that St. Luke’s is doing in connection with care homes. It has been involved in care home education for many years, and although it believes that some care home care is excellent, it also believes that much expertise can be shared both ways. It is considering how to have a closer, more supportive relationship with care homes locally and is commissioning a report on strategic planning and what sort of relationship and support would make a positive difference to care home delivery of end-of-life care. Let us support such innovations and others throughout the country to develop the excellent work of the hospice movement here, of which we can all be proud. I look forward to hearing from the Minister how the country and the Government can continue to support and promote the extension of the excellent palliative care in this nation.

Stafford Hospital

Jeremy Lefroy Excerpts

Tuesday 20th December 2011 Westminster Hall

[Jeremy Lefroy (Stafford) (Con)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. It is also a pleasure to see the Minister in her place. I am expecting my colleagues from Staffordshire to come into the Chamber during this debate and to intervene if they so wish.

On 1 December this year, Stafford hospital started a temporary night-time closure of the accident and emergency department from 10 pm to 8 am. That happened principally as a result of a shortage of A and E specialists and the need to maintain a safe service. The hospital has been unable to recruit such specialists, partly as a result of a national shortage and partly owing to problems that Stafford has experienced. I wish to set out why it is important for the hospital’s A and E department to return to full-time working and to draw out some more general conclusions.

The hospital is part of the Mid Staffordshire NHS Foundation Trust, which also runs the non-acute Cannock hospital. Stafford serves a population of some 250,000 to 300,000 people in the middle and south-west of the county. As my intention is to highlight the importance of A and E, I will dwell only briefly on the Francis public inquiry, which is completing its work and will report next year. The inquiry is considering the lessons that can be learned from what happened. Certainly, lessons learned from the initial Francis investigation into the hospital have largely been put into practice. There continue to be major improvements, though clearly there is no complacency. It has been very encouraging to hear from constituents about the quality of care that they receive and their praise for staff.

I have heard some say that the Francis inquiry is not necessary, but I disagree profoundly. Let me simply report the words of a senior member of the Royal College of Physicians who said that that is the most important inquiry into the NHS in a generation. I am most grateful to the Government for their support for the hospital and the trust through a particularly difficult time for Stafford and the whole surrounding area. I ask for that support to continue, as the trust develops its plans to provide high-quality and financially sustainable services.

The importance that people in Stafford, Cannock, Rugeley and beyond place on the A and E department is shown by the more than 18,000 people who have signed petitions that support it. Stafford borough council has also shown strong support by passing a unanimous resolution at full council. Since the temporary night-time closure, a number of people have told me how concerned people, particularly the elderly, are that they no longer have a night-time emergency service relatively close to hand. We need to remember that, across the country, A and E departments not only treat people in medical need and save lives, but provide reassurance, whether to parents with a child who becomes sick in the middle of the night, or elderly people who have no transport of their own and are worried about imposing themselves by calling out an ambulance and overburdening the service. For them, an emergency service that is as local as possible is essential.

Let me make it clear that the closure was necessary. The decision was not taken lightly, but was made in the interests of patient safety. The temporary night-time closure is giving the hospital time to recruit the necessary staff and to improve training, which is difficult when one is overstretched.

I should like to thank the Minister and the Minister of State, Department of Health, my right hon. Friend the Member for Chelmsford (Mr Burns), as well as the Secretary of State for Health and the Department of Health for their help and support. I also thank the Ministers and staff of the Ministry of Defence for providing armed forces medical staff to assist for some 12 weeks. They have been invaluable both in providing additional cover and in helping with training.

I should like to thank the leadership and staff of the University hospital of North Staffordshire, New Cross hospital in Wolverhampton, Manor hospital in Walsall and Burton hospitals for taking the strain of additional patients during the temporary night-time closure. I also thank the staff of the West Midlands ambulance service for providing the necessary additional cover.

I should now like to turn to the reasons why Stafford requires a 24-hour A and E department. First, the population of the area is growing. Stafford itself is a growth point and expects to see another 15,000 to 20,000 people settle in the area in the coming 20 years, with 2,000 to 3,000 from the armed forces returning from Germany to MOD Stafford between 2015 and 2018. Cannock and Rugeley are also growing.

[Mr Aidan Burley (Cannock Chase) (Con)]

I congratulate my hon. Friend on securing this debate. He mentions Cannock, which is my constituency. Does he agree that the answer to all the problems that we have seen in Stafford is not to close Cannock but to impose a two-site solution, with services both at Stafford and at Cannock and an improved and more vibrant Cannock hospital? That is the only way forward and a solution on which we both agree as neighbouring constituency MPs.

[Jeremy Lefroy]

I entirely agree with my hon. Friend. It is essential that we have services both in Cannock and Stafford. Both hospitals are vital to their local communities, although they perform different services.

Secondly, we have an increasing elderly population who rely on local accident and emergency services. Increasing life expectancy is welcome, but when the elderly become ill, they tend to be more acutely ill. The combination of population growth and more elderly people will inevitably lead to more demand for emergency and acute services. Successive Governments have tried, with varying degrees of success, to persuade people who are not seriously ill to use alternatives to A and E. That is important—I welcome the Government’s moves in that direction—but it will only relieve a small part of the pressure on these departments.

Thirdly, Stafford’s accident and emergency department is extremely busy. The admissions for the past 12 months, up to November 2011, numbered 52,255. That is some two thirds of the number of admissions to Manor hospital in Walsall and slightly more than half of the admissions to the University hospital of North Staffordshire and New Cross hospital in Wolverhampton.

[Gavin Williamson (South Staffordshire) (Con)]

I congratulate my hon. Friend on securing this debate. He touches on an important point, especially at this time of peak demand for hospitals. New Cross hospital and hospitals in Walsall and Stoke-on-Trent are under a lot of pressure. It is vital that we ensure that this closure is only temporary and that we resume full-time, 24-hour accident and emergency services.

[Jeremy Lefroy]

I am most grateful to my hon. Friend for making that point. I reiterate my thanks to those hospitals for taking on the extra patients in the night-time hours during this difficult time in the winter. Stafford accounts for 14% of the entire number of A and E admissions for the whole region, which includes Staffordshire, Wolverhampton and Walsall.

Fourthly, with Stafford being shut at night, most patients have to travel considerably further for emergency care. The University hospital of North Staffordshire in Stoke is 19 miles away, New Cross in Wolverhampton is 18 miles away, Manor hospital in Walsall is 19 miles away and the hospital in Burton is 27 miles away. The absence of Stafford, even for 10 hours at night, leaves a very large hole in accident and emergency provision for the region. It is a matter not only of distance, but of the amount of traffic on the roads. Night-time travel is usually reasonable in the area, but congestion can be substantial during the day, particularly when the M6 is closed between junctions 12 and 14 and all motorway traffic is diverted through the middle of Stafford.

It has only been possible to cope with the temporary night-time closure with the use of several additional ambulances and increasing staff cover. Such facilities are expensive. Indeed, they are more expensive than keeping the A and E department open 24/7, which emphasises the fact that the decision was taken for reasons not of cost but of patient safety.

It is essential that Stafford hospital has a full-time accident and emergency service, but not every emergency can be treated there. Given the advances in medical science and treatment, it makes sense for some of the most serious emergencies to be treated by top specialists who will only be in the largest hospitals. Patients with major trauma, severe strokes or major heart attacks already go to regional centres such as UHNS. That is understood and generally accepted. However, a district general hospital should be able to respond safely to a number of emergency conditions and provide a minimum set of services, such as acute medical, including rheumatology and geriatric; acute surgical and orthopaedic; paediatric; maternity; and mental health, particularly for overdoses. In some cases, hospitals may have to stabilise a patient before they can be transferred to a specialist centre.

Retaining a core set of emergency services in district general hospitals is important to protect their viability. As John Donne said:

“No man is an island.”

That can equally be said of many acute services. It is not possible to retain acute medicine, which provides the lion’s share of the income of an acute hospital, without having access to surgical opinion on the spot. Any emergency service also needs the full-time support of critical care units and radiology, to name but two. That is not to say that there can be no change—there must be changes to make district general hospitals financially sustainable in a difficult climate—but we must not put so much pressure on them that their only option is to close their doors to emergencies from the communities that they serve, forcing people to travel considerable distances for all but minor injuries.

Changes must be thought through and discussed openly with those communities. There should be no sudden changes and nothing hidden in the small print. The NHS is paid for by the British people and is a service that gives us great reassurance, even if we are fortunate enough rarely to need it.

I have set out clearly why Stafford hospital needs a full-time accident and emergency service. I am making the argument from the point of view not of the hospital itself, the bricks and mortar, but of the patients—my constituents and those of my hon. Friends the Members for Cannock Chase (Mr Burley), for Stone (Mr Cash) and for South Staffordshire (Gavin Williamson), many of whom rely on its services.

Stafford hospital provides a first-class service to many people in our area. The management, the staff, my parliamentary colleagues and I are not complacent; we recognise that there is more to be done. None of us will be satisfied until our hospital is known nationally, as I believe it will be, for its high-quality treatment and care and it has the confidence of all those whom it serves.

National Health Service

Jeremy Lefroy Excerpts

Wednesday 26th October 2011 Commons Chamber

[Jeremy Lefroy (Stafford) (Con)]

I apologise for missing the opening few minutes of the debate. I was attending the awarding of the gold Duke of Edinburgh’s award to 800 young people in London. It would be marvellous if the press would give as much time to reporting the fantastic achievements of our young people as to the occasional incidents of antisocial behaviour in our communities.

I wish to speak about what I have learned from the experiences that we have had in my constituency regarding our own hospital over the past few years, which have been very troubling for many of us. I will consider these under three headings. First, there is the quality of care and patient safety. As we have learned only recently in the report by the Care Quality Commission, there are problems with quality of care, particularly for elderly people, around the country. That is not the case everywhere; there are some fantastic instances all over the country of very high-quality care. However, it is clearly something that we have to address. I congratulate the Secretary of State on taking the initiative in instigating the CQC report, and I would be very interested to hear from him, as would my right hon. Friend the Member for Bermondsey and Old Southwark (Simon Hughes), about what action he proposes to take in the coming years. I know that the Secretary of State takes this matter extremely seriously.

Patient safety is absolutely essential to the NHS. “First, do no harm”—we all know that from the Hippocratic oath. It is given the highest priority, but it does not always seem to happen. Of course, it is a matter of several different things coming together, such as training, levels of staffing and process—but, above all, attitude. What is the Secretary of State doing more to promote the culture of patient safety throughout the NHS? Again, he takes that particularly seriously, and it was mentioned in last year’s White Paper.

Sometimes, the NHS seems almost to rely too much on the complaints system. A complaint happens when it is too late and when the experience has passed: when something unfortunate or tragic has happened, or when care has not been all that it could have been. I would suggest a system that has been taken up by some trusts and particularly in Brighton, whereby people can raise an issue via an urgent phone line while they, their loved one or their relative is in hospital, perhaps to an independent person who can take up the concern, whether it be about malnutrition in hospital, a lack of care or the inaccurate dispensing of drugs. It can then be addressed on the spot rather than after the event, when a complaint goes through the procedure and lots of letters are written and time consumed. I ask the Secretary of State to take that into account.

The second issue is changes in hospital services, which are a huge challenge for many acute hospitals, especially smaller ones. I agree with the right hon. Member for Leigh (Andy Burnham) and my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) that care has to be taken out of the hospital setting. That is being done across the country and it is essential to the future of the NHS. However, it has to be done in a careful and measured way, so that the reconfiguration and integration of community services complement each other. It is no good having reconfiguration without integrated community services. I heard the case of a constituent who was waiting in an NHS hospital for several weeks at a cost of about £600 a night when she could have been discharged, because the care services were not available in the community. I am glad to say that Staffordshire county council is working closely with the NHS to produce an integrated care trust. That must be the way forward for most, if not all, of the country.

There is concern in all our communities about emergency services. We have to bear it in mind that the population of this country is likely to rise to 70 million by 2028 according to the Office for National Statistics. We need to ensure that the local development plans that are being toiled over at the moment take into account the increasing population and where it will be in 10 to 20 years’ time, and that we do not just base our services on the current population figures. We must also consider communications and whether it will be possible for somebody to get to an A and E department in a reasonable time if their closest one is downgraded. Those matters need to be taken into account because they are of huge concern to all our constituents. I ask the Minister to respond on that point.

On communication, let us be honest about the pressures on the NHS and say that we will not be able to have everything that we want. We need to talk with our constituents and hear what their priorities are in each area.

Finally, I want to refer to shortages in trained staff. There has been a shortage of A and E consultants at my local hospital. I am grateful to the Department of Health, the primary care trust and the Secretary of State for taking a personal interest in the matter and giving us assistance. However, that is a short-term solution and we need a long-term one. The previous Government did well to start up some new medical schools, including one at Keele university in Staffordshire, but we need to train more people. I understand that up to 30% of NHS doctors come from overseas. We are relying on the medical training of other countries, many of which need those doctors more than we do. I ask the Secretary of State what plans he has to ensure that we begin to see a flow-through of trained doctors and nurses into the NHS. Of course, we have to start that now to fulfil the needs that we will have many years down the line.

Stafford has been through difficult times and continues to experience them, even though many incredibly dedicated people are tackling our problems. I welcome the help that the Government, the Secretary of State and the primary care trust have given. The next few years will be very trying for all of us as we meet those challenges. As my hon. Friend the Member for Central Suffolk and North Ipswich said, we must remember that the patient is at the heart of everything—not processes, not bodies, not organisations, but the patient.

Oral Answers to Questions

Jeremy Lefroy Excerpts

Tuesday 18th October 2011 Commons Chamber

[Mr Speaker]

Order. I remind the House that there is intense interest, and therefore there is a premium on brevity from Back and Front Benchers alike.

[Jeremy Lefroy (Stafford) (Con)]

T4. Several of my constituents, including members of the Cure the NHS group, have raised concerns over the way in which “Do not attempt resuscitation” notices are used in hospitals. Will the Secretary of State tell the House what the NHS is doing to ensure that the national guidance is followed?

[Mr Lansley]

This is an area in which the medical director of the NHS, the General Medical Council and others issue guidance to the NHS. I will gladly write to my hon. Friend setting out the details.

Health and Social Care (Re-committed) Bill

Jeremy Lefroy Excerpts

Tuesday 6th September 2011 Commons Chamber

[Jeremy Lefroy (Stafford) (Con)]

I have been listening carefully to the hon. Gentleman. Will he accept and welcome the fact that clause 3 imposes on the Secretary of State a duty to reduce inequalities? Is that duty not a welcome innovation in legislation that he expects the Secretary of State to apply with rigour?

NHS Future Forum

Jeremy Lefroy Excerpts

Tuesday 14th June 2011 Commons Chamber

[Mr Lansley]

I do not think that the hon. Gentleman listened to or heard the Prime Minister when he made absolutely clear our commitment to keeping waiting times low. Not only did the Prime Minister make that commitment, but it is in the constitution. In practice, the opportunity for patients increasingly to see the performance of the hospitals to which they can choose to go will help to drive increases in performance. As I told the House in response to an earlier question, waiting times are now lower for in-patients and out-patients than at the time of the last election. I am also old enough to remember that in June 1944, Winston Churchill, as the leader of a coalition Government, went to the Royal College of Physicians and set out an ambition for a national health service that would give everybody in the country access to the highest quality health care, free for all, regardless of means.

[Jeremy Lefroy (Stafford) (Con)]

The Cure the NHS group, founded by Julie Bailey in Stafford, has rightly stressed the importance of a culture of caring and zero harm to patients—something that my right hon. Friend has always emphasised. How does he think the recommendations of Professor Field’s report will help with embedding such a culture across the NHS?

[Mr Lansley]

As my hon. Friend knows, much can contribute to that change of culture, not least making safety one of the central domains for measuring outcomes in the NHS. In addition, it must be personal to each member of staff in the NHS that they have that responsibility. We have too often seen cases in which people have been professionally responsible but have not acted in line with that responsibility. A central part of what we need to do is not about organisations and structures but about creating that sense of personal responsibility in professionals across the service to look after their patients and those for whom they care and to blow the whistle if there is harm or abuse; and we must protect and secure that whistleblowing when it happens.

Future of the NHS

Jeremy Lefroy Excerpts

Monday 9th May 2011 Commons Chamber

[Jeremy Lefroy (Stafford) (Con)]

I would like to take this opportunity briefly to raise three matters and I hope that my right hon. Friends on the Front Bench will, in the spirit of the listening exercise, take note of them. I know from previous experience that these issues concern them. They arise in relation to the public inquiry that is going on at the Mid Staffordshire NHS Foundation Trust.

First, the motion refers to an NHS that refuses to tolerate unsafe care and that achieves quality and outcomes that are among the best. I do not think that any right hon. or hon. Member would disagree with either of those aims. One thing that has come out of the Mid Staffordshire inquiry is the whole problem of unsafe care, particularly the quality of care that elderly patients receive. Mid Staffordshire is by no means the only place for which that has been a problem. It has been highlighted in a recent report as being an issue for other parts of the country as well. For me, the key question is how patient care and safety can be upheld to the highest possible standards across the NHS. Occasionally people have cited the example of civil aviation in this country. Both the Civil Aviation Authority, which has a first-class safety record, and the NHS serve the public. The CAA emphasises continuous improvement and risk-based monitoring. I urge my right hon. Friends to look at the example and practices of the CAA and consider how those might be incorporated in the work of the NHS.

The Health and Social Care Bill contains helpful provisions on patient safety. GP commissioning will bring commissioning closer to patients. It will ensure that if there are problems, they will be heard about more quickly. The health and wellbeing boards will ensure greater local accountability and, again, problems should come to the attention of the authorities more quickly, which did not happen in my own trust. Healthwatch will be established and there will be more foundation trusts.

However, there is a risk of a fragmented approach to patient safety. We have the Care Quality Commission, but as hon. Members who served with me on the Public Bill Committee know, there are concerns about the additional work load that will be placed on the commission. Will it be able to cope with the volume of work? Will it be able to ensure that patient safety and quality of care are upheld across the NHS? I should like to hear the Minister of State’s comments on that. It has been suggested that the critical question of patient safety should be brought to the top of the NHS, perhaps with a directorate within the Department of Health reporting directly to the Secretary of State on patient safety. I should also be interested in his comments on that.

The second point that I wish to make is about foundation trusts, which were key under the previous Government and will continue to be so, but I am concerned about the level of training available to governors and directors. I should like to hear my right hon. Friend’s comments on that. I refer particularly to foundation trusts that are responsible for district general hospitals, which many hon. Members have in their constituency, as do I. Those are the trusts that will probably come under most pressure in the current constrained financial circumstances, and that would have been the case under any Government.

My third point relates to the length of contracts that are awarded. Whatever the position is with competition under the Bill on Report, it is clear that contracts, whether with NHS or outside providers, will be of the utmost significance. I am concerned that contracts are sometimes awarded for only a short period. Hence, a considerable amount of time is taken up with tendering and retendering. I ask for some comments on that.

In conclusion, the Francis inquiry, which we expect to report later this year, will be one of the most significant reports on the national health service in the past 20 or 30 years. I urge the Government to take good note of its conclusions and implement them as far as possible.

Health and Social Care Bill

Jeremy Lefroy Excerpts

Monday 31st January 2011 Commons Chamber

[Mr Lansley]

Let me make two points to the right hon. Gentleman. First, in the impact assessment that we published with the Bill on 19 January, we set out very clearly our estimates—they are no more than estimates since they will have to be decided by the general practice commissioning consortia and local authorities—that between 50% and 70% of the staff in primary care trusts would be employed in the successor organisations.

Secondly, the idea that somehow general practice-led commissioning consortia would engage the private sector where that has not happened up until now is, I am afraid, completely contradicted by the facts. Under the Labour Government, in the two years leading up to the election, there was an 80% increase in the use of management consultants, while at the same time the number of administrators and managers in those same organisations was rising dramatically. We arrived at the point where there were 50,000 administrators in primary care trusts, and they were still spending nearly £300 million a year on top for management consultancy. That all has to change.

One thing that Labour abjectly failed to do was to empower patients with a real voice in the health service. Through this Bill we will establish local healthwatch organisations that will represent the patient’s voice in the design of local services and help individual patients, especially the most vulnerable, to make the most of the choices available to them and to help them when things go wrong. Sitting within the Care Quality Commission, the national healthwatch organisation, too, will act as the eyes and ears of the quality regulator, and work to give the local organisations real teeth in their dealings with their local NHS—something that was completely, abjectly destroyed by the Labour Government when they abolished community health councils. Indeed, I know that families of those treated at the Mid Staffordshire hospitals welcome the additional powers for patients to have a voice.

[Jeremy Lefroy (Stafford) (Con)]

rose—

[Clive Efford]

rose—

--- Later in debate ---

[Mr Lansley]

Time does not permit me to explain the extraordinary ignorance of that series of points. First, the Bill sets out that the regulator will have a responsibility to establish a failure regime. In 2003, when the predecessors of those currently on the Labour Front Bench took the health legislation through the House, they said that they would introduce a failure regime, to be implemented by Monitor, in legislation. They never did so. At the moment, there is therefore no proper failure regime.

Secondly, European competition law—indeed, competition law—applies in this country. A body was established in the national health service under the previous Labour Government called the co-operation and competition panel, the express purpose of which was to apply competition rules in the NHS. To that extent, all the Bill will do is to ensure that the rules that already apply are applied fairly, consistently and transparently across all providers.

[Jeremy Lefroy]

The Secretary of State referred to the Mid Staffordshire NHS Foundation Trust, into which an inquiry is taking place. What lessons from the various investigations have been applied in the Bill to address the concerns that have been raised?

[Mr Lansley]

I am grateful to my hon. Friend for that question. In addition to the measures on healthwatch and patient voice, we are strengthening the responsibilities of commissioners. As I suspect he knows from his local knowledge, general practitioners knew in many cases that the services at Stafford hospital were not meeting the quality of care that they ought to have met. However, there was no transparency in the outcomes, and there was no responsibility collectively among general practices and local health professionals to intervene. There was no mechanism that enabled or incentivised them to do so. We are going to change that. When Sir Robert Francis’s report is published in due course, I hope that the Bill, by strengthening patient voice, commissioning and the regulatory structure, will give the opportunity for whatever recommendations he makes to be implemented rapidly.

Swine Flu

Jeremy Lefroy Excerpts

Monday 10th January 2011 Commons Chamber

[Jeremy Lefroy (Stafford) (Con)]

Does my right hon. Friend agree that the reason that acute beds are under such pressure at this time of swine flu is that we do not have sufficient step-down or community beds into which people can transfer from acute beds?

[Mr Lansley]

My hon. Friend makes an important point. Primary care trusts and local authorities working together should now be able to have confidence that the resources are available in this financial year—and £648 million will be available in the next financial year, and more in years beyond—to improve the relationship between health and social care not only through things such as step-down beds, but through operating, for example, hospital at home services, community equipment services and home adaptations to ensure that only those people who need to be in hospital are in hospital.