Radiotherapy Services (North East Hertfordshire)

Oliver Heald Excerpts

Wednesday 4th February 2015 Westminster Hall

[Sir Oliver Heald (North East Hertfordshire) (Con)]

This debate could not be better timed, because today is world cancer day, and the day on which we heard from the charity, Cancer Research UK, that although we are seeing better outcomes with cancer, more people are at risk. This is also an opportunity for me to ask for help for my constituents, who have to travel day after day, for many hours, to get their radiotherapy, which is tiring, dangerous, onerous and needs changing.

The situation that I am about to describe affects people not only in my constituency, but in Stevenage, North East Bedfordshire and Hitchin and Harpenden. I am glad to see my right hon. Friend the Member for North East Bedfordshire (Alistair Burt) and my hon. Friend the Member for Stevenage (Stephen McPartland) in the Chamber to support the campaign. I am also receiving great support from the public, patients and their families in seeking to ensure that radiotherapy treatment is available to cancer patients at the Lister in Stevenage, in my hon. Friend’s constituency. I pay tribute to his work in raising the issue so strongly.

I have asked questions in Parliament and have secured today’s debate. The Minister will, I know, listen to our case, and I hope that she will intercede for us with NHS England to break the logjam, so that we finally get the Lister hospital this facility, which it needs. The hospital recently opened a new cancer centre in conjunction with Macmillan Cancer Support, and radiotherapy would be an important addition. Furthermore, our local newspaper, The Comet, has long supported the cause.

Radiotherapy for people living in the Stevenage, Letchworth, Baldock and Hitchin area, and just over the border in Bedfordshire, at the moment takes place in Mount Vernon hospital in north London, in Hillingdon. It is a great hospital and the treatment is excellent but it is a difficult journey there, either by car or by the hospital bus service. That service takes all day—it collects patients at 7.30 am, delivering them back at 4 pm. Those long daily journeys are often needed for a three-week period, which is gruelling for patients and their families.

My constituents have described the visits as tiring and stressful. One young woman who is about to start treatment says:

“I am having to go for a three week stint at Mount Vernon, after my breast cancer op at Lister. I’ve been told by people in the same boat that it’s quite a stressful journey and the parking! Lister also has a small bus service pickup from your home at 7.30 back at 4ish! Daily. This is great but after all the patients go through it would be another stressful stage of getting well and to fight cancer.”

Another said:

“I had 39 Radiotherapy sessions for prostate cancer treatment at Mount Vernon Hospital. The treatment was excellent and was given by wonderful staff. Fortunately the transport was provided but this would have been saved if Lister had the appropriate facilities.”

One of the constituents of my right hon. Friend the Member for North East Bedfordshire told me:

“I am pleased to see you raising the question of installing a radiotherapy unit in the Lister Hospital. This treatment is sorely needed in N. Herts as the travel and journey is particularly onerous for what can be very repetitive and tiring treatment to Mount Vernon in Middlesex…from Stotfold where I live. Myself and two neighbours have had need of this treatment in the past 12 months…the requirement generated from a single road so the need is certainly there.”

[Alistair Burt (North East Bedfordshire) (Con)]

I have already apologised to both my hon. and learned Friend and the Minister that I am not able to stay to hear the Minister’s speech. I very much want to support my hon. and learned Friend. My constituent’s point is very pertinent. The A1 runs directly down from where that constituent was talking about to the Lister. Does my hon. and learned Friend agree that that is a perfect example of how a facility closer to north-east Bedfordshire would make all the difference to relieving our constituents’ suffering?

[Sir Oliver Heald]

I totally agree with my right hon. Friend. There are many arguments for the change. One patient from east Hertfordshire, who is a constituent of mine, said:

“Being diagnosed with cancer is devastating for the person and the family and to discover that part of the treatment involves regular journeys to north London just adds to the stress that family is undergoing.”

Another aspect to consider is patients with children. One constituent wrote to me about her daughter, who is in her 30s and has three children. She needs radiotherapy at Mount Vernon and will have to find someone to travel with her and someone to look after her children on a daily basis for three weeks. Her mother says:

“This all adds to the stress of having to deal with cancer, especially at such a young age.”

She ends her letter to me:

“Here’s hoping we are successful in making someone see sense.”

[Stephen McPartland (Stevenage) (Con)]

I congratulate my hon. and learned Friend on securing this debate, which is important to my constituents in Stevenage. He and I have secured the support of the local newspaper, The Comet, and have run a petition over a number of years to improve radiotherapy access. We have dealt with thousands of people. There is no public transport available for them to get from Stevenage in north-east Hertfordshire to Hillingdon in London, so they are very much stuck with having to have private vehicles and people to support them.

[Sir Oliver Heald]

That is very much the nub of the issue: there is no alternative to the car or the bus, and the bus takes a day to take patients and bring them back.

The NHS is currently mapping the country to find areas where it takes more than 45 minutes by car to reach radiotherapy, in order to assess pressing need for new and satellite centres. My hon. Friend and I have been in contact with Kim Fell of NHS England about this issue. We have arranged to meet her, Ruth Derrett, who is the head of specialised services, Dr Adrian Crellin, who is the radiotherapy clinical reference group chair, and Pam Evans of the specialised commissioning team, because they think that the journey from our area takes less than 45 minutes.

We have been told that, as part of the review, the National Clinical Analysis and Specialised Applications Team has produced a map that shows the 45-minute position across our area. Apparently, the map shows that only a small proportion of the population of Stevenage travels more than 45 minutes for treatment, and questions have been asked about whether that would generate sufficient activity for the satellite service that we are asking for.

The methodology used is clearly flawed, so we are pressing on the 45 minute figure. Even if one ignores the heavy traffic congestion in our area—my hon. Friend the Member for Stevenage and I have been campaigning for some years to widen the A1(M) between Stevenage and Welwyn because it is so congested, and we have recently got about £100 million for it—the AA, the RAC and everyone who does that journey all say that it takes longer than 45 minutes. The senior management at the trust that runs both hospitals, East and North Hertfordshire NHS Trust, allows one hour 15 minutes each way for the journey. I have done the journey only once, and it took me two hours in the rush hour. I have offered to do the drive seven times at different times of the day using the three possible routes and to report the findings to NHS England. I am waiting to hear whether it considers that to be a satisfactory methodology. My hon. Friend the Member for Stevenage and I have suggested that the key officials might like to come with us on the journey one morning at the same time as the bus, so that they can see the challenge to the 45 minute figure.

I am arguing that Mount Vernon hospital should put a satellite radiotherapy centre at the Lister hospital. We like the Mount Vernon hospital—the treatment there is excellent—so we would like it to use its staff and machines at the Lister. The machines that they use do need to be replaced from time to time, and there are currently eight of them. I am told that fairly soon an opportunity will arise when two need to be replaced. The new machines should be sited at the Lister hospital. That would leave six at Hillingdon and allow Mount Vernon to offer its expertise to an even wider area, thereby securing its position as a cancer centre. It would be able to offer services to a larger group in Bedfordshire, for example, than it currently can. That would benefit the status of Mount Vernon hospital as well as helping the patients.

The Lister hospital has recently benefited from the opening of the wonderful Macmillan cancer care centre on its site. Radiotherapy would greatly improve the support and care available to people in our area. Patients and their relatives strongly support the idea of the move, which has been described to me as “wonderful”. Another person wrote to me to say:

“It would be fabulous to have the device at Lister. It makes sense as we have just opened a great cancer chemotherapy unit”.

I hope that the Minister might intercede on our behalf with NHS England so that our case can be properly considered. The idea that it takes 45 minutes or less from our area to Mount Vernon must be reconsidered. It is time for a satellite radiotherapy centre at the Lister, but we need help to make it happen. I intend to present a petition to Parliament in March. We already have hundreds of signatures, and it can be downloaded from my website: www.oliverheald.com. I will present it on the Floor of the House. My right hon. and hon. Friends, our constituents and I feel strongly that it is time for the change to be made. It is time that those endless journeys, hour after hour, day after day, ended.

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[Jane Ellison]

I will certainly draw NHS England’s attention to the force with which the invitation was put in this debate.

Let me say a few words about the bigger picture on cancer before we go into the detail in the contribution by my hon. and learned Friend the Member for North East Hertfordshire. The Government are committed to improving cancer outcomes and matching the best in Europe. As Members are aware, we do not match the best in Europe; we were certainly lagging behind some important countries when the Government came to office in 2010.

The 2011 strategy, which was backed by £750 million, set the ambition of saving an additional 5,000 lives a year. We believe that we are on track to save an additional 12,000 lives a year, far exceeding that ambition. Much of the focus has been on early diagnosis and awareness. Given the clear interest in cancer that Members have expressed by being here, I hope that they will join me in welcoming the announcement of NHS England’s cancer taskforce, which is charged with designing a new cancer strategy for the NHS to take us through to 2020.

I thought Members might be interested in the statistics for East and North Hertfordshire NHS Trust over the last 12 months. Some 2,881 more patients with suspected cancers were seen than in 2010—a 49% increase. In addition, 239 more patients were treated for cancer than in 2009-10—an 11% increase. Local NHS staff, to whom I pay tribute, are therefore doing a good job of seeing more people.

[Sir Oliver Heald]

I am grateful to the Minister for giving way on that important point. About half of the patients require radiotherapy, so the numbers on that journey are getting higher and higher, and there surely comes a point when we can have our satellite.

[Jane Ellison]

Indeed, and I will address some of the issues my hon. and learned Friend raised, but let me say a quick word on radiotherapy more generally. The Government have set about improving these services. NHS England will be investing an additional £15 million in stereotactic ablative radiotherapy on top of the £6 million already committed. That will benefit about 750 patients a year. There is also a £23 million radiotherapy innovation fund, which has resulted in the doubling of intensity-modulated radiotherapy activity. In addition, we are investing £250 million in building two new proton beam therapy centres. A lot of investment is therefore being made in some very up-to-date and important technology.

Let me turn to local health matters. First, I congratulate my hon. and learned Friend the Member for North East Hertfordshire, my right hon. Friend the Member for North East Bedfordshire and my hon. Friend the Member for Stevenage, who are all known as doughty champions of their local health services. It is particularly good to see the latter, who champions health matters with great vigour in this place.

I am aware of the issues that have been raised. Regardless of the part of the country we live in, we would all expect patients to have ready access to radiotherapy services as part of patient care. Obviously, radiotherapy is a specialised service. It is commissioned directly by NHS England. Fortunately, it is not needed by the majority of NHS patients, but it is vital to those who do need it. The smaller number of patients involved means that the health service needs to think carefully about access—locating units to provide the maximum benefit closest to the highest possible number of people. I will go on to talk about the implications for expertise.

Such decisions are made locally, and are best made locally, by clinical leaders who have the full benefit of local knowledge. However, it is right, of course, to bring concerns to Parliament and to give Ministers a chance to understand what is happening in the local health economy, so that we are aware of the issues and can discuss them, where necessary. Decisions on where to locate specialist services need careful consideration. The issue is of particular note to those who represent more rural constituencies. Patients who live some distance from treatment centres—not only those providing radiotherapy—can, unfortunately, face repeated, long and tiring journeys. I realise that the seats of my hon. Friend the Member for Stevenage and my hon. and learned Friend the Member for North East Hertfordshire are not necessarily rural, but those are factors in parts of our country. My hon. and learned Friend gave us examples of the anxieties that long, tiring journeys bring, alongside the already stressful situation of being treated for cancer.

Interest in where radiotherapy services are located is understandably heightened by the NHS England review of stereotactic radiotherapy and stereotactic radio surgery services, which is being undertaken at a national level. For the benefit of Members, let me explain that those services involve a type of external beam radiotherapy treatment currently commissioned by NHS England for the treatment of patients with a wide range of cranial cancers. That consultation closed recently, on 26 January, and as part of the review, NHS England found

“an unmet need in the provision of treatment, with services distributed unevenly across the country.”

The proposed changes to the way in which stereotactic radio surgery and radiotherapy services are commissioned in England was looked at in the public consultation. Proposals include consideration of the location of services provided in the interests of ensuring equity of access, and the results are being reviewed by NHS England.

My hon. and learned Friend will be aware that NHS England has also carried out a separate, high-level exercise to assess capacity and demand for external beam radiotherapy more generally at a national level to give it a sense of the national picture. A further phase of work is proposed to take place locally, as there will be some specific local issues of which commissioners and providers will need to take account. That process is due to begin in late March.

Accessibility is characterised by an assurance that all patients are offered the most appropriate and effective treatment for their cancer. The latest research suggests that about 40% of all cancer patients should receive radiotherapy, complementing earlier recommendations made by the National Radiotherapy Advisory Group that aim to boost cancer survival through increasing access to that therapy, delivered as part of a treatment with curative intent. The England average access rate was 33% in 2007, and 38.8% in the most recent figures, which demonstrates real progress. I know, however, that there is further to go, as my hon. and learned Friend made clear in his speech.

NHS England has told me that the radiotherapy clinical reference group, which supports it in commissioning radiotherapy, is of the view that all patients should be offered equitable access to specialist radiotherapy care and treatment. The clinical reference group plans to build on the assessment of radiotherapy demand and capacity for England by considering aspects such as innovative treatments, the stock of equipment and how needs differ across areas. That national overview will enable commissioners to ensure that the right services are in the right places to meet future demand, including innovative forms of radiotherapy. Such improvements might well mean that, in future, patients need fewer episodes of treatment, so the problem of repeated tiring journeys would at least be reduced. I think we would all welcome that.

Access to radiotherapy treatment locally is a matter for NHS England to lead on. The decisions on the introduction of satellite radiotherapy centres will need to involve the local providers—in this case, East and North Hertfordshire NHS Trust—and NHS England as commissioners. As my hon. and learned Friend said, his closest radiotherapy services are the excellent services at the Mount Vernon hospital, and there are also services at Addenbrooke’s hospital in Cambridge. NHS England will continue to review the need for additional radiotherapy facilities outside those centres, if such facilities would benefit sufficient numbers of patients, be economically viable and enhance the existing care pathways.

It is possible that, as a result of those discussions, it will be found that more radiotherapy services are needed, but the optimum location will be determined by a number of criteria, including the impact on nearby trusts and existing cancer pathways—in other words, in trying to balance out one lack of access, we would not want to cause a problem elsewhere. Such decisions need to be looked at in the round in the local health economy. However, my hon. and learned Friend made good points about access, and I will ensure that those are underlined.

I understand that in 2009-10 there was a capacity review of radiotherapy provision for the Mount Vernon cancer network. That concluded that although the capacity to meet future demand up to 2016 could be met by the current providers, increasing access to the north of the network was an objective that needed looking at. My hon. and learned Friend underlined that point.

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[Sir Oliver Heald]

It is remarkable that the county of Hertfordshire, which has 1.2 million people, does not have radiotherapy facilities at all. Does my hon. Friend agree that the urgency of the matter is changed by the fact that the whole county—or at least most of it—has to go all the way down to London? That is a rather old-fashioned approach. I do not know whether she is prepared to ensure that my remarks, and the support of my right hon. Friend the Member for North East Bedfordshire (Alistair Burt) and my hon. Friend the Member for Stevenage (Stephen McPartland), are relayed to NHS England.

[Jane Ellison]

I will certainly do that. I make a point of drawing the attention of the relevant clinical leaders to our debates, and to the strength of feeling expressed by Members on behalf of their constituents. I am of course happy to do that.

The siting of a satellite unit at either the Luton and Dunstable hospital or the Lister hospital in Stevenage was considered in the previous review, but given that the system already had sufficient capacity to meet future requirements, the report acknowledged that any satellite development would need to be planned as part of existing capacity, not additional capacity. In other words, services would have to transfer.

Any review should include an assessment of the best fit, to ensure that if a radiotherapy satellite service is a preferred solution, it is located in the right place. I understand all the points made about location and the county not having such a facility, but equally, looking purely at the geography and the county boundaries might not always lead one to completely the right conclusion. That point was, however, important and has been well underlined today. The unit has to be located in the right place, so that there is capacity, and so that the preferred location offers cost-effective treatment to a sufficiently large number of patients. That is the important point: the number of patients.

I understand, too, that my hon. and learned Friend is not talking about using old equipment, but looking at the location of new equipment. Furthermore, sometimes there is concern about involving what might be called the “penny packet” approach, scattering specialist services thinly to achieve better access. One of the challenges with that approach, however, is that while it can often make sense to people on the face of things—“Of course we want those services there”—there is always the caution about staff not getting the benefit of mutual support, and expertise in particular can become diluted. That approach might also make it sometimes more difficult to manage demand, as one unit might become overwhelmed while others are underworked.

Those factors need to be taken into account, and I underline the expertise one in particular. We all want our constituents to be seen by people who treat sufficient specialist health problems to be really expert in them. We want those experts to see enough patients to know what they are doing when they see something. Concentration of expertise is important in many areas of health and has been much focused on.

[Sir Oliver Heald]

I am suggesting a Mount Vernon operation—that it provides the service in the Lister. Mount Vernon would have two fewer machines, which we would have in the Lister. In that way, we hope that the expertise would be as good as it always has been, but people would not have to do the long journeys.

[Jane Ellison]

I completely understand that point. I expect local clinical leadership to understand the expertise and staffing available. All those factors will be taken in the round and looked at, because the work is specialist. I would expect the NHS to look at things such as his suggestion about the new machines at Mount Vernon. I will of course write, drawing attention to the particular concerns of my hon. and learned Friend and of my hon. Friend the Member for Stevenage about access and the travel distances. They, however, would in turn expect the local NHS to look at issues such as the distribution of expertise to ensure that the continuity of expertise was available.

Respiratory Health

Oliver Heald Excerpts

Tuesday 3rd February 2015 Westminster Hall

[Stephen McPartland (Stevenage) (Con)]

It is a pleasure to serve under your chairmanship, Ms Dorries. I would like to talk about respiratory disease, which affects one in five people in the UK, is responsible for about 1 million hospital admissions and costs the NHS almost £5 billion a year. It is also the third biggest cause of death in the UK. It is the poor relation compared with the investment that goes into tackling the other four big conditions. To put that into context, in 2012, respiratory disease killed 80,000 people—that does not include lung cancer, which killed an additional 35,500 people.

The UK also has the highest mortality rate for respiratory disease among the OECD nations, double that of countries such as Poland and Germany and treble that of countries such as Estonia and Finland. Sadly, the worst thing about those statistics is that many of the deaths would be preventable with the right care. I understand and welcome the announcement by the Secretary of State that he is making it a priority for NHS England to prevent people from dying prematurely from respiratory disease. His ambition is to make us one of the best in Europe for survival rates by improving prevention, diagnosis and treatment. That is a very big statement and a huge aspiration when we are talking about reducing respiratory deaths in this country by almost two thirds.

I want to focus my remarks predominantly on asthma and chronic obstructive pulmonary disease—known as COPD—which together affect almost 6 million people in the UK, including me. I am chairman of the all-party group on respiratory health. With the support of Asthma UK and the British Lung Foundation, we conducted an inquiry into respiratory deaths in an effort to help the Government and the NHS to understand why so many people are dying from these conditions and what can be done to prevent that. I am grateful to the other members of the all-party group for their support, and for the amazing contributions that we receive from patients.

[Sir Oliver Heald (North East Hertfordshire) (Con)]

I pay tribute to my hon. Friend for his work as chairman of the all-party group. What does he make of the NICE evidence that about a third of the people who are receiving treatment should not be, while there is such a lot of undiagnosed asthma? That seems very odd.

[Stephen McPartland]

My hon. and learned Friend makes an incredibly important point, to which I will return later. The information that has come out of NICE is sadly testament to the complacency that we see regarding the effects of respiratory disease, and to how some professionals and patients treat the condition, ultimately resulting in those patients’ deaths.

Contributors to the all-party group’s report include health care professionals, charities, patients, families and professional organisations, as well as a range of other people who contributed both written and verbal evidence. I will read the story of one of those people a little later, but first I want to look at chronic obstructive pulmonary disease, which is an umbrella term for a set of conditions that includes bronchitis and emphysema. Combined, such conditions kill more than 30,000 people a year in the UK—around 5% of all deaths in the UK from all causes. A COPD patient’s journey is often punctuated by multiple exacerbations, which are sudden worsenings of the symptoms, often triggered by external factors such as infection and problems with air quality, that often lead to hospitalisation.

To put it into context, people suffering from COPD exacerbations are the second most common cause of emergency hospital admissions in this country, the biggest being ischaemic heart disease, which is effectively coronary heart disease—heart attacks and strokes. It is estimated that COPD leads to 94,000 admissions a year, with cold weather often a major contributory factor. The direct costs on the NHS are more than £800 million a year, so COPD is causing a huge problem in terms of the costs for the NHS and the impact on individual patients. One of the worst statistics that the all-party group’s inquiry came across was that 50% of people who are admitted to hospital with severe COPD die within four years—once it has reached the stage of their being admitted to hospital, they sadly have a life expectancy of four years.

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[Sir Oliver Heald (North East Hertfordshire) (Con)]

Rightly, my hon. Friend the Member for Stevenage (Stephen McPartland) and other Members who have contributed have talked about the most serious incidents and life-threatening situations. I want to say a few words about mild asthma, of the sort that can affect someone playing sport. If we are talking about campaigning about asthma awareness, there are quite a lot of people who are not going to die because of their asthma but whose lives are spoilt by it.

My own experience is that when I was young I was a keen rugby player. I could play rugby, but after a match I was always wheezy. It never occurred to me that that was because of a medical condition, but I was talking to my doctor one day, when I had been playing rugby for years—I was in my teens at the time—and he said, “Actually, we can help you with that.” He gave me an inhaler and told me to take a puff before I played, and my life was transformed. There was no more wheezing and I improved; I was able to play rugby much better, and was able really to enjoy it for the first time. There must be a lot of people in the country who have not really realised that they have asthma, as it is undiagnosed.

My first point is that in making people aware of respiratory conditions we are talking not just about saving lives but about improving the quality of people’s lives. I am told that there are any number of top sportsmen who have the same condition of mild exercise asthma.

[Caroline Nokes]

My hon. and learned Friend makes an interesting point. This is a problem not just for elite sports players and those who participate in sport regularly, but for those who are not active enough, or not taking part in any physical activity. They tend to look for reasons not to take part in those activities and being a bit wheezy, for some, can be a convenient excuse.

[Sir Oliver Heald]

My hon. Friend makes a good point. It is easy to see this issue as 1 million hospital admissions and the third highest cause of death, without also looking at the huge effect on other sufferers. We know that 5.4 million people are being treated in the UK for asthma, and I rather share the view that the National Institute for Health and Care Excellence, in saying that a third of people have no symptoms at any particular time, may be making a slightly complacent comment. By the time I was in my late 20s I had no symptoms at all and I no longer needed to use an inhaler to do sport. However, when I had a problem one year with flu, they came back. It is a variable condition, and that can be underestimated.

Kay Boycott, the chief executive of Asthma UK, said:

“Asthma has many complex causes, which is one of the reasons why it is sometimes difficult to get a definitive diagnosis. It is also a highly variable condition that can change throughout someone’s life or even week by week, meaning treatment can change over time.”

One of the great lessons to learn is that we need to monitor regularly for asthma. My hon. Friend the Member for Stevenage made a particularly important point about attending the asthma clinic for the test.

The Royal College of Physicians recently made a point about variability and how asthma can suddenly deteriorate. As it said, there are different kinds of asthmatics: brittle asthmatics who can move from having no wheeze to severe problems; others for whom it appears just in the early morning; and others for whom it disappears for a period. We need more research and a campaign on awareness.

[Mark Hunter (Cheadle) (LD)]

I apologise for being late for the start of the debate. Does the hon. and learned Gentleman agree that variability is one of the key problems with asthma? From hon. Members’ contributions, it is clear that each of us who suffer from asthma have different experiences of it. One of the biggest challenges, which has been brought home by the medical advice I have been given by doctors over the years, is never to underestimate asthma. One of the problems is that so many long-time sufferers think that they are in control, and that their medication is on top of it. He talks about the condition being variable for people with mild symptoms, but it can be a killer. A key part of the campaign that all of us want to support is about ensuring that people have regular check-ups and do not ever take asthma for granted.

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[Sir Oliver Heald]

That is exactly the point that I was coming on to make. It would be a mistake to assume that because NICE found that one third of the people it looked at had no symptoms, those people could heave a sigh of relief and forget about asthma for ever. People—as I did—can have periods when they are symptom-free, but they still need regular reviews to ensure that it does not come back or suddenly get worse.

The Royal College of Physicians identified major avoidable factors in two thirds of cases where people died, which were about the constant monitoring and attention to detail that my hon. Friend the Member for Stevenage mentioned. It did not cite all the evidence, but it seems that there are two unstable types of asthma that are often resistant to treatment and that can be a contributory factor. We need more research, awareness and knowledge that it is a variable condition, and that people should therefore not make assumptions or be complacent.

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Dorries. I congratulate the hon. Member for Stevenage (Stephen McPartland) on securing the debate. I commend the work that he and the all-party group on respiratory health do to raise awareness of these important issues in Parliament.

It cannot be denied that care for respiratory health conditions demands far more attention than it currently receives. Asthma, after all, is one of the most widespread and pernicious conditions around, and takes up a huge amount of resources in our health service. I share the hon. Gentleman’s concerns. We need to ensure the proper use of inhalers. My eldest son is asthmatic. He certainly has regular asthma reviews, and my wife and I, like the hon. Gentleman, try to ensure that such reviews are never missed, because they are so important.

The amount of research time that asthma gets is not proportionate to the scale of the problem, and routine asthma care simply is not up to scratch. The hon. Gentleman made that point well; the fact that he has been receiving pretty much the same treatment for the past 15 years speaks volumes. Respiratory disease is the third biggest killer in the UK, but the risk of conditions such as chronic obstructive pulmonary disease and asthma is perennially underestimated. The rate of deaths from respiratory disease in the UK is around three times that in Estonia and Finland.

Like the hon. and learned Member for North East Hertfordshire (Sir Oliver Heald), I get wheezy at sport. That has nothing to do with being asthmatic; it is more to do with my fitness levels. However, he made an important point that awareness of asthma, in the medical community in particular, is crucial. In 2010, I was very ill. My GP diagnosed asthma and prescribed me inhalers, which made me much worse because I was not asthmatic; I had pneumonia. That highlights the real need for the GP community to understand the specific needs of patients and whether asthma is prevalent, because some medication, as I found out to my detriment, can make people much sicker.

We have not touched on smoking to any degree, but we need to reduce its impact on respiratory health. That is a key factor. Patients need to be supported by clearer links being made between smoking and the start of respiratory disease, and there needs to be easier access to effective smoking cessation services and implementation of appropriate tobacco control measures.

There is, of course, a general awareness of the dangers of smoking. Needless to say, many have accepted the associated risks, but many have not. Two thirds of adult smokers took up smoking as children, so alongside measures to help people to quit smoking, we need to support those who have quit so that they do not relapse. We need to reduce exposure to second-hand smoke, and we should focus on protecting children and helping them not to take up smoking in the first place.

Around 10 million adults in Britain—about 20% of the population—smoke. Every year, smoking causes around 100,000 deaths. It is a major driver of health inequalities. Smoking rates are markedly higher among low income groups. I was pleased to see that the APPG report recommended the urgent implementation of standardised packaging for cigarettes, which Labour wholeheartedly agrees with. An independent report by King’s college London found that it was

“highly likely that standardised packaging would serve to reduce the rate of children taking up smoking”.

I commend the Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison), on her commitment to introducing plain packaging; I hope that the Minister present today will join her in the Lobby and encourage his colleagues in the Cabinet and on the Back Benches to support the measure. Christopher Hope of The Daily Telegraph only last week suggested that as many as 100 Conservative MPs planned to vote against the measure. Will the Minister support the measure and, if so, will he encourage his colleagues to do the same?

There are other measures that the Government could implement to reduce rates of smoking. Tackling the problem of toxic second-hand smoke, for instance, is crucial. It can pose terrible challenges to children’s health because of their smaller lungs and faster breathing, and the risks are increased in the confines of a car, for example. It is staggering that every year, second-hand smoke results in about 300,000 GP visits and nearly 10,000 hospital admissions among children.

That is why I was proud of the sterling efforts of my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger) in getting a ban on smoking in cars through Parliament. More than 430,000 children every week are exposed to second-hand smoke in the family car, so when the House of Commons voted overwhelmingly for a ban, it was a great moment. However, the onus is now on the Government to act according to the wishes of the House, and to make the measure law at the earliest opportunity. I call on the Minister to commit to taking that step.

I was pleased by the proposals in the all-party group’s report for more joined-up asthma care. As part of Labour’s 10-year plan for the national health service, we have proposed a joined-up approach to long-term care, with patients being given more say in their care plans and more control over their data, so that that they can make more informed choices. That would be particularly pertinent to conditions such as chronic obstructive pulmonary disease, where a bad flare-up can prove life-threatening. Patients with such conditions should have more say in their care pathways. COPD exacerbations are the second most common cause of emergency hospital admissions, so it is clear how important it is to ensure that people can prevent complications where possible.

Clearly, there is some way to go on cutting rates of smoking and giving people support to stop smoking. However, it is also our responsibility to give people the option to influence their own health care. Hospitals provide advanced care, which often cannot be provided anywhere else, but swift developments have meant that lots of care that could previously be provided only in hospital can now be provided in the community. That is a huge leap forward. On the whole, the most deprived are admitted to hospital more often, not because of a higher propensity to fall ill, but because of the inadequacy of community services.

For example, with forms of COPD, most medical professionals firmly believe that good self-care can provide an incalculable benefit to patients. Those who know exactly how to administer their own long-term care tend to live longer and experience less pain, anxiety and depression. They also enjoy a better quality of life because they are more active and independent.

[Sir Oliver Heald]

That bears on a point made by my hon. Friend the Member for Stevenage (Stephen McPartland). Does the hon. Gentleman agree that, in many ways, carers have an important role as well? When someone encourages a person to take their medicine on time, or to go to their annual review, that is important. Carers are often unsung.

[Andrew Gwynne]

I absolutely agree. Carers have an important role in how we integrate health and social care, and we should never underestimate the role they play in providing care for close relatives and friends. The hon. and learned Gentleman is right.

It is only with integrated care that complications can be spotted earlier and hospital admissions potentially avoided. Regular reviews with a patient’s health care team, including information-sharing with other parts of the NHS, can make all the difference. However, there is also a lot to be said for the provision of far more advice and help to those caring for people with COPD.

Labour has said that it will guarantee a single point of contact for people with complex physical and mental health conditions—somebody with the authority to get things done. We will also establish the right to a personalised care plan, developed with the individual and their family, tailored to personal circumstances and not restricted by service boundaries. Patients with conditions such as COPD will also have the right to access peer support and advice from others learning to manage the same condition, which could prove helpful.

I commend the hon. Member for Stevenage on his hard work in advancing the cause of those with respiratory health conditions. Irrespective of the general election outcome, which is largely out of the control of all of us, this issue must be an absolute priority for whomever forms the Government in the next Parliament, and I give the hon. Gentleman a commitment from the Labour party that, if we find ourselves on the Government Benches, it will be.

National Health Service

Oliver Heald Excerpts

Wednesday 21st January 2015 Commons Chamber

[Paul Burstow]

I may return to that point later, but first I want to talk about my own experiences of my local national health service, and in particular about a visit that I paid to my local trust, Epsom and St Helier University Hospitals NHS Trust, at the beginning of the month. During the visit I had a chance to meet staff, including A and E staff. I pay tribute to the hard work that is done in the trust, and especially to the work that is done in the A and E department. Last week Epsom and St Helier was placed sixth among all the London trusts in terms of the time for which people were having to wait in A and E, when measured against the standard, and, according to figures that were published yesterday, 99% of people are seen within the standard four hours. That is an example of great performance. The trust is facing great pressure, but it is doing a fantastic job none the less, and that side of the story ought to be told. We ought not to focus only on hospitals that may not have learnt some of the lessons that have been learnt by my local trust.

The A and E staff members whom I met made it clear that there was no single cause of the pressures in their department. In fact, the precise mix of factors varies from one hospital to another, and from one area to another. St Helier, however, has made excellent use of the winter funding it has received. It has added capacity to A and E, and has introduced examples of good practice. For instance, there are daily reviews of patients to ensure they are being given the right treatment in the right place; patients who are ready to be discharged are identified on the previous day so that arrangements can be made in good time; and there is a system of “ward buddies”, enabling corporate staff to provide additional administration support at times of extreme pressure—such as the present time—in order to assist safe discharge. A further welcome boost is the news that an extra £325,000 has been provided to assist people’s safe discharge to their own homes or to step-down care.

A piece of work examining the position in the Sandwell and west Birmingham area revealed huge variations between attendance rates by practice. Its authors found that some people considered A and E attendance to be the norm, and that a fifth of attenders made a conscious decision to go to A and E on the previous day. They also found that many A and E attenders believed that it was not even worth trying to access primary care in the first place. There are issues relating to communication, understanding of the system, and how we explain it. That cannot be dealt with in a universal, national way; it must be tailored to patients’ preferences and their expectations of the system at local level. That piece of work has already helped those in Sandwell to think about how to target messages more effectively in order to ensure that people have access to the support they need at the time they need it.

[Sir Oliver Heald (North East Hertfordshire) (Con)]

Does my right hon. Friend agree that there should be a proper investigation into winter planning in each area? As he says, factors vary greatly. In my area, for instance, the factors affecting Addenbrookes hospital are very different from those affecting the Lister hospital in Stevenage. I think that planning needs to improve. This year, the same thing happened throughout the country. The A and E departments asked for £700 million, the Government gave it to them, and yet there have been all these problems.

[Paul Burstow]

I think it important for the system to learn lessons from the areas where winter planning has worked well, and for us to ensure that those lessons are transferred and replicated around the country. The NHS is not always as good as it could be at ensuring that lessons are not just stuck in one place.

--- Later in debate ---

[David T. C. Davies]

I am absolutely certain that the A and E situation in England would be far better under this Government than it is in Wales, where, according to the House of Commons Library report, 13% of patients in major departments wait more than four hours in A and E. That is approximately double the percentage recorded by major departments in England. The question of ambulances has been raised several times today. Wales has the worst ambulance response rate in the United Kingdom, with around 55% arriving within eight minutes, compared with more than 70% in England.

The shadow Secretary of State talked about privatisation, but it was the Labour Government who, quite rightly, started using the private sector to improve the national health service. I have here a quote from the Labour Secretary of State in 2002; I will not mention his name. He said of the private sector that

“we intend to use it when it can bring expertise or resources to help improve services.”—[Official Report, 26 February 2002; Vol. 380, c. 547.]

We have carried on doing the same thing. A few years later, a different Health Secretary said:

“The NHS has always made use of the private sector and will continue to do so”.—[Official Report, 25 October 2005; Vol. 438, c. 163.]

She also promised that, the following year, patients would be able to choose from any health care provider—NHS or independent sector—that met NHS standards.

It was Labour’s policy in government to use the private sector. There is nothing wrong with that, but it is totally ridiculous for Labour Members now to pretend that the Conservatives are trying to privatise the NHS. That is a big lie: we will never, ever privatise the NHS, but we are quite happy to use the private sector when it can provide a better service, just as the Labour Government did. The last word on this came in 2005, when Professor Allyson Pollock wrote a damning book about the privatisation of the national health service. She was criticising the Labour Government.

[Sir Oliver Heald]

Does my hon. Friend agree that Labour took things a bit too far? The shadow Secretary of State tendered out the Hinchingbrooke hospital, which ended up in the private sector. That has not been a success, and I think it is better if a trust runs the hospital—

[Andy Burnham]

I did not do that.

[Sir Oliver Heald]

Oh yes he did!

[David T. C. Davies]

I agree with my hon. and learned Friend the Member for North East Hertfordshire (Sir Oliver Heald). The reality is that Labour Secretaries of State said over and over again that they were quite happy to use the private sector, and they did. They were probably right to do so in many instances, and we have continued to do so. There has been no departure from that policy.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

You have certainly corrected that. It is a point of correction, rather than a point of order. It is all on the record now and everyone can continue. Let us see whether we can turn the heat down a bit.

[Sir Oliver Heald]

Further to that point of order, Mr Deputy Speaker. I just do not accept the point of order that the shadow Secretary of State has made. May I just—

[Mr Deputy Speaker]

Order. No—I said straight away that it was not a point of order, but a point of correction. The point is that it is all on the record for people to read tomorrow, to continue a debate on who is right and who is wrong. Both parties, quite rightly, have stated what their belief is. Mr David T.C. Davies has not much time to go and I am very worried that he will not get to the end of his speech. He has only eight minutes in total.

--- Later in debate ---

[Stephen McPartland (Stevenage) (Con)]

I am proud of the NHS and I am proud of its staff. The Lister hospital in my constituency is very large and employs thousands and thousands of staff who, I am proud to say, save lives on a daily basis. The hospital is one of the NHS’s big success stories, as it is currently undergoing a £150 million redevelopment.

I spend a lot of time at the hospital, because I am always opening things and looking at new plans and buildings, which include a new endoscopy unit and theatre, a new A and E unit and a new theatre and ward block, none of which have as yet been fully opened. I have opened a variety of other units, including new scanning units. Some £150 million has been invested in the NHS in Stevenage, which is the biggest ever investment in the NHS in Hertfordshire’s history. As the county predates the Norman Conquest, Members will understand that that is a pretty big investment.

[Sir Oliver Heald]

I congratulate my hon. Friend on the investment and the fantastic facilities of his hospital. In my neighbouring constituency, we say that if someone wants to find the Lister hospital, they should look for the cranes, which are there for the construction of all the new buildings. Does he agree that it has taken a Conservative-led Government to make those improvements?

Contaminated Blood

Oliver Heald Excerpts

Thursday 15th January 2015 Commons Chamber

[Sir Oliver Heald (North East Hertfordshire) (Con)]

The hon. Member for Newport East (Jessica Morden) has explained this tragedy extremely well. I first became aware of the issue in the early 2000s when I was a member of the all-party group on hepatitis C. I would like to pay tribute to the work of Jim Dobbin, whose memorial service it was yesterday. He was a great campaigner on a number of health issues and will be sadly missed.

I congratulate my right hon. Friend the Member for North East Bedfordshire (Alistair Burt) on doing a wonderful job to secure the debate, and on working so hard on this issue. A constituent of mine recently told me that attending a meeting chaired by him in the House had left her more reassured than ever that he, and the group of MPs involved, would eventually obtain a decent settlement for all victims and their families.

I have a very old friend who has haemophilia. He has kept me informed on the issue over many years but is not very well these days. I would like to pay tribute to my constituent Mrs Ward. She campaigns on the issue on behalf of her family, who have been very badly affected by it. It is an issue of compassion; it is an issue for our generation; it is an injustice and a scar on the NHS. It has to be resolved.

We all feel for the people who are continuing to struggle with the aftermath of this decades-old mistake. The right hon. Member for Cardiff Central (Jenny Willott) made the point that this blight can run down the family for years. Obviously we understand the background of the original lack of understanding and the medical challenge to treat people with haemophilia, not knowing with security that the blood was safe. It is good that Governments have now recognised the extreme harm and the disaster that this was for victims, for which compensation was necessary. The arrangements put in place in 2011 were a major step forward.

I want to make three points. The first is that the APPG’s excellent report highlights the confusing system for compensation, with the five separate bodies all receiving Department for Health funding. There are two private companies and three registered charities; it is too opaque. I hope Ministers will see whether there is some way of improving the signposting to ensure that people can find their way through it.

The second point is that even if one understands the funding to which one is entitled, the process of claiming it is difficult, confusing and onerous.

[Mark Tami (Alyn and Deeside) (Lab)]

Does the hon. and learned Gentleman agree that people need help through the difficult and complex process to ensure they get the outcome they deserve?

[Sir Oliver Heald]

Yes, I do agree. The hon. Gentleman will know that there were people who underwent treatment for hepatitis C, but somehow the NHS has lost their records. That affects their applications. As the hon. Gentleman says, some way must be found to support people in this complex process.

One of my constituents tells me that new treatments for curing genotype 1 hepatitis C have been approved, but access seems to be granted only on “compassionate grounds”. Apparently, that excludes that constituent. She describes it as a “painful irony” that the problems that led to the NHS providing contaminated blood in the first place are now denying a survivor the appropriate treatment. I hope the Minister will look into this case, so that rather than having to prove compassionate grounds it can be dealt with as an entitlement.

The tragedy of this is deeply upsetting, and we must step up to tackle its legacy. The Penrose inquiry is expected to report soon, and its findings will, I am sure, be considered carefully by the Government. We are all pleased that these steps are being taken and that there has been progress, but this has not yet led to closure. That is necessary for the survivors, and it is necessary for the survivors and their families to have the support and dignity that they deserve. It is incumbent on our generation to sort this out, and this is the place to do it.

National Health Service (Amended Duties and Powers) Bill

Oliver Heald Excerpts

Friday 21st November 2014 Commons Chamber

[Clive Efford (Eltham) (Lab)]

I beg to move, That the Bill be now read a Second time.

Today we begin to restore the sovereignty of this House over our national health service. We begin to put patients at the heart of decision making. We will restore the responsibility of the Secretary of State to promote a comprehensive national health service. We will tear the heart out of the hated Health and Social Care Act 2012. We will remove the health service commissioners’ obligation to put services out to tender. We will replace the 49% private patient cap, and allow the Secretary of State to set limits. We will prevent competition authorities from interfering in mergers that are in the interests of NHS patients. We will stop the sale of assets that are in the long-term interests of patients and our national health service. We will restore the powers of the Secretary of State to direct health commissioners. We will create a framework for national health service contracts that will put the interests of patients before competition. We will protect the NHS from the imposition of competition rules by the transatlantic trade and investment partnership, and give sovereignty to this House.

Through this House, the Secretary of State will be accountable for promoting a comprehensive national health service. If any Government dare to impose competition on our national health service in the future, they will have to come before the House and repeal this Bill, if it becomes an Act. We, as Members of the House, will be accountable to our constituents for how we vote in that debate. There will be no hiding place.

Some have expressed the fear that the Bill opens the door to further privatisation. It does not. I accept that the last Labour Government unlocked the door to competition, albeit in a modest and measured way. I voted against the creation of hospital foundation trusts, which introduced legally binding contracts with NHS commissioners; in retrospect it was a mistake, because it brought procurement law into parts of the NHS.

[Sir Oliver Heald (North East Hertfordshire) (Con)]

I congratulate the hon. Gentleman on being so lucky in the draw. He has referred to competition. Does he not accept that Labour did much more than he is suggesting? The then Secretary of State, who is now the shadow Secretary of State, privatised an entire hospital in the east of England. That is privatisation. [Interruption.]

[Clive Efford]

It is not possible to compare what went on under the last Government with what has been introduced by the raw market mechanisms of the 2012 Act.

--- Later in debate ---

[Sir Tony Baldry (Banbury) (Con)]

I congratulate the hon. Member for Eltham (Clive Efford) on introducing his Bill and on the robust candour with which he did so. I am only sorry that he was displaced from his usual perch in the House. However, I am confident that when, after the next general election, the Labour party finds itself again in opposition on those Benches, Labour Members will not have to share them with the UK Independence party because we will have won those seats back.

I can understand why, when there was a coalition Government at the start of this Parliament, the Liberal party wanted, as a condition of the entering into the coalition Government, a five-year fixed-term Parliament. However, one of the difficulties and drawbacks of five-year fixed-term Parliaments is that we have some of the longest general election campaigns ever, and that makes it quite difficult to differentiate substantive and serious political points and what is essentially electioneering. I can just imagine the hon. Gentleman making that speech on a wet Thursday evening during the general election campaign in the trades hall somewhere on Eltham high street.

[Sir Oliver Heald]

Does my right hon. Friend agree that it is good to hear an authentic south London voice speaking up for Labour values rather than the snooty lot from north London who manage the party now?

[Sir Tony Baldry]

Yes, but the first point I want to make is this. We need to be careful about what we say about the NHS in the run-up to general elections. The first general election campaign that I was seriously involved in was back in 1966. In every one since then, there has been a period when the Labour party has run around saying things along the lines of “24 hours to save the NHS.” That is very destabilising, as was evidenced today in a letter to a national newspaper by Dr Michael Dixon, the chairman of the NHS Alliance, and a number of other GPs, in which they say:

“As NHS doctors, we are deeply concerned about the misguided and potentially disruptive National Health Service Bill being debated today.

The Bill’s proponents claim it will remove competition from the NHS and guard against ‘privatisation’ by repealing key clauses of the 2012 Health and Social Care Act.

We believe this would be a backwards step for patient care, reorganising the NHS in a top-down way at a time when it needs to be looking ahead to the huge challenges of the future. These were set out in the NHS England Five Year Forward View, and we urge all politicians to support it rather than using the NHS as a political football.

Suggesting that GP commissioners have a ‘privatisation agenda’ is an ill-informed attack on the clinical leadership which improves services and helps patients.”

I agree. It is disappointing if politicians use the NHS as a political football.

The NHS is an enduring part of the post-war consensus on the welfare state. That consensus was agreed on by everyone who had gone through the deprivations of the second world war, had lived through the blitz, and were determined that there would be a better Britain. The NHS was supported by everyone, including Archbishop Temple, a brilliant Archbishop of Canterbury, who was the person who first coined the phrase “the welfare state”.

I have always been interested in the NHS, not least because both my parents became part of the NHS on its very first day. When it came into being in 1948, my father was a recently qualified registrar and my mother was a theatre sister, having served as a theatre nurse during the Coventry blitz. My parents spent the whole of their working lives in the NHS: my father went on to become the research secretary of the British Tuberculosis Association and a chest and heart specialist, and my mother went on to become a sister tutor.

The other reason I have always been extremely interested in the success of the NHS is that, in the nearly third of a century I have been fortunate to be the Member of Parliament for north Oxfordshire, the most important issue in my constituency has probably been the position of Horton general hospital and the retention of its services.

I have left instructions in my will that my body should go to the anatomy department of the university of Oxford, partly because there is quite a lot of it for them to work on, but also because I feel that the liver of anybody who has been an MP for nearly a third of a century must be worthy of some anatomical research. I am also determined that when they open me up, they will discover engraved on my heart, “Keep the Horton general.”

What we heard from the hon. Member for Eltham was a litany of gloom in the NHS, but Horton general hospital now has more consultants than at any time in its and the NHS’s history. The Oxford University Hospitals NHS Trust employs 11,598 staff, including 1,800 doctors and 3,600 nurses. It is important to make clear that, since 2010, the number of patients seen by the trust, including at Horton, has increased significantly. There has been a 19% increase in elected in-patient admissions, a 9% increase in emergency in-patient admissions, a 24% increase in day-care admissions and a 12% increase in out-patient attendances. Those are significant increases in just over four years, so the NHS continues to treat more out-patients and in-patients.

Over the past two years, the Oxford University Hospitals NHS Trust has managed completely to eliminate its financial deficit and increase the amount paid to the Oxfordshire clinical commissioning group, such that the group finished the year with a surplus. Most importantly, over the past couple of years the trust has managed to create 400 new jobs, almost all of them new doctors and new nursing posts. Sir Jonathan Michael and his team deserve considerable congratulations on managing to balance the finances of the trust and securing a large number of new medical and nursing posts.

--- Later in debate ---

[Sir Tony Baldry]

We heard that argument during the passage of the Act, and it is simply wrong. It is wrong to suggest that somehow the Act opened the door to competition.

[Sir Oliver Heald]

I wonder if my right hon. Friend shares my consternation at the shadow Secretary of State’s remarks, given that throughout the 2000s, all we heard from Labour, John Hutton and the other Ministers he has mentioned was the importance of value for money and tendering for things. They are going back to the days of the right hon. Member for Holborn and St Pancras (Frank Dobson) being in charge.

[Sir Tony Baldry]

My hon. and learned Friend makes a very good point. There is confusion about whether we have got new Labour or old Labour. The Labour party has to set out how it would undo the market it created without further top-down reorganisation. It could not do it simply by removing the health rules that manage it. There has been no change on when to tender competitively; the rules on procurement are the same as those used by the previous Government. The Act makes it clear that the Secretary of State remains politically accountable to the NHS. The changes in the Bill would restrict the greater autonomy given to the NHS and inhibit staff from making the innovative changes needed to secure sustainable, high-quality care for patients. In particular, it would tie the hands of clinical leaders on CCGs, which the NHS England five-year forward view says should have more powers, not fewer.

--- Later in debate ---

[John Healey]

The hon. Gentleman normally finds a common touch in the way he makes his points. I have to tell him that if he tries to trot out those sorts of figures on the doorstep in the next five months, he will find that they cut no ice with the public, because they know what is happening to their NHS day to day, and we will make sure they understand why it is happening.

[Sir Oliver Heald]

rose—

[John Healey]

I will give way to the hon. and learned Gentleman and then make some progress.

[Sir Oliver Heald]

Why should I apologise for the £150 million of investment in Lister hospital in Stevenage or the £98 million in Addenbrooke’s hospital in Cambridge—fantastic, world-beating facilities?

[John Healey]

We on the Labour Benches cannot wait for the debate on the NHS to be put right at the heart of the next five months of policy and political debate, and my right hon. Friend the shadow Secretary of State will make sure that happens.

Let me return to my point about the way that we in this House were misled about the reorganisation and the legislation. I am disappointed to see that the man who led it, the right hon. Member for South Cambridgeshire (Mr Lansley), is not in the Chamber today to explain himself. He argued—it was completely wrong, but he argued it—in the debate on Second Reading in January 2011:

“It is about gearing the entire system towards supporting the relationship between doctor and patient”.—[Official Report, 31 January 2011; Vol. 522, c. 617.]

Of course, it was not and it is not. As I argued, at the time from the Opposition Front Bench:

“The reorganisation and legislation is designed to break up the NHS, to open up all areas of the NHS to private health companies, to remove requirements for proper openness, scrutiny and accountability to the public and to Parliament, and make the NHS subject to both UK and European competition law.”—[Official Report, 16 March 2011; Vol. 525, c. 378.]

The Government were and are driving free market political ideology through the heart of our NHS.

The arguments that those of us on the Opposition Benches made then are those that we make now, and that my right hon. Friend the Member for Leigh (Andy Burnham) makes especially strongly from our Front Bench. That is why the Bill that my hon. Friend the Member for Eltham (Clive Efford) has introduced is so essential and why I am so pleased and proud to be one of his sponsors.

--- Later in debate ---

[Andy Burnham]

I am sure that Tory central office has been ringing around for a few days trying to find some doctors who are still in favour of the 2012 legislation, and they found 11. Well, I think that is probably about the limit for the number of people prepared to put their name to it. I can tell the hon. Lady that thousands of doctors lined up with the Opposition and pleaded with her party to call off its reorganisation, and that included the British Medical Association and the royal colleges, but it would not listen. The Government ploughed on regardless, and the NHS has gone downhill ever since.

That is why my hon. Friend the Member for Eltham gave a stirring speech of the kind this House needs to hear more, full of conviction and passion, standing up for the national health service that he believes in. He has brought before the House a Bill that reaffirms the words of Nye Bevan’s original National Health Service Act 1946 on the democratic accountability of the NHS to the Secretary of State and, by extension, to this House. The Bill abolishes the compulsory tendering of NHS services and removes market forces. It reduces the private patient income cap back down to single figures. Once and for all, it fully exempts the NHS from EU procurement and competition law, as is our right under the Lisbon treaty. It sends the Government an uncompromising message that the NHS will never be touched by any TTIP treaty.

In particular, I commend my hon. Friend for saying that it is about time this House regained full sovereignty over the national health service. They gave it away—the Eurosceptics sitting there on the Government Back Benches—when they mandated open tendering of services. By doing that, they placed the NHS in the full glare of European competition law. [Interruption.] They do not like to hear it, but that is what they did.

[Sir Oliver Heald]

Is the right hon. Gentleman the same man who used to talk about an end to the polarising debate on private and public sector provision? Is he the same man who, when Secretary of State, privatised the services for an entire hospital at Hinchingbrooke? What is he doing today? It is buff and blow party politics.

[Andy Burnham]

I told the hon. and learned Gentleman earlier that that was incorrect and that he should withdraw the suggestion, because I did not do that. The contract for Hinchingbrooke was awarded under his Government. I will tell him who this man is. This is the man who, when Secretary of State, introduced the concept of NHS preferred provider, because I believe in the public NHS and what it represents, unlike him. I believe in an NHS that puts people before profit, unlike him. That is the man he is talking to, and that is what I will always stand up for.

[Andy Burnham]

I am afraid that the hon. Gentleman has to get his facts right, because they are wrong. When I was Health Secretary and Hinchingbrooke needed to find a new operator, I asked local NHS trusts in his area to come forward, and at the time none of them wanted to do that, so we had to find an operator—

[Sir Oliver Heald]

On a point of order, Madam Deputy Speaker. I may have inadvertently said that the contract was let, but I do not believe that I did. The true position is that it was the right hon. Gentleman who took the decision to privatise the services in that hospital, and it is wrong for him to seek to deny it. [Interruption.]

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. I appreciate that the hon. and learned Gentleman wishes to ensure that the record is set straight. He has attempted so to do, but it is not a point of order for me to deal with.

--- Later in debate ---

[Sir Oliver Heald (North East Hertfordshire) (Con)]

I am grateful to have the opportunity to make a few short remarks. The hon. Member for Worsley and Eccles South (Barbara Keeley) is right to be concerned about any problem that occurs in the NHS, but I am sure she would accept that it is an enormous organisation and that the key point is that when things go wrong, the lessons are learned and things are put right. Most of the life of the NHS has been under Conservative Governments, and we on the Government Benches are as proud of the NHS as Labour Members are.

I congratulate the hon. Member for Eltham (Clive Efford) on being a strong voice for Labour principles, but I am concerned that the effect of his Bill will be to undermine the operational independence of the NHS, cause disruption and introduce unnecessary bureaucracy. Putting powers back with the Secretary of State through the re-establishment of powers of direction is going in the wrong direction. Preventing illness, diagnosing and treating patients are not political activities. They should be in the hands of professionals and the operational independence of the NHS means that clinical considerations are paramount. When I was a health spokesperson, I went to look at health systems in Europe, and the key point I took away was that the best systems were those with a lot of clinical input in management.

It is not necessary to rewrite the Act. Instead, the changes we have made need to work their way through. The shadow Secretary of State said that the competition element is dominant in the Act, but that is not true. The procurement policy is set out to secure the needs of patients and improve quality and efficiency. I want to give an example from my constituency of how the reforms are working. Royston is part of the Peterborough and Cambridge CCG. Before that was so, we had a proposal for the redevelopment of Royston hospital. A Royston hospital action group was formed, while the friends of Royston hospital were concerned about the proposals, which were top down. However, Tom Dutton, the CCG strategic lead, has worked tirelessly with the NHS and the local community, as has the local chairman, Dr John Hedges, a GP in Royston, and they understand local needs, so we are now getting tailored provision that suits the needs of my constituents.

I meet the CCG, councillors, local groups and other stakeholders every six weeks, and I believe that we are now getting a service for Royston and a proposal that meet local needs. The £1 billion tender for older people’s services was in our CCG area. The hon. Member for Eltham criticised the cost, but we had a consultation meeting in Royston that 150 local people attended, while 250 local people filled out the questionnaire. The proposal and consultation will have cost money, yes, but the end result was that the tender process was won by the Uniting Care partnership, an NHS partnership involving Addenbrooke’s hospital and the Cambridge and Peterborough NHS trust, and it is now delivering more joined-up care.

[Dr Huppert]

I was delighted with that outcome. One of the successes I hope the hon. and learned Gentleman will mention is the better joint working between acute care, mental health care and community services to avoid delays in the transfer of care. This could be a very good outcome for the NHS and patients.

[Sir Oliver Heald]

That is exactly the point I was going to make. The process, which involved local people, has resulted in a reform that gives us the sort of joined-up care the hon. Gentleman mentions.

To conclude, the Bill seeks to prevent privatisation that is not happening on the ground, while some of the changes we have made are bringing positive benefits for people in my constituency.

Oral Answers to Questions

Oliver Heald Excerpts

Tuesday 21st October 2014 Commons Chamber

[Mr Hunt]

The Government are happy for people to travel anywhere in the United Kingdom. My concern about health services in England is the pressure created, because for every patient that goes from England to Wales, five want to come from Wales to England.

[Sir Oliver Heald (North East Hertfordshire) (Con)]

17. My right hon. Friend will be aware that his new website, My NHS, is providing much more openness and transparency for patients from England. To what extent does the extra information and ability to improve standards in hospitals as a result also apply to Wales?

[Mr Hunt]

This is the big lesson that we have learned after the tragedy of Mid Staffs. The Francis report said that the NHS had become over-dependent on a targets culture that was damaging for patients, and the Government think that the way to improve standards is through transparency, openness, and the pressure of peer review. We have embraced that lesson wholeheartedly, and it is such a shame that the Welsh Labour Government have taken a different tack.

Reform of Social Care

Oliver Heald Excerpts

Monday 4th July 2011 Commons Chamber

[Mr Lansley]

The difference in approach is the result of devolution.

[Oliver Heald (North East Hertfordshire) (Con)]

I welcome the fact that the Secretary of State has gone wider than the Dilnot report today. It was at least two years ago that the Commission for Social Care Inspection, the regulator, called for wider powers to deal with financial regulation, and it is very welcome that that is to happen. Does my right hon. Friend agree that the level at which the cap is set under the Dilnot regime will be important in deciding whether an insurance market can develop? If it is set too low, the risk that is being shared will not be great enough, and if it is set too high, it will be too expensive.

[Mr Lansley]

I am grateful to my hon. Friend. That is precisely why we drafted the Health and Social Care Bill in the way we did. I hope that people will bear that in mind when debating the need for, and appropriateness of, this further regulatory measure. He made a perfectly valid point, and it is one reason we need to ensure engagement. It is not only a matter of whether the insurance and financial services industry would respond: along with stakeholders and the public, we need to understand what the public’s attitude would be were they to have greater clarity about potential care costs and if they were willing to engage with financial services products in meeting those care costs. If they were, significant benefits would be derived, not least through bringing additional resources to bear and through creating organisations with a direct incentive to undertake more prevention.