NHS Funding

Jonathan Ashworth Excerpts

Monday 31st October 2016 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab)]

(Urgent Question): To ask the Secretary of State if he will make a statement on NHS funding.

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

Compared with five years ago, the NHS is responsible for 1 million more over-75s. In five years’ time, there will be another 1 million over-75s. Our determination is to look after each and every NHS patient with the highest standards of safety and care, but there is no question but that the pressures of an ageing population make this uniquely challenging.

I welcome the chance to remind the House of this Government’s repeated commitment to supporting our NHS. The NHS budget has increased in real terms every year since 2010. NHS spending has increased as a proportion of total Government spending every year since 2010, and is 10.1% higher per head in real terms than when we came to office. The OECD says that our spending is 10% higher than the OECD average for developed countries. At 9.9% of GDP, it is about the same as that in other western European countries, for which the average is 9.8%.

Given the particularly challenging current circumstances, in 2014 the NHS stepped back and for the first time put together its own plan for the future. It was an excellent plan, based on the principle that because prevention is better than cure, we need to be much better at looking after people closer to or in their homes, instead of waiting until they need expensive hospital treatment. The plan asked for a minimum increase of £8 billion in NHS funding over five years. It asked for this to be front-loaded to allow the NHS to invest in new models of care up front.

Following last year’s spending review, I can confirm to the House that the NHS will in fact receive an increase of £10 billion in real terms over the six years since the “Five Year Forward View” was published. In cash terms, that will see the NHS budget increase from £98.1 billion in 2014-15 to £119.9 billion in 2020-21. That rise is highly significant at a time when public finances are severely constrained by the deficit that this Government regrettably inherited. Because the NHS’s particular priority was to front-load the settlement, £6 billion of the £10 billion increase comes before the end of the first two years of the spending review, including a £3.8 billion real-terms increase this year alone. That £3.8 billion represents a 52% larger increase in just one year than the Labour party was promising over the lifetime of this Parliament.

[Jonathan Ashworth]

This morning the Chair of the Health Committee and her colleagues on that Committee said that the Government’s NHS spending claims were “inaccurate” and “false”. The Opposition agree with that analysis. Ministers—and the Secretary of State has just done this again—tell us that they are investing £10 billion more in the NHS, but it has now been confirmed that that figure is

“not only incorrect but risks giving a false impression that the NHS is awash with cash.”

Is not the reality that the Government have cut adult social care, the public health budget and the NHS capital budget? Now we learn that the average amount we spend on healthcare for each person in this country will fall in 2018-19. Does that not raise serious questions about the claims that Ministers, and, indeed, Prime Ministers, have been making from that Dispatch Box? In fact, the only way the Government’s figures could be further discredited is if the Secretary of State slapped them on the side of a bus and got the Foreign Secretary to drive it.

Will the Secretary of State admit that the Government have not actually given the NHS the money it needed? Will he give us an accurate account of spending plans for the NHS? Will he tell us when the Chancellor is going to respond to the Health Committee’s letter, and what representations he himself is making to the Chancellor ahead of the autumn statement?

We have also learned today from Health Service Journal that one in three local areas intend to close or downgrade A&E departments within 18 months, one in five expect to close consultant-led maternity services, and more than half plan to close or downgrade community hospitals. Will the Secretary of State confirm whether those reports are accurate? How many A&E departments, maternity units and community hospitals does the Secretary of State expect to close or be downgraded within the next year and a half? Our constituents want those answers.

Before the last election, the Secretary of State told us he was “confident” about delivering the money the NHS needed. Today that confidence has been exposed as utterly misplaced. Tory promises are completely in tatters. Rather than defending the Prime Minister’s spin on the £10 billion figure, why does the Secretary of State not stand up for patients and staff, and deliver the funding that the NHS and our social care sector desperately need?

[Mr Hunt]

I start by welcoming the hon. Gentleman to his first urgent question in his new role. As I am a relative old timer in my role, I hope he will not mind me reminding him of some of the facts about health spending.

First, the hon. Gentleman said that the Government did not give the NHS what it asked for. Let me remind him that Simon Stevens, a former Labour special adviser—I know for new Labour, but he was none the less a Labour special adviser—said at the time of the spending review settlement last year that

“our case for the NHS has been heard and actively supported”

and that the settlement

“is a clear and highly welcome acceptance of our argument for frontloaded NHS investment. It will…kick start the NHS Five Year Forward View’s fundamental redesign of care.”

I will tell the hon. Gentleman who did not give the NHS what it asked for: the Labour party. At the last election, it refused to support the NHS—[Interruption.] I know this is uncomfortable for the new shadow Health Secretary, but the reality is that the party on whose platform he stood refused to support the NHS’s own plan for the future. As his question was about money, I will add that the Labour party also refused to fund it. The NHS wanted £8 billion; Labour’s promise was for additional funding of £2.5 billion—not £6 billion or £4 billion, but £2.5 billion, or less than one third of what the NHS said it needed. Even if we accept the numbers of the Chair of the Select Committee—and, as I will go on to explain, I do not—Labour was pledging over the course of the Parliament only around half of what this Government have delivered in the first year of the spending review.

The hon. Gentleman used other choice words, one of which was “spin”. I will tell him what creates the most misleading impression: a Labour party claiming to want more funding for the NHS when, in the areas where they run it, the opposite has happened. Indeed, in the first four years of the last Parliament, Labour cut NHS funding in Wales when it went up in England—[Interruption.] Yes, it did. Those are the official figures. That is in a context in which the Barnett formula gives the Government in Wales more than £700 more per head to spend on public services, so there is more money in the pot.

The hon. Gentleman talked about social care. May I remind him of what the shadow Chancellor at the time of the last election—Ed Balls, who is now sadly no longer of this parish—said? During the election campaign, he said of funding for local councils “not a penny more”. We are giving local councils £3.5 billion more during the course of this Parliament.

The hon. Gentleman talked about other cuts that he alleges will happen in A&E departments and other hospital services. I simply say to him that we have to make efficiency savings. I do not believe they will be on the scale he talked about, but how much worse would they have to be if the NHS got a third of the money it currently gets?

If the hon. Gentleman and his party think the NHS is underfunded, they need to accept that the policies that they advocated in the past two elections were wrong —they advocated spending less than the Conservatives. Until they are serious about changing their policy, no one will be serious about listening to their criticisms.

Community Pharmacies

Jonathan Ashworth Excerpts

Monday 17th October 2016 Commons Chamber

[David Mowat]

I agree with my right hon. Friend. Boots makes a big contribution. It owns 1,724 pharmacies and is the biggest of the big four, which between them own 40% of all pharmacies. The Government’s position is that community pharmacists make a big contribution, but I repeat that the number of locations has increased by nearly 20% over the past decade, and each one gets £25,000 per annum just for being open and for being a pharmacy. One consequence is that we have seen a great deal of clustering, and 40% of pharmacies are within half a mile of three others. It is right that the Government look at that and make a judgment.

[Jonathan Ashworth (Leicester South) (Lab)]

I congratulate my hon. Friend the Member for Barnsley East (Michael Dugher) on securing this urgent question and on his exceptional campaigning on the issue. He is, no doubt, as disappointed as I am by some of the Minister’s replies.

Ministers appear to be intent on pushing ahead with the cuts that have been outlined, under which thousands of community pharmacies could close and patients could lose out on essential medical services. The Pharmaceutical Services Negotiating Committee has described the Government’s proposals as “founded on ignorance” and warned that they will do “great damage”. The National Pharmacy Association says that the proposal is a “dangerous experiment” that

“shows a complete disregard for the well-being of patients.”

Is that not an absolute indictment of the Government’s handling of this matter? The Minister has said that he will make an announcement shortly. Given the concern among Members from across the House, including Conservative Members, can he be more specific and tell us when he will give us a final decision? Will he also be negotiating a solution with the Pharmaceutical Services Negotiating Committee? As the Minister knows, his predecessor talked of the potential for up to 3,000 pharmacies to close. Is that correct, in the Minister’s judgment? If not, can he tell us how many pharmacies he thinks will close, and how many of those will be in deprived areas?

Has the Minister had a chance to study the PwC report that describes the cash savings that community pharmacies bring to the NHS? What will be the financial impact on the NHS of more patients presenting themselves at A&E departments and GP surgeries because pharmacies have closed?

Is not the real reason why Ministers are pressing ahead with these cuts the complete mismanagement of NHS finances? Hospitals ended last year £2.45 billion in the red. We have had continual warnings from experts in the NHS, and over the weekend we learned from the Prime Minister that there is no more money for the NHS. The Secretary of State and the Prime Minister would be wrong to continue to ignore the advice of experts and pretend that everything is going to be okay. Unless the Government get a grip of the funding crisis facing the NHS, I fear that these cuts are just the start and that there is worse to come.

[David Mowat]

The Government spend more than the OECD average on the NHS. We spend more than the commitments made by the Labour party before the last election. That does not mean that we do not have a duty to spend that money as effectively as we can, however, and that is exactly what we intend to do. The money that may be saved by the measures we are consulting on will not go to the Treasury; it will be recycled back into NHS England. That is what NHS England wants to happen.

The hon. Gentleman mentions the excellent PwC report, which reaffirmed the value of community pharmacists to this country. PwC did not consider whether that same value could be still provided after some savings to the network. That is what we are looking at, and it is reasonable and responsible for the Government to do so. To say that that is not the case is simply incorrect.

The hon. Gentleman mentioned that the previous Minister talked about 3,000 pharmacies closing. We do not believe that the number will be anything like that big. In some areas, there are 10 or 11 pharmacies within half a mile of each other. [Hon. Members: “Where?”] Leicester, Birmingham—we can talk more about this. It is quite possible that at the end of the review, some of those pharmacies will merge. If that happens, it will not mean that provision has been reduced. We do not believe that patient provision will suffer at all from the changes that we are considering.

Oral Answers to Questions

Jonathan Ashworth Excerpts

Tuesday 11th October 2016 Commons Chamber

[Mr Dunne]

I am well aware, from representations made by my hon. Friend and other neighbouring MPs, of the concerns that that has caused locally. The Secretary of State has already indicated to me that he does intend to meet my hon. Friend and campaigners in due course.

[Jonathan Ashworth (Leicester South) (Lab)]

The Minister says that no rhetoric or scaremongering was used last week. Can he explain to the House what the Prime Minister meant when she said:

“there will be staff here from overseas in the interim period until the further numbers of British doctors are trained and come on board in terms of being able to work in our hospitals”?

What did that mean? What should we expect next—ambulances plastered with “Go home” slogans?

[Mr Dunne]

That is exactly the kind of ill-judged remark I have been talking about, and I am surprised that the hon. Gentleman has used it in his first appearance in his new post. By the way, I congratulate him on that new post, but I very much hope that he will use more measured language in the future, rather than spreading that kind of inappropriate rumour. The interim period referred to is the period during which doctors will be trained. We will not get new doctors coming in under the increased allocation until 2023, and during that time we will clearly need to use all measures to ensure that we fill the spaces that I acknowledge we have across several of our hospitals.

[Jonathan Ashworth]

I appreciate the Minister’s warm welcome, and I can tell him that I am very much looking forward to shadowing the Secretary of State, but his comments on ill-judged remarks should be directed at the Prime Minister, not me. We have seen 8,000 fewer nurses, student nurse bursaries are set to be cut, there is a reliance on agency staff and a failure to train enough doctors, and now, after six years in office, the Government are talking about self-sufficiency. Given the concerns that these plans do not go far enough, will the Minister tell us what steps he will take to ensure that no staff from the EU lose their jobs, and will the NHS still be able to recruit from the EU if necessary post Brexit?

[Mr Dunne]

Health Ministers have been very clear about reassuring all the 53,000 EU citizens working in our NHS that their roles are secure. Regarding clinicians, I remind the hon. Gentleman that, although we have some vacancy rates, which are acknowledged, we now have 7,800 more consultants employed in the NHS than in May 2010, 8,500 more doctors than in May 2010, and over 10,500 more nurses working on our wards. We have gone through a very consistent policy of recruiting more people to work in the NHS under this Government.

A and E (Major Incidents)

Jonathan Ashworth Excerpts

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

I absolutely do agree. Labour Members should talk to some of the front-line NHS workers in their own constituencies, who will tell them that the last thing they want at this time is for the NHS to be a political football.

[Jonathan Ashworth (Leicester South) (Lab)]

The Secretary of State will know that major incident status was declared at Leicester hospitals this week for the seventh time in three months. In the week before Christmas, just 67% of patients at Leicester Royal Infirmary in my constituency were seen within the four-hour target, and clinicians, who are working flat out, expect pressures to increase over the next three months. What is he now going to do to support clinicians in Leicester and get a grip of this situation?

[Mr Hunt]

I am aware of the situation in Leicester. The hospital has had significant space pressures in its emergency department, and a couple of nights ago it had a high in-flow during one night, but it is absolutely on the case in trying to resolve this. What are we doing? We have put in £9.2 million of winter pressures money to make sure that whatever people decide the right solution is, it is not through lack of resources that they cannot do it.

Children’s Heart Surgery

Jonathan Ashworth Excerpts

Wednesday 12th June 2013 Commons Chamber

[Mr Hunt]

I know that the whole House will want to send its condolences to Arabella Campbell’s family, and the way that my hon. Friend has brought the issue to the attention of the House shows the seriousness of the issues that we are considering. Part of what the IRP talks about is a proper review of the screening process for people who have congenital heart failure. Yesterday I met a group of campaigners on sudden adult death syndrome who had an equally tragic story, and I am waiting for advice from the national immunisation and screening committee on the right way forward in this respect. I thank my hon. Friend for his comments.

[Jonathan Ashworth (Leicester South) (Lab)]

Clinicians at Glenfield hospital, and people across Leicester and the wider east midlands, will welcome what the Secretary of State said today on the suspension of Safe and Sustainable, but I want to ask him a further question on the point that the hon. Member for North West Leicestershire (Andrew Bridgen) made about the future of the extra corporeal membrane oxygenation centre. The decision to move ECMO from Leicester to Birmingham was a direct consequence of Safe and Sustainable. That decision is now suspended—I hope that is what the Secretary of State is saying. Will he reconfirm that the future of ECMO provision will be fully taken into account by NHS England?

[Mr Hunt]

I can confirm that. One of the recommendations of the review was that the ECMO decision be linked to what is decided under Safe and Sustainable, and I know that NHS England will want to consider that carefully. I hope to be able to come back to the House to report what it decides as soon as possible.

Heart Surgery (Leeds)

Jonathan Ashworth Excerpts

Monday 15th April 2013 Commons Chamber

[Mr Hunt]

The hon. Lady makes an important point. At the heart of this is a change happening in the NHS, where heart surgery is leading the way and we are discovering that we can make dramatic improvements to mortality rates. It has happened in heart surgery, where we have moved from being one of the worst performers in Europe to one of the best, because of the collection of risk-adjusted data. That has now been extended to cancer outcomes and to a total of 10 specialities. We shall gradually collect those data over the next two years, which will allow peer review in a way that cannot normally happen. It is a big change and part of the issue was that the hospital in Leeds did not realise how seriously the data would be taken, which may have meant that it did not supply as complete data as it should have, and that led to the problem. There is a big change, but also a big opportunity for the NHS to improve its outcomes.

[Jonathan Ashworth (Leicester South) (Lab)]

I want to reinforce entirely the point put to the Secretary of State by the hon. and learned Member for Harborough (Sir Edward Garnier) a few moments ago. Safe and Sustainable made recommendations about Leeds and about closing children’s heart surgery at Leicester, but in recent days published data show that Leicester has one of the lowest mortality rates. Can the Secretary of State guarantee that the Independent Reconfiguration Panel will fully take into account those data published just a few days ago?

[Mr Hunt]

Absolutely.

Children’s Cardiac Surgery (Glenfield)

Jonathan Ashworth Excerpts

Monday 22nd October 2012 Westminster Hall

[Jonathan Ashworth (Leicester South) (Lab)]

It is a pleasure to speak in this debate under your chairmanship, Mr Hollobone.

I pay tribute to the hon. and learned Member for Harborough (Sir Edward Garnier) for securing this debate, and I am grateful to the Backbench Business Committee for allowing us to hold it this afternoon.

The hon. and learned Gentleman, who is one of my parliamentary neighbours, spoke with typical eloquence, as is his wont, and I for one am disappointed that he no longer graces the Government Front Bench. The Front Bench’s loss is the Back Bench’s gain, and I thought that he spoke extremely well. I apologise in advance if I echo many of his points, but that indicates the cross-party support for the campaign. Although we are perhaps blessed in not having any Liberal Members in the east midlands, I am sure that, if we did, they, too, would support the campaign.

As I am sure that the Minister, who represents an east midlands seat, is aware, this issue has caused considerable concern, not only in my Leicester South constituency, but across the east midlands region. It is no surprise to those of us who have been involved in the campaign that the e-petition has hit 100,000 signatures, and I pay tribute to Adam Tansey, the father of Albert Tansey, who set up the e-petition.

There has been widespread opposition to the proposals from the Safe and Sustainable review and how they affect Leicester. The review recommended the closing of the children’s heart unit and the associated moving of Leicester’s world-class extracorporeal membrane oxygenation service to Birmingham. Local people have campaigned vigorously against the proposal, and I pay particular tribute to Ms Robyn Lotto—a constituent of mine who has magnificently led much of the local campaigning in recent weeks. We should also pay tribute to Glenfield’s staff, who are very concerned, as the hon. and learned Gentleman indicated when he read out the circular that we were all sent.

Many organisations in Leicester and beyond have spoken out. The vice-chancellor of Leicester university, Sir Bob Burgess, said:

“Glenfield is a leading international heart hospital where excellent clinical care takes place within a context of internationally significant research. I would therefore ask that the proposal to move the Glenfield services be reconsidered and this valuable facility retained for people of our region.”

The Bishop of Leicester, who I see observing us, said:

“It is not…clear that the movement to Birmingham will be straight forward… In fact I fear that the movement of these services will be harmful to the nation as a whole”.

As I have mentioned, politicians from all parties have come together on this campaign. Politicians on the Labour-dominated Leicester city council are working alongside politicians on the Conservative-dominated Leicestershire county council and on what I assume is the Conservative-dominated Lincolnshire county council, and they have all expressed their concern.

MPs on both sides of the Chamber are speaking up, and, as the hon. and learned Gentleman did, I pay tribute to my hon. Friend the Member for Leicester West (Liz Kendall), who in many ways has spearheaded the campaign from our side with her usual pizzazz, and to the hon. Member for Loughborough (Nicky Morgan), who cannot speak in this debate because she is a Government Whip—fortunately for me, Opposition Whips can speak—but who I am sure would speak if parliamentary convention allowed.

I am, of course, pleased that the Secretary of State for Health has today announced that the independent committee will conduct a full review and report back at the end of February next year. Notwithstanding that welcome announcement, I want to make a number of points on which I hope the Minister can provide clarification.

On demand and capacity—I appreciate some of these points might be for the review committee, but it is important to get them on the record—genuine questions have been raised about the assumptions on demand and the capacity on offer at Birmingham that the joint committee of primary care trusts used. As I understand it, the national projections used by the review assume that demand will be flat, yet the most up-to-date data show demand increasing, because birth rates in the east midlands and west midlands are well above national averages. The projections of population trends used by the review team were based on data from 2006-07. Using those data would suggest a relatively stable work load rising to 3,990 cases in 2025, but, if the latest data on population expectations from the Office for National Statistics are used, the projected rise in surgical case loads hits 5,422 in 2025. Questions have also been raised about the likely patient flows, with clinicians suggesting that Sheffield and Doncaster have indicated a preference for Birmingham rather than Newcastle.

Given that extra surgery work, the movement of the ECMO provision, the increased population projections for the midlands and the worries about increased patient flows from south Yorkshire, I would be grateful to the Minister if she let us know whether the Department is confident that Birmingham has the capacity to meet what is clearly set to be considerably increased demand.

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

The hon. Gentleman knows, of course, that the Independent Reconfiguration Panel will no doubt consider all his points. As he knows, from the outset, this has been an independent process decided by clinicians. In those circumstances, I am sure that he will make it clear that I am in no position to answer any of his points, which must be addressed by the IRP. Does he agree with me on that?

[Jonathan Ashworth]

The Minister makes an important point. None the less, I still think that, even if it is not appropriate for her to respond, as I suggested might be the case, this is an appropriate forum to put some of those points on the record, and I will continue to do so. I entirely understand her position.

I have a couple of points to make on Leicester’s paediatric cardiac intensive care unit, which the hon. and learned Member for Harborough mentioned. There is concern about how the decision will affect the wider paediatric cardiac intensive care on offer in Leicester, with the potential closure of the unit at Glenfield increasing pressure on the other Leicester hospitals and, more generally, reducing the supply of paediatric intensive care across the east midlands and placing more demand on Birmingham. Again, that is an important point. If the Minister cannot respond, I hope that the committee at least will take it into account.

I want to focus on the ECMO service, as the hon. and learned Gentleman did, and as I suspect many other hon. Members will, too. As I said at the outset, I entirely welcome the Secretary of State’s announcement this morning, but—I will quote from the letter, as the hon. and learned Gentleman did—I am disappointed that he said:

“The decision of the SoS taken regarding the removal of the ECMO equipment”—

he uses the rather bland word “equipment,” but the decision is quite controversial, so describing it in that way is unfortunate—

“from Glenfield to Birmingham should not form part of the review as the decision was not taken by the Joint Committee of Primary Care Trusts.”

That is right, but as has been said, the two things go hand in hand.

I shall repeat some of the points that have already been made. The ECMO service at Glenfield is the longest-established and provides 80% of ECMO capacity nationally. Many of its staff have more than 20 years’ experience. Glenfield’s ECMO service has some of the very best mortality rates. The mortality rate for ECMO at Glenfield is 20%, but the national mortality rate is 50% higher. Will the Minister address the decision not to include ECMO in the review? Does she expect to be able to pick up an ECMO unit in one hospital, plonk it into another and find that the same expertise and mortality rates will transfer with it? As has been said, many international experts do not think so—certainly not in the short run. We have already heard about Kenneth Palmer, the expert ECMO adviser, who told BBC Radio Leicester:

“They could never have the same survival rate in another unit if you move it like this.”

He also said—I think that the hon. and learned Member for Harborough quoted this, and I will repeat it:

“Moving one unit to another place is the same as totally closing down and rebuilding from zero in the new place... I have been very clear…that you cannot move a unit; you can just destroy it and rebuild with many years of decreasing survival rate and increasing morbidity.”

In other words, he is concerned that lives will be lost.

Another international ECMO expert, Dr Thomas Müller, says that

“in the interest of best patient care the decision to close down the most experienced centre in the UK is difficult to comprehend.”

Jim Fortenberry, the chair of the ECMO leadership council in Atlanta, has already been quoted in the debate. He said on BBC Radio Leicester that the ECMO unit is

“considered one of the finest ECMO units”

and described it as a “real jewel”. When he was asked on the radio whether he thought lives would be lost he said:

“I do agree with that unfortunately, I think the risk is great”.

International experts are therefore deeply concerned about moving ECMO from Leicester to Birmingham. One of their concerns is that the institutional memory, built up over a generation by the team, will be lost. That is one reason why I find it slightly disappointing when the Secretary of State presents the matter as just moving equipment from Glenfield to Birmingham. We have already heard that many of the staff feel that they will not be able to move. I shall repeat the quotation from the letter that they sent us all, because it is worth focusing on:

“We are not in a position to leave our homes and families, to move to Birmingham to work. As a team of (predominantly) women, we are (predominantly) second wage earners, with husbands, children and homes.”

As I understand it, 13 nurses are required for one ECMO bed, so there are concerns about Birmingham’s ability in the short run to build and develop a dedicated team of expert staff similar that at Leicester.

Given that the review panel will not consider the ECMO decision, I should be grateful to the Minister if she shared her analysis, or the Department’s analysis, of the risk assessment of moving the ECMO facility. It has been suggested in past debates—indeed, if my memory serves me correctly, it was suggested in a useful meeting that we had with the previous Minister, now the Minister of State, Department for Transport, the right hon. Member for Chelmsford (Mr Burns)—that different experts had advised the Department and that they did not share the analysis of Mr Palmer and others. I apologise if my memory of that is slightly wrong, but if that is the case, perhaps the Department will agree to publish the evidence.

We have a campaign including an e-petition signed by 100,000 people—clinicians, staff and members of the public—who are deeply concerned about the proposal to move the ECMO unit. They accept the argument made by Mr Palmer and others. If the Department thinks that there is a different analysis to be considered, perhaps it will finally publish it, so that both sets of analysis can be properly scrutinised, and we can come to a considered opinion. That would reassure us on the point about mortality rates.

I would be interested in hearing the Minister justify the decision not to allow the IRP to consider the ECMO decision. Was not the decision to move ECMO taken and presented as a necessary consequence of the decision taken by the JCPCT in relation to the Safe and Sustainable review? Given that that was the context in which the ECMO decision was made, does it not seem odd that the review committee will not now consider the decision to move ECMO? If the justification is that there is a procedural argument that the various local authorities have asked the committee to consider the outcome of the Safe and Sustainable review and that ECMO was not part of that, fair enough, but it would leave a rather sour taste in the mouth of many campaigners who signed the petition. If that is the case, is there any way in which the ECMO decision can be reviewed? Can the Secretary of State consider reversing the decision of the previous Secretary of State? Many of us who are involved in this cross-party campaign would be grateful for guidance on that from the Minister. I am not sure whether the campaigners would feel pleased if, despite their winning the review, the ECMO unit were still to be shifted.

Many hon. Members want to speak, and because of the cross-party nature of the campaign, we are probably all making similar points, so I will conclude my remarks, but I encourage the Minister to focus on the point about ECMO. There is deep concern about it. People will be pleased about the review, but concerned that ECMO seems to have been excluded from it, and I hope that she can give us some reassurance.

Health

Jonathan Ashworth Excerpts

Tuesday 17th July 2012 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab)]

Like many other Members, I should like to say a few words about the outcome of the Safe and Sustainable review. Children’s heart surgery services in Glenfield, in the constituency of my hon. Friend the Member for Leicester West (Liz Kendall), have been earmarked for closure—a decision that came as shattering news when we heard it the other week to many of the staff who work there and many families of patients who have been treated there.

Many of my constituents have got in touch with me, and I have also been contacted by people across Leicester and the country. I do not have time to go through everything that they said, but Stacey Whiteley from Lincoln has contacted me. People have contacted me from Corby, Coalville and Northampton to express deep concern and opposition to the decision. Many of them said that there were a number of questions that they wanted answered and, as I think that they are legitimate concerns, I want to put them on the record.

My constituents have asked me, for example, why the extra options I to L were not presented for public consultation. Other constituents have pointed out that option A was the most popular, but was apparently ignored. Some constituents have questioned the impartiality of some advisers to the panel and others have pointed out that, in the consultation document, option A was described as being consistently the highest scoring option. Why was there a U-turn and option B chosen? It is right that those decisions should be made by clinicians, but these are legitimate questions from people concerned about the decision.

[Andrew Percy (Brigg and Goole) (Con)]

The hon. Gentleman makes an important point, but the decision was made not by clinicians but by commissioners, who have left the eastern side of England between Newcastle and England without a heart unit. Many of my constituents would have gone to Leicester in preference to Newcastle. Now they will probably travel to London or Liverpool.

[Jonathan Ashworth]

Indeed. Many of the hon. Gentleman’s constituents would have been welcome in Leicester. He is quite right: where do our constituents in the east of the country, between Newcastle and London, go? That is something else that many of my constituents have raised with me.

I wish to concentrate on the biggest deficiency of the decision, which is the impact on our world-class ECMO—extracorporeal membrane oxygenation—service. On Friday, the Secretary of State announced that he would accept the recommendation to shift our ECMO service from Leicester to Birmingham. In Leicester, we have had a brilliant, world-renowned ECMO service for 20 years.

[Liz Kendall (Leicester West) (Lab)]

I am grateful to my hon. Friend for accepting my intervention, as I cannot speak in the debate because I am a Front-Bench spokesperson on health. Is he aware of the international evidence that shows that Glenfield’s ECMO survival rates for children are 50% to 75% higher than other centres? Those very good survival rates, and the benefits that they bring for children, must be taken into consideration as part of the review.

[Jonathan Ashworth]

My hon. Friend is right, and she makes the point with her usual eloquence and insight. I pay tribute to the work that she has done and, indeed, the work of other Leicestershire Members—I see that the hon. Member for Loughborough (Nicky Morgan) is in the Chamber—on the ECMO service. I thank the Minister for agreeing to meet a delegation of east midlands MPs, as we had a useful discussion.

Giles Peek, a consultant paediatric heart surgeon, said last year of the ECMO service:

“We use it not just after surgery but also to stabilise children and to stop them dying before surgery. We are always full and often take children from other hospitals…Our role at Glenfield as a national reference centre for this treatment is important and underestimated.”

I fear that Giles Peek’s concerns have come true and that our ECMO service has been underestimated.

I was grateful that the Minister said in the meeting that the Secretary of State’s decision was based on the Agnes review, but there are other ECMO experts who disagree with that review, so I hope that he will consider publishing the Agnes report. In the few minutes I have left, I shall run through the points that various ECMO experts have made. For example, Glenfield has a world-class facility with more than 20 years’ worth of service. There are deep concerns that by uprooting it from Leicester to Birmingham expertise will be lost along the way. Mr Kenneth Palmer, an ECMO expert, gave a stark warning on Radio Leicester today that, as a result of shifting the children’s ECMO service from Leicester to Birmingham, lives would be lost, saying:

“They could never have the same survival rate in another unit if you move it like this. Leicester has one of the highest survival rates in the world, 10%-20% higher than the normal survival rate in the world. To come up to the same skill it will take 5 years at least.”

He has been joined by other experts who have warned about the impact of shifting the unit from Leicester. Jim Fortenberry, the chair of the ECMO leadership council in Atlanta, when asked whether he agreed that lives would be lost, said:

“I do agree with that unfortunately. I think the risk is great that by attempting to move and start over that you’d really start the learning curve all over again and the improved outcomes take time and experience to develop, and so by effect starting over on the learning curve you certainly would potentially put lives at stake and it could be very significant.”

I accept that the Minister takes advice from experts, but given that there is one set of experts making one argument, presumably he receives advice from a different set. If he published his evidence, those of us who are laymen on health policy can try to make our own judgments as those experts scrutinise one another’s work.

Concerns have been raised about the Birmingham facility and whether it can deal with the new ECMO service. Dr Andrew Coe, a paediatrician from Coventry, said on Radio Leicester this morning that he was

“not convinced that Birmingham will cope with increased demand following closure”

of Glenfield. It was suggested to me that if the 80 ECMO nurses at Leicester are not prepared to leave Glenfield, it will take up to eight years for nurses in Birmingham to be trained to the appropriate level of expertise.

I conclude by mentioning the family from South Cambridgeshire, which the Secretary of State represents, who appeared on Radio Leicester this morning. They said clearly and movingly that the service they received for their little girl was the best they could receive and went beyond what staff needed to do. I hope that the Minister will give us guidance on what is next for Leicester’s ECMO service. I hope that he will consider publishing his evidence, and that we can have some sort of review of, or at least look again at, the shift of Leicester’s ECMO service to Birmingham.

Health and Social Care Bill

Jonathan Ashworth Excerpts

Tuesday 28th February 2012 Commons Chamber

[Mr Lansley]

I am grateful to my hon. Friend. I suppose that we should not be surprised that the Labour party in opposition has abandoned everything it said in government, but for it to abandon so quickly so many of the things it said even in its manifesto is pretty dramatic.

[Jonathan Ashworth (Leicester South) (Lab)]

If I may say so, I think that the Secretary of State and the Government have been at sixes and sevens over this issue in recent weeks and they would be better off dropping this disastrous Bill. However, may I press the right hon. Gentleman on the answer he gave to my hon. Friend the Member for Dunfermline and West Fife (Thomas Docherty)? If he now agrees that the amendments are significant, as the Deputy Prime Minister has boasted, does that mean that the Prime Minister’s spokesperson was wrong to downplay them as a mere reassurance?

[Mr Lansley]

I am clear that sometimes we need to ensure through amendments that we not only achieve the effect that we intend, but reinforce it in legislation. Some of them will reassure, and some will have significant effects directly on the governance of the NHS.

NHS Risk Register

Jonathan Ashworth Excerpts

Wednesday 22nd February 2012 Commons Chamber

[Ben Gummer]

The hon. Gentleman is entirely correct. I am trying to put in the round the position of this Government on freedom of information—that is, respecting the Act brought in by the previous Government in going through the necessary process, and in the meantime showing greater transparency in their dealings with the public than any previous Government. One need not look only at the transparency inherent in departmental business plans and departmental spending above £5,000. The risk registers quoted by the shadow Secretary of State, which he revealed with a flourish as though he were some latter-day Carl Bernstein, came from the websites of local PCTs and were revealed as a result of transparency initiatives by this Government. In their motion and in their attack on the Government, the Opposition have shown inconsistency that reveals their true intent.

The shadow Secretary of State repeatedly called into question the Government’s motivation for not releasing the risk register. Their motivation is precisely the same as that which drove him to refuse to release a risk register in 2009. In turn, I question his motivation for calling this debate and picking a fight on this matter. It is not, as the motion might suggest, to inform the public debate, but to fuel the misinformation campaign that has been the basis of the Opposition’s attack on the NHS reforms; to take out of context statements from a document that, by its very nature, considers risks rather than benefits; and to use that in an effort to undermine a programme of reform that has the support of increasing numbers of health care professionals in my constituency to whom I have spoken, and is showing real results.

[Jonathan Ashworth (Leicester South) (Lab)]

Will the hon. Gentleman give way?

[Ben Gummer]

I will not, if the hon. Gentleman does not mind.

That is not responsible opposition; it is dangerous opposition. The Leader of the Opposition goes around lecturing everyone about responsible capitalism, but he might like to start at home and have a look at responsible opposition. In undermining the ability of the machinery of government to operate correctly, the Opposition undermine not only this Government’s, but successive Governments’, ability to make decisions on our constituents’ behalf. Wiser colleagues of the shadow Secretary of State might rue the day that they wanted all risk analysis by Departments to be made public, thereby unbalancing our debates. That would have made impossible even the timorous reforms of Tony Blair in academies and in foundation trusts.

Let me inform the shadow Secretary of State of the effects that these health reforms are already having in my constituency. We have better care for the elderly that stops them going into hospital and allows them to be treated at home, and a drugs budget that is being kept under control for the very first time. He turned down a heart unit in my local hospital; we are now having it built at a cost of £5 million. The reforms will deliver real benefits to my constituents in Ipswich, and I wish that his constituents could have received them too.