A and E (Major Incidents)

Peter Bone Excerpts

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

I say gently to the hon. Gentleman that if we are to solve the problems in his area and others, we should listen to the doctors about the structures that will work best. The structures that we put in place are the structures that doctors advised us to set up. That is why we are supporting them.

[Mr Peter Bone (Wellingborough) (Con)]

Mrs Bone would like to offer best wishes for the new year to the Secretary of State. The reason she can do this is the excellent health care provided by the NHS in both Kettering general hospital and Northampton general hospital. Locally, the commissioners and the acute hospitals are together working out a plan to deal with accident and emergency. Is not that the way forward?

[Mr Hunt]

Indeed. I pass on my best wishes for the new year to Mrs Bone. Like many people, she has benefited from superb NHS care. A million more people are having operations every year under this Government, and 700,000 more people are being seen within four hours at A and E under this Government.

Oral Answers to Questions

Peter Bone Excerpts

Tuesday 10th June 2014 Commons Chamber

[Jane Ellison]

I absolutely join my hon. Friend in congratulating everyone involved in turning that performance around—it is really, really impressive. He is right to say there are lessons to be learnt everywhere from people innovating, joining up services and the various things that have gone on in the background. I know that the local Members have been involved and engaged in the process and I congratulate them on that. That is really valuable and I urge everyone to get involved. We should congratulate A and E staff everywhere on dealing with the pressures they are under. We know they are considerable, but they do a great job.

[Mr Peter Bone (Wellingborough) (Con)]

May I congratulate my hon. Friend the Member for Kettering (Mr Hollobone) on the work he has done to help with this amazing turnaround? The Minister is aware of the plans to have a community urgent care centre at Isebrook hospital in my constituency, which will mean that my constituents will not have to go to Kettering hospital. Is this not another way forward to improve A and E results?

[Jane Ellison]

My hon. Friend highlights that there are a lot of different approaches to reducing the pressures on A and E. The great thing is that we are seeing real innovation from local clinicians, supported by local Members of Parliament. That shows what can be done when we address these problems with an innovative approach, and think about how we can reduce these pressures and ensure that as many people as possible are served in the right way and treated outside A and E, if that is not the place they should be.

Mental Health Services (South-East Essex)

Peter Bone Excerpts

Wednesday 5th March 2014 Westminster Hall

[Norman Lamb]

I am conscious that I am close to running out of time, but community services often do enormously good work in their local areas. The focus on mental health must shift towards a prevention approach. We must intervene early rather than allowing a problem to deteriorate and acting only after something has happened. We must also focus much more on recovery. So often, we seek to contain people’s ill health rather than helping them to recover in a meaningful sense.

Finally, I would like to mention our crisis care concordat, which will set high standards of crisis care in mental health that have never existed before. We expect every area to implement that concordat to ensure that people, wherever they are in the country, get access to the right standards of care.

[Mr Peter Bone (in the Chair)]

Order. I apologise to Members for having to curtail the debate, because I am sure that it could continue.

Accident and Emergency

Peter Bone Excerpts

Wednesday 18th December 2013 Commons Chamber

[Mr Philip Hollobone (Kettering) (Con)]

Kettering general hospital will be well known to the Secretary of State, because he was good enough to visit it a year ago to see the excellent service provided by its doctors, nurses and ancillary staff. The hospital has been in existence for 116 years and it is badly needed and much loved. At one time or other, every resident of Kettering has had a member of their family go through the hospital.

The hon. Member for Corby (Andy Sawford), my hon. Friend the Member for Wellingborough (Mr Bone) and I have put our party political differences aside and joined forces to campaign for extra investment for the accident and emergency facility at Kettering general hospital, because it is needed by all of our constituents. We are working as one on the issue. The other good news is that both the hospital trust and the local clinical commissioning groups are working as one on the issue.

I thank the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), who is not in his place, for meeting all three of us, together with representatives from the hospital and the CCGs, over the summer. He has been good enough to agree to meet us again on 15 January.

All the professionals have come together and agreed that, despite their best efforts and despite following the advice of the Department of Health’s intensive support team to the letter, whichever Government are in power would have to face the fact that the A and E at Kettering is, sadly, not fit for purpose and needs extra capital investment. Their bid to the Department of Health will be for £20 million for Kettering A and E and an extra £3 million to create community hubs—in other words, urgent care centres-plus—in Corby, Kettering and Wellingborough. The three hon. Members, the CCGs and the hospital trust will make a joint bid for that money when we meet the Minister in January.

The challenge the A and E at Kettering general hospital faces is serving one of the fastest growing populations in the country. In the last decade, Kettering’s population growth ranked 31st out of 348 districts around the country and it had the sixth highest increase in the number of households. Few other parts of the country are growing as fast as the Kettering area, which also has an increasingly ageing population.

The A and E department at Kettering general hospital was constructed in the 1970s for about 25,000 to 30,000 attendances a year. In 2001 attendances had hit 56,000 and that figure is now 85,000. The A and E centre is effectively bursting at the seams, and attendances show absolutely no sign of falling off. Typically, there could be between 170 and 230 attendances a day—the highest has been 260 in a 24-hour period this year.

The professional staff—the clinicians—in the A and E have made multiple operational changes. They have adopted all the best practice ideas provided by the Department’s intensive support team, but the key issue remains the estate, and the only way to solve that problem is an injection of capital investment. With that investment and with the development of community facilities in Corby, Kettering and Wellingborough, the professional clinicians are confident that the A and E department could at long last start hitting its A and E targets. At the moment, it is treating only 89% —well below the 98% target specified by the Government—of patients within a four-hour period.

[Mr Peter Bone (Wellingborough) (Con)]

I apologise for being out of breath, Madam Deputy Speaker, but I just wanted to ask my hon. Friend whether the proposal he is talking about has all-party support in the north of the county?

[Madam Deputy Speaker (Dawn Primarolo)]

Order. Mr Peter Bone has just arrived in the Chamber, but one is normally expected to be in the Chamber for more than just a few seconds so as to hear the debate before intervening. I am sure the hon. Gentleman apologises to the House.

[Mr Hollobone]

I am very grateful for the intervention from my hon. Friend the Member for Wellingborough because he has many duties to attend to in this House on behalf of his constituents and he has been at the forefront of the campaign to get extra investment into Kettering’s A and E, and also to develop the community hub patient facilities in Corby, Kettering and Wellingborough.

With the £3 million capital expenditure bid going to the Department, one of the options would be for a community hub at the Isebrook hospital, which would help to serve my hon. Friend’s constituents in Wellingborough and, by doing so, would take the pressure off the A and E at Kettering. If we are successful in this cross-party bid, the A and E at Kettering would be transformed into an A and E plus an urgent care centre on the site of Kettering general hospital. It would be a one-stop shop for local patients. The A and E at Kettering has the confidence of local people, but the local population growth means that capital investment is needed more than ever, and we look to the Government to provide that in early January.

[Mr Bone]

On a point of order, Madam Deputy Speaker. I apologise to the House for the discourtesy shown, but I was very surprised that my hon. Friend the Member for Kettering (Mr Hollobone) was called so early in the debate.

[Madam Deputy Speaker (Dawn Primarolo)]

I do not think that is a point of order, but the House has noted it and we will move on now so we do not waste any more time.

Tobacco Packaging

Peter Bone Excerpts

Thursday 28th November 2013 Commons Chamber

[Mr Speaker]

The sedentary remarks of the hon. Member for Shipley (Philip Davies) are almost as entertaining as those he makes when he is on his feet.

[Mr Peter Bone (Wellingborough) (Con)]

I sometimes feel sorry for the Government. We have an excellent Minister at the Dispatch Box who is listening to Parliament and asking for an independent report, yet she gets Members of Parliament complaining about that. That is ridiculous. I think I understood her to say that if regulation is to be introduced, it will be done by statutory instrument. I hope that the Government are not going to proceed in that way, because we can only reject or approve a statutory instrument—we cannot amend it. Will she think again on that point?

[Jane Ellison]

I thank my hon. Friend for his support. The exact technicalities are still under review. As I said, we are strongly minded to use the affirmative procedure, but that matter is not completely resolved. Of course, we do have a little time, because we expect the review to report in March 2014.

Mid Staffordshire NHS Foundation Trust

Peter Bone Excerpts

Tuesday 19th November 2013 Commons Chamber

[Mr Hunt]

Absolutely. It is a sign of great confidence when a hospital is open about things that have gone wrong. When I meet the top chief executives who are running the best hospitals in the country, I am always struck by how willing they are to be open about the problems that they have had. It is often in the less well-performing hospitals that the management feel less confident and willing to talk about the problems. That culture is really important. I hope that today is a step in the right direction.

[Mr Peter Bone (Wellingborough) (Con)]

I thank the Secretary of State for coming to the House and making such a detailed statement. I served under the previous Chairman of the Select Committee on Health, the right hon. Member for Rother Valley (Mr Barron), during the inquiry into patient safety. The Secretary of State has a point. The problem at the moment is that people make a complaint after something goes terribly wrong, but the complaints system is deliberately long, drawn-out and delayed. One never actually reaches the ombudsman. If we are to have a change in culture, we have to stop the managements of hospitals delaying the complaints system deliberately.

[Mr Hunt]

I totally agree with my hon. Friend. That is why I hope that what we have announced today will bring about a transformation in the way in which hospitals manage complaints. Some excellent work has been done to help us do that. The heart of the matter is that hospitals should be really interested in the complaints that they receive, because that will enable them to understand where they are not delivering good care and what they can do to put it right. That does not happen everywhere. Too often, the complaints system is treated as a process, in effect, to fob people off, rather than to get to the heart of what people are talking about. We absolutely need to change that.

Accident and Emergency Departments

Peter Bone Excerpts

Tuesday 10th September 2013 Commons Chamber

[Mr Hunt]

The royal colleges have come up with a number of important and good ideas. I hope that the hon. Lady has seen from my announcement today that we are making some profound changes to address the underlying problems in A and E which incorporate much of their thinking, but there are other ideas. We will continue to engage closely with the royal colleges because they can give us a lot of help in ensuring that we get the right answer.

[Mr Peter Bone (Wellingborough) (Con)]

Wellingborough’s nearest A and E is Kettering general hospital, which is 30 minutes or more for most of my constituents to get to. However, the proposal for an urgent care centre at the Isebrook hospital in Wellingborough will allow 40% of those constituents to go locally and relieve pressure on Kettering. Is this the sort of thing that the Secretary of State wants to encourage?

[Mr Hunt]

I always try to support the ideas that come up from different parts of the NHS because people on the ground usually have the best ideas about what needs to be done, but when decisions cross my desk it is important that I consider the knock-on effect on other areas, and I get independent advice on that as well. I shall follow closely the proposal that my hon. Friend mentions.

Tobacco Packaging

Peter Bone Excerpts

Friday 12th July 2013 Commons Chamber

[Anna Soubry]

I have been very pleased to have a number of discussions with colleagues north of the border and in Wales. It is a pleasure, as always, to continue to work with them.

[Mr Peter Bone (Wellingborough) (Con)]

I draw the House’s attention to an interest in the register.

I congratulate the courageous Minister on making this decision. She has led from the front and done completely the right thing in having an evidence-based decision. The shadow Minister’s attack on her was completely unfounded. This Minister would never do something against her principles; if she thought it was wrong, she would resign. Is not this exactly the way Government should be: evidence-based rather than rushing through things?

[Anna Soubry]

I agree.

Herbal Medicine (Regulation)

Peter Bone Excerpts

Tuesday 9th July 2013 Westminster Hall

[David Tredinnick]

I have seen evidence in Europe that when doctors combine the two, the allopathic drugs bill can be reduced because herbs tend to be less expensive. That may worry manufacturers, and it has long been said that they are actively campaigning against this. They would be wise to accept that working with natural medicine is good for sales of conventional medicine.

[Mr Peter Bone (in the Chair)]

Order. I apologise that I forgot to say at the beginning that I intend to start the wind-ups no later than 10.40, and that two Members have written to me asking to participate in the debate.

[David Tredinnick]

You are ever courteous, Mr Bone, and I will not detain the Chamber much longer. I am acutely aware of not taking up other people’s time.

The Minister has three options. The Health Practitioners Council was the original idea. The Professional Standards Authority for Health and Social Care oversees the regulatory work of other organisations but is not as robust. A special licensing system for practitioner-prescribed products is a possibility, provided they are not traded between member states, and that may be a way out of the problem. We must find a solution, or there will be a disaster in the long term. I have used Chinese herbs and herbal medicine for many years, and I find them extremely safe and effective. I want people in this country to be able to use herbs. The key objective for the Minister is to ensure that the maximum number of products is available safely through regulated practitioners.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

It is a pleasure to serve under your chairmanship, Mr Bone, for, I believe, the first time. I am sure that you were salivating, listening to the issues raised in the debate—

[Mr Peter Bone (in the Chair)]

Order. I want to make it clear to the Minister that when I sit in this Chair, I have no views on anything.

[Dr Poulter]

Indeed, Mr Bone, as you say, you have no views on anything when you are impartially chairing the debate, but I am sure you pay keen interest to the topics raised, in your position as Chair and otherwise.

I pay tribute to my hon. Friend the Member for Bosworth (David Tredinnick) for securing the debate, which I am sure is of interest to the consumers and practitioners who use herbal medicines, as well as to the many Members who attended the debate today. None of us disagree with the principles articulated here—we can all sign up to them—but good government is about working through the practicalities of proposals to ensure that they become good laws, as I will discuss later.

There have been many good and worthy contributions to the debate. The hon. Member for Strangford (Jim Shannon) showed his strong support for herbal practitioners in his constituency, and he was right to say that things in Government do not happen in a flash but have to be properly thought through. I want to reassure him that some of the products he mentioned—he talked about the benefits of vitamin E, for example—are freely available from herbal practitioners, and indeed from pharmacists and other places.

There were other strong contributions from my hon. Friend the Member for Kettering (Mr Hollobone), who is no longer in his seat, and the hon. Member for Vauxhall (Kate Hoey). The hon. Lady made her case eloquently, and I would be happy to meet with her at a later date to discuss sports therapists further, but I would not wish to intrude on Mr Bone’s patience by talking about the issue today and I hope she will forgive me for that.

I pay particular tribute to my hon. Friend the Member for Bosworth for his principled and long-standing support for herbal practitioners and his interest in alternative therapies, homeopathy and many other such issues. Today he has demonstrated his extensive knowledge of the topic under debate, and of alternative therapies in general. I am sure I am right in saying that he is the most informed Member of Parliament on many of these issues, and it is a great tribute to him that he has secured the debate today. I am sure that herbal practitioners and alternative therapists would wish to pay tribute to his great work and his advocacy on their behalf, and on behalf of his constituents.

My hon. Friend is right to highlight the chief medical officer’s challenge about the future of antibiotics, but we can make a clear distinction between those remarks and the subject of today’s debate. I am sure that the chief medical officer would not wish her remarks to be associated with a call for a greater use of herbal medicine—that was clearly not outlined in her paper. Although it is important that we always consider ways—via traditional medical routes or otherwise—of improving people’s health and providing the right therapies, the paper clearly laid out the long-standing challenges as being about antibiotic resistance, and it would be wrong, therefore, to allow the two issues to be confused.

By way of background, it is worth highlighting that although we support patient choice some herbal products have caused harm to consumers. There are a number of reasons why that might happen: the herb may be intrinsically toxic; the product may be accidentally or purposefully contaminated by harmful materials or heavy metals; people may choose herbal products for serious conditions when medicines with a solid evidence base would be more appropriate; and, if herbal products are taken together with conventional medicines, the interactions may be unpredictable. It is right, therefore, that we support the responsible use of medicines and have a licensing system.

Directive 2004/24/EC on traditional herbal medicinal products was introduced to harmonise the European Union internal market and remove barriers to free movement. The directive deals with products manufactured on an industrial scale, and makes all operators in the market comply with the same set of rules, facilitates free movement and ensures increased product safety, which, I am sure we agree, has a positive impact on patient safety and public health.

The question of whether herbalists and traditional Chinese medical practitioners should be statutorily regulated has been debated since the House of Lords Science and Technology Committee first reported on the matter in 2000. The hon. Member for Vauxhall and my hon. Friend the Member for Bosworth outlined in their remarks that there is a lot of background and history. The previous Government grappled with the issues, and the current Government are also considering how to address and fulfil the commitments made by the previous Health Secretary, my right hon. Friend the Member for South Cambridgeshire (Mr Lansley). Hon. Members will be aware that on 16 February 2011 the Government announced their intention to take forward the regulation of herbal medicine practitioners and traditional Chinese medicine practitioners, specifically with regard to the use of third-party products in their practice.

Herbal products broadly fall into three categories. The first are the 310 herbal medicines that already have a marketing authorisation or a traditional herbal registration—in other words, a product licence. Those 310 medications are currently available for use and are effectively licensed. They are safe and widely used, and have undergone all relevant testing and checks. The second category, which is the one we are addressing today, covers products manufactured by a third party. Such products have been illegal since April 2011, following the implementation of the EU directive. The third category is products made up by a practitioner on their own premises following an individual consultation. Although such products are not affected by the directive, some of the herbal ingredients may be restricted by the Human Medicines Regulations 2012.

The previous Health Secretary’s concerns about the second category—products manufactured by a third party—prompted the decision to take forward statutory regulation of such products. The Government’s intention was to allow regulated herbal practitioners lawfully to source third-party manufactured herbal medicines, with appropriate safeguards in place to minimise the risks associated with the products, but since April 2011 the European directive has made it illegal for herbal practitioners in the UK to source such products for their patients.

Following the EU judgment in the case of the Commission v. Poland, which my hon. Friend the Member for Kettering mentioned, we have reassessed the risks. That case actually concerned unlicensed conventional medicines being used because they were cheaper, and although there is a clear distinction between those products and herbal remedies we had to look at what else the judgment said. It looked at the specials regime and, critically, it emphasised how strictly the regime must be applied. The judgment has a knock-on effect for what we propose for the use of herbal medicines manufactured by third parties without a licence, and it therefore needs careful consideration because there is a very high risk that we would be found to be in infraction of the European directive. We therefore need to consider further herbal products manufactured by a third party, and I will return to that point later.

The Government would, of course, like to find a way through the issue that supports responsible businesses and ensures public safety. Since the announcement in February 2011, the Department of Health has been working with officials in the devolved Administrations and with the Health and Care Professions Council to establish a statutory register for herbal practitioners. Alongside that, we have been considering a strengthened system for regulating medicinal products, to enable consumers to have access to a greater range of third-party manufactured herbal medicines. The process continues to be complex and lengthy, and it has been further complicated by the judgment in the European Union v. Poland case.

We acknowledge that there is strong support from some groups of herbal practitioners for the statutory regulation of the sector, but not all practitioners are in favour. I am sure, therefore, that hon. Members will appreciate that it would be irresponsible for the Government to undertake to alter the status of a group of workers without first ensuring that the policy and final decision offered an appropriate form of regulation and ensured that the proposals adequately addressed the risks posed to consumers of third-party manufactured herbal medicines.

As I stated earlier, complex issues are involved. We are discussing how to ensure that our proposals are fit for purpose and proportionate, and that they properly protect the public. I want to assure the hon. Member for Vauxhall that the matter has not been dropped. We absolutely support the principles outlined by my right hon. Friend the Member for South Cambridgeshire in his written ministerial statement to the House, and I fully appreciate that the delay is causing anxiety and concern to practitioners of herbal medicine and to consumers.

To ensure that we take forward the matter effectively, we want to bring together experts and interested parties from all sides of the debate to form a working group that will gather evidence and consider all the viable options in more detail, particularly because of the Polish case. I am aware of the concerns of my hon. Friend the Member for Bosworth about making timely progress, and I would therefore very much welcome his direct involvement in the working group to ensure that the interests of practitioners are properly looked after. We can meet when the House returns to work out how to take forward the proposal.

I hope that my commitment to setting up a working group will reassure my hon. Friend and all hon. Members that the Government are carefully considering this important issue. We recognise and agree with the principles, but the practicalities are such that we must have legislation that is fit for purpose—that does not trigger infraction proceedings from the European Union, but protects the public. That is vital in all health care matters, whether in relation to traditional medicines or to herbal medicines and alternative therapies. For that reason, we want to set up a working group and to work with my hon. Friend, and herbalists and others, to ensure that the legislation is fit for purpose. I look forward to discussing that with him in due course.

--- Later in debate ---

[Dr Poulter]

We need to sit down together. I very much want to involve my hon. Friend the Member for Bosworth, and the hon. Lady would be very welcome to join that discussion when the House returns. The idea is to get a working party up and running in the early autumn to ensure that we progress matters. We obviously need to discuss issues raised today about statutory regulation and third-party manufactured products, and to look at such products in detail to see which might be classified as more akin to food additives or vitamin and mineral supplements and which as more akin to medications, because there is a spectrum. We need to work through such issues to make sure that we get to the right place.

It is important that any legislation not only passes the test of principle—we are all signed up to it—but is practical and fit for purpose. Particularly in light of the judgment in the case of the EU Commission v. Poland, we have other issues to consider that make the matter a little more complex. I reassure my hon. Friend the Member for Bosworth and the hon. Member for Vauxhall that we are committed to making timely progress, and when we meet on our return in September, we can progress things. I am sure that my hon. Friend’s involvement will keep the Government keen to their task.

[Mr Peter Bone (in the Chair)]

I thank hon. Members for taking the time for an absolutely splendid debate.

Immigrants (NHS Treatment)

Peter Bone Excerpts

Monday 25th March 2013 Commons Chamber

[Mr Hunt]

I understand my hon. Friend’s sense of unfairness at being asked to pay for her treatment by credit card, when we do not do that to foreign nationals who are treated in the NHS. I do not, however, want the NHS to become a service where the first question people are asked relates to their credit card or cheque book. If we are going to protect that much-cherished principle of NHS treatment, we need to get a grip on the kind of abuse that has run unchecked for far too long.

[Mr Peter Bone (Wellingborough) (Con)]

Does the Secretary of State agree that the House is divided by two schools: the Opposition, who believe that the NHS should not charge anyone, which is why they did nothing for 13 years; and Government Members, who believe that foreign nationals who should pay, must pay.

[Mr Hunt]

I agree, and nothing we have heard this afternoon will give the British public any comfort at all that the Opposition get this problem.