Oral Answers to Questions

Philip Dunne Excerpts

Tuesday 11th October 2016 Commons Chamber

[Rob Marris (Wolverhampton South West) (Lab)]

4. What estimate he has made of the value of assets funded by PFI health projects which will remain in private ownership after the contracts for those projects have concluded.

[The Minister of State, Department of Health (Mr Philip Dunne)]

Between 1997 and 2010, 103 NHS hospital PFI schemes reached financial close, creating liabilities for the NHS of £77 billion. Three legacy PFI schemes have been signed since 2010 on stricter terms, with liabilities of £1.7 billion, and one scheme has been signed under the new PF2 model, worth £340 million. In nearly all cases, except for a few of the early schemes, ownership of the hospital reverts to the NHS at the end of the PFI contract. But even in those schemes, the NHS always has the first option on whether to end or continue with the contract.

[Rob Marris]

Effectively, those figures will mean even more debt for the next generation. Will the Minister commit the Government to abandoning all PFI? It always was an idiotic scheme. No more PFI, no more PF2, etc—just abandon it, Minister.

[Mr Dunne]

The hon. Gentleman has a consistent track record in opposing PFI, even when the vast majority of the schemes were put under contract by the Government of which he was a member—so I will not take any lectures from him about how to deal with PFI. We will continue to use the new stricter terms as and when appropriate.

[Norman Lamb (North Norfolk) (LD)]

The National Audit Office concluded that the PFI contract for the Norfolk and Norwich hospital was a bad deal for the taxpayer and for the NHS, yet last year Octagon Healthcare made a record profit as the Norfolk and Norwich’s finances sank ever further into the red. Will the Minister consider making a formal approach to Octagon Healthcare to ask it to forgo part of its profit to help confront the enormous financial black hole that the trust faces?

[Mr Dunne]

We have provided access for seven of the worst affected trusts with obligations under PFI to a support fund of some £1.5 billion to help them with those obligations. I am not sure whether Norfolk is one of them; I suspect that it is not. I would be happy to talk to the right hon. Gentleman about this, but rather than raising his hopes inappropriately I have to say to him that many of the schemes are too costly to divert resource to pay them off completely.

[Mr Steve Baker (Wycombe) (Con)]

5. If he will take steps to ensure that clinical commissioning groups publish their proposals for implementing the NHS “Five Year Forward View”.

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[Andrew Bridgen (North West Leicestershire) (Con)]

7. What steps his Department is taking to improve NHS procurement.

[The Minister of State, Department of Health (Mr Philip Dunne)]

I agree with my hon. Friend that this is an important area. In his report earlier this year, Lord Carter identified potential annual savings of £700 million from reducing the variation in procurement performance between providers. We have announced a first tranche of 12 standardised products for all NHS providers to use; this will boost procurement volumes and bring about economies of scale, securing lower prices. These initial products, including commodity items such as gloves and needles, cover £100 million of trust spending. We expect this to result in savings of up to 25%.

[Andrew Bridgen]

Innovative private sector suppliers have successfully partnered with the NHS since its inception, and it is quite right to say that for that relationship to be sustainable, those suppliers must make a profit. However, does the Minister agree that rogue companies that exploit the NHS’s lack of commercial expertise could be named and shamed, because they are making a lot of money at taxpayers’ expense?

[Mr Dunne]

We believe that the right approach to securing procurement savings is to take advantage of the immense amount of data available across the NHS. That is why we have set up the purchasing price index benchmarking tool. Data on more than £8 billion of expenditure, covering over 30 million separate procurement transactions, has been collated and will be analysed. We will use that information judiciously to save the taxpayer money. We think that that is the right way to start, rather than naming and shaming.

[Chris Leslie (Nottingham East) (Lab/Co-op)]

I urge the Minister, when thinking about national procurement and national commissioning, to look at the national strategies that can underpin them—for example, at why we need to renew the national stroke strategy. Some 100,000 people a year suffer a stroke, and nearly 1 million people in this country have had a stroke. They care very much about rehabilitation and other services.

[Mr Speaker]

The Minister’s challenge is to relate that very important matter to the equally important issue that happens to be the subject of the question: procurement.

[Mr Dunne]

I am grateful to you, Mr Speaker, for drawing the hon. Gentleman’s attention to the fact that the topic is procurement. The hon. Gentleman is right to highlight the fact that we have looked at an acute heart treatment strategy. We are creating centres of excellence across the country to ensure that if people suffer from an acute heart incident or a stroke, they are treated by the specialists who will give them the best prospects for recovery.

[Sir Henry Bellingham (North West Norfolk) (Con)]

8. What progress his Department is making on turning around hospitals in special measures.

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[Imran Hussain (Bradford East) (Lab)]

9. What steps he plans to take to address shortfalls in staff recruitment and retention in the NHS.

[The Minister of State, Department of Health (Mr Philip Dunne)]

I join the Secretary of State in welcoming the dedication and commitment of everyone who works in the NHS. We are taking active steps to encourage more people to become doctors, nurses and support staff. Only last week, my right hon. Friend announced a commitment to recruit an additional 25% of doctors to train in the NHS, which is 1,500 more doctors on top of the 6,000 currently trained every year.

[Imran Hussain]

Net temporary and agency staff expenditure has risen by 40% since 2013. It accounted for 8% of total staff expenditure in 2015-16, which equates to £4.13 billion. Does the Minister agree that rising agency costs point to a recruitment crisis, and will he make a statement to the House outlining his plans to address that crisis?

[Mr Dunne]

We recognise, absolutely, that bills for agency staff have become unsustainable, which is why we have taken deliberate action, including by introducing price caps on hourly rates last November, which has had a significant impact on reducing agency costs. In the year to date, agency costs are some £550 million less than they were last year.

[Jeremy Lefroy (Stafford) (Con)]

I welcome last week’s announcement about the increase in the number of medical school places. What plans does the Department have to ensure that there are sufficient clinical training places for those medical students?

[Mr Dunne]

I can reassure my hon. Friend that there is considerable excess demand from UK-based students to train to become a clinician in this country—only half of those who apply to train in medical school are accepted at present—so we are confident that there will be plenty of take-up for those extra places. With regard to clinical placements, we are in discussions with universities, colleges and teaching hospitals to ensure that there are adequate numbers of places.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

I welcome the 25% expansion in medical student places, but I reject tying that to the elimination of 25% of overseas doctors who currently work in our NHS. With 10% of posts unfilled and ever-rising patient demand, the Secretary of State must know that we will always need international graduates in the future. Does he not recognise that he is creating unrealistic expectations and conflict with this idea of a British-only medical service?

[Mr Dunne]

I am grateful to the hon. Lady for giving me the opportunity to set the record straight and stop this scaremongering, which is undoubtedly unsettling many of the very valuable doctors, nurses and other foreign nationals who are currently providing vital services to the NHS. Last week’s announcement was about adding more doctors to be trained who are UK-based. We are not changing any of the present arrangements for international students being trained here, or doctors and nurses working here.

[Dr Whitford]

The Government might not be changing their position right now, but with one in 10 posts currently unfilled, and given the rhetoric used last week, how does the Minister expect us even to retain foreign doctors, let alone attract them to fill those posts?

[Mr Dunne]

There was no rhetoric used. In making that announcement, my right hon. Friend the Prime Minister used no rhetoric whatsoever regarding the very valuable contribution of foreign clinicians to our health service, and that remains the case.

[Nick Boles (Grantham and Stamford) (Con)]

Staff shortages this summer led United Lincolnshire Hospitals NHS Trust to introduce a temporary closure of Grantham A&E, causing huge concern to my constituents. Will the Secretary of State agree to meet me and Jody Clark, the founder of a local campaign group, to discuss how we can resolve this unacceptable situation?

[Mr Dunne]

I am well aware, from representations made by my hon. Friend and other neighbouring MPs, of the concerns that that has caused locally. The Secretary of State has already indicated to me that he does intend to meet my hon. Friend and campaigners in due course.

[Jonathan Ashworth (Leicester South) (Lab)]

The Minister says that no rhetoric or scaremongering was used last week. Can he explain to the House what the Prime Minister meant when she said:

“there will be staff here from overseas in the interim period until the further numbers of British doctors are trained and come on board in terms of being able to work in our hospitals”?

What did that mean? What should we expect next—ambulances plastered with “Go home” slogans?

[Mr Dunne]

That is exactly the kind of ill-judged remark I have been talking about, and I am surprised that the hon. Gentleman has used it in his first appearance in his new post. By the way, I congratulate him on that new post, but I very much hope that he will use more measured language in the future, rather than spreading that kind of inappropriate rumour. The interim period referred to is the period during which doctors will be trained. We will not get new doctors coming in under the increased allocation until 2023, and during that time we will clearly need to use all measures to ensure that we fill the spaces that I acknowledge we have across several of our hospitals.

[Jonathan Ashworth]

I appreciate the Minister’s warm welcome, and I can tell him that I am very much looking forward to shadowing the Secretary of State, but his comments on ill-judged remarks should be directed at the Prime Minister, not me. We have seen 8,000 fewer nurses, student nurse bursaries are set to be cut, there is a reliance on agency staff and a failure to train enough doctors, and now, after six years in office, the Government are talking about self-sufficiency. Given the concerns that these plans do not go far enough, will the Minister tell us what steps he will take to ensure that no staff from the EU lose their jobs, and will the NHS still be able to recruit from the EU if necessary post Brexit?

[Mr Dunne]

Health Ministers have been very clear about reassuring all the 53,000 EU citizens working in our NHS that their roles are secure. Regarding clinicians, I remind the hon. Gentleman that, although we have some vacancy rates, which are acknowledged, we now have 7,800 more consultants employed in the NHS than in May 2010, 8,500 more doctors than in May 2010, and over 10,500 more nurses working on our wards. We have gone through a very consistent policy of recruiting more people to work in the NHS under this Government.

[Mr John Baron (Basildon and Billericay) (Con)]

10. What steps his Department is taking to model the potential cost savings to the NHS budget of earlier diagnosis of cancers.

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[Sir Simon Burns (Chelmsford) (Con)]

11. What estimate his Department has made of the amount accrued to the public purse from efficiency savings in the NHS since May 2010.

[The Minister of State, Department of Health (Mr Philip Dunne)]

In 2010 a target was set by NHS leaders to make £20 billion of efficiency savings by 2015 in order to make more funds available for treating patients and to allow the NHS to respond to changing demand and new technology. Under my right hon. Friend’s inspirational leadership as a Health Minister, the NHS broadly delivered on this original challenge, reporting savings of £19.4 billion over this period. All these savings have been reinvested into front-line NHS services.

[Sir Simon Burns]

As Members would imagine, I warmly welcome that answer from the Minister. Would he confirm that those savings were achieved through greater efficiency and effectiveness in the delivery of care and by cutting waste in the NHS that occurred between 2002 and 2007? Can he confirm that the benefit of that achievement to the NHS is that not a single penny of those savings goes to the Treasury, but is reinvested in the NHS and front-line services?

[Mr Dunne]

My right hon. Friend managed to include several questions in his impressive supplementary. I can confirm that much of the waste that took place in the years he cited—2002 to 2007—related to projects of the previous Labour Government that they themselves then cancelled, such as the IT project. I can also confirm that savings generated in the NHS are kept in the NHS. Lord Carter, whose report I referred to earlier, has identified £5 billion of efficiency savings, which we hope to deliver during this Parliament.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

There is a distinction to be drawn between realistic efficiency targets and systematic underfunding. Only last month, Simon Stevens told the Public Accounts Committee that for three of the next five years

“we did not get what we originally asked for”.

Chris Hopson, chief executive of NHS Providers, also said last month that

“we’ve got a huge gap coming… it’s the chairs and chief executives on the front line…who are saying they cannot make this add up any longer.”

On funding, the Government keep saying that the NHS is getting all that it has asked for; those actually running the NHS say something quite different. Who is right?

[Mr Dunne]

The hon. Gentleman stood on a manifesto 18 months ago in which his party was not prepared to commit the funding that our party was prepared to commit. Labour committed £5.5 billion to the NHS; we committed £8 billion, and we have delivered £10 billion.

[Colleen Fletcher (Coventry North East) (Lab)]

13. What steps his Department is taking to reduce the number of men who take their own life.

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[Dr Tania Mathias (Twickenham) (Con)]

T4. What will the Government do to scrutinise and assist the London ambulance service, which has had an appalling and consistently poor record on call-out times for category A emergencies?

[The Minister of State, Department of Health (Mr Philip Dunne)]

My hon. Friend is right to highlight the fact that the London ambulance service is in special measures and has been for some time. I visited it this summer and am pleased to confirm that some £63 million of additional funding has been provided to the ambulance service since April 2015. The service is starting to make significant inroads in increasing the number of paramedics who are available on call, with some 250 more being added over the last couple of years.

[Paula Sherriff (Dewsbury) (Lab)]

T2. Last October, the then Health Minister, the right hon. Member for North East Bedfordshire (Alistair Burt), confirmed that my constituency fell far below the national average in terms of NHS dental provision. In fact, it is one of the worst in the country. Unfortunately, nothing has changed since then. Does the Secretary of State believe it is acceptable that my constituents, including many children, are unable to get an NHS dentist?

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[Wendy Morton (Aldridge-Brownhills) (Con)]

T8. As Ministers will be aware, this week is baby loss awareness week. Access to neonatal cots and neonatal transport services are vital parts of the care of premature and sick babies. What assurances will my right hon. Friend give that his Department is continuing to review the findings of the Bliss report, and when can we expect to hear more?

[Mr Dunne]

I am grateful to my hon. Friend for raising baby loss awareness week. I am sure that, along with other hon. Members, she will be participating in the Backbench Business debate on that later this week. In February the independent maternity review, Better Births, made a number of recommendations, including on neonatal critical care. We are studying those recommendations and are due to report initial findings from our work in December.

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

I listened very closely to the Secretary of State’s comments earlier on mental health. On 9 December he stood at that Dispatch Box and said that

“CCGs are committed to increasing the proportion of their funding that goes into mental health.”—[Official Report, 9 December 2015; Vol. 603, c. 1012.]

However, my research shows that 57% of clinical commissioning groups are reducing the proportion they spend on mental health—yet another broken promise. When will we have real equality from this Government for mental health?

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[Seema Kennedy (South Ribble) (Con)]

I welcomed last week’s NHS Improvement report which states that there are now sufficient staff for Chorley and South Ribble hospital’s A&E department to reopen, but I am dismayed that the trust is delaying the reopening until January next year. Will the Minister reassure me that he will work with me and other stakeholders to oblige the trust to open as soon as possible?

[Mr Dunne]

My hon. Friend has been a doughty champion of Chorley, in combination with another Member of the House and local campaigners, who visited the Houses of Parliament yesterday to meet local MPs. While welcoming the reopening of the A&E from January, I am happy to continue to work with my hon. Friend to see whether it can be brought forward.

[Mr Speaker]

The other doughty champion of the hospital is of course the right hon. Member for Chorley (Mr Hoyle), who regularly deputises for me in this Chair. I am sure the House will want to acknowledge that important fact.

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[Kevin Foster (Torbay) (Con)]

The Secretary of State will be aware of the concern in my constituency about the future of Paignton hospital, which prompted hundreds to turn up to a recent meeting. Does he agree with me that it is vital the clinical commissioning group, in publishing its plans, does not just publish what it will remove but the details of what it will replace them with?

[Mr Dunne]

Considerable efforts are going into sorting out some of the historical challenges in the provision of both acute and community care in Devon. I hosted a meeting for a number of colleagues who are concerned about this and I am happy to continue to engage with colleagues across the county.

[Lilian Greenwood (Nottingham South) (Lab)]

Two years ago, Nottingham University Hospitals NHS trust privatised support services, including cleaning, handing them over to Carillion in an effort to save money. Since then there have been shortages of equipment, shortages of staff and an appalling decline in standards of cleanliness. Will the Secretary of State condemn Carillion for putting patients at risk? When will he ensure that hospital services in Nottingham are properly funded?