Orkambi and Cystic Fibrosis

Marie Rimmer Excerpts

Monday 19th March 2018 Westminster Hall

[Ms Marie Rimmer (St Helens South and Whiston) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Evans. I congratulate the hon. Member for Sutton and Cheam (Paul Scully) on securing the debate. For good reason, the issue has galvanised popular opinion.

As we all know, cystic fibrosis is an extremely serious, debilitating and life-limiting—yet thankfully rare—diagnosis. As we have heard, in February, Vertex proposed a portfolio approach whereby all current and future cystic fibrosis medicines, including Orkambi, would be made available to eligible patients through a fixed budget cap to the NHS.

I was extremely disappointed to hear NHS England’s response on Friday that there will not be further funding for Orkambi. As it is a treatment that is proven to improve and prolong the lives of 50% of sufferers, that decision is a cruelty to cystic fibrosis sufferers across the country. The portfolio approach has been accepted and agreed in the Republic of Ireland, Austria, Denmark, France, Germany, Luxembourg, the Netherlands, Italy, Greece and the US, but sadly, discussions here—with the world’s best health service—have broken down.

CF causes a build-up of mucus in the lungs that means that patients require physiotherapy, almost from birth, to keep them breathing properly. CF patients are more susceptible to lung infections and can suffer from malnutrition owing to the effect of the condition on the pancreas. When NICE made its initial evaluation of Orkambi as a treatment for the devastating condition, the evidence that it slows lung deterioration by 52% and reduces hospital admissions was not available, and therefore not costed. NICE is simply not fit for purpose any longer; it cannot evaluate a portfolio approach and precision drugs. For NHS England to turn its back on the small group of patients that suffers with this rare, debilitating illness and to ask Vertex to reapply to NICE is shocking. If it did reapply, it would get exactly the same answer—so why do it? Does NHS England understand that? Does NICE understand that? Are we going to send these seriously affected families around and around?

Vertex now has a broader pipeline of 18 drugs that will follow Orkambi in the next seven years. If the portfolio is agreed, it will advance on to those medicines. Will the Minister work towards a more flexible approach? Simply, he must get involved to benefit the small group of patients for whom a much better quality of life is in sight, but just out of reach, otherwise they will never get the treatment that they deserve and that they should be getting.

The parents of two constituents, Christian Jones and George Barton, contacted me. Christian’s mother, Hayley, wrote to me and said that Orkambi

“is not a cure but it is life altering, as it lowers admissions and reduces lung deterioration by 42%.”

She believes that Christian’s other medications will only increase unless he can access the drug. She also wrote:

“This genetic condition is awful to live with as a parent, wondering whether you will bury your child before they reach 20. I can’t begin to know how it must be for my son and other patients when they can’t breathe properly or speak without coughing or how his lungs must burn.”

She has nothing but praise for the NHS, in particular Whiston Hospital in my constituency where Christian has been treated since he was just weeks old. He is now two. In trials, Orkambi has been shown to help children aged between six and 11 to improve their oxygen uptake by up to 10%.

Orkambi would also be of immeasurable benefit to my constituent George Barton. George’s mother, Louise, wrote to me when she heard that the NHS’s provision of Orkambi was going to be debated in this place. George is eight years old and, like Christian and most other CF sufferers, was diagnosed as a young baby. CF is progressive, so George’s lungs are beginning to degenerate. Every day, he takes 30 to 40 tablets, has an hour of physio and takes two nebulised antibiotics. Louise told me that when he catches an infection, he can quickly become so seriously ill that he needs extra physiotherapy and intravenous antibiotics three times a day for a full two weeks. At times, George has to stay in Whiston Hospital, or, because he and Louise live nearby, the nurses come out and take care of him at home. In fact, when Louise first wrote to me, she was in hospital with George on a two-week stay. She wrote that although

“the damage to his lungs is becoming more serious, Orkambi can slow this down”.

George, Christian and thousands of other CF patients need that niche treatment, and there is the political will in this place to fight for them. Only about 3,000 people would benefit from the drugs. I urge the Minister to get involved, to facilitate further discussions between NHS England and Vertex, and to push for a flexible solution. Orkambi is a different type of drug that we cannot evaluate at this time. This is not only about licensing Orkambi, but the promise of those 18 drugs still to come, which Vertex will advance on to. NICE simply cannot evaluate and I urge the Minister to intervene.

Organ Donation (Deemed Consent) Bill

Marie Rimmer Excerpts

2nd reading: House of Commons
Friday 23rd February 2018 Commons Chamber

[Ms Marie Rimmer (St Helens South and Whiston) (Lab)]

I pay tribute to my hon. Friend the Member for Coventry North West (Mr Robinson) for introducing this Bill, which speaks to our common humanity. To be in the Chamber today to support it is a great honour for me. Three people die daily in the UK because of the lack of available organs for transplant, and this Bill would increase the chance of an unwell person and a life-saving organ being united.

I pay tribute to my hon. Friend the Member for Sunderland Central (Julie Elliott), who described very similar situations to those of a member of my family who was successful, in the end, in getting their transplant. She was a mother with a newly born third child. We did not know what was wrong with her. She had no energy, could not pick the other children up from school, was not eating, and was often going to the hospital. Eventually, after her husband took her to hospital, she was whisked off to Birmingham. Fortunately she got a kidney transplant while she was there, but unfortunately it was not successful, and we were told that it was highly unlikely that another suitable kidney would be found within the time when it was needed. Thankfully, we got that kidney, she lived, and three children still had their mum. The trauma that the family went through during that time was just unbelievable. We saw the care that the immediate family had to give those three children when she and her husband—my cousin—were in Birmingham. They took care of the children and did what they could. We have been the recipients of the saving of a family—a dear family.

This Bill will change individuals’ autonomy to choose what happens to their own body. Opt-out organ donation carries with it the weight of 80% public support, the support of the British Medical Association, and cross-party political support—all seven parties are represented among the Members who have sponsored the Bill. It also carries the support of past and present Prime Ministers.

I would like to talk about another case in the town that I represent. Last year, tragically, we lost a little girl aged four, Violet Grace, who was killed in an accident on her way home, with grandma, from the nursery. It was a criminal act, with a car going at 80 mph in a 30 mph zone. The parents of little Violet Grace took the brave decision to donate their four-year-old daughter’s organs. Today, we know that two lives were saved. The family tell me, and all the town, that they get great comfort from that. When her little brother asks about her, they try to explain that to him so that he can grow up with that knowledge.

The parents of Violet Grace have been joined by the widow of another person in my town, Steve Prescott, a former champion rugby league player. He had a multiple organ transplant that was successful, but unfortunately there were some other complications.

[Paula Sherriff]

Does my hon. Friend agree that although it can sometimes be a difficult conversation, these situations also bring about the opportunity for families, friends and loved ones to talk about what they want to happen after their death, including things like funeral arrangements? I knew from a very early age that when I went, I wanted to donate my organs. I still have my original organ donation card, which is over 30 years old now. Hopefully this debate will get the media attention that will encourage people to have that conversation with those they love.

[Ms Rimmer]

Yes, I do agree.

Steve Prescott’s widow, along with colleagues, friends and members of the community of St Helens, set up the Steve Prescott Foundation. She also approached the parents of Violet Grace to give comfort and support. They have set up a huge and very successful campaign in our town, urging us all to donate our organs. Steve died, unfortunately. The actual transplant—a multiple organ transplant—was a success, but it was other things that killed him. I pay tribute to the families involved, and to the parents of little Violet Grace for their bravery. This Bill would have saved them the trauma of making that decision at such an emotional time when their little girl was dying. It could save people a lot of trauma.

This is the moment to act. A move to opting out would save a predicted 500 lives a year. Done properly, with the right publicity, the right engagement and the right involvement of all communities, changing the law on organ donation should have the support of all of us. The support shown here today is really gratifying, and I pay tribute to the Daily Mirror, which has run a fantastic campaign. It has urged people sign up for donation even now, without waiting for the change.

I understand—perhaps the Minister could enlighten us on this—that the Government intend to go out to public consultation on how opt-out donation would be implemented sensitively. The proposal in the Bill to involve a person’s family in decisions, as a safeguard against any unregistered objection to donating, is an important protective measure that will reassure families who have concerns.

Only 5,000 people a year in the UK die in circumstances where they can successfully donate, while 6,500 people are currently waiting for life-saving donations. None of us ever expects, or perhaps even thinks about the possibility, that we or someone we love may need an organ from someone else to survive, but many Members have pointed out how it can suddenly happen in our own families. However, there is a gulf between the supply of organs and the urgent need for them, and it is time that we made a conscious decision to take affirmative action. The time is right—80% of the public support organ donation, but only 36% are on the register. That needs to be addressed.

In the first six months since Wales adopted the opt-out, 60 organs donated by 31 people have been transplanted. Consent had been received from 50% of those people. Those are the latest facts from Wales. An opt-out system has therefore been proven to work, even in its infancy. I urge the House to back deemed consent as a proven, popular policy.

The British Medical Association makes a point that goes to the heart of this debate. As a result of this Bill, the choice for the individual about what should happen with their own body will remain the same—to donate, or not to donate—but a change in the law means a switch of the default position, towards donation and towards saving more lives. I urge the House to support the Bill.

Oral Answers to Questions

Marie Rimmer Excerpts

Tuesday 19th December 2017 Commons Chamber

[Mr Hunt]

I would always listen to the hon. Lady on those matters, because she has huge professional experience. I do not think we do well enough for families with autism, and we are looking at what we can do better, but I have a lot of sympathy for the case the hon. Lady is making.

[Ms Marie Rimmer (St Helens South and Whiston) (Lab)]

9. What steps his Department is taking to reduce the number of hospital admissions for malnutrition.

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

Ensuring all our constituents—particularly the vulnerable and the elderly—are getting an adequate diet is critically important. That is why, for instance, we have given half a million pounds in funding to a special Age UK taskforce to reduce malnutrition among older people, and we will continue to train NHS staff so that early action can be taken.

[Ms Rimmer]

A merry Christmas to you, Mr Speaker, and to the Ministers on the Front Bench—maybe they will answer my letter soon.

In the world’s sixth largest economy, it is damning that, under this Government, we have seen a 122% increase in the overall numbers admitted to hospital with malnutrition. It is clear that more action is needed to ensure that we eradicate malnutrition in our society. The Department for Work and Pensions and the Health Department must work together so that, rather than introducing measures such as universal credit eligibility criteria, which will see at least 1 million children lose free school meals, we commit as a country to tackling this issue head on. Will the Minister use his power and influence to ensure that this issue is addressed immediately and that we see an end to this failure to axe malnutrition in the 21st century?

[Steve Brine]

Happy Christmas to St Helens as well. I agree that we need to work together. The Healthy Start programme, for which I am responsible, provides a nutritional safety net to hundreds of thousands of pregnant women and families with children under four. There is a slight increase in cases being reported in recent years. In part, that is due to much better diagnosis and detection. Some 1.1 million children get free school meals in England, and the Government are investing £26 million in breakfast clubs. Only last week, Kellogg’s was here with its breakfast club awards—an excellent innovation.

King’s College Hospital Foundation Trust

Marie Rimmer Excerpts

Tuesday 12th December 2017 Commons Chamber

[Mr Dunne]

My hon. Friend is quite right. There are financial pressures across the NHS in England. We have been very clear and very open about that. Some trusts are managing within those financial challenges and other trusts are not. That is in large part down to the rigour and leadership given to those trusts. Unfortunately, in this trust there has not been sufficient of either.

[Ms Marie Rimmer (St Helens South and Whiston) (Lab)]

Given the financial incapacity problems currently affecting the NHS, is it right or fair that individual acute trust leaders should be removed from their post when surely their perceived failures are part of wider systems issues and funding pressures?

[Mr Dunne]

The hon. Lady is right to identify pressures across the system, but it is also the case that when leaders change their position in a very short period of time and oversee a period of significant deterioration, the regulator has to take a view on whether those individuals are the right people to continue to lead that organisation. I think that that is what has happened in this case.

Oral Answers to Questions

Marie Rimmer Excerpts

Tuesday 14th November 2017 Commons Chamber

[Mr Hunt]

We are absolutely committed to that. We are spending around £1.4 billion more than we were three years ago, and there is more that we need to invest. I am pleased that my hon. Friend mentioned crisis care, because for people who believe in parity of esteem, ensuring that people can get help in a mental health crisis as quickly as they could go to A&E for a physical health crisis is one of the big gaps that we have to fill.

[Ms Marie Rimmer (St Helens South and Whiston) (Lab)]

I know that the Secretary of State will have been impressed by and enjoyed his visit to Whiston and St Helens hospitals. I am very proud of the collaboration between St Helens Council, the CCG and the hospitals, but additional resources are needed. The Secretary of State will see the good use that is made of those resources, but we cannot deliver everything that is required without that additional push of resources. Will he help us, please?

[Mr Hunt]

I recognise the picture that the hon. Lady paints. I did have an excellent visit to the hospitals, and they are doing some fantastic work on patient safety. Collaboration between the partners in the local health economy is much better than it has been, but there are financial pressures. We are going to have a million more over-75s in this country in 10 years’ time, and that is why we have committed to increasing the resources going into both the NHS and the social care system.

Mental Health Units (Use of Force) Bill

Marie Rimmer Excerpts

2nd reading: House of Commons
Friday 3rd November 2017 Commons Chamber

[Oliver Dowden]

I am not sure that I entirely agree with the hon. Gentleman. Of course there have been historical problems with the funding of mental health. I hope that Opposition Members will recognise, as we do on the Government Benches, that over the decades there has not been enough funding going into that area. On the question of the NHS, however, despite this Government inheriting the largest budget deficit in our peacetime history and an appalling fiscal situation in which we were spending £4 for every £3 we earned, we made a decision to prioritise health. Health spending has risen every year under this Government and we are committed to implementing Simon Stevens’ recommendations. He, after all, was a Labour special adviser who advised this Government, and he recommended £8 billion of additional funding. I am very pleased that we have been able to do that.

[Ms Marie Rimmer (St Helens South and Whiston) (Lab)]

rose—

[Oliver Dowden]

I would be delighted to give way to my hon. Friend on the other side of the House, if I may call her that.

[Ms Rimmer]

When public services are stretched and under-resourced, and with rising demands, it is more important than ever that we have the correct processes in place. Our public services do an exemplary job, and the Bill is not about criticising them. It is about having a regulated, transparent process so that we can minimise harm to staff and the people they care for. I have been contacted by many of my constituents on this matter. Indeed, there is widespread public concern about it. Does the hon. Gentleman agree that we should not turn this into a debate on another issue? Please let us stick to what we are here to talk about today.

[Oliver Dowden]

I was responding—

Oral Answers to Questions

Marie Rimmer Excerpts

Tuesday 7th February 2017 Commons Chamber

[Mr Dunne]

The hon. Gentleman is right to point out that the STPs are looking at providing more integrated care across localities. A number of indicative proposals have to be worked through. At the moment, NHS England is reviewing each of the STPs, and the results will be presented to the Department for its consideration in the coming weeks and months. On bed closures, I gently remind him that, in the past six years of the previous Labour Government, more than 25,000 beds were closed across the NHS. In the six years since 2010, fewer than 14,000 were closed by this Government and the coalition.

[Marie Rimmer (St Helens South and Whiston) (Lab)]

7. What assessment he has made of the effect of changes to local authority social care budgets on demand for health services.

[Liz McInnes (Heywood and Middleton) (Lab)]

15. What assessment he has made of the effect of changes to local authority social care budgets on the provision of adequate health and social care services.

[The Parliamentary Under-Secretary of State for Health (David Mowat)]

The relationship between health and social care budgets is complex. A recent study by the University of Kent has shown that, for every pound spent on care, hospital expenditure falls by between 30p and 35p. The hon. Lady will also be aware that there has been an increase in delayed transfers of care over the past two years, which has resulted in an increase in the number of unavailable hospital beds. Our best estimate of that increase is around 0.7% of total NHS bed capacity due to the increase in social care delays.

[Marie Rimmer]

It is quite amazing that the Minister is prepared to stand up and accept that there is a crisis in the NHS caused by the lack of social care provision. The crisis in social care means that more and more local authorities are reduced to just washing, feeding and toileting our elderly people. The crisis in residential care means that people from homes are going into the hospitals and choosing to leave the patients with the most complex needs, because they cannot afford the staff to look after them—

[Mr Speaker]

Order. I apologise for interrupting the hon. Lady, but we must have a question: one sentence and a question mark, thank you.

[Marie Rimmer]

There is no comfort for our elderly people. It is not too late for the Government to act. I ask the Minister to look at protecting social care funding. Will he bring forward the £6 billion and the £700 million—

[Mr Speaker]

Order. I am sorry, but there is a lot to get through. It is not fair on other colleagues.

[Marie Rimmer]

It is not fair on the elderly.

[Mr Speaker]

Order. I am sorry. I say to the hon. Lady without fear of contradiction that we must spread things out evenly.

Alcohol Harm

Marie Rimmer Excerpts

Thursday 2nd February 2017 Westminster Hall

[Marie Rimmer (St Helens South and Whiston) (Lab)]

I applaud the right hon. and hon. Members who secured this debate with the hope of influencing the Government to update the alcohol strategy, which is absolutely necessary. In particular, the all-party parliamentary group for foetal alcohol spectrum disorder would like an update on action on point 5.15 of the strategy. It reads:

“Fetal alcohol spectrum disorders…result from mothers drinking alcohol during pregnancy. They are lifelong conditions that can have a severe impact on individuals and their families—leading to a wide range of difficulties including low IQ, memory disorders”—

such as forgetting how to swim, “attention disorders”, such as when people detach themselves from family members and adoptive parents—

“speech and language disorders, visual and hearing defects, epilepsy and heart defects. They are caused entirely by drinking during pregnancy, and so are completely preventable. We do not have good information about the incidence of FASD…FASD can be caused by mothers drinking even before they know they are pregnant; so preventing them is strongly linked to reducing the levels of heavy drinking in the population as a whole, and especially among women.”

The rate of alcohol consumption is much higher among women in my constituency than in many others. The alcohol strategy says that we need to reduce consumption in the population as a whole, especially among young women,

“including by increasing the awareness of health professionals.”

There is a lack of understanding and awareness about this problem.

Let me give a general overview. Some 10.8 million people in England drink at levels that pose a risk to their health. Most of us have a drink, which is why we do not recognise the problem—we say, “They are just having an extra one. They might have had a bit more than me, but they have not really got a problem.” Overall, alcohol costs the UK £21 billion every year. It affects millions of lives and places a huge burden on public services. The Government cannot afford not to do something about alcohol, because of the drain on the national health service, social services and children’s social care, and because of the number of children who have been placed in care or are up for adoption because of alcohol.

I have seen younger relatives die from alcohol. A great friend of mine died from alcohol—he was head hunted to work in this place some years ago. That professional, skilled person was lost to alcohol, and nobody recognised or faced the problem.

Alcohol is 54% more affordable now than in 1980, which has helped to drive the historically high levels of alcohol consumption. I could not believe, and could not convince my colleagues on the council, how much cheaper alcohol is than bottles of water. I took them round two local supermarkets where alcohol was cheaper than water—cheaper than milk, even. Supermarkets frequently use heavy discounts to sell alcohol more cheaply. The evidence is still around us today.

The figures suggest a modest drop in overall consumption in recent years, but we are still drinking at historically high levels. It is the culture where I come from. St Helens was born of Irish immigrants; it was as far as people could walk from the docks of Liverpool when they landed there after escaping the potato famine. They worked very hard in the pits and in glass and chemicals manufacturing, so it was normal to have a drink at night. But what has gone wrong is that many of the pubs and clubs where the working men could enjoy good company with their pals on a night out have closed down, largely because supermarkets are selling drinks so cheaply. People buy alcohol and drink it at home, where they do not get the company and other people do not see how much they are drinking—it is just their families, who are least able to cope with the problem.

Some 2.1 million children in England are negatively affected by other people’s drinking every year, and the Government have to do more for them. Children do not ask to be born. Young people in the UK tend to drink more and start drinking earlier than young people in other European countries because they see drinking in the house more. Children exposed to a lot of alcohol advertising are more likely to drink heavily and start drinking at an earlier age—10 to 15-year-olds in the UK view more alcohol ads on TV than adults over the age of 25. By the age of 15, 44% of girls and 39% of boys in the UK have been drunk at least twice.

In England, 100 children end up in hospital each week due to alcohol. I could go on and on with the facts, but I would like to give a general overview. More than anything, I want to focus on children. As a member of the all-party group for FASD, I was driven to this issue. I was alarmed by the number of cases coming up at my surgery, many raised by parents seeking to adopt children. It was heartbreaking. I want to talk about one family in my constituency that came to see me. They were a couple with two children in their late teens and they were on the road to adopting a young child aged eight. They had fostered her and had been given no information at all on health issues, but it soon became obvious that the child was a victim of FASD. She had detachment disorder and had forgotten how to swim, even though she had been taught. She displayed inappropriate behaviour towards visitors and their families, and visitors stopped coming to the home.

A dreadful battle ensued to get a diagnosis and a care package from the local authority. It was difficult because the child was not from the local authority area that the family were living in. They were advised that if the adoption was not completed in a certain timescale, the child would be removed from them. The adoptive parents had taken time off work, but had to return to their jobs. They were prepared to reduce their working hours to care for the child, but they needed a diagnosis and a care package. They were at risk of losing their home—that is how much they loved that child.

[Bill Esterson]

My hon. Friend is speaking incredibly well. I pay tribute to her for the work she has done as a constituency MP and for the support she has given the all-party group as well. The point she is making demonstrates the need for support for adoptive parents. All too often there is no post-adoption support, particularly with this condition of FASD. It is even more important than perhaps we knew in the past, so perhaps I can make that point via my hon. Friend to the Minister to pass on to colleagues in the Department for Education.

[Marie Rimmer]

I totally agree with my hon. Friend.

My constituents needed diagnosis and a care package. They were at risk of losing their home. They were heartbroken at the thought of the child being taken away from the family and put into another foster home, and then going through, again and again, more placements because families cannot cope with such children. It is so difficult to care for them and yet they are so lovable. The parents were absolutely heartbroken. Silent tears rolled down the cheeks of this professional couple. The tears rolled down quietly as they sat facing me. It was heartbreaking to watch them. The child was part of the family. The two teenage children were beside themselves at the thought of losing their little sister who had become a part of the family. It was only through my direct contact with the local authority chief executive that the child was allowed to stay with the family. In the end, the chief executive apologised and gave a commitment to the family that the necessary diagnosis, care and support would be provided.

More than 7,000 children affected by FASD are born in the UK each year. As a member of the FASD all-party group, I have raised the issue with officers at St Helens Council, where statistics show that alcohol-specific hospital admissions of females were the fourth worst in the country. It is a cultural thing. We see drinking in the family: it goes on, becomes the norm and then leads to an extra drink. Where I come from, we never used to see alcohol in supermarket baskets. There was certainly never any alcohol in our homes. Unfortunately, alcohol is in most homes now. That is where families and children see it being drunk and then becoming part of the culture. It becomes the norm and it is much harder to tackle.

In Peterborough, 75% of children referred for adoption have a medical history of pre-natal alcohol exposure. Most of the looked-after children in St Helens come from alcohol-related problem families. I have met officers at St Helens Council who have given me a principled commitment to progress matters. I am delighted that a training programme with all appropriate staff took place last year. It is estimated that 1% of babies born each year in Knowsley have FASD—that could mean 19 babies in the two wards in my constituency that are in that authority.

I am delighted that action is being taken locally by St Helens Council, but without a national response from the Government, FASD as an issue will continue to be overlooked by the population as a whole. As a local MP, I have done my best, but it is certainly not enough. I have supported the awareness strategy and campaign at Whiston Hospital maternity unit. A recent survey found that 72% of people in Merseyside believe the Government have a responsibility to reduce alcohol-related harm, which is a drain on services.

My understanding of where I live in the north-west—not just in the Merseyside authorities but outside—is that well over 50% of the children on looked-after registers and going forward for adoption are damaged by alcohol and are being raised in families with alcohol-related problems. How can the Government not look at that drain on services, but—more importantly—the damage to those children’s lives? What will they grow up to be? What quality of life will they have? They do not ask to be born. The Government must do more than they are doing now.

I commend the hon. and right hon. Members who secured this debate. So many people and families are distraught at the damage caused by alcohol. More must be done and I plead with the Minister to act accordingly.

Southern Health NHS Foundation Trust

Marie Rimmer Excerpts

Tuesday 3rd May 2016 Commons Chamber

[Alistair Burt]

The best way that I can convey it is to say that constant monitoring is being done. First, the improvement director, who was appointed not by the trust, but by NHS Improvement, is there. In due course he will have a constant presence, but the monitoring needs to be done on a very regular basis. Also, the CQC has made it clear that should there be any need for further unannounced inspections, it will carry them out, so the trust is on constant notice that there can be a further inspection at any time. Further powers of the CQC include issuing another warning notice, varying and removing conditions of registration, monetary penalty notice for prescribed offences, suspending registration, cancelling registration, and prosecution. I understand from speaking to Mr Paul Lelliott that none of these measures has been ruled out.

[Marie Rimmer (St Helens South and Whiston) (Lab)]

It is that very point I wish to talk about. The duty of candour was going to give us so much more strength, but it is not being applied as yet. It is a statutory duty, placed on people carrying out regulated activities. It can lead to prosecution by the CQC, including without a warning notice. Will the Minister assure me that he will watch carefully to make sure that the CQC uses those powers appropriately? If it does not, we are once again failing these very vulnerable people.

[Alistair Burt]

Absolutely. If we now have a system where there is, quite rightly, a degree of autonomy, and Ministers’ responsibility is to make sure that the process and the system work well, Ministers cannot make all the decisions personally, but we do have to make sure that decisions that need to be taken are taken and, if not, that there is a good explanation of why not.

The CQC’s powers have been strengthened. Just a few months ago, we had the first case of a care home owner being jailed because of the care given to people in their home. While I recognise that the work done in caring for vulnerable people is complex and difficult, and that prosecution will not be the right answer in every case, knowing that powers are there is really important. The hon. Lady’s anger is appropriate, and I know the CQC takes these powers very seriously.

NHS Trusts: Finances

Marie Rimmer Excerpts

Monday 1st February 2016 Commons Chamber

[Ben Gummer]

I can give the hon. Lady that reassurance. When I was in Hull a few months ago, I had a fantastic series of conversations with clinicians—not just those who are leading the hospital, but those on the frontline in the wards—about how to address the staffing challenges in Hull and east Yorkshire. It is tailored responses to the problems in individual localities that will provide the quality of service in Hull that she wants for her constituents. I am committed, as are the staff in Hull, to ensuring that she sees it.

[Marie Rimmer (St Helens South and Whiston) (Lab)]

Will the Minister join me in visiting my local clinical commissioning group, trust and social services? The reason I ask is that St Helens and Knowsley Teaching Hospitals NHS Trust has just been rated “good” in four of the five areas and “outstanding” in care. The chief executive is managing Southport hospital to help there in the interim. She previously helped Warrington out of its problems. We have no problem with our chief executive and our staff are outstanding and work hard. However, we are having to recruit nurses from Spain. There is a wonderful working relationship between the CCG, the hospitals and adult social care, with lots of pooling going on. Nevertheless, Whiston faces a £7 million deficit and that is not down to the PFI tariff. [Interruption.] Sorry, Mr Speaker, I will come to the question. Will the Minister please join me for a constructive discussion with those people to see what is happening on the frontline?

[Ben Gummer]

I know that the Under-Secretary of State for Public Health was in Whiston last year. I was in Manchester a few weeks ago, and I plan to go back there and to the north-west in the next few weeks. I will be doing a regional tour, and I would very much like to meet the hon. Lady and talk to her trust’s chief executive. She raises an interesting point, which is that chief executives in many trusts across the NHS are of exceptional quality. It is often easy to knock managers in the NHS, but there are some fantastic managers, and I am sure that her constituency has one.