Health and Social Care Leadership Review

John Stevenson Excerpts

Wednesday 8th June 2022 Commons Chamber

[Sajid Javid]

When it comes to ambulance services, an important part of the NHS, this review is just as important. We all want to see good leadership in ambulance services, but if we get better leadership across the board we will see better collaboration and co-ordination—something heavily referred to in the report.

[John Stevenson (Carlisle) (Con)]

I welcome this statement; leadership is vital and it is something we do not talk enough about in this country, whether in the private or public sector. My right hon. Friend referred to recommendation 6 on non-executive directors. Does he agree that we need to attract a more diverse set of non-executive directors, with regard to their skillset as much as anything else?

[Sajid Javid]

Yes, I do.

Public Health

John Stevenson Excerpts

Tuesday 14th December 2021 Commons Chamber

[John Stevenson (Carlisle) (Con)]

If a member of the NHS decides that they do not want to be vaccinated, will they be given a redundancy payment; and if not, why not? But if they are and that is the policy, how much would it cost the NHS, and would that be a good use of taxpayers’ money?

[Sajid Javid]

I believe that it would not be classed as redundancy because it would not be redundancy; that job would not have become redundant. If an individual chooses not to get vaccinated, that is of course a decision for them to make. The way in which this should be, and no doubt will be, implemented by the NHS is that getting vaccinated should always be a positive choice. The NHS has put in place a number of methods to try to provide the information that people want to share, including through one-to-one consultations and providing more information especially for those who may have received misinformation. The outcome when a similar measure was implemented for care homes was that many staff—when provided with the right, positive information —chose to be vaccinated, rather than to leave their jobs.

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[Wes Streeting (Ilford North) (Lab)]

I begin by acknowledging that there are sincere and deeply held views on both sides of this debate and, indeed, on both sides of the House. I respect those who take a different view from the one I will be outlining on behalf of the Opposition, but we owe it to our country to have a debate worthy of the finest traditions of this House.

In the light of comments made in recent days by at least one Conservative MP comparing these measures to the situation in Germany during the 1930s, it should not be for me, as shadow Secretary of State, to point out that we are not living in the 1930s and that the Secretary of State and his team are not Nazis. On their shoulders rest the health of our nation and the responsibility to protect our NHS. Indeed, it is a responsibility we all share. They need our support, and they are owed better treatment than they have received from some on their own side in recent days and even this afternoon.

No matter how dysfunctional the Conservative party has become, the country can rely on Labour. We will act in the national interest, as we have throughout the pandemic, by putting public health before party politics and supporting the motions under consideration this afternoon. We do not do so lightly. Throughout the pandemic we have asked the British people to make big sacrifices to support the national effort against coronavirus—sacrifices that have impacted on lives, livelihoods and liberties. Whenever this House considers such measures, we owe it to the British people to explain why they are necessary. We believe these measure are a necessary response to the omicron threat, necessary to protect ourselves, necessary to protect the ones we love and necessary to protect our NHS.

We cannot yet be sure about the severity of the omicron variant, but we can be certain it is spreading, and spreading fast—faster than any other variant. Even if a smaller proportion of omicron victims are hospitalised, the rapid advance of the virus through the population could see large numbers of people admitted to hospital during the months in which the NHS is under greatest pressure. There should be no complacency about this. The winter months present the greatest pressures on the NHS in any normal year and, as we know, this is far from a normal year. The NHS is contending with winter pressures, a serious backlog, the delta variant and now the omicron variant. When people invoke the story of the boy who cried wolf, of the warnings that came before but never materialised, they should remember that, in the end, there was a wolf.

Many of the challenges facing the NHS are understandable, given the unprecedented challenges of the covid-19 pandemic, but we have to be honest and acknowledge that confronting these challenges has been made much harder because we went into the pandemic with NHS waiting lists at a record 4.5 million, 100,000 staff vacancies and 112,000 vacancies in social care. It is not just that the Government did not fix the roof while the sun was shining; they dismantled the roof and removed the floorboards.

Now the NHS is locked in a race against time: a race against the fastest variant of covid-19 we have seen to date and a race to get as many people boosted as possible before the end of this month. The Opposition support the Government in that task, and let me say on behalf of all of us in the Labour party to every NHS worker, every GP, every pharmacist, every public health official in local government, every member of our armed forces and every volunteer stepping up to meet this enormous task that we are with them 100%. If anyone can do it, they can.

[John Stevenson]

Can the hon. Gentleman explain why the Labour party did not support mandatory vaccinations for care workers but has changed its mind for NHS workers?

[Wes Streeting]

I will outline our position on that, but the hon. Gentleman will have to be patient because I will come on to that later in my speech.

We need to buy the NHS and its helpers some time. The measures put forward for consideration today are an attempt to do just that by slowing the spread of the virus whilst trying to protect Christmas so that people can enjoy the festive season safely, by limiting our interactions in the workplace, by wearing face coverings in settings where the virus finds it easier to spread, by testing before we attend large indoor gatherings, and by getting behind the booster roll-out to ensure that everyone is protected.

Health and Care Bill

John Stevenson Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

In conclusion, the Bill needs to go further than it currently does to include evidence-based measures that reduce alcohol harm. I encourage Members across the House to support these much-needed amendments, so that we can tackle this silent health crisis affecting so many of our constituents.

[John Stevenson (Carlisle) (Con)]

I rise to support the amendments in my name: 110, 111, 112 and 113. I draw the attention of the House to the fact that I have a significant number of food and drink manufacturers in my constituency, and that I chair the all-party parliamentary group for food and drink manufacturing. I also support the amendments tabled by my hon. Friends the Members for North East Bedfordshire (Richard Fuller) and for Buckingham (Greg Smith), and fully support and endorse their comments.

In reality, I and many others would have preferred clause 125 and the whole of schedule 16 to have been removed from the Bill. I and I think many others are not convinced that that is really the way forward or that it will achieve very much. That view is shared by many of my colleagues, but also by many in the advertising industry and the food and drink sector. That is not because they are against the Government’s attempts to respond to the challenge of obesity, which is and should be a concern for all of us, but because their impact is likely to be so insignificant that it is disproportionate to what is proposed. We should also remember that the industry has already done a huge amount. It is incredibly innovative—reformulation, reductions in salt and sugar—and the reductions we have already seen are very significant. The industry continues to make changes and I believe it will continue to do so in the future. We should also remember that there is something called personal responsibility.

There is an opportunity, however, for compromise and improvements to schedule 16—hence the various amendments that have been tabled. I very much hope that the Government will be willing to compromise in their approach and see the benefits of the amendments that stand in my hon. Friends’ names and mine. I do not intend to detain the House for long, because my amendments are primarily technical rather than anything greater.

I tabled amendments 111, 112 and 113 because I believe that we want a food and drink manufacturing sector that is competitive and is based in the UK as much as possible. As presently drafted, the Bill exempts certain businesses, but the criteria are based on UK employee numbers. Large multinational companies could therefore be exempt if the UK element of their business has under 250 employees; conversely, a UK business with 250-plus employees would not be exempt. That has the potential to be unfair in many respects to UK businesses from a competition perspective, and could lead them to divert manufacturing abroad. A simple solution would be to take account of turnover as well as staff numbers. I have suggested using the definition in section 465 of the Companies Act 2006, which I believe would deal with the situation.

Under the Bill, paid-for branded adverts for products that are high in fat, salt or sugar would be prevented on retailer-owned spaces, but retailers would still be able to advertise equivalent HFSS own-brand products. That could distort competition directly between retailers’ and manufacturers’ products. Amendment 110 would ensure a level playing field, which in my view would be much fairer.

I hope that the Government will be receptive to my amendments—if not now, via changes introduced in the other place. In anticipation of such a compromise, I do not intend to put them to the vote.

[The Minister for Health (Edward Argar)]

I am grateful for this evening’s debate. More than once during the passage of the Bill, I have put on the record the Government’s commitment to improving and protecting the public’s health and have paid tribute to the hard work and dedication of our NHS and public health professionals in rising to the greatest infectious disease challenge of modern times. I would again like to put on the record those important points, with which I know Opposition Front Benchers agree.

Our commitment to public health is clear in the Bill, in the proposals set out in the Government’s recently published plan for health and care, “Build Back Better”, and in our wider programme of public health reform. A focus on the prevention of avoidable diseases is a central principle in delivering a sustainable NHS and in levelling up health outcomes across the country.

Childhood obesity is one of the biggest health challenges that this nation faces. The latest data from the national childhood measurement programme revealed that approximately 40% of children leaving primary school in England were overweight or living with obesity.

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[Edward Argar]

I am grateful to the hon. Lady, with whom I worked in London local government many moons ago on issues not dissimilar to those that we are debating. The Bill focuses on diet and the obesity that it causes, but she is right to highlight that exercise and a healthy lifestyle also play a key role in tackling obesity. We do not believe that the Bill is the right place to put that role into legislation, but I join in the sentiment underpinning what the hon. Lady says. Schools, local authorities and health bodies need to consider the issue in the round.

Nearly two thirds of adults—64%—are also overweight or living with obesity. I am grateful to my hon. Friend the Member for North East Bedfordshire (Richard Fuller) for gently tempting me to respond to his points about the nanny state, but I would argue that it is not being a nanny state to look out for the health of our citizens. Yes, it is about giving advice and giving people the information to make informed judgments, but it is also about putting in place a proportionate framework in legislation.

As with the speech of my hon. Friend the Member for Harrow East (Bob Blackman), I did not agree with everything that the hon. Member for Central Ayrshire (Dr Whitford) said, particularly her concluding comments, but I listened carefully to her comments about seatbelts. She said that she, as a clinician, saw the impact that legislation on that public health and public safety measure had on reducing injuries.

[John Stevenson]

Does the Minister agree that the industry itself is doing an awful lot now to support the Government’s agenda? Does he also acknowledge that personal responsibility is very important?

[Edward Argar]

I wondered what I was about to have bowled at me there, but my hon. Friend is absolutely right. I entirely agree that a huge amount of progress has been made; we believe that we need to go further with our proposals, but he is right to highlight that progress. He is also right to highlight the relevance of the central role of personal responsibility and the decisions that we and our families all take.

To meet the ambition of halving childhood obesity by 2030, it is imperative that we reduce children’s exposure to less healthy food and drink product advertising on TV and online. We want to ensure that the media our children engage with the most promote a healthy diet. The Bill therefore contains provisions to restrict the advertising of less healthy food and drink products on TV, in on-demand programme services and online.

Health and Care Bill

John Stevenson Excerpts

2nd reading
Wednesday 14th July 2021 Commons Chamber

[John Stevenson (Carlisle) (Con)]

In the short time I have to speak, I would like to comment generally on the Bill and specifically on one part of it. This is a Second Reading debate, and I see much merit in many of the provisions of this Bill, and the general thrust and direction of it. I understand much of the thinking behind it, as it is a real opportunity to improve the overall performance of our health service, remove some of the unnecessary bureaucracy that has grown up around it and rationalise some of the geography through the ICSs—a very relevant issue to Cumbria—as well as to improve the decision-making process through the boards and encourage collaboration within the health service, although we must still be open and transparent. These are all very welcome changes that have broad support, including from the health professionals in my community with whom I have already had discussions. This will be on top of the additional financial commitment to the health service that this Government have already made, and of the commitment to more doctors and nurses, all of which is very welcome.

I would, however, like to focus on an area of the Bill where I have some concerns. Clause 125 and schedule 16 relate to advertising, and they have the potential to adversely affect our food and drink sector. I remind the Minister that that is the largest manufacturing sector in the country. It employs a significant number of people up and down the country, it makes a huge contribution to our economy and our exports and—this is a key point—it is an innovative sector with considerable research and development and investment. It has already done a huge amount of reformulation to take sugar and salt out of our foods and it continues to do much on this.

I fully appreciate that obesity is a major concern for our society, and rightly so. Everybody wants the UK to be a fit and healthy country, but we have to tackle this issue in a sensible and proportionate manner. I am not convinced that schedule 16 in its present form will achieve very much. What it will do is reduce investment, resulting in fewer products coming to the market, including fewer healthy products—and those are what we want to see those. There would be less incentive to innovate and ultimately fewer jobs and less money in our economy, and all for very little gain in many respects. Also, as an aside, we need to remember that our own health and wellbeing are our own responsibility. I shall therefore be supporting the Second Reading of the Bill today, but in Committee and on Report, I and I am sure other hon. Members will seek amendments to schedule 16. That is so we get the right balance between our health agenda, the food sector and our individual freedoms and responsibilities.

Cystic Fibrosis Drugs: Orkambi

John Stevenson Excerpts

Monday 10th June 2019 Westminster Hall

[Paul Scully]

My hon. Friend is absolutely right. I have been to the Cystic Fibrosis Trust twice, and I was absolutely blown away. It is the kind of organisation that I got into politics to help. I met Lynsey Beswick, who works there—she may be in the Public Gallery. She is a CF sufferer, and she has just climbed Snowdon. I would struggle with that, and she has reduced lung capacity. [Applause.] That is the first time I have got a round of applause in Westminster Hall; I am not sure it is to be encouraged. Lynsey, that is for you.

[John Stevenson (Carlisle) (Con)]

My hon. Friend is giving personal experiences of how this illness has affected individuals. I met Ayda’s family last week to discuss how it affected them. I have been thinking about the benefits that the introduction of the drug could bring about. One is a saving to the NHS through not needing to use other drugs. The family would need fewer visits to the hospital, which would have an effect on patient care and would free up time for the hospital to look after other patients. Does he agree that it would also bring about a significant improvement to family life, not just for the individual, but for the extended family too?

NHS Winter Crisis

John Stevenson Excerpts

Monday 8th January 2018 Commons Chamber

[Mr Dunne]

I put on the record my appreciation of the hon. Gentleman’s role not only on the Health Committee but in undertaking shifts, as he mentioned. On deferred procedures, we have given very clear instructions that time-critical operations should not be cancelled—cancer operations should not be cancelled. Ultimately, it comes down to the clinical decisions that are made at each hospital about who they should treat and who they believe can wait.

[John Stevenson (Carlisle) (Con)]

Clearly there is pressure on the NHS, including on the Cumberland Infirmary in Carlisle. However, does the Minister agree that we must not lose sight of the positives, such as the £1.8 million investment in cancer equipment that has just gone into the hospital and the proposed £38 million investment in a proposed cancer unit, all of which are in the long-term interests of healthcare in Carlisle and Cumbria?

[Mr Dunne]

Cumbria is one of the parts of the country that has had persistent challenges in the delivery of healthcare. I am pleased that decisions have been taken over the past year or so, including those about investing in improving cancer facilities in Carlisle that my hon. Friend referred to, which we hope will address long-standing issues that have not been addressed under successive Governments.

Oral Answers to Questions

John Stevenson Excerpts

Tuesday 19th December 2017 Commons Chamber

[Mr Hunt]

This is money that will, to answer the right hon. Gentleman’s question, make a big difference in helping the NHS get back to meeting its constitutional waiting time targets.

[John Stevenson (Carlisle) (Con)]

I very much welcome the £2 million winter allocation for the hospitals in my area. Funding is clearly important, but given the improvements in the hospitals in my area that are down to the leadership of the chief executives, the leadership team and the staff, does the Secretary of State agree that leadership is as important as funding?

[Mr Hunt]

My hon. Friend is absolutely right. Of course, both things matter, and hospitals do need the right level of funding, but one of the highlights of the year for me was visiting my hon. Friend’s local trust in Carlisle and seeing the total transformation in leadership there. It was one of the most troubled trusts in the NHS but, thanks to the incredible dedication of the doctors, nurses and everyone working in the trust, it has really turned things around.

Land Registry

John Stevenson Excerpts

Thursday 30th June 2016 Commons Chamber

[John Stevenson (Carlisle) (Con)]

I am pleased to make a contribution to this very important debate about a significant national organisation. Of course I am aware that the consultation has concluded and acknowledge that the Government have not yet come forward with any proposals for the actual privatisation of the Land Registry. I also bring to the House’s attention my entry in the Register of Members’ Financial Interests: I am a practising solicitor.

There are plenty of arguments for retaining the Land Registry in state hands, and we have already heard a number of them. Some of those arguments may be valid and some undoubtedly have merit, but quite a few are, to be honest, bordering on irrelevant. Similarly, there are very sound arguments to suggest it would be far more beneficial for the Land Registry to move out of state ownership into more commercially minded ownership.

[Dr Offord]

I wanted to say this to the right hon. Member for Tottenham (Mr Lammy) as well: while I certainly am a privatisation believer, I do not understand why the Government are seeking to take a public monopoly and make it a private monopoly. I cannot see the benefit that the market will be able to bring to that.

[John Stevenson]

My hon. Friend makes an interesting point, and unsurprisingly I could support many of the arguments for privatisation, but I will come to that in due course.

I want to make two specific contributions to this debate. First, I shall comment as a practitioner—as someone who actually uses the services of the Land Registry and whose firm works with the Land Registry on a daily basis. Secondly, I shall comment as a Conservative politician.

Speaking as a practitioner, the Land Registry is an extremely important aspect of the conveyancing and land ownership process. Indeed, it is central to the whole system as over 75% of land is already registered and ultimately all land will be registered, at which point no physical deeds will be required. Therefore, the accuracy and integrity of the register is absolutely vital. Each day thousands of transactions are logged through the Land Registry portal, queries are raised, and in some cases disputes are resolved. It is part of the everyday work of the conveyancer.

However, we have to accept that the Land Registry is not in any way perfect. Most practitioners would confirm this and I suspect the Land Registry itself would also acknowledge it. The Land Registry does make mistakes, it has backlogs, it needs investment, and it needs to modernise—it is in many respects just like many other organisations that have similar issues.

[Robert Flello]

The hon. Gentleman lists a number of things that, understandably, need to be done, but the Land Registry makes a profit. Why are the Government not putting the profit back into improving it?

[John Stevenson]

The Land Registry does make a profit, and it is quite rightly trying to modernise. It also continuously develops its programmes, and all conveyancers are aware of that.

Like many other practitioners, I acknowledge that the Land Registry plays a vital and central role in the property market. Practitioners greatly value and respect the services that it provides. As a legal practitioner, I see the worth of the Land Registry and its services. We should also not forget the many skilled people who work for the Land Registry, all of whom ensure that the legal profession, the owners of land and the financial institutions are well served.

As a Conservative politician, not unsurprisingly I believe in a market economy, in competition and in competitive markets. I have absolutely no issue with the privatisation of businesses or industries, as I firmly believe that, more often than not, private sector ownership leads to greater efficiency and innovation and better value for money for the taxpayer and the consumer. I do, however, believe in a strong liberal democracy, in the importance of the rule of law and in the significance of property rights in a market economy—in this case, the rights relating to the ownership of land. We must therefore tread very carefully when considering the future ownership of the Land Registry, given its central role in the property market.

The Land Registry is at the very centre of land and property rights in this country, and the integrity of the system is critical. Its importance is such that all solicitors, property owners, leaseholders, lenders and financial institutions must have complete confidence in its integrity, openness and honesty. It has to be trusted. Any doubts or concerns about its integrity, about possible conflicts of interest or about misuse of information could affect this central part of our capitalist system. We must also recognise the fact that the Land Registry is a natural monopoly, a bit like the police or other institutions that do not lend themselves to competition. Such monopolies, which are of great importance to the very fabric of our system, must be treated with great care.

[Mrs Moon]

A considerable number of my constituents work in the Land Registry in south Wales. Their concern is that they constantly have to adapt their practice on the basis of new policy guidelines from the Government. They work within an overarching public interest requirement, and they are worried that that ability to adapt will go if there is a constant need to renegotiate contracts and seek changes with a private sector company. How can we keep that integrity for my constituents if we have to factor in the profit motive of a private sector company?

[John Stevenson]

The hon. Lady raises an interesting point about the constant changes in the Land Registry. As practitioners, we have to deal with those changes as new rules are put forward by this place in relation to the Land Registry and other aspects of property transactions.

As I have said, the Land Registry is central to our property system in this country, and it is vital that it has absolute integrity and openness. It has to be trusted.

[Caroline Lucas]

Will the hon. Gentleman give way?

[John Stevenson]

I am about to conclude my speech, so I will continue.

It is for those reasons that I believe that, if the Government were to bring forward privatisation proposals for the Land Registry, it would be a privatisation too far.

Oral Answers to Questions

John Stevenson Excerpts

Tuesday 22nd March 2016 Commons Chamber

[Ben Gummer]

I do not know why the hon. Lady is shaking her head. She asked what I am doing, and 5,000 additional GPs will help to solve her problem. Secondly, we are putting a greater proportion of funding into general practice, by comparison with the proportion of the NHS budget as a whole, than any previous Government. Thirdly, we are increasing the number of GP training places. I am pleased to report that we are doing well in ensuring that more people in training positions are choosing to become general practitioners.

[John Stevenson (Carlisle) (Con)]

12. What progress his Department has made on improving the performance of hospitals in special measures.

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

Trusts put into special measures have recruited 1,363 more doctors and 4,190 more nurses, with one estimate saying that this has reduced mortality rates by up to 450 a year.

[John Stevenson]

In the past six years, the North Cumbria University Hospitals NHS Trust has had four chief executives, an acquisition that is going nowhere and a so-called success regime that is reporting later than intended. There are clearly tough decisions to be made in the north Cumbria health economy, and the sooner they are made, the better. Will the Secretary of State undertake to ensure that the recommendations of the success regime are implemented in full and in a timely manner?

[Mr Hunt]

I thank my hon. Friend for his persistent campaigning on behalf of his local trust. He is right that there are big issues there. He is also right generally that the NHS has too rapid a turnover of chief executives. There is a new one, Stephen Eames, who is one of the top-rate NHS chief executives. The Care Quality Commission says that things are improving and mortality rates are going down. I will support my hon. Friend in every way I can to resolve the situation as quickly as possible.

Oral Answers to Questions

John Stevenson Excerpts

Tuesday 5th January 2016 Commons Chamber

[George Freeman]

This is the most extraordinary welcome for one of the most important announcements in the autumn statement. Having come under pressure to raise more money for social care, the Chancellor and the Secretary of State announced £3.5 billion extra for social care, from the new adult social care precept and the better care fund. The Opposition say that it is not enough and that it will fail, but the data do not support that. If we look at the early data from the better care fund, which was introduced by this Government early last year, we see 85,000 fewer delayed transfers, 12,500 more older people at home within three months of discharge and 3,000 people supported to live independently. We are making real progress.

[John Stevenson (Carlisle) (Con)]

6. What progress his Department has made on improving the performance of hospital trusts in special measures.

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

Eleven of the 26 hospitals that have been put into special measures have exited that regime because of good clinical progress, the most recent being Morecambe Bay NHS Foundation Trust, which exited in December 2015.

[John Stevenson]

Given that North Cumbria University Hospitals NHS Trust has been in special measures for two and a half years, that there are now serious concerns about the wider health economy in north Cumbria, and that we have the success regime in place, will the Minister now give a commitment that the Government will ensure that the acquisition of the trust will happen?

[Mr Hunt]

First, I thank my hon. Friend for the campaigning he does for his local hospital. He knows that I very much support that merger and hope that it will go ahead. It is worth paying tribute to the staff at the trust, who have brought down mortality rates to within the NHS average. The Care Quality Commission says that plans to improve safety are working well. We should celebrate the fact that even the trusts in special measures have hired 700 more doctors and 1,800 more nurses and are making real progress in improving patient safety.