UK Ebola Preparedness

Debate between Margot James and Jeremy Hunt

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)

Debate between Margot James and Jeremy Hunt

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

Debate between Margot James and Jeremy Hunt

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.

Special Measures Regime

Debate between Margot James and Jeremy Hunt

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

Debate between Margot James and Jeremy Hunt

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?

Patient Safety

Debate between Margot James and Jeremy Hunt

Tuesday 24th June 2014 Commons Chamber

[Mr Hunt]

I absolutely agree with my hon. Friend. I have had many discussions with him as he has campaigned in the House for his local hospital. The creation of a culture of openness and transparency should have support in all parts of the House, but that will not happen if every time we are honest about a problem, we are told that we are somehow running down the NHS. I urge Labour Members to think carefully about the way in which they approach this issue.

[Margot James (Stourbridge) (Con)]

I applaud the cultural change that my right hon. Friend is leading in the NHS and the social care sector. As he may know, three former members of staff at Granary care home, owned by Shaw Healthcare, were last week found guilty of appalling violence and abuse of frail elderly patients. The sentences handed down to those three individuals were utterly derisory, the longest being four months in prison. Will my right hon. Friend meet the Secretary of State for Justice to review sentencing in this crucial area?

[Mr Hunt]

I shall be happy to raise that issue with the Justice Secretary, and I thank my hon. Friend for raising it. I think it reminds us that whatever changes we may make in the House, it will take time for them to filter through. I am afraid that, even now, some terrible things are happening. One of the things that worries me most is that abuse of this kind often involves people who have dementia and cannot speak up for themselves. That is why it is so important for us to raise the profile of dementia, and to improve the training of those who care for people with the condition.

Oral Answers to Questions

Debate between Margot James and Jeremy Hunt

Tuesday 14th January 2014 Commons Chamber

[Mr Hunt]

Thank you for that guidance, Mr Speaker. Let me assure you that this winter, a lot is happening in Telford to break down the barriers between the health and social care systems. One big change we are championing—it is starting to happen for the first time—is a seven-day social care system, so that hospitals can get people assessed and discharge them at weekends. With respect to the hon. Gentleman, if he looks at the facts, he will see that that is beginning to happen in a way that it did not when Labour was in power. He should welcome it.

[Margot James (Stourbridge) (Con)]

I congratulate my right hon. Friend on the planning for, and the extra resources he has committed to, relieving winter pressures in A and E departments. What effect does he expect the additional combined budget for health and social care to have on admissions to A and E, particularly of older people?

[Mr Hunt]

We know that every year, 1.2 million of 5.2 million admissions to hospitals are avoidable if we have better alternatives in the community. The Government believe that restoring that personal link between doctors and the people on their lists—the people in their communities—who could often be much better looked after outside hospitals is the way to deal with that. That is why we are making that major change to the GP contract—it is the biggest change since named GPs were removed in 2004. That will benefit my hon. Friend’s constituents and those of all hon. Members.

Oral Answers to Questions

Debate between Margot James and Jeremy Hunt

Tuesday 26th November 2013 Commons Chamber

[Mr Hunt]

We have gained more than 600 additional A and E doctors over the last three years, so the numbers are rising. However, the best thing that we can do for A and E staff is to give them a sense that we are addressing the long-term challenges that they face. The issues of integration with social care and delayed discharges are being addressed through the health and social care integration transformation fund, but we must also ensure that there are better primary care alternatives. The named GP for the over-75s will make a big difference in that regard.

[Margot James (Stourbridge) (Con)]

My local hospital, Russells Hall, is experiencing considerable difficulty in recruiting A and E consultants. Would not a good alternative approach be to train more paramedics to serve on ambulances and provide more effective and robust triage at emergency centres, so that patients can be redirected when necessary?

[Mr Hunt]

As ever, my hon. Friend speaks very wisely about this subject. In his review of A and E services, which was published a couple of weeks ago, Professor Keogh said that paramedics could deal with 50% of 999 calls on the spot, without taking people to hospital. I think that there is a big role for ambulance services that are prepared to upskill. It is also important for us to ensure that they have the necessary information. One of the main changes that we intend to make next year will ensure that they have access to the GP records of the people whom they pick up, so that they can give those people the care that they need in their own homes.

Mid Staffordshire NHS Foundation Trust

Debate between Margot James and Jeremy Hunt

Tuesday 19th November 2013 Commons Chamber

[Mr Hunt]

I absolutely want to encourage that. I know that the right hon. Lady has campaigned a great deal on the needs of people with dementia, and I share her desire to do much better for them. Salford Royal is one of the best hospitals in the country and we should always learn from what it does, but 25% of people in hospitals now have dementia. The tragedy of what happened at Mid Staffs and of many of the stories of poor care in other hospitals that we read about is that very often they involve people with dementia, because they are the kinds of people who have been deprioritised when hospital managements have decided, for example, that they want to cut nursing inappropriately. We absolutely have to change that culture. There is now a very good system at several hospitals. People with dementia, in particular, must be helped to eat and drink at meal times. Many of us have been shocked by the stories of full trays of food being taken away because someone is unable to eat unaided. That, in particular, we need to stamp right out.

[Margot James (Stourbridge) (Con)]

The Cavendish review found too many instances of health care assistants being badly treated and managed by nurses. Health care assistants, now to be called nursing assistants, are on the front line of very many patient experiences. Will my right hon. Friend assure the House that other measures, in addition to the very welcome new certificate for nursing assistants, will provide the extra support to those staff that is obviously needed?

[Mr Hunt]

It is really important that we value the work of some of the lowest-paid people in hospitals who are carrying out some of the most important personal care for patients. They need to be managed properly, fairly and decently, given how important that work is. We need to ensure that nurses have the right attitude to the health care assistants who are working for them—as, most of the time, they absolutely do. That is why earlier in the year we proposed changes that we are piloting, so that before getting funding for a nursing degree, people had to spend time, potentially up to a year, on the front line as health care assistants. That will allow them to experience just how important that work is and then perhaps appreciate it a bit more.

Hospital Mortality Rates

Debate between Margot James and Jeremy Hunt

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

Yes, I can. We have accepted the recommendation that there should be a duty of candour on the boards of hospitals, with criminal sanctions if they fail to tell members of the public that they or their loved ones have been harmed by the hospital, and if they fail to tell the system that those incidents have happened. We have commissioned a review of safety by Sir Don Berwick, one of the greatest experts in the world, and we shall ask him whether we should extend that duty of candour to below board level. We shall wait to hear what he says. We understand the reasons why people might want to do that, but we are also aware that others have expressed the concern that it might destroy an atmosphere of trust in a hospital if people were worried about criminal consequences if they did not talk about any failures they saw in their daily work.

[Margot James (Stourbridge) (Con)]

I warmly welcome my right hon. Friend’s break with the culture of cover-up that has been so prevalent in the past. I reject absolutely the shadow Health Secretary’s claim that the Dudley Group NHS Foundation Trust’s performance has deteriorated since 2010—[Interruption.]

[Margot James]

Thank you, Mr Speaker.

I reject the shadow Health Secretary’s claim. The new leadership that was appointed to the trust in 2009 found deep-seated problems there. Does my right hon. Friend the Secretary of State welcome, as I do, the positive notes in Sir Bruce Keogh’s report about that new leadership’s abilities, and Sir Bruce’s finding that the overall work force at our trust are

“committed, loyal, passionate, caring and motivated”?

[Mr Hunt]

I welcome that, and I am delighted that my hon. Friend’s trust was not one of the ones that it was necessary to put into special measures. We have learnt a lesson from the successful way in which the schools system is regulated. Ofsted distinguishes between failing schools that have in place good management who are able to turn the school round and those where a change of leadership is required, and I am pleased that the report found that Dudley had the right leadership in place.

Oral Answers to Questions

Debate between Margot James and Jeremy Hunt

Tuesday 16th July 2013 Commons Chamber

[Margot James (Stourbridge) (Con)]

11. What steps he is taking to improve the care of vulnerable older people.

[The Secretary of State for Health (Mr Jeremy Hunt)]

We are taking a great deal of measures to improve services for vulnerable older people, who make up the bulk of the work the NHS does, and in particular to make sure they are always treated with dignity and respect.

[Margot James]

I thank my right hon. Friend for his answer. Earlier this year the Care Quality Commission found that people with dementia end up in hospital more often, stay longer and are more likely to die there. What can he do to encourage greater provision of good-quality specialist care places for patients with dementia in the community?

[Mr Hunt]

My hon. Friend makes an important point. Nearly 60% of people with dementia are in a care setting, but one of the tragedies is that many of them could continue to live healthily and happily at home for much longer if they were given the support that they needed. Often, however, that support does not arrive until it is too late, when the carer or family member is under too much pressure to be able to look after them. The dementia diagnosis rate at the beginning of this Parliament was less than 40%, but our objective is to get that up to two thirds by the end of the Parliament. Also, we want to ensure that a proper care plan is in place for the two thirds who are diagnosed, so that we can avoid the problems that my hon. Friend has highlighted.

Care Quality Commission (Morecambe Bay Hospitals)

Debate between Margot James and Jeremy Hunt

Wednesday 19th June 2013 Commons Chamber

[Mr Hunt]

They need to explain why Barbara Young made the comments that she did. I think there was a general desire to talk up the NHS and not to talk about some of the very deep-seated problems that have now come to light. It is our duty in all parts of the House to make sure that we have a more mature discussion about the NHS when problems arise, and that we do not always seek to throw party political stones but recognise when problems arise. We should talk about them, not cover them up.

[Margot James (Stourbridge) (Con)]

I attended a presentation given by the CQC in early 2011 and I was shocked at the low calibre of what I heard. In particular, I found the CEO at that time to be out of her depth. My right hon. Friend will know that the individual concerned was previously CEO of the West Midlands strategic health authority between 2006 and 2008, at the time of the scandal of Mid Staffs. Will my right hon. Friend say a little more about what he plans to do to improve the appointment process for senior positions in the wider health service to ensure that proper scrutiny of people’s prior performance takes place?

[Mr Hunt]

That is a very good question from my hon. Friend. We need to make sure that we have absolutely the right people in place. One of the lessons that we have learned from Ofsted, which has been an extremely successful regulator in the education sector, is that what works is having people who are prepared to speak truth to power—who are prepared to say uncomfortable things even to the people who have appointed them. I have had this conversation with Mike Richards, because I have the highest opinion of Mike, and I also know that he will say things while I am Secretary of State that will make me deeply uncomfortable. We have to understand that part of the way that we will make sure that the NHS is and continues to be one of the very best health services in the world is having that rigour in the inspection process.

Mid Staffordshire NHS Foundation Trust

Debate between Margot James and Jeremy Hunt

Tuesday 26th March 2013 Commons Chamber

[Mr Hunt]

That is the kind of shocking practice that is totally unacceptable.

[Margot James (Stourbridge) (Con)]

I very much welcome the return of student nurses to the wards for a year of their training. Project 2000 has much to answer for. On the subject of resourcing and staff to patient ratios, may I remind my right hon. Friend that many of the reports we have seen in the last few years, criticising hospitals for poor care and lack of dignity in the care of older people in particular, have shown that wards in the same hospitals have had very different standards of care? How can that be about resourcing?

[Mr Hunt]

My hon. Friend makes an important point. It is important that these assessments are made not just at an organisation level, but drill down into the different parts of a hospital, and we have taken that message on board from the Nuffield report on ratings. She is right that it is not just about resources, but sometimes it is about resources. Parts of a hospital can be understaffed when it comes to people who are required to perform basic and important roles in terms of care. Because it is a complex picture—and because numbers can be part of the problem, but are certainly not the whole problem—we want a chief inspector who will take a holistic view of every aspect of the performance of a hospital and be able to give proper feedback that a hospital can use to improve its performance.

Social Care Funding

Debate between Margot James and Jeremy Hunt

Monday 11th February 2013 Commons Chamber

[Mr Hunt]

I think the hon. Gentleman needs to study these proposals with a great deal more care. If he had listened to them, he would know that we are extending dramatically the help available to people who have to pay up to £75,000, by increasing the threshold from £23,000 to £123,000 at 2017-18 prices.

[Margot James (Stourbridge) (Con)]

I warmly welcome the action that my right hon. Friend has taken today. To the critics who say that the cap should be lower, would he not say that the main purpose is to provide protection for those people who face catastrophic charges, which are roughly 10% to 15%? Is that not the main point? Does he agree further that this represents a fair resolution between the people’s responsibility to save for their retirement and the responsibilities of the community to protect those to whom catastrophic charges might apply?

[Mr Hunt]

My hon. Friend, as so often on health matters, is absolutely right. This is about a partnership between the state and the citizen, recognising that the state is not able to bear all these costs on its own, and trying to create the incentives and the certainty whereby private citizens are able to make provision for their own social care costs in the way that they make provision for their pension and, as such, is a very important step forward.