Oral Answers to Questions

Lord Cryer Excerpts

Tuesday 11th October 2016 Commons Chamber

[John Cryer (Leyton and Wanstead) (Lab)]

On the behaviour part of the question, what can the Minister do to combat what seems to be an emerging picture of over-consumption of painkillers and to enforce NICE guidelines on their use?

[Nicola Blackwood]

The hon. Gentleman raises an important issue relating to drug and alcohol misuse. We have prioritised this question as one of the local statutory requirements. We have given £16 billion to local health authorities for public health delivery, and we will expect them to prioritise this issue.

Junior Doctors Contracts

Lord Cryer Excerpts

Monday 18th April 2016 Commons Chamber

[Mr Hunt]

My right hon. Friend speaks wisely. A whole chorus of senior doctors, from Professor Sir Bruce Keogh to Dame Sally Davies to Lord Darzi, have urged doctors to think hard about the ethics involved. My right hon. Friend is absolutely right to say that consulting the ethics committee in the trust is a wise thing to do. Doctors might also take note of what the General Medical Council said about it being increasingly difficult to justify the withdrawal of emergency care and about the ethics involved. In the end, this is a personal decision for doctors, and it is about whether it is right to withdraw emergency care from patients in an industrial dispute about pay. This is a bridge that the NHS has never crossed before. It is a very big decision, not only for the NHS, but for every single doctor inside it.

[John Cryer (Leyton and Wanstead) (Lab)]

On the basis of the Secretary of State’s previous comments, and particularly his opening comments, is he absolutely confident that he has the legal power to impose the new contract?

Oral Answers to Questions

Lord Cryer Excerpts

Tuesday 13th October 2015 Commons Chamber

[Mr Hunt]

I shall tell the hon. Lady how I expect to do it. We are, in fact, making very good progress. By March next year, a third of the country will be able to access routine GP appointments at evenings and weekends. We do need more GPs. I agree with her that it takes too long to get a GP appointment, but we are doing something about it. That is why we have announced plans to recruit an estimated 5,000 more GPs. That will be a 15% increase in the number of GPs, the biggest increase in the history of the NHS.

[John Cryer (Leyton and Wanstead) (Lab)]

It is widely known that there is a serious lack of doctors who want to go into general practice. At the same time, the Secretary of State is guilty of an abject failure to engage with the British Medical Association in negotiations on junior doctors’ practices. On that basis, how the hell can he promise to increase general practice?

[Mr Hunt]

Just look at our track record in the previous Parliament: we increased the number of GPs by 1,700—a 5% increase. We are, on the back of a strong economy, putting in funding that will make it possible to increase that number even more. The hon. Gentleman talks about the BMA. I simply say that the people refusing to negotiate are not the Government, but the BMA.

Oral Answers to Questions

Lord Cryer Excerpts

Tuesday 25th November 2014 Commons Chamber

[Jane Ellison]

I am encouraged by the evidence from Australia. We have seen some really impressive statistics regarding the cessation of smoking. The Government have not yet made a final decision on the matter, but Health Ministers are on the record as saying that we are minded to move forward on this, and we want to make progress. I regret the loss of jobs in the hon. Gentleman’s constituency, but I know that he will be working hard to assist his constituents in looking for other employment.

[John Cryer (Leyton and Wanstead) (Lab)]

If plain packaging were introduced, what assessment has there been on whether that will make life easier or more difficult for the counterfeiters?

[Jane Ellison]

That is one issue that we will weigh up before making a final decision. Obviously, we received a large amount of evidence from the consultation, and we are looking at it in detail. Some of it was around that matter, although it is also the case that Sir Cyril Chantler made some robust statements in his report, rebutting some of the claims, but that is all part of the final consideration that the Government will make.

Oral Answers to Questions

Lord Cryer Excerpts

Tuesday 21st October 2014 Commons Chamber

[Dr Poulter]

As my hon. Friend will be aware, when commissioning services, it is important that regard is given not only to competition because, under the 2012 Act, we have ensured that there must be regard to delivering an integrated and joined-up approach for local services. That is an issue for local commissioners to decide in the best interests of the patients they look after.

[John Cryer (Leyton and Wanstead) (Lab)]

Are not certain CCGs starting to merge decision-making processes, meaning that some important strategic decisions are removed even further from local communities and there is therefore a complete lack of accountability?

[Dr Poulter]

For some more specialist services, collaboration between various parts of the local NHS will always be needed. That is about good health care commissioning and ensuring that services are joined up in a collaborative way. Whereas day-to-day, bread-and-butter services will be commissioned by a local CCG, for more specialist services, clinical commissioners will of course need to work together to ensure that local centres of excellence are commissioned.

Wanstead Hospital

Lord Cryer Excerpts

Thursday 4th September 2014 Commons Chamber

[John Cryer (Leyton and Wanstead) (Lab)]

I wish to thank Mr Speaker for granting this debate on the closure of Wanstead hospital in Redbridge in north-east London in my constituency.

Wanstead hospital has not existed as a full general hospital since it closed in 1986. It is where my hon. Friend the Member for Ilford South (Mike Gapes) was born 62 years ago—it is his birthday today, so I wanted to mention it. Hon. Members will have noticed all the bunting hung outside to celebrate that event, and he is happy for me to point it out. What remains of Wanstead hospital are two intermediate care wards called Heronwood and Galleon. The care is usually provided to elderly people who have perhaps been ill or in hospital and are not well enough to go home, and they need intermediate care before they can return to their homes.

This issue affects not only the London borough of Redbridge but three London boroughs: Redbridge, Barking and Dagenham, and Havering. It stretches from the boundary of Redbridge in the west to the boundary between Havering and Essex in the east—a huge swathe of north-east London. The plan is to take the three boroughs, cut all the intermediate care beds—there are currently 104—and reduce them to 40 beds located at King George hospital in Ilford. Apart from anything else, that is six miles from Wanstead so it is a long way for people in my constituency, many of whom are elderly, to travel. The facility in Dagenham at Grays Court is being closed, and the biggest facility is Wanstead hospital, which has 48 intermediate care beds over the two wards. We have already lost 35 beds in St George’s hospital—not to be confused with King George hospital—which is in Hornchurch in Havering and is an old RAF hospital. Those beds were lost last year and the plan is now to concentrate all the intermediate care beds in one place in Ilford at King George hospital.

The ongoing consultation has been produced and launched by an obscure and unaccountable group led by chief officer Conor Burke and the chairman, Dr Mehta. This group is not a clinical commissioning group; it has an overall strategic planning role above the CCG. Conor Burke and Dr Mehta are accountable to a small board that is made up of representatives of the three CCGs from those boroughs—hardly a shining example of democratic accountability.

It is basically a deeply flawed consultation. I was told by Conor Burke and Dr Mehta on 13 June that they might possibly be engaging in a consultation that would lead eventually to the closure of what remains of Wanstead hospital and those two wards. They did not volunteer that information; they said that there might possibly be a consultation only because I asked what the future held for Wanstead hospital. They said not that it was closing at that point, but that there might be a consultation. I asked three times for an assurance—which I received—that I would be informed as soon as the decision to consult on the future of Wanstead and the other facilities was made. I was not told about that decision. I found out about it only on 18 July when I received a letter with a consultation document stating that the consultation was already under way. If they treat elected representatives like that, God knows how they treat members of the public. It calls their track record into question.

The consultation document has not been made widely available, and I receive e-mail after e-mail saying that it is difficult to get hold of it or access it online. It is not in the libraries, GP surgeries or community centres—at least not the ones that I or anybody I know frequent. The document sets out a series of options, and then states, “This is the option we want.” It is clearly pushing respondents in a particular direction. That is not a clear, fair or neutral consultation. They are saying, “We’ll set out a few options for you, but this is the one we want, and if you respond, we want you to support this option.” That is clearly what the consultation document says, as anyone will see, if they can actually get hold of it. Only a couple of hours ago, I received an e-mail from a constituent I know quite well who told me about her difficulty—she is an articulate, intelligent person—getting hold of the consultation document and then responding online.

Another great difficulty, and a point that has met with another rebuff, was the request to extend the consultation deadline. The consultation started in July and will end on 1 October, but there has been call after call to extend it until 31 October, because most of the current consultation period falls in the holidays and most people do not know it is happening. I have met scores of people in Wanstead and elsewhere, even people who have used the facilities, who do not know the consultation is up and running. One of the richest ironies of the process is that the newly elected health scrutiny committee on Redbridge council—all people elected on 22 May—clearly requested an extension to 31 October, but so far the health tsars in north-east London have said it is not necessary.

The plan put forward by the senior health managers was to create two teams. The community treatment team, which provides care in people’s own homes—I have nothing against that, but I think we need the intermediate care beds as well—is not available after 10 pm, and the intensive rehabilitation team stops at 8 pm. It is promised that the CTT will respond to any call within two hours, but if someone needs help at 3 o’clock in the morning, when both teams are off duty, they will need to call the out-of-hours service or the emergency services, which I think is inadequate for a lot of people in need of intermediate care.

Both teams are up and running and seem to have done a good job. The reaction from the public who have received their care has been very positive—I cannot dispute that. However, we now see a proposal to introduce massive changes to intermediate care across a huge swathe of north-east London, including three of the biggest London boroughs—Havering is the second-biggest and Redbridge is one of the biggest—based on very little evidence. There have been intermediate care beds at King George for only a year, and the beds lost at St George’s in Hornchurch were cut only last year, in 2013, yet we now face a huge cut in bed numbers and their concentration in a facility that has been run for only a year, with two relatively new community-based teams, both based at King George hospital. The system is just not tried and tested. In my view and that of most of the people I represent—in my experience—we are not in a position to say the system will work, yet those beds will be lost, and once beds are lost, they are rarely got back.

The health tsars tell me that the beds are not being used. I dispute that. For one thing, last winter, which was very mild, 75 out of the 104 intermediate care beds were used. That is a relatively low number, but, as I say, it was a mild winter. If this or next winter is very cold and harsh and intermediate care beds are needed, we will only have 40 located at King George, rather than what we used to have, which was three far more accessible facilities across the three boroughs. I am being told stories off the record—nobody has gone on the record—by NHS staff and constituents that people are being turned away from Wanstead hospital and sent to King George in Ilford in order, I can only imagine, to massage the figures. I am also told by doctors and nurses who work for the health service that it is quite difficult to get into Wanstead hospital. Again, that will bring down the bed occupancy figures, adding grist to the mill of the senior health managers who are keen on getting bed occupancy down, so that they have a perfect justification for closing Grays Court and Wanstead hospitals and putting 40 beds in the King George hospital.

The Minister will be acutely aware, I imagine, of the difficulties experienced by local hospitals, by which I mean general hospitals. Queen’s hospital in Romford has faced enormous difficulties, as I am sure she will be aware. Capacity at Queen’s was forced down because the Care Quality Commission felt that the hospital was not capable of dealing with the relevant number of people—particularly in maternity, but in other areas, too. Whipps Cross hospital in my constituency has also had significant problems, receiving a series of very critical reports from the CQC.

King George hospital, where the intermediate beds are planned to be located, has been under threat of closure for years. It is only because of the stalwart efforts of my hon. Friend the Member for Ilford South and others in campaigning to keep the hospital open that it is still there. It could close at some point in the future. Against that background, with all those problems in the acute trusts across north-east London, it seems to me that taking out all the intermediate care beds with huge cuts and putting in 40 beds in Ilford at the King George is, at best, a foolhardy decision.

Let me make one more point about the consultation—the lack of accountability. The whole process, in my view, has been deeply flawed. Perhaps the greatest talking point among my constituents is the pig-headed refusal to extend the deadline to the consultation until the end of October, which seems a fairly modest sort of request. The demand for it was overwhelming and the scrutiny committee elected on 22 May called for the extension, yet the senior health managers in north-east London seem absolutely determined to refuse that relatively modest request.

Why are these senior managers so unwilling to respond to public opinion? It is because they do not have to respond to public opinion. The two people responsible for this exercise were not elected. I am not saying that there was a glorious era when everybody running the NHS was elected—such an era never existed—but these two people were certainly not elected and they are not particularly accountable. If they are at all, it is to a fairly obscure board, indirectly appointed. That has resulted in a process that provides a pretty disgraceful example of sweeping aside the wishes of local people, local councillors and locally elected representatives, and saying, “We know best. If only all these daft people would leave us alone and let us get on with it, we can make all the decisions and run the health service efficiently.”

I do not say this as a party political point, but I do not think the national health service was set up for the convenience of well paid senior managers whose wages are paid by the taxpayers I represent. The NHS was set up by Nye Bevan after the second world war in order to provide care for everybody. In future, we should move to a position whereby the people who use the NHS and run it at the sharp end should be far more involved in decisions about how to provide care that will always be free at the point of need. There has to be a change. This exercise has brought home to me just how unaccountable so many senior NHS managers are. If they are unaccountable, they will not care what the people who use the facilities for which they are responsible think. Their lack of accountability has to change in the long term.

[Madam Deputy Speaker (Dame Dawn Primarolo)]

I call the Minister.

Oral Answers to Questions

Lord Cryer Excerpts

Tuesday 25th February 2014 Commons Chamber

[Jane Ellison]

We anticipate that we will be able to share the data collected with all appropriate Government Departments and partner organisations. On local education campaigns, I see no reason why requests to access the data would not be approved. We want to build a proper national picture of what is going on with FGM so that we can do all we can both to care for victims and to stamp out this abuse.

[John Cryer (Leyton and Wanstead) (Lab)]

On the issue of widening education, could the Minister encourage her colleagues at the Department for Education to write to schools to raise awareness of this abhorrent practice?

[Jane Ellison]

Fahma Mohamed, the brilliant young woman who has led the campaign on this, will meet the Education Secretary today and there is a lot of work under way across all Government Departments. There was recently a cross-Government declaration on the things that are going on to stamp out FGM and to care for its victims. The hon. Gentleman’s question is a matter for the Department for Education, but I assure him that the Government as a whole are hugely committed to wiping out FGM within a generation and to caring for its victims.

Oral Answers to Questions

Lord Cryer Excerpts

Tuesday 14th January 2014 Commons Chamber

[Mr Hunt]

I absolutely join my hon. Friend in congratulating Herefordshire Housing. One of the key things about people with dementia is that relatively small adjustments to their homes can make it possible for them to live at home healthily and happily for much longer under the care of a husband, wife or partner without having to go into residential care. Those are precious years that we should treasure and do everything we can to facilitate, so I am delighted that that is happening, and he will be pleased to know that, thanks to the Government’s initiative, it is happening all over the country.

[John Cryer (Leyton and Wanstead) (Lab)]

Figures from the House of Commons Library show that £1.8 billion has been cut from social care budgets since 2010. Does not that imply that delayed discharge among older people will be driven upwards because the finances are just not there to look after them?

[Mr Hunt]

I think the figures the hon. Gentleman is talking about are efficiencies and not actual cuts. [Laughter.] Well, Members should look at the figures carefully. If they are the figures from the Association of Directors of Adult Social Services, that is what they will find. If the hon. Gentleman looks more specifically at the figures related to delayed discharges, he will find that, year on year, the number attributable to the social care system went down by 50,000 bed days in the last year.

Oral Answers to Questions

Lord Cryer Excerpts

Tuesday 26th November 2013 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

My hon. Friend may know that specialist NHS stoma nurses offer a range of support and advice to help patients adapt to life with a colostomy, and this advice can cover colostomy irrigation, if appropriate. This is supplemented with patient literature on colostomy, which is widely available in the NHS.

[John Cryer (Leyton and Wanstead) (Lab)]

Further to question 15, I understand that responsibility for walk-in centres has been devolved. Why does that necessarily prevent central Government from collecting those figures centrally? It is pretty staggering that a Minister should turn up and say, “Well, the decisions are made locally so we just don’t bother finding out.”

[Dr Poulter]

That is a question that the hon. Gentleman had much better address to his own Front Bench, who made the decisions to devolve these responsibilities locally. When it comes to commissioning health services, we believe it is down to doctors and nurses, who are now leading clinical commissioning on the front line, to determine which services are appropriate in local areas. There were clearly concerns about the way that urgent care centres had previously been commissioned. That is why so many of them are now being relocated and co-located in accident and emergency departments.

Oral Answers to Questions

Lord Cryer Excerpts

Tuesday 16th July 2013 Commons Chamber

[John Cryer (Leyton and Wanstead) (Lab)]

Further to the question from the hon. Member for Bristol North West (Charlotte Leslie), Ministers often—quite rightly—mention the importance of whistleblowers, so why have the Government weakened protection for whistleblowers through the Enterprise and Regulatory Reform Act 2013?

[Mr Jeremy Hunt]

We are strengthening protection for whistleblowers and are going much further by creating a culture of openness and transparency in the NHS, where people are not bullied if they speak out about poor care.