Oral Answers to Questions

Margot James Excerpts

Tuesday 29th October 2019 Commons Chamber

[Margot James (Stourbridge) (Ind)]

6. What recent assessment he has made of the effectiveness of Bedrolite in treating (a) multiple sclerosis and (b) other neurological conditions.

[The Secretary of State for Health and Social Care (Matt Hancock)]

We have changed the law so that specialist doctors on the GMC’s specialist register can now prescribe cannabis-based products. I have asked the NHS to undertake a rapid review of how this is working, and my Department is now working with delivery partners to implement the report’s recommendations.

[Margot James]

I thank my right hon. Friend for his answer, and for his work in this area, but leaving the decision to prescribe cannabis for medical use to individual doctors while NICE is saying that more evidence is needed risks the inertia that has led the MS Society to conclude that not a single person has yet benefited from the legalisation of cannabis for medical use, except those who are able to pay up to £1,000 a month. Will my right hon. Friend meet the MS Society and me to discuss more ways of accelerating the uptake of Bedrolite among patients who have a reasonable expectation of benefiting from it?

[Matt Hancock]

I am very happy to meet my hon. Friend and colleagues from the MS Society. She is right to say that we need to ensure we get the evidence that the clinicians understandably want, and in fact we have committed public funds, through the National Institute for Health Research, to establish clinical trials to develop that evidence base.

The National Health Service

Margot James Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Matt Hancock]

Yes, that will absolutely be addressed. We also have a report by Baroness Cumberlege that will look specifically in that matter, which is incredibly important for many people. We absolutely have to get it right.

I wish to touch briefly on three further measures: first, the Health Service Safety Investigations Bill. Millions of people receive life-saving care in the NHS, but saving lives also involves risk. It is important that we learn both when things go well and when things go badly. We want to create that learning culture right across the NHS. The legislation will establish in law the first independent body of its kind to investigate patient safety concerns and share recommendations to improve care. I pay tribute to my predecessor, my right hon. Friend the Member for South West Surrey (Mr Hunt), for all his ongoing work in this area.

Let me turn now to adult social care. We have already announced a new £1 billion grant for social care to address urgent needs, building on the 11% rise in social care budgets over recent years. We have to end the injustice that means that after a lifetime of hard work—of striving and saving—people are being forced to sell their homes to pay for care.

[Margot James (Stourbridge) (Ind)]

I commend my right hon. Friend for his work to improve patient safety. Will he also look into how whistleblowing is being managed in the NHS? We have had a concerning number of issues relating to whistleblowing in my local Dudley healthcare provider. I feel we have not yet managed to get a free and open environment for whistleblowers all the way through the NHS.

[Matt Hancock]

I very much agree with my hon. Friend. In many trusts, things have gone very well over the past few years and there is a much more open and less hierarchical culture, with less bullying and more openness to challenge. However, that is not the case in every part of the NHS, and that needs to change. The Health Service Safety Investigations Bill addresses that directly. After the welcome given by the shadow Secretary of State, I hope that Bill will proceed on an essentially consensual basis.

NHS (Government Spending)

Margot James Excerpts

Wednesday 28th January 2015 Commons Chamber

[Chris Leslie]

If my hon. Friends will allow me, I want to make a little progress, but I will certainly give way again in a moment.

As a member of the shadow Treasury team, I want meticulously to explain the alternative course by which we will deal with the requirement for 20,000 additional nurses and 8,000 additional GPs, and the time to care fund of £2.5 billion. First, we would raise £1.2 billion from the levy on ultra-high-value properties—those worth more than £2 million—the so-called mansion tax.

Secondly, we would raise least £1.15 billion by closing three tax loopholes. The first is that hedge funds are avoiding stamp duty by getting tax-exempt investment banks to buy shares for them. At least £500 million is lost through that tax loophole, and we must close it. The second is that many large corporations, including some of the water utilities, are shifting profits out of the UK by borrowing large sums at high interest rates via their owners’ subsidiary companies through offshore stock exchanges. That is known as the quoted eurobond exemption. The third is that many employment agencies sign up workers to umbrella companies almost at random, and exploit tax reliefs on travel and subsistence without passing them on to the work force. Between £300 million and £600 million is lost to the Exchequer in that way. Those three tax loopholes must be closed.

Thirdly, we need to take £150 million a year from a new levy on tobacco company profits. That levy has worked in the United States, and we believe it is now appropriate in this country.

The sum of £2.5 billion is a significant investment that our NHS needs. It will also provide the time to care for the patients who deserve much more than the 15-minute chunks they have been getting recently.

[Margot James (Stourbridge) (Con)]

Leaving aside the fact that the previous Government were not much good at closing tax loopholes, I am sorry to hear that the Labour party has lost faith with one of the fundamental principles of the NHS, which is that it should be based on need and funded through general taxation. That is the most stable basis for funding our NHS, and the Labour party is taking a great risk with NHS finances by proposing otherwise.

[Chris Leslie]

That is rather interesting. The hon. Lady would criticise us if we said that we would do this through general taxation, but when we show where the money will come from—pound for pound—she criticises that as well. I want to hear the Conservatives say where they will get the extra money from for the NHS. I will come to that in a moment, but I will first give way to my hon. Friend.

--- Later in debate ---

[Margot James (Stourbridge) (Con)]

Let me begin by reminding the House of a few facts. This Government have presided over an additional £12.7 billion of public spending on the NHS, which amounts to a real-terms increase of 4%. That is a singular achievement, given that there have been cuts in every other area of public spending bar two—cuts forced on us by the Labour Government’s appalling management of the public finances.

The public will judge as they find. Anyone who lives anywhere near the Welsh border will know that additional pressures on hospital services have arisen from the exodus of Welsh people in search of decent care. As Government Members have already pointed out, the Labour-run Welsh Assembly Government have cut the NHS in Wales by 8%. That contrasts very unfavourably with this Government’s 4% increase in spending on the English NHS. As I have said, the public will judge as they find.

I want to say a little about our spending on health services in comparison with that of other countries. We are doing quite well at the moment. The European Union average is 8.7% of GDP; the United Kingdom figure is 9.2%, 0.5% higher, and is identical to the Australian figure. We also get a very efficient return on our spending. I applaud the NHS, certainly in my area, for all that it does with that money. Our system is considerably more efficient than the United States’, which is a privatised system based on private insurance. It costs a great deal more to run, and health outcomes are poorer because of the under-treatment of people who are underinsured, and the over-treatment of people who are insured properly. The administrative costs of the American system are also excessive compared with those of the publicly funded NHS.

That is one of the reasons why I am so enraged by Labour’s lies and smears about our position on the NHS. We have no wish to privatise the NHS, even if we thought that was a good idea from an ideological point of view. I am an ex-business person, and if I took over the NHS, the last thing I would want to do is privatise it and create a system that would cost more to run and deliver worse outcomes.

[Grahame M. Morris]

I am sorry to interrupt the hon. Lady’s flow, but I want to defend the land of my fathers, Wales. I do not know whether the hon. Lady was present for the urgent question. We often measure the stress on the system according to the declaration of emergency and major incident plans. There have been 15 in England but, as far as I am aware, none in Wales.

[Margot James]

I do not want to cast aspersions relating to cover-ups and the like on some of the NHS management in Wales, but I think that some members of the hon. Gentleman’s own party have some salutary tales to tell on that front.

However, as was pointed out by my hon. Friend the Member for Sherwood (Mr Spencer), this is not just about spending; it is about how we control the budget and what we get for the money that we spend. I appeal to those who rate the Labour party on the basis of its health policies to reflect on its record. They should remember how much Labour was borrowing when it was running the NHS, and that it was spending money as though it were going out of fashion.

Under the last Government, the number of managers increased three times as fast as the number of nurses, and managers’ pay increased far faster than nurses’ pay. The management pay bill more than doubled under the last Government, but we have reduced it by nearly a fifth. There was absolutely no integration of health and social care under the last Government, although they had 13 years in which to put that right. Despite severe financial constraints, our record has been so much better than theirs, and that is the position I will put to my electorate when the time comes. We have produced 13,000 more doctors and nurses, and 21,000 fewer administrators and managers. That is what the public want to see. They know that this Government have the right priorities. In my area, that has translated to 353 more nurses and 84 more doctors in my hospital since this Government came to power. I congratulate our health ministerial team on not caving in all the time to producer interests—another facet of the last Government, with their command and control culture.

I want to mention a few of the things I am proud this Government have achieved within severe spending constraints. We have ended the indignity of mixed sex-wards. We have reduced infection rates dramatically. C. difficile infection rates have come down by a staggering 63%. The last Government grappled with this issue for 13 years, leaving a disaster when they left office. They had an appalling record. Another great innovation—one of many; I have not got time to mention them all—is the Cancer Drugs Fund, which has helped many of my constituents to get the treatment they were denied under the last Government, with all their spending largesse. That has also flowed through to the hospital sector—imaging and radiodiagnostic tests have increased by 34%. All these benefits have been achieved with very small real-terms increases in spend. That is what this Government have been able to do: deliver more with less.

[James Morris]

Under the previous Government, all the in-patient wards in one of my local hospitals, Rowley Regis, were closed, but during the last four and a half years they have reopened, and there has been lots of innovation and new services coming into that hospital.

--- Later in debate ---

[Margot James]

That is a good example, and I know how hard my hon. Friend has worked in his constituency to assist in bringing about that improvement.

The polls clearly show that the public have very little confidence in Labour’s proposals to manage the economy. However, I want to make sure I do everything I can to get the public to cast a weather-eye over the Opposition’s plans for the NHS, and to remember which party introduced privatisation into the NHS, and why. I remember calling on an elderly lady who had been waiting almost two years for a cataract operation on both eyes. That was what the previous Government presided over, and in desperation they called in the private sector to reduce those waiting times. They could not bring about change within the NHS because of their target-driven management culture and their command and control-driven philosophy, so they had to bring in the private sector.

What we are seeing now is a tiny increase: the whole of the private sector accounts for less than 7% of total NHS activity, so we are talking about a small element that the Opposition are blowing up out of all proportion.

[Barbara Keeley]

Will the hon. Lady give way?

[Margot James]

I am sorry, but I am running out of time.

Labour’s record in government, when the producer interest held sway, stands as a salutary lesson which I hope people will remember.

No wonder there are serious divisions within the Opposition about their health policy, as was reported in the press only today. One Labour Front Bencher was anonymously quoted as saying that it would be a “fatal mistake” to increase the health budget without reforming it. I know there are some people with common sense on the Opposition Benches, but it is a shame they are not in control of health policy.

[Several hon. Members]

rose—

UK Ebola Preparedness

Margot James Excerpts

Monday 5th January 2015 Commons Chamber

[Mr Hunt]

If we could buy it, we would, but there is no availability internationally, and we are waiting for more supplies. We are using other experimental treatments on Pauline, and it is important to stress that we do not know whether ZMapp actually worked, but we want to do absolutely everything we can.

[Margot James (Stourbridge) (Con)]

I wholeheartedly support my right hon. Friend’s comments about the bravery of Pauline Cafferkey and the other health and military workers fighting Ebola in Sierra Leone. Their sacrifice and bravery humble us all. Will he confirm that the Government will continue to follow medical advice and keep a sense of perspective regarding the real threat of contagion when monitoring and setting screening policies here in the UK?

NHS (Five Year Forward View)

Margot James Excerpts

Monday 1st December 2014 Commons Chamber

[Mr Hunt]

I recognise the hon. Lady’s concern about the way funding is allocated, and it is a concern that is shared in all parts of the House. It has been very difficult to get that right in a period when NHS funding has not been going up by large amounts, but that matter is now decided at arm’s length from Ministers by NHS England. It will make its decisions at a board meeting on 17 December, and I will make sure that I relay to it her concerns.

[Margot James (Stourbridge) (Con)]

Does my right hon. Friend agree that all patients, especially older and vulnerable patients, deserve the security of an NHS funded out of general taxation rather than part-funded by an unpredictable and opportunistic tax on people’s homes as proposed by the Labour party?

[Mr Hunt]

The trouble with a mansion tax is that, in the end, it will apply not to mansions but to homes, flats and people on low incomes. That is why it is the wrong way to put more funding into the NHS. The right way to do it is to have a strong economy, and only this Government can deliver that.

Five Year Forward View

Margot James Excerpts

Thursday 23rd October 2014 Commons Chamber

[Mr Hunt]

No, and that is why the Government legislated for parity of esteem between mental and physical health. As I said earlier, we have introduced maximum waiting times for some mental health conditions, and we have focused on improving access to psychological therapies—IAPT—and on dementia. Anxiety and depression and dementia are two of the most common mental health conditions in respect of which we can make a real difference, and we are doing more all the time.

[Margot James (Stourbridge) (Con)]

May I remind the Opposition that the primary care trusts that the clinical commissioning groups replaced sat above primary care, and were remote from it? Let me give an example of how much more integrated the system is now. Our clinical commissioning group has joined our hospital to fund the opening of an urgent care centre, which will relieve pressure on accident and emergency departments and give more patients a chance to gain access to the hospital from primary care. Does my right hon. Friend agree that that is an example of integration, not fragmentation?

[Mr Hunt]

Exactly—that is precisely the point. This report has example after example of how the new structures—clinical commissioning groups—are integrating care. That is why it makes it so clear that it would be wrong to do what Labour wants to do, which is to repeal the Health and Social Care Act 2012 and to strip CCGs of their powers when they are providing precisely the integrated care that we all think is important.

Oral Answers to Questions

Margot James Excerpts

Tuesday 21st October 2014 Commons Chamber

[Dr Poulter]

It is right that hospitals respond when there are not enough staff working there, if that is affecting patient care. That is why under this Government 2,500 more nursing staff are working now than in 2010. That is progress to ensure that we are facing up to challenges in care where they exist at local hospitals.

[Margot James (Stourbridge) (Con)]

Russells Hall hospital in the borough of Dudley has appointed 56 new nurses from overseas since the Keogh review last year. Will my hon. Friend join me in welcoming the graduate trainee programme for nursing that Russells Hall has put in place, which will provide for 100 trained nurses over future years?

[Dr Poulter]

That sounds like a commendable programme. It is good to hear that my hon. Friend’s local trust, where there was a shortage of nurses, is facing up to that and employing more nurses to ensure that patient care is as good as it can be.

Special Measures Regime

Margot James Excerpts

Wednesday 16th July 2014 Commons Chamber

[Mr Hunt]

What are we doing? We are doing what I set out in the statement. We are putting more nurses and doctors into hospitals that are in special measures. We are turning around the failing hospitals that Labour swept under the carpet.

Even if Labour has not understood the lessons of Mid Staffs, the NHS has. We have 6,000 more nurses; five hospitals are out of special measures; there is record public confidence in safe and compassionate care; and, from today, we have new plans to stamp out poor care in adult social care. When everyone in the NHS is so keen for those plans to work, is it not time that Labour ended its denial about the past and backed them as well?

[Margot James (Stourbridge) (Con)]

I congratulate my right hon. Friend on bringing back an expert-led inspection regime for adult social care. I ask him to learn from the experience with schools in Birmingham five, six or seven years ago, which managed to bamboozle Ofsted by planning for the inspections. I ask him to ensure that a good proportion of the inspections under the new regime have no notice whatsoever.

[Mr Hunt]

My hon. Friend, as ever on health issues, makes an extremely important contribution. She is right that we drew a lot of inspiration from the Ofsted regime, which is clear, transparent and easy for the public to understand. She is right that snap inspections are importation. I reassure her that the CQC has the power to perform snap inspections. It has already used that power and will continue to do so.

Oral Answers to Questions

Margot James Excerpts

Tuesday 15th July 2014 Commons Chamber

[Mr Jeremy Hunt]

Let me gently explain to the hon. Lady that she has excellent GP provision in Tower Hamlets, led by Dr Sam Everington. It is a model of what can happen under the Government’s reforms. The way in which we are going to make it easier for people to see their GP is with additional capacity. We have 1,000 more GPs during this Parliament, and we have achieved that only because we took the difficult decision to get rid of 19,000 managers, which was bitterly opposed by the hon. Lady and the Labour party.

[Margot James (Stourbridge) (Con)]

T4. Now that the Medicines and Healthcare Products Regulatory Agency has concluded its consultation on the use of generic asthma inhalers by schools in cases of emergency when a child does not have his or her own inhaler, will my hon. Friend update the House on the next steps? In particular, does she expect schools to be allowed to keep these inhalers in the new school year?

[Jane Ellison]

I congratulate my hon. Friend on her great campaigning on this issue, and on the really good results that she has had. As she says, we have recently consulted on changing the regulations under the Medicines Act 1968 to allow schools to hold inhalers in the way that she has described. There was overwhelming support for such a change, and we will lay the necessary statutory instrument this week to enable the change to come into force on 1 October.

Learning Disabilities (Care in the Community)

Margot James Excerpts

Tuesday 8th July 2014 Westminster Hall

[The Minister of State, Department of Health (Norman Lamb)]

I congratulate the right hon. Member for Coatbridge, Chryston and Bellshill (Mr Clarke) on securing the debate and thank him for doing so. I do not think I disagree with a single word he said in his speech today. The right hon. Member for Oxford East (Mr Smith) also talked about the scandalous case of Connor Sparrowhawk. I have met his mother and what happened there should shock us all. There was acknowledged negligence in the care and these things simply cannot go by without a proper and effective response to stop repeats of this sort of thing ever happening again.

One thing that the right hon. Member for Coatbridge, Chryston and Bellshill focused on was the families, to whom I pay enormous tribute for their campaigning. What is most shocking when one talks to them is the sense that they are not listened to—that they raise their concerns with public bodies and get no effective response. They are ignored and that should shock us all.

The right hon. Gentleman also said that it is an ongoing scandal and a scandalous misuse of public money, and I completely agree with him. This has now gone on for very many years. It is an unacceptable remnant of the previous system of institutional care that has to come to an end. The thing that has depressed me in this job, more than any other aspect of it, is the extent to which it is so difficult to change the culture that allows this sort of thing to carry on. There is the sense that those commissioning care seem, it appears, to be willing to carry on with business as usual, when we know that the outcomes for those individuals are not acceptable, and that very many of these individuals are able to live a better life in supported living in their communities. The imperative to achieve change is as strong as ever, and for as long as I am in this job, I will do everything I can to try to change things.

Because of my total frustration about the way in which commissioning has happened, I chose to go out to visit one 17-year-old girl a couple of weeks ago in an assessment and treatment centre to see it for myself, and to see the barriers that that family are up against and the problems that they have had engaging with the commissioners of care, which, in that case, is NHS England. Indeed, with regard to the case of Josh that the right hon. Gentleman mentioned, I have invited the clinical commissioning group to come into my office on, I think, 22 July, together with NHS England and with the family, so that we can get to the bottom of what has gone wrong and try to achieve a solution. I am prepared to intervene in this way if necessary, to force change to a situation that I regard as completely unacceptable.

I am very pleased to have the opportunity to focus on the needs of people who, as the right hon. Gentleman said, are among the most vulnerable in our society. Many of us share the concern that people with learning disabilities and their families are still getting an unacceptable raw deal from the health and care system, from other public services, and from society in general. People with learning disabilities have exactly the same rights as anyone else, yet they continue to experience discrimination, abuse and a basic lack of respect for their fundamental rights. That should shock us all.

[Margot James (Stourbridge) (Con)]

I am most encouraged by my hon. Friend’s remarks, and I congratulate the right hon. Member for Coatbridge, Chryston and Bellshill (Mr Clarke) on securing this important debate. Has my hon. Friend come across the organisation based just outside my constituency, Changing Our Lives? It was founded by Jayne Leeson, who was awarded the MBE for her services in this area. It is doing such innovative work that demonstrates clearly the potential of people currently in residential care with learning disabilities, who can live a most fulfilling life outside, in the community, through supported living.

[Norman Lamb]

I am very grateful to my hon. Friend for that intervention. I would be interested to hear further information about the organisation to which she refers. It is clear that sometimes a leap of faith is required to give a person the chance of a better life outside, and the system is horribly risk averse. We know that the main cause of decisions to keep people in assessment and treatment centres is the clinical judgment that the person needs to stay there, so that needs to be challenged. I want to give people the right to a second opinion and I am in discussions with Simon Stevens, the chief executive of NHS England, to give people that right, because we have to find ways of giving a voice to people who hitherto have felt that they are ignored and not listened to and that nothing ever changes.

I pay tribute to the two organisations mentioned by the right hon. Member for Coatbridge, Chryston and Bellshill: Mencap and the Challenging Behaviour Foundation, which have continued to make the case on behalf of people with learning disabilities.

Winterbourne View and the appalling abuse of people there reminded us that there is still a massively long way to go to ensure that people are safe and get the right support—the support that they need. The Government’s review following the Winterbourne View case looked at the systemic issues facing people with learning disabilities and their families. At the end of the review, we published the concordat—the right hon. Gentleman referred to that—bringing together all the national organisations to commit to change. In a way, the most distressing thing is that I felt that organisations committing to the concordat and the change set out in it were doing that with a seriousness of intent that they would deliver on. The lack of change that there has been since then is really shocking, given that they committed to achieving that change. Eighteen months on, we all need to remind ourselves that progress so far has not been nearly good enough and that we all need to continue to work in partnership to deliver on the commitments solemnly made at the start of all this.

I have said recently, and the information that we have shows, that far too many people with learning disabilities are still stuck in hospitals, often hundreds of miles from home and in many cases for years, with serious questions about whether they are getting the right care and support.

I have also met Mike Richards, the chief inspector of hospitals, and Paul Lelliott, the deputy chief inspector for mental health, to ensure that the Care Quality Commission challenges organisations. If someone is living in an assessment and treatment centre, which is there for assessment and treatment, not for long-term living, surely it is not delivering the right model of care. That needs to be challenged by the Care Quality Commission and not simply accepted and tolerated.

Collectively, we need to be honest and say that the system has so far completely failed to deliver on the commitment made in the concordat significantly to reduce the number of people with learning disabilities who are in effect living in hospitals—for whom hospital is their home.