Access to GP Services and NHS Dentistry
Lindsay Hoyle Excerpts(1 year, 10 months ago)
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Wes Streeting
I am very, very grateful to the hon. Lady for that intervention. Our party has been clear: we did not want to see the strikes go ahead. We believe the strikes could have been averted if the Government had shown responsible action. The absolute brass neck of the Secretary of State! It is one thing pretending they have not been in government for the last 12 years; now they are pretending they are not in government today and that, somehow, it is down to me, the shadow Health Secretary. Somehow, if I had uttered the magic words, “Don’t go ahead,” the RMT would have said, “Oh no, the shadow Secretary of State for Health has spoken now. We better put a stop to it.” [Interruption.]
Mr Speaker
Order. I want to help a little bit. We do not want to open up a debate that is not down for today. We have got a little bit carried away. The hon. Member for Kensington (Felicity Buchan) got in, and I was quite right to allow a response, but I think we have heard enough now.
Wes Streeting
Thank you, Mr Speaker.
I was about to quote the great political philosopher, Jonn Elledge, who, in response to what the Secretary of State said, commented on Twitter that we are
“all as ants before the might of the all powerful shadow health secretary”.
When is the Health Secretary going to wake up to the fact that he is in government, he has responsibilities, he is discharging the greatest crisis in the history of the NHS and he is doing nothing about it? Instead of lecturing the Opposition, when is he going to show some leadership and get on with governing?
Dr Johnson
As part of that, I suggest that the hon. Gentleman remembers that GPs take 10 years to train. He is right to say that we have been in government for 12 years, but most of the current GP shortage is because the previous Labour Government did not train those GPs at the time. One of the first things the Conservative Government did was to set in train the opening of five medical schools to increase the number of medical students. We had enough doctors but they do take 10 years to train. The reason I stood up to intervene on the hon. Gentleman was to say that one of the challenges that doctors—I refer to my entry in the Register of Members’ Financial Interests, as a doctor—and members of staff face is being abused in a surgery. I wonder whether he would like to apologise for some of the comments he has made on social media—
Mr Speaker
Order. Interventions are meant to be questions. I know that the hon. Member is down to speak. I would not want you to use up your speech now; I want you to save something for later.
Wes Streeting
Let me first say in response to the final point the hon. Lady made that there is absolutely no excuse for abusing NHS staff whatsoever. Most people in this country do not blame NHS staff for the state of the NHS; they place the blame squarely where it belongs, with the Government who have been in power for the past 12 years. Her first point would be more powerful if we did not have 1,500 fewer full-time equivalent GPs now than we did when her party came to power. Her point would have been more powerful if her party had not whipped its MPs to vote against having a workforce plan for the NHS, but I am afraid that that is what it did. Conservative Members cannot run way from their choices and decisions, and from the fact that they have now been in government for 12 years and there is no one else to blame but themselves. In communities right across the country, we now see the consequences of their mismanagement.
Oral Answers to Questions
Lindsay Hoyle Excerpts(1 year, 10 months ago)
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Sajid Javid
The hon. Lady is right to talk about the importance of eye care services. That is why we are putting record investment into dealing with those covid backlogs. As she rightly points out, many of those are in eye care and ophthalmic facilities and surgeries. That record investment is going in, and we will keep it under review to make sure it is leading to the outcome that we all want to see.
Andrew Gwynne (Denton and Reddish) (Lab)
More than 2 million people are affected by the backlog in cancer care. Smoking is the leading cause of cancer, and we know that a key component of tackling the backlog is prevention. Given that, can the Secretary of State assure the House that no current or former tobacco lobbyist working in or with No. 10 will have any influence on the Government’s tobacco control plan, prevention strategy or planned response to the Khan review?
Ms Marie Rimmer (St Helens South and Whiston) (Lab)
People with dementia deserve to be treated with dignity and respect. There are ways to enable those living with dementia to lead the lives they want. This is what the all-party group on dementia inquiry is currently investigating. Will the Secretary of State commit to attending the all-party group’s inquiry—
Mr Speaker
Order. Sorry, but that is not relevant to the question, which is about dentistry.
Mr Speaker
I cannot jump questions; this question is about dentistry so I now call the shadow Minister, Feryal Clark.
Feryal Clark (Enfield North) (Lab)
Members across the House have been calling on the Minister to fix the crisis in NHS dentistry, but she seems intent on burying her head in the sand. The Government have no plan, with the Minister running scared from even talking to dentists at a conference last week. Patients are suffering as a result, with a third of adults and half of all children not having access to an NHS dentist. In Wakefield alone, a child under 11 is admitted to hospital every day for tooth decay. Does the Minister agree that the people of Wakefield should bear this in mind next Thursday?
Edward Argar
I am grateful to my hon. Friend for drawing attention to this important issue as well as for highlighting what is going on in Norfolk and the opportunities to learn from that. The Government have put record funding into mental health, and I understand that my right hon. Friend the Secretary of State is due to meet him and supporters of the campaign soon.
Dr Rosena Allin-Khan (Tooting) (Lab)
Working a shift in A&E just two days ago, I could not have felt prouder of the teams of nurses who form the foundation of our NHS. As the Minister is so gushing about the Government’s track record, will he explain why specialist food banks are being opened up in hospitals? Will he explain why, in a report by the Royal College of Nursing, 83% said that staffing levels on their last shift were not sufficient to meet patients’ needs safely and effectively? These lifesavers need a Government who are on their side. Only Labour will deliver for the NHS workforce and ensure that nurses and patients get what they rightly deserve.
Lucy Allan
Orthopaedic surgery at the Princess Royal Hospital has still not restarted since the pandemic. That is causing huge suffering for those who have been waiting for surgery, in some cases for several years. A hip replacement is transformative to quality of life and reduces other care needs, but orthopaedic surgeons continue to be paid despite not operating, and no alternative is being offered to patients—they are not even being given an expected operation date. Will implementing the Messenger review require NHS leadership to be more accountable to the public so that decisions such as refusing to restart much-needed surgery can be challenged?
Mr Speaker
This is a strange grouping, but it is a very important question, so do answer it, please.
Sajid Javid
I thank my hon. Friend for her tireless campaigning on the issue, which she brought up recently in the Health and Social Care Committee. I am pleased to tell her that elective orthopaedic surgery at the Princess Royal Hospital will resume from 20 June.
My hon. Friend is right about the importance of the Messenger review. There were many examples of excellent leadership in it, but sadly there were also examples of poor leadership, including bullying and blame cultures. That is why it is essential that we have this huge reform.
Maria Caulfield
My hon. Friend has been campaigning on this issue for a long time, particularly on the tragic case of his constituent, Vicky Clarke. I have met the all-party parliamentary group on medical cannabis under prescription and we have had debates on the issue in this place and in Westminster Hall. The key is to get those products licensed, and we have been in discussion with the Medicines and Healthcare products Regulatory Agency on how to do this. It is about gathering the evidence base. I am pleased to say that NHS England and the National Institute for Health and Care Research have recently announced two clinical randomised controlled trials to try to build that evidence base to get more of these products licensed.
Martyn Day (Linlithgow and East Falkirk) (SNP)
The lack of evidence on the quality, safety and efficiency of cannabis-based products for medical use is the main barrier to their being prescribed by NHS clinicians, which is why the SNP continues to support the development of clinical trials. Without proper funding, the UK Government are holding back potential successful health outcomes, so what steps are they taking to increase the priority of medicinal cannabis in research funding?
Sajid Javid
I am happy to respond to my hon. Friend. He is right that we of course want to ensure that everyone has timely access to NHS dentistry and that the profession is an appealing career choice. Health Education England has a dental education and reform programme, which will help retain new dentists in the NHS by placing training in areas of greatest need, and offer more flexibility and more career pathways. I can also tell him that, in Lincolnshire, commissioners are already looking at ways to support NHS dentistry through support such as the golden hello incentives.
Wes Streeting (Ilford North) (Lab)
I associate myself with the Secretary of State’s remarks as we remember the anniversary of the Grenfell Tower tragedy and support the families in their ongoing quest for justice. I also associate Opposition Members with your remarks, Mr Speaker, on the 40th anniversary of the end of the Falklands war.
Last night’s shocking BBC “Panorama” investigation into Operose Health revealed the extent of the crisis in GP surgeries, with patient referrals and test results left unread for up to six months, and with patients being seen by less qualified staff standing in for GPs without supervision. This is exactly what happens when private profit is placed above patient health and safety. Why is the Secretary of State asleep at the wheel instead of launching an investigation into this scandal?
Sajid Javid
My sincere condolences to the family of David Hopkins. Cancer diagnosis and treatment is an absolute priority, which is why we are putting £2.3 billion into campaigns and new initiatives to encourage people with suspected cancer to come forward. I am pleased that the referral rate is currently 120% of the pre-pandemic level. I will, of course, read the APPG’s report. I visited the largest neurology hospital in the UK last month with my hon. Friend the Member for Hexham (Guy Opperman), and I am determined to ensure that our investment in this vital area of research goes straight to the frontline.
Martyn Day (Linlithgow and East Falkirk) (SNP)
The Government have noted that Sir Robert Francis will give evidence on his work on the infected blood inquiry on 11 and 12 July, and said that they will act after hearing his evidence. What discussions has the Secretary of State had with Cabinet colleagues on the potential impact on victims’ mental health of the lengthy waiting times for compensation in relation to contaminated blood?
The Minister for Health (Edward Argar)
I am grateful to my hon. Friend; he rightly alludes to the fact that he is a strong champion of his constituents and has met me on a number of occasions to argue the merits of the Thornberry health centre. As he will be aware, we now have a multi-year capital settlement for our NHS, which will allow us the opportunity, through local systems, to consider the most appropriate projects for investment.
Matt Western (Warwick and Leamington) (Lab)
Sajid Javid
I am afraid that it was not clear to me which tests the hon. Gentleman was talking about; all I heard was “300,000 tests”. So if he cares to write to me, I will respond properly to his question.
Jeremy Hunt (South West Surrey) (Con)
Has the Secretary of State read the study in the British Journal of General Practice that says that people who see the same GP over many years are 30% less likely to go to hospital, 30% less likely to need out-of-hours care and 25% less likely to die? If he has, will he consider changing the GP contract to restore individual patient lists and reverse the change of two decades ago so that everyone has their own family doctor?
Edward Argar
It was a great pleasure to visit my hon. Friend before the jubilee weekend and to meet the staff who do such an amazing job at his local hospital. As ever, his puts his case clearly and firmly for a new hospital to replace the QE in King’s Lynn, and we hope to be able to announce the longlist of those expressions of interest in due course.
Neale Hanvey (Kirkcaldy and Cowdenbeath) (Alba)
Health and Social Care Leadership Review
Lindsay Hoyle Excerpts(1 year, 11 months ago)
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Sajid Javid
The hon. Lady is right to highlight the importance of this issue and she will know that my predecessor had asked for a review on it. It was done and we have accepted its outcome, and it is being implemented. I hope she will understand that in implementing the outcome of that review it is important that we listen to clinical advice from within the NHS and make sure that we put the interests of each patient first.
Jeremy Hunt (South West Surrey) (Con)
I thank the Health Secretary for this excellent report and commend Sir Gordon Messenger and Dame Linda Pollard for all their work in putting it together. It has some very important recommendations. People who run hospitals are doing one of the most difficult jobs in Britain today, and anything we can do to give them better support in their careers will help all of us.
Does my right hon. Friend agree that the elephant in the room is that one thing that makes their job most difficult: we have more national targets in the NHS than any other health system anywhere in the world? That means not only that there is a risk of patients turning into numbers, but that we remove the autonomy from managers to show the leadership that Sir Gordon is advocating in this report. So as my right hon. Friend implements the recommendations, will he look at the role of national targets in the NHS and whether we need to simplify and reduce them?
North East Ambulance Service
Lindsay Hoyle Excerpts(1 year, 11 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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The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
Can I start by saying how horrified I was to read the concerns raised about the North East Ambulance Service in reports over the weekend? My thoughts are first and foremost with the families affected by the tragic events described. I cannot imagine the distress they are going through. It is hard enough to lose a loved one suddenly, but to have fears that mistakes were made that could have made a difference, and more than that, that the facts of what happened were not revealed in every case, goes further. They have my unreserved sympathy and support.
In healthcare, a willingness to learn from mistakes can be the difference between life and death, and it is because of this that, as a Government, we place such a high value on a culture of openness and a commitment to learning across the NHS. That is why the allegations raised by The Sunday Times this weekend are so concerning. As was made abundantly clear by the Secretary of State’s predecessor almost a decade ago, non-disclosure agreements have no place in the NHS and reputation management is never more important than patient safety.
The Government are wholly supportive of the right of staff working in the NHS to raise their concerns. Speaking up is vital for ensuring that patient safety, and quality of services, improve, and it should be a routine part of the business of the NHS. That is why, over the last decade, substantial measures have been introduced to the NHS to reduce patient harm and improve the response to harmed patients, including legal protections for whistleblowers, the statutory duty of candour, the establishment of the Health Services Safety Investigations Body and the introduction of medical examiners. It is also why, in response to a recommendation of the Sir Robert Francis “Freedom to speak up” review in 2015, the Government established an independent national guardian to help to drive positive cultural change across the NHS so that speaking up becomes business as usual. However, when it comes to patient safety, we cannot afford to be complacent. It remains a top priority for the Government and we continue to place enormous emphasis on making our NHS as safe as possible.
I note the concerns raised in this weekend’s reports. They have been subject to a thorough review at trust level, including through an external investigation, and the trust’s coronial reporting is subject to ongoing independent external audit and quarterly review by an executive director. I also note that the Care Quality Commission has been closely involved. However, given the seriousness of the claims reported over the weekend, we will of course be investigating more thoroughly and will not hesitate to take any action necessary and appropriate to protect patients.
The Government are also committed to supporting the ambulance service to manage the pressures it is facing. We have made significant investments in the ambulance workforce, with the number of NHS ambulance and support staff increasing by 38% since 2010. Health Education England has mandated a target to train 3,000 paramedic graduates nationally per annum from 2021, further increasing the domestic paramedic workforce to meet future demands on the service, while 999 call handlers have been boosted to over 2,400, so we are very serious about improving resources for the service.
I fully appreciate the concerns of right hon. and hon. Members across this House, and we will be pleased to meet any who have constituents affected by the reports this weekend so we can look at the issue more fully.
Mr Speaker
Can I just say that it is three minutes—and that means three minutes, not three minutes and 40 seconds —and I am sure whoever writes these speeches can actually time them through? I say to those on both Front Benches that we have to think about Back Benchers, who need to get their hospitals mentioned and their ambulance trusts as well.
I call the shadow Secretary of State, who I am sure will stick to the allocated time.
Wes Streeting
I pay tribute to the courage of the whistleblowers, as well as The Sunday Times journalists David Collins, Hannah Al-Othman and Shaun Lintern, without whom none of this would have come to light. But with respect to the Minister, it should not have taken an urgent question to bring her to the House today. On what she said about the Department further investigating, what form will this investigation take, who will be involved and what assurance can she give the families that there will be both answers and accountability, which is what they deserve?
Peter Coates died after an ambulance did not reach him in time. An ambulance two minutes away could not be dispatched because the station door was faulty, and staff did not know about the manual override. The ambulance that was dispatched decided to stop at a service station, even though it had sufficient fuel. Information about these errors was then withheld by the service, statements were changed and staff were asked to withhold the mistakes from the coroner. Peter Coates’ family learned the full truth only when contacted by reporters last week. His is just one of what is thought to be 90 cases involving gross negligence, cover-ups and tens of thousands of pounds of taxpayers’ money offered in exchange for staff silence.
The Minister mentioned the CQC. Why did it fail to spot this, rating the service “good” in 2018? Why did it fail to spot the situation even after being tipped off in 2020? Why is taxpayers’ money still being offered to buy the silence of staff when non-disclosure agreements were supposedly banned in 2014? What role did under-resourcing and understaffing play in this scandal?
Record ambulance waits exist in every part of the country, with heart attack and stroke victims waiting longer than an hour for an ambulance. As for the North East Ambulance Service, it is advising the public to phone a friend or call a cab rather than wait, while presiding over gross negligence, cover-ups and taxpayer-funded gagging orders on staff. That is the record on its watch. It is a national disgrace. What are the Government doing about it?
Maria Caulfield
We take the patient safety element of this extremely seriously. To answer the hon. Gentleman’s questions on who we will be meeting, I am happy to meet all the families affected to hear their concerns and the actions that they want taken. We met with the CQC this morning on this specific example, but we will be meeting with the ambulance trust. I also want to meet the coroner, and we want to hear from the whistleblowers. I am very happy to meet any member of staff who wants to raise concerns so that we can get to the bottom of exactly what has happened.
This Government introduced the duty of candour. Mistakes will always happen, no matter how much money is put into the health service or how many staff it has, but when a mistake does happen the hospital trust or ambulance trust should be open and up front about it, start a proper investigation, and learn the lessons so that it never happens again.
Jeremy Hunt (South West Surrey) (Con)
I thank the Minister, who is a practising nurse, for her profound commitment to patient safety. What happened to Peter Coates, Quinn Evie Beadle and others was a terrible tragedy for them and their families. No doubt the paramedics made mistakes, but everyone makes mistakes in the course of their work. What is unforgivable is the cover-up by the North East Ambulance Service, and the fact that we made the families go through such hell to get to the truth.
At the heart of this is that we still make it far too difficult for everyone involved in such cases to distinguish between ordinary human error and gross negligence, with the result that the organisations responsible for people’s care default to a defensive, covering-up position. Will the Minister take this up with the Ministry of Justice to ensure much clearer delineation between the ordinary human errors that we all make and gross negligence, which is never forgivable?
Oral Answers to Questions
Lindsay Hoyle Excerpts(2 years ago)
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Sajid Javid
That is exactly what the new integrated care systems are all about. My understanding is that the hon. Gentleman sat on the Health and Care Public Bill Committee, which made it a reality.
Mr Speaker
I call the shadow Secretary of State, Jake Berry. [Laughter.] Sorry, Wes Streeting.
Wes Streeting (Ilford North) (Lab)
Thank you, Mr Speaker. You have clearly had a happy Easter.
The fact is that the Government’s failure to fix the social care crisis is causing huge pressures on the NHS. As of last week, more than 20,000 patients were fit to leave hospital but could not be discharged because the care was not available, which means that 22,000 patients each month are waiting more than 12 hours in A&E and that heart attack and stroke victims have to wait more than an hour for an ambulance. We are used to hearing about winter crises, but is it not the case that, after more than a decade of underinvestment in the NHS, a failure to fix social care and the absence of a plan even to address the staffing challenge in the NHS and social care, we have not just a winter crisis but a permanent crisis in the NHS?<
Sajid Javid
My right hon. Friend is absolutely right to raise this issue. We have heard time and time again in this Chamber about the pressures our constituents are facing in order to get that kind of face-to-face access to their GPs. We all know why the situation was particularly bad at the height of the pandemic, but we expect it to improve rapidly. The percentage of people being seen face to face is increasing substantially, in large part because of the measures the Government have taken, including the £250 million access fund that was announced a few months ago.
Martyn Day (Linlithgow and East Falkirk) (SNP)
Thank you, Mr Speaker.
Integration and service improvement cannot be delivered without sufficient staff, and the only way to attract people to a career in social care is by valuing them. In Scotland, they are already paid better than those in England and Wales, and through the national care service the Scottish Government will improve terms and conditions for care workers, through the introduction of national pay bargaining. Have the UK Government considered following the Scottish Government’s approach and commitments?
Sajid Javid
My hon. Friend is right, and of course I will be happy to meet her and discuss this further, but I can also tell her that that is one of the key things we will be covering in our upcoming women’s health strategy.
Andrew Gwynne (Denton and Reddish) (Lab)
Warm words from the Secretary of State, but people in the most deprived parts of England are almost three times as likely to lose their lives from an avoidable cause as those in the least deprived areas. With the cost of living soaring and the Resolution Foundation estimating that 1.3 million people will be pushed into poverty as a result of the Chancellor’s spring statement, those inequalities will worsen. Why will the Secretary of State not just admit that his Government have failed the poorest communities, and start doing something about it?
Gillian Keegan
The hon. Lady raises a very good question. Last year, we committed an additional £2.7 million to further expand Op Courage following the recent events in Afghanistan, and NHS England has put in place several bespoke services and initiatives to meet the needs of our armed forces community. In addition to Op Courage, there is the veterans trauma network, the veterans prosthetic panel and the veteran-friendly GP accreditation scheme, but given ongoing events in Ukraine, we will of course keep everything under review. I am very happy to meet the hon. Lady to discuss further what may be required.
Dr Rosena Allin-Khan (Tooting) (Lab)
Our veterans have risked their lives for our country and deserve excellent mental health support. We must go even further: from the military frontline to frontline workers who have kept us safe, everyone deserves proper mental health provision. People have stepped up to protect our country and save lives during the pandemic, so is it any wonder that teachers and NHS staff are so furious with the comments made by the hon. Member for Lichfield (Michael Fabricant), about how they would go back to the staffroom and have a “quiet drink”, in an attempt to justify the indefensible actions of the Prime Minister? What does this say about the effect of mental health on our frontline staff? Will the Minister please condemn those comments and apologise for the hurt caused by those remarks?
Edward Argar
I am grateful to my hon. Friend, who takes a close interest in this issue, which she and I have discussed on a number of occasions. She is right to highlight the challenges that some more remote or rural communities can face in securing the workforce they need to meet their communities’ needs. The HEE work and the subsequent workforce framework will be looking at that across the whole range of different geographies and the challenges they face.
Martyn Day (Linlithgow and East Falkirk) (SNP)
The Scottish Government have recently bought Carrick Glen, a private healthcare hospital, in order for it to become part of the national network of treatment centres, which once fully operational will have capacity for over 40,000 additional surgeries and procedures each year. In contrast, the UK Government have taken the path of further privatisation of the NHS, so what recent assessment has the Minister made of the impact on the workforce of further privatisation of NHS England?
Sajid Javid
My hon. Friend is right to raise this. We are already in contact with the acute trust in Gloucestershire and some of the other trusts that are finding delayed discharge a particular challenge. My hon. Friend will know that, because of the pandemic, what has been a long-term challenge has become much more acute, not least because of the lost beds due to infection protection control and staff absences both in healthcare and in social care. Our delayed discharge taskforce is making a difference—the numbers are coming down overall—but we will be working with Gloucestershire.
Wes Streeting (Ilford North) (Lab)
Why does the Health Secretary think he has any licence to lecture the British people on their moral duty to pay taxes when he spent so many years avoiding his own?
Sajid Javid
I am very happy to answer if you will allow me, Mr Speaker. The hon. Gentleman could have asked me a question on anything to do with health and care—anything he wanted—but instead he chooses to talk about my personal affairs before public life. That was his choice. He could have asked me about the covid backlogs that he pretends he cares so much about. He could perhaps have given me suggestions—
Mr Speaker
Order. Secretary of State, I have got it. These are questions about your responsibilities. Now we can have another try—Wes Streeting.
Wes Streeting
Thank you, Mr Speaker. I would just say to the Secretary of State that he should be careful what he wishes for. I hope he will at least reply to the letter I sent him last Thursday—I will place a copy in the Library of the House. He has been stonewalling journalists’ questions, but since he says he wants to talk about the Government’s record, let me ask him about that instead. We went into the pandemic with NHS waiting lists already at 4.5 million. We went into the pandemic with NHS staff shortages of 100,000. We went into the pandemic with social care staffing vacancies of 112,000. So it is not just the case that the Tories did not fix the roof while the sun was shining; they dismantled the roof, removed the floorboards and now they have no plan to fix it. Where is the Secretary of State’s plan to fix the NHS crisis?
Mr Speaker
Order. Once again, I remind Members that topicals are short and punchy questions, not lengthy statements. A lot of Back Benchers on both sides deserve to get in to raise constituency matters, so please let us give them time. I do not want a lengthy fall-out, and these are Health questions.
Sajid Javid
Mr Speaker, you have been very generous to the hon. Gentleman: you gave him another try, but that was another failure to ask a question. Again, the hon. Gentleman is not asking about the serious issues, which again shows that he will play petty party politics and that Labour has no plan for the challenges this country faces.
Mr Speaker
May I just reassure the Secretary of State for Health that I was not being generous? The shadow Secretary of State had two questions, so I have not been generous in any shape, way or form.
Mark Fletcher (Bolsover) (Con)
Several hon. Members rose—
The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
I thank the hon. Lady for her question, and we have met to discuss this previously. I am happy to discuss with Health Education England whether one of its centres for dentist development could be suitable for her constituency.
Jeremy Hunt (South West Surrey) (Con)
The Secretary of State will have read the scandal exposed in The Sunday Times this weekend that six babies are born every month after being exposed to sodium valproate, which has been known for many years to cause disabilities. Last year the Government consulted on putting warning labels on valproate. Is it not time to go much further and ban the prescription of sodium valproate to epileptic pregnant mothers?
Mr Toby Perkins (Chesterfield) (Lab)
Mr Speaker
Order. Let us move on. What a waste of a question. Dehenna Davison.
Dehenna Davison (Bishop Auckland) (Con)
Thank you, Mr Speaker. I will try not to make this one a waste. I was grateful to the Minister for meeting me to discuss my ongoing campaign to restore the A&E to Bishop Auckland Hospital. Many of my constituents face a long drive to get to Darlington or Durham, and given that swift treatment can be a significant factor in outcomes for conditions such as strokes and heart attacks, does he agree that having A&E services spread geographically rather than just in strong population centres is an essential part of keeping our community safe?
Ockenden Report
Lindsay Hoyle Excerpts(2 years, 1 month ago)
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The Secretary of State for Health and Social Care (Sajid Javid)
With permission, Mr Speaker, I would like to make a statement on the Ockenden report. The independent review was set up in 2017 in response to concerns from bereaved families about maternity care at Shrewsbury and Telford Hospital NHS Trust. Its original scope was to cover the cases of 23 families, but since it began, sadly, many more families have reported concerns. Due to this tragically high number of cases and the importance of this work to patient safety, early conclusions were published in an initial report in December 2020. We accepted all the recommendations of the first report, and the NHS is now taking them forward.
Today, the second and final report has been published. This is the one of the largest inquiries relating to a single service in the history of the NHS. It looks at the experiences of almost 1,500 families from 2000 to 2019. I would like to update the House on the findings of the report, and will then turn to the actions that we are taking as a result of it.
The report paints a tragic and harrowing picture of repeated failures in care over two decades, which led to unimaginable trauma for so many people. For these families, their experience of maternity care, rather than being of moments of joy and happiness, was one of tragedy and distress. The effects of these failures were felt across families, communities and generations. The cases in the report are stark and deeply upsetting. In 12 cases where a mother died, the report concludes that in three quarters of them, the care could have been “significantly improved”. It also examined 44 cases of HIE—hypoxic ischaemic encephalopathy—a brain injury caused by oxygen deprivation. Two thirds of the cases featured “significant and major concerns” about the care provided to the mother. The reports also states that of almost 500 cases of stillbirth, one in four was found to give rise to major concerns about maternity care that, if managed appropriately, “might or would” have resulted in a different outcome.
When I met Donna Ockenden last week, she told me about basic oversights at every level of patient care, including in one case where important clinical information was kept on Post-it notes, which were swept into the bin by cleaners, with tragic consequences for a newborn baby and her family. In addition, there were repeated cases where the trust failed to undertake serious incident investigations; and where investigations did take place, they did not follow the standards that would have been expected.
Those persistent failings continued until as late as 2019, and multiple opportunities to address them were ignored, including by the trust board accountable for these services. Reviews from external bodies failed to identify the substandard care that was taking place, and some of the findings gave false reassurances about maternity services at the trust. The Care Quality Commission rated maternity services inadequate for safety only in 2018, which is unacceptable given the huge deficiencies in care that are outlined in the report.
The report also highlights serious issues with the culture in the trust. For instance, two thirds of staff who were surveyed reported that they had witnessed cases of bullying, and some staff members withdrew their co-operation on the report within weeks of publication. The first report has already concluded that
“there was a culture within the Trust to keep Caesarean rates low because this was perceived as the essence of good maternity care”.
Today’s report adds:
“many women thought any deviation from normality meant a Caesarean section was needed and this was then denied to them by the Trust”.
It is right that both the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives have said recently that they regret their campaign for so-called normal births. It is vital, across maternity services, that we focus on safe and personalised care, in which the voice of the mother is heard throughout.
The report shows a systemic failure to listen to the families affected, many of whom had been doggedly and persistently raising issues over several years. One mother said that she felt like a
“lone voice in the wind”.
Bereaved families told the report that they were treated in a way that lacked sensitivity and empathy. Appallingly, in some cases, the trust blamed the mothers for the trauma that they had been through. In the words of Donna Ockenden, the trust
“failed to investigate, failed to learn and failed to improve”.
We entrust the NHS with our care, often when we are at our most vulnerable. In return, we expect the highest standards. I have seen in my family the brilliant care that NHS maternity services can offer, but when those standards are not met, we must act firmly, and the failures of care and compassion set out in the report have absolutely no place in the NHS.
To all the families who have suffered so greatly: I am sorry. The report clearly shows that you were failed by a service that was there to help you and your loved ones to bring life into this world. We will make the changes that the report says are needed, at both a local and national level.
I know that hon. Members and the families who have suffered would want reassurances that the individuals who are responsible for these serious and repeated failures will be held to account. I am sure that the House will understand that it is not appropriate for me to name individuals at this stage. However, I reassure hon. Members that a number of people who were working at the trust at the time of the incidents have been suspended or struck off from their professional register, and members of senior management have been removed from their posts. There is also an active police investigation, Operation Lincoln, which is looking at around 600 cases. Given that this is a live investigation, I am sure that hon. Members will recognise that I am not able to comment further on that.
Today’s report recognises that since the initial report was published in 2020, we have taken important steps to improve maternity care. That includes providing £95 million for maternity services across England to boost the maternity workforce and to fund programmes for training, development and leadership. The second report makes a series of further recommendations. It contains 66 for the local trust, 15 for the wider NHS and three for me as Secretary of State. The local trust, NHS England and the Department of Health and Social Care will accept all 84 recommendations.
Earlier today, I spoke to the chief executive of the trust, who was not in post during the period examined in the report. I made it clear how seriously I take this report and the failures that were uncovered, and I reinforced the message that the recommendations must be acted on promptly, but as the report identifies, there are also wider lessons that must be learned, and it sets out a series of actions that should be considered by all trusts that provide maternity services. I have asked NHS England to write to all of those trusts, instructing them to assess themselves against these actions, and NHS England will set out a renewed delivery plan that reflects those recommendations.
I am also taking forward the specific recommendations that Donna Ockenden has asked me to. The first is on the need to further expand the maternity workforce. Just a few days ago, the NHS announced a £127 million funding boost for maternity services across England. That will bolster the maternity workforce even further, and fund programmes to strengthen leadership, retention and capital for neonatal maternity care.
Secondly, we will take forward the recommendation to create a working group, independent of the maternity transformation programme, with joint leadership from the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists.
Finally, Donna Ockenden said that she endorses the proposals that I announced in January to create a special health authority to continue the maternity investigation programme that is run by the Healthcare Safety Investigation Branch. Again, we will take her proposals forward, and the SHA will start its work from April next year.
I thank Donna Ockenden and her whole team for the forensic and compassionate approach that she has taken throughout this distressing inquiry. The report has given a voice at last to those families who were ignored and so grievously wronged, and it provides a valuable blueprint for safe maternity care in this country for years to come.
Finally, I pay tribute to the families whose tireless advocacy was instrumental to the review being set up in the first place. I cannot imagine how difficult it must have been for them to come forward and tell their stories, and the report is a testament to the courage and fortitude that they have shown in the most harrowing of circumstances.
This report is a devastating account of bedrooms that are empty, families that are bereft and loved ones taken before their time. We will act swiftly, so that no families have to go through the same pain in the future. I commend this statement to the House.
Mr Speaker
The Secretary of State is quite right that this is a very important statement, so I will offer the shadow Minister, Feryal Clark, six minutes.
Sajid Javid
I thank the hon. Lady for her remarks. It is not often that we get to say this in this Chamber, but I agree wholeheartedly with what she has just shared with the House. She is absolutely right to talk about this as a fight for justice and to say that if these brave families had not been so persistent in coming forward with what was done to them and what went wrong, the inquiry might never have happened. She is also right to talk about institutional failure at the trust, which the first report set out in some detail and which we are seeing in much more detail today.
The hon. Lady talked, rightly, about patient safety. She will know that the Government have already set out plans to appoint a patient safety commissioner; that appointment will be made soon, but we need to do much, much more. That is why it was right to accept all the interim report’s recommendations, including seven immediate and essential actions and 27 local actions. I can tell the House that the trust has implemented all the actions set out in the interim report; that was backed at the time by £95 million in extra funding. As I said a moment ago, the final report quite rightly makes many more recommendations, which have all been accepted and which are backed by funding of at least £127 million, much of which will go to workforce.
The hon. Lady is right about the need to increase the size of the workforce, especially with respect to midwives. Last year’s acceptance figures for student nurses and midwives were, I think, the highest that the country had seen in decades, but clearly there is much more to do.
Jeremy Hunt (South West Surrey) (Con)
Today’s report goes beyond my darkest fears. When I commissioned it as Health Secretary in 2016, I was approached by 23 families; we have heard today that more than 200 babies might have been alive today if better care had been provided. I thank Donna Ockenden and her team for an incredibly thorough investigation. I also thank the Health Secretary for his compassionate and comprehensive response to the House today.
Donna Ockenden does not use the word “recommendation”; she talks about immediate and essential actions. What is the Secretary of State’s deadline for the implementation of those actions? That is something that every expectant mother in the country desperately wants to know.
May I gently say to the Secretary of State that while I warmly welcome more midwives and more doctors, that approach is not consistent with voting down today the Lords amendment to the Health and Care Bill that would make sure that we never have those shortages again?
Finally, I pay tribute to Richard Stanton and Rhiannon Davies and to Kayleigh and Colin Griffiths. Richard and Rhiannon came to talk to me about their daughter Kate, who died in 2009; Colin and Kayleigh’s daughter Pippa died in 2016, when I was Health Secretary. Because of the blame culture and the culture of fear in the NHS, it was left to them and many other families to fight for justice. Can this be the last time that we put that burden on the shoulders of bereaved families? Can we build a culture in the NHS that is open and transparent and that accepts that things go wrong, but is hungry to learn from mistakes so that we never again repeat the tragedies?
Oral Answers to Questions
Lindsay Hoyle Excerpts(2 years, 2 months ago)
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Sajid Javid
I can tell my hon. Friend that we have and that that assessment continues. Sadly, as he will know, we have seen a significant increase in mental health referrals, especially for young people, over the past two years. The extra support that we have provided through the action plan and the £500 million of funding is helping, but I am afraid that there will be some long-term challenges created by the pandemic. We are very much looking at what more we can do.
Dr Rosena Allin-Khan (Tooting) (Lab)
I echo the words of solidarity with Ukraine that many colleagues have shared in recent days.
There are stark inequalities in children’s mental health services, from the postcode lottery of whether a child is ever seen after a referral to the luck-of-the-draw results of eating disorder treatment. Children from black and mixed-race backgrounds make up 11% of the population, but account for a staggering 36% of those detained in the highest-level mental health units. However, just 5% of those who access routine children’s mental health services are black. That is unacceptable—something clearly is not working.
Labour will put a mental health support hub in every community and a specialist mental health staff member in every school. What are the Government going to do?
Sajid Javid
As my right hon. Friend will know, when I presented the NHS’s elective recovery plan for the covid-19 backlog in the House a couple of weeks ago, I made it clear that we expect waiting lists to rise before they fall. That is because some 10 million people stayed away during the pandemic, and we want as many as possible of those who want and are able to come forward to do so. At the same time, the NHS will be massively increasing its activity, in new ways and with new funding. It is essential for there to be much greater integration between the NHS and social care, and we set our plans in detail in the White Paper published last week.
Karin Smyth (Bristol South) (Lab)
The Government seem to think that there is some kind of magic staffing tree, but there is no increase in capacity, no elective recovery and no fixing of social care without an immediate and ambitious workforce plan. We have legislation in this place, and we have seen a tsunami of White Papers, but none of that includes a credible workforce plan. Given the estimated 93,000 NHS vacancies and more than 110,000 vacancies in social care, when will we have that plan?
Government Contracts: Randox Laboratories
Lindsay Hoyle Excerpts(2 years, 2 months ago)
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Maggie Throup
I respect the hon. Gentleman and I look forward to the outcome of the work of his Committee. The code of conduct for MPs rightly remains a matter for Parliament. Today, we are talking about the Humble Address that my Department responded to, quite rightly. There are lessons that can be learned. We are now looking at making sure we have mechanisms in place for the future. Standards are in place in the House and it is quite right that hon. Members meet those standards. I look forward to the outcome of your Committee’s work to make sure we have a rounded approach and that the situation with Mr Paterson does not happen again.
Dan Carden (Liverpool, Walton) (Lab)
It really is quite remarkable: what the Minister has outlined in her response is what should have happened during the course of the pandemic and what has been proven not to have happened. Instead, the situation has been epitomised by Tory donors receiving billions of pounds in contracts, Ministers losing mobile phones when their Department and the law have tried to find out what has gone on, and decent companies with great experience in this field—I am thinking of Arco up in the north-east—being left with next to nothing. How can the Minister stand there and defend the indefensible?
Points of Order
Lindsay Hoyle Excerpts(2 years, 2 months ago)
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Anneliese Dodds (Oxford East) (Lab/Co-op)
On a point of order, Mr Speaker. On 17 November 2021, the House approved a humble address motion compelling the Government to publish the minutes from or any notes of the meeting of 9 April 2020 between Lord Bethell, Owen Paterson and Randox representatives. Last week, my right hon. Friend the Member for Ashton-under-Lyne (Angela Rayner) received an answer to a written parliamentary question that explained that the Department of Health and Social Care had previously released the minutes of the meeting, referring to an attached document containing some heavily redacted notes. But when that very same document was made public in response to a freedom of information request in January 2021, it was with the explicit caveat that they were “draft notes” and that official minutes were not taken and sent to attendees. The Government appear to being arguing with themselves, and not for the first time. Can you offer some assistance to explain whether it is in order for the Health Secretary to describe documents as “minutes” that his own Department has previously denied are minutes? If not, will he be afforded an opportunity to correct the record, explain what status those draft notes have and inform the House once and for all what happened to the formal minutes taken at that crucial meeting?
The Secretary of State for Health and Social Care (Sajid Javid)
indicated dissent.
Mr Speaker
Then I will try to do the best I can. I thank the hon. Member for giving me notice that she would raise the point of order. The Chair is not responsible for the content of Ministers’ answers to parliamentary questions or for Departments’ responses to freedom of information requests. If the hon. Member believes that there is an inconsistency between the two in this case, there are always ways in which she can press the Department for further information to clarify the matter. Can I suggest that she takes it up with the Table Office for further advice? I hope that those on the Treasury Bench are well aware that this issue has been raised and are able to inform ministerial colleagues. I think we do need the answers: I do not want to keep dealing with the same points of order.
Stephen Morgan (Portsmouth South) (Lab)
On a point of order, Mr Speaker. Have you been given notice that the relevant Minister will make a statement to the House on this year’s GCSE and A-level examinations? As you will know, advance materials were published yesterday, following weeks of uncertainty, the Government’s lacklustre education recovery efforts and concerning reports of A-level grade inflation in private schools. Given the impact on millions of pupils, school staff and parents across England, it is important that the House has an opportunity to scrutinise those developments properly.
Mr Speaker
Let me first state clearly that I have received no notice from Ministers that they intend to make a statement on this matter. Ministers on the Front Bench will, however, have heard the hon. Member’s point of order and, I hope, have noted his request.
Yvette Cooper (Normanton, Pontefract and Castleford) (Lab)
On a point of order, Mr Speaker. I rise to ask again whether you have had any response from the Prime Minister after the UK Statistics Authority said that the statements that the Home Office, and subsequently the Prime Minister, made on crime were misleading. “Misleading” is not my word—it is the word of the independent chair of the UK Statistics Authority. The Prime Minister told the House
“we have been cutting crime by 14%”—[Official Report, 31 January 2021; Vol. 708, c. 24.]
The Office for National Statistics found instead
“a 14% increase in total crime, driven by a 47% increase in fraud and computer misuse”.
I raised yesterday “Erskine May”, resolutions of the House and the ministerial code, which all record the importance of the Prime Minister correcting the record at the earliest opportunity. This is five days on from the Statistics Authority’s comments. Do you have any guidance on what counts as “earliest opportunity”, as this does not feel like that?
The ministerial code also expects Ministers to abide by the Statistics Authority code of practice which says that people must be “truthful, impartial and independent” in their use of statistics. Given that the Statistics Authority, whose job it is to be independent, impartial and truthful, has said that the Government are being misleading, surely it is now a matter of basic respect for the House and the standards that we all signed up to about not misleading Parliament that the Prime Minister should give us a response.
Mr Speaker
First, I am grateful to the right hon. Lady for giving notice of her point of order. I can confirm that I have not had any notification of a statement, or any other response, on this issue.
I am not able to add to the responses to the three previous points of order on this matter. The right hon. Lady has put the point on the record, and I am sure she will find alternative ways to pursue this issue. I recognise it is important that this is heard, and I am sure that the Table Office, or possibly other available avenues, will now be used.
Oral Answers to Questions
Lindsay Hoyle Excerpts(2 years, 3 months ago)
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Sajid Javid
My hon. Friend is right to raise this issue. It is of increasing concern, especially as we have seen hospitalisations rise because of the omicron wave. I believe that the national taskforce is already looking at Northamptonshire. If it is not, I will certainly make sure it does.
Karin Smyth (Bristol South) (Lab)
Around 10,000 medically fit people are currently in hospital when they should be at home with their families or in a supported setting. That is a tragedy for them and a mark of shame on this Government. Short-term cash, taskforces or threatening legal action are not solutions. Social care support is a lifeline not a luxury, so will the Government now work with us cross-party in line with the joint Select Committee report of 2018 to bring forward immediate change and offer hope and respite to those receiving and giving social care?
Dr Murrison
I thank the Minister for that reply. The facts are that the vaccination programme has been massively successful in reducing hospitalisation, particularly admission to intensive therapy units. So will the Minister confirm that, on 26 January, particularly given what we now know about the nature of the covid variant that we are currently struggling with, those regulations will lapse? Will she further confirm that she will amend advice on working from home? Most importantly, will she ensure that we reverse the counterproductive compulsory vaccination of NHS staff that the Government’s own figures suggest—
Maggie Throup
Although evidence shows that the omicron variant causes less severe disease than previous variants, yesterday in England we still had over 16,000 covid patients in hospital and over 84,000 reported cases. Plan B measures are currently in place in England, and will be reviewed before the regulations expire on 26 January. The best thing everyone can do to help to keep the virus under control is to keep coming forward for booster jabs to help to stop the spread of infection and manage the immediate pressures on the NHS.
The Minister for Care and Mental Health (Gillian Keegan)
The hon. Member makes a very good point. It is important that people get the right to visit their loved ones in care homes. That is why we have introduced guidance that says that essential care givers should get access to care homes at all points, even during outbreaks. There is a process, which the Care Quality Commission manages, for reporting those that do not comply, but if there are specific examples, I am very happy for him to write to me with details and I will follow it up.
Jeremy Hunt (South West Surrey) (Con)
This morning, the Health Secretary is reported in The Times as saying that the NHS can learn from the way in which academy chains are regulated, but he will know that the education system has no national targets, while the NHS uses more national targets than any healthcare system anywhere in the world. Will he look at the role of targets and the risk that they focus managers on bureaucratic numbers, sometimes at the expense of quality of care for patients?