(9 months, 2 weeks ago)
Commons ChamberThe Citizens Advice office covering my constituency will be grateful for that fact that the local housing allowance has been changed. The people who supply drink, and drinkers, will be pleased that alcohol duty is being frozen, at least for the time being. That will help drinkers, and will also not increase inflation.
I am glad that the Chancellor pointed out to the shadow Chancellor that the only time the Labour Government did really well was when they obeyed the Conservative rules between 1998 and 1999, before they let go of the valves and drove the economy to the point at which, when we took over, they were spending £4 for every £3 of Government revenue.
May I now ask the Chancellor to respond, not today but in time, to an injustice done to 500,000 pensioners overseas? Anne Puckridge, who was born five years before the Chancellor’s father, served in intelligence in the Navy, the Army and the Royal Air Force during the war, and retired to Calgary on a pension of £72 a week. It is still £72, instead of £156. That is an injustice which needs attention, and I hope Anne Puckridge will get it and we will have proposals that will enable us to change this bad situation.
I thank the Father of the House for his comments, and I will look into the issue of overseas pensioners as he requested. If I may, I will write to him, but I am also happy to talk to him about it. May I also thank him for his comments about what happened in 1997? Then as now, the Labour party was trying to say that its economic policies were basically the same as those of the Conservatives, but the reality was quite different. Because Labour did not fix the roof when the sun was shining, the recession after the financial crisis was much worse.
(1 year, 9 months ago)
Commons ChamberThe Chancellor will have noticed that Labour Members laughed when he talked about stability, growth and public services. Those who are watching our proceedings will have noticed, as will he, that when he was making his announcements about how we will ease the burden on the poorest and give opportunities to those who most need them, those Members were silenced. People around the country will give backing to his approach. We may have arguments about details, but the key point is to get stability and growth, and to defend public services.
I thank my hon. Friend the Father of the House. He is right. What I have discovered in the short time that I have been doing this job is that although one might arrive thinking that decisions about money are about numbers and spreadsheets, they are actually about values. Today, I have tried to express our values not just as a Conservative party but as a country. That means protecting the most vulnerable.
(5 years, 4 months ago)
Commons ChamberRather than responding to the hon. Gentleman from the Dispatch Box, I will look into the work that we are doing and, if I may, write to him giving the full details. I know that we do an enormous amount of work in trying to strangle the sources of terrorist funding throughout the world.
My right hon. Friend and the shadow Foreign Secretary set the tone for this set of exchanges. I think that more and more people are saying, as they did when the Provisional IRA was at its peak, “This has not been done in our name”—even people who may somehow be beyond those who know what they are doing in directing violence of this kind.
I spent Christmas with my family in a church in Sri Lanka at a multilingual service. During our time in Sri Lanka, we were very impressed by the intercommunal peace and harmony. It was clear to us that tourism matters a great deal to the development of Sri Lanka as it recovers from its past. I hope that people will soon realise that they can travel to Sri Lanka safely and enjoy helping it to put itself back on its feet.
We must do what we must also do in Tunisia, Egypt and other countries where people have tried to destroy the prosperity of others in the countries that they share.
My hon. Friend is absolutely right. He is also right to point out that there has been great progress in Sri Lanka, and great progress in religious tolerance. It is important to recognise that the extent of religious tolerance in any developing country is also a function of its political leadership. If there is leadership from the Prime Ministers and Presidents of those countries, it is possible to set the right tone when it comes to religious tolerance, but if those leaders fan the flames of populism or extremism, things can go wrong very quickly.
(6 years, 2 months ago)
Commons ChamberWith respect, this is a huge increase in NHS funding, the like of which I am not aware that the Liberal Democrats were proposing at the last election. Although I am grateful to the right hon. Gentleman for welcoming the settlement, for him to stand up and say that it is not enough is not a satisfactory response. As he knows, we have actually put our money where our mouth is and demonstrated that we are committed to the NHS, with one of the biggest single injections of cash in the history of the NHS.
I am glad that both my right hon. Friend and the Prime Minister have welcomed the fact that all parties have supported the health service: the Liberals first with Christopher Addison, for whom my father once worked, in 1919; Henry Willink, a Conservative member of the coalition Government, in 1944; and Aneurin Bevan, who made some changes and nationalised the hospitals, rather than the family doctors. Both the resources and the reform are needed, and future generations will be grateful to this Government—hopefully with the support of other parties—for taking this forward.
I thank my hon. Friend for that comment. If there is ever a memorial built to Sir Henry Willink for his role in the White Paper that critically announced to this House that we were going to have a national health service, my hon. Friend should certainly be the person to unveil it because he has done a huge amount to make the point that, although Nye Bevan’s role was absolutely critical, other people in other parties also played a vital role.
(7 years, 7 months ago)
Commons ChamberLet me tell the right hon. Lady what we have done about A&E doctors. Their number has gone up by 1,200 since 2010, which is an increase of over 50%. The number of A&E consultants has gone up by 500, which is an increase of over 20%. At the same time, we have recruited 2,000 more paramedics. As a result of those changes, our emergency departments are seeing—within the four-hour target—2,500 more people every single day compared with 2010. That is not to minimise the pressures in the NHS we have had over the winter or to say that there is not more that needs to be done, which is why I outlined a number of things in my statement.
The Secretary of State kindly came to see the plans for the emergency room at Worthing hospital and came back six years later to see how it is working and to admire it in operation. I hope that the next time he comes he can look at the Zachary Merton community hospital and the Swandean mental health services as well.
On child mental health care, may I put it to him that a quarter of the 700,000 teenagers going through each stage each year will have bumps and need resilience, and that their parents and teachers need help? Will he make sure that the Green Paper covers advice to parents and teachers so that they know what is in the normal range of behaviours and what is outside that range?
I commend my hon. Friend for his one-man campaign, which I continue to admire on many occasions, against the misinformation put out by 38 Degrees. I thank the staff at Worthing hospital for their fantastic work over the busy Christmas period. As usual, he puts his finger on a very important issue, which is that as we seek to raise the profile of mental health treatment for children and young people, we must not medicalise every single moment of stress. For example, worries before exams are not cause to talk to an NHS psychiatrist. A lot of work on the Green Paper will be looking at how we can promote self-help and at how we can help schools to support people through difficult patches, but we will also look at how we can make sure people get NHS care quickly when it is needed.
(7 years, 12 months ago)
Commons ChamberI thank the hon. Lady for what she did alongside many colleagues working in A&E departments over many years, but to call this an imposition is a mischaracterisation given what actually happened. The contract was not only agreed, but recommended and supported by the leaders of the BMA. Before she was elected, we had many discussions in the House about whether negotiations were possible and what I should do, and there were a range of different views. In the end, I listened—just as she has asked me to today—and sat down and negotiated a deal that was supported by the BMA’s leaders. That is why it is so incomprehensible that those same leaders—the people who represent her and her profession—have now called the most extreme strike in NHS history.
I put it to my right hon. Friend that the choice for junior doctors or doctors in training is whether they have the old contract or the agreed contract. I have not yet had a letter from any of my doctors saying that they think the old contract is better for them, for the health service or for patients. May I therefore recommend that they sign up willingly to the new contract, that they start discussions with the BMA, and through the royal colleges, on what should happen in a few years’ time when the contract itself comes up for review and that they work to improve the non-contractual situation, which my right hon. Friend has provided a good lead on?
My hon. Friend is absolutely right on that. In May, the BMA leadership, with whom we were having a very open discussion, had satisfied themselves that on the concerns many junior doctors have about their working conditions, many of which I accept are wholly legitimate, we had done pretty much everything we could inside a contract and the work that needed to be done was on the extra-contractual things. I am talking about the way the training system works when people are being rotated to a different hospital every six months, the fact that some people were being sent to a different city from their partner and how bad that was for family life, and all sorts of other things that need to be sorted out. Ironically, since the introduction of the working time directive, things have got a lot worse for many people, although we do not want to go back to the excessive hours of before. Those were the things we were patiently working through, and the way that is done is through dialogue, not confrontation, which is why this action is such a step backwards.
(8 years, 1 month ago)
Commons ChamberActually, in my statement I took the trouble to praise BMA leaders. Admittedly, at the outset I did not agree with their tactics at all, but they did then have the courage to negotiate a deal and try really hard to get their members to accept it. I respect them for doing that. Part of the problem was that in the early stages of the dispute, there was a lot of misinformation going around. There were a lot of doctors who thought, for example, that their salary was going to be cut by about a third. That was never on the table and never the Government’s intention. A lot of doctors thought that they were going to be asked to work longer hours. That, too, was the opposite of what we wanted to do. I am afraid that that created a very bitter atmosphere. I simply say that, in the end, the best way to restore morale is to support doctors in giving better care to their patients, and that is what the NHS transformation plan is all about and what we are working on.
Around 10 years ago the mishandled introduction of MMC—modernising medical careers—and the medical training application service started some of the problems for junior doctors. I pay tribute to the BMA who, in the discussions up to May, helped to agree with NHS England employers changes to the proposed contract, which were to the benefit of doctors in training? I say to the Secretary of State and, through him, to the employers that I hope they will pay attention to the extra-contractual issues which are of concern to doctors, and that the BMA will catch up with the rest of us in saying that we rely on them and others in hospitals to give a good, safe service to patients. They need to work together with everybody else and we will support them in doing that.
I am absolutely prepared to give that assurance and I thank my hon. Friend for his comments. He is right. We can look at MTAS and such changes. We can go even further back and look at the introduction of the European working time directive—strange to bring that up in the current context—and the shift system, which sensibly reduced some of the crazy hours that junior doctors were being asked to work, but unfortunately at the same time got rid of the “old firm” system which gave junior doctors a sense of collegiality, meant that there was a consultant whom they knew and related to, and made their training a lot more rewarding and satisfying. That was disrupted when we introduced the shift system and the maximum hours limits. We need to think about—and we are doing some very important work on this—how we could recreate some of that sense of collegiality, which is particularly missing for junior doctors in the first two years of their training, before they have joined a specialty.
(8 years, 4 months ago)
Commons ChamberWhat is devastating to the morale of junior doctors is when they are represented by an organisation that constantly feeds them misinformation about the contents of the new contract. First, the BMA told them that it was going to mean that their pay was cut. Then it told them that they were going to be asked to work longer hours. In fact, the reverse is true on both those things. The way that we raise morale among the very important junior doctor workforce is by the BMA saying that it is prepared to take a constructive approach to sensible negotiations, not refuse to budge, as we saw in February.
It is important to be both rational and reasonable. It is reasonable for registrars to be earning, on average, £53,000 a year and, when fully established, more than £100,000. It is rational for junior doctors’ leaders to accept that rostering should be a matter of discussion, as there is a right and a wrong level. The remaining issue is some of the premium pay for Saturdays. It seems that it would be a good idea if those behind the BMA negotiators came out into the open and explained in detail to my patients and the patients of the 649 other MPs, or the MPs in England anyway, what the issue is that is stopping it calling off the strikes, getting people back to talks and making agreements.
As ever, my hon. Friend is absolutely right. When I have spoken to junior doctors who are protesting, they have not wanted to bring up issues in the new contract, as much of it is very good for them. I am talking about the fact that they cannot be asked to work six consecutive nights, which they can be at the moment; the fact that they cannot be asked to work more than six long days in a row, which they can be currently; and the fact that the maximum hours that they can be asked to work is going down from 91 to 72. There are many things that are good in this new contract, which is why the sensible and rational thing for them to do is to sit down and discuss it with the Government and not to set their face against it at any cost.
(8 years, 4 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
We do face many challenges; the right hon. Gentleman is absolutely right to say that we need to focus on those, and so the sooner we resolve this dispute with the BMA, the better. I simply say to him that if we were to carry on negotiations that were clearly not going anywhere at all, this dispute would go on for even longer. We have been trying to resolve these issues for a very, very long time, and in the end one has to decide if one is going to do what it takes to move forward.
Mr Speaker, if every one of the 650 MPs came to you and said that one of their constituents was dying unnecessarily every five weeks—that is the lower estimated number of excess deaths; it would be once every two weeks at the higher estimated number—I would hope that you would grant this kind of debate every day until we had a system that was safer for patients and junior doctors, and until we brought into the open the nameless characters behind the BMA negotiators. They refuse to come out into the open and argue their case on its merits, and to say why they will not discuss Saturday pay.
My hon. Friend is absolutely right. Part of the hallmark of this Government’s approach to the NHS has to be honesty about where we have too many avoidable deaths, and where there is the weekend effect for people admitted to hospital at the weekends. We have a big responsibility in that regard. The reason why we discharge that responsibility is that we believe in the NHS. We want the NHS to be the safest, highest-quality system in the world. Just as this Government have pioneered reforms that have dramatically improved the quality of state education, so too we need equal reforms in the NHS. That is why it is absolutely right to say that we have to focus on these things and debate them in this House. We should not automatically say that there is someone who must be blamed when we are dealing with these difficult situations. Unfortunately, one of the things that has led to feelings running high in this dispute has been the sense of blame being tossed around, when what the Government want to do is try to solve the problem.
(9 years, 8 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I agree that that is an excellent hospital, and I commend the leadership of Sir Andrew Cash, its chief executive. I have been to the hospital myself; it was absolutely spotless, and I was very impressed by what I saw.
The hon. Gentleman is right. What we cannot do, given the pressures faced by the NHS, is start pointing fingers at individual hospitals, because even well-run hospitals are experiencing a high level of pressure. Hospitals tell us that the solution is often not in their own hands. It is a question of the number of people who turn up at the front door and the number of people whom they are able to discharge at the back, and if neither of those problems is sorted out—which will require proper links with the rest of the local NHS—there will be further problems. The system resilience groups that are now working throughout the country are trying to deal with the issue.
I praise the clinical and other staff at Worthing and Swandean hospitals, and at Rustington’s Zachary Merton hospital. Could hospitals and GPs in each region or locality get together with care homes and nursing homes and establish, with the help of paramedics and members of the ambulance service, which people should be taken to hospital and which people should remain at the nursing or care homes? Too often, people in old age are taken to hospital when that is inappropriate.
My hon. Friend is absolutely right. I commend the care at Worthing hospital. As he will know, I try to go out on the NHS front line and take part in a shift most weeks, and the very first hospital I went to was Worthing hospital, where I thought the care was excellent. He is right that it is about close working; people in care homes who end up going to A and Es when they could have been better looked after at their care home is probably top of the list of admissions to hospital that we could avoid, because we know the vast majority of those people will end up being admitted to hospital if they arrive at an A and E. That is often not the best thing for people with late-stage dementia, for example, so my hon. Friend is absolutely right and I want to reassure him that that is a big focus of our efforts this winter.
(11 years, 5 months ago)
Commons ChamberWe are not saying that minimum standards of adequate staffing levels are not needed, but we reject the idea that they should be mandated from the centre—I think there is cross-party agreement on that. The chief inspector will look at and highlight the reasons for poor care and, if they are due to inadequate staffing levels, ensure that something is done about it.
On the rare occasions when a clinician or other member of hospital staff raises a problem and it is not taken care of, may I suggest that employers have a box in which to put in a note saying what the problem is? There should be a receipt so that if there is an inquiry later, it can be shown what the hospital should have paid attention to right at the beginning.