Defending Public Services

Simon Burns Excerpts

Monday 23rd May 2016 Commons Chamber

[Mr Hunt]

As the right hon. Gentleman knows, the chair of that organisation has stepped down, but he is absolutely right about accountability. Accountability needs to be about not just individual organisations within the NHS, but the people commissioning mental health care and care for people with learning disabilities. That is why, from July, we will for the first time be publishing Ofsted ratings on the quality of mental health provision and of provision for people with learning disabilities by clinical commissioning groups, so that we can see where the weak areas are and sort them out.

I conclude on quality by saying that important though a seven-day NHS is, we need to go further if we really are to make NHS care the safest and highest quality in the world. According to the respected Hogan and Black analysis, we have 150 avoidable deaths in our NHS every week. That is 3.6% of all hospital deaths with a 50% or more chance that that death could have been avoided. In the United States, Johns Hopkins University said earlier this month that medical error was the third biggest killer after cancer and heart disease, causing 250,000 deaths in the United States alone every year. That is why this year England will become the first country in the world to lead a transparency revolution in which every major hospital will publish its own estimate of its avoidable deaths and its own plans to reduce them. This year, we will focus particularly on reducing maternal deaths, stillbirths and neonatal death and harm, with plans I hope to outline soon to the House.

If we are to do that, perhaps most difficult of all will be transforming a blame culture found in too many parts of the NHS that still makes it far too hard for doctors and nurses to speak openly about medical error. Among other measures, we have set up a new healthcare safety investigation branch to conduct no-blame investigations when we have tragedies. It is modelled on the highly successful air accidents investigation branch. As in the airline industry, our model for reducing avoidable death must be transparency, openness and a learning culture that supports rather than blames front-line professionals, who in the vast majority of cases are only trying to do their best. Part of that new culture of responsibility and accountability must be a return to proper continuity of care, which is why this Government have brought back named GPs for every patient, which had been abolished in 2004, and are introducing lead consultants for people who go to hospital with complex conditions.

In conclusion, for this Government defending the NHS involves higher standards of care, wise use of resources and secure funding from a strong economy. Because the challenges we face in England are the same as in Wales, Scotland and Northern Ireland— indeed, the same as in developed countries all over the world—we should exercise caution in politicising those pressures, or we simply invite scrutiny of the relative performance of the NHS in different parts of the UK, which often shows that those who complain loudest about NHS performance in England are themselves responsible for even worse performance elsewhere.

What this Government want is simple: a safer seven-day service, backed by funding from a strong economy. Already we have delivered more doctors, more nurses, more operations and better care than ever before in NHS history.

[Sir Simon Burns (Chelmsford) (Con)]

Will my right hon. Friend give way?

[Mr Hunt]

I am about to conclude, so I shall finish, if I may.

But with that achievement comes a renewed ambition that our NHS should continue to blaze a trail across the world for the quality and safety of its care, and that is how this Government will continue to defend our biggest and most cherished public service.

--- Later in debate ---

[Heidi Alexander]

I am grateful to the Secretary of State for that intervention. He might want to rake over the last general election but he clearly does not want to talk about the crisis in NHS finances today, with a £2.45 billion deficit among hospitals at the end of this year, cuts to public health spending, and £4.5 billion coming out of the adult social care budget over the past five years. I am quite happy to debate NHS finances with him. The truth is that the NHS is getting a smaller increase this year than it got in every single year of the previous Labour Government.

The King’s Fund and the Health Foundation concluded:

“Getting public spending figures right is important, otherwise they can mislead and detract from the real issues. The fact is that the NHS is halfway through its most austere decade ever, with all NHS services facing huge pressures.”

[Sir Simon Burns]

May I recommend that the hon. Lady read a recently published book by Tom Bower which shows the utter failure of the Blair Government, who pumped billions of pounds into the NHS over a period of years but had no control over it and made no attempt to increase productivity, so that from 1998 performance flatlined for six years, and the then Health Secretary was forced to bring back health policies that they had abandoned in ’97?

[Heidi Alexander]

I am grateful for the reading advice from the right hon. Gentleman, but I simply say this: I am very happy to defend the record of the previous Labour Government, who trebled the NHS budget and had the highest-ever public satisfaction ratings and the lowest-ever waiting lists.

We should be crystal clear about the crisis that we face today. The decade from 2010 to 2020 is set to be marked by the biggest sustained funding squeeze on the NHS ever. As a percentage of GDP, spending on health is set to fall from 6.3% in 2009-10 to just 5.4% by the end of the decade.

Junior Doctors Contract

Simon Burns Excerpts

Thursday 19th May 2016 Commons Chamber

[Mr Hunt]

I welcome the tone of the hon. Lady’s comments; we might have wished for a similar tone from the shadow Health Secretary. Let me address the comments of the hon. Member for Central Ayrshire (Dr Whitford) as constructively as she made them to me. She is right about flexible training. We have to recognise that the junior doctor workforce is now majority female, and that a number of family and caring pressures need to be taken account of. We need to do that for the NHS not only because it is the right thing to do, but because we will lose people if we do not. Those people will simply leave medicine, even though they have been through very extensive and expensive training.

We have to look particularly at the responsibilities of doctors with young children. One of the things that we announced yesterday was an obligation on trusts to take account of caring responsibilities. If, for example, a doctor wanted to work fewer hours in school holidays and more hours in term time, we cannot guarantee that a hospital would always be able meet those needs—the needs of patients always have to come first—but they could at least be taken account of, in the same way as they are in many other industries that operate 24/7. The hon. Lady is absolutely right to say that modern technology is key to that. An air steward or a pilot who works for British Airways can go on to an electronic system and choose the shifts and hours that they want to work. Because we have failed to modernise the NHS, we have seen a huge growth in agency and locum work, which is partly driven by the fact that it offers precisely the flexibilities that people need. These are important changes, and we intend to take them forward.

[Sir Simon Burns (Chelmsford) (Con)]

My right hon. Friend’s actions and those of the Department and the BMA in reaching an agreement will be warmly welcomed and met with a sigh of relief. Does he accept that the fact that the BMA was prepared to think again on crucial issues, such as overtime at weekends, should be seen as a sign not of weakness but of maturity, in working with the Government to ensure that we have a seven-day NHS that is for the benefit of patients and patient safety?

[Mr Hunt]

I absolutely agree with that wise comment, and it befits someone who is experienced in working in the Department of Health. We always get further if we sit around the table and talk about such issues. The Government are determined to improve the quality and safety of care for patients, and it is important to recognise that if the Government are successful, it will be better for the morale of doctors. The happiest, most motivated doctors work in the hospitals that are giving the best care to patients. That is why it is a win-win.

I say to Labour Members that it was the refusal of the BMA for many years to talk about the issue that my right hon. Friend referred to that meant we reached a deadlock. The fact that the Government were willing to proceed with important reforms on our own if we had to meant that, in the end, everyone came together and had a sensible negotiation. We got to the right place. I am sure everyone wishes that we had not had to go on the journey we went on to get there, but now that we have got there, I think it is the time for being constructive on all sides.

Oral Answers to Questions

Simon Burns Excerpts

Tuesday 10th May 2016 Commons Chamber

[Mr Hunt]

That is not correct. It is worth saying that the reason for the dispute is a manifesto commitment to a seven-day NHS that the Government made to the people of England and that the Scottish National party has not made to the people of Scotland. The weekend effect does not happen just in England. There are studies in Scotland, including the Handel study, which states:

“The excess of admissions ending in deaths at weekends compared with those during weekdays seen elsewhere were also found in Scotland.”

I gently say to the hon. Gentleman that yes, we want to improve the quality of life for junior doctors so that they can live and work in the same city as their partners, and we are looking at the solution to that problem, but that he might think about doing the same thing in Scotland.

[Sir Simon Burns (Chelmsford) (Con)]

Will my right hon. Friend bear it in mind that Secretary of State Dean Rusk always said that jaw-jaw was better than war-war, and that it is welcome that the negotiations have resumed with the BMA on this difficult problem? Does he also accept that everyone wishes the talks well so that we can get a meaningful agreement that ensures a seven-day NHS for the benefit of patients and their safety?

[Mr Hunt]

My right hon. Friend speaks very wisely. Indeed, I was thinking about the talks as I spoke on my mobile phone and he was having a cigarette just outside the House yesterday morning. He is absolutely right about jaw-jaw. That is why I think that across the whole House we wish the talks well. However, for them to succeed all sides need to recognise their objective, which is a safer seven-day service for patients. I hope that, on that basis, we will be able to make progress.

Junior Doctors Contracts

Simon Burns Excerpts

Monday 18th April 2016 Commons Chamber

[Mr Hunt]

Let me gently ask the hon. Lady how long she expects us to sit round the table. We have been trying to discuss this for three years. She asked how the maths added up. I will tell her how the maths adds up. It adds up because we are putting an extra £10 billion, in real terms, into the NHS over the course of this Parliament. Conservatives put money into the NHS. The Scottish National party, incidentally, takes money out of the NHS.

The hon. Lady referred to the equality impact assessment selectively. She normally pays very good attention to detail, but the paragraphs from which she quoted related to changes that were agreed to by the BMA. What she did not quote was paragraph 95, which says that the overall assessment of the new contract is that it is “fair and justified” and will promote “equality of opportunity”. Why is that? Because shorter hours, fewer consecutive nights and fewer consecutive weekends make this a pro-women contract that will help people who are juggling important home and work responsibilities.

[Sir Simon Burns (Chelmsford) (Con)]

Does my right hon. Friend agree that, notwithstanding the appalling nature of the decision that, for the first time during strike action, junior doctors may not provide life-saving care for young children and other vulnerable patients, that decision is also totally incomprehensible, given that the doctors’ own leader has said that it is indefensible to take such action?

[Mr Hunt]

It is totally incomprehensible, and I know that many doctors will be wrestling with their consciences. However, I think that, in the context of the House, this could be an occasion for us to put aside party differences. I think that there was a time when Members in all parts of the House would have condemned the withdrawal of life-saving care in a pay dispute, but that day has sadly passed, and it is the Conservatives who must now show leadership in this regard. As we heard from my right hon. and learned Friend the Member for Rushcliffe (Mr Clarke), the NHS faces huge challenges, but we will not tackle those challenges if we allow obstructive unions to hold a gun to the Government’s head and refuse to allow us to proceed with really important changes—modern contracts that will allow safer care for patients and better terms for doctors. We are determined to do the right thing for the NHS, and, indeed, to be the party of the NHS.

Oral Answers to Questions

Simon Burns Excerpts

Tuesday 9th February 2016 Commons Chamber

[Mr Speaker]

Last but not least, Sir Simon Burns.

[Sir Simon Burns (Chelmsford) (Con)]

14. What assessment he has made of the adequacy of provision of GP practices in Chelmsford constituency.

[The Minister for Community and Social Care (Alistair Burt)]

NHS England advises that in Chelmsford there is a GP to patient ratio of 1,927 patients per whole-time equivalent GP, which is slightly lower than that for the Mid Essex clinical commissioning group area. The Care Quality Commission has inspected eight of the 13 Chelmsford GP practices—seven were rated “good” overall and one, Sutherland Lodge, was rated “outstanding”.

[Sir Simon Burns]

Does the Minister think it would be possible for the NHS review of the personal medical services scheme to ensure that the good and innovative work promoted by PMS, as exemplified by Sutherland Lodge surgery, can be sustained?

[Alistair Burt]

I hope so. I appreciate my right hon. Friend’s visit to my office yesterday with members of that surgery and NHS representatives. The £1.4 million released from PMS in Essex will be reinvested in the CCG area, but it is important that there is an opportunity for all practices to bid for that money so that some of the work already done under PMS gets the chance, if it is vital and still needed, to continue, which certainly includes services that are rated “outstanding”.

Oral Answers to Questions

Simon Burns Excerpts

Tuesday 17th November 2015 Commons Chamber

[Mr Hunt]

I urge the hon. Lady to correct for the record her wholly untrue statement that I ever said that doctors do not work outside 9 to 5. That is exactly the kind of inflammatory comment that makes the current situation a whole lot worse than it needs to be. I have always recognised the work that doctors do at weekends, but I also recognise that we have three times less medical cover at weekends, which means that mortality rates are higher than they should be. On A&E performance, we are taking extensive measures to ensure that the NHS is prepared for winter. It will be a tough winter, but unnecessary and wholly avoidable industrial action by the BMA will make it worse.

[Sir Simon Burns (Chelmsford) (Con)]

17. Does my right hon. Friend agree that the failed attempt by the BMA to get an injunction against the General Medical Council to stop it issuing guidance on how doctors should behave responsibly towards patients if there were to be a strike undermines the BMA’s claim that it is putting patient safety first? Will he assure the House that the BMA will have no veto on a seven-day NHS? That was a Conservative party manifesto commitment and it is what the vast majority of people in this country want.

[Mr Hunt]

My right hon. Friend championed the cause of patients when he was a Health Minister, and we must continue to do the right thing for patients, which is also the right thing for doctors. It is wholly inexplicable that the BMA should try to gag the GMC and stop it issuing guidance to doctors about their professional responsibilities. Whatever the disagreements over the contract, the most important thing is to keep patients safe.

Oral Answers to Questions

Simon Burns Excerpts

Tuesday 13th October 2015 Commons Chamber

[Mr Hunt]

I am very happy to do that, and to correct some of the misleading impressions given by the BMA about what the changes are. The changes are about patient safety. They are about the fact that someone is 15% more likely to die if admitted on a Sunday than on a Wednesday because we do not have as many doctors in our hospitals at the weekends as we have mid-week. I want to give better support to the doctors who work weekends by making sure that they have more of their colleagues and more consultants there, as well as proper safeguards, which I do not believe we have at the moment. I will be getting that message out, and I hope that the hon. Lady will, too, when she next meets her junior doctors.

[Sir Simon Burns (Chelmsford) (Con)]

I urge my right hon. Friend to continue on his drive to improve patient safety and to reduce avoidable harm in our NHS because that is crucial for patients and the professions.

[Mr Hunt]

I thank my right hon. Friend for his question, and for the interest that he showed in these issues when he was a Minister.

The reality is that about we have about 200 avoidable deaths every week in our hospitals. It is the same in other countries—this is not just an NHS issue—but it is a global scandal in healthcare, and I want England and our NHS to be the first to put it right. I think that that is consistent with NHS values, and consistent with what doctors and nurses all want.

Oral Answers to Questions

Simon Burns Excerpts

Tuesday 7th July 2015 Commons Chamber

[Alistair Burt]

The way that children and young persons’ mental health services have been handled over a lengthy period has been extremely poor, and many MPs have similar concerns on behalf of their constituents. That is why one of my major priorities for this Parliament is to build on the good work of the previous coalition Government, with £1.25 billion to be spent on transforming care services for children and young persons—a commitment that I think the Labour party would struggle to match.

[Sir Simon Burns (Chelmsford) (Con)]

Despite the excellent work done over the past two decades, does my right hon. Friend agree that the challenge facing us all—not only in government but among members of the public—is to end the disgraceful stigma that is associated with mental ill health, and break down the barriers of prejudice so that people suffering from mental ill health are treated in the same way as those suffering from a physical infirmity?

[Alistair Burt]

My right hon. Friend is correct. The damage that has been done over many years by not regarding mental ill health as seriously as it should be regarded, and by not having that parity of esteem, has been immense. The campaigns that have been launched against stigma, often fronted by brave people—including some in this House—have done much to correct that, but he is correct to say that the campaign against stigmatisation must continue.

A&E Services

Simon Burns Excerpts

Wednesday 24th June 2015 Commons Chamber

[Mr Reed]

My hon. Friend makes a prescient point. The Government talk the talk but do not want the walk, and she has detailed precisely why that is the case.

[Sir Simon Burns (Chelmsford) (Con)]

I am grateful to the hon. Gentleman for giving way, particularly as he has just responded to the intervention by the hon. Member for Bridgend (Mrs Moon), who is from Wales. Does he accept that in every financial year since 2010 the NHS in England has had a real-terms increase in funding, albeit a modest one, but that there has been a cut of 8% by the Labour Government in Wales and the A&E target in Wales has not been met since 2008?

[Mr Reed]

I congratulate the right hon. Gentleman on his knighthood—it is remiss of me not to have done that. He will know that real-terms increases and cash increases are not the same. He will also know, because he voted for it, that the budget in Wales has been cut by this Government by more than £2 billion. Let us compare like with like.

The Royal College of Nursing has calculated that almost £1 billion—£980 million—was spent on agency staff in the last year alone. Those and other choices made by this Government have meant that, collectively, trusts in England reported a total deficit of £822 million in 2014-15. That is simply unsustainable. A recent survey by the King’s Fund found that 90% of trust financial directors and 85% of commissioners are concerned about the financial state of their local health economies, and that view will be shared by many Members on both sides of the House. An investigation by Pulse revealed that clinical commissioning groups were being forced to use their 2015-16 winter pressures allocations just to maintain regular services.

Questions must also be asked about this week’s revelations that thousands of foreign nurses working in our NHS could be forced to leave the country as a result of the Government’s immigration rules. The RCN points out that this would cause chaos for the NHS and waste tens of millions of pounds—the Secretary of State laughs as I mention that. It would make matters much worse for patients and for front-line clinicians. Will the Minister tell us how many nurses will be lost from A&E and how many will be lost in total as a result of this move? Where in the country will they be lost? How will the vacancies be filled? What will this cost? Has he or any Minister in his Department made representations to the Prime Minister about the effects of this policy? If so, will he share those with the House? When did Health Ministers know that this policy might cause so much damage?

NHS Success Regime

Simon Burns Excerpts

Thursday 4th June 2015 Commons Chamber

[Ben Gummer]

I heard the right hon. Gentleman’s comments during the debate on the Queen’s Speech, and I know that he has taken a keen and detailed interest in the problems in his local health economy. I know also that he has been very careful and keen to include local commissioners and those who understand what is happening on the ground. That is why I had hoped he would be pleased about the introduction of the success regime, which will build on the financial consultations and discussions that have been going on, will involve local commissioners and, importantly, will provide the back-up of national regulators and NHS England. I did not hear the comments of Simon Stevens on local radio but I did read his speech, in which he made the opposite point to the one that the right hon. Gentleman suggested. The reforms that were brought in, far from being as the right hon. Gentleman characterised them, have saved £1.5 billion in this year, in addition to the £5 billion previously—money that is being invested in care in his constituency.

[Mr Simon Burns (Chelmsford) (Con)]

I am grateful to the Minister for the statement. How will my constituents in mid-Essex and the local health economy in mid-Essex see the results of what is going to be done under this regime? Can he assure me that it will examine the funding formula for health care per head of the population in mid-Essex, which has historically been skewed away from mid-Essex towards other parts of the country?

[Ben Gummer]

My right hon. Friend will be aware of the hospitals in Essex that have been placed in special measures. He will also be aware that focusing on one or several particular institutions is not sufficient to sort out the problems in the wider local health economy. That is why the success regime is being brought in—to try and deal with those systemic issues. Once the success regime has been concluded, I hope that his constituents will rapidly see an improvement in the service that they receive and that they deserve, wherever they are in the county.

On his second point about funding per head, he will know that NHS England has already started to look at that and, in some instances, address it. I have the same problem in my constituency in Suffolk, and it needs sorting out in the medium term across the country.