Community Pharmacies

Margaret Greenwood Excerpts

Wednesday 2nd November 2016 Commons Chamber

[Naz Shah (Bradford West) (Lab)]

This debate could not come at a more important time for my constituents, because a potential 25% of the 42 community pharmacies in my constituency face closure due to the funding deal that this short-sighted Government imposed last week.

Pharmacies in Bradford West play a vital role in the total holistic healthcare services on offer to my constituents. My constituency is the fourth most deprived in the country, and we have one of the most diverse communities. Constituents face genuine day-to-day struggles to access the services and advice that they require. The 2014 patient survey report showed that more than a quarter of them could not access a GP appointment when they needed it.

We acknowledge the essential and diverse service that our community pharmacies perform and, in an attempt to maximise their impact, Bradford trialled the minor ailments scheme, which the Minister has referred to, in 2014. I spoke to Mr Ajmal Amin of my local pharmacy, Sahara, only this morning, and he explained that, in addition to the more than 100 people a week who walk through his door, an average 50 a week do so as part of the minor ailments scheme. Even if one in four people end up going to a GP appointment, that means 90,000 extra GP appointments a year in my constituency alone, at a cost of more than £4 million.

Bradford has a higher incidence of cancer, diabetes, stroke and coronary heart disease, and that is because poverty, deprivation and ill health go hand in hand—there is a clear correlation between them.

I will give a recent personal example. Over the past few months, my mother has suffered three transient ischaemic attacks. One of them was a potential stroke and she has already had cancer. Only last week, she was admitted to Luton hospital with an acute kidney infection. On Monday morning, it took 42 attempts for me to get through to my GP practice to make an appointment, but by the time I got through at 23 minutes past 8, all the appointments had gone. That experience is not unique to me; it is happening across the country. If we close community pharmacies, GPs will come under extra pressure. I have not seen a Government plan to give my constituency—which is one of five in Bradford—£4 million for another 90,000 appointments a year.

The reality is that the proposals will disproportionately affect those who need healthcare the most. Yes, we have lots of pharmacies, but the Government’s proposals do not take into account diverse communities with complex health needs.

[Margaret Greenwood (Wirral West) (Lab)]

It is interesting to hear what is happening in my hon. Friend’s constituency. Five of the 23 pharmacies in my constituency of Wirral West are at risk of closure because of the Government cuts. Given the huge pressures that NHS services are under, does my hon. Friend share my concerns that the cuts will further inhibit the options of elderly and infirm people in particular in accessing the services that they need?

[Naz Shah]

I agree with my hon. Friend. My constituents have so many complex health needs. I am a former NHS commissioner, and I commissioned services in accordance with public health priorities in Bradford. Obesity, cancer and diabetes are long-term chronic conditions and they impact on those communities with the most deprivation. It is not just one whammy: we have deprivation, lack of jobs and so on. We need to look holistically at people. Taking away pharmacies from our communities is not the way to provide healthcare services. We cannot and must not look at pharmacies as stand-alone items. They are part of a holistic care package across the board, and they complement the NHS and GPs.

Let me be clear: the fact that I could not get through to my GP surgery until my 42nd attempt is not a reflection on my GP practice, Kensington Street health centre, which is one of the best I have ever experienced. The staff are amazing. They are working to try to fit a square peg into a round hole because of the extent of the cuts that they have already experienced. This is not about GP practices not delivering what they can; it is simply that they do not have the resources. We do not have enough GPs as it is, and taking away pharmacies will not help.

I urge the Government to revisit this proposal, which has not been clearly thought through and does not take into account constituencies such as mine. I urge the Government to abolish it and bring something else to the table, because it is clearly not going to work.

NHS Funding

Margaret Greenwood Excerpts

Monday 31st October 2016 Commons Chamber

[Mr Hunt]

I accept responsibility for the fact that in the hon. Gentleman’s part of the country, as in every part of the country, we have more doctors, more nurses and more operations than there were when his party left office.

[Margaret Greenwood (Wirral West) (Lab)]

I am particularly concerned that the Government are cutting supply in public health to create demand for a private healthcare market, which means that, like the United States, we will have a two-tier system. I was very concerned by the vague response that the Secretary of State gave to my hon. Friend the Member for Wallasey (Ms Eagle). Will he guarantee this afternoon that there will be no closures of Arrowe Park hospital, Clatterbridge hospital or the Countess of Chester?

[Mr Hunt]

With respect to local service provision, these things are decided locally. If the hon. Lady wants to dig up the old chestnut about the privatisation of the NHS, let me say that the outsourcing of services to the private sector increased much faster under her Government than under this Government. If we did have those malign motives for the NHS, increasing its budget by £10 billion over the course of this Parliament and increasing doctor training by one of the biggest increases in its history would be a strange way of going about it.

Oral Answers to Questions

Margaret Greenwood Excerpts

Tuesday 11th October 2016 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. I find it extraordinary that the Labour party said that our plan to train more doctors was “nonsense”. We currently have 800 doctors in the NHS from Sri Lanka, 600 from Nigeria, 400 from Sudan and 200 from Myanmar. They are doing a brilliant job and I want them to continue doing that job, but we have to ask ourselves whether it is ethical for us to continue to recruit doctors from much poorer countries that really need their skills.

[Margaret Greenwood (Wirral West) (Lab)]

I was alarmed to read at the weekend that NHS chiefs are warning that hospitals in England are on the brink of collapse. Is it the Government’s intention to cut the public supply of healthcare in order to create demand for a private healthcare system, or will they give the NHS the additional funds it needs?

[Mr Hunt]

Let me remind the hon. Lady that the party that introduced the most outsourcing to the private sector was her Labour Government under the previous Health Secretary, Alan Milburn. Our view is that we should be completely neutral as to whether local doctors decide to commission their care from the public sector or private sector. We want the best care for patients.

NHS Sustainability and Transformation Plans

Margaret Greenwood Excerpts

Wednesday 14th September 2016 Commons Chamber

[Margaret Greenwood (Wirral West) (Lab)]

To understand the significance of the Government’s creation of the sustainability and transformation plans, we need to be aware of what has gone before and consider the extent of the financial crisis. In 2012, the coalition Government passed the Health and Social Care Act, paving the way for the privatisation of the national health service and removing the duty of the Secretary of State to provide and secure a comprehensive health service in England. I believe the STPs are a key part of the Government’s plan to drive through privatisation.

[Mr George Howarth (Knowsley) (Lab)]

Does my hon. Friend agree that the concern in our part of the world is that the word “sustainability” is all about financial sustainability, not the sustainability of services?

[Margaret Greenwood]

My right hon. Friend has hit the nail on the head.

Monday’s Liverpool Echo leaked some of the detail of Merseyside and Cheshire’s STP, reporting an anticipated £1 billion deficit by 2021. The STP talks about a

“need to reduce demand, reduce unwarranted variation and reduce cost.”

Those are all very nice ambitions, but the idea of trying to reduce demand just to plug a £1 billion funding gap is, frankly, the wrong way to deal with planning a sensible health service. The STP also says that there is an “appetite” for hospital reconfiguration—an appetite among whom, one might ask—as the existing set-up is unaffordable. It says there will be a requirement for

“our hospitals to be reconfigured, consolidated with less sites and clinicians and consultants working increasingly in new emerging networks.”

There is a problem with commas in the document, so who knows what it means. In other words, there will be cuts to staff and cuts to hospitals.

[Mr Mark Hendrick (Preston) (Lab/Co-op)]

Does that not show—it was certainly the case in the Chorley A&E closure—how this is being done by stealth? There has clearly been an increase in demand, but the support has been spread, rather than targeted at localities.

[Margaret Greenwood]

My hon. Friend is absolutely right.

The plan goes on to say that

“the shape and size of the hospital’s bed base will need to be reconfigured”.

In other words, there is a real threat to the number of available hospital beds we will have, and I am particularly concerned about Arrowe Park hospital in my constituency. One radical proposal is the merger of four major hospitals in the area.

Let us be clear: the STPs are vehicles for cuts. They are being devised in secret—hence the need for the local paper to leak the details—and are to be delivered by local areas at arm’s length from the Secretary of State, just as the Health and Social Care Act 2012 allows. He can just shrug his shoulders and say that it is nothing to do with him. That is absolutely not good enough.

The Government must publish the STPs in full. They must provide time and resources for meaningful consultation with healthcare workers, the public and elected representatives, and provide the extra funding the NHS so desperately needs. Otherwise, the STPs will prove the final piece in the privatisation jigsaw, and we will see the sale of assets, our hospitals sold off, and the break-up of services, with patients having to find their way around a fragmented and dwindling healthcare system. Our hard-working NHS staff will see more and more of their jobs moving to private providers and their pay, terms and conditions being undermined. The public absolutely do not want that. They know what the Government are up to—I have had such a big mailbag on this issue. People are concerned and absolutely understand the context. There is a way around this: it is time for the Government to hold up their hands, admit that they have been rumbled and put an end to their privatisation of the national health service.

Oral Answers to Questions

Margaret Greenwood Excerpts

Tuesday 5th July 2016 Commons Chamber

[Ben Gummer]

There will be 10,000 additional places over the five years from when the policy was announced last year, and that will give NHS organisations throughout the country the assistance that will enable them to bring down their agency costs. It is only through such bold initiatives that we can reform the NHS for the betterment of patient care throughout the country.

[Margaret Greenwood (Wirral West) (Lab)]

13. What assessment his Department has made of the potential effect of measures to reduce the size of NHS deficits on NHS staff numbers.

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

Trusts and foundation trusts are responsible for ensuring that their workforces are affordable, given the financial control totals that have been set for this financial year. We are clear about the fact that the first priority in the reduction of provider deficits will be to reduce unsustainable spending on high-cost temporary staff.

[Margaret Greenwood]

Five per cent. of NHS workers in England come from the European Union. What steps is the Minister taking to ensure that every effort is made to retain those skilled workers, and will he provide them with the confirmation of their permanent employment status that they so urgently need?

[Ben Gummer]

At the risk of repeating what the Secretary of State and I have said previously, we very much welcome the contribution of all EU nationals working in the NHS. It is for the process of the negotiations to establish the precise status of everyone, both EU nationals and British nationals working abroad. That was not my choice at the referendum, but the decision has been made by the British people. I hope that the hon. Lady will take comfort from what the Home Secretary has been clear about: that she hopes to be able to secure a deal so that we can retain EU nationals in this country.

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[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

Community hospitals form an important part of the NHS landscape and are valued by local communities, many of which have contributed to them through their fundraising efforts. The Secretary of State has to abide by the decisions of the Independent Reconfiguration Panel and the advice of clinicians, but it is clear that community hospitals that evolve and modernise will have a place in the NHS in the future.

[Margaret Greenwood (Wirral West) (Lab)]

T6. The cancer drugs fund is due to be handed back to NICE later this month. In May, 15 leading UK cancer charities published an open letter detailing their concern that that would see patients missing out on clinically proven cancer drugs because the NICE system is outdated and no longer fit for purpose. Will the Secretary of State agree to carry out a wide-ranging review of NICE’s health technology appraisal process for cancer drugs to ensure that all cancer patients can access the drugs they need?

[George Freeman]

I am delighted to assure the hon. Lady that as part of the accelerated access review, we are considering how we can ensure that the £1 billion commitment to the cancer drugs fund is used to accelerate through the most effective treatments, and, through the new system that NHS England is putting in place, to make sure that patients get access to better drugs more quickly.

Land Registry

Margaret Greenwood Excerpts

Thursday 30th June 2016 Commons Chamber

[Mr Lammy]

I am hugely grateful to my right hon. Friend for all the work he is doing on the basic issue of transparency. The strength of feeling in the House is largely based on that issue, to which I shall return in the course of my speech.

[Margaret Greenwood (Wirral West) (Lab)]

I congratulate my right hon. Friend on securing this important debate. I too have been inundated with responses, and indeed I met a constituent who was proud to have worked for the Land Registry for many years. Does he agree that public confidence is vital, particularly for our housing industry, and that in these times of real uncertainty about the economy and the future of house building in this country, the Government are taking an unnecessary risk?

[Mr Lammy]

My hon. Friend makes an excellent point. In these troubled times, when confidence in this House and in major political parties is at a low ebb, it is important to recognise the institutions that the public hold dear, of which the Land Registry is certainly one. As a former Minister who had responsibility for the Land Registry, I am well aware of the valuable roles it plays.

NHS Bursaries

Margaret Greenwood Excerpts

Wednesday 4th May 2016 Commons Chamber

[Margaret Greenwood (Wirral West) (Lab)]

I am pleased to hear that the hon. Member for Sherwood (Mark Spencer) values the NHS so highly, but he might like to reflect on the fact that the coalition Government legislated to allow all NHS hospitals to make up to 49% of their money from private patients. Perhaps he will review his opinion of his party’s performance when he starts to see the number of private patients in his local hospital increase and the number of NHS patients decrease.

The Royal College of Nursing and the Royal College of Midwives are concerned that abolishing nurse bursaries and free tuition will break the historic link between the NHS and trainee nurses. I share their concern, and I believe that the Government’s proposal is part and parcel of wider changes that they are seeking to make to the culture of the NHS. They are turning the emphasis away from training people to be part of the NHS family, in which they can work with dedication throughout their working lives, towards training them to work in a fragmented health marketplace. If the plans go ahead, the nurses of the future may no longer feel the same obligation to work in the NHS and could be more inclined to work abroad or in private hospitals to pay off their debt. Who could blame them? They will feel that the Government have deserted them.

The Minister was unable to tell us what the average repayment would be, so I will let the union Unison give him the answer. It states that debt repayment will effectively mean a pay cut of more than £900 a year. The question arises of whether the changes will deter people from training to be nurses in the first place. The Royal College of Nursing and other bodies such as the Royal College of Midwives, the College of Podiatry and the Royal College of Speech and Language Therapists think that they will. The Government’s own consultation document estimates that a trainee nurse who takes out the maximum tuition and maintenance loans for three years will graduate with debts of between £47,712 and £59,106. Who would want to embark on a lifetime of caring for others with a debt of that size?

That brings us to the concern that the measures will lead to further shortages. We are all aware of the shortages in our hospitals. The coalition Government allowed the number of training places to fall from more than 20,000 to just 17,000 in 2011 and 2012, the lowest level since the 1990s. As a result, over 8,000 fewer nurses were trained in the 2010 to 2015 Parliament compared with 2010-11. Those cuts in training places have meant that nurse numbers have failed to keep pace with demand. According to calculations by the House of Commons Library, the number of nurses per 100,000 population has fallen from 679 in 2009 to 665.

There are real concerns that removing NHS bursaries will only make matters worse. As was mentioned by my hon. Friend the Member for Scunthorpe (Nic Dakin), the independent NHS Pay Review Body has said that

“the removal of the incentive of the bursary could have an unsettling effect on the number and quality of applications for nursing training places in the early years. In addition, the reduction of net pay in the early years, as nurses repay their loans, will make the employment package and medium to long term reward offer an important factor in attracting high calibre students who are choosing between courses and career options.”

The Secretary of State should definitely focus on that.

The Royal College of Nursing is also concerned that there is a risk that the changes could result in an uneven distribution of students across nursing specialties and geographically across the UK. Health Education England currently commissions student places for four branches of nursing: adult, children, learning disabilities and mental health. Without workplace planning by a central body, there could be insufficient numbers across the four branches, as some may be more popular than others. There has been no indication of whether there will be any control over which sectors nurses train for in future or whether that will simply be determined by—of course, under this Government—the market. That could leave some sectors with even greater shortages than at present.

Tuition is currently paid for by Health Education England. Under the current system, no students have to pay tuition fees and fees are not means-tested. Students also receive a non-means-tested grant of £1,000, or £1,000 pro rata for part-time students. Students also qualify for a maintenance grant or bursary, which is means-tested, as well as additional allowances when a term lasts longer than 30 weeks, and help with the costs of clinical placements. I believe that that is the appropriate way to deliver NHS nurse training. If we are to continue to have a state-run public NHS, free at the point of need, we must continue to provide bursaries for our NHS nurses. It is the very least that we owe them.

Junior Doctors Contracts

Margaret Greenwood Excerpts

Monday 18th April 2016 Commons Chamber

[Mr Hunt]

Of course I am delighted to engage with junior doctors, and I have been talking to a number of them over recent months. I agree with my hon. Friend. My observation from talking to junior doctors is that most of the time I am with them, they are not talking about things they do not like about the new contracts. They are concerned about things to do with their training and quality of life—things that I think we can sort out outside the current contractual negotiations. As my hon. Friend has correctly been passing on to them, there are many things in the new contract that will benefit junior doctors, and we should make sure that everyone knows about them.

[Margaret Greenwood (Wirral West) (Lab)]

How can the Secretary of State claim that he is motivated by a desire for a seven-day NHS when he and others in the coalition Government legislated to allow hospitals to make up to 49% of their money from private patients? If hospitals achieve that 49%, what impact will that have on mortality rates for NHS patients?

[Mr Hunt]

The difference between those of us on the Government side of the House and those on the Opposition side is that we do not have an ideological view about a trust wanting to offer some private treatment in order to benefit its NHS patients. That is what some trusts are doing, within very strict constraints. I think that most people know that all the scare stories that were put out about the Health and Social Care Bill in 2012 have not materialised. We are finding that trusts are being very sensible about making sure they get that balance right. Indeed, in certain circumstances it makes a big difference to improving NHS care.

Oral Answers to Questions

Margaret Greenwood Excerpts

Tuesday 22nd March 2016 Commons Chamber

[Mr Hunt]

We are actually putting in £10 billion of additional public money to support the NHS over the next few years. That means that we need to find between £20 billion and £22 billion of efficiency savings. We will be reviewing the progress of the plan as we go through it, but I want to reassure my hon. Friend that I meet the chief executive of NHS England to view the progress of the plan every week and that we are absolutely determined to ensure that we roll it out as quickly as possible.

[Margaret Greenwood (Wirral West) (Lab)]

T4. I would like to express my sadness at the news that two people in my constituency lost their lives in a house fire yesterday. My thoughts are with their family and friends at this extremely sad time. The coalition Government legislated for NHS hospitals to earn up to 49% of their money from private patients. Arrowe Park hospital in my constituency is highly valued by local people for the service that it delivers, so for the sake of clarity will the Minister tell us whether he sees an increase in the number of NHS beds being used for private patients and a decrease in the number being used for NHS patients as a sign of success or a sign of failure?

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

The matter of private beds is entirely for the trust to decide, but we are very clear that NHS patients should always come first.

BMA (Contract Negotiations)

Margaret Greenwood Excerpts

Monday 21st March 2016 Westminster Hall

[Margaret Greenwood (Wirral West) (Lab)]

It is a pleasure to serve under your chairmanship, Sir David. Today we are here to consider the e-petition that calls on

“Jeremy Hunt to resume meaningful contract negotiations with the BMA.”

This is a matter of the utmost urgency. We have an unprecedented situation in our country: the Secretary of State for Health has turned what should have been constructive negotiations into a battle with junior doctors—the highly skilled and committed professional people on whom we all rely. The last strike by junior doctors was 40 years ago. This strike is one that nobody wants and to which everyone wants to see a resolution.

In the autumn last year I met a group of junior doctors in my constituency. They came to visit me at my office in Hoylake. They spoke in great detail about the problems they had with the new contracts. Their stand-out concerns were: the impact on patient safety; the effect the new contracts would have on the ability of doctors to have a family life of their own; the damage the contracts would do to the prospects of those professionals who seek to pursue different specialisms as their careers progress; and the impact they would have on the careers of women in particular and in turn the impact that would have on the NHS.

One junior doctor who came to speak to me was nearly in tears—in fact, she told me that she had been in tears—as she described how she had wanted to be a doctor since the age of 10. She loves her job, but she also loves her children. She feels she is being forced to choose between being a doctor and being a mum, and that is an impossible decision for any woman. Her children need to see her on Saturdays, and she needs to see them, too.

The period for which doctors are paid at the standard rate, or plain time, is currently Monday to Friday, 7 am to 7 pm. Under the new contract, plain time will be extended to Monday to Friday, 7 am to 9 pm, and will include Saturdays from 7 am to 5 pm. Those are considerable changes that interfere with the prospects of junior doctors enjoying their weekends. They should be entitled to spend at least some of their weekends with their families.

That meeting happened last autumn, and we are more than six months further down the line. Instead of listening to the concerns of junior doctors, as so many MPs have, the Secretary of State has decided to impose a contract that the vast majority do not wish to sign up to. A couple of weeks ago I received an email from Charlotte, a junior doctor in Wirral. She told me:

“Since the announcement of the imposition juniors are scared, confused and do not know what the future holds for them…Junior doctors are angry that the government has failed to recognise and value the workforce through this imposition. Due to this, there is a big and real risk of exacerbating a recruitment and retention crisis as demoralised and demotivated doctors leave the profession or leave the country to work abroad.”

Of course, Charlotte is right. The threat of the NHS losing many junior doctors to Wales, Scotland and as far away as Australia is real. In the 10 days after the Government first announced their intention to impose a new contract, the General Medical Council received 3,468 requests for a certificate of current professional status, the paperwork needed to register and practise medicine outside the UK. In more stable times, the GMC might normally expect to receive 250 such requests at most. If there is indeed an exodus of junior doctors from the NHS in England, that will deliver a real blow to the operational capacity of the NHS and will come on top of the crisis in nurse training places.

Charlotte made other important points, and I assured her that I would raise them with the Minister. She said:

“The proposals governing non-resident on call (NROC) availability have not been properly worked out. The concerns are that the very low availability of allowance may contribute to recruitment problems (especially in psychiatry)”.

That is a real concern now that we are all agreed that we should have parity of esteem between physical and mental health. She also said that

“the allowance does not reflect how busy NROC can be and the means of pay would be an estimate for hours worked...Pay protection on changing specialty is also an issue.”

That is something I have heard from other junior doctors in my constituency. She continued:

“At the moment if someone choses to train in another specialty (eg GP to A&E) the pay remains the same as a recognition that skills are transferable and that the doctor has beneficial experience that they can take with them…I myself spent a year in surgery before I realised it was not for me and transferred to A&E. Under the new contract if you transferred to another specialty, your pay would go back down to the lowest pay point which would be very problematic.”

I think we can all see how someone who has experience in surgery and who then decides to change course will be so much more useful in the new path that they choose.

Charlotte continued:

“Indeed, many juniors do not understand how to work out what their pay is likely to be under the new contract and it is likely to be after imposition in August that we find this out. Many doctors—an estimate of over 50%—do not follow a straight, continuous path through training. Maternity leave…time out for academic or other training, changes of specialty, or alterations to training mean that it is unclear to many what training or experience will or will not be recognised in the new contract…The failure to recognise the work junior doctors do throughout the 7 day week is another factor. We are not objecting to working weekends and indeed most juniors already do, but we just want the opportunity cost of doing so to be recognised in pay. It is disappointing that junior doctors are being seen as the barrier to seven-day services without the government defining what this means or adequately resourcing the whole multi-disciplinary team.”

Charlotte is right: the truth of the matter is that we already have a seven-day NHS. It operates 24 hours a day, seven days a week, and junior doctors regularly work at weekends and accept that as part of the job. That is not in dispute. In fact, the report by Sir Bruce Keogh into a 24/7 NHS acknowledged that and instead focused on the availability of consultants and diagnostic staff such as radiologists or phlebotomists, not junior doctors. The report said:

“our junior doctors feel clinically exposed and unsupported at weekends”.

Another junior doctor told me that he felt that the attack on junior doctors was just the start of the Government’s plans for NHS staff. He said:

“If they manage to force the junior doctors to take unsafe and unfair contracts, the rest of NHS staff will fall like skittles.”

It seems then that the Secretary of State has lost the trust of the profession, and that has to be of real and serious concern.

My hon. Friend the Member for Warrington North (Helen Jones) has ably raised the questions around what the Government mean by a 24/7 NHS, but it is important that we also consider the funding crisis facing the NHS. In the past couple of days, worrying news seems to be emerging that the Prime Minister knew in the last Parliament that the financial situation in the NHS was far worse than was being claimed. Simon Stevens, the chief executive of NHS England, calculated that the NHS needed £16 billion more over the course of this Parliament, but was ordered by Downing Street to halve the size of his cash demands. I would be very interested if the Minister could comment on that. If the Prime Minister did know that, it raises serious questions about what the Government’s stated ambition to expand NHS services at weekends is all about. Is it realistic and costed? Is it rash or is it something else? I would appreciate an answer on those points. The issue of trust has been raised yet again.

There cannot be a single Member of the House who has not at some time in their life had reason to thank our junior doctors. We put our trust in them. They are there at difficult births and when people die, and the level of commitment and expertise that we receive at their hands—free at the point of need and paid for through taxation—is the envy of the world. We cannot let the mishandling of the negotiations lead to catastrophic damage to our most treasured institution. No one wants to see the Government inflict such a blow on the capacity of our national health service, and I urge the Minister to row back from the imposition of junior doctors’ contracts and to get back to the negotiating table.

--- Later in debate ---

[Andy Slaughter]

I will move on, because when someone is in a hole, they should really stop digging.

[Margaret Greenwood]

I could not let the comment made by the hon. Member for Morley and Outwood (Andrea Jenkyns) pass. Jeremy Corbyn is the leader of the Opposition, and the Conservative party is in turmoil today in the face of his leadership. Being a Corbynite and a member of the BMA is no bad thing—I just wanted to clear that up.

[Andy Slaughter]

I will try to put an end to this exchange, but it is tragic that a party of the stature of the Conservative party should turn its guns on the profession and on a representative body such as the BMA in this despicable way. It is extraordinary. I will go further and praise those in the BMA who have had their positions undermined and suffered character assassination and being idly quoted in tittle-tattle on Twitter. Last week the hon. Member for Central Ayrshire (Dr Whitford) hosted an open session for Members at which I was pleased to renew an acquaintance with Dr Johann Malawana, who has been a particular target of insidious and malicious personal attacks, supported by the jackals in the right-wing press. Is that really how a Government should behave in dealing with any industrial dispute, particularly one as serious as this?

Depending on when the debate ends, I may have to leave for a constituency engagement—I have said that to you, Sir David, and I apologise to you and to the Front Benchers—so I will make my comments brief to give other Members time to make theirs. I simply want to say to the Minister, who can no doubt take the message from this debate back to the Secretary of State, that there is nothing dishonourable about continuing negotiations in this dispute. There is an attitude of despair among junior doctors, which has led to some of the statistics we have already heard about those who now wish to leave the profession or move to other jurisdictions where they would be more appreciated.

The Government were initially resistant to going to ACAS, but in the end they agreed. Progress was made at ACAS, but at the end there were still matters outstanding. Everything that I have learned from talking to junior doctors suggests that not only do they not want to take industrial action, and not only do they want to continue serving their patients to the best of their ability, but they are prepared to sit down and compromise. However, they are faced with a wholly intractable Government.

Is the best that we can get from the Secretary of State the misappropriation of statistics to prove something that is clearly false on two levels? It is false because the so-called weekend deaths are not as he has presented to the public, and it is false to say that we do not have a seven-day emergency service now. Of course we do. I strongly believe that we need to restore trust and faith in the relationship between the NHS and junior doctors, and the Government have an important role to play in that. Unfortunately, individual trusts are under such financial pressure, and their management under such strain, that it is tempting for them to exploit junior doctors.

On the guardianship system, we know about the assurances that have been given and the protections in the existing contracts. I do not think there has been a previous example of a contract being imposed on the NHS in this way. I simply urge the Government to think again. There is a deal to be done, there really is. The fact that they are not even prepared to sit down and negotiate again implies that they do not want a deal to be done. They want to play hardball, and they want to get something that is completely different from what they say. They already have their emergency service and they already have junior doctors working the way they want, and they say they do not wish to save money. They have different motives from those that they are expressing. They therefore need to return to the negotiating table. They need a pragmatic solution, and they need to step back and calm down.

I will read the Front Benchers’ speeches tomorrow if I am not here for them, but I hope we will hear a better spirit of conciliation than we have heard so far.