Finance (No. 2) Bill
Debate between Lindsay Hoyle and Grahame Morris(9 years, 8 months ago)
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Grahame M. Morris (Easington) (Lab)
Further to that point of order, Mr Deputy Speaker. I do think it is an absolute outrage that the hon. Member for Bristol North West (Charlotte Leslie) did not give us notice that she was raising the matter. She is subject to a referral. Other Select Committees have chosen not to publish reports.
Mr Deputy Speaker
I am sure that you are aware that Mr Speaker has sent a letter to the Chair of the Select Committee. I can also inform you that it is not a matter for the Chair; it is a matter for the Committee. In the new Parliament, there will also be a new Committee that can look into it. Unfortunately, as I say, it is not a matter for the Chair.
NHS (Government Spending)
Debate between Lindsay Hoyle and Grahame Morris(9 years, 10 months ago)
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Grahame M. Morris
I would rather weaponise it than privatise it, which is what I accuse the Government of doing. That would not have been possible without the active support of the Liberal Democrat party—talking of which, the hon. Member for Redcar (Ian Swales) has just taken his place in the Chamber. I feel bitter about what has happened. The hon. Gentleman and I both served on the Health and Social Care Bill, which has now been enacted. The lead advocates were the right hon. Members for Chelmsford (Mr Burns) and for Sutton and Cheam (Paul Burstow). That Act was a really dangerous move, because part 3 opened up our national health service to the full force of competition. Conservatives may say that the difference is only marginal, but the truth is that that Act allows hospital trusts to have up to 49% of their income come from private patients.
I know that we are desperately short of time, but I want to set out some political dividing lines. Labour and the Conservatives are making very different offerings for the NHS. Labour’s offering is that it will provide more nurses and GPs, and I think it will find favour. In the next general election—
Francis Report
Debate between Lindsay Hoyle and Grahame Morris(10 years, 8 months ago)
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Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. The hon. Member for Beckenham has only just come in. He perhaps ought to hear a little bit more of the debate to get the flavour of it before he intervenes. That would help his good self.
Grahame M. Morris
We should remember that most hospitals provide very high standards of care, and have dedicated and compassionate staff. I am not just talking about doctors and nurses, but ancillary workers, cleaners and support staff. I worked in a pathology department as a medical scientific officer for a number of years. We should remember that the NHS is an integrated service that relies on all of its elements to perform at a high level and deliver a high-quality service.
Clearly, what happened in Mid Staffs was alarming. There were unacceptable practices, including, as other Members have said, professional failings. The hon. Member for Stafford (Jeremy Lefroy), in a terrific speech that was considered, thoughtful and non-partisan, alluded to those professional failings. My right hon. Friend the Member for Rother Valley (Kevin Barron), a former Chair of the Health Committee, made the point strongly that many Labour Members feel there should be a duty of candour on individuals. That is one of the recommendations of the Francis report that was rejected by the Government but could well make a difference. There were clear signs that changes needed to be made and we need to ensure that failures are never repeated elsewhere.
When care failures are uncovered, the priority above all else is to make a candid assessment of what went wrong and what needs to be done to fix it. Francis was clear on the need for cultural change. That is exactly what happened in the wake of the Mid Staffs scandal. Despite attempts by some Government Members to undermine Labour’s commitment to the NHS, for the record we should be aware that it was the then Secretary of State, my right hon. Friend the Member for Leigh (Andy Burnham), who is now in his place, who called in Robert Francis to lead the initial review into what had happened so that we could find out what went wrong and learn lessons for the future.
I accept the point made by the hon. Member for Stafford that we should not hark back to previous Administrations, but my recollection, as a relatively new Member from 2010, is that that was not something we engaged in. It was a huge issue for Labour, and for me personally, that people were dying due not to lack of care in a hospital setting, but to the length of waiting lists—people were dying on waiting lists. After 1997, the NHS was transformed. Spending had tripled to £104 billion when Labour left office. Under Labour, 100 new hospitals were constructed, and the Labour Government employed 89,000 more nurses and 44,000 more doctors than had been employed in 1997. The transformation of the NHS under the last Government was reflected in public satisfaction with the service, which rose from record lows before 1997 to record highs.
There was a bit of contention during Prime Minister’s Question Time, and subsequently during the opening speeches in the debate. The Secretary of State suggested that the number of nurses had risen, but my information from the Royal College of Nursing and FactCheck indicates that that is not the case. I hope that the record can be corrected, because staff numbers are a key issue. A number of Members have referred to it today, and Robert Francis cited staffing as a causative factor.
It would, I think, be irresponsible to assume that a combination of implementing the Francis recommendations—even all of them—and talking down the last Government will be sufficient to ensure the provision of high-quality care throughout the NHS. The truth is that the combination of cuts in alternative services—I am not just talking about the replacement of NHS Direct with the 111 service, the reduction in the number of walk-in treatment centres, the difficulties in gaining access to GP services and, indeed, the cost and disruption caused by the top-down reorganisation—is more likely to contribute to failures in care. It will certainly increase the pressure on accident and emergency departments.
The Francis report made it clear that the “overwhelmingly prevalent factors” in the failures at Mid Staffordshire
“were a lack of staff, both in terms of absolute numbers and appropriate skills”.
It was made clear that ensuring that our hospitals are adequately staffed is key to ensuring that standards of care are high. That point was made by the hon. Member for St Ives (Andrew George), who I know has been campaigning on the issue for some time. A year on from the Francis report, a survey found that 39% of nurses believed that the staffing position had become worse rather than better, and 57% said that their wards remained dangerously understaffed. I hope that the Minister has noted that, because it must be cause for concern.
The hon. Member for Stafford told us that when he was first elected the NHS trust was running a deficit of £10 million, and the focus of the hospital management was on reducing the deficit in order to secure foundation trust status. What went through my mind then were figures given to the Select Committee, according to which nearly a third of NHS trusts are predicting deficits towards the end of the current financial year, and the possibility that similar pressures will be applied as a result. We are now seeing the spectre of clause 119 of the Care Bill, which we are to debate next week on Report and Third Reading. If it paves the way for rapid hospital closures—Labour Members fear that predatory private health care interests may seize the opportunity—that will be very dangerous. We must examine that issue very seriously.
According to evidence from the survey conducted, I think, by the RCN, not only are hospital wards increasingly understaffed, but nurses are being burdened with work that is preventing them from doing their jobs. I am sorry to fire statistics at the House, but, according to that evidence, 86% agreed that the amount of non-essential paperwork had increased in the last two years. There has thus been an historic recent increase in administrative duties. That has been keeping nurses in their offices or at their nurse stations, standing in front of computers or photocopying machines, instead of being available on the wards providing the TLC—that direct health care—that patients require.
Just this week the president of the Royal College of Psychiatrists warned the Government that the mental health sector is heading towards its own Mid Staffs-type scandal. I am very concerned about that. The figures for that field were given earlier, but the fact that the budget for mental health services is reducing in real terms should be a cause for concern. This Government gave a commitment to parity of esteem as between physical and mental health. That was promised and loudly trumpeted as a significant step forward, but in truth it has failed to materialise. There is a clear funding imbalance between acute providers and non-acute trusts, which will disproportionately impact on mental health services in the wake of the Francis report.
I also want to touch on the tariff reduction. In 2014-15 there will be an overall reduction in the tariff price—essentially, the price that hospitals are paid for procedures and operations they perform—of 1.5% for acute providers and 1.8% for non-acute trusts. A third of NHS trusts are predicting they will be in deficit at the end of the financial year, and this tariff reduction will only compound that problem. This means the efficiency target for mental health and community trusts is in practice a fifth higher than for acute trusts, so perhaps it is no wonder that we have a chronic bed shortage, highlighted by various newspapers and the BBC, with children and adolescents travelling long distances to access appropriate care and sometimes temporarily being put in police cells. This is not acceptable, and there are real concerns that programmes introduced by the last Labour Government to make talking therapies available to people with mental health conditions are not getting the priority they deserve. Last year half of all patients referred for counselling did not see a specialist, with a third giving up entirely because the waits were so long.
As I mentioned in an earlier intervention, 1,700 mental health beds have been lost over the last two years, and services are under such pressure that people with mental illnesses are ending up either in police cells or presenting at accident and emergency departments, as the right hon. Member for Sutton and Cheam (Paul Burstow) said. Those are completely inappropriate locations.
I want to mention the cuts to social care since 2009 and the impact they are having on the ability of the service to deliver quality care in the light of our review of the Francis recommendations. We should not forget that since 2009-10 some £1.8 billion has been cut from local authority budgets for adult social care. The cumulative spending power of my own local authority, Durham county council, is being reduced by 17.3% under this Government.
Areas such as mine with a legacy of coal mining or industry have higher care needs. These are the areas that are being hardest hit by cuts to local government. It is simply not possible to make cuts of this significance to local government without it having an impact on standards of care. Some 76% of community nurses agree that social care cuts have resulted in increased work pressures, with just 15% thinking that patients are receiving adequate support from social care services. Cuts mean that an increasing number of those with care needs are going without any support—the figure I have seen is about 800,000—and those receiving support are not even having basic needs met. We know about the 15-minute visits, and councils are now having to introduce or increase charges for services that may well have been free before or might be free in other parts of the country.
Care in the home and in the community is declining, and people are turning to their local hospitals—this is the point I am trying to make—as the default option. That means that those who should be taken care of at home are staying unnecessarily in hospital beds. Accident and emergency is the coal face—the pressure point—and any failures in the system show up there, putting even more pressure on an already burdened system. In “The Francis Report: one year on”, Robert Francis said that there needs to be
“a frank discussion about what needs to be provided within the available resources…It is unacceptable to pretend that all can be provided to an acceptable standard when that is not true.”
I agree with him. It is no good telling people that care standards will be improved or maintained while removing the support that is required to provide high standards of care, particularly social care. In conclusion, I agree with the Health Committee that legislation and regulatory bodies can only do so much to ensure that care standards are met if the necessary staff and resources are not available.
Mr Deputy Speaker (Mr Lindsay Hoyle)
I now have to announce the result of Divisions deferred from a previous day.
On the motion relating to the draft Marriage (Same Sex Couples) (Jurisdiction and Recognition of Judgments) Regulations 2014, the Ayes were 360 and the Noes were 104, so the Question was agreed to.
On the motion relating to the draft Marriage of Same Sex Couples (Registration of Shared Buildings) Regulations 2014, the Ayes were 363 and the Noes were 100, so the Question was agreed to.
On the motion relating to the draft Marriage of Same Sex Couples (Use of Armed Forces’ Chapels) Regulations 2014, the Ayes were 366 and the Noes were 103, so the Question was agreed to.
On the motion relating to the draft Consular Marriages and Marriages under Foreign Law Order 2014, the Ayes were 367 and the Noes were 100, so the Question was agreed to.
On the motion relating to the draft Marriage (Same Sex Couples) Act 2013 (Consequential and Contrary Provisions and Scotland) Order 2014, the Ayes were 365 and the Noes were 103, so the Question was agreed to.
On the motion relating to the draft Overseas Marriage (Armed Forces) Order 2014, the Ayes were 368 and the Noes were 98, so the Question was agreed to.
I now call Alex Cunningham.
National Health Service
Debate between Lindsay Hoyle and Grahame Morris(13 years, 1 month ago)
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Grahame M. Morris
I shall not, if the hon. Gentleman does not mind, because I do not think I will get any injury time if I do so and I have rather a lot to get through.
I have mentioned the transfer of resources from the NHS budget to meet the growing costs of social care. We have also discovered, from evidence that was given to the Select Committee, that there has been an underspend of almost £2 billion—much of it from the capital budget, with some of it, presumably, being saved by cancelling the new hospital that was to serve my area. Meanwhile many NHS trusts are sitting on hundreds of millions of pounds of debt, and figures produced by the Department of Health show that six large NHS trusts in London are predicting year-end deficits of £170 million. The pressures on the system are enormous and will inevitably show through in reductions in services, having an impact on the front line.
The reductions in tariffs for operations and the further pressures in that area will also mean that foundation and NHS acute trusts will bear the brunt of financial pressures within the system. Again, that means that the buck and the spotlight of transparency are being passed away from the Secretary of State to the NHS Commissioning Board, although he might have to reconsider that after last night’s Lords amendments.
Another area of pressure in the NHS comes from the huge redundancy costs being incurred as a consequence of the premature closure of primary care trusts and strategic health authorities, which is estimated to cost the taxpayer more than £1 billion. The opening up of the NHS entirely to the private sector, and the prospect of the £103 billion NHS budget being taken out of the public sector and placed within the remit of shareholders in private health care companies, is anathema to the majority of the British public. The Minister of State, Department of Health, the right hon. Member for Chelmsford (Mr Burns) is cringing, but the majority of the British public are cringing at the thought of this proposal.
NHS Reorganisation
Debate between Lindsay Hoyle and Grahame Morris(13 years, 8 months ago)
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Grahame M. Morris
We have heard about the layers of bureaucracy that the coalition Government propose to take away, but what does the hon. Gentleman have to say about the additional layers that they are imposing through the exponential growth of Monitor, which will be the economic regulator? They are increasing its budget from £21 million a year to as much as £140 million a year. How many more thousands of people will it employ? How many lawyers? It will cost £600 million over the course of a Parliament.
Point of Order
Debate between Lindsay Hoyle and Grahame Morris(13 years, 9 months ago)
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Grahame M. Morris (Easington) (Lab)
On a point of order, Mr Deputy Speaker. May I seek your guidance on what recourse is available when a ministerial answer to a written question is not only incorrect but directly contradicts the Government’s own impact assessment of the Health and Social Care Bill? When asked about the cost distortions involved in the private sector providing health care services, compared with an NHS provider, the Minister of State, Department of Health, the hon. Member for Sutton and Cheam (Paul Burstow) said in his written answer:
“it has not been possible to determine, on balance, whether NHS bodies or private providers of NHS services are systematically advantaged or disadvantaged relative to the other.”—[Official Report, 4 February 2011; Vol. 522, c. 1007W.]
And yet, Mr Deputy Speaker—
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. That is not a point of order, or a matter for me. I would advise the hon. Gentleman that the Table Office is the place to take this matter up, and I am sure that it will be very helpful in trying to put it right. If he takes the matter to the Table Office, I am sure that it can be sorted out quickly.
Fixed-term Parliaments Bill
Debate between Lindsay Hoyle and Grahame Morris(14 years ago)
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The Chairman
Order. The next set of amendments deals with no confidence motions. I think that the hon. Gentleman is in danger of jumping ahead, and I am sure that he does not want to do that.
Grahame M. Morris
I am concerned less about hon. Members’ definition of a confidence issue than about whether that definition would be acceptable to the court if a certificate were challenged. However, I accept that that is the subject of a later clause.