A and E and Ambulance Services

Meg Hillier Excerpts

Thursday 18th December 2014 Commons Chamber

[Mr Hunt]

My hon. Friend is right. The NHS wants to know that it has a Government who have a long-term plan for the NHS, who are prepared to fund that plan and who have thought about the long-term solutions. Better access to GPs is one of the key things, as is access to a GP who actually knows about the patient and their condition. Sadly, we lost named GPs following the changes to the GP contract in 2004, but I am proud to say that, from next April, we will be bringing them back.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

The Secretary of State has accused Opposition Members of political scaremongering. Perhaps I should refer him to the Public Accounts Committee’s report on out-of-hours services, which showed cost-shunting to the ambulance service by out-of-hours providers, and to our recent hearing on A and E, which revealed an incredible waste of public money and a lack of joined-up thinking. That is not scaremongering; those are facts from the National Audit Office being interpreted by Members from all parties.

[Mr Hunt]

Yes, and those are the facts that we are acting on with our winter plans. We are trying to reduce the amount of money spent on locum staff and to increase flow going into and out of A and E departments. There is a huge amount of practical things that can be done. I have absolutely no problem with dealing with constructive suggestions from both sides of the House on how we can help A and E departments to get through a difficult winter. It is unacceptable, however, constantly to turn this issue into a political football, when everyone knows that the pressures of an ageing population are making life very difficult for NHS staff and that those staff have a Government who are doing everything they can to support them.

Oral Answers to Questions

Meg Hillier Excerpts

Tuesday 21st October 2014 Commons Chamber

[Jane Ellison]

My hon. Friend takes a great interest in this matter and led the Back-Bench business debate on 1 September. I will certainly ask the HFEA and the expert panel to look at the study to which she refers, but I can provide the reassurance I have given before—that the wide body of expertise and information out there about mitochondrial disease is regularly reviewed over a long period of time.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

The Secretary of State makes great play of protecting the NHS budget, but NHS England, the Nuffield Trust and his hon. Friend the Chair of the Health Committee all agree that it needs another £30 billion investment, so how can he tell people that the NHS is safe under his watch?

[Mr Jeremy Hunt]

We have not just protected the NHS budget, but increased it in real terms, which I think is a huge achievement given the state of the economy we inherited. [Interruption.] I simply say to the hon. Lady that the way to protect and secure NHS funding for the future is by making sure that there is a strong economy to pay for it. That is the single most important thing of all.

Oral Answers to Questions

Meg Hillier Excerpts

Tuesday 10th June 2014 Commons Chamber

[Dr Poulter]

My hon. Friend is right to highlight the fact that as much money as possible always needs to be put into front-line patient care. Under the previous Government, spending on managers and administrators more than doubled from £3 billion to £7 billion, and we have seen the number of administrators fall by 20,000. There is clearly work to do in his area, because as much money needs to go on front-line patient care as possible, and I hope that local commissioners will be looking to share back-office services as much as possible with other commissioning groups to reduce costs and put money into front-line patient care.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

Earlier the Secretary of State and his Minister said that the minimum practice income guarantee was unfair. What is unfair is that so many practices in Hackney and east London are set to close, in an area where there is great deprivation. What are they going to do to make sure that patients still have practices to go to?

[Dr Poulter]

We have had this discussion. A payments system that is almost 20 years out of date and is not funding patients according to clinical need or is not per head of population will not deliver good care. The payments system needs to be changed and NHS England is working with practices that are facing challenges to address those challenges and ensure that high-quality patient care can still be delivered locally.

Oral Answers to Questions

Meg Hillier Excerpts

Tuesday 14th January 2014 Commons Chamber

[Dr Poulter]

Yes. My hon. Friend will be aware that I have a particular knowledge of his local trust. I pay tribute to the dedication of the many high-quality front-line staff working there, and to those who put in extra hours to work as locums, usually from within the existing trust work force, who often have to cover maternity leave and other periods of staff sickness.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

17. The Minister talks complacently about improvements in A and E consultants, but in Queen’s hospital in Romford only seven of the 19 posts have permanent A and E medical doctors in post. Surely he is fiddling while Rome is burning. People are not getting the service they need, while he is spending a fortune on locums.

[Dr Poulter]

The important point the hon. Lady has to remember is that it takes six years to train an A and E consultant, so it would be much better to put the question about advanced work force planning to the former Secretary of State, the right hon. Member for Leigh (Andy Burnham), rather than to members of this Government. Since we have taken charge of medical education and training, the number of those entering acute common training—those who may go on to become A and E consultants—has increased. We are now seeing a complete fill rate for those entering that training—something that the previous Government were not able to achieve.

Tobacco Packaging

Meg Hillier Excerpts

Thursday 28th November 2013 Commons Chamber

[Jane Ellison]

My hon. Friend is right to remind us all that, even if the Government decide to implement the policy at the end of the review, there will still be many other things to be done in relation to this important issue. Major public health campaigns will proceed as they have been doing under Governments of all colours.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

My hon. Friend the Member for Bridgend (Mrs Moon) pointed out that 190 health organisations were in favour of standardised packaging. While I appreciate that there may be tensions within the Government, the hon. Lady is Minister for public health. Will she tell us whether any health organisation is opposed to plain packaging?

[Jane Ellison]

We have asked Sir Cyril to conduct an independent review and to weigh all the different evidence. I do not wish to seem to pre-empt the review, because it is important that it is independent, but I will say that I am not aware of any health organisations that are not in favour of plain packaging. Indeed, as the hon. Lady can imagine, such organisations have expressed the opposite view to me with considerable strength.

Urgent and Emergency Care Review

Meg Hillier Excerpts

Tuesday 12th November 2013 Commons Chamber

[Mr Hunt]

We have put in an additional £2 billion—that makes a total of £3.8 billion being invested to support the social care budget. That is significant because it is recurring expenditure. We have shown our commitment by continuing to support the social care system through this Parliament. The trouble with underspends is that they depend on how many resources we have in any particular year. It is therefore much harder to invest off the back of them.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

The Secretary of State has spoken about the importance of continuing care from one’s own GP to limit admissions to A and E, yet in Hackney, when GPs tried to take over and run the out-of-hours service, the commissioners were paralysed by the fear of legal challenge and, rather than putting patients’ interests first, put the rich lawyers’ interests first.

[Mr Hunt]

If I may say so, it was the Government whom the hon. Lady supported who removed the responsibility for out-of-hours care from GPs. I welcome and want to help any GPs who want to take it back.

Accident and Emergency Departments

Meg Hillier Excerpts

Tuesday 10th September 2013 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. I am astonished that the Labour party seeks to defend those changes to the GP contract, which got rid of named GPs, removed responsibility for out-of-hours services from them and broke the personal responsibility that the best GPs always wanted to feel for the people on their list. In fact, many brave practices refused to go along with those contract changes and continue to have named GPs. There is clear evidence that people who have named GPs use hospital services less. If we are going to give older people the right care, we need to undo those damaging changes.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

The Secretary of State has spoken confidently about how his changes will make a difference in the short term, but over the weekend the BBC revealed that A and E departments are, on average, 10% understaffed and that one trust in London is 75 nurses down. Despite what he has announced today, how can he be sure that those vacancies can be filled?

[Mr Hunt]

The hon. Lady is right that there are staff shortages, and it is not because trusts do not want to employ people; it is because it is difficult to find people to fill all those vacancies. Those are some of the longer-term problems that we will have to address when looking at how to make working in A and E more attractive. There are a number of things we can do in the short term to alleviate the pressure, such as putting GPs on the front desks at A and E departments so that people can get help, ensuring that the social care system is open seven days a week so that people can be discharged on Saturdays and Sundays, and extending consultant cover late into the evenings and at weekends, when A and E departments are busiest. I think that it is right that we do those things straight away while trying to address the longer-term problems.

Oral Answers to Questions

Meg Hillier Excerpts

Tuesday 16th July 2013 Commons Chamber

[Anna Soubry]

I am more than happy to meet the hon. Lady and the family but, as she knows, this is a treatment that we have talked about endlessly, and we have had many meetings, which I am more than happy to continue to have with her.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

Since 2010, thousands of NHS staff have left the NHS with big, fat redundancy cheques, only to go through the revolving door and get new jobs in the NHS, often months later. Will the Secretary of State tell us how much has been spent on redundancy payments and whether he regrets that waste of NHS money?

[Mr Jeremy Hunt]

The hon. Lady asks that question as if that kind of thing never happened under Labour. The answer is that it is not acceptable, which is why we are changing the rules to ensure that people cannot get payoffs and then walk straight into another NHS job. The other answer is that the reorganisation that she criticises means that we have put more money on the front line, including for 6,000 more doctors, which I think was the right thing to do.

Oral Answers to Questions

Meg Hillier Excerpts

Tuesday 11th June 2013 Commons Chamber

[Norman Lamb]

I applaud the CCG for the priorities it has set. Reducing waiting times for access to psychological therapies is a really good move, and the virtual ward has the potential to keep people out of hospital, maintaining their health better and reducing cost to the NHS.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

Hackney CCG was one of the first to be up and running in shadow form. It is now operational but it is still persisting with a tendering approach to out-of-hours services. Will the Secretary of State write to the CCG to explain what has been said in this House—that tendering is not a requirement—and make it absolutely clear where the law lies?

[Norman Lamb]

The point I have tried to make all along is that this is about the judgment of the clinical commissioning groups, and nothing is imposed by the Government in what is required of them. European procurement rules existed under the Labour Government and this Government, but it is up to CCGs, working within the health and wellbeing board arrangements, to commission as they see fit for the benefits of their population.

Accident and Emergency Waiting Times

Meg Hillier Excerpts

Wednesday 5th June 2013 Commons Chamber

[Andy Burnham]

That shows the human cost of the failure that we have seen in recent weeks; my hon. Friend has identified yet another aspect of it.

There has been a huge reduction in nurse-led call back, so inexpert advice is being to people who should probably have other options put to them. An internal graph produced by NHS Direct shows that under the old 0845 NHS Direct service, about 60% of calls received a nurse call back; under 111, that has now dropped to between 17% and 19%. What is happening to these people? They are getting poor advice, so they are frightened and are going to A and E. What is this Secretary of State doing about it? Absolutely nothing.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

The Public Accounts Committee recently heard evidence about out-of-hours services in Cornwall. The bad experiences there showed that a lot of cost shunting was going on. If there was even a risk of taking somebody on through the GPs on call, it was cheaper and easier for that service to shunt the costs to the NHS through for ambulance services. Does my right hon. Friend agree that that is a complete waste of money and that it underlines the shambles that he has just described?

[Andy Burnham]

I agree that there is a false economy here. The picture is repeated. The Government go for these privatised contracts, such as with 111, at the lowest cost, resulting in a drop in standards and less clinical support. What happens? People then turn up at A and E. What happens when social care is cut? People turn up at A and E. What happens when NHS walk-in centres are closed? People end up at A and E. This has serious implications. Across England, 22 serious incidents, including three deaths, are being investigated in connection with NHS 111, and we know that one in five calls is abandoned. This service is failing; it needs urgent action to tackle these problems.