(11 years ago)
Commons ChamberI will not give way, because Mr Deputy Speaker wants us to make progress.
Order. Everyone wants to get in, but we are running out of time. I need to remind the House that the opening speech was to be 15 minutes, but we are well over that already.
Now that we have the evidence, I ask the Government to listen to the debate. We will hear a response from the Minister, and I trust that by the end of this debate, the view of the House will be overwhelming and the Government will seek to introduce regulation on standardised packaging as fast as possible. We will not seek to divide the House today—this is a general debate—but if the Government do not come forward with regulations before Christmas, we will seek another debate on a motion that allows the House to divide and express its clear will.
Order. I shall now reduce the speaking time limit to eight minutes—[Interruption.] If the hon. Member for Stockton North (Alex Cunningham) wants me to reduce it further, I shall be more than happy to do so, but I am sure that he would rather speak for eight minutes than five. The danger is that speeches will run on, and many Members wish to speak in the second debate.
(11 years, 4 months ago)
Commons ChamberI advise the House that Mr Speaker has selected the amendment in the name of the Prime Minister.
I will give way to the hon. Gentleman, but I hope that his intervention will not be about Wales. [Interruption.]
Mr Deputy Speaker, I can assure you that my intervention will be about Wales, because it is about my constituents who are suffering. Will the right hon. Gentleman pay tribute to the transparency that the right hon. Member for Cynon Valley (Ann Clwyd) is seeking to enforce by exposing the different data that apply to Wales and England? Does he share my dismay that only 83% of patients who are admitted to A and E are admitted, treated and discharged in hospitals in Wales, compared with the 91% who are admitted, treated and discharged in hospitals in England? Why do my constituents have to wait 89 days, compared with the 51-day waiting time in England—
Order. Mr Cairns, do not take advantage of the situation; it is not fair to other Members who also want to intervene. We want this debate to be heard in the best possible way.
This is debate is about the NHS in England, and if the hon. Gentleman has concerns about the NHS in Wales, why does he not have a word with his right hon. Friend the Chancellor of the Exchequer and get a better deal for the Welsh Assembly so that a bit more money could be put back into the Welsh national health service?
As I was saying, the Government have put staff morale at rock bottom, and where are the promised benefits of this reorganisation? Clinical commissioning groups are not, as we were promised, the powerhouse of the new NHS; they are embryonic at best and anonymous at worst. Members of all parties, I am sure, write letters to CCGs that get passed to NHS England, which then either does not provide a proper answer or passes them on again. [Interruption.] I hear the public health Minister saying it is dreadful that Members do not get proper answers. When my hon. Friend the Member for Easington (Grahame M. Morris) wrote to her about cancer services in his constituency, she also brushed it off to NHS England. Is this proper accountability? No.
Order. If the right hon. Member wants to give way, he will give way. We do not need people standing up, shouting and bawling. I want to hear what the shadow Secretary of State has to say, just as I want to hear what the Secretary of State has to say. Let us have a little more courtesy from everyone.
Thank you, Mr Deputy Speaker.
Alarming patients, demoralising staff and casually trading figures about deaths in the pursuit of political advantage is no way to run the NHS, and those are not the actions of a responsible Government. Today people are asking what kind of Government this is, if they are willing to cause further damage to fragile hospitals for their own self-serving political ends. Yesterday the Secretary of State told the BBC that he had no idea who had put the 13,000 figure in the public domain. Does he seriously expect us to believe that?
(11 years, 4 months ago)
Commons ChamberMy hon. Friend is right: in a rural location the distances become further. I do not know the particular situation in his region, but I would suggest that there are probably location issues with regard to existing hospitals.
Moving neatly on, that is why—yes, you heard it here first: a Conservative calling for a Soviet-style central plan—I have called for a national plan for acute and emergency care. By definition, we cannot have a market interfering in that; we need to look at it in the round and say, “Where would we put these hospitals? Where are the motorways? What is the population density? Where is the rural location? Where is the urban location?” The problem is that if we reconfigure in isolation—I have seen this locally—it has a knock-on effect on other hospital services which then say, “Where are we getting our patients from?”
We should have a national plan that everyone from both parties has bought into. We should have—dare I say it?—a cross-party party committee looking into this. We should take it out of the political exchanges that we all engage in. We know what is going to happen in certain quarters in 2015—it will become a political football. I know that my hon. Friend the Minister is very aware of this. That is dreadful when we are talking about saving lives. Let us try to take this out of party politics. We can have robust exchanges, on principle, about payment, about how services are commissioned or not commissioned, and about whether there should be top-down reorganisation, but the fundamental question of where hospitals—acute and community hospitals—are located should be decided nationally; otherwise we could have perverse decisions whereby some services wither on the vine and we end up with gaps in emergency and acute care across the country. I make a plea for some cross-party activity on this.
Let us put the national health service’s budget into context. This country has debts and liabilities in excess of five times the size of our economy, and the situation is getting worse. Almost 40% of spending is on health and welfare, and it is growing. We know that that will happen; we have heard it this afternoon. Let us be realistic: there is only so much we can afford. I genuinely want a service that is based on clinical need. I genuinely want somebody to arrive at the appropriate location and get the very best care available. I fear that if we continue along this path of denial as regards how the service is paid for and, more important, structured, we will end up with more and more scandals. There are more in the pipeline. The chief executive of Tameside hospital has just resigned.
The public out there want more from us. They want us to make some difficult decisions, for sure, but using evidence, not party politics. I make that plea to everybody. If we can do that, we can structure a service that becomes the envy of the world; it is not that at the moment. However long I end up staying in this House, if that is achieved in the time I have been here, I will retire a happy man.
Before I call the Front Benchers, may I remind Members that if they are going to bring mobile phones into the Chamber they must be on silent and that they should not wait for them to ring? This is not the first time I have said that, but I certainly want it to be the last. Has the hon. Member for Strangford (Jim Shannon) taken that on board? Excellent.
Did you want to come back, Mr Dorrell? We are up against time with the next debate.
I am not pressing; I was led to believe that it is the convention to respond. I believe I have two minutes.
(11 years, 5 months ago)
Commons ChamberI am not sure whether the hon. Gentleman was present when I said that we need to be much smarter about how we use the money available. One of the things we need to do—I think there is a degree of agreement here—is integrate health and care. It is a crazy silo situation that we face. We are not using the money effectively. We could achieve much better support if we combined the disparate parts of the system to provide support shaped around the needs of the individual and their family.
The last spending round provided local government with a challenging settlement. That is why we decided to provide extra funding to help local authorities maintain access to services. However, local authorities ultimately have discretion over how they use their resources. Improving care and support is not simply a case of more money. Local authorities must look at how they can transform care through innovation and new ways of working. As I said earlier, collaboration with the voluntary sector is critical to this. Many local authorities are successfully integrating health and care services to improve quality, and we are developing the concept of “pioneers” to act as exemplars to support the rapid dissemination and uptake of lessons learned across the country.
Some hon. Members talked about the role of doctors and other health care workers. I agree that much more needs to be done. We can look at incentives such as the GP survey mentioned in the exchange that I had with the shadow Minister, the hon. Member for Leicester West, and we have provided funding for the Royal College of General Practitioners and others to encourage GPs to think about the role of carers, but what we see from examples around the country, such as Changing Lives in Cornwall, is that once GPs start to collaborate and work as a partnership—as a team—with carers and the family, they begin to see that their burden is relieved because others can help them in the role that they have to perform. That is the essential change that it is so important to achieve.
My right hon. Friend the Member for Sutton and Cheam referred to the £400 million funding over four years for carers’ breaks. It is deeply frustrating that that has not been used as intended in all parts of the country. There are some areas, including Surrey and many others, which have done good, innovative things as a result of that. The Department asked the policy research unit in economic evaluation in health and care intervention to conduct a survey of a number of PCTs to gain their views on the benefits of NHS support for carers’ breaks. The findings will be published shortly and will help inform our understanding of what has happened. The early indications are that there may be more good things happening than we sometimes recognise, but clearly there have been significant gaps and much more needs to be done.
I appreciate that time is almost up. I entirely agree with my right hon. Friend and many others about the importance of work. I make the point again that providing help and assistance to enable people to remain in work is in employers own self-interest, as they maintain the skills in the work force while enabling that person to continue their caring responsibilities.
This has been a good debate. There has been some informed discussion and I am very grateful to hon. Members for their contributions.
(11 years, 5 months ago)
Commons Chamber I congratulate my hon. Friend the Member for Truro and Falmouth (Sarah Newton) on securing this debate and on her ongoing tremendous advocacy on behalf of her constituents. She talked eloquently of her own knowledge of the school—“care farm” is the expression I would use in my constituency—and the relationship between the school and the old hospital. She highlighted the importance when looking for value in NHS land of doing as much as possible to maximise the land receipt and put that money back into the NHS, but of course NHS land is community land, and it is important that, wherever possible, we work with surrounding communities to support them in local activities that benefit the population.
My hon. Friend also outlined eloquently the challenges faced by more rural parts of the country, and Cornwall in particular. We know that community resources and facilities are much scarcer in rural areas, as she highlighted in her speech. When we look at the affordability of local homes and the provision of community facilities, rurality is an important consideration and one that we always bear in mind in the NHS.
I appreciate my hon. Friend’s interest in the Budock hospital site and support her concern that best use be made of public sector land not only in releasing its monetary value, but regarding the availability of affordable homes for local people to live in. I understand that NHS Property Services has intervened to begin the process of facilitating a mutually beneficial resolution of the issues previously hindering the sale of this land to the local school. Those issues predate the transfer of ownership to NHS Property Services, and were between the former Cornwall and Isles of Scilly primary care trust and Falmouth school. Thanks to swift action since NHS Property Services took over control of the NHS estate, the issues are well on their way to being unlocked. NHS Property Services inherited a portfolio of 4,000 other properties from 161 disparate previous NHS organisations on 1 April, and a win-win resolution is now in sight.
I am sure we will have other debates on similar matters, so it is worth outlining to the House the role of NHS Property Services and some early successes that have occurred. On 1 April, NHS Property Services inherited about 4,000 NHS assets, including health centres, office accommodation, care homes and hospital buildings. It houses about 12,000 tenants and is valued at more than £3 billion. It also inherited more than 3,000 members of staff from former PCTs and strategic health authorities throughout England. This brand new organisation is already doing tremendous work in the face of this huge challenge to create efficient, fit-for-purpose facilities and services for the benefit of patients and the public. All too often in the past, there was an unacceptable variability in estates management—not just in this case, but throughout the NHS—by PCTs and SHAs. The advantage of having estate management under one central roof has already paid dividends throughout the NHS. The creation of NHS Property Services has generated an opportunity to explore options to bring together a fragmented system—
Order. May I just gently remind the Minister that this is a very tight debate? We are talking about one site; we should be dealing with Falmouth and nowhere else. There may be a good story to tell but we can save that for another day.
Indeed. Thank you, Mr Deputy Speaker, for bringing me back to the task in hand. There are many good stories to tell from other constituencies but you are quite right; we should focus on how successes in Ludlow and South Suffolk can be translated into success at the Budock hospital site.
The focus of NHS Property Services is about resolving some local planning concerns where PCTs have had difficulties in the past, which is what we are going to concentrate on. I understand that Falmouth school’s plans to purchase the Budock site pre-date the transfer of land to NHS Property Services on 1 April 2013. The school and the former Cornwall and Isles of Scilly primary care trust had previously agreed to enter into a land swap to release the school’s playing fields—which were difficult to access—for the hospital site. The NHS was then to dispose of the playing fields for housing land.
I understand that differences in the size and estimated value of the sites, and planning permission issues, had prevented both parties from reaching agreement to progress this proposal, which commenced some time ago in 2011.
The Government’s priority for easing the shortage of land for housing development is to see development take place in sustainable locations; the predominantly brownfield sites of some of the old NHS estate no longer used for clinical purposes can help bring forward land for affordable homes to be built for local families. The Budock site is brownfield land and is located in a settlement that is forecast to experience significant growth over the coming years, as my hon. Friend outlined.
The site was assessed under the Cornwall strategic housing land availability assessment and found to be suitable for approximately 100 dwellings. My hon. Friend will also be aware that Treasury guidelines on managing public money state that public sector organisations may transfer assets among themselves without placing the property on the open market, provided they do so at market prices. They also state that the organisations should work collaboratively on the transfer to agree a price, and that it is good practice to commission a single independent valuation to settle the price to be paid. My hon. Friend said that is the plan in this case.
I am pleased to report that NHS Property Services and the school have agreed that the original proposal can be revisited, with a planned joint instruction to the district valuer from both parties. NHS Property Services has agreed with Falmouth school that it will take the Budock hospital site off the market while reviewing the original land swap option. To enable both the school and NHS Property Services to deliver these proposals, support will be required from the local planning authority to ensure that a clear planning brief is available for both sites. I am sure my hon. Friend will be helpful in facilitating that accord. This will ensure that both organisations and the district valuer can understand and agree an estimated value for both sites.
This value can be demonstrated in land value and in wider community benefits such as housing, health and well-being, and education and leisure use. My hon. Friend eloquently outlined the many local sports and leisure groups that are hugely supportive of this project, and rightly so. The project will be for the sake of the local community and would be beneficial as well to the NHS through the profits from the land, which could be distributed elsewhere to support local NHS projects.
The potential outcome from this approach is a win-win situation for the local community, the school and the NHS. NHS Property Services will be able to maximise receipts from the sale of the current school playing fields for reinvestment in front-line NHS services. Falmouth school and the wider community will benefit from improved access to leisure facilities on the former hospital site, and much needed housing development in the Falmouth area will be brought one step closer. I understand that an initial report setting out the context and options for the proposed transaction can be delivered within six weeks. That will require the co-operation of the school, NHS Property Services and, importantly, the local planning authority. The report should set out a programme to include a target of three to six months for initial agreement, in the form of a contract to be reached for the transaction. This could take a number of forms, subject to the advice that both parties receive from the district valuer—contract for sale and option agreement.
This evening my hon. Friend has eloquently outlined the case for why the project should go ahead. I will of course be monitoring progress on the ground. The door is always open for her to come and see me if there are further problems or concerns. I am sure that her tremendous advocacy on behalf of her constituents will continue to unlock the potential of these proposals and make them a reality.
Question put and agreed to.
(11 years, 5 months ago)
Commons ChamberOn a point of order, Mr Deputy Speaker. I apologise to hon. Members for having to raise this point of order at the end of a passionate speech in an important debate. I seek your guidance, Mr Deputy Speaker. Today I had a telephone call from someone in the press asking me to comment on a parliamentary question I had asked and for which they had the answer. Unfortunately I was not party to that answer, as it had not been delivered to me. When I contacted the Table Office, it could not elucidate either. I was, however, able to obtain a scanned copy from the press. Would you agree, Mr Deputy Speaker, that this is not the way to conduct business and ensure that Members are appropriately briefed?
It certainly is not good form; in fact, it is very bad form. The Member should always know at least at the same time, but preferably before. The matter is now on record and I hope that those on the Front Bench will pass it on, so that we can get to the bottom of it.
(11 years, 5 months ago)
Commons ChamberThat is a laudable aim. I do not think it is going to solve the A and E crisis right here, right now, but I do not disagree with it as an aim.
Drawing on what was said at the summit, I have developed an A and E rescue plan with five practical proposals. [Interruption.] Government Members do not want to hear it. Okay, later on they can give me their plan. I am putting forward a plan and calling this debate. They are not calling this debate. Why are they not doing something to take a grip on the situation? It is no good just sitting back and saying, “Oh”—[Interruption.]
Order. I want to hear the right hon. Gentleman, as I am sure that people on both sides of the House do, and all the shouting is not going to allow any of us to do that.
It has been left to us to call this debate, and now Government Members sit there and groan. Well, it is not good enough. They are going to hear what I have to say because they need to do something about what is happening.
I am grateful to my right hon. Friend for giving way; he is being very generous with his time. He is absolutely right: areas such as Stoke-on-Trent have had their budgets slashed and destroyed year on year under this Government. In Stoke-on-Trent, which is the third hardest hit area, the local authority is expected to spread the money it does have even more thinly across a population that is not only deprived, but ageing. The sniping and comments from those of the Government Front Bench are totally inappropriate. Does my right hon. Friend know when the Government got the NHS to write to accident and emergency departments to ask for their plans?
Order. A lot of Members want to speak, so we need very short interventions.
That is part of my point. NHS England wrote to clinical commissioning groups on 9 May. What is going on here? They were all in the chaos of reorganisation until then—no one could have received a letter, because CCGs were not in place. In the crucial period between January and March, when the NHS was under intense pressure, primary care trusts were on the way out and CCGs were not in place. As a result, the NHS was in limbo; at the precise moment that it needed grip and leadership, it was drifting. That is absolutely shocking.
As I have said repeatedly, the Government must act to shore up social care in England, which is collapsing. Our solution is for the Secretary of State to use about half of last year’s underspend in the NHS, £1.2 billion, to provide emergency support to councils over the next two years to maintain integrated, home-based support. As he knows, the Budget revealed a £2.2 billion underspend in last year’s Department of Health budget. No use was made of the budget exchange scheme. In other words, he handed that money back to the Treasury. I call on him to reconsider his decision, reopen negotiations with the Treasury and act to prevent a social care emergency.
Order. [Interruption.] Mr Karl Turner, thank you for your advice, but we can manage without it today. I make this appeal to both sides: I want to hear what the Secretary of State has to say, just as I wanted to hear what the Opposition had to say.
Thank you, Mr Deputy Speaker.
I repeat: it was one of the poorest speeches ever given by an Opposition on the NHS, and I predict that the right hon. Member for Leigh (Andy Burnham) will bitterly regret choosing to make an issue of A and E pressures, because the root causes of the problem have Labour’s fingerprints all over them.
The right hon. Gentleman was right on one thing, however: there is complacency on this issue—not from the Government, who have been gripping it right from the start, but rather from Labour, which still does not understand why things went so badly wrong in the NHS on its watch.
Labour’s narrative has, I am afraid, a single political purpose at its heart: to undermine public confidence in one of our greatest institutions—an institution which, in challenging circumstances, is performing extremely well for the millions of vulnerable people who depend on it day in, day out.
Labour’s story today is a totally irresponsible misrepresentation of reality. One million more people are now going through A and Es every year than in 2010, which creates a lot of pressure, so how are A and E departments actually performing? The latest figures show performance, against the 95% target, of 96.7%. The week before it was 96.5%, then before that 96.3%, 96.6% and 95.6%. Yes, we had a difficult winter and a cold Easter, and I will come to the causes of the problems we had then, but, thanks to the hard work of NHS doctors and nurses, our A and E departments are performing extremely well.
Order. We want a little more calm. Mr David, you are getting far too excited. It is not good for you and it is not good for the Chamber—[Interruption.] Order. I do not want you to repeat your point. I have just explained to you that I need you to be a little calmer. It is up to the Secretary of State whether he wishes to give way and at the moment he is not doing so. It is his choice and shouting will not make any difference whatsoever.
On a point of order, Mr Deputy Speaker. The Secretary of State has just said at the Dispatch Box that the budget for the NHS has increased in real terms. In December, I referred the Secretary of State’s comments to the UK Statistics Authority and I received a letter back saying that they were incorrect. Will you ask the Secretary of State to correct the parliamentary record and ensure that when the statistics commissioner makes a ruling it is adhered to by the Secretary of State?
That is not a point of order, but the right hon. Gentleman has certainly made his clarification for the record.
I thought that the shadow Health Secretary might try to do that, so let me give him the figures. I have the figures provided by the Department of Health finance department, based on the latest GDP deflators, as published at the Budget. Spending in the NHS—not the budget—in 2009-10 was £99.7 billion and for 2012-13 it is forecast to be £106.6 billion. That is a cash increase of £6.9 billion and a real-terms increase of £0.6 billion, so there is a real-terms increase in the NHS budget. The shadow Secretary of State does not agree with the real-terms increase of £600 million in the NHS today; there would be a Labour cut in NHS spending and I suggest that he might want to correct the record, as I am afraid he has got this wrong.
Order. We have 19 speakers to get in, so we are introducing a four-minute limit.
(11 years, 6 months ago)
Commons ChamberCan I help the right hon. Gentleman? We said that he would have 15 minutes, but we are now on 20 minutes and other people are waiting to speak.
Order. It is for the Chair to decide what is in order and what the debate is about. I need no help from the Back Benches, although it was very kind of the hon. Lady to intervene.
I have clearly outstayed my welcome, so I will conclude. I realise that time is short.
The point that I want to make is that there is a significant mental health aspect to FGM, but that it is not well documented. Not many of our front-line professionals have it at the front of their minds when trying to explain other problems. I just want to put that on the record so that the Minister and the Department of Health can reflect on it and so that it starts to become a normal thing for mental health professionals to talk about and think about, particularly when they see people from communities that practise FGM and who might have suffered it.
Many of the young girls and women who talk about FGM speak of a silent scream for help. All I wanted to do today was to give that scream a voice in the House of Commons.
Yes, absolutely; I understand the importance of that. Incidentally, I visited children and adolescent services in Oxford and I was very impressed by the work under way there. I am getting a message that I am under some pressure from Mr Deputy Speaker to make some progress—
I may be able to help the Minister there. It is not a question of pressure from me; it is a question of the Backbench Business Committee suggesting that Front-Bench contributions should be up to 15 minutes. If he looked at the clock, he would recognise that he has spoken for more than 20 minutes. He should not suggest that the Chair is interfering; it is the Backbench Business Committee.
I am sorry for putting the blame in the wrong place; I take full responsibility; I have tried to be responsive to Members as I have proceeded.
We are working with NHS England to decide how best to measure progress in these areas. Because, as we all know, words are not enough, we have to be certain that the objectives we have set out on paper actually translate into better, more accessible care for those who need it.
Thirdly, I mention the three outcome frameworks: for the NHS, adult social care, and public health. These frameworks will enable us to hold the health and care system to account for achieving what matters most—good outcomes for the people who use services and for the population as a whole. In the NHS outcomes framework, there are four measures that relate specifically to mental health and many others that include mental health just as much as physical health. The other outcomes frameworks contain other measures designed to ensure that we improve well-being and tackle the wider determinants of mental health, and that we provide the best possible care and support to those people with mental health problems who need it.
Finally, I want to mention our continuing commitment to the IAPT programme. Since the programme began, it has treated more than 1 million people with depression and anxiety, and as a result nearly 75,000 people have moved from benefits into work. Nevertheless, we need to do more. We are currently involved in a joint programme with the Department for Work and Pensions, which involves commissioning work to find a way of providing much speedier access to psychological therapies for people with mental health problems who are out of work. It seems crazy that we are spending money on benefits when giving those people access to therapy might help them to recover and return to work.
(11 years, 6 months ago)
Commons ChamberWill you confirm, Mr Deputy Speaker, that I may speak until 9.40?
The hon. Gentleman has eight minutes, and if two interventions come along that will give him 10 minutes.
I am sure that my colleagues will intervene.
I thoroughly enjoyed the opening of Parliament. It always fills me with a sense of optimism to look forward to another Session and what we can do. As the DUP Health spokesman, that optimism was dulled when I noted, with some dismay, that the Government had not included standardised cigarette packs in the Queen’s Speech. It would have been great to see essential measures on that.
I am reminded of the dance, the hokey-cokey: they are in for packaging, they are out for packaging, they are in for packaging, they are out for packaging, and they swing it all about. I cannot do the hokey-cokey, but I know who can. The Government can do the hokey-cokey and nobody can do it better. Bruce Forsyth often says, “Didn’t they do well?” If he ever retires, there are two hon. Members who will be vying for his position.
I am encouraged that some hon. Members have had the courage of their convictions. The hon. Member for Salisbury (John Glen) has taken a clear stance on plain packaging, as have other Members. I appreciate that.
I have received many e-mails from constituents on this issue. One stated:
“Since tobacco advertising became illegal in the UK, the tobacco companies have been investing a fortune on packaging design to attract new consumers. Most of these new consumers are children with 80% of smokers starting by the age of 19.”
Other Members have made it clear that we must stop smoking being an attraction for young people. About 200,000 children as young as 11 years old are smoking already and the addiction kills one in two long-term users. A recent YouGov poll showed that 63% of the public back plain packaging and that only 16% are against it.
Last week, I asked the Prime Minister whether he would introduce plain packaging. He said:
“On the issue of plain packaging for cigarettes, the consultation is still under way”.—[Official Report, 8 May 2013; Vol. 563, c. 24.]
That is not exactly accurate because the standardised packaging consultation started on 16 April last year and ended nine months ago on 10 August 2012. I am keen to hear from the Government just what is happening.
(11 years, 8 months ago)
Commons ChamberOrder. Before the hon. Lady responds—[Interruption.] I am sorry, but does the Opposition Whip have something to say?
Thank goodness for that.
We need short and concise interventions, because many Members wish to speak and I do not want to have to reduce the time limit further, but that is what will happen if we are not careful.
I congratulate the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson) on seeking to defend his Government’s record. I will address his point fully later in my speech.
Don Berwick’s report was commissioned by Ministers, led by Lord Darzi and with the support of David Nicholson, to celebrate the 60th anniversary of the NHS. It states:
“The NHS has developed a widespread culture more of fear and compliance… It’s not uncommon for managers and clinicians to hit the target and miss the point”.
It highlighted the inadequacy of quality-control mechanisms in the NHS, stating that the priorities that are emphasised by these assessments are
“seen as being motivated by political rather than health concerns”.
It also highlighted the anger felt by many conscientious medics at Government changes to their employment and at being pressurised to put targets ahead of patients:
“The GP and consultant contracts are de-professionalising... Far too many managers and policy leaders in the NHS are incompetent, unethical, or worse.”
The report warns that
“this… must be alleviated if improvement is to move forward more rapidly over the next five to ten years.”
But those warnings were ignored, and we know that the improvements never happened. The report’s conclusion on a decade of health care reform is that
“the sort of aim implied by Lord Darzi’s vision…is not likely to be realised by the 1998-2008 methods.”
Don Berwick’s report was not alone; let me reveal what the other two reports said. They referred to
“the pervasive culture of fear in the NHS and certain elements of the Department for Health”
and stated:
“The Department of Health’s current quality oversight mechanisms have certain significant flaws”.
Perhaps the most damning indictment of all is that the politicians are responsible:
“This culture appears to be embedded in and expanded upon by the new regulatory legislation now in the House of Commons.”
Instead of being acted on with urgency, this was all buried. We know of the existence of Don Berwick’s report and the other reports only because a medic was so concerned that Berwick’s warnings and solutions had been buried that he tipped off a think-tank, Policy Exchange, which had to use a freedom of information request to bring them to public light in 2010, two years later. They were not even available to the Health Committee.
Let us get one thing clear. The NHS is a huge, monolithic organisation with an exceptionally difficult and, some might say, almost impossible task. In reality, things will go wrong, sometimes very wrong. The crime is not so much that things were going wrong, bad as that is, but that instead of immediately focusing on tackling it, the priority was to cover up an awful truth that was uncomfortable for Ministers and chief executives. All too often, Dispatch Box appearance mattered more than the reality of patients’ lives, leaving whistleblowers and patient groups such as Julie Bailey’s, which was disgracefully dismissed by David Nicholson as a “lobby group”, screaming into a vacuum, often at great personal cost. The crime is the smothering of the truth which costs lives—the deadly silence.
What was the cost of suppressing Don Berwick’s urgent prescription for the NHS? The clinical director of NHS Scotland recently suggested that in following Don Berwick’s recommendations it has experienced an estimated 8,500 fewer deaths since January 2008. We may well ask what was the cost in lives for our NHS of the previous Government’s decision to bury the truth. Across the 14 trusts now being investigated as well as Mid Staffs, there were 2,800 excess deaths between the time that the reports by Don Berwick and others were presented to Ministers and their final revelation in 2010. If the previous Government had been urgently implementing Don Berwick’s recommendations for those five years, who knows how many of those lives might have been saved?
How was this allowed to happen? I have put in freedom of information requests asking what meetings took place to discuss the reports and who was present. Although David Nicholson was working closely with Lord Darzi on the next stage review, he said in front of the Health Committee that, incredibly, he
“knew nothing about the reports”.
That is the Select Committee, so we must take him at his word. The question that then remains is who did read and suppress these vital reports. Was it Ministers? Was it officials? If officials, how was this allowed to happen? If the Department of Health is to move away from a culture of cover-up, I expect a full and accurate response to my request to know who was responsible, and I ask the Secretary of State to assist me in that.
Former Labour Ministers will complacently say, as they already have, that these reports fed into Lord Darzi’s next stage review and informed the report, “High Quality Care For All”. I ask the House whether a document that starts with the then Secretary of State, the right hon. Member for Kingston upon Hull West and Hessle, beamingly saying
“On its 60th anniversary the NHS is in good health”
reflects the content of the reports that we have just heard about. It certainly does not. Indeed, while the Department of Health claims that it “drew heavily” on the three reports in putting together “High Quality Care For All”, a source close to the authorship of those reports said that they found that claim to be “disingenuous at best”. David Flory, the deputy chief executive of the NHS, later told the Francis inquiry that he at least had some responsibility for what happened to the reports, as he had read them, but insisted that they were “caricatures”. That would help to explain why they were not acted on, but it makes the Department of Health’s insistence that it “drew heavily on them” rather odd.
Further indication that the documents were not acted on is the fact that they raise issues almost identical to those highlighted five years later in the Francis report. If Don Berwick’s warnings had been acted on five years ago, there would be no need to ask him to come back now to step in to sort things out and implement his recommendations.
Order. I remind Members that there is a seven-minute limit.