Oral Answers to Questions

Debate between John Pugh and Simon Burns

Thursday 25th April 2013 Commons Chamber

[Mr Burns]

As the hon. Lady knows, Crossrail 2 is the responsibility of the Mayor of London because it is a devolved matter. However, I accept that there is a knock-on effect for other rail services that are wholly the responsibility of the DFT. The Mayor of London announced recently that there will be a full consultation process. We await that and look forward to seeing any business case or justification. Those matters will be considered in due course, but we have to go through the due processes first.

[John Pugh (Southport) (LD)]

I was sentenced to two years on the Crossrail Bill Committee. HS2 is jam tomorrow; Crossrail is £6 billion now. Is not enough money spent on London proportionately at the moment?

[Mr Burns]

I strongly believe that there is an overwhelming case for high-speed rail in this country. Indeed, I would go further and say that we cannot afford not to have high-speed rail. I regret, as much as I suspect the hon. Gentleman does, going by his question, the length of time that it takes to establish any major project in this country, because that is not in the country’s best interests. However, it is certainly in the national interest to press ahead with a high-speed rail network throughout the country.

Health and Social Care Bill

Debate between John Pugh and Simon Burns

Tuesday 20th March 2012 Commons Chamber

[Mr Simon Burns]

No.

[John Pugh]

The Minister says “No”, but I tabled a question recently in which I asked him whether he had taken advice from the European Commission. He told me that he had not. [Interruption.] We are talking about European law—

Veterans (Mental Health)

Debate between John Pugh and Simon Burns

Wednesday 7th March 2012 Westminster Hall

[John Pugh]

I defer to the hon. Gentleman’s experience, and he is probably right in advocating that solution. The question is who will secure that proper mix.

[The Minister of State, Department of Health (Mr Simon Burns)]

Will the hon. Gentleman give way?

[John Pugh]

The Minister is going to tell us.

[Mr Burns]

I am grateful to the hon. Gentleman. Given that I will not have very much time to speak, can I deal with the question of who will commission veterans’ mental health services? It will be the responsibility of the NHS Commissioning Board.

[John Pugh]

I am relieved that it is placed within an appropriate body, although the board has an awful lot else to do.

Oral Answers to Questions

Debate between John Pugh and Simon Burns

Tuesday 10th January 2012 Commons Chamber

[Mr Burns]

It is nice that the hon. Gentleman got the mantra in at the end—I have been expecting it all through this Question Time. He is wrong; what is important and what this modernisation has at its heart is the need for GPs to commission care for patients, because GPs are best equipped to know the needs of their patients. That is the way forward. Also, we are cutting bureaucracy and administration by 45% so that we can reinvest that money in front-line services. We want to spend money on health care and on improving outcomes, not on managers and bureaucracy.

[John Pugh (Southport) (LD)]

May I congratulate the Secretary of State and the Prime Minister on the productive ward initiative? The NHS document “Top Tips for spreading The Productive Ward” says:

“Set a realistic time scale. Take your time and do not rush. Take small steps and complete them before moving on to the next.”

Is this advice generally applicable to NHS reform?

[Mr Burns]

As the hon. Gentleman recognised at the beginning of his question, this is important and excellent advice for nurses and other health care professionals to give care, consideration and attention to all patients so that they can be looked after in an appropriate and caring way. That is the way forward to making the health service more responsive to the needs of patients and to the improvement of health outcomes.

Hospital Finances

Debate between John Pugh and Simon Burns

Tuesday 19th July 2011 Westminster Hall

[John Pugh (Southport) (LD)]

I could not help thinking on my way here, as I passed the scrum of photographers and reporters, “There are an awful lot of people. They can’t all be coming for the debate on hospital finances, however important it might be.” I apologise in advance to the Members present, who I know debated such themes extensively in the Committee that considered the Health and Social Care Bill. I can only say that I did not anticipate that today would turn out as it has. I wanted to flag up an important issue that I think will dominate next year’s headlines and to put some of my thoughts and concerns on record. I will not suggest that we could all go off quietly, have a cup of tea and discuss it in a genteel way, but if the Minister and the Opposition spokesman give adequate responses, we might curtail this debate before an hour and a half.

When I arrived in this place in 2001, one of the first people whom I met was another new MP, Dr Richard Taylor, a distinguished Member who had just won the Wyre Forest constituency somewhat unexpectedly. David Lock, an unfortunate colleague of yours, Mr Betts, had lost half his votes in the election simply by virtue of his stance on hospital reconfiguration. Since then, an axiom in this place has gone something like this: “If you back hospital changes and any sort of configuration, you lose; if you oppose hospital changes and any sort of configuration, you ordinarily win.” I certainly sat through many debates, somewhat better attended than this, on hospital configuration in many parts of England when I was part of the Liberal Democrat health team, and generally speaking, that has been the invariable subtext to the debate.

Offstage, away from the Commons arena, many groups were set up during the previous Parliament to defend their local hospitals in a variety of ways. An all-party group was set up on community hospitals, and another, of which I was a founding member, was set up on small hospitals. It is recognised that reconfiguration and change in the acute sector is ordinarily political dynamite. Understandably, this and previous Governments have wanted to keep the issue at arm’s length.

One way to do so is to suggest that it is all a matter of local decision making, although somehow it always comes back to the Secretary of State’s desk. Another way is to refer such matters to a reconfiguration panel, a device set up expressly to keep things off the Secretary of State’s desk. A third way is to claim that whatever change is in the offing is the result of extensive work by consultants—McKinsey is often involved. I have never found them particularly helpful myself, as ordinarily they suggest that hospitals solve their financial problems by simply doing less, meaning closing wards and so on. However the technique favoured by most Governments hitherto has been deferral: putting off the agony in the expectation that some other Secretary of State will have to pick up the ball and run with it. The current Secretary of State is a veteran of many hospital configuration debates, having been a health spokesman for his party for a long time.

That is the background to the issue. However, I suggest that the landscape is changing dramatically. First, there is a widely accepted view that more services should be delivered in the community, and, presumably, that fewer services should be delivered in the acute hospital sector. Many of the effects of the “any willing provider” policy and patient choice are already working their way through the system, leading to an increase in the deficit on the acute hospital side. Since the 2010 Budget, there is clearly a need across the health sector to find substantial savings, amounting in national terms to £20 billion.

Added to that is the chronic effect of private finance initiatives, which appear to be crippling many in the hospital sector. An investigation conducted by The Daily Telegraph found, for example, that one fifth of hospital trusts with active PFIs have closed casualty departments, while during the same period only 4% of hospitals without PFIs closed or proposed to close casualty departments. We can clearly see from the cases of some individual hospitals—I shall not name them here—that severe problems have been brought about chiefly, if not exclusively, by long-standing PFI debts. The Daily Telegraph investigation—we do not need to believe The Daily Telegraph, but this is what it says—found that

“Some PFI hospitals—built and run by private firms and effectively rented back to the state—will end up costing taxpayers more than 10 times their capital value.”

Much of that cost, of course, is picked up by the acute sector.

In addition, constant deferral has sometimes made problems more acute, which is particularly true in London. Further grief is generated, to some extent, by adjustments, not uninfluenced by the Department of Health, to the tariff for many acute services. Not long ago, primary care trusts were strapped for cash and acute hospitals were okay; to some extent, intervention in the tariff has changed that, and the acute sector could do absolutely nothing except remonstrate.

Some trusts are in serious trouble, and their problems cannot be eternally deferred. The problems of the South London Healthcare NHS Trust, for example, are critical. The other day—I am sure that the Minister will be familiar with this issue—I picked up a brochure distributed around Merseyside saying, “Save Whiston and St Helens hospital”. He might be surprised to know that it says that

“local politicians have been informed by Ministers in the Department of Health that plans are in place to privatise”

Whiston and St Helens hospitals.

[The Minister of State, Department of Health (Mr Simon Burns)]

As the hon. Gentleman is not an MP for that area, I will explain a bit of the background. One or two hon. Members are scaremongering among the local population. Despite repeated assurances from me and others, they will not accept that there is no intention, in any shape or form, to privatise Whiston or any other hospital.

[John Pugh]

To be fair to the Minister, I was using that case as an illustration not of what is afoot but of how such things become inflamed and distorted and how emotion tends to dominate, rather than facts.

[Mr Burns]

I certainly accept that, but will he join me in saying that hon. Members have a responsibility to be accurate about the true situation? Some hon. Members are prepared to put grubby party politics ahead of accuracy in their public accusations.

General Practitioners

Debate between John Pugh and Simon Burns

Thursday 20th January 2011 Ministerial Corrections

[Dr Pugh]

To ask the Secretary of State for Health what proportion of doctors working in GP practices in England are partners in the practice where they work.

[Official Report, 26 July 2010, Vol. 514, c. 833W.]

Letter of correction from Mr Simon Burns:

An error has been identified in the written answer given to the hon. Member for Southport (John Pugh) on 26 July 2010.

The full answer given was follows:

[Mr Simon Burns]

As at 30 September 2009, there were 35,719 general practitioners (GPs) (excluding GP registrars and retainers) in England. Of these, 28,607 (79.6%) were partners in the practice they worked in.

The correct answer should have been:

Accident and Emergency Services

Debate between John Pugh and Simon Burns

Tuesday 14th September 2010 Westminster Hall

[Mr Burns]

As the hon. Lady will be aware, this is a coalition Government. That means merging the best practice that each party to the coalition has to offer. That is why we have adopted from the Liberal Democrat manifesto the policy of abolishing SHAs. When we unveiled our proposed reforms, which concentrate commissioning with GP commissioners and GP consortiums, because GPs are at the forefront and are closest to patients, it became clear that if we were to have proper democratic accountability with local authority involvement, the role of PCTs would be diminished to the point where it would have been a waste of resources to keep them, as their functions would be performed by other groups, such as GP consortiums and local authorities. It is a question of merging best practice to get the best solutions and provide the best health care for all our constituents.

[Dr Pugh]

Will the Minister give way?

[Mr Burns]

I will, but I am relatively short of time if I am to deal with all hon. Members’ questions.

[Dr Pugh]

It should be said that the previous Government shied away from every chance to give a decisive voice on the construction of health services to anybody who held elected office. I promoted a private Member’s Bill that endeavoured to introduce a different form of democratic accountability, but the test of the White Paper will be whether people with a democratic mandate have a voice in deciding health services.

[Mr Burns]

I am grateful for that intervention. The hon. Gentleman makes a valid point.

As we do away with politically motivated, top-down-process targets, we will focus all the NHS’s resources on what doctors and patients most want: improving health outcomes. Accident and emergency and urgent care services will be reshaped to reflect those changes in the coming years. I will outline some of our plans.

For many years, accident and emergency services have been operating under the rigid law of the four-hour wait target. How long someone waits in A and E before receiving treatment is important, of course. Not only does it affect the patient’s overall experience of care, but timely treatment generally means better and more effective treatment. However, the problem with the four-hour wait target, an incredibly blunt instrument by itself, was that it became the be-all and end-all of performance management. Such a narrow focus led to the distortion of clinical priorities. I am sure that we are all familiar with tales of hospitals admitting patients unnecessarily, solely in order to meet the target. There have even been persistent allegations that some hospitals have failed to record figures properly, undermining confidence in the whole system. I am sure that hon. Members will agree that that will not do.

From next April, we will introduce a range of more meaningful performance indicators balancing timeliness of treatment with other measures of quality, including clinical outcomes and patient experience. I trust that the shadow Minister will reflect on that. She is looking a little puzzled, because that is at variance with the shock-horror statement about targets and A and E that she made in her contribution.