Oral Answers to Questions

Simon Burns Excerpts

Tuesday 27th March 2012 Commons Chamber

[Gavin Shuker (Luton South) (Lab/Co-op)]

7. What his most recent estimate is of the cost 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. It will save £4.5 billion over the rest of this Parliament and £1.5 billion a year to 2020. We will reinvest every penny saved in the NHS in front-line services.

[Mr Crausby]

The Bolton clinical commissioning group estimates that its budget will be about £25 per Bolton resident, or £100 for a couple with two children. Is that not too much, considering that they will get no medical treatment at all from that money, just administration money paid to doctors who should really be treating patients and not sat in the back office?

[Mr Burns]

No, I do not believe it is. The administration figure that has been announced for CCGs throughout the country is £25 a patient, but if a CCG is more effective and efficient in providing administration and bureaucracy and makes savings, those savings can be transferred and reinvested in funding the care of their patients. That is an incentive for them to be streamlined and to ensure that that happens.

[Gavin Shuker]

The Minister speaks of reinvesting every single penny in the NHS budget. How does that fit with the £500 million raid on the NHS budget spoken of this week?

[Mr Burns]

If I could explain this to the hon. Gentleman, the £500 million that he is talking about was part of the savings made through renegotiating the IT contract. It is a perfectly normal procedure, because as the right hon. Member for Leigh (Andy Burnham) will know, the average figure for previous years was £850 million, and one year when he was a Minister at the Department of Health, it was £2.3 billion.

[David Tredinnick (Bosworth) (Con)]

As part of the reorganisation, my right hon. Friend the Secretary of State has decided—rightly in my view—that the Health Professions Council will regulate Chinese medical practitioners, but there is widespread concern in the community that these practitioners will not have protection of title. Will he please ensure that they do when he finishes his consultation?

[Mr Burns]

I am extremely grateful to my hon. Friend and, as his question suggested, there is a consultation process. I can give him an assurance that the point that he has made will be fully considered as part of that consultation process.

[Robert Halfon (Harlow) (Con)]

Is my hon. Friend aware that the NHS reorganisation will abolish the strategic health authority in the eastern region, which will save £46 million a year—money that will be spent on front-line services in Harlow and elsewhere?

[Mr Burns]

I am extremely grateful to my hon. Friend for pointing that out. It is crucial that we slim down the bureaucracy and management of the NHS so that we can make savings, so that they can go where they should—to provide more care for patients in the NHS.

[Andy Burnham (Leigh) (Lab)]

Last week in the emergency debate, the Secretary of State said:

“Risk registers…are not a prediction of the future. They set out a worst-case scenario”.—[Official Report, 20 March 2012; Vol. 542, c. 676.]

I now have an early version of the risk register that civil servants gave him in September 2010. Risk No. 7 of his reorganisation was that “Financial control is lost.” That was red rated and, according to the document, likely to happen with major consequences. Is it not clear that last week the Secretary of State gave an inaccurate description of the risk registers he saw, and should he not now come to the Dispatch Box to correct the record?

[Mr Burns]

May I reassure you, Mr Speaker, if not so much the right hon. Gentleman, that my right hon. Friend did not mislead anyone? The answer to the right hon. Gentleman’s question is the same as he and his predecessors pursued under the last Labour Government—and was pursued under the Thatcher and Major Governments—which is that Ministers do not comment on leaked documents.

[Andy Burnham]

The rest of the world is, and we would be interested to hear the Government’s views on it. Here we have it in full colour. It is not the worst-case scenario, as the Secretary of State claimed, but 43 very real and predictable risks, 21 of which are red rated and 14 likely to happen with major consequences. They include:

“Emergencies…less well managed…more failures…GP consortia go bust or have to cut services…performance dips and key staff lost”.

Is it not now clear for all to see that the Secretary of State and his Ministers have knowingly taken major risks with the national health service, ignored warnings from civil servants and kept those risks secret from Parliament in order to get their unnecessary Bill through?

[Mr Burns]

I am not quite sure which word in my last answer the right hon. Gentleman did not understand, so I will repeat it. Like previous Governments, we do not comment on leaked documents. Instead of coming to the Dispatch Box and talking down the fantastic work that nurses and doctors do day in and day out, why does he not read the quarter, the latest copy of which is full of facts about how the NHS is improving its performance and delivering better quality care for patients throughout England?

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

3. What assessment he has made of progress in tackling tuberculosis in England.

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[Stephen Barclay (North East Cambridgeshire) (Con)]

9. What steps his Department is taking to develop more effective performance management of GPs.

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

As set out in the Health and Social Care Bill, performance management of general practice will become the responsibility of the new NHS Commissioning Board from April 2013. This will enable, for the first time, a single, consistent approach to be developed for the assessment and management of general practice.

[Stephen Barclay]

As with any profession, the performance of GPs varies widely. As more power is devolved to GPs, does my right hon. Friend recognise the importance of independent performance management of GPs, in order to identify outliers and improve patient care?

[Mr Burns]

I am extremely grateful to my hon. Friend, given his past association as a constituency MP with this subject, because of the problems in his constituency. I believe that we have a strong system of general practice in this country, but I am afraid that more can be done to address variations in aspects of the quality of provision by some general practitioners. As I have said, the NHS Commissioning Board will adopt a single, consistent approach, allowing an overview of performance, which is not currently possible, and ensuring that interventions occur at an early stage. I think that will go a considerable way towards helping with the problems that have been experienced.

[Jim Shannon (Strangford) (DUP)]

As an elected representative for a great many years, I have often been made aware of issues relating to GPs and patient lists. Does the Minister agree that there should be greater co-operation between the Health Department and GPs with regard to their patient lists, and specifically with regard to the transfer of patients?

[Mr Burns]

With regard to the transfer of patients, we are seeking to give greater choice to patients under the modernisation programme so that they can move from one GP, or one GP practice, to another in a way that they cannot do at the moment. That will help to enhance the power of patients to get the GP of their choice and preference.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I am sure that the Minister would agree with me about the importance of addressing alcohol misuse through the alcohol strategy announced last week. On the performance management of GPs, however, does he agree that we need to do more than just monitor how much people drink, and that we need to ensure that GPs are incentivised to tackle the problem drinkers who attend their surgeries?

[Mr Burns]

Yes, my hon. Friend raises an important issue. We must ensure that every contact counts, and that there is greater working between GPs and patients to help to deal with what is a significant problem among certain sections of the community.

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

The first step that the Government should take is to start listening to doctors. Is it not the case that some senior GPs are now spending as little as one day a week seeing patients because they are too busy working on the Government’s massive NHS upheaval? It is costing the NHS up to £124,000 a year to replace each of those GPs with a locum. That is why the Department’s leaked transition risk register warns that GP leaders are not sufficiently developed to run consortia, and that they might be drawn into managerial processes that drive clinical behaviour, rather than the other way round. The risk rating for that is that it is likely to happen, with major consequences. When is the Minister going to get his head out of the sand and start listening?

[Mr Burns]

Well, that interesting rant bore little relation to the facts—[Interruption.] If the hon. Member for Copeland (Mr Reed) would just button it for a minute, he will get the answer. The answer is that we are constantly listening to GPs, nurses, consultants and others within the NHS health economy. As we showed during the progress of the Health and Social Care Bill, we listened and we accepted a number of recommendations from the Future Forum and from a number of others, which strengthened and improved the Bill. I have to say that the hon. Member for Denton and Reddish (Andrew Gwynne) just does not get it.

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[Neil Carmichael (Stroud) (Con)]

15. What assessment he has made of the provision of vision screening for children.

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

The Department of Health has made no assessment of the provision of vision screening for children. However, the UK National Screening Committee, which advises Ministers and the NHS on all aspects of screening, has commissioned a national mapping exercise to look at how many primary care trusts offer vision screening.

[Neil Carmichael]

There is some evidence of variance across the country, with some PCTs not conforming to current arrangements. What thought has been given to how to improve the situation and iron out the variance?

[Mr Burns]

As my hon. Friend will be aware, the National Screening Committee recommends screening for visual impairment for children between the ages of four and five, and encourages all PCTs to follow those recommendations and ensure that children are screened. However, the Government are aware that, as my hon. Friend says, there are variations in the commissioning of vision screening across PCTs, and it welcomes the review that is being undertaken. We await its recommendations as regards those variations, but we hope that under the new arrangements, after the abolition of PCTs, there will be a far more uniform approach to commissioning and screening.

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[Jeremy Lefroy (Stafford) (Con)]

T8. Could my right hon. Friend indicate how he proposes to use his welcome new duty to reduce health inequalities under the Health and Social Care Bill?

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

I am extremely grateful to my hon. Friend for that question. As he will be aware from his time on the Bill Committee this Government have for the first time in the 64 years of the NHS put into legislation a duty to reduce health inequalities. That will be done through the NHS Commissioning Board and clinical commissioning groups, each being under a duty to have regard to the need to reduce inequalities in access to and the outcomes of health care. The Secretary of State will also have a wider duty to have regard to the need to reduce inequalities relating to the health service. That will include his duties for both the NHS and public health. It is a great step forward and I am surprised that the previous Government did not think of doing it during their 13 years.

[Rosie Cooper (West Lancashire) (Lab)]

T4. At a time of major upheaval in the national health service, the people of west Lancashire and other areas of Lancashire are being failed by the chief executive of the Lancashire primary care trust cluster. Living in Yorkshire and working from Lancaster, Janet Soo-Chung has failed to meet with me or other colleagues, including my hon. Friend the Member for Chorley (Mr Hoyle). Can the Secretary of State assure me that the necessary time and development is being invested in health services in west Lancashire to ensure that authorisation takes place in a timely way without conditions and that the health services provided to my constituents are good?

[Stuart Andrew (Pudsey) (Con)]

Currently, there is a review into paediatric cardiac services going on. I recognise that that is independent of Government, but we now have the independent analysis of patient flows, which says exactly what we have been saying—that patients in south and west Yorkshire will not go to Newcastle. Does my right hon. Friend agree that this is an important development and that the options should reflect that because this is a serious problem for heart services in the north of England?

[Mr Simon Burns]

I congratulate my hon. Friend on his persistent championing of his constituents, but sadly I cannot be drawn into a discussion about evidence, facts and figures that might come up around this issue, because as he will appreciate it is an independent review which is divorced from Ministers.

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

T5. Mindfulness-based meditation techniques have been deemed by the National Institute for Health and Clinical Excellence to be more effective than drug-based therapy in the treatment of recurring depression in many circumstances. Will the Minister tell the House his views on mindfulness-based techniques and say what other conditions and diseases he thinks would benefit from such therapy?

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[Mr Simon Burns]

I hope I can reassure my hon. Friend. PCTs carrying legacy debt into 2012-13 must clear it. Clinical commissioning groups will not be responsible for resolving primary care trust legacy debt that arose prior to 2011-12. It is expected that aspirant CCGs will continue to work closely with primary care trusts and primary care trust clusters in 2012-13 to ensure that no PCT ends 2012-13 in a deficit position.

[Bill Esterson (Sefton Central) (Lab)]

One NHS consultant told me that

“NHS reorganisation could mean that you are forced to spend around 10% of your income on private health care insurance.”

Does the Secretary of State accept that the doctor is right to say that people will either wait longer for care or they will have to pay for it?

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[Mr Speaker]

Order. The hon. Gentleman should resume his seat. I do not wish to be unkind, but topical questions are about short questions, and that was not. I am very sorry. The Minister may give a brief reply if he wishes.

[Mr Simon Burns]

The industrial action to which my hon. Friend refers showed both the best and the worst sides of industrial relations in this country. On the one hand, it showed the worst excesses of union militancy and intransigence in failing to put effective contingency plans in place ahead of strike day, and then in refusing to call off the strike. On the other hand, it showed the best traditions of public services when the Metropolitan police, St John Ambulance and many out-of-hour providers came to the aid of the London ambulance service. Were it not for their help, the situation could have been even more serious.

[Mr Speaker]

The Minister’s power to anticipate what will be said to him is extremely impressive, and I congratulate him immensely warmly.