Oral Answers to Questions

Debate between Paula Sherriff and Ben Gummer

Thursday 14th April 2016 Commons Chamber

[Tom Brake (Carshalton and Wallington) (LD)]

16. What discussions she has had with the Secretary of State for Health on the effect of the proposed new junior doctor contract on women in that profession.

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

The Secretary of State fully understands his obligations under the Equality Act 2010 and his public sector equality duty. He is aware that he must pay due regard to each of the statutory equality objectives, which cover all of the protected characteristics, not just those that affect women. The new contract is a huge step forward for achieving fairness for all trainee doctors. For the first time, junior doctors will be paid and rewarded solely on the basis of their hard work and achievement, whether they work full or part time. Pay progression will be linked to the level of training rather than arbitrarily to time served. On 31 March, we published the equality analysis and family test alongside the new national contract.

[Paula Sherriff]

By next year the majority of doctors working in our NHS will be women, yet the Government have freely admitted in their own equality impact assessment of the new junior doctor contract that aspects of it will disproportionately hit female doctors, so how can the women and equalities department possibly condone this shocking treatment by the Government?

[Ben Gummer]

I thank the hon. Lady for bringing this important matter to the attention of the House. I know that she will want to read the full equality impact assessment over the weekend, and she will find if she does so that it makes it clear that this contract is good for women, that it is a fairer contract and that it does not directly or indirectly discriminate against women. That is why I am very keen to see it implemented as fast as possible.

Junior Doctors: Industrial Action

Debate between Paula Sherriff and Ben Gummer

Thursday 24th March 2016 Commons Chamber

[Ben Gummer]

My hon. Friend is right to point out that not all junior doctors are members of the BMA. In fact, a significant minority are not, which is why fewer than half have been turning out for industrial action. The number has been decreasing with each successive strike, and I have no doubt that as we move to the withdrawal of emergency cover, most junior doctors will say, “This is not something I went into medicine to do”, and will want to show their support for patients, rather than an increasingly militant junior doctors committee.

[Paula Sherriff (Dewsbury) (Lab)]

I plead with the Minister to respond to the comments from Jeremy Taylor, chief executive of National Voices, which represents 160 health and care charities and which has called on the Government to drop imposition and on both sides to get back around the negotiating table. In his words, if they do not,

“the only people who will suffer are patients.”

[Ben Gummer]

I disagree with the gentleman on two points. First, we have been trying to get around the negotiating table for over three and a half years, but it requires both sides to negotiate, and I am afraid the BMA has refused to do so. When only one party is at the table, negotiations cannot continue. Secondly, it is not just bad for patients; it is also bad for doctors in terms of their careers and what they want, which is to provide the best possible care for patients. That is why I urge all doctors not to withdraw emergency cover at the end of next month.

Mid Yorkshire Hospitals NHS Trust

Debate between Paula Sherriff and Ben Gummer

Monday 21st March 2016 Commons Chamber

[Paula Sherriff]

Given that Ernst & Young’s services were used, at some considerable cost, and that some of the matters it considered were staffing issues and staff forecasts, it is relevant to point out the contract has now ended after about four or five years. Does the Minister agree that it is quite worrying to find ourselves in this position after spending somewhere in the region of £15 million?

[Ben Gummer]

As a constituency MP, I, too, have been frustrated by consultancy contracts, both before and after the 2010 election. Across the service, we have managed to bear down on consultancy spend considerably. It is for the hon. Lady and her consultants to determine whether the trust has got good value for money. It is not for me to pass comment on that, except for the fact that all hospitals should account to their local people and to the trust and local authority responsible for making sure that money is being spent wisely.

I completely agree with the hon. Lady in that behind the statistics of poor performance that she identified, there are people who are not receiving the care they require. That was picked up by Professor Sir Mike Richards in his report into the quality of care provided at the hospital. He was very clear about it, saying

“we found medical care, end of life services and community inpatients either hadn’t improved or had deteriorated since our last inspection.”

He found areas of significant staffing shortages affecting patient care, especially on the medical care wards, community in-patient services and in the specialist palliative care team. He said that there was a shortage of medical staff for end of life services. He came to the same conclusion as the hon. Lady did.

The difference here is that I hope we have made progress since the Mid Staffs tragedy that the hon. Lady identified, and are now able to be more open about this. There will not be a culture of denial from the Government Benches about problems where they exist. Clearly, there is a problem here; it has been identified by the Care Quality Commission. The distressing story of the hon. Lady’s constituent that she raised with the Secretary of State in the Chamber and in the letter and again just now has been supplemented with additional stories that her colleagues have brought to the attention of the Department, and these make it clear that things need to be done in Mid Yorkshire.

What, then, is the solution to the problems that the hon. Lady has identified? The first is a local one, and all these problems have to be addressed locally, but I of course take the hon. Lady’s point that the Department has to take a degree of responsibility. Of course the Secretary of State and I take responsibility for everything that happens in the health service—that is ultimately our duty—but we cannot micromanage every hospital. It is for the local team to ensure that they are universalising the best and implementing the kinds of changes in their trust that have made such a success of hospitals not very far from the hon. Lady’s own. If they are able to do that, they will already be able to bring considerable improvements to the quality of the care that they can provide.

I can obviously do additional things as a Minister to give the local team the tools to do the job, as I can for other hospitals across the country. That includes ensuring that they have the best guidance to enable them to roster their staff properly. Lord Carter’s review is being conducted with the Care Quality Commission and with NHS Improvement. It is a tripartite review of safe staffing ratios that will give hospitals cutting-edge support to roster their staff according to the acuity of their patients to ensure maximum safety and efficiency, learning from best practice across the globe. Salford Royal Infirmary has already been looking at this particular model in one guise.

[Paula Sherriff]

My hon. Friend the Member for Batley and Spen (Jo Cox) and I share considerable concerns about the senior leadership at the trust. We have regular monthly meetings, but we were made aware only at the last meeting—we now have an interim chief executive—of some of the chaotic things that were going on at the trust, although we had been aware of anecdotal stories. We would therefore appreciate some support from the Department of Health team to ensure that communication channels between us as elected Members are as effective as possible.

[Ben Gummer]

I shall certainly impress that upon NHS Improvement, which will be taking over the functions of the NHS Trust Development Authority in the next few days. I expect that it will keep an even beadier eye on the quality of management than has been the case so far. It will do so under the watchful eye of Jim Mackey, its chief executive, who ran one of the best hospitals not only in England but in the world. He is now running NHS Improvement and I know that he will be able to provide the support that the hon. Lady wishes to see. I will tell him later this week about the discussion that we have had tonight and I will ensure that he provides hon. Members with the kind of resource that they are asking for so that they can ensure that their local leadership is doing the right thing.

On the wider issue of staffing, the fact is that the nursing numbers in the service, which were found wanting at the time of the Mid Staffs scandal, could have been addressed only by significant changes in commissioning levels not two, three or four years ago but 10, 15 or 20 years ago. The service has failed under successive Administrations to predict the number of staff that it needs for the future. One of the more extraordinary functions that I possess is to have to sign off every year the commissioning of staff that will be required in 20 or 30 years’ time. My officials are a wise and brilliant group of people, but no one can behave like Nostradamus and expect to know what the service will require after that period of time.

That is why we have come to the conclusion that we need to increase significantly the number of places commissioned. Within the current spending envelope, however, it is simply not going to be possible to achieve the numbers that we wish to see. I think that Governments from both sides would have found that very difficult—in fact, impossible. That is why we came to the conclusion that we should release those places by transferring nurse graduates on to a loan system. I know that that is unpopular with Labour Members, but I hope that they will understand the rationale behind our doing so. It will allow us to add 10,000 additional places between now and the end of this Parliament. Those are 10,000 places that we will then be able to feed into additional nursing places, which will in time solve the underlying issues that parts of the country such as the hon. Lady’s have suffered for decades.

One final aspect that I wish to bring to the hon. Lady’s attention, which I hope she will be pleased with, is that of the new role of nursing associate. It is supported by the Royal College of Nursing and to some extent by Unison, although it has reservations—a consultation is starting soon on this. It will provide a ladder of opportunity to healthcare assistants to move through an apprenticeship level up to the midway point of a nursing associate, and then on to being a full registered nurse. At present that is a course that healthcare assistants cannot take; it is not open to them.

I know that other parts of Yorkshire have no problem at all hiring healthcare assistants, but find it very difficult to hire registered nurses. That is a particular local difficulty. What I have proposed is a mechanism to give an opportunity to healthcare assistants to progress themselves, which they have many times missed out on because they did not have access to the decent formal education that we aim to provide now under the reformed education system. We are now offering, through an apprenticeship route that would not be open to them otherwise, a ladder of opportunity to a much wider group of people in the NHS, and at the same time helping to solve staffing issues where there are traditional, historical difficulties in hiring nurses.

I hope that with those general measures we will be able to do far more in the long term to solve the issue that the hon. Lady has identified. On the specific issues, I will ensure that she gets the reassurance she requires, not just on the reconfiguration, but on the leadership of her trust. I thank her and her colleague for bringing this important matter to the attention of the House.

Question put and agreed to.

Oral Answers to Questions

Debate between Paula Sherriff and Ben Gummer

Tuesday 5th January 2016 Commons Chamber

[Ben Gummer]

I can assure my hon. Friend of precisely that.

[Paula Sherriff (Dewsbury) (Lab)]

Mid Yorkshire Hospitals NHS Trust is planning to implement a significant reconfiguration plan 12 months earlier than was agreed by the Secretary of State. Dewsbury hospital will be significantly downgraded before infrastructure is in place to ensure that patients still receive vital care safely. Will the Secretary of State meet me to discuss this premature move, which appears to be purely financially driven and not in the best interests of my constituents?

[Ben Gummer]

I thank the hon. Lady for bringing that issue to the notice of the House. The reconfiguration she mentions is the responsibility of local commissioners, but I am very happy to meet her, and anyone she wishes to bring with her, to discuss the planned changes.

Oral Answers to Questions

Debate between Paula Sherriff and Ben Gummer

Tuesday 17th November 2015 Commons Chamber

[Ben Gummer]

The principles that the Department publishes are clear that charges, if they are set, should be proportionate and fair and should be set at a level that assures people of a car parking space. One of the problems of free car parking is that it often means there are no spaces for carers and for the sick when they turn up. Clearly, hospitals should exercise judgment in making sure that carers and people making frequent visits get a heavily discounted rate so that such charges do not become an impediment to free access to healthcare.

[Paula Sherriff (Dewsbury) (Lab)]

Mid Yorkshire Hospitals NHS Trust has recent imposed charges for blue badge holders. Many constituents have told me that, as a result, they will struggle to attend their appointments. The trust admitted to me that it had not considered the impact on the DNA—did not attend—rate. Does the Minister agree that not only does this place an extra financial burden on the vulnerable, but could lead to their being denied access to the healthcare that they desperately need?

[Ben Gummer]

The hon. Lady raises the surprising point that the hospitals did not consider the impact on their operations, which they should have done. The principles make it quite clear that disabled drivers should get concessionary rates, although charges sometimes need to be applied so that there are spaces for disabled drivers. The hospitals should have thought that through, and should look for savings elsewhere in their operations before they look at car parking charges.