Oral Answers to Questions

Simon Burns Excerpts

Tuesday 10th January 2012 Commons Chamber

[Jason McCartney (Colne Valley) (Con)]

3. If he will take steps to ensure that the safe and sustainable review of paediatric cardiac services is fully inclusive.

[The Minister of State, Department of Health (Mr Simon Burns)]

The review of children’s congenital heart services is a clinically led NHS review, independent of Government. In conducting it, the Joint Committee of Primary Care Trusts has aimed to be as inclusive as possible in relation to all issues.

[Jason McCartney]

The Minister will be aware that the review has been called into question because the consultation has not encompassed other medical conditions such as respiratory problems. Will he intervene so that a consensus approach can now be taken?

[Mr Burns]

As I have said, the review is clinically led and independent of Government, and I am afraid that it would not be appropriate for me, or my colleagues, to intervene. Moreover, the review is the subject of legal proceedings. It will be for the Joint Committee of Primary Care Trusts, on behalf of local commissioners, to decide the future pattern of children’s heart services on the basis of the best available evidence.

[Greg Mulholland (Leeds North West) (LD)]

It seems nonsensical to deal with the provision of surgical services for adult and child congenital cardiac patients in separate reviews. Given the delay in the review of children’s services, does the Minister not agree that it is time to consider including them in the forthcoming review of adult services?

[Mr Burns]

I am grateful to the hon. Gentleman for his suggestion, but I am afraid that I do not share his view. As he knows, there will be a review of adult services, but it has always been considered most appropriate to deal with paediatric cardiac services before adult care, and that is what we will continue to do.

[Dr Julian Lewis (New Forest East) (Con)]

Although the paediatric heart unit at Southampton general hospital is rated the best in the country outside London, it was included in only one of four options under the review. In the past, the Minister has helpfully hinted he might not be confined to considering only those four options. Can he expand on that?

[Mr Burns]

I can expand on it by saying that it will not be me who considers the options. As I have told my hon. Friend before, this is an independent review. However, as he suggests, the JCPCT may decide on four, six or seven possible sites. It all depends on what the consultation produces, and the clinical decision on what is the most appropriate number of sites, which will happen eventually.

I congratulate my hon. Friend on his championing of Southampton general hospital as the local Member of Parliament.

[Mr David Evennett (Bexleyheath and Crayford) (Con)]

4. What recent representations he has received on access to the cancer drugs fund; and if he will make a statement.

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[Steve McCabe (Birmingham, Selly Oak) (Lab)]

10. What recent estimate he has made of the cost to the public purse of NHS reorganisation.

[The Minister of State, Department of Health (Mr Simon Burns)]

The cost of the NHS modernisation is estimated to be between £1.2 billion and £1.3 billion. That will save £4.5 billion over this Parliament, and £1.5 billion per year thereafter. We will reinvest every penny saved in front-line services.

[Steve McCabe]

I am grateful for that answer. The Minister will be aware that the figure he has given is about half what the primary care trusts believe they are required to keep back to fund the reorganisation: they put it at £3.4 billion. Given his answer today, will he write to South Birmingham primary care trust to tell it that it no longer has to hold back £25 million for that purpose and that it can use that money to cut the 18-week waiting list, which has risen by 36% since he assumed office?

[Mr Burns]

May I say, in the nicest possible way, that I think the hon. Gentleman is a tiny bit confused? I think he is confusing the one-off costs of the modernisation with the 2% hold-back figures used by the PCTs, which put aside money—a process instigated by the right hon. Member for Leigh (Andy Burnham), which we carried on—that can be used if a PCT gets into financial problems. If it does not get into financial problems, it can then use the money to invest in front-line services.

[Mr Peter Bone (Wellingborough) (Con)]

The Conservative-led coalition should be congratulated on introducing a measure that will get rid of red tape and bureaucracy by getting rid of strategic health authorities and primary care trusts. Do the Labour Opposition not look like dinosaurs when they try to defend those bodies?

[Mr Burns]

I am very grateful to my hon. Friend and I am always reassured when he congratulates the coalition Government, as it suggests to me that we are getting something right. My hon. Friend is absolutely right. As everyone who understands health policy in this country recognises, the NHS must evolve to meet changing needs and we are improving effectiveness and efficiency and saving money by cutting out administration and bureaucracy so that we can reinvest in front-line services to look after the health interests of all our constituents.

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

Figures revealed to the Opposition under freedom of information procedures show that GPs will receive up to £115 an hour for commissioning health care services on top of their existing salary. It makes no sense at all to take GPs away from patient care to become part-time accountants. When the NHS needs every penny it can get, patients will be astounded to hear that the Government plan to pay GPs twice. This comes at a time when 48,000 nursing posts are being axed and £3.5 billion is being set aside for the Minister’s bureaucratic upheaval. Will he now accept that the NHS can ill afford for money to be wasted on a top-down reorganisation that few want? Is it not now time for him to scrap the Bill?

[Mr Burns]

It is nice that the hon. Gentleman got the mantra in at the end—I have been expecting it all through this Question Time. He is wrong; what is important and what this modernisation has at its heart is the need for GPs to commission care for patients, because GPs are best equipped to know the needs of their patients. That is the way forward. Also, we are cutting bureaucracy and administration by 45% so that we can reinvest that money in front-line services. We want to spend money on health care and on improving outcomes, not on managers and bureaucracy.

[John Pugh (Southport) (LD)]

May I congratulate the Secretary of State and the Prime Minister on the productive ward initiative? The NHS document “Top Tips for spreading The Productive Ward” says:

“Set a realistic time scale. Take your time and do not rush. Take small steps and complete them before moving on to the next.”

Is this advice generally applicable to NHS reform?

[Mr Burns]

As the hon. Gentleman recognised at the beginning of his question, this is important and excellent advice for nurses and other health care professionals to give care, consideration and attention to all patients so that they can be looked after in an appropriate and caring way. That is the way forward to making the health service more responsive to the needs of patients and to the improvement of health outcomes.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

What assessment has the Minister made of the impact of the NHS reorganisation on waiting times?

[Mr Burns]

The hon. Lady raises an extremely important point. The whole purpose of the modernisation of the NHS is to enable it to meet the challenges of an ageing population, an increased drugs bill and new medical procedures, so that we can ensure that patients get their treatments, within the responsibilities of the NHS constitution, and do not have to wait undue lengths of time for treatment.

[Chris Ruane (Vale of Clwyd) (Lab)]

11. What recent representations he has received on the Health and Social Care Bill.

[The Minister of State, Department of Health (Mr Simon Burns)]

The Government have listened to representations throughout the passage of the Health and Social Care Bill. In addition to the consultation on the White Paper, the NHS Future Forum has undertaken two engagement exercises. The first involved 6,700 people directly and received more than 28,000 comments and e-mails, and the second involved more than 12,000 people at more than 300 events. Ministers have also continued to meet and to receive representations from a range of interested parties on a regular basis, and we will continue to do so.

[Chris Ruane]

I thank the Minister for that response. May I ask what specific representations he has had on children’s well-being? Is he aware that the Children’s Society will this Thursday publish its 2012 “Good Childhood” report, which will include a specific report on how central and local government could improve and promote positive well-being among children? Will the Minister and the Secretary of State meet the Children’s Society to discuss that important report?

[Mr Burns]

Throughout the consultation process there have been comments and responses to proposals across the whole of the health area, including on children’s health and well-being. Obviously, I cannot comment on a report that will not be published until later this week, but I or one of my ministerial colleagues would be more than happy to meet the Children’s Society once the report has been published if the society thinks that a meeting to discuss the report’s contents would be worth while.

[Mr Stephen Dorrell (Charnwood) (Con)]

Against the background of the recommendation of the NHS Future Forum that a key priority for the future is greater integration between health care and social care—a priority that was explicitly endorsed last week by the Prime Minister—does my right hon. Friend agree that the key opportunity in the Bill, through the health and wellbeing boards, is to drive that agenda, which has been much talked about for many, many years now, and actually to start to deliver on that rhetoric?

[Mr Burns]

My right hon. Friend is absolutely right; of course, when he was Secretary of State he did a considerable amount of work to lay the ground rules for the move towards greater integration, because that is the way forward. My right hon. Friend makes a very valid point: it is the way forward and we fully recognise that. We are deeply committed to achieving that aim, and that is why my right hon. Friend the Secretary of State has added an extra £150 million to the existing £300 million, to facilitate progress towards it.

[Andy Burnham (Leigh) (Lab)]

May I tell the Secretary of State and the Minister that he will receive more representations on his Bill later this week from two hospital doctors who, early this morning, began a 160 mile run to protest against his Bill, from Bevan’s statue in Cardiff to his Department? [Interruption.] The Secretary of State should listen. Let me remind him why people are so angry. Nobody voted for the Bill. It was ruled out by the coalition agreement, and it is now the unelected House deciding the future of the NHS, passing amendments that he was too scared to table in this House.

Will the Minister today have the courage to admit that it is now the Government’s intention to allow NHS hospitals to make 49% of their income, effectively devoting half of their beds, from the treatment of private patients?

[Mr Burns]

May I say a happy new year to the right hon. Gentleman as well? I believe that his analysis of the support for the Bill is flawed, because there are a number of areas where a number of organisations warmly welcome its contents. For example, the BMA voted in favour of GP commissioning at its special general meeting last year.

On the question of 49%, the shadow Secretary of State has been uncharacteristically forgetful, because of course he will appreciate that the cap applies only to foundation trusts, not to non-foundation trusts, and that is no different today from what it will be after the modernisation—and it was a policy that his Government brought in.

[Andy Burnham]

No, it was not. That policy would never, ever have come forward under a Labour Government—and I know that the right hon. Gentleman has not denied it. We, the Opposition, will now make it our business to tell every single patient in England about his plans for the NHS. People can finally see the Bill for what it is: a privatisation plan for the NHS. England’s hospitals will never be the same again if the Bill gets through: an explosion of private work; longer waits for NHS patients; profits before patient care. Will not the only choice on offer for patients be the old Tory choice in the NHS: wait longer or pay to go private?

[Mr Burns]

I am afraid that the shadow Secretary of State is just totally wrong. This Government have no intention to and will not privatise the national health service. We want to improve patient outcomes and the patient experience. The right hon. Gentleman should look again at the 49% that he talks about, because we are not changing the situation, particularly because it does not apply to trusts at the moment; it is only for foundation trusts.

[Andy Burnham]

That is garbage.

[Mr Burns]

The right hon. Gentleman says it is garbage. I think that is confusing from him, because I remind him that of course it was in the Labour party manifesto at the last general election to remove the private patient cap.

[Guy Opperman (Hexham) (Con)]

12. What steps he has taken to implement a flexiscope bowel cancer screening test.

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[Mr Frank Field (Birkenhead) (Lab)]

13. What estimate he has made of the cost to the public purse of NHS reorganisation in (a) Birkenhead constituency and (b) England.

[The Minister of State, Department of Health (Mr Simon Burns)]

The cost of the NHS modernisation is estimated to be between £1.2 billion and £1.3 billion. That will save £4.5 billion over this Parliament, and a further £1.5 billion each year thereafter. [Hon. Members: “It is a different question.”] It is the same question. We do not have a local breakdown of these figures, as that will depend on local decisions.

[Mr Field]

Perhaps the right hon. Gentleman will ask the House of Commons Library for the answer so that he can give it to me next time, and also look at the increase in the number of managers in Wirral over the past five years. The number has gone up by more than a quarter. With that size increase, why are those staff not being used to pilot his reorganisation?

[Mr Burns]

The right hon. Gentleman is absolutely right. There was a significant increase in managers in the NHS in the last two or three years of his Government. Since we came to power, there are just under 15,000 fewer managers and administrators, and 3,700 extra doctors.

[Patrick Mercer (Newark) (Con)]

The Minister is well aware of the reforms to the NHS in my English constituency, but many of my constituents question whether they are getting value for money in view of the expansion of population in Newark over the next couple of years. Will he look again, please, at the Newark health care review?

[Mr Burns]

If my hon. Friend would be kind enough to write to me with specifics on the situation in Newark, I would be more than happy to look into it in detail and respond to him.

[John Mann (Bassetlaw) (Lab)]

14. How many (a) accident and emergency departments and (b) maternity units he expects will be (i) downgraded and (ii) closed between May 2010 and May 2015.

[The Minister of State, Department of Health (Mr Simon Burns)]

The reconfiguration of local health services, including A and E and maternity services, is and will remain a fundamentally local process. What matters is that decisions about service changes are clinically driven, and that patients and the public are involved in those changes to ensure that they get the highest quality care.

[John Mann]

I refer to the answer that the Minister just gave to the hon. Member for Newark (Patrick Mercer). The buck stops with the Minister. Would he like to congratulate the SOS Save Our Services group in Bassetlaw, which in the past two months has overturned the proposals to downgrade A and E and maternity services at Bassetlaw hospital? Is that not a good example of the real big society?

[Mr Burns]

As the hon. Gentleman knows, on 20 May 2010 my right hon. Friend the Secretary of State brought in the four conditions that had to be met for reconfiguration, which included paying attention to the views of local stakeholders and the medical profession. So, as the hon. Gentleman rightly says, the decision has been taken not to proceed with the changes at Bassetlaw hospital. No doubt he also welcomes the £900,000 that is being invested to expand and improve Bassetlaw hospital’s A and E facility.

[Mr Jamie Reed (Copeland) (Lab)]

The whole House will note that the moratorium on hospital and ward closures has clearly ended, but as my hon. Friend the Member for Bassetlaw (John Mann) rightly said, the NHS risk registers held by regional and local health boards around the country clearly showed the risks associated with closures and the downgrading of hospital wards. The Government’s Health and Social Care Bill poses risks to the safety and quality of services, yet the Secretary of State has appealed against the Information Commissioner’s ruling that the NHS national risk register should be published. Members of both Houses may be denied the opportunity to scrutinise the real risks that the Bill poses to the NHS before they are asked to vote on it for a final time. Will the Minister give a binding commitment that the risk register produced by his Department will be published in full before the Bill returns from the Lords?

[Mr Burns]

The right hon. Member for Leigh (Andy Burnham) did not publish a risk register during his tenure. His predecessor, the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson), did not publish the risk register on two occasions during his tenure. The bits relevant to the Health and Social Care Bill have been made public, but we will not be publishing the risk register because, as the hon. Gentleman knows, my right hon. Friend the Secretary of State is appealing, as he is entitled to do, against the Information Commissioner’s decision—[Interruption.] We have a right of appeal, which we are exercising, and we will have to wait until a decision has been reached on appeal. Until then, no we will not be publishing the risk register, because it is not necessary or appropriate.

[Mr Graham Allen (Nottingham North) (Lab)]

15. What steps his Department is taking to prevent ill health and its associated costs through early intervention.

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

The Prime Minister speaks of the “health and safety monster”; does the Minister believe it is right that advertising for personal injury lawyers should be displayed in hospital A and E departments, which many might think would feed the monster and make it bigger?

[The Minister of State, Department of Health (Mr Simon Burns)]

I am very grateful to my hon. Friend for raising that, because it is an important issue. As he might be aware, there are rules and regulations: it is not acceptable for that sort of advertising in NHS hospitals. I would hope that any trusts behaving in that way immediately review their procedures.

[Jim McGovern (Dundee West) (Lab)]

T8. Yesterday, I had a meeting with Patricia Osborne, the chief executive of the Brittle Bone Society, a UK-wide organisation that is headquartered in my constituency. It was made clear to me that given the current funding squeeze across the voluntary sector, the society is concerned about its ability to provide the vital services that it currently provides. Also troubling the society is the lack of support for adult sufferers of osteogenesis imperfecta. What can the Secretary of State tell me about the Government continuing to support that important society, and what more can they do to support adults with that condition?