NHS Winter Crisis
Jonathan Ashworth Excerpts(6 years, 4 months ago)
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Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
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Jonathan Ashworth (Leicester South) (Lab/Co-op)
(Urgent Question): To ask the Secretary of State for Health to update the House on the NHS winter crisis.
The Minister of State, Department of Health (Mr Philip Dunne)
I thank the hon. Gentleman for applying to ask the urgent question as I agree that it is helpful for colleagues in the House to be updated on the current performance of the NHS during this challenging time.
We all know that winter is the most difficult time of the year for the NHS, and I start by saying a heartfelt thank you to all staff across the health and care system who work tirelessly through the winter, routinely going above and beyond the call of duty to keep our patients safe. They give up their family celebrations over the holiday period to put the needs of patients first. Those dedicated people make the NHS truly great.
Winter places additional pressure on the NHS and this year is no exception. The NHS saw 59,000 patients every day within four hours in November. That is 2,800 more every day compared with the previous year. The figures for December will be published on Thursday. We have done more this year in preparing and planning earlier than ever before. That means that the NHS is better able to respond to pressure when it arises. In the words of Professor Sir Bruce Keogh, the national medical director:
“I think it’s the one”
winter
“that we’re best prepared for. Historically we begin preparing in July/August. This year we started preparing last winter. We have, I think, a good plan.”
Let me tell the House about some of the things that have been done differently this year. We further strengthened the NHS’s ability to respond to risk, and the NHS set up the clinically-led national emergency pressures panel to advise on measures to reduce the level of clinical system risk.
We are supporting hospital flow and discharge. We allocated £1 billion for social care this year, meaning that local authorities have funded more care packages. Delayed transfers of care have been reduced, freeing up 1,100 hospital beds by the onset of winter. Additional capacity has been made possible through the extra £337 million we invested at the Budget, helping 2,705 more acute beds to open since the end of November.
We have also ensured that more people have better access to GPs. We allocated £100 million to roll out GP streaming in A&E departments and I am pleased that 91% of hospitals with A&E departments had this in place by the end of November. For the first time, people could access GPs nationally for urgent appointments from 8 am to 8 pm, seven days a week, over the holiday period. In the week to new year’s eve, the number of 111 calls dealt with by a clinician more than doubled compared with the equivalent week last year, to 39.5%, thereby reducing additional pressures on A&E.
We extended our flu vaccination programme, already the most comprehensive in Europe, even further. Vaccination remains the best line of defence against flu and this year an estimated 1,175,000 more people have been vaccinated, including the highest ever uptake among healthcare workers, which had reached 59.3% by the end of November.
We all accept that winter is challenging for health services, not just in this country but worldwide. The preparations made by the NHS are among the most comprehensive, and we are lucky to be able to depend on the extraordinary dedication of frontline staff at this highly challenging time.
Mr Speaker
Order. For a moment I thought that the Minister intended to treat this as though it were an oral statement, to judge by the length. I think it is fair and correct for those following our proceedings to point out that this is not an oral statement offered by the Government: it is a response to an urgent question applied for to, and granted by, me.
Jonathan Ashworth
It is always a delight to see the Minister, but the Secretary of State for Health should be here to defend his handling of the crisis, not pleading for a promotion in Downing Street as we speak.
I join the Minister in paying tribute to all those NHS staff working flat out. Many of them have said that this winter crisis was entirely predictable and preventable. When you starve the NHS of resources, when you cut beds by 15,000, when you cut district nurses, when walk-in centres are closed, when we have vacancies for 40,000 nurses, when you fragment the NHS at a local level and drive privatisation and when social care is savaged, is it any surprise that we have a winter crisis of this severity?
More than 75,000 patients, including many elderly and frail, were stuck in the back of ambulances for over 30 minutes in the winter cold this December and January. A&Es were so logjammed that they were forced to turn away patients 150 times. In the week before new year’s eve, 22 trusts were completely full for up to five days. The blanket cancellation of elective operations means that people will wait longer in pain, distress and discomfort. Children’s wards have been handed over to the treatment of adults. Of course, we do not know the full scale of the crisis, because NHS England refuses to publish the operational pressures escalation levels alerts revealing hospital pressures. Given Ministers’ keenness on duty of candour, why are OPEL alerts data not being collected and published nationally for England?
The Minister mentioned the winter pressures funding, but that money was announced in the Budget on 22 November. Why were trusts not informed of allocations until a month later? That is not planning for the winter: it is more like a wing and prayer. He will know that cancelling elective operations has an impact on hospital finances. What assessment has he made of the anticipated loss of revenue for trusts from cancelling electives? Will he compensate hospitals for that loss of revenue, or should we expect deficits to worsen? Can he tell us when those cancelled operations will be rescheduled?
The Prime Minister defends this crisis by saying nothing is perfect. Patients do not want perfection: they just want an NHS which is properly funded and properly staffed without the indignity of 560,000 people waiting on trolleys in the last year, in which operations are not cancelled on this scale, and in which ambulances are not backed up outside overcrowded hospitals. Patients do not just need a change of Ministers today: they need a change of Government.
Mr Dunne
I am glad that the hon. Gentleman mentioned the Secretary of State. I want to put on record my tribute to my right hon. Friend, who has served in that position for almost as long as Aneurin Bevan, who was the first Secretary of State for the NHS.
I am delighted to be here to respond to the hon. Gentleman, who, as usual, listed a cacophony of allegations, very few of which are directly related to the challenges that our hospitals face today—the increase in demand and pressure on our NHS as a result of a combination of the increase in population and challenges posed by demographics, as well as the weather and the presence of flu in many parts of the country, adding to the pressure on staff at this time of the year.
The hon. Gentleman asked several questions. On the funding issue, he is well aware that the £337 million announced in the Budget was allocated in December. His own local trust, which includes the Leicester Royal Infirmary, received £4.2 million. It is a great shame that he chose not to welcome that extra money for his local trust. The money announced in the Budget has been allocated, but we have kept £50 million in reserve to allocate this month if particular pressures that become apparent during the course of the month need addressing.
The hon. Gentleman asked about the impact of the cancelled operations. We do not know that operations are cancelled. There have been a few thus far; procedures and treatments are being deferred. It will not become apparent until after this period has finished how many actually do end up being cancelled, so it is not possible to calculate the financial impact on any of the trusts where deferral is taking place.
The hon. Gentleman referred to the situation as unprecedented. I gently remind him that we have a winter crisis of some kind or another every year. He will have been in Downing Street in 2009-10, when, as it happens, the then Conservative shadow Health Secretary chose not to try to take advantage of the near flu pandemic at the time because he recognised that there were operational pressures on the NHS and it was not down to him to score party political points. The hon. Gentleman has unfortunately chosen to do that. At that time, tens of thousands of elective procedures were cancelled to provide capacity to cope with the emergency at the front doors of our hospitals. So this is a routine way to deal with pressure coming through hospital front doors.
What distinguishes this year from previous years is that in the past elective procedures were cancelled within hours of operations being due to take place. Sometimes it was the day before and sometimes it was on the day. That caused patients considerable distress and gave rise to considerable problems for staff. We have set up the national emergency pressures panel to anticipate problems when we see the signals, and we can then give notice to patients that their procedures are going to be deferred. That is a much more humane and sensible way to do things and it provides much more opportunity for hospitals to cope with the pressures that are coming through the door.
Oral Answers to Questions
Jonathan Ashworth Excerpts(6 years, 4 months ago)
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Mr Hunt
I have a great deal of sympathy with what my right hon. Friend says, and he is right that the recruitment and retention of GPs is a big issue. I have a constituency interest, in that I have a university that is also very keen to host more medical school places, so I am recusing myself from the decision. However, I wish all universities good luck, because this is a historic expansion of medical school places for the NHS.
Mr Speaker
Order. I am sure that the shadow Secretary of State will be brief, in recognition of the enormous demand from Members wishing to contribute in this session.
Jonathan Ashworth
May I join the Secretary of State in wishing all our NHS and social care staff a very merry Christmas, and in thanking them for their commitment this winter?
Virgin Care recently won a £100 million contract for children’s health services in Lancashire, but in the Secretary of State’s own backyard of Surrey, Virgin Care recently took legal action against the NHS, forcing it to settle out of court. This money should be going to patient care, not the coffers of Virgin Care, so why will he not step in and fix this scandal so that his Surrey constituents and the NHS do not lose out?
Mr Hunt
I, too, am very disappointed about the action taken by Virgin Care, but I gently point out to the hon. Gentleman that, contrary to the narrative that he and his colleagues put out, the reason why it took action was that the NHS stripped it of its contract and gave that back to the traditional NHS sector—hardly the mass privatisation that he is always talking about.
Jonathan Ashworth
The Secretary of State’s Surrey constituents will have heard that he will not be taking action against Virgin Care.
Our research has revealed that there are vacancies for 100,000 staff across the NHS, and there is a “national crisis in workforce”—not my words, but those of the Royal Surrey County Hospital NHS Foundation Trust in the Secretary of State’s constituency. With bed occupancy at the Royal Surrey hitting a peak of 98.7% this winter already, and 94.5% across the NHS on average, can he tell us how he expects the NHS to cope this winter when it is understaffed, overstretched and underfunded?
Mr Hunt
If we decide that we want more nurses following Mid Staffs, that creates vacancies. If we want to transform mental health provision, that creates vacancies. That is why we announced a workforce plan, which I notice the Welsh Government have not had time to do yet. But I will finish by wishing the hon. Gentleman a merry Christmas. If he wants to take a bit longer off and stay away for January, we are happy to hold the fort.
King’s College Hospital Foundation Trust
Jonathan Ashworth Excerpts(6 years, 4 months ago)
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Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Mr Dunne
I am grateful to my hon. Friend, because I can confirm that the NHS is receiving record levels of funding, in advance of the plan that was agreed with the NHS chief executive for the five year forward view. That was front-loaded for the five years, so the NHS has received increases of funding for the first three of those five years over and above what was requested.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
Lord Kerslake has said that the Government are
“simply not facing up to the enormous challenge the NHS is currently facing”.
We agree. The Nuffield Trust has today called King’s
“the canary down the coalmine”
for NHS finances. Hospitals across London and beyond have been forced to cut costs by 4% a year since 2011, yet the report that Ministers commissioned from Lord Carter advised that trusts should find savings of 2% a year.
Does the Minister agree with NHS Providers, which warns that the saving hospitals have been ordered to find
“risks the quality of patient care”?
He will know that, by September this year, 83% of acute hospital trusts were in deficit to the tune of £1.5 billion. Does he agree that these deficits, across London and beyond, are a consequence of Government underfunding, cuts to tariffs and the failure to get a grip of delayed transfers of care because of the £6 billion of cuts to social care? Does he expect delayed transfers of care to increase in the coming weeks, and will trusts again be ordered to cancel elective operations this winter?
Before the Budget, the NHS argued publicly for an extra £4 billion in revenue a year. Why did the Chancellor refuse to give the NHS the extra funding that Simon Stevens asked for? Lord Kerslake has said that our NHS faces the
“tightest spending figures in recent times”.
Does that not mean that, as at King’s, there will be continued hospital deficits, growing waiting lists, greater rationing of care, the dropping of the 18-week target, more privatisation and an NHS pushed to the brink because of this Government’ persistent underfunding? Do patients not deserve better?
Mr Dunne
I think the hon. Gentleman’s critique would have a shade more credibility if he acknowledged that, before the 2015 election, the then shadow Health Secretary indicated that he wanted £5.5 billion less for the NHS than my party was offering. If we had followed that prescription, the financial position of the NHS would be far worse.
The hon. Gentleman asked about delayed transfers of care. In March, the Chancellor gave an additional £2 billion to the adult social care system, precisely targeted on reducing DTOC, and significant progress is being made in freeing up beds across the system. He also asked about NHS funding in the most recent Budget. The Chancellor awarded an additional £2.8 billion in revenue support for this year, next year and the following year, and a further £3.5 billion of capital to support programmes.
Maternity Safety Strategy
Jonathan Ashworth Excerpts(6 years, 5 months ago)
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Jonathan Ashworth (Leicester South) (Lab/Co-op)
I am grateful to the Secretary of State for the advance copy of his statement. At the outset, may I pay tribute, as he has done, to the hon. Members who have spoken out so movingly in recent months about baby loss? They include, as he has said, the hon. Members for Colchester (Will Quince), for Eddisbury (Antoinette Sandbach), for Banbury (Victoria Prentis) and for North Ayrshire and Arran (Patricia Gibson), and my hon. Friends the Members for Lewisham, Deptford (Vicky Foxcroft) and for Washington and Sunderland West (Mrs Hodgson). They are all a credit to the House.
Our national health service offers some of the best neonatal care in the world, and the progress set out by the Secretary of State today is a tribute to the extraordinary work of midwives and maternity staff across the country. We welcome his announcement that all notifiable cases of stillbirth and neonatal death in England will now receive an independent investigation by the healthcare safety investigation branch. That is an important step, which will help to bring certainty and closure to hundreds of families every year.
We also welcome the move by the Secretary of State to allow coroners to investigate stillbirths. May I assure him that the Opposition stand ready to work constructively with him to ensure the smooth and timely passage of the relevant legislation, should he and the Government choose to bring any before the House? I also pay tribute to the work carried out by the team at the University of Leicester that leads on the perinatal aspects of the maternal, newborn and infant clinical outcome review programme, which provided the evidence for today’s announcement.
The number of deaths during childbirth has halved since 1993, saving about 220 lives a year, but we welcome the Secretary of State’s ambition to bring forward to 2025 the target date for halving the rate of stillbirths, neonatal deaths, maternal deaths and brain injuries that occur during or soon after birth. If that target is to be delivered, however, it is essential that NHS units providing these services are properly resourced and properly staffed. We welcome the launch of the Atain e-learning programme, as well as the increased training for consultants on the care of pregnant women with significant health conditions. We also welcome the emphasis on smoking cessation programmes, but we should remind the Secretary of State that public health budget cuts mean that many anti-smoking programmes have been cut back across the country.
The Secretary of State will know that the heavy workload in maternity units was among the main issues identified by today’s study, which found that “service capacity” issues in maternity units affected over a fifth of the deaths reviewed. Earlier this year, our research revealed that half of maternity units had closed their doors to mothers at some point in 2016, with staffing and capacity issues being the most common reasons for doing so. The Royal College of Midwives tells us that we are about 3,500 midwives short of the number needed. A survey published by the National Childbirth Trust this year showed that 50% of women having a baby experienced what the National Institute for Health and Care Excellence describes as a red flag event, which is an indicator of dangerously low staffing levels, such as a women not receiving one-to-one care during established labour.
We therefore believe that the NHS remains underfunded and understaffed. I would be grateful to the Secretary of State if he told us what further action he intends to take to ensure that maternity services are properly funded and to address the staffing shortages as part of a full strategy to improve safety across the board. The NHS has excellent psychological and bereavement support services for women affected by baby loss, but we all know that the quality of those services remains variable across the country. Indeed, we are still a long way from full parity of esteem for mental health in neonatal care. What action does the Secretary of State intend to take to plug these gaps?
Overall, this welcome set of announcements from the Secretary of State may help the NHS to provide the best quality of care for all mothers and their babies. The Opposition look forward to working constructively with the Secretary of State and the Government, but I hope he can reassure us that they will provide the resources that NHS midwives and their colleagues need to deliver on these ambitions.
Mr Hunt
I thank the shadow Health Secretary for the constructive tone of his response to the statement. I think he is right to point out both the achievements that have been made over many years, but also the challenges ahead. We have about 1,700 neonatal deaths every year—that has actually fallen by 10% since 2010—but behind that figure, there is variation across the country. For example, our best trust has about three deaths in 1,000, but in other trusts the figure can be 10 in 1,000, which is more than three times as many neonatal deaths. That shows we are not as good as we need to be at spreading best practice. Today’s announcement is really about ensuring that we can confidently look every expecting mum in the eye and say, “You are getting the very highest standards of care that we are able to deliver in the NHS.”
I thank the hon. Gentleman for his offer to co-operate on any legislation needed to expand the scope of inquests to full-term stillbirths, and we will get back to him on that. I also thank him for raising the issue of bereavement services. I spoke to a bereavement midwife this morning, and I think bereavement midwives are among the most extraordinary people working in the whole NHS. We do have a programme to improve the consistency of bereavement services and to roll out the use of bereavement suites across the NHS; our best trusts have such suites, but by no means all of them do.
The hon. Gentleman was absolutely correct to raise the issues of both funding and staffing. We have seen an increase of 1,600 in the number of midwives since 2010, which is a rise of 8%, and an increase of 600 in the number of obstetricians and doctors working in maternity departments, which is a rise of about 13%, but we need more. There are lots of pressures across the NHS, and we also have to fund the extra midwives and doctors that we need. There was a welcome boost for the NHS in the Budget, with an extra £1.6 billion available for the NHS next year. However, looking forward to the next 10 years and all the pressures coming down the track for the NHS—with a growing birth rate, but also with an ageing population—I do not pretend that we will not have to revisit the issue of NHS funding and find a long-term approach. Probably the most appropriate time to do that will be when we come to the end of the five year forward view and start to think about what happens following that. If we are to put more money into the NHS, we need to have the doctors, midwives and nurses to spend that money on, which is why, in the past year, the Government have committed to a 25% increase in the number of nurse training places and a 25% increase in the number of medical school training places.
My final point for the hon. Gentleman is that, although we have lots of debates in this House in which we take different positions in relation to the NHS, one thing we can be united on is our aspiration, which is shared across the House, that the NHS should be the safest healthcare system in the world, and I very much thank him for his support on that.
Oral Answers to Questions
Jonathan Ashworth Excerpts(6 years, 5 months ago)
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Mr Hunt
I do agree. I also know that, although areas such as Wealden are beautiful places in which to live, it is sometimes very difficult to recruit people to become, in particular, new partners in general practices in such areas. We are concerned about that. Nationally, we have a plan to recruit 5,000 more GPs by 2020-21, but we need to ensure that they go to rural areas such as that represented by my hon. Friend.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
The Secretary of State will know that there are huge numbers of vacancies across the NHS, particularly in nursing, partly driven by pay restraint. He has said that the pay cap will be scrapped, so does he agree with Simon Stevens, who said that it would be an “own goal” not to fully fund the scrapping of that pay cap in the Budget next week and to expect it to be paid for by productivity gains?
Mr Hunt
I have been clear about this: the Government are willing to be flexible in terms of funding additional pay beyond the 1% for nurses, but we want some important reforms to the contracts that they operate under. If those negotiations go well—at the moment we have been having very constructive discussions with the Royal College of Nursing—I am hopeful that we can get a deal that everyone will be happy with.
Jonathan Ashworth
So the Secretary of State does not agree with Simon Stevens. May I ask him about Simon Stevens’s comments last week? He warned that if the underfunding continues, waiting lists will rise from 4 million to 5 million, cancer care will deteriorate, the mental health pledges the Secretary of State has committed to will not be met, and the 18-week target will be permanently abandoned. And is it not the case that if in next week’s Budget the Chancellor does not allocate at least an extra £6 billion a year for the NHS, the right hon. Gentleman will have failed in his responsibility as Secretary of State?
Mr Hunt
What Simon Stevens noticed, and we all noticed, was that when he came with this plan in 2014 Labour refused to back it, and in the 2015 election they refused to fund it—to the tune of the £5.5 billion more that the Conservatives were prepared to put in, but the hon. Gentleman’s party refused to put in. He is quoting Simon Stevens, who also said that when the British economy sneezes, the NHS catches a cold—it will be far worse than a cold for the NHS if we have Labour’s run on the pound.
Oral Answers to Questions
Jonathan Ashworth Excerpts(6 years, 7 months ago)
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Jonathan Ashworth (Leicester South) (Lab/Co-op)
Can the Secretary of State tell us how many elective operations he expects to be cancelled by 31 December?
Jonathan Ashworth
I am grateful to the Secretary of State for his answer, but already more than 80,000 elective operations have been cancelled. That is an increase on the past year. A&E attendance is up on the past year, bed occupancy is higher than last year and the Care Quality Commission has today warned that the NHS is straining at the seams. Winter is coming. Last week, the Tory party made spending commitments worth £15 billion, but not 1p extra for the NHS, so will the NHS fare worse or better than last year this winter, or are we set for another winter crisis made in Downing Street?
Mr Hunt
What the CQC actually said this morning is that the majority of health and care systems across the NHS are providing good or outstanding quality; that the safety of care is going up; and that performance is improving. None the less, the hon. Gentleman is right that we are always concerned about winter. Let me tell him the new things that are happening this year to help prepare the NHS: £1 billion more going into the social care system in the most recent Budget; a £100 million capital programme for A&E departments; 2,400 beds being freed up; and an increasing number of clinicians at 111 call centres. A lot is happening, but, overall, let me remind him that our NHS is seeing 1,800 more people every single day within four hours—that is something to celebrate.
NHS Pay
Jonathan Ashworth Excerpts(6 years, 7 months ago)
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Jonathan Ashworth (Leicester South) (Lab/Co-op)
I beg to move,
That this House notes that in 2017-18 NHS pay rises have been capped at one per cent and that this represents another below-inflation pay settlement; further notes that applications for nursing degrees have fallen 23 per cent this year; notes that the number of nurses and midwives joining the Nursing and Midwifery Council register has been in decline since March 2016 and that in 2016-17 45 per cent more UK registrants left the register than joined it; and calls on the Government to end the public sector pay cap in the NHS and give NHS workers a fair pay rise.
This is the first Opposition Supply day for six months, and it is my pleasure to bring a motion to the House on lifting the public sector pay cap. In the past 24 hours, the Government have been briefing that the pay cap has ended. The Chief Secretary to the Treasury has said that Ministers now have “flexibility” when setting pay above 1%. If—and it is a big “if”—that flexibility means lifting the cap for the whole public sector and giving public sector workers a fair pay rise above inflation, which stood at 2.9% yesterday, that will be a victory for the Labour party, for the Leader of the Opposition, for the Royal Colleges, for the trade union movement, for the MPs of all parties who signed the early-day motion and, above all, for the millions of public sector workers who have campaigned for fair pay. That flexibility that the Chief Secretary to the Treasury has talked about must mean giving NHS staff fair pay as well.
What a climbdown this represents for the Prime Minister! The House will recall that, in the general election campaign, she showed the deftness of touch that has come to characterise her dismal, beleaguered premiership by dismissing the heartfelt concerns of a nurse, saying that there was no “magic money tree”. It is funny that the money was there when the Conservatives needed the votes, though.
Gloria De Piero (Ashfield) (Lab)
May I tell my hon. Friend about Neil Thompson, a district nurse from Eastwood in my constituency? He has told me:
“I didn’t expect, after 40 years in the NHS, to be as poor now as when I first started out.”
How can that be just?
Jonathan Ashworth
My hon. Friend is right to raise that point. It is not just, which is why the Labour party has consistently campaigned to get rid of the cap. The Conservatives have voted against getting rid of it when we have brought motions on this issue to the House.
Given that the Government are now briefing that the cap is being abandoned, I trust that they will accept the motion in the name of the Leader of Opposition and myself and not divide the House later today. If they are indeed abandoning the cap, let us put them on notice that it must apply to the whole public sector, including the 55% of workers not covered by pay review bodies. We also put them on warning that we will not accept a divide-and-rule approach that plays one set of public workers off against another. Nor will we let Ministers get away with presenting below-inflation pay offers as amounting to a fair pay rise when that is still, in effect, a pay cut.
Catherine West (Hornsey and Wood Green) (Lab)
My hon. Friend is making an excellent beginning to his speech. What is his view of the impact of this crucial question on recruitment and retention in our hospital trusts?
Jonathan Ashworth
My hon. Friend is right to raise that point. I shall go on to explain that the pay cap is at the heart of the recruitment and retention crisis that is now facing the national health service.
Rosie Cooper (West Lancashire) (Lab)
Does my hon. Friend share the shock of GPs and NHS staff when they learned that, while frontline staff were limited to a 1% pay rise, the governing body of the Liverpool clinical commissioning group gave themselves rises of between 15% and 81%? None of the regulators noticed this, including NHS England and NHS Improvement, and it all took place under the nose of the Government. This shows that there is one rule for the bosses and another for the workers.
Jonathan Ashworth
My hon. Friend is absolutely right. She has been determined in her pursuit of this issue and I know that that will continue.
Jonathan Ashworth
I will make a little progress now, if I may. I promise I will take more interventions later.
I say directly to the Chief Secretary to the Treasury, who will be responding to the debate later, that if Ministers are given flexibility to set pay rates, and if the pay cap has indeed been abandoned, she also needs to grant the NHS the funding that it needs. The NHS is underfunded and it is going through the biggest financial squeeze in its history. On the published figures, head-for-head NHS spending will fall in the next year. Hospitals are in deficit, waiting lists are at 4 million, the A&E target is never met and the 18-week target has been abandoned. Hospital bosses are warning that there will not be enough beds this winter. Last winter, hospitals were overcrowded, ambulances were backed up and social care was at a tipping point. Some even characterised it as a humanitarian crisis. It is not good enough for the Chief Secretary to the Treasury just to grant “flexibility” and expect hospitals to fund a staff pay increase from existing budgets.
Lucy Frazer (South East Cambridgeshire) (Con)
If the hon. Gentleman does not get the increases he would like, will he support co-ordinated illegal action?
Jonathan Ashworth
The Labour party supports people taking legal industrial action, and if the hon. Lady supports public sector workers, she should be joining us in the Division Lobby later.
Helen Whately (Faversham and Mid Kent) (Con)
Does the hon. Gentleman agree that the pay restraint over the past few years has been uncomfortable but necessary, in order to bring Government spending—[Interruption.]
Helen Whately
None of us would want anyone to be paid any less, but it has been difficult but necessary, in order to control the overspending by Government and put right the financial mess that the country was left in after the last time the hon. Gentleman’s party was in government.
Jonathan Ashworth
I agreed with the hon. Lady’s comments at the time of the debate on the Gracious Speech, when she said:
“I’m of the view we need to look at public sector pay in the light of increasing inflation.”
If those were her comments then, she should be joining us in the Division Lobby this afternoon.
Several hon. Members rose—
Jonathan Ashworth
I will let the hon. Member for Wells (James Heappey) in because he has been very persistent, but first let me make some progress.
It is not good enough for the Chief Secretary to grant the Secretary of State flexibility and not grant him the funding that the NHS needs. Overcrowded, overstretched hospital trusts cannot be expected to absorb pay rises from existing budgets. We need extra investment now to give the staff the fair pay they deserve.
Jonathan Ashworth
Let me make a little bit of progress, and then I will give way.
Over the past seven years, a public sector worker on the median public sector wage has seen the value of their wage drop by £3,875. That is more than the cost of feeding the average family for a year. Given what we know about inflation, on the figures published yesterday and on the Treasury’s own inflation forecast, if this cap was to remain in place until the end of the Parliament, a public sector worker on the median wage since 2016 will have seen their pay drop by at least another £2,200.
Jonathan Ashworth
The Chief Secretary says it is not true. These amounts are based on her own Treasury figures.
James Heappey
The shadow Minister has been very generous in giving way. May I be helpful and invite him perhaps to revise his earlier statement that the pay rise should be universal across the public sector? Surely that would advantage those in more senior, management positions, who would disproportionately benefit from such a pay rise, and perhaps actually the Government’s position of offering Ministers flexibility to increase pay where there is a clear need is a much better proposal than the universal pay rise that would only benefit fat cat managers.
Jonathan Ashworth
There we have it—the Conservative party playing one part of the public sector off against the other. We believe the whole of the public sector deserves a pay rise.
Ellie Reeves
In my constituency, NHS staff are having to rely on food banks in order to be able to eat. A constituent, an ambulance technician who transports critically ill children across the country, told me that she does not have nearly enough money to live on. Does my hon. Friend agree that this is a disgrace?
Jonathan Ashworth
It is a shocking disgrace, which is why the Labour party has consistently campaigned to get rid of the pay cap; it is why, in our manifesto, which we took to the British people a few months ago, we said we would get rid of the pay cap, and why it is absolutely disgraceful that Conservative Members stood on a manifesto to keep the pay cap.
Jack Dromey (Birmingham, Erdington) (Lab)
Mandy McKeown’s son Liam died seven times. He survived, thanks to the dedicated work of neonatal intensive care nurses. Tracey, who came to Parliament last week, spoke of having suffered a 14% cut in pay, two-thirds of her fellow nurses taking second jobs and a haemorrhage of nurses from the profession that they love. Does my hon. Friend agree that it is utterly shameful to treat those to whom we owe the difference between the life and death of sick babies in this way?
Jonathan Ashworth
My hon. Friend has spoken incredibly powerfully about that case and he is quite right to say it is shameful.
Jonathan Ashworth
The hon. Lady has often spoken out on this matter, so I feel I should take her intervention, but then I will make progress, if the House will indulge me.
Maria Caulfield
It is generous of the hon. Gentleman to give way. As he says, I support the lifting of the pay cap and I am pleased that the Government are moving on this. My concern about supporting this motion is that Labour do not seem to have learned the lessons from crashing the economy in the first place. Could he outline what level of pay rise the Labour party is proposing for public sector workers—1.5%, 2% or 3%—and how it will be paid for? That is crucial to influencing the voting intentions of Members like me.
Jonathan Ashworth
I have a huge amount of respect for the hon. Lady; we have had conversations outside the rough and tumble of this Chamber, and I know she takes these matters extremely seriously. I would ever so gently say to her that she has been telling newspapers that she supports getting rid of the cap; she has been hosting nurses in Parliament, saying that she would get rid of the cap; well, this evening she has an opportunity to take a stance, ignore the Tory Whips and vote for getting rid of the cap.
Maria Caulfield
In this debate, we must be honest with the British public about how we are going pay for the lifting of the pay cap. If Labour wants to lift the pay cap, can the hon. Gentleman explain how the Labour party will pay for it? Will it be through increased taxation or more public borrowing, or will Labour shift spending priorities? We need to know the detail in order to be able to support this policy.
Jonathan Ashworth
I hope the hon. Lady made those points at the rally last week, when she was talking to nurses. But I would say to her that the Government have found an extra £1 billion or so for Northern Ireland. We do not begrudge Northern Ireland that, but the Government have found more money for Northern Ireland. Also, the Government are giving away billions and billions in corporation tax cuts. They have given away £1 billion in inheritance tax cuts. Government is indeed about making choices. We would make a different set of choices, but if the hon. Lady is genuine, as I believe she is, and sincere, as I believe she is, in wanting to get rid of this cap, she needs to send a message to the Chancellor, not the Tory Whips, and vote for our motion.
Ian Paisley (North Antrim) (DUP)
I thank the hon. Gentleman for giving way on this very important issue, and I must say that I and my colleagues are minded to support the motion that he has put before the House. But it would be appropriate if true sincerity was shown by all Members of this House—if they stopped attacking the Government for giving Northern Ireland that £1 billion, so that we can alleviate the costs that would allow us to make that pay gap narrow.
Jonathan Ashworth
I did say I did not begrudge Northern Ireland the money; I was just making the point that the Government have found the money, when they keep telling us that there is no money for anything else. But we are grateful that the Democratic Unionist party has signed the early-day motion in the name of my hon. Friend the Member for St Helens North (Conor McGinn), and we are aware that the DUP has said consistently that it supports getting rid of the pay cap for public sector workers. We would be very happy for the party to join us in the Division Lobby this evening.
Lady Hermon (North Down) (Ind)
I am really pleased to hear what the hon. Member for North Antrim (Ian Paisley) has said today, but I want to put it on the record that DUP Members did have an earlier opportunity to support the removal of the pay cap but actually voted against that—all 10 of them—in the debate on the Queen’s Speech. An amendment was tabled by the colleagues of the hon. Member for Leicester South (Jonathan Ashworth), and the DUP voted it down, but we always welcome repentance.
Jonathan Ashworth
I am grateful to the hon. Lady and I am grateful that she also signed the early-day motion. This issue may be debated further as hon. Members make their speeches today.
As we know, according to the Office for National Statistics, many public sector workers regularly work an average of 7.8 hours’ unpaid overtime a week, worth £11 billion to the economy. With the pay cap, the Government have effectively been asking them to do more and more on less and less. That is unfair.
Jonathan Ashworth
I will make progress, if I may.
MPs on both sides of the House have spoken out against this pay cap. We would hope that they will join us in the Division Lobby, including the hon. Member for North Antrim (Ian Paisley). I pay tribute to my hon. Friend the Member for St Helens North for tabling early-day motion 132, which calls for an end to the NHS pay cap, and which we have picked up and adopted as our motion today.
I know there are many who have sympathy for getting rid of the pay cap. The reason that many in the House have sympathy for getting rid of the pay cap is that in all our constituencies we have met nurses, very directly at our advice surgeries, or indeed in lobbies at Parliament, who have told us that the cap has meant they have seen a 40% real-terms drop in their earnings since 2011.
Jonathan Ashworth
I want to make progress; but I will try to let in as many hon. Members as possible.
We have all read reports of nurses on their way home from a shift stopping off at food banks. The Royal College of Nursing tells us that two-thirds of its members are forced to undertake bank and agency work to help make ends meet. Is that not an example of how self-defeating the pay cap is, because it is driving an agency bill of £3.7 billion in the NHS?
We have all read surveys showing that more and more NHS staff are turning to payday loan companies and pawning their possessions, and we will have heard from the RCN lobby recently of the huge hardship that our nurses are facing. Many nurses have been in touch with us.
Let me give the House the story of Rebecca, who got in touch with my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams). Her story brings into sharp focus the impact of the pay cap, particularly when it is combined with the severe social security cuts that the Government are pushing through. Rebecca is a single parent. She was originally on working tax credit, but she was transferred to universal credit last year, with her payments falling as a result. As a consequence of that reduction and of the ongoing cap on her wages, which have lost their value, she has accrued rent arrears of over £800. Her landlord has now issued her with an eviction notice. There we have it: nurses are turning to food banks, pawning their possessions, and even being issued with eviction notices. Is that not shameful in 21st-century Britain? What a depressing human consequence of Tory economics.
Ms Karen Lee
I am a nurse and I believe in fairness. This is not just about paying nurses properly; it is about the porters, the housekeepers, the cooks, the cleaners and the admin staff, because they all do a good job. This is about not just healthcare workers but the whole public sector, because if the Government can find £1 billion for the DUP, they can pay the public sector properly.
Jonathan Ashworth
What a pleasure it is to see a Labour MP in Lincoln, Mr Speaker. My hon. Friend is a former nurse—
Jonathan Ashworth
She is still a nurse—I do beg her pardon—and she makes her case powerfully.
Jonathan Ashworth
I will give way to the hon. Member for Croydon South (Chris Philp) because he has been so persistent, but I will then try to get on with my speech.
Chris Philp
It is kind of the shadow Minister to give way. Of course our hearts go out to the people in the stories he is relaying to the House, but we need to consider the whole picture. In its March report, the NHS Pay Review Body said:
“We do not see significant short-term nationwide recruitment and retention issues that are linked to pay.”
The pay review body itself says that pay is not causing retention issues, so should the House not take account of that?
Jonathan Ashworth
Perhaps we really should, but I think the hon. Gentleman, who is an enthusiastic supporter of his Front-Bench team, is quoting selectively from the report, which I will move on to in a few moments.
Today’s motion is not just about doing what is right for NHS staff; it is about doing what is right for patients, too. I remind the House that we are significantly short of GPs and that we are short of 3,500 midwives. According to the Royal College of Nursing, we are also short of 40,000 nurses, with one in 10 nursing posts remaining vacant. Nearly 40% of the full-time vacancies advertised on NHS Jobs earlier this year were in nursing, and the Opposition know that Brexit is having an impact through nurses leaving the UK. The Nursing and Midwifery Council shows an increase in the numbers of nurses and midwives leaving its register. The average midwife has seen the value of their pay drop by over £6,000 since 2010, and we are significantly short of numbers, with 80% of midwives intending to leave the profession in the next two years as a result of the pay cap.
Jonathan Ashworth
May I make a little progress?
The hon. Member for Croydon South said that pay does not affect retention and recruitment, but the Opposition say that the pay cap is at the heart of the retention and recruitment crisis. Earlier this year, NHS Providers, which represents hospital trusts, warned that low pay is causing staff to leave the NHS to stack shelves in supermarkets. Chris Hopson said:
“Years of pay restraint and stressful working conditions are taking their toll. Pay is becoming uncompetitive. Significant numbers of trusts say lower paid staff are leaving to stack shelves in supermarkets rather than carry on working in the NHS.”
Anna Soubry (Broxtowe) (Con)
Does the hon. Gentleman appreciate that anybody listening to his speech would take away from it a story of gloom and doom about our NHS? While there are difficulties and challenges, every day millions of people overwhelmingly enjoy one of the finest health services anywhere in the world, and I and many others are sick and tired of Labour talking it down.
Jonathan Ashworth
The right hon. Lady says that we are talking the NHS down. We are not talking it down; this Tory Government are running it down. She seemed concerned about public sector pay in the NHS a few months ago when she tweeted:
“The important retention & recruitment of public sector workers is about working conditions (esp in NHS) as well as pay”.
If she stands by that tweet, she should join us in the Lobby this evening.
Alison McGovern (Wirral South) (Lab)
I thank my hon. Friend for giving way, but I thank him even more for coming to Eastham in my constituency, where our precious walk-in centre is closing owing to staff shortages at our A&E, which is in crisis. The Tories says that we are talking down the NHS and lowering morale, but does he agree that it is not words that matter but action, and that is why we need action on pay?
Jonathan Ashworth
My hon. Friend is right. A popular, successful walk-in centre in her constituency has had to close to shift the staff to fill vacancies at the local A&E at Arrowe Park hospital, because the pay cap and other Government decisions have led to a staffing crisis in the wider NHS.
Jonathan Ashworth
I did promise my hon. Friend that I would give way, but I will take no more interventions afterwards.
Mr Cunningham
Has my hon. Friend noticed that the Government do not necessarily have to abide by the pay reviews? In other words, they could give an increase that goes further than what the pay review body recommends. The Tories are wrecking the national health service. They should put their money where their mouth is. If they really appreciate NHS and its staff, they should vote with us tonight.
Jonathan Ashworth
My hon. Friend is absolutely right. The Tories have been running the NHS for seven years now. It is going through the biggest financial squeeze in its history and we have some of the worst waiting times on record.
The hon. Member for Croydon South should note that the NHS Pay Review Body’s March report said that
“public sector pay policy is coming under stress. There are significant supply shortages in a number of staff groups and geographical areas. There are widespread concerns about recruitment, retention and motivation that are shared by employers and staff side alike.”
Again, NHS Providers said that
“seven years of NHS pay restraint is now preventing them from recruiting and retaining the staff they need to provide safe, high-quality patient care. The NHS can’t carry on failing to reflect the contribution of our staff through fair and competitive pay for five more years.”
We agree. Addressing NHS pay and lifting the pay cap are crucial to addressing the retention and recruitment crisis now facing the NHS.
Jonathan Ashworth
I have given way to the hon. Lady once and I have been generous, so I hope she will forgive me if I do not give way again.
We have heard several examples of what vacancies in the NHS mean for services. We have heard about the walk-in centre in Wirral, but Macmillan Cancer Support warned last week that bigger workloads and vacancies in key roles are creating “unrelenting pressure” on the cancer care workforce and that some cancer patients are attending A&E because they cannot get help elsewhere. I have mentioned midwifery, and this summer we revealed that almost half of maternity units closed their doors to patients at some point in 2016, with understaffing often used as the justification. Earlier this year, I revealed FOI requests that showed a rising number of cancelled children’s operations, with 38% of trusts citing workforce shortages as the reason for those cancelled operations. Visit any hospital and doctors will talk about rota gaps, and the latest NHS staff survey reveals that 47% of staff view current staffing levels as insufficient to allow them to do their job properly.
Not only is the pay cap unfair on hard-working staff who are struggling to make ends meet, but it is unfair on patients, who suffer the direct consequences of under-staffed, overstretched services. We look forward to the Health Secretary telling us how he will use his newfound flexibility. We look forward to his telling us what remit he will set for the NHS Pay Review Body in the coming days. He has had all summer to think through his response to these demands. I know that he got into a big argument with Professor Stephen Hawking, but we will leave that there. The Health Secretary sets the remit—he tells the pay review body what it is able to provide—so we look to him to tell us what he is going to ask it to provide. We want him to tell us today when he will publish the remit letter.
Jonathan Ashworth
I have been very generous to Government Members, and the hon. Lady has already had a chance.
The pay cap must be scrapped, and it must be done by giving the NHS extra investment. The self-defeating nature of this policy means that we are already spending £3 billion on agency workers, and the Government have found billions for corporation tax and inheritance tax giveaways, so this new flexibility must mean more investment. We will not tolerate hospital bosses being forced to cut services to find these funds.
Jonathan Ashworth
I have been very generous, and I want to wrap up because a huge number of Members want to speak in the debate.
As the Government are briefing that the pay cap has gone, we expect the Health Secretary or, if he cannot do it, the Chief Secretary to the Treasury to tell us what extra investment will be made available to the national health service in the coming year to get rid of this pay cap. If they are not prepared to put the extra investment in the health service to get rid of this pay cap, we can quite rightly conclude that the consequence will be further cuts to services at the frontline.
Jonathan Ashworth
I have been extremely generous, and I will now wrap up.
If the Government are genuine and sincere about getting rid of the pay cap, I see no reason why they should seek to divide the House today. If they do seek to divide the House, I say directly to all those Conservative MPs who went to the Royal College of Nursing rally last week, to all those Conservative MPs who have tweeted that they support getting rid of the pay cap, but just not on this occasion, and to all those Conservative MPs who have responded to constituents by telling them that they have their sympathy and that they want to get rid of the pay cap: this is not a time to sit on your hands. I know Conservative MPs will be reconciling the pressures of wanting to be loyal to the Treasury Bench and to their Whip, but 1 million NHS staff, nurses and their constituents are looking to this House to show some leadership and take a stand by giving our NHS staff the fair pay they deserve.
I commend our motion to the House.
The Chief Secretary to the Treasury (Elizabeth Truss)
We have had an important debate, in which it is fair to say that both sides of the House have recognised the importance and hard work of workers across the NHS. I saw this hard work in action on the Becket ward of Worthing Hospital a few weeks ago, where deputy sister, Sue Grace, and her team were in an improvement huddle, where every day they look at how they can make life better for their patients. That goes on right across our NHS. Because of the hard work of NHS workers across the country, there have been 1 million more operations and cancer clear-up rates have improved.
The Health Secretary recognised in his opening comments that there are challenges to address. We need to ensure that we retain those hard-working staff, that we can recruit the next generation into the service and, as my hon. Friend the Member for Totnes (Dr Wollaston) pointed out, that we are able to recruit people in specialisms. We need to look at making jobs more flexible so that people have a good work-life balance and we need to look at banding, as my hon. Friend the Member for Lewes (Maria Caulfield) pointed out. That is why the Government announced yesterday that we are moving from a blanket approach of having a 1% public sector pay cap to greater flexibility in each workforce across the public sector.
Just to be clear—because there seems to be some confusion on the part of Opposition Members—the prison officers and police settlements were for 2017-18. Our new policy is for 2018-19. There is already a clear process in place for that. The Health Secretary will submit evidence to the independent pay review body. It will look at issues such as recruitment, retention and affordability, and will then come back with a recommendation. That is the way we should do it; we should look at the evidence. Rather than shouting out numbers in the debate, we need to look at the circumstances. We need to ensure that pay is fair for people in the NHS, but that it is also fair for the taxpayers who fund those services.
OECD figures show that we spend 9.8% of our GDP on health and social care. That is above the European Union average of 8.6%. We are able to do that because we have run a strong economy. Today we announced record levels of employment. We have not heard any concrete proposals from Labour Members this afternoon. We have just heard reckless pledges that they will spend more money without looking at how they are spending it. As my hon. Friends the Members for South West Bedfordshire (Andrew Selous) and for Copeland (Trudy Harrison) pointed out, the Conservatives do not just spend more money. We actually make sure that the money goes to the frontline, that it helps and empowers people there to do their jobs, and that it makes those jobs more fulfilling.
It is not just about spending more money; it is also about the way we spend it. If we followed the Labour party’s advice, we would end up crashing our economy in exactly the same way the Greeks did with their economy. What was the result of that? They ended up cutting health service spending by 36%.
We have recognised that there are challenges in the national health service and in other parts of our public sector, and this policy applies right across the public sector. We have reflected on that situation, and we have moved to a more flexible policy that looks at issues of recruitment and retention.
However, it is important, as my hon. Friend the Member for Walsall North (Eddie Hughes) pointed out in an excellent speech, that we also look at fairness for the people who pay for our public services. It is only by having a strong economy and by being disciplined in our approach to debt that we can get the great public services that we all want.
Question put and agreed to.
Resolved,
That this House notes that in 2017-18 NHS pay rises have been capped at one per cent and that this represents another below-inflation pay settlement; further notes that applications for nursing degrees have fallen 23 per cent this year; notes that the number of nurses and midwives joining the Nursing and Midwifery Council register has been in decline since March 2016 and that in 2016-17 45 per cent more UK registrants left the register than joined it; and calls on the Government to end the public sector pay cap in the NHS and give NHS workers a fair pay rise.
Jonathan Ashworth
On a point of order, Mr Deputy Speaker. Is it not now clear that the House has been unanimous in saying that we should end the pay cap in the NHS and give health workers a fair pay rise? Is it not also clear that the reason the Government did not divide on this motion is that they knew they would lose?
Mr Deputy Speaker (Mr Lindsay Hoyle)
The point of order is well made. It is not for me to judge, but I am sure many people will make a judgment, whatever side of the House they may be on.
Oral Answers to Questions
Jonathan Ashworth Excerpts(6 years, 10 months ago)
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Mr Hunt
I welcome my hon. Friend’s first question to me. I am very aware of the issues faced by the Worcestershire Acute Hospitals NHS Trust, which I visited during the difficult winter period that it has just come through. It now has a new chief executive and leadership team, who have made a very promising start. From the experience of many other hospitals that have been through difficult patches, we have found that it is usually never about the commitment of staff, but about getting the right leadership in place. I can assure her that I saw outstanding commitment from the staff of the trust.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
The number of nurses has fallen for the first time in a decade, which is why we need fair pay now. I read in the newspapers that the Health Secretary now supports the Labour party policy of scrapping the cap, although he did not vote with us last week. Given that he supports our policy, when he soon sets the remit for the NHS Pay Review Body, will he tell it to scrap the cap, and will he publish his instructions before the summer recess?
Mr Hunt
I did not vote for the hon. Gentleman’s amendment, because—as usual—Labour Members have told us a lot about how they want to spend the money, without having the faintest idea of where it will come from. He is ignoring an elephant in the room: if we had followed the spending plans he campaigned for in 2015, the NHS would have £2.6 billion less this year, which is the equivalent of 85,000 fewer nurses.
Jonathan Ashworth
I want to talk about the spending plans for 2017, in which the Secretary of State can find £1 billion for Northern Ireland, but nothing for nurses in England. Would it not be fairer not to go ahead with further cuts to corporation tax, and to put that money towards giving our doctors and nurses a fair pay rise?
Mr Hunt
Let me tell the hon. Gentleman what extra money is going into the NHS: three years ago, £1.8 billion, which was not asked for by Labour; two years ago, £3.8 billion, which is nearly £1 billion more than Labour was promising; and this year, £1.3 billion. That is a lot of extra money. Why is it going in? Because, under this Government, we have created nearly 3 million jobs, and that strong economy is funding an improving NHS.
NHS Shared Business Services
Jonathan Ashworth Excerpts(6 years, 10 months ago)
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Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Jonathan Ashworth (Leicester South) (Lab/Co-op)
(Urgent Question): To ask the Secretary of Statement to make a statement on NHS Shared Business Services.
The Secretary of State for Health (Mr Jeremy Hunt)
As the House knows, on 24 March 2016 I was informed of a serious incident involving a large backlog of unprocessed NHS patient correspondence by the company contracted to deliver it to GP surgeries—NHS Shared Business Services. The backlog arose from the primary care services’ GP mail redirection service that SBS was contracted to run. No documents were lost, and all were kept in secure storage, but my immediate concern was that patient safety had been compromised by the delay in forwarding correspondence. A rapid process was started to identify whether anyone had been put at risk.
The Department of Health and NHS England immediately established an incident team. All the documentation has now been sent on to the relevant GP surgery where it was possible to do so, following an initial clinical assessment of where any patient risk may lie. Some 200,000 pieces were temporary residence forms and a further 535,000 pieces were assessed as low risk. A first triage identified 2,508 items with a higher risk of harm, of which the vast majority have now been assessed by a GP. Of those 84% were confirmed to be of no harm to patients and 9% as needing a further clinical review. To date, no harm has been confirmed to any patients as a result of this incident.
Today’s National Audit Office report confirms that patient safety was the Department and NHS England’s primary concern, but as well as patient safety, transparency with both the public and the House has been my priority. I was advised by my officials not to make the issue public last March until an assessment of the risks to patient safety had been completed and all relevant GP surgeries informed. I accepted that advice for the very simple reason that publicising the issue would have meant GP surgeries being inundated with inquiries from worried patients, which would have prevented them from doing the most important work, namely investigating the named patients who were potentially at risk.
A proactive statement about what had happened was again not recommended by my Department in July for the same reasons and because the process was not complete. However, as I explained to the House in February, on balance I decided that it was important for the House to know what had happened before we broke for recess, so I overruled that advice and placed a written statement on 21 July. Since then, the Public Accounts Committee has been kept regularly informed, most recently being updated by my permanent secretary in February. The Information Commissioner was updated in August.
In July 2016, I committed to keeping the House updated once the investigations were complete and more was known, and I will continue to do so.
Jonathan Ashworth
I welcome the Secretary of State to his place, but is it not an absolute scandal that 709,000 letters, including blood test results, cancer screening appointments and child protection notes, failed to be delivered, were left in an unknown warehouse and, in many cases, were destroyed? Does not the National Audit Office reveal today a shambolic catalogue of failure that took place on the Secretary of State’s watch?
As of four weeks ago, 1,700 cases of potential harm to patients had been identified, with this number set to rise, and a third of GPs have yet to respond on whether unprocessed items sent to them indicate potential harm for patients. Does the Health Secretary agree that this delay is unacceptable? When will all outstanding items be reviewed and processed?
The Secretary of State talks about transparency, but he came to this House in February because we summoned him here. In February, he told us that he first knew of the situation on 24 March 2016, yet the NAO report makes it clear that the Department of Health was informed of the issues on 17 March and that NHS England set up the incident team on 23 March, before he was informed, despite his implying that he set up the incident team. Will he clear up the discrepancies in the timelines between what he told the House and what the NAO reported?
The Secretary of State is a board member of Shared Business Services, and many hon. Members, not least my right hon. Friend the Member for Exeter (Mr Bradshaw), have warned him of the problems and delays with the transfer of records from SBS. Given that those warnings were on the record, why did he not insist on stronger oversight of the contract?
The cost of this debacle could be at least £6.6 million in administration fees alone, equivalent to the average annual salary of 230 nurses. Can the Health Secretary say how those costs will be met and whether he expects them to escalate?
Finally, does the right hon. Gentleman agree with the NAO that there is a conflict of interest between his role as Secretary of State and his role as a board member? Further to that, can he explain why his predecessor as Secretary of State sold one share on 1 January from the Department to Steria, leaving the Secretary of State as a minority stake owner in the company, and never informed Parliament or reported that share in the Department’s annual report—
Mr Speaker
Order. We are immensely grateful to the hon. Gentleman, but sooner or later the discipline of sticking to the two minutes has to take root. I am afraid that it is as simple as that and I am sorry, but he has had two and a half minutes.
Oral Answers to Questions
Jonathan Ashworth Excerpts(7 years, 1 month ago)
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The Parliamentary Under-Secretary of State for Health (Nicola Blackwood)
We are firmly committed to improving the UK’s air quality and cutting harmful emissions. We have committed £2 billion since 2011 to increase the uptake of ultra-low emission vehicles, support greener transport schemes and set out how we will improve air quality through a new programme of clean air zones. In addition, in the autumn statement we announced a further £290 million to support electric vehicles, low emission buses, taxis and alternative fuels. I regularly meet the Department for Environment, Food and Rural Affairs to see how we can roll out this work.
Jonathan Ashworth (Leicester South) (Lab)
The Government have not met the four-hour target for A&E since July 2015. In the NHS mandate, finally published yesterday, the Secretary of State is effectively telling hospitals that they do not need to meet it in 2017 and that it only needs to be met in aggregate across hospitals
“within the course of 2018”.
Is that not the clearest admission that the targets will not be met next year, because in the next 12 months the NHS will be denied the funding it needs and, as a consequence, patients will suffer?
Mr Hunt
Apart from observing that if the hon. Gentleman cares so much about the 95% target he might want to ask his colleagues in Wales why they are looking at scrapping it, on the money let me be very clear: in the next year, the NHS will be getting about £1.5 billion more than his party were promising at the last election and the social care system will be getting £1.5 billion more than his party were promising at the last election. We are doing our job.
Jonathan Ashworth
The Secretary of State says he is doing his job, so why does he not take that up with NHS Providers, which is warning that because of the underfunding, it will be “mission impossible” in the next 12 months to deliver standards of care. Returning to the NHS mandate, did you notice, Mr Speaker, that in that mandate there is no mention whatsoever of Brexit, even though the NHS relies on 140,000 NHS and care workers? I know that the Secretary of State is not a member of the Cabinet Brexit committee, but will he use his considerable influence with the Prime Minister to ensure that when she triggers article 50 next week, she will finally give an absolute guarantee of the rights of all those EU workers in our NHS?
Mr Hunt
First, let me first reassure you, Mr Speaker, that I will be attending the Brexit committee when it is relevant to the NHS; in fact, I shall attend it this week, because issues relating to the NHS are coming up in it. What we are not going to do in that committee, however, is to take steps that would risk the welfare of British citizens living in countries such as Spain, Ireland and France. That is why, although it is a top priority for us to negotiate the rights of EU citizens living in Britain, including those working in the NHS, it has to be part of an agreement that protects the rights of British citizens abroad.