Oral Answers to Questions

Liz Kendall Excerpts

Tuesday 12th July 2011 Commons Chamber

[Mr Lansley]

I certainly will. Indeed, the Minister of State, Department of Health, my hon. Friend the Member for Sutton and Cheam (Paul Burstow), and I launched the outcomes strategy for mental health earlier this year, in order to make it absolutely clear that across the NHS, and indeed public health, we ensure that mental health services attract the right priority and focus as we develop outcome measures.

[Liz Kendall (Leicester West) (Lab)]

The Prime Minister has promised that waiting times will not rise despite his massive NHS reorganisation, but we now know that in May 15,500 patients waited more than six weeks for their diagnostic tests—four times as many as last year—and that 1,800 waited more than three months, which is 10 times as many as last year. Average waits for diagnostic tests are also up. Does the Minister agree with the Royal College of Physicians that those increased waits, including waits for vital tests to diagnose cancer, will harm patient care: yes or no?

[Mr Lansley]

No, we have met the standard that patients should not wait longer than 18 weeks—a 90% standard for admitted patients and 95% for non-admitted patients. If I recall correctly, the latest data for diagnostic tests showed that there was a 1.9 week average wait for diagnostic tests, which compares with 1.8 weeks in May last year. On cancer waiting times we have achieved an improvement—up to 96%—in the number of patients who are seen by a specialist within two weeks. The hon. Lady really needs to go back and talk to her colleagues in Wales, where 26% of patients wait longer than 18 weeks, compared with less than 10% of patients here; indeed, many patients in Wales wait more than 36 weeks. We have a contrast between a coalition Government in England who are investing in the health service, with improving performance, and a Labour Government in Wales who are cutting the NHS budget and seeing performance decline.

Congenital Cardiac Services for Children

Liz Kendall Excerpts

Thursday 23rd June 2011 Commons Chamber

[Liz Kendall (Leicester West) (Lab)]

It is a real privilege to take part in today’s debate, and to follow the thoughtful, moving and at times passionate speeches of Members of all parties. I thank the Backbench Business Committee, and I particularly thank the hon. Member for Pudsey (Stuart Andrew) for securing the debate.

Like the right hon. Member for Charnwood (Mr Dorrell), I wear two hats today. As the Member for Leicester West, home of Glenfield hospital’s superb congenital heart centre, I know how important the review of children’s heart surgery is for my constituents, as it is for those of each of the hon. Members who have spoken. As the Opposition spokesperson, however, I am also well aware of my national responsibility, and that of the House, to ensure that every child gets the very best quality of care.

I want to start by making the case for change, as did other Members including my hon. Friends the Members for Liverpool, West Derby (Stephen Twigg) and for North West Durham (Pat Glass), my right hon. Friend the Member for Newcastle upon Tyne East (Mr Brown) and my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell), who made brave and courageous speeches.

Following the devastating findings of the Bristol Royal infirmary inquiry almost 10 years ago, clinicians and professional bodies have been clear that children’s heart services need to change to ensure that every child gets the best standard of care now, and crucially also in the future. They include the Royal College of Surgeons, the Royal College of Nursing, the Royal College of Paediatrics and Child Health, the Society for Cardiothoracic Surgery, the British Congenital Cardiac Association, the Paediatric Intensive Care Society and many others.

The reason why services need to change is that children’s heart surgery is becoming ever more sophisticated. Technological advances mean that care is increasingly specialised and capable of saving more lives and improving outcomes for very sick children. However, services in England have grown up in an ad hoc manner. As my right hon. Friend the Member for Oxford East (Mr Smith) said, surgeons are too thinly spread. Care needs to be better planned to pool expertise in specialist centres so that all children get excellent quality care. I therefore welcome the Safe and Sustainable review, which was initiated by the previous Government. The challenge, as the House has rightly demonstrated today, is to ensure that the right aims, objectives and criteria drive the review, and, crucially, that they have the right weighting and that the right balance is struck.

Of course, improving the quality of care must be our primary concern. The review rightly calls for fewer, larger surgical centres to provide 24/7 consultant cover, and seeks to ensure that surgeons treat a sufficient number of patients with a sufficient variety of problems to ensure that they have the best possible skills.

The review also recommends the development of congenital heart networks, so that care is better co-ordinated at all stages of a child’s life, and that assessments and ongoing care can be provided closer to where patients live. However, as several hon. Members have said, the review cannot look at children’s heart surgery services in isolation; it must also fully consider the knock-on effect on other specialties at the hospitals in question.

As my hon. Friend the Member for Leicester South (Jon Ashworth) and the hon. Member for Loughborough (Nicky Morgan) rightly said, the work of Glenfield children’s heart surgery centre is closely linked with its extra corporeal membrane oxygenation service. ECMO helps patients with reduced heart or lung functions to have complex surgery that they might not otherwise survive. Glenfield is the country’s leading specialist ECMO centre, and trains and supports other services nationally and internationally. There is real concern at the possibility that that service will be moved to another hospital, because of the time that it would take to build up expertise elsewhere. Not only does it take up to 18 months to train new specialist nurses, but it takes many years to develop equivalent experience.

Ensuring high quality care is not just about surgery standards or links with other specialisms. The wider help and support that families get from doctors and nurses are vital. I was genuinely moved when hon. Members spoke of their conversations with parents and staff in their centres. Time and again, parents emphasise the communication skills of staff, and their ability to explain diagnoses and procedures simply and clearly, at what is often a frightening and worrying time.

Parents at Glenfield tell me that staff are like members of their families—they can ring day or night if they have any concerns. Such familiarity and trust is crucial, and it links to the issue of providing ongoing help and support, which many hon. Members mentioned. When children who have had heart surgery grow up, they have to deal with difficult issues such as whether they can have children. Many families are understandably concerned about having to build new relationships with a different team of doctors and nurses if their local centre closes. It is vital that the review look closely at the links between child and adult congenital heart services, but it has probably paid insufficient attention to that so far. I hope and believe that that will change before the review concludes.

As well as stressing the importance of the quality of clinical care, many hon. Members stressed the importance of ensuring fair access to services. We heard passionate speeches about that from my hon. Friends the Members for Leeds East (Mr Mudie) and for Scunthorpe (Nic Dakin). Accessibility matters, because time is of the essence when seriously ill children need to get to heart surgery centres in life-or-death situations, as the hon. Members for Meon Valley (George Hollingbery) and for Isle of Wight (Mr Turner) rightly said.

However, travel times also matter to families who need ongoing care and support. My hon. Friend the Member for North West Durham rightly said that many parents would travel to the ends of the earth for their children, but as the hon. Members for Leeds North West (Greg Mulholland) and for Oxford West and Abingdon (Nicola Blackwood) said, making families travel further than they already travel would make such a difficult time even harder for them, especially if they must also hold down a job or care for other children.

The difficult balance between specialising services in some areas but ensuring fair access is the crucial issue for the review.

[Mr Dorrell]

The hon. Lady is making an important point about access being one of the quality characteristics that need to be taken into account in making these decisions. However, does she agree that the Safe and Sustainable work programme has taken that into account? It was one of the key factors it took into account in making its recommendations and drawing its conclusions on the relative merits of these units.

[Liz Kendall]

The right hon. Gentleman makes an important point, but hon. Members have said that they feel the issue was given insufficient weighting. At the Leicester consultation, one parent said to me, “If we’d known that all the services were safe”, as the review has said, “we might have placed more importance on the issue.”

The affordability issue has not been mentioned. Hon. Members will, I am sure, be as one in saying that the review must be driven by the need to improve the quality of care, not by reducing costs. However, it is important to recognise, particularly in these financially constrained times, that significant costs are associated with all the current, and likely future, options in the review. That needs to be taken into account.

In conclusion, changing how we provide any hospital service is difficult, but when changes are necessary to improve patient care, as I believe they are for children’s congenital heart services, the House must have the courage to make them happen. Hon. Members have rightly raised a range of concerns on behalf of their constituents, but I am sure we would all agree that the final decision must be made by clinicians on the basis of evidence, not on political considerations. I hope that the joint committee will seriously consider the points raised in this debate and then make final recommendations in patients’ best interests.

Information Technology (NHS)

Liz Kendall Excerpts

Tuesday 14th June 2011 Westminster Hall

[Liz Kendall (Leicester West) (Lab)]

Thank you for calling me, Mrs Brooke. It is a pleasure to serve under your chairmanship and to take part in this important debate.

I want to start by paying tribute to the hon. Member for South Norfolk (Mr Bacon) for his tireless work on this issue. His determination and tenacity in highlighting the problems and difficulties of a national programme for IT have been second to none. He frequently made the life of the previous Government difficult and I am sure that he will also be a thorn—perhaps a constructive thorn—in the side of the current Government. In his work, he has demonstrated the importance of effective parliamentary scrutiny and the difference that a Back-Bench MP can make. As a new MP, I hope to learn from his experience and follow, at least in some ways, his example.

The reason for the debate’s importance is that effective IT can and must play a key role in improving both the quality and efficiency of health care. At its best, IT helps clinicians and patients share information about the quality of services that are available, which not only supports patient choice but improves standards of care. Good IT can also help patients to get care in different parts of the system without having to give the same information repeatedly about their conditions and treatments to different doctors and nurses. In addition, it can help clinicians and managers to develop more effective and efficient services, organising treatments and services around the needs of patients rather than vice versa.

As the hon. Member for Thurrock (Jackie Doyle-Price) rightly pointed out, one of the key challenges facing the NHS is to ensure that GPs, their primary care teams, social care professionals and specialists work much more closely together, so that care is more effectively co-ordinated. Indeed, the NHS Future Forum said yesterday:

“Better information systems and the development of more integrated electronic care records will be a major enabling factor for this.”

The national programme was meant to help the NHS secure those objectives. However, as the hon. Member for South Norfolk has eloquently outlined and as countless reports from the National Audit Office and the Public Accounts Committee have also shown, the programme has fallen far short of achieving them. There were poor specifications about what was required by Government and what suppliers could deliver in return. In addition, as the hon. Members for Thurrock and for Stroud (Neil Carmichael) have said, there was over-claiming by both sides about what could be delivered and by what date. Furthermore, there were poor lines of accountability and responsibility for the programme, at least in its initial stages. All of those problems have led to one delay followed by another and, crucially, to a lack of control over costs.

I do not intend to go over those problems in detail. My knowledge of the subject is nowhere near as comprehensive or forensic as that of the hon. Member for South Norfolk. Instead, I want to take a step back and suggest three broad lessons that need to be learned from the problems of the national programme, as part of a constructive contribution to the Minister that he can take forward in his thinking on this subject.

The first lesson is that any IT system, whether it is in the NHS or elsewhere, must be led by its users. In the case of the NHS system, it must be clinically led. That is not only about getting clinical “buy-in” but about ensuring that doctors and nurses directly shape and develop the IT system so that it helps them do their job properly for the sake of patients.

NHS clinicians have said that they want IT to achieve five key objectives: first, allowing information about appointments to move around within hospitals, and between hospitals and the rest of the NHS, so that appointments can be booked; secondly, communicating information about discharges from hospital to hospital, and from hospitals to GPs and community services, so that staff in all parts of the system know what conditions patients have; thirdly, allowing staff to book tests such as MRI scans, ultrasounds and so on, and to get the results back to the patient and their clinician at the right time and in the right place; fourthly, the ability to schedule all the different tests, treatments, operations and so on that a patient has in a way that meets the needs of the patient; and finally, enabling electronic prescribing of drugs and the gathering of necessary pharmaceutical information to ensure that patient care is as safe and effective as possible.

Those five key objectives emerged from a consultation exercise with clinicians in 2008. However, as the hon. Member for South Norfolk has said, that was too late; the consultation exercise should have happened before the contracts were signed and not halfway through the process.

Can the Minister say how the Government will ensure that clinicians continue to be involved in developing the IT strategy for the NHS? Did the NHS Future Forum consider the IT strategy as part of its recommendations to Government? I ask because there was only one small line on the IT strategy in that report. Also, have the Government received any specific responses on this issue and, if so, will the Minister publish them?

On a related point, can the Minister say when he will publish the Government’s information strategy? In October 2010, the Government published “Liberating the NHS: an information revolution”. That document set out the Government’s plans to ensure that patients, the public, clinicians and managers have the information that they need to improve health and health care. I do not agree with some of the tone of that document; it seemed to suggest that the previous Government had done nothing on the matter. When Labour was in government, we acted on he issue. For example, if one considers a programme such as NHS Choices, to which there was quite a lot of opposition at the time, one can see that we moved the agenda forward. Having said that, I absolutely agree that we all need to go further.

My concern is that the consultation on the Government’s information strategy closed six months ago today. In that time, the Government could have provided more information to patients and the public to improve choice and quality. When will that strategy be published?

The second lesson that we can learn from the national programme is that we cannot have a one-size-fits-all IT system in the NHS, or indeed in any health care system. As Sir David Nicholson, chief executive of the NHS, told the PAC on 23 May, attempting to provide one type of medical record that covers everything for everybody everywhere in the country “has proved unworkable”. The challenge is striking the right balance between what—if anything—is delivered centrally and nationally, and what is delivered locally. That is a perennial challenge in all parts of the NHS and needs to be thought through.

The national programme is currently being reviewed by the Cabinet Office’s Major Projects Authority. On 18 May, the Minister told Radio 4’s “Today” programme that he wants to allow local hospitals to adapt their existing systems rather than to get rid of them altogether or, indeed, to scrap the national programme for IT. Last month, David Nicholson told the PAC that the Department of Health wants to move towards a situation whereby hospitals have their own direct relationship with software suppliers and where individual organisations take responsibility for their IT. However, he also said that, with all the reorganisation of the NHS that is going on, we need an interim step, a transitional body that will

“look very similar to Connecting for Health”.

He said that it was very important to have that body,

“to enable us safely to transit from where we are at the moment to a place where individual organisations take responsibility.”

I would like the Minister to explain a few things. What is that transitional body? Who will be responsible for running it? How much will it cost? How will it be different from Connecting for Health? At what stage will it disappear and how? Finally, if a national, centrally led programme has been part of the problem in the past, why will this new national, centrally led body somehow deliver the future when individual trusts are in control?

The final lesson that must be learned relates to a point that the hon. Member for Stroud made, which was about a much bigger problem for Government than the other problems that I have mentioned. How do the Government have an effective relationship with the private sector in contracting with it, not only in relation to IT projects but to all sorts of other projects? I am thinking, for example, about the problems that the Ministry of Defence has experienced with its contracting. Successive Governments have found it extremely difficult to negotiate effective contracts with the private sector, and not just IT contracts. It is fair to say that they have not exactly covered themselves in glory in that respect.

[Duncan Hames]

Will the hon. Lady reflect on whether one reason why Governments have such difficulty in controlling contracts with the private sector is that politicians routinely make policy changes that alter the specifications for what is required, and contracts are not able to accommodate that? I wonder what lessons she might learn if we looked, for example, at how the choice agenda was rolled out in the NHS during this period, and at the demands that that placed on changing requirements for private contractors.

[Liz Kendall]

The hon. Gentleman makes a very important point about the nature of the political process, with politicians frequently determined to fill the newspapers with headlines about new policies, while the difficult process of implementation takes far longer on the ground. When I had the privilege of working in the Department of Health, I saw the NHS Choices project and thought, “This doesn’t look like what I thought the politicians meant. It wouldn’t give me, as a patient, the information I needed about which consultant or hospital to choose.” There is, therefore, the problem of how about we go from a political idea to a policy on the ground, and how quickly that changes.

With the greatest respect to the civil servants sitting in this room, we have perhaps not thought through effectively what kinds of skills and experience are necessary in Departments. What steps has the Minister taken since the Government were elected to ensure that the Department of Health has people with the right skills and experience to deal with such high-level negotiations? Have the Government as a whole decided to look at that issue? Has the Cabinet Secretary, Sir Gus O’Donnell, considered how best to ensure that there are people across the whole civil service with the skills and experience that politicians urgently need to support them in their work?

I thank all Members for their contributions today. This is a very difficult subject, and we need to find a way through that does not waste more taxpayers’ money but understands that IT and information are crucial to improving health and health care. The key issue is how we get there.

Oral Answers to Questions

Liz Kendall Excerpts

Tuesday 7th June 2011 Commons Chamber

[Mr Lansley]

My hon. Friend will be aware that in the run-up to the election and since, the Rarer Cancers Forum has mentioned the number of applications to the exceptional cases panels of primary care trusts that have been turned down, and pointed out how often patients in this country have not got access to new cancer medicines that are regularly available to patients in other European countries. That was the basis on which we estimated the level of demand for the cancer drugs fund, and it has actually turned out to be a very good predictor of demand. Patients are now receiving second-line or new medicines for a range of cancers, including prostate and bowel cancer. People with common cancers as well as rarer ones are getting access to new medicines that are increasing their quality of life or life expectancy.

[Liz Kendall (Leicester West) (Lab)]

Today the Prime Minister pledged to increase NHS funding, protect universal coverage and keep waiting times low, but his promises are already being broken on cancer care. Three quarters of the cancer drugs fund is not additional money, as the Secretary of State claims, but money taken from other patients, and half as many new cancer drugs are available in some parts of the country as in others. Whatever he claims, can he now confirm that the number of patients waiting more than six weeks for their diagnostic test, including for cancer, has doubled since this time last year?

[Mr Lansley]

The hon. Lady seems to have forgotten that we were very clear at the time of the election that we would establish the cancer drugs fund not least on the basis that under this Government, the NHS would not have to pay the additional employer’s national insurance contributions that it otherwise would. The money available for the NHS is being used for the benefit of patients, and it represents additional resources.

I might also remind the hon. Lady that before the election, her party was not committed to protecting the NHS budget. The Leader of the Opposition was completely wrong today when he said that Labour was going to protect NHS spending, as we did. That is not true. Actually, it was committed to only 95% of NHS funding, which was that for the PCTs. It was going to cut the rest, and centrally funded budgets such as the cancer drugs fund are precisely what would have disappeared.

The hon. Lady asked about diagnostic tests. The figures show that a year ago, the average waiting time was 1.7 weeks, whereas the latest figure is 1.8 weeks.

Oral Answers to Questions

Liz Kendall Excerpts

Tuesday 26th April 2011 Commons Chamber

[Mr Lansley]

Yes, I can confirm that. We are looking for commissioning consortia not only to lead from a primary care perspective on behalf of patients, but to work on commissioning services with their specialist colleagues. Of course, the stroke research network has formed a strong basis upon which such commissioning activity can take place.

There have been many improvements in stroke care. Over the last year, we have seen a significant improvement in performance in relation to responses to transient ischaemic attack, and I hope we continue to see improvements in future.

[Liz Kendall (Leicester West) (Lab)]

Last year, the Prime Minister made a very clear pledge to protect front-line NHS services. Will the Secretary of State confirm that in the run-up to next year’s Olympics, which will bring around 1 million extra people to the capital, the London ambulance service is cutting 560 front-line staff? Will the Secretary of State also confirm that nationally, A and E waits of more than four hours are up 65%, that the number of patients waiting more than six weeks for their cancer test has doubled, and that more patients are waiting for longer than 18 weeks than at any time in the last two years? Will he now admit that the Prime Minister’s pledge to protect front-line care is unravelling even faster than the Secretary of State’s chaotic Health and Social Care Bill?

[Mr Speaker]

There were three questions there, but I know that the Secretary of State will provide a characteristically succinct reply.

NHS Reorganisation

Liz Kendall Excerpts

Wednesday 16th March 2011 Commons Chamber

[Liz Kendall (Leicester West) (Lab)]

This debate is about one of the most important issues facing this House and this country: the future of our NHS. It has been an excellent and at times lively discussion, with important contributions from all parts of the House.

My hon. Friend the Member for Sheffield Central (Paul Blomfield) spoke with great passion about his recent experience of using the NHS and the importance of the NHS for his constituents. My hon. Friends the Members for West Lancashire (Rosie Cooper), for Oldham East and Saddleworth (Debbie Abrahams) and for Kingston upon Hull East (Karl Turner) gave compelling speeches about their concerns over what is really in the Health and Social Care Bill, including the implications of removing certain duties from the Secretary of State and of introducing competition law explicitly in the NHS for the first time. The hon. Members for Southport (John Pugh) and for St Ives (Andrew George) raised important and serious issues with regard to the Bill, including the implications of centralising services such as dentistry, pharmacy and primary care. It is far from clear how a national body will know what primary care services need to be commissioned in my constituency. They also expressed concerns about the dangers in the Bill. My hon. Friend the Member for Warrington North (Helen Jones), whom I am proud to be following, raised the importance of the threats to the “national” in the national health service and concerns about patients with long-term and chronic conditions, of whom we know there are an increasing number in the NHS.

The debate has shown that, as on so many occasions with this Government, it is not their rhetoric but the reality that counts. They promised in their manifesto an end to top-down reorganisations, but instead they are forcing the NHS through the biggest reorganisation of its life. As the right hon. Member for Charnwood (Mr Dorrell) has said many times, although unfortunately not in the House today, they are doing that at a time when the NHS faces its toughest ever period of funding, when jobs are already being cut and when, far from what the Secretary of State told the House earlier, waiting times are starting to rise.

The Government also say that they want clinicians to lead changes in the NHS, but their Health and Social Care Bill fails to guarantee even that GPs will be running consortia, let alone that hospital doctors, nurses or other NHS staff, who are so crucial to improving the quality of care, will be involved. As eight of the country’s leading patient charities said in a letter to The Times last month:

“The reforms will place £80 billion of the NHS budget into the hands of GPs, but plans to make GP consortia accountable to the public are far too weak.”

There is no requirement to have elected representatives on GP consortia, as the coalition agreement promised for primary care trusts. The new health and well-being boards will have no power to require GP consortia to do anything, and local councils’ scrutiny committees will actually lose some of their powers to refer decisions to the independent reconfiguration panel in the case of services not on the safe list of designated services.

At the heart of the Bill are proposals to change the NHS fundamentally that the Secretary of State simply does not want to talk about: his plans to run the NHS along the same lines as the gas and electricity companies.

[Nicky Morgan]

I know that the hon. Lady is a hard-working fellow Leicestershire MP, but I disagree with her. Is not the fundamental principle of the Bill, as we have discussed in the Public Bill Committee, that what constituents want is an NHS free at the point of need and the delivery of services, and funded by taxpayers? Which part of the Bill changes that fundamental principle?

[Liz Kendall]

What patients want is their views and voices to be heard. As the hon. Lady well knows, eight of the country’s leading patient charities, including the Alzheimer’s Society, Asthma UK and Diabetes UK, have said that the patient and public voice is not strong enough under the Bill, and they have demanded changes. I respectfully ask that she look at their comments and act on their views.

The fundamental issues at the heart of the Bill are turning Monitor, which is currently responsible for foundation trusts, into a powerful new economic regulator to promote competition across the NHS, and enshrining UK and EU competition law into primary legislation on the NHS for the first time. That is not my view but the view of David Bennett, the new chairman of Monitor, expressed in his evidence to the Public Bill Committee. The Government are explicitly modelling the NHS on the gas, electricity, railway and telecoms industries. Government Members who are shaking their heads or looking blank should read the explanatory notes to the Bill, which make that absolutely clear.

[Grahame M. Morris]

May I point out that yesterday, in an Adjournment debate in Westminster Hall about the future of the blood services contract, the Under-Secretary of State said in response to a question from my hon. Friend the Member for Middlesbrough South and East Cleveland (Tom Blenkinsop) that EU competition rules would apply?

[Liz Kendall]

The Minister of State, Department of Health, the right hon. Member for Chelmsford (Mr Burns), also said yesterday, in the Health and Social Care Bill Committee, that EU competition law would apply, and gave me some assurances that that would somehow not change anything. When I asked whether the Government had taken legal advice on that, he admitted that they had. I asked him then to publish that advice so that hon. Members did not have to take my word for it, and I shall do so again. Will he publish that advice so that hon. Members can see whether GP-commissioning consortia and providers will be subject to EU competition law? Sadly, it appears that he will not do so.

[Dr Poulter]

If the hon. Lady is so concerned about competition and markets, why did the previous Government introduce Monitor, and why were they happy to pay the private sector 11% more than the NHS to provide NHS services?

[Liz Kendall]

I am sure the hon. Gentleman knows that Monitor was established as part of the regulation of foundation trusts. Removing that responsibility will mean that there will be no outside checks and balances on those trusts as there are now. Government Members should think seriously about that.

Our health and our NHS are not the same as gas, electricity or the railway. That the Secretary of State believes that they are shows how dangerously out of touch he is. What is the likely result? GPs will be forced to put local services out to tender even if they are delivering good quality care that patients choose and like; hospitals and community services will be pitted against one another when they should work together in patients’ interests; care, which as many hon. Members have said is vital as our population ages and there is an increase in long-term conditions, will become more and not less fragmented; the financial stability of local hospitals will be put at risk, and they will have no ability to manage the consequences of choice and competition in the system; and the whole system will be tied up in the costs of red tape, as GPs and hospitals employ an army of lawyers and accountants to sign contracts and fight the threat of legal challenge, huge fines and the potential of being sued. Let us also be clear that the Bill gives Monitor the same functions as the Office of Fair Trading, so it can fine organisations up to 10% of their turnover.

The more we see of the Bill, the more the truth becomes clear. The Secretary of State says that he wants clinicians to be more involved, and “no decision about me without me” for patients, but when the Royal College of General Practitioners, the Royal College of Surgeons, the Royal College of Nursing, the Royal College of Midwives, the British Medical Association or anyone else tells him that he should stop, think again and halt his reckless NHS plans, he refuses to listen. When the Alzheimer’s Society, the Stroke Association and Rethink tell him that his proposals will not give patients a stronger voice and improve public accountability, he simply tells them that they are wrong. When health experts such as the King’s Fund warn that driving competition in every part of the NHS will make it more difficult to commission the services that best serve patients’ interests, he simply puts his fingers in his ears and walks away. What makes this Secretary of State think that he is right when professional bodies and patient groups know that he is wrong?

Doctors and nurses do not support the Government’s plan, patients do not want it, some Conservative Back Benchers and members of the Cabinet do not like it, and the Liberal Democrats hate it. They had the sense last Saturday to see what the hon. Member for St Ives (Andrew George) called the potential catastrophe as far as the future of the NHS is concerned, and to ask for amendments to the Bill. I hope they have the sense to join us in the Lobby tonight. I commend the motion to the House.

Oral Answers to Questions

Liz Kendall Excerpts

Tuesday 8th March 2011 Commons Chamber

[Mr Burns]

I am grateful to my hon. Friend, who was present at last Thursday’s Adjournment debate. He will know that the proposals, the options put together and the consultation, which we have just begun, have been organised at arm’s length from Ministers by the joint committee of PCTs. As I said on Thursday, I trust that he will forgive me if I say that it would be totally inappropriate for me to comment, because that might be seen as trying to influence or prejudge the ultimate outcome.

[Liz Kendall (Leicester West) (Lab)]

Before the election, the Secretary of State went up and down the country promising that his NHS reforms would save local A and E and maternity services, but on 1 March, during consideration in Committee of the Health and Social Care Bill, when I asked the Minister whether London’s A and E departments would be on the safe list of designated services that will not close, he said that

“I suspect the answer is that no…it will not be a designated service…there is a significant number of A and E services in London. There would not be a need to designate them”.––[Official Report, Health and Social Care Public Bill Committee, 1 March 2011; c. 349.]

Will the Minister now give the House a clear and simple answer to a simple question: will every London A and E remain open under this Government—yes or no?

[Mr Burns]

Mr Speaker, if you had had the opportunity to read the exchange in Committee, you would understand that the hon. Lady’s question is not factually correct. She asked me figuratively what would happen in an urban area as compared with a rural area, and as I explained three times during further interventions from her, my answer was illustrative, not definitive, because that would have been premature. She is trying to scaremonger—causing fear with something that she knows is inherently not true.

--- Later in debate ---

[Mr Lansley]

That will be the leak that took place when the head of the Foundation Trust Network gave it to the BBC.

The hon. Lady might not be very experienced in these matters, but she will know that at this time of year, in anticipation of the new financial year, hospitals tell their local primary care trusts how much money they would like to have, but that is not the same as the amount of money available in the whole system. That is part of the contract negotiations. She should also know that the necessity to deliver efficiency savings and redesign clinical services will mean that hospitals need to deliver 4% efficiency gains year on year, right across the NHS.

[Liz Kendall (Leicester West) (Lab)]

It will be 6.5%.

[Mr Lansley]

It will not be 6.5%, because things need to change so that efficiencies can be achieved within hospitals. That much is absolutely clear, and we have been clear about that. It does not threaten the future of hospitals, but incentivises to improve the design of clinical services and improve care for patients, providing more accessible care in the right place and at the right time.

Oral Answers to Questions

Liz Kendall Excerpts

Tuesday 25th January 2011 Commons Chamber

[Mr Lansley]

The shadow Secretary of State cannot actually criticise what we put forward in the White Paper or the Bill and is resorting to inventing something else and attacking that. Let me tell him that the one thing we will not do with the private sector is rig the market so that private companies get contracts and guaranteed money whether or not they treat patients. We are not going to give them 11% more money than the NHS would get for doing the same work. We will give NHS organisations a proper chance to deliver services for patients.

[Liz Kendall (Leicester West) (Lab)]

Whatever the Secretary of State claims about his reorganisation, a King’s Fund survey showed that more than three quarters of doctors do not believe that it will improve patient care, and even his Department’s impact assessment on the Health and Social Care Bill says that the reorganisation risks distracting staff and making them less focused on patient care.

Will the Health Secretary now confirm that the number of patients waiting more than six weeks for their cancer test has already doubled under this Government, and that routine operations are being cancelled? Will he finally listen to the Royal College of Nursing and the British Medical Association, which have told him that his plans are

“extremely risky and potentially disastrous”

for the NHS and patient care?

Swine Flu

Liz Kendall Excerpts

Monday 10th January 2011 Commons Chamber

[Mr Lansley]

I have two points for the right hon. Gentleman. First, all NHS staff, including ambulance staff, are eligible for the vaccine. Regrettably, when I last looked, under 20% had availed themselves of that opportunity. I wish that it were higher.

[Liz Kendall (Leicester West) (Lab)]

“Wish”? Does the Secretary of State think wishing is enough?

[Mr Lansley]

They are all offered it, so they can all be provided with it. I am not in a position to require people to take a vaccine. We are not providing mandatory vaccination in this country yet, and I do not suppose that we shall.

Secondly, I was not admitting that I had done nothing—on the contrary. What the right hon. Gentleman perhaps does not understand is that one cannot simply order additional large-scale supplies of a vaccine. A long process of manufacture is required, as it is an egg-based culture system. The amount is ordered in the spring for autumn delivery, so the amount was determined in the spring. When I entered office in May, there was not any reason particularly to think that we would need more than in other flu seasons, and we knew that we had the back-up of the H1N1 vaccine if we needed it. In early August, I made it clear that I intended to review further the system of procurement, distribution of flu vaccine and its supply. That review is ongoing and will be published shortly.

Oral Answers to Questions

Liz Kendall Excerpts

Tuesday 7th December 2010 Commons Chamber

[Paul Burstow]

In fact, there is a further pot of money, which relates to the proposals for a ring-fenced budget in respect of public health. One of the problems has been the NHS’s raiding that pot to spend on other things. We believe that public health is a priority, and we will therefore ring-fence those resources in future. The £1 billion that will go into social care directly through the local government settlement will be available for local government to support social care services. The £1 billion that will go in via the NHS will also be there to support social care, but it will particularly address issues such as reablement and preventive services.

[Liz Kendall (Leicester West) (Lab)]

The Government are abolishing all PCTs and handing £80 billion to GP consortiums that do not yet exist for services including the co-ordination of care. Is not this reorganisation a huge gamble for patients and taxpayers, which is why No. 10 and the Treasury are so concerned, as we see today in The Independent? Will the Minister finally agree to publish details about the financial assurance regime for GP consortiums, and will he guarantee that under his plans £80 billion of public money will be accountable to Parliament in the same way that it is today?

[Paul Burstow]

Of course the money will be accountable to Parliament, as it is now. The hon. Lady’s comments reflect an interesting campaign that the Labour party has dreamed up, which is very much to ally itself with the interests of primary care trusts rather than those of patients and ensuring that we improve public services. This Government’s proposals will improve the way in which services are commissioned, deliver better outcomes for patients up and down the country, and deliver the integration across health and social care that the previous Government failed to deliver.