NHS Reorganisation

Jeremy Lefroy Excerpts

Wednesday 17th November 2010 Commons Chamber

[Paul Burstow]

No, I said that the Opposition had failed and that they were defending a failed status quo. Let me give the House an example of a failed status quo. If the NHS were performing at the level of the best in Europe, 10,000 more lives could be saved every year. This is what our focus on outcomes is all about. It is what patient-reported outcomes are all about, too.

We all agree that elderly patients should be treated with dignity and compassion, yet for far too many, that is not what happens in practice. Just last week, a report on patient deaths found that 61% of older people received “inadequate” care in their final days. After 13 years of a Labour Government, the NHS is in the bottom third in Europe in dealing with dementia—way behind Ireland, Spain and Portugal.

[Jeremy Lefroy (Stafford) (Con)]

As the Minister will know, the independent public inquiry into Stafford hospital is taking place in my constituency at the moment, and the matters that he has just mentioned are highly relevant to that. Will he give the House an undertaking that the evidence given to that inquiry will inform the debate on the forthcoming Bill?

[Paul Burstow]

We will, of course, follow the inquiry closely and ensure that we learn lessons from it. We would not have set up the inquiry if we did not intend to learn lessons.

Labour’s legacy is a demoralised and disempowered work force. Reforms have been half implemented, and billions of pounds have been wasted on a flawed NHS IT programme. This Government are clear that the NHS can be so much better than it is today—spending better and doing better both for patients and for the taxpayer. It is this Government’s purpose to liberate the NHS so that it can deliver health care that is among the best in the world, to learn the lessons of Labour’s top-down target-driven approach to health care, to reverse the obsessive focus on process that has stifled innovation and created dependency in the system, and to move away once and for all from a culture that measures success by ticking boxes, hitting the target but missing the point.

Labour talked about reforming the NHS and making it more patient centred, but its reforms were half-hearted, lacking coherence and a clear purpose. Reforms such as the introduction of foundation trusts, practice-based commissioning groups and patient choice, which promised so much, did not deliver under Labour.

NHS White Paper

Jeremy Lefroy Excerpts

Monday 12th July 2010 Commons Chamber

[Mr Lansley]

It is broke, and we are fixing it. We are fixing it because primary care trusts have not succeeded in delivering the outcomes that we are looking for, and they have consumed an enormous amount of money. I remind the hon. Gentleman that in the last year, at a time when we knew that there was a financial crisis facing the public sector and that the NHS would have to deliver more for less, the strategic health authorities and primary care trusts increased their management costs—not their spending on patients—by 23% in one year. It was outrageous.

[Jeremy Lefroy (Stafford) (Con)]

I thank my right hon. Friend for his statement. As he will know, concerns were expressed about the role played by Monitor in the authorisation of the Mid-Staffordshire NHS Foundation Trust. Does he have any plans to beef up Monitor’s role and ensure that it plays a better role in the future in the authorisation of trusts?

[Mr Lansley]

Yes, and hon. Members will see in the White Paper the way in which we can strengthen the role of Monitor. It is not just about the authorisation processes for foundation trusts, but a continuing responsibility for the quality and standard of care being provided in all our trusts, NHS trusts or foundation trusts. It is important to focus on quality, on what constitutes quality and on ensuring sufficient incentives to support quality. In addition, I hope that some of the lessons that will be learnt from the inquiry being conducted by Robert Francis QC will inform how we can put a better system in place.

Mid Staffordshire NHS Foundation Trust

Jeremy Lefroy Excerpts

Wednesday 9th June 2010 Commons Chamber

[Mr Lansley]

I am grateful to the right hon. Gentleman for indicating that he supports this further inquiry, and that he and his colleagues will give it that support. They will know that for more than six years as shadow Secretary of State I always gave both a balanced and positive view of what the staff of the NHS achieve daily on our behalf. That extends to the staff at Stafford hospital, as I have made clear to them when I have visited them in the past. Indeed, I shall be visiting again tomorrow in order to make that even clearer—and I have asked Robert Francis to ensure that as he conducts his inquiry, he does whatever he can not to divert them from continuing to improve care for people in Staffordshire.

The right hon. Gentleman asked what the difference is between the inquiry that I am announcing today and what he said should happen in a second stage Francis report, and I must tell him that there are a number of very serious differences. First, this is an inquiry not under the National Health Service Act 2006 but under the Inquiries Act 2005, so there will be a presumption that hearings will be held in public, and that records of evidence and information given to the inquiry must be made available to the public.

In addition, there will be a power of compulsion in respect of witnesses and evidence. I simply do not accept his assertion that had there been a different legal basis for the earlier inquiry people would not have come forward to give evidence. Either they would have done so or, if they had not been willing to do so, they could have been compelled to do so; that power will be available now. This inquiry will have a power to take evidence on oath and a power under the 2005 Act to make recommendations, if Robert Francis so concludes, concerning not only NHS organisations, which are covered by the 2006 Act, but non-NHS organisations. The terms of reference make it clear that Robert Francis will be able to look more widely. The inquiry will examine, for example, the actions of the coroner and the Health and Safety Executive. Indeed, he will be able to make recommendations in relation to the General Medical Council. He would not have been empowered to do that in an inquiry simply under the 2006 Act.

Finally, may I deal with the right hon. Gentleman’s point about targets? The four-hour target is not a measure of outcome; it is not a measure of the result for patients. The result for patients is about their going to an emergency department and their disease, injury or illness being treated successfully. What happened at Stafford hospital provided evidence—we saw other such evidence in many other places—to suggest that the four-hour target was being pursued not in order to give the best possible care to patients, but in spite of what would be the best possible care for patients. Patients were being discharged when they should not have been, and patients were being transferred to inappropriate wards where there was no provision to look after them.

It is vital that we focus on the result for patients. Like me, the right hon. Gentleman knows that the length of wait in the emergency department is not an irrelevant fact for patients. We are therefore going to consider, constructively, how to scrap the four-hour target as it currently exists, and, as my right hon. Friend the Prime Minister said at Prime Minister’s questions, work on the basis of saying that what the clinical evidence makes clear directly contributes to delivering the best possible results for patients. We will start that process soon, in making that clear to the NHS. Our approach will go beyond the simple question of how long people wait in an emergency department; it will go to the outcomes being achieved in those departments. That is what putting quality at the heart of the NHS actually means; it means quality and results, not just processes.

[Jeremy Lefroy (Stafford) (Con)]

I am most grateful to my right hon. Friend for his statement and for the announcement of an inquiry under the 2005 Act. I am also grateful to him and to the Prime Minister for their support for my constituents over the extremely difficult past year. The Secretary of State will recall that I have written to him on a number of matters in connection with this case, but I should like to raise just one now. Can he assure me that the resources needed both for the inquiry itself and for staff cover will be made available to the trust, so that staff can continue the vital work of restoring public confidence in Stafford hospital?

[Mr Lansley]

I am grateful to my hon. Friend for that question. Although he has only recently arrived in this House to represent his constituents, I know from my personal experience of our conversations, our meetings and my visits to see him and others in Stafford just how diligently and consistently, and in what a compelling way, he has represented his constituents over the past year or so. In reply to his question, I can tell him that although I have made it clear to Robert Francis that we must do this swiftly—and, therefore, without incurring excessive costs—we must do it successfully and achieve a quality result in order to inform everything we need to do to improve the NHS. We need to go beyond the mere structures and the processes—we have seen all that—to find out why people in all those structures were not focusing on patient safety and quality of care, and how they can be better incentivised, encouraged and required to do that in future. I am sure that my hon. Friend knows that we are ensuring that the additional costs that the Mid Staffordshire trust has had to meet in the course of the first Francis inquiry and now, and in supporting the delivery of better care, are being met with additional resources from the strategic health authority.