Oral Answers to Questions

Debate between John Pugh and Jeremy Hunt

Tuesday 7th February 2017 Commons Chamber

[John Pugh (Southport) (LD)]

T4. Will the Minister update the House about NHS litigations, which rocketed to £1.4 billion last year? Are they anything like under control?

[Mr Hunt]

The hon. Gentleman is absolutely right; this issue is a very big concern. The only way, in the long run, to reduce those litigation costs is to have safer care. That is why the Government have prioritised safety in everything we do.

Oral Answers to Questions

Debate between John Pugh and Jeremy Hunt

Tuesday 10th May 2016 Commons Chamber

[John Pugh (Southport) (LD)]

5. What plans he has to reduce agency staffing expenditure in the NHS.

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

We have taken tough measures to control unsustainable spending on agency staff, which cost the NHS more than £3 billion last year. Overall agency spend is now falling and we expect to save the NHS at least £1 billion this year as a result.

[John Pugh]

I thank the Secretary of State for his answer. I do not share his optimism. Is not the real problem the shortage of permanent staff and the budgetary constraints on the acute sector? Most of them are now below establishment.

[Mr Hunt]

I think the hon. Gentleman is right that we have historically not trained enough staff to work in the NHS and been over-optimistic about the staff needs. That is why, in this Parliament, we will be training over 11,000 more doctors as a result of the spending review, and 40,000 more nurses.

Oral Answers to Questions

Debate between John Pugh and Jeremy Hunt

Tuesday 5th January 2016 Commons Chamber

[John Pugh (Southport) (LD)]

T1. If he will make a statement on his departmental responsibilities.

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

Yesterday evening the British Medical Association regrettably decided to walk away from the talks on a new junior doctors’ contract and announced plans for strike action. We had made significant progress in negotiations on 15 of the 16 areas of concern, including doctors’ hours and patient safety, and will now do everything we can to make sure that patients are safe. We promised the British people we would deliver truly seven-day services and, with study after study telling us that hospitals have higher mortality rates than should be expected at weekends, no change is not an option.

[John Pugh]

I thank the Secretary of State for that response. He will recall the 3 million lives telehealth programme. Since then, it has all gone rather quiet on telehealth. What is the Government’s current strategy on telehealth and what pump-priming funding is there for it?

[Mr Hunt]

I thank the hon. Gentleman for his consistent interest in telehealth. The technology landscape has changed significantly since the 3 million lives programme was launched in 2012. We are absolutely committed to it, but we do not want to isolate a few individuals who we think would particularly benefit from it, because we think everyone could benefit from being able to talk to their GP via video conferencing or whatever. The plans we will announce for technology in the next few months will show how we can roll it out to an even wider audience.

NHS Reform

Debate between John Pugh and Jeremy Hunt

Thursday 16th July 2015 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for his passionate support for that trust through a very difficult period. I also thank him for giving us perhaps the single biggest insight into how to transform a hospital in difficulty: according to all the measures, the most important single thing is to engage with staff. If staff feel supported and listened to, the result is safer care for patients and better outcomes. That is something they have done in East Lancashire, and it is something that many other hospitals could learn from.

[John Pugh (Southport) (LD)]

Many current failures in care are caused by poor integration of services, not the failure of a specific service. What, in the proposals announced, addresses that problem?

Oral Answers to Questions

Debate between John Pugh and Jeremy Hunt

Tuesday 26th November 2013 Commons Chamber

[John Pugh (Southport) (LD)]

T3. What measurable progress is being made in improving data sharing, not just between hospitals and general practitioners, but between the NHS and social services, to avoid bureaucracy and additional cost?

[Mr Hunt]

My hon. Friend has taken a great interest in this topic, and he is absolutely right to do so, because if we are to give integrated, joined-up care, in which people deal with NHS professionals who know about them, their medical history, their allergies and all the other important things, it is vital that, if they give their consent, their medical record can be accessed. That needs to be from GP surgery to hospital to social care system. Under the named GP policy that we have announced, there is a big opportunity for care homes to access GP records and keep them updated daily, so that GPs are kept in daily contact with how some of the most vulnerable people are doing.

Managing Risk in the NHS

Debate between John Pugh and Jeremy Hunt

Wednesday 17th July 2013 Commons Chamber

[John Pugh (Southport) (LD)]

Will the right hon. Gentleman give way?

[Mr Hunt]

I will make some progress and then give way, because I want to come on to one of the main things that the right hon. Member for Leigh said, which was to criticise an NHS reorganisation that has put 8,000 more people on the frontline of the NHS.

The right hon. Gentleman said that that reorganisation cost £3 billion, when he knows full well that the National Audit Office shows that it will be half that amount. It will save £5.5 billion in this Parliament alone. For the avoidance doubt, it is that £5.5 billion saving that means we are now employing 1,000 more health visitors, 1,400 more midwives and 5,600 more doctors than at the previous election.

The right hon. Gentleman talked about the risk register. Let us look at what he said about publishing the risk register when he was Health Minister in 2007. These are his own words:

“Putting the risk register in the public domain would be likely to reduce the detail and utility of its contents. This would inhibit the free and frank exchange of views about significant risks and their management, and inhibit the provision of advice to Ministers.”—[Official Report, 23 March 2007; Vol. 458, c. 1192W.]

I agree with him.

The right hon. Gentleman is right that pressures on A and E are building, so why does he oppose changing the GP contract to make primary care more accessible? Why does he criticise the extra £2 billion being put into joint commissioning by health and social care systems to reduce the number of delayed discharges? Why does he tell the NHS Confederation he supports the reconfiguration of services and then refuse to support every difficult reconfiguration, such as at Trafford or Lewisham?

Care Quality Commission (Morecambe Bay Hospitals)

Debate between John Pugh and Jeremy Hunt

Wednesday 19th June 2013 Commons Chamber

[Mr Hunt]

My hon. Friend speaks well. Even under the current system, when problems are identified they seem to fester without being properly addressed. Under the new single failure regime for hospitals, when failure is identified there will be a maximum period of one year to sort it out or the board’s trust will be suspended. There will be a cut-off which does not exist at present to make sure that the local NHS, the trust board and, in the end, even Ministers bite the bullet when there are problems so that we do not allow them to continue.

[John Pugh (Southport) (LD)]

After Francis, after the Health and Social Care Act 2012, are we not asking a deeply dysfunctional and damaged organisation to shoulder additional responsibilities? Is not that in itself risky? In the Secretary of State’s statement he mentions “potentially criminal prosecution” of providers. Exactly who will be prosecuted? Managers? Clinicians? Board members? And exactly on what charge?

[Mr Hunt]

The criminal sanctions apply to boards for withholding information about safety breaches at their trust, and as I mentioned earlier, we are considering whether those sanctions should apply below board level. We want to wait for Professor Berwick’s advice on that, because there is a balance between proper accountability for mistakes and the need to create that culture of openness, where people report mistakes that they might see a colleague making, which might not happen if they were worried about criminal prosecutions. I want to take the advice of an expert on that.

A and E Departments

Debate between John Pugh and Jeremy Hunt

Tuesday 21st May 2013 Commons Chamber

[Mr Hunt]

I am not blaming any doctors; I am blaming the Labour party for making disastrous decisions in office. We are addressing the issues that his party failed to address. If Southampton is not meeting its A and E targets, that is unacceptable. We are talking to all the hospitals struggling to meet those targets, but they all say—I am sure that people in Southampton would say this as well—that we need to look at the fundamental issues, which are barriers between the health and social care systems, poor primary care alternatives and problems inside hospitals with how A and E is handled. We are addressing all those issues.

[John Pugh (Southport) (LD)]

Better co-ordination of ambulance trusts and A and E departments is essential, but it will not happen by accident. Are we not now missing the strategic health authorities, given that ambulances are being sent to units already working at full capacity?

Oral Answers to Questions

Debate between John Pugh and Jeremy Hunt

Tuesday 16th April 2013 Commons Chamber

[John Pugh (Southport) (LD)]

T9. What is the Department doing to deal with the difficulties presented by poor data sharing between health and social care agencies and the threat to integration that that presents?

[Mr Jeremy Hunt]

My hon. Friend makes a very good point, and I pay tribute to him for raising this issue frequently. We will not have properly integrated, joined-up health and care services unless we crack the issue of data sharing. There need to be protections for people so that they can prevent their data from being shared if they do not want that, but by the same merit we have to make sure that there is better availability. For example, delayed discharges from hospitals, which are causing pressure on A and Es, would be directly helped if we cracked this. That is why we have called for a paperless NHS by 2018.

Mid Staffordshire NHS Foundation Trust

Debate between John Pugh and Jeremy Hunt

Tuesday 26th March 2013 Commons Chamber

[Mr Hunt]

The hon. Lady will know that, when it comes to individuals—appalled as I am, and as appalled as all hon. Members are, by what happened at Mid Staffs—I must try not to prejudge due process. If we are to bar people from employment, we must have a fair process and system and a right of appeal, which is required under our law anyway. However, I would not expect any manager responsible for the kind of things that happened at Mid Staffs to be able to get a job in the health service ever again.

[John Pugh (Southport) (LD)]

Peter Walsh from Action against Medical Accidents has described the legally enforceable duty of candour as the

“the biggest advance in patient safety and patients rights in the history of the NHS.”

Does the Secretary of State agree?

Immigrants (NHS Treatment)

Debate between John Pugh and Jeremy Hunt

Monday 25th March 2013 Commons Chamber

[Mr Hunt]

The rules existed for 13 years under the Labour Government, who did absolutely nothing to change them. We are tackling the problem. If Labour Members had any grace, they would thank us for doing so.

[John Pugh (Southport) (LD)]

When I tabled questions last year, I was told that we collect £51 million a year for treatment from EU countries, but that they collect £451 million—nine times more—back from us. Is this an issue not of immigration, but of coding, charging and collecting?

[Mr Hunt]

My hon. Friend might be right—we need to look at that—but as I have told my hon. Friend the Member for Dover (Charlie Elphicke), one factor is that a number of our pensioners retire to sunnier climates, which leads to that imbalance.

Oral Answers to Questions

Debate between John Pugh and Jeremy Hunt

Tuesday 26th February 2013 Commons Chamber

[Mr Hunt]

I know that the hon. Gentleman asks a lot of questions about radiotherapy. We use a strict evidence base before we make any investments. We also want to embrace innovation, but our absolute priority is to save as many lives as possible from cancer. He will know that we are in the lower half of the European league tables when it comes to cancer survival rates, and that is something that we are determined to put right.

[John Pugh (Southport) (LD)]

On collecting performance data, has the Secretary of State seen the NHS Confederation publication “Information overload: tackling bureaucracy in the NHS”, which points to a great deal of duplication in information? What is his reaction to it?

[Mr Hunt]

There is far too much bureaucracy in the NHS, which is why I have asked the chief executive of the NHS Confederation to report to me on how we could reduce the bureaucratic burden on hospitals by a third. If there is a lesson from the Francis report on the tragedy at Mid Staffs, it is that we need to free up the time of people on the front line to care, which is what they went into the NHS to do.

Social Care Funding

Debate between John Pugh and Jeremy Hunt

Monday 11th February 2013 Commons Chamber

[Mr Hunt]

This is a devolved matter, as the hon. Gentleman knows, but different approaches are being tried in all four constituent parts of the United Kingdom and we must look at what is happening in the different parts and all learn from each other.

[John Pugh (Southport) (LD)]

I welcome the statement. Regardless of the details and figures announced today, does this overall approach not promise certainty and predictability where previously there was anxiety and uncertainty? Is that not the big gain?

[Mr Hunt]

That is the main point of what is being announced today. We are not able, with the public finances as they are, to offer a huge amount of support, but what we can do is give the certainty that means that for the first time people will be able to plan and make provision for their social care costs. We will be one of the first countries in the world that does that, which is why this is a very encouraging and very important day for people who care about the tremendous uncertainties associated with growing old.

NHS Commissioning Board (Mandate)

Debate between John Pugh and Jeremy Hunt

Tuesday 13th November 2012 Commons Chamber

[Mr Hunt]

Let me remind the hon. Gentleman, as I reminded the right hon. Member for Leigh, that for the four years that preceded this Government, there were underspends, including when the right hon. Gentleman was Health Secretary, and in three of those four years the underspend was higher than it was in our first year in office. But we do want innovative cancer treatments to be available. That is why we introduced, among other things, the cancer drugs fund, which was not introduced by his Government and which has transformed the lives of thousands of cancer sufferers.

[John Pugh (Southport) (LD)]

I welcome the statement, particularly the use of IT and online resources, but how will we avoid the previous errors of Connecting for Health and its huge costs?

[Mr Hunt]

That is a very important question. We are going to avoid that because I will not be signing any big national IT contracts. The initiative will be locally led and locally driven. Guidelines will be laid down to make sure that all the systems developed in different parts of the country are inter-operable. That is very important, but we will not have any grand plans nor will there be a big single database, so we can thereby avoid some of the problems. We must none the less be prepared to grasp what technology changes can mean for the NHS, just as they do for the rest of society.

Mental Health (Approval Functions) Bill

Debate between John Pugh and Jeremy Hunt

Tuesday 30th October 2012 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. The key point is that those patients are free to challenge any element of the clinical decisions made as part of that very thorough process. This proposed law is about the technical irregularity only, and it is precisely because of the legal risks associated with that irregularity that we think it is necessary, in the interests of those 5,000 people, to enact this Bill.

[John Pugh]

I totally accept the point that the clinical need trumps the patient’s right to due process, but if the clinical need is questioned by the patient themselves it becomes more arguable, does it not?

[Mr Hunt]

If the patient wishes to challenge their clinical assessment, they are free to do so and the Bill will not affect that in any way. It is important that that point is understood. In fact, the Bill is very narrowly defined for that precise reason, and I think that is why the Attorney-General felt comfortable saying that it complied with the ECHR.

In conclusion, we have had a constructive debate on this very important and sensitive issue, but there are broader lessons to be learned about the importance, more generally, of mental health issues, and I and my colleagues in the ministerial team will take those very seriously as we progress. I am grateful to all hon. and right hon. Members present for their contributions to this debate.

Question put and agreed to.

Bill accordingly read a Second time; to stand committed to a Committee of the whole House (Order, this day).

Mental Health Act 1983

Debate between John Pugh and Jeremy Hunt

Monday 29th October 2012 Commons Chamber

[Mr Hunt]

I am grateful to my hon. Friend for saying that, but I think that we should extend our gratitude to the Opposition on this occasion. It is possible to move with speed only when there is cross-party co-operation, and I think that everyone has recognised the seriousness of the situation.

[John Pugh (Southport) (LD)]

Given the huge, overwhelming concentration on the subject of detention during the passage of the National Health Service Act 2006, which revised the Mental Health Act 1983, why was this departure from the law not brought to Members’ attention, or, indeed, to light? Someone in the Department of Health must be answerable, surely.

[Mr Hunt]

The truth is that no one in the Department of Health knew that this irregularity was happening. I do not think that anyone in the system knew that it was happening, until the issue arose in Yorkshire and Humberside when a particular decision was challenged. However, the hon. Gentleman is right: there is an important question mark over why it was possible for the irregularity to continue for so long without being noticed. I think that we need to listen to what Dr Harris says about why he believes that it was possible for it to continue for so long, and to act on his advice.