Mental Health

Jonathan Reynolds Excerpts

Wednesday 9th December 2015 Commons Chamber

[Mr Hunt]

I will proceed with my speech for a little longer, if I may.

We are seeing the prospect of very real progress, and we as a Government need to give careful thought to which areas to prioritise. We do not have a monopoly of wisdom in this area, which is why we set up the independent mental health taskforce that is led by Paul Farmer, the chief executive of Mind. We will receive its report early in the new year. It will follow a successful independent report produced by the cancer taskforce, chaired by Harpal Kumar. I think that it is a good way of uniting the Government, Members in all parts of the House, and the mental health campaigning charities, so that we can decide together on the key areas that we want to transform in the coming years.

We are still working on the detailed planning, but we have already announced the provision of £2 billion of additional mental health funding over the course of this Parliament, which will benefit CAMHS, perinatal mental health treatment, the treatment of eating disorders, and talking therapy. Some of that funding is a result of promises made by the coalition Government which we have said we will honour, and some is a result of promises that we ourselves have made.

I agree with the hon. Member for Liverpool, Wavertree that as we increase investment in mental health, we need greater transparency in respect of the way in which that money is spent. I am pleased to say that next June, following consultation with the King’s Fund, there will for the first time be independently assured Ofsted-style ratings that will tell us very simply, CCG area by CCG area, whether mental health provision in the health economy as a whole is outstanding, is good, requires improvement, or is inadequate. As far as I know, ours is the first country in the world to do that. The hospital sector underwent the same process in the wake of Mid Staffs, and, on the basis of that experience, I believe that it will lead to a dramatic reduction in variation and an improvement in care as people are given independent information about how their services compare with those of their peers. That increased transparency will also mean the development of a new mental health data set, which will enable us to collect more and better data and then share them with the House, debate them, and learn what needs to be learnt.

[Jonathan Reynolds (Stalybridge and Hyde) (Lab/Co-op)]

rose—

[Mr Hunt]

I will give way once more.

[Jonathan Reynolds]

I recognise the thoughtful case that the Secretary of State is making in saying that things are not good enough but they are getting better, but I must say to him—in a non-partisan way—that when it comes to funding, the stories about funding in my area do not match what we are hearing from him today. There is a story on the Manchester Evening News website about a £1.5 million cut in Greater Manchester.

[Mr Hunt]

We, as a Government, make commitments and choices in terms of where we want resources to go, and we then have a duty to ensure that they are followed up locally. As we know from our experience of the health service, sometimes—under all Governments—that advice is followed, and sometimes it is not. The introduction of proper independent ratings, area by area, will enable us to expose the areas that are not making the commitment to mental health that they should be making. As has been pointed out many times by Members in all parts of the House, failing to invest what is needed in mental health is a false economy. It stores up problems for accident and emergency departments and for the providers of mental health services, because late intervention means more expensive intervention, and it is of course a very real human tragedy for the individuals concerned.

Junior Doctors’ Contracts

Jonathan Reynolds Excerpts

Wednesday 28th October 2015 Commons Chamber

[Mr Hunt]

Yes, I am shocked. I am really shocked about the suggestion that there is a difference between what is right for patients and what is right for doctors. The shadow Secretary of State spent a lot of time talking about morale. The worst possible thing for doctors’ morale is their being unable to give their patients the care they want to give.

[Jonathan Reynolds (Stalybridge and Hyde) (Lab/Co-op)]

Does the Secretary of State not see anything perverse in making the case for a seven-day NHS—he has repeatedly done so—while drawing up a junior doctor contract that financially penalises doctors who already work evenings and weekends? How can that make any sense?

[Mr Hunt]

The contract will not do that. The contract we are proposing will give more reward to people who work the most antisocial hours. I will explain the details of that later.

The shadow Secretary of State talked about academic studies, so let us look at what the academic studies on the weekend effect say. The Freemantle study, published in the British Medical Journal, which is owned, incidentally, by the British Medical Association, said in September that the mortality rate for those admitted to hospital on a Sunday is 15% higher than for those admitted on a Wednesday. It said the weekend effect equated to 11,000 excess deaths. Let us be clear about what that means. It does not mean that every one of those 11,000 deaths is avoidable or preventable—it would be wrong to suggest that. It means that there are 11,000 more deaths than we would expect if mortality rates were the same as they are on a Tuesday, Wednesday or Thursday. Professor Sir Bruce Keogh, the NHS England medical director, called it

“an avoidable ‘weekend effect’ which if addressed could save lives.”

It is not just one study. In the past five years, we have had six independent reviews. Another study in the British Medical Journal, by Ruiz et al, states:

“Emergency patients in the English, US and Dutch hospitals showed significant higher adjusted odds of deaths…on Saturdays and Sundays compared with a Monday admission.”

The Academy of Medical Royal Colleges—the body that represents all the royal colleges—said in 2012 that deficiencies in weekend care were most likely linked to the absence of skilled and empowered senior staff and the lack of seven-day diagnostic services.

Pancreatic Cancer

Jonathan Reynolds Excerpts

Monday 8th September 2014 Westminster Hall

[Jonathan Reynolds]

I am grateful to you, Mr Chope, for giving me the opportunity to speak in this important debate. I add my thanks to the hon. Member for Lancaster and Fleetwood (Eric Ollerenshaw) and my hon. Friend the Member for Scunthorpe (Nic Dakin) for securing it. We heard two excellent and personal speeches from them both. I echo the kind words from my hon. Friend and those from my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) about Julie Hesmondhalgh and her role in this. I am proud to say that Julie is one of my constituents. I hope that the hon. Member for Lancaster and Fleetwood will not mind me saying that another important constituent is his mum. I think we all agree that she should be very proud of his speech and the part he has played in the campaign.

This is a hugely important topic, about which there has been great public concern, as evidenced by the e-petition calling for more awareness and funding having reached more than 100,000 signatures. My awareness of pancreatic cancer has substantially increased due to the effectiveness of the campaign. I have been shocked at the information the campaign has highlighted, particularly about mortality rates, and I am pleased that we have the chance to discuss this issue today.

As we have heard, the threat posed by pancreatic cancer could not be starker. It is the fifth leading cause of cancer deaths in this country and, worryingly, has the worst survival rate of all cancers. Despite that, it receives only 1% of research spending, and that figure has jumped out at many of us when we have been approached by constituents, yet the survival rate has been just 3% over five years, having not improved in more than 40 years. I was staggered to learn that, especially as the cancer mortality rate overall between 1996 and 2008 fell by 19%. The statistic is terrible on its own, but even more worrying in that context.

As a result, I have several concerns, which other hon. Members share and which I want to raise today. However, first, I want to pay tribute to my constituent, Mrs Jan Lord, who was brave enough to share with me her personal experience of losing her mother to pancreatic cancer. Jan’s mother had been complaining of bowel and back problems for months before she sadly passed away in September 2012 from pancreatic cancer. She had been told by her GP and hospital doctors that her mother’s deterioration was due to irritable bowel syndrome or perhaps just old age. Her mother was diagnosed with pancreatic cancer just five weeks before her death, and Mrs Lord believes that that diagnosis was reached only when she had pressed doctors to investigate further her mother’s failing health. That is a very sad story to hear, especially when we consider that with greater awareness and understanding, things could have been different. I am sure that everyone present today can sympathise and has heard similar heartbreaking stories from their constituents. I hope that there is some comfort in the fact that many of the families affected by such stories have been the ones behind this campaign to raise awareness, and they should be very proud of what they have achieved.

I want to bring up some specific issues that I hope the Minister will address in her closing remarks—of course, they are similar to those we have heard in other speeches. The first is that lack of research spending, or, more accurately, that lack of research spend. As I have mentioned, the pancreatic cancer research field currently receives only 1% of all cancer research spend, and we have to find a way to improve the amount of research occurring. The urgency for that is paramount. More research will lead to earlier diagnosis, which is crucial, especially because earlier diagnosis means a greater likelihood of being able to operate. I understand that, at present, only 10% of people diagnosed are offered surgery as a solution.

Early diagnosis will also mean that we are able to run more clinical trials and improve the data we possess. Those two things are clearly related. I was present at the meeting last week of the APPG on pancreatic cancer, where that subject was raised. It was an incredibly useful and insightful meeting. An argument was put forward about the need to improve the way in which we record and use patient data, making them available far sooner—in fact, almost as soon as the patient interaction occurs—to improve our understanding of what might be successful. The arguments were so compelling that they have made me substantially rethink how I feel about patient data and how they can be used in future.

I would be interested to hear what the Government believe is necessary to develop better screening tests. The analogy given at the APPG was that we are currently asking a GP to sit on a motorway bridge on the M1 and spot a car that passes only once every three years. Clearly, we need to give GPs more support, and I hope that the Minister will express a willingness to do so. In our system, the GP is the gatekeeper; they are the first port of call for a patient, and we have to recognise that we are asking something very difficult of them. However, research shows that knowledge of linking pancreatic cancer symptoms to the disease is often low and that diagnosis is often missed, which is perhaps not surprising given the lack of research and that many similar but less deadly ailments have comparable symptoms. GPs do an excellent job—I hope they do not think we are having a go at them—but they clearly need more help in this area. To go back to the comments at the APPG, we need to find a way to put some cameras on the M1 bridge to help them spot that car going past.

My hon. Friends in the shadow health team are looking at how best to improve cancer diagnosis, treatment, research and outcomes across a range of cancers. I was cheered by the shadow Secretary of State for Health, my right hon. Friend the Member for Leigh (Andy Burnham), saying that improving cancer outcomes would be a priority for us, and I believe that we will see a cross-party agreement on that in future.

To conclude, I want to pay tribute again to the hon. Members who secured the debate and to the remarkable campaign behind it. I also want to thank again my constituent, Jan Lord, for her campaigning and the courage she has shown in highlighting the need for more to be done to tackle pancreatic cancer. I believe that it has shown that not enough is happening at the moment and I intend to take a close interest in this area now that I am aware of just how great the need is. I look forward to the Minister’s response, and I hope that the Government also see this as a priority in future.

Healthier Together Programme (Greater Manchester)

Jonathan Reynolds Excerpts

Tuesday 22nd July 2014 Westminster Hall

[Jonathan Reynolds (Stalybridge and Hyde) (Lab/Co-op)]

I thank my hon. Friend the Member for Blackley and Broughton (Graham Stringer) for securing the debate. It is particularly useful that we can express our views before the summer recess. I do not want to speak for too long. I will echo my colleagues’ sentiments about the quality of the consultation process, but I want to give a view from the eastern part of the conurbation, Tameside, and make a couple of additional observations.

A lot is going on with the NHS and health care in Greater Manchester at the moment, so the timing is not very conducive to running such a consultation. The changes to Trafford A and E have already been mentioned. Passenger transport has been privatised from the NHS ambulance service to Arriva. Most of the walk-in centres that I am aware of have gone. I do not know about the situation in other constituencies, but in mine GP access is a huge issue—people regularly wait a fortnight for access to a GP in Stalybridge. Of course, in Tameside there are particular challenges because of the Keogh review in Tameside hospital. All the Tameside MPs warmly welcome that. It has been a positive process enabling a light to be shone on many of the things that we have been discussing for several years. However, when all the factors I have mentioned are added together, it is a difficult time to carry out a consultation on any part of the NHS and particularly on hospitals, because the public are most sensitive about them in many ways.

I understand the need for specialisation. I echo the remarks of my hon. Friend the Member for Stretford and Urmston (Kate Green). Even if we had substantially greater resources, it would be difficult to recruit the people we would need to meet the standards now required for hospitals in the conurbation. With the financial modelling that has been done in Tameside, we are perhaps a little more advanced in our forward projection work than some other boroughs, and I think that we are in a perfect storm. We have had to spend a lot of money at the hospital to try to meet the higher standards that people should expect by correcting some of the processes that the Keogh review highlighted as wrong. On top of that, the council was always one of the leanest in the country, let alone in Greater Manchester, so it suffered the worst from the severe reductions made by the coalition in northern local authorities. Our clinical commissioning group is in a relatively good position, but clearly it is not to anyone’s benefit simply to use that financial picture to prop up other parts of the system that are not working so well.

History will be hard on the coalition for prioritising such a big ideological reorganisation at a time when the figures show that the situation I have described is the challenge that incoming Health Ministers should have concentrated on. The promise that no A and E departments in our hospitals will close is welcome news, but I wonder whether the scale of the rhetoric around Healthier Together justifies or validates that promise. Either we shall not produce the results that have been promised, or that promise on the long-term future of hospitals and A and Es may not be honoured in the way we expect.

[Graham Stringer]

My hon. Friend is right to say that that commitment was given when we met the Healthier Together people and in some background documents. Does he agree that it is worrying that it is not in the consultation document, whatever credibility we give to the commitment itself?

[Jonathan Reynolds]

I do agree. That is a matter of extreme concern to me. My understanding is that we have been given a cast-iron pledge that there will be no hospital or A and E closures as part of Healthier Together. The problem with all hospital reconfigurations anywhere—it happened with the maternity services consultation—is that they always appear to people to be about cuts. It is hard to get across the argument that they are about improving services. There is some mixed messaging about the primary outcome of such a process.

My principal problem with specialisation is the one that arises with specialisation in any field. Greater Manchester’s geography makes it hard to get from one borough to another. Public transport and the railway system are not configured to operate in that way. I should love the opposite to be true—if we had the resources and local autonomy to make public transport work differently. That will come one day, I think, but it is not true at the minute. I did not by any measure expect to become an MP in the 2010 general election, and my daughter was booked in to be born at St. Mary’s, because I worked in the centre of the city and it was easier to have appointments there than to get back to Tameside for them. Frankly, we were concerned about the possibility of labour starting in Tameside at the wrong time, because of the journey to get to St Mary’s and what that might mean. I think that that would be the same for many people, whatever the health issue: the journey is not easy in a car, but by public transport it is almost untenable. That would be people’s primary concern when they thought about the outcome of such a consultation

[Lisa Nandy]

I am grateful to my hon. Friend for raising that matter, because I do not think that the Healthier Together team has given it enough thought. My constituency has not only chronic transport problems, including traffic and the fact that some areas of the borough are densely populated and quite far from the existing hospital, but also large, tightly knit families who often do not have a huge number of resources. When a loved one is suddenly taken ill, the whole family wants to visit, which is particularly problematic and something that the team has not thought about. Does my hon. Friend agree?

--- Later in debate ---

[Jonathan Reynolds]

That is absolutely true. If someone lives near the station in Stockport, it is sometimes quicker to get to London than to another part of Greater Manchester.

I am pleased that the hon. Member for High Peak (Andrew Bingham) was here, because something that is forgotten across the conurbation is that the health economy and structures are not coterminous with the political structures of Greater Manchester. Glossop is part of Tameside’s health economy and getting from Glossop to Ashton-under-Lyne is not an easy journey, but trying to get to a different part of Greater Manchester in an ambulance or with a need to access a particular service would be extremely worrying.

[Julie Hilling]

It must be recognised that people living within Greater Manchester will also travel to hospitals outside. Some of my constituents might travel to Chorley for treatment, for example, because it is much closer than Bolton or Wigan. My hon. Friend is absolutely right that there is no wall around Greater Manchester in terms of people travelling in or out.

[Jonathan Reynolds]

That is absolutely true and has been mentioned by several colleagues today. My specific point about Glossop is that it shares an NHS trust hospital and clinical commissioning group with Tameside and that must be considered in a manner that people do not fully appreciate at the moment.

Looking at the financial picture for the NHS in Tameside and Glossop, we see many challenges to meet in future. I cannot see the utility in a big hospital reorganisation such as this unless there is much wider reform of out-of-hospital care, because we will still face the problem of too many medically healthy people being in hospital because they have nowhere else to go. Such reform would require much stronger integration of social services, public health, the CCG and the hospital, but the Government’s entire direction of travel is towards a more fractured and competitive system. I understand the motivation, but I cannot see how it tallies with something such as the Healthier Together programme.

The Minister has several points to address in his speech, but I hope that he can respond to that one in particular, because I am unsure about why we are going through this process if it will not deliver the improvements in health care that should be the ultimate goal of any kind of reorganisation.

--- Later in debate ---

[Norman Lamb]

I note the hon. Lady’s point, but I come back to Lord Smith’s statement:

“We accept the case for change made in this consultation document”.

It cannot be clearer than that.

[Jonathan Reynolds]

Will the Minister give way?

[Norman Lamb]

Let me finish the point. I am acutely aware that it is critical to develop those out-of-hospital services to which the hon. Member for Wigan referred. That is the whole essence of integrated care, of which Manchester is seeking to be an exemplar. I applaud Manchester for doing that, because that is a big shift towards the greater focus on preventing ill health, rather than on repairing the damage once it is done.

[Jonathan Reynolds]

rose—

[Norman Lamb]

I am conscious that I need to make progress in my response to the debate, but I will give way to the hon. Gentleman.

[Jonathan Reynolds]

I am extremely grateful to the Minister for addressing my point directly. It is pleasing to see that he is well briefed. He is right about some of the exciting conversations about integration going on in Greater Manchester. I anticipate that he knows something about the proposals. If they develop into specific plans, is it his desire and belief that the Government would not seek to apply the competition law to which the NHS is now subject and allow them to proceed?

[Norman Lamb]

I have made the case very clearly that the whole purpose of the pioneer programme is to use the pioneers—although we are not simply focused on them—to identify the barriers to integration and to remove them. That is the whole point. There are concerns about all sorts of things that could block integrated care, such as information sharing across different providers and competition.

I should stress, incidentally, that in the section 75 regulations is a specific recognition that integrated care is an ambition that should be achieved, so commissioning can be for the whole integrated care pathway. There should be no problem in securing our ambition. Where barriers are found, they need to be addressed and removed.

I am conscious that the hon. Member for Stretford and Urmston asked to intervene—

--- Later in debate ---

[Norman Lamb]

I understand that the health and wellbeing boards are keeping a watching brief throughout. They will have a decisive voice at the end of the consultation process in declaring whether they support the outcome. They bring together the local authority and the NHS, so they are pretty central to the whole process—and rightly so. The local NHS is constantly seeking to modernise delivery of care and facilities to improve patient outcomes, to develop services closer to home and, most importantly, to save lives.

The hon. Member for Stalybridge and Hyde focused on specialisation, and expressed scepticism about the case for it. Let me give him a case. It is from during the Labour Government and should be applauded—the lessons from it should be learned here. Stroke care in London, centralised into eight hyper-acute stroke units, now provides 24/7 acute stroke care to patients, regardless of where they live across the city.

Transport links are not that great across much of London—[Interruption.] Hon. Members should listen to Members from London complaining about transport links. Stroke mortality is now 20% lower in London than in the rest of the UK and survivors with lower levels of long-term disability are experiencing better quality of life. Hundreds of lives have been saved as a result of the specialisation undertaken predominantly under the previous Government.

[Jonathan Reynolds]

I was very fair in my speech and said that I absolutely accept the case for specialisation. I actually made the most positive case of any made by an Opposition Member today as to why that might be important for my borough, so the Minister has perhaps misunderstood that. But I have to say that comparing the transport situation in Greater London with that of Greater Manchester or any other northern city will, I am afraid, have our constituents in uproar: it is simply not the same picture by any means.

[Norman Lamb]

I acknowledge that, just as in London, there are real bottlenecks in Manchester. I have a son who was at university in Manchester—and found it to be a very fine city—so I understand the transport challenges there completely. The point remains that specialisations can save lives. We all have to recognise that.

All service changes should be led by clinicians and be based on a clear, robust clinical case for change that delivers better outcomes for patients.

Special Measures Regime

Jonathan Reynolds Excerpts

Wednesday 16th July 2014 Commons Chamber

[Mr Hunt]

I totally agree with my hon. Friend. It is an absolute tragedy for people who use the NHS in Wales and Welsh NHS workers that they are not getting the support that people in England get to deal with poor care. For some reason, the Labour Administration in Wales believe that it would be incredibly embarrassing to find problems, but that is what hospitals and hospital staff are crying out for. The staff did not go into those jobs to deliver poor care. They want the support to deliver the best care. It is time that Labour in Wales understood that and got the support of Labour in England to do so.

[Jonathan Reynolds (Stalybridge and Hyde) (Lab/Co-op)]

The Secretary of State will know that the local MPs covering Tameside hospital have never pulled their punches in calling for the need to improve our local hospital. He may recall that we publicly called for the previous leadership of our hospital to be removed even before the Keogh review process began. Speaking on behalf of my hon. Friend the Members for Denton and Reddish (Andrew Gwynne), who sits on the Opposition Front Bench, and my hon. Friend the Member for Ashton-under-Lyne (David Heyes), we are disappointed that Tameside remains in special measures, but we believe that progress has been made, particularly in A and E and with regard to mortality rates. We believe that the new management team, who have brought about those changes, deserve our support. We will never accept anything but the very best care in Tameside, and we agree that there is more to do, but we believe we are on a journey of improvement and that our hospital is in a different place from where it was 12 months ago.

[Mr Hunt]

I thank the hon. Gentleman for the tone of his comments and totally agree with his sentiments. Tameside has recruited 70 new nurses and nursing staff. To take one important indicator—it is only one—the number of falls has decreased by 18%. The staff definitely feel more supported by the management. However, he is right that this is a long process—the trust has been troubled for many years—and we are absolutely determined to back the staff and get them over the line.

Francis Report

Jonathan Reynolds Excerpts

Wednesday 5th March 2014 Commons Chamber

[Jonathan Reynolds (Stalybridge and Hyde) (Lab/Co-op)]

I will focus on the impact of the Francis report on my local hospital in Tameside.

Tameside hospital has been a major issue for me, as the MP for Stalybridge and Hyde, and it featured prominently in my election literature in 2010. At the general election, I pledged to work with my hon. Friends the Members for Denton and Reddish (Andrew Gwynne) and for Ashton-under-Lyne (David Heyes), to resolve what we believed to be the serious problems at Tameside hospital by building on their work and statements in the previous Parliament. Securing improvements at the hospital has been a priority for all of us and it will continue to be so. The stance that we have taken, combined with the work of Sir Bruce Keogh, has allowed genuine improvements to take place at Tameside and I am proud of that work.

I regret the journey that there has been in this Parliament towards making Francis a more partisan issue. The Prime Minister’s initial statement on the matter was quite admirable and the work of Sir Bruch Keogh offered a way forward for problem hospitals such as mine. We all stand to lose that if we try to game it for partisan advantage. There is a feeling that the Government have tried to obscure the unpopularity of the NHS reorganisation by doing so. Surely we can all agree that the two matters should not be conflated.

I love the NHS, but I love my constituents even more. If any institution is letting them down, I will not hesitate to call it out. I believe that that is true of all my Opposition colleagues.

The recommendations of the Francis report were, without doubt, an important contribution to improving the quality of health care in England. The circumstances that led to the creation of the Francis inquiry threatened to undermine public faith in the NHS, and a serious and independent investigation into those factors was crucial to maintain people’s trust in the NHS. That investigation was begun by my right hon. Friend the Member for Leigh (Andy Burnham), in whom I have tremendous faith.

The stories of poor care at Mid Staffordshire and other NHS trusts were indefensible and often heartbreaking. I hope that we never see such instances again in the NHS. However, it is important that we also take this opportunity to commend the thousands of doctors and nurses who work tirelessly to provide people in this country with the very best of care. The people who work for the NHS, including those from overseas who choose to come and work in the NHS, do an incredible job and they must always know that we appreciate them greatly.

Following the publication of the Francis report, my local trust, Tameside Hospital NHS Foundation Trust, was one of five trusts that were investigated by Sir Bruce Keogh. It was not the work or recommendations of the Francis inquiry that were of the most immediate significance to my area, but the fact that the publication of the report sparked a chain of events that had a significant impact on the delivery of care at the local hospital in Tameside.

At the time of publication, Tameside had the second worst record for hospital deaths. Data from the summary hospital-level mortality indicator showed that 18% more patients than expected died at Tameside in the 12 months leading up to June 2012. The standards of care at the hospital had been of concern to the public for some time. I should perhaps mention that the information on Tameside hospital was complicated by the legacy of the crimes of Harold Shipman in my constituency. That had a huge impact on how people thought about care at the end of their life and on where they went for that care. That was always a plausible excuse for the mortality scores, but there was a need to push past the excuse and discover the real causes.

In the light of those problems, I cited my concerns about aspects of care at Tameside hospital on the record on several occasions, acting in conjunction with my hon. Friends the Members for Denton and Reddish and for Ashton-under-Lyne. We had already called for the resignation of the trust’s chief executive so that the hospital could improve.

The problems at Tameside were indicative of the broader issues that Francis and Keogh were attempting to address. The confidence of the local community in members of the senior management team had all but disappeared. That led to problems often not being adequately addressed or even acknowledged. The hospital became defensive and saw the issue as one of public relations management, rather than service improvement.

There is a fundamental point that we must grasp if we are properly to understand what factors contribute to the level of public trust. People understand that mistakes are sometimes made. That is the case in all professions and walks of life. However, people cannot understand it—and nor should they—when mistakes happen but no serious attempt is made to address the concerns of patients or clinicians in an open and transparent way to resolve the issues.

Sadly, that is exactly what happened for too long at Tameside hospital. In the worst cases, the hospital management actively tried to downplay the problems raised by patients, family members, elected representatives and even, in some cases, each other. That behaviour is not acceptable and a failure to address it undermines public faith in the NHS.

Putting the spotlight on these hospitals has had some success in breaking through this culture, and Tameside now has a clear set of objectives on which to develop a strategy for improvement. Without the Francis report and the subsequent work of Sir Bruce Keogh, that long overdue process of improvement at Tameside hospital might not have happened. We as local MPs would still be calling for those changes to happen, but we would not have had the expert analysis that the process provided to back up what we were saying.

[Andrew Gwynne (Denton and Reddish) (Lab)]

I am grateful to my hon. Friend for setting out the case. Does he share my confidence that the hospital has indeed turned a corner? Part of that is down to the buddying arrangements with the University Hospital of South Manchester in Wythenshawe and the excellent interim leadership of Karen James.

[Jonathan Reynolds]

I endorse those comments entirely and thank my hon. Friend for his contribution. The negative attention that the hospital received as part of the Keogh investigation was undoubtedly the catalyst for the departure of the former chief executive in 2013, and the first step on the road to improvement.

It is important, however, for us to note the limits of Government’s capacity to push this agenda. Of course, Government have to be the ones who set the framework for improvement in the NHS, but cultural changes can properly come only from the front line. What Tameside hospital now has is a set of recommendations to be implemented, a framework for the delivery of those changes, and new leadership which, ultimately, will deliver the improvements that patients in our area need. I still visit the hospital regularly; indeed, I was there on Friday last week, and I am pleased to say that in my view it is certainly turning a corner. I hope the Government maintain their commitment to all the Francis recommendations, and ensure that the high expectations are hardwired into the NHS’s leaders.

Just before Christmas, I was walking my dogs in Stalybridge as usual, and a friend of mine whom I had not seen for quite a long time shouted over to me. He explained that he had been receiving treatment for more than a year at Tameside hospital. Over that time he had been able to witness, in his words, visible improvements to his care and to how the hospital was run and how it functioned, due to the changes facilitated by the Francis report, the Keogh inquiry and, I believe, the work of myself and my hon. Friends. We will not stop that work or feel self-satisfied because of it, but I am pleased that we have been able to make that difference. That, ultimately, is what we should all be trying to bring about by discussing the anniversary of the Francis report.

Hospital Mortality Rates

Jonathan Reynolds Excerpts

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

Yes it is, but I hope that we can give them confidence today that the problems will finally be addressed.

[Jonathan Reynolds (Stalybridge and Hyde) (Lab/Co-op)]

I have welcomed the Keogh process from the beginning. Although the report on Tameside is hard hitting, I entirely welcome it—it is consistent with what has been in the public domain for two weeks—and the evidence that all Tameside MPs gave to Keogh to demand a change in leadership has been justified. Although I speak as an MP who has campaigned critically against his hospital, may I say that the tone and comments of the Secretary of State were neither helpful nor accurate with regard to Tameside? We need him to focus on implementing the reforms that are needed, one of which is clearly to deal with the inadequacy of the previous inspection regime. The extent of the scrutiny of these 14 trusts was great, but that is needed for all hospitals, so can he tell us what he will do to put that into effect?

[Mr Hunt]

I absolutely can. The new chief inspector of hospitals starts work today. We would like him to start the new inspection regime, adopting the same methodology as the Keogh review, as soon as possible, but it takes time to assemble a team of expert inspectors. He plans to start a pilot round of inspections this autumn before getting into full swing next year, and all the hospitals on today’s list will be inspected again within the next 12 months.

Health Services (North-West)

Jonathan Reynolds Excerpts

Thursday 11th July 2013 Commons Chamber

[Mr Hunt]

That is already built into the funding formula. We made reducing health inequalities a duty of NHS England in the NHS mandate, and that needs to be done in a way that is also fair to socially deprived people living in the countryside, in rural areas and even in the fringes of affluent areas. We have to find a way of ensuring that the process is fair to everyone who is socially deprived and to do what we can to reduce health inequalities.

[Jonathan Reynolds (Stalybridge and Hyde) (Lab/Co-op)]

No one should be in any doubt that there will be huge shock back home in Greater Manchester at the announcement about Trafford. The conurbation has specific problems with its hospitals, such as mine in Tameside, where we have finally changed the management. We have the Healthier Together process, which is reviewing practically everything, and we are still coping with the impact of the reorganisation with which the whole country has to contend, and now we turn up at Parliament on a Thursday morning to hear the unilateral announcement that Trafford is going. Given the scope of the Healthier Together process, how can the Secretary of State honour the assurances that he gave in his statement? He could not answer the question asked by my right hon. Friend the Member for Wythenshawe and Sale East (Paul Goggins) about foundation trusts and capital at all. What further changes to hospitals in Greater Manchester is he going to spring on us in the future?

[Mr Hunt]

Foundation trusts can apply for a capital grant, and I said in my statement that, as soon as we get a business case, we will give that a high priority. We are sympathetic to awarding it, but we have to wait for the business case to be presented.

In a period in which the NHS faces huge pressures, it is important to show leadership, and that means local MPs understanding that difficult decisions sometimes need to be taken that are in the interests of their constituents, as a number of Members have done today. It also involves supporting what local doctors have been arguing for over many years, but taking the line of the right hon. Member for Leigh (Andy Burnham) by supporting the unions, not the doctors, is totally irresponsible.

Carers

Jonathan Reynolds Excerpts

Thursday 20th June 2013 Commons Chamber

[Jonathan Reynolds (Stalybridge and Hyde) (Lab/Co-op)]

Thank you, Mr Deputy Speaker, for calling me to speak in this important debate. I congratulate the right hon. and hon. Members listed on the Order Paper on securing it.

I want to make a relatively short contribution to place on the record my view that the work that carers do for little or often no reward should never be underestimated or forgotten. They provide care and compassion of the highest level in the most challenging of circumstances.

I believe we need a far bigger and bolder response to meet the challenges of our increasingly ageing population. We need to recognise that in many circumstances a complicated mix of care is delivered by a combination of professional carers, family members or both. Carers need more support and that can only come from the Government. I want to address two issues in order to make that point.

First, we should acknowledge the importance of creating a care industry that people aspire to work in by appropriately rewarding the work they do. Secondly, the Government need to recognise further the work of thousands of unpaid carers up and down the country.

The demographic make-up of our population is obviously changing, which is already starting to stress our care system. That is happening against the backdrop of large-scale cuts across the system. According to the Local Government Association, local authorities have had to cut their adult social care budgets by 20% over the past three years, which means that in many places, such as Tameside, the metropolitan borough that my constituency covers, the amount of respite care available is being severely squeezed. I have seen some appalling cases in my surgeries—the kinds of cases that stay on my mind and often prevent me from sleeping at night because of the situation that many people face when the care they need is being taken away.

Against the backdrop of cuts, many carers work day in, day out, delivering excellent care but for poor pay, whether they work in a residential home or in a person’s home. Many of them are paid little more than the minimum wage for a job that should not just be a job, but a rewarding career for life. If we as a society want to demand the highest standards of care for ourselves when we get old, we should at the very least be prepared to pay a living wage for those who seek to deliver it.

That should happen alongside a concerted effort to improve skills across the care industry, investing in training and development to make the sector one in which people aspire to work. It could be a huge source of employment for the future—it is not possible to outsource care in the same way as we outsource other industries to another country—but I do not think that we even have a strategy to get us to that point.

Secondly, I want to discuss the impact on non-professional carers of the current pressures in the care system. In Tameside, approximately 2 million hours of unpaid care are given every year. If purchased from a paid carer, that would cost in the region of £22.5 million. That puts a high strain on carers, as has been mentioned. In Tameside, people are substantially more likely to be in ill health if they are carers, and that is in an area that already has poor public health. We should all take the time to recognise the stressful and important work that carers do.

Several of my constituents who are dedicated carers for the people they love have told me that they receive no recognition for the valuable work they do. That is why debates such as this are important. Many of them have had to give up their jobs, and in several cases the person for whom they are caring feels responsible for that, even though it is no fault of theirs.

The burden on many of those who care for loved ones has increased since the Government introduced their welfare reforms in April. In Tameside, increasing numbers of carers are reporting stress due to financial worries. The Government’s impact assessment into the changes to disability living allowance and carer’s allowance and the introduction of the personal independence payment shows that almost 10,000 fewer carers will be entitled to carer’s allowance. That is a massive blow for those who care full time. Locally, the number of people who are seeking support to complete their benefit forms is increasing. How can it be right that we are penalising these people for the work that they do? Where are the Government to support these people when they so desperately need and deserve it?

To conclude, I welcome the principle in the Care Bill of capping care costs. I do not think that it is set at the right level, but it is a welcome first step in reducing the burden of care. However, I believe that we need to explore a genuinely integrated health and social care system. That would not only help people to stay independent in their own homes for as long as possible, but reduce the burden on family members who deliver care each and every day. That is the challenge. I hope that we will see a developing political consensus, with Members on both sides of the House moving towards such a system, so that we can enshrine it, secure it and give people the system that they deserve and need for the years ahead.

Oral Answers to Questions

Jonathan Reynolds Excerpts

Tuesday 17th July 2012 Commons Chamber

[Mr Lansley]

As my hon. Friend will, I hope, have understood from previous exchanges, the focus on the delivery of care to the resident population in an area covered by a clinical commissioning group will mean that we try, as far as possible, to align resources with the needs of a whole population rather than with just the practice-registered population.

[Jonathan Reynolds (Stalybridge and Hyde) (Lab/Co-op)]

T3. The Government often talk about reducing the number of managers in the health service to defend the front line, but following my recent meeting with my local representative from the Royal College of Nursing, can the Secretary of State confirm that under the Government’s definition a ward sister at band 7, who has a hugely important front-line role, is actually considered a manager?