Oral Answers to Questions
Simon Burns Excerpts(10 years, 10 months ago)
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Mr Hunt
Because there is sustained pressure throughout the NHS. Across the NHS, hospitals and ambulance services are doing very well in the circumstances. I am happy to look at the hon. Gentleman’s specific concerns to make sure that his local NHS trust is doing everything it should.
Mr Simon Burns (Chelmsford) (Con)
Is the Secretary of State aware that every fast food outlet in the United States displays the number of calories for each portion of food that it sells? Given that some fast food restaurants in this country, such as McDonald’s, already do that, does he believe that more should be done to make all fast food outlets in this country display the number of calories so that people are educated before they make a choice about what they are going to purchase?
Jane Ellison
My right hon. Friend is quite right to say that that is a real priority. The responsibility deal, on which we have worked with our partners, means that 70% of fast food and takeaway meals sold on the high street in the UK have clearly labelled calories, but there is always more to do. This is a priority for the responsibility deal and we are working closely with our industry partners to make more progress.
Hospices (Children and Young People)
Simon Burns Excerpts(10 years, 11 months ago)
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Mr Simon Burns (Chelmsford) (Con)
I congratulate my hon. Friend the Member for Pudsey (Stuart Andrew) on securing this important debate. It was refreshing to listen to such a fluent and interesting speech by someone who has done so much work in the hospice movement before entering this House three and a half years ago.
As many hon. Members have said, and others will know from constituency experience, the hospice movement is fantastic. The dedication of those who work in it, whether providing the care or, equally importantly, raising the finances in their community, is vital. We cannot thank them enough for their dedication and hard work.
We have concentrated in the debate, as people often do when talking about the hospice movement, on children’s and adult hospices, which are vital. However, there is an area in between that is all too often overlooked: the need for more palliative care, and hospice care and treatment, for young people aged between 18 and 40. The needs of someone in their late teens or 20s are completely different from the needs of children, or of aged adults, who make up a large proportion of the people cared for in adult hospices. Things have been improving in recent years, with greater recognition of the situation, but I do not think enough account was taken in the past of the age group in question.
I will be honest: 10 years ago it would never have occurred to me that there was a problem. I assumed that someone who was not a child would go to an adult hospice, where the care would be wonderful—as it is—and that would meet the needs of even a young adult. However, when I met my constituent Denise Whiffin, and the friends around her, it was brought home to me how much extra attention and concentration is needed to meet the special requirements of that age group. Denise Whiffin’s son Jonathan was diagnosed, aged three, with Duchenne muscular dystrophy. Of course he was cared for through the children’s hospice movement. However, when he was in his late teens that was of course no longer the most appropriate form of care. He moved to an adult hospice, with people who were much older, and whose needs, outlook, attitudes and requirements were totally different.
Denise Whiffin and others in my constituency looked around and came across a role model. I believe that it was the first hospice to be created in this country—in Oxfordshire—specifically for those aged 18 to 40. The group was inspired to try to replicate that in Chelmsford, to provide the same sort of help for mid-Essex. Those involved have done sterling work in the past decade, raising money from scratch. For some years they have been able to provide a wide range of badly needed services for young adults, in the patient’s home setting. Those things include specialist advice and support; unique care packages for each patient, drawn up by the clinical nurse specialist; expert advice on transition from children’s to adult services; practical nursing care; respite care in the home; counselling—which is vital for many families and young people; and a chaplaincy service and music therapy. They have expanded because of demand for specialist care for the age group, and their hope and ambition now is that in due time they will acquire premises in which to provide health care and palliative care.
Sarah Champion
My colleague has hit the nail on the head, and his example of a hospice is exemplary. However, aside from the social aspect, one of the most shocking things for a child is that on their 18th birthday the support of the paediatric consultant who has been with them all the way through is taken away. They are given an adult consultant who might not be able to see them for three or four months.
Mr Burns
The hon. Lady makes a valid and important point, which comes as no surprise, given her distinguished professional work before coming to this House after the Rotherham by-election. It is about continuity of care. Just because someone reaches a cut-off point in their age and lifespan, they should not necessarily—automatically—have to change from those who have been providing their health care up until that point. The individual’s needs and requirements might progress or change so that their consultant or other health care practitioner needs to change because of the skills that they have, but that is a totally different argument. I hope that my hon. Friend the Minister and the Department of Health as a whole will look at the matter to see how we can provide greater continuity of care from health care professionals where that is appropriate, so that there is not an arbitrary cut-off point.
I do not want to detain hon. Members much longer, because I know that others want to contribute, but I do think that we must bear this in mind. Fantastic work is going on, as has been shown by a number of interventions and speeches during the debate, in children’s hospices and, equally, in adult hospice care, but let us concentrate more on developing for the young people in the 18-to-40 age group provision that meets their specialist requirements, so that they, too, can have provision and quality of care that is tailored to their requirements and demands.
Mark Durkan (Foyle) (SDLP)
On the point about supporting people in the age group to which the right hon. Gentleman refers, does he agree that it is important for Government at all levels to encourage not just the hospice movement, but housing associations and good providers of sheltered housing models and supported housing models to think about how they might style particular developments and units precisely to accommodate people in that age group, so that they can live in a supported context but have premises that guarantee them more independent living, which is more appropriate to that age group?
Mr Burns
I am very grateful to the hon. Gentleman, too, for that constructive intervention. I know that, particularly in health debates, the term “holistic approach” is for ever used and can become rather hackneyed, but I do think that such an approach is crucial both in general health care in the NHS and in specialist areas such as palliative care, hospice care and end-of-life care. There really must be an holistic approach, and this is not simply about different sections of the health care community. As the hon. Gentleman says, it also involves housing and, as the hon. Member for Rotherham (Sarah Champion) said, the benefits system, where that is appropriate, for a number of people, because it is at this time in someone’s life and the life of their family and friends that they want the minimum amount of hassle, as they are going through some of the most difficult parts of their lives or their loved ones are. We want to minimise the extra pressures, concerns and worries, and that can be done through a more joined-up, holistic approach to the whole provision of care.
I know that the Minister will be listening very carefully to the comments made in the debate. I know that the Department of Health is extremely committed to the whole area of palliative care, end-of-life care and the hospice movement. I know that my hon. Friend will go away from the debate, reflect on a number of the points that have been made and do her best to help to address a number of the issues that I and other hon. Members around the Chamber have raised in the course of the debate.
G8 Summit on Dementia
Simon Burns Excerpts(10 years, 12 months ago)
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Tracey Crouch (Chatham and Aylesford) (Con)
I beg to move,
That this House has considered the G8 summit on dementia.
It is a pleasure to see you in the Chair, Madam Deputy Speaker; this is the first opportunity I have had to give you my warm congratulations on your election.
I am incredibly grateful for the support of the right hon. Members for Salford and Eccles (Hazel Blears) and for Sutton and Cheam (Paul Burstow), and others, for helping to secure this debate. I thank the Backbench Business Committee for allowing Members time to contribute—albeit briefly—to a debate on what many believe is one of the most important issues facing our health and social care system in the future. I shall keep my opening comments as brief as possible, as I know that others wish to speak, but it is important to congratulate the Prime Minister on using the opportunity of hosting the G8 summit on 11 December to focus on international efforts to prevent, delay and effectively treat dementia. The debate will allow parliamentarians an opportunity to shape discussions at the summit, following on from wider and commendable consultation with the public. Collaboration, which is at the heart of the conference, is the basis of my contribution to the debate.
Before addressing the specifics, it is important to set out the global perspective. Dementia affects more than 35 million people worldwide and is now considered to be one of the greatest global health challenges of our time. It is estimated that, by 2050, more than 150 million people will suffer from dementia.
Hon. Members will have seen the devastating human cost of dementia if not in their families, then in their constituencies. We know of the suffering of those with the condition and those who become carers for their loved ones. However, we perhaps do not so obviously see the huge economic effects of dementia, the worldwide cost of which is estimated to be about £400 billion, which is the equivalent of 1% of world gross domestic product. Without urgent action, that figure will increase in line with the number of people who are anticipated to get dementia, which is why global collaboration is essential. The more we can do together globally, the better the outcomes we can secure nationally.
Mr Simon Burns (Chelmsford) (Con)
My hon. Friend makes an extremely important point. Does she accept, however, that it is equally important to do more on seeking diagnoses? About 350,000 people in this country are undiagnosed and go without the help and support that those who have been diagnosed receive.
Tracey Crouch
I agree entirely with my hon. Friend. The all-party group on dementia recently produced a report on diagnosis. Shockingly, only about 42% of people get diagnosed, which leaves a massive diagnosis gap. The earlier people are diagnosed, the better their treatment and pathways.
Oral Answers to Questions
Simon Burns Excerpts(10 years, 12 months ago)
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Norman Lamb
That sort of experience is not acceptable and has to be addressed, and I am sure the hon. Lady will welcome the encouraging news that the sanctions in the national contracts that clinical commissioning groups enter into with hospitals have resulted in a 38% reduction in delays, comparing the first two weeks of last November with the first two weeks of this November, which is the first period during which we measure winter pressures on handovers. That sign of a significant increase is to be welcomed.
Mr Simon Burns (Chelmsford) (Con)
As an east of England MP, the Minister will be aware of the problems with the East of England ambulance service and handover times at Broomfield hospital. While I warmly welcome the initiative, through the contract, to bring pressure to bear to reduce handover times to 15 minutes, will he join me in paying tribute to the new management of the ambulance service for what it is doing, through its assessments and monitoring, to deal with this problem?
Norman Lamb
I have had a similar experience at the Norfolk and Norwich hospital. It is clear that the number of delays in the east of England has reduced substantially, and I pay tribute to everyone involved. Getting urgent care right requires collaboration between ambulance trusts, acute care and GPs and social care workers on the ground. Significant improvements have been made in the east of England, as well as across the rest of the country.
Pre-Paid Meters (Level of Debt)
Simon Burns Excerpts(12 years, 2 months ago)
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Chris Bryant (Rhondda) (Lab)
On a point of order, Mr Speaker—you do not have to smile.
In 1624, as I am sure you are aware, the House decided that no Member could resign their seat. In 1680, we decided that we would invent the legal fiction that a Member appointed to an office of profit under the Crown is deemed to have resigned their seat. At the beginning of August this year, Mrs Louise Mensch— I make no criticism of her whatever—believed she had resigned her seat, but was not appointed to an office of profit under the Crown for a further three and a half weeks. Consequently, she described herself as a “resigned MP”, but was none the less a Member of Parliament, because a Member has not resigned their seat until the Chancellor appoints them to the office.
I raise this matter as a point of order because there is an important matter of precedent here. I am not aware of any time in the past when there has been such a delay, other than in 1842 when the Government refused for party political purposes to appoint a Member so as not to allow a by-election.
Chris Bryant
Will you, Mr Speaker, therefore reinforce to the Chancellor that it is important to appoint a Member the moment they seek to resign their seat through such an appointment?
Oral Answers to Questions
Simon Burns Excerpts(12 years, 4 months ago)
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Andy Burnham (Leigh) (Lab)
I shall give the Secretary of State one last chance on rationing.
Andy Burnham
The right hon. Gentleman needs to listen carefully to what I am about to say. Yesterday, he promised action to stop the restricting of cataract operations for financial reasons, if given evidence. How about this example? NHS Sussex has imposed severe restrictions that contradict the Department’s own guidance, “Action on Cataracts”, and this has seen the number of operations in Sussex fall from 5,646 in 2010 to 4,215 in 2011. Does the Secretary of State consider that fair to older people, and will he now take the action his Department has promised?
Tom Greatrex (Rutherglen and Hamilton West) (Lab/Co-op)
5. What assessment he has made of the availability of insulin pumps for young diabetics.
The Minister of State, Department of Health (Mr Simon Burns)
We are currently undertaking a national audit to give us a clear picture of provision of pump services in England. This will be published shortly. The rapid response survey for 2010-11 suggests that half of all those eligible for a pump in England already have one, or have funding agreed—a significant improvement on the initial survey in 2010.
Tom Greatrex
I thank the Minister for that reply. I am sure he will be aware that Nicola Sturgeon, the Health Minister in the devolved Administration at Edinburgh, announced earlier this year that all the under-18s requiring an insulin pump would get one. My constituent 13-year-old Fiona Clark has been told by Yorkhill hospital in Glasgow that she will have to wait an unspecified time to receive the pump her doctors say she needs. Given that the National Institute for Health and Clinical Excellence estimates the standard benchmark rate for the uptake of insulin pump therapy for type 1 diabetes in England is 12.4%, will the Minister offer his Department’s assistance to help those in Scotland to get above the current paltry 3.1% uptake?
Mr Burns
I am extremely grateful to the hon. Gentleman, but as he will appreciate as a Scottish Member of Parliament, this is a devolved responsibility for the Scottish Government. On the specific issue—[Interruption.] If the right hon. Member for Leigh (Andy Burnham) would shut up, it would be helpful. It would probably be useful if the hon. Gentleman raised the specific issue with the Scottish Government, but on the general principle let me say that we are determined, certainly in England, to do all we can through education, the workings of the NHS and the operating framework to ensure that the number of people receiving pumps increases, as it already has in the last two years.
Diana Johnson (Kingston upon Hull North) (Lab)
6. How many children received milk through the nursery milk scheme in each of the last three years.
Paul Goggins (Wythenshawe and Sale East) (Lab)
8. How many patients attended the accident and emergency department at Wythenshawe hospital in the last 12 months for which figures are available.
The Minister of State, Department of Health (Mr Simon Burns)
The Department does not collect data on accident and emergency attendances at hospital level. These data are only available at trust level. In the 12 months up to 8 July 2012, there were 108,393 accident and emergency attendances at University Hospital of South Manchester NHS Foundation Trust.
Paul Goggins
I am grateful to the Minister for that reply, and I am sure he will want to join me in thanking the staff at Wythenshawe A and E department, particularly given that that colossal number of 108,000 attendances has taken place in a unit originally designed for 70,000 patients. However, if the A and E department at Trafford general hospital is closed, as is currently proposed, that would lead to a still greater increase in the number of patients at Wythenshawe A and E. Given that, is it not essential that the £11.5 million that will be required for extra facilities at Wythenshawe should be made available?
Mr Burns
I hope the right hon. Gentleman is not disappointed, but I cannot add anything to the answer I gave in the debate we had last week when he asked that specific question. I can assure him, however, that local commissioners have assessed the impact of the proposed changes at the Trafford and other hospitals, including Wythenshawe. The plans are still at an early stage and are yet to go to public consultation, and I have been informed that local commissioners will continue to review the impact of these changes on the other hospitals, including Wythenshawe. I urge the right hon. Gentleman, other Members whose constituencies are in the area and their constituents to contribute fully to the consultation process.
Kate Green (Stretford and Urmston) (Lab)
The Minister knows that the proposal is, first, to reduce services at the Trafford to urgent care provision and then, within not less than two to three years, to a minor injuries unit. What processes will be put in place to ensure that the most stringent criteria are applied in respect of investment in Wythenshawe and the other hospitals, as well as in Trafford community services and improved services to patients, before any such further move is contemplated?
Mr Burns
As the hon. Lady will be aware from the debate we had last week, these proposals are subject to the consultation process and to consideration of the results. Commissioners fully recognise the need to minimise the impact the changes will have on neighbouring A and E departments and other services. The Trafford and South Manchester clinical commissioning groups are working on developing further integrated care services, and on developing community care services as an alternative to hospital care, as well as on ensuring that the final decisions meet the needs of the local health economy by providing first-class quality care for the people of that area.
Mr Jamie Reed (Copeland) (Lab)
Of course, it is not just Wythenshawe A and E that is facing difficulties. All Members throughout the House are grateful for the work our medical professionals do in extremely trying circumstances, but the truth is that the Government’s chaotic reorganisation has resulted in longer waits in accident and emergency. The Minister of State said last night that A and E departments were meeting the target, but figures published by his Department last week show that the Government have failed to meet the 95% target across major type 1 A and E units. If he cannot get his own figures right, he cannot expect to command the trust of patients or medical professionals. Will he now take this opportunity to show some respect for this House, for the public and for patients in general, and correct the record?
Mr Burns
I am most grateful.
Of course, the hon. Gentleman is playing with the figures. As he knows from previous discussions, he is talking about the SITREP—situation report—figures, which do not form the basis of the figures the Government use. [Interruption.] If he will keep quiet for a minute and listen, I will reiterate the point I made last night. Regarding A and E waits of under four hours and the percentile of 95, we are at 96%, which means we are within and above the level set down by the Government’s figures.
David Mowat (Warrington South) (Con)
11. What plans he has to review the health allocation formula.
Mr Virendra Sharma (Ealing, Southall) (Lab)
13. What recent representations he has received on the reconfiguration of children's heart services.
The Minister of State, Department of Health (Mr Simon Burns)
I have received representations about the review of children’s heart services via letters, parliamentary questions and e-mails from hon. Members, via letters and e-mails from organisations and the public, and via meetings. My right hon. Friend the Secretary of State has received two overview scrutiny committee referrals, one from the Yorkshire and Humber joint health and overview scrutiny committee and one from the royal borough of Kensington and Chelsea.
Stuart Andrew (Pudsey) (Con)
My right hon. Friend will be aware of the concerns in Yorkshire about the review. Can he confirm to us, for the sake of absolute clarity, with whom this decision will lie finally?
Mr Burns
I am very grateful to my hon. Friend; this is the hors d’oeuvre before the main meal later today. Ultimately, if any overview and scrutiny committees of relevant local authorities do not agree with the final decisions, they have a right to write to my right hon. Friend the Secretary of State asking him to refer the matter, with their concerns, to the Independent Reconfiguration Panel. If it is asked to look into the matter, it will then come to a conclusion, of which it will inform my right hon. Friend and he will then take a decision.
Greg Mulholland (Leeds North West) (LD)
The Scottish Government have decided that although the Yorkhill unit is currently unsafe, it can be made safe in the context of three surgeons doing 300 operations, whereas the “Safe and Sustainable” review, which is increasingly discredited, is demanding 400 to 500 operations. Why is it one rule for children in Scotland and another for children in Yorkshire?
Mr Burns
I have to tell the hon. Gentleman that the decisions that the Scottish Government and the Scottish Health Department might take with regard to Glasgow is a matter for them. The fact is that we recognise what is commonly accepted among the international community: that the safest way of providing that surgery is by carrying out about 400 operations a year.
Stephen Phillips (Sleaford and North Hykeham) (Con)
14. What steps his Department is taking to ensure that confidentiality agreements do not discourage NHS whistleblowers from coming forward.
Tom Brake (Carshalton and Wallington) (LD)
T9. The clinician-led “Better Services Better Value” review has condemned the accident and emergency unit, and the maternity and children’s wards at St Helier hospital, because it expects out-of-hospital services to be expanded instead. Will the Secretary of State meet me to discuss local concerns that the £5 million allocated to provide the out-of-hospital services will be totally inadequate to the task?
The Minister of State, Department of Health (Mr Simon Burns)
I am grateful to the right hon. Gentleman for that question. As he knows, any proposals for service changes will be subject to the Secretary of State’s four tests and a full three-month public consultation across south-west London, which I am sure the right hon. Gentleman and his constituents will take part in. My right hon. Friend the Secretary of State will be more than happy to meet him to discuss the matter further.
Mrs Mary Glindon (North Tyneside) (Lab)
T8. In the north-east region, there is one neuromuscular care adviser providing dedicated specialist care and support for more than 3,000 people with muscular dystrophy and associated conditions. Will the Minister give assurances that care advisers will continue to be funded and commissioned at specialist NHS Commissioning Board level so that they can carry on supporting community teams across the country?
Mary Macleod (Brentford and Isleworth) (Con)
T10. I commend the Government for their plans to improve the care and support system, especially for an ageing population. How will the changes make a real difference to carers, particularly those supporting people with Alzheimer’s and dementia? Is there more we can do to support them?
Clive Efford (Eltham) (Lab)
The chair of the South London Healthcare NHS Trust has written to the Secretary of State to correct inaccurate information given out by the Department of Health regarding the trust’s performance. [Interruption.] Instead of barracking me, would the Secretary of State—[Interruption.] Instead of shouting at me now, it is a shame that the Secretary of State did not meet the local MPs when he had the opportunity. Will he distance himself from the false information put out by unattributable sources in his Department, which will undermine the performance of the hospital and shows little respect for the health service workers who are working to improve services?
Mr Speaker
Order. There is, frankly, too much noise on both sides of the House. It does not suit the Minister now for the hon. Member for Eltham (Clive Efford) to shout from a sedentary position, and I absolutely understand, similarly, that it does not suit Opposition Members when the right hon. Gentleman and his colleagues chunter from a sedentary position. Let us have a truce, and the right hon. Gentleman can be a statesman—we look forward to it.
Mr Burns
As ever. I do not share the hon. Gentleman’s analysis of the interpretation of what has happened with regard to the trust’s performance. There has been an historic problem with its performance, but I pay tribute to the staff, who have made tremendous efforts to improve performance, and have achieved some improvement. The trouble is that it is not sustainable not to put the trust on a sustainable financial footing. The hon. Gentleman said that he would like a meeting with me or my right hon. Friend the Secretary of State. [Interruption.] As he will know, if he keeps quiet for a minute, I have written to him offering a meeting with my right hon. Friend, on 24 July; I hope that the hon. Gentleman can attend.
Zac Goldsmith (Richmond Park) (Con)
Cases of blood poisoning from E. coli have increased by nearly 400% in the past 20 years, and E. coli resistance to antibiotics is almost certainly linked to record levels of antibiotic usage on factory farms. By over-using antibiotics we risk ruining for future generations one of the great discoveries of our species. Will the Department put pressure on the Department for Environment, Food and Rural Affairs finally to take that issue seriously?
Dr Julian Lewis (New Forest East) (Con)
Ministers may recall the concern of patients and carers in the New Forest area about the decision to close a third of acute adult mental health beds in Hampshire. Are Ministers aware of a similar trend in other parts of the country, and if they are, as they should be, what do they think about it?
Mr Burns
My hon. Friend has raised that issue in different forms on many occasions, and feels strongly about it. The decision to reconfigure services in his constituency was made locally, and the Hampshire overview and scrutiny committee decided not to write to my right hon. Friend the Secretary of State asking him to refer it to the Independent Reconfiguration Panel, because it presumably believes that it is the right way forward to continue to provide first-class quality care for patients.
John Woodcock (Barrow and Furness) (Lab/Co-op)
Does the Secretary of State agree that commissioners in Cumbria must bear their share of responsibility for the deep-seated problems in the Morecambe Bay health trust, which have taken far too long to address. Will he join me in urging those commissioners to protect services such as Barrow’s maternity unit in their forthcoming review?
Health
Simon Burns Excerpts(12 years, 4 months ago)
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Jason McCartney (Colne Valley) (Con)
I, too, rise to speak about the Safe and Sustainable review of children’s heart surgery. The joint committee of primary care trusts—the decision-making body comprising local commissioners—was tasked with considering the pattern of children’s heart surgery services. On 4 July, it announced its decisions, which included the news that Leeds general infirmary will not provide children’s heart surgery in future.
The two-hour radius around the Leeds heart surgery unit reaches 14.5 million people. Including check-up appointments, the unit sees 10,000 children annually and performs about 350 operations.
I acknowledge that the decision was independent of the Government. Local council overview and scrutiny committees are free to refer decisions to the Secretary of State, via the independent panel. I heard this morning that our OSC has just done so; I welcome that move. Our Yorkshire body was due to meet on 24 July. Now that the committee has referred the decision to the Health Secretary, I hope he will revisit it based on the four tests stipulated for the redesign of services.
The Minister of State, Department of Health (Mr Simon Burns)
If my hon. Friend is correct—and I am sure he is—in saying that his local authority OSC has referred the matter to my right hon. Friend the Secretary of State, the process is that the OSC explains why it does not agree with the decision and asks my right hon. Friend to refer it to the independent reconfiguration panel for consideration. The panel will then respond to my right hon. Friend and state whether it thinks the decision is right or wrong.
Jason McCartney
I thank the Minister. I said earlier that the decision would go to the Secretary of State via the independent panel. I look forward to its going through that process.
The first test for redesigning services is that there should be clear clinical benefit. The health impact assessment was that option G—to keep Leeds open—had fewer negative impacts than the chosen option. The second test is clinician support. There is no evidence that the decision has the support of clinicians; in fact, most have given their support to the Leeds unit.
The third test involves the views of the public. Surely nothing can be clearer than the views of the 600,000 people who signed the petition to keep the Leeds unit open, and the admirable cross-party support for the campaign. The fourth and final test is that there should be support for patient choice. A survey in west and south Yorkshire clearly shows that patients would not travel up to Newcastle.
Many constituents with experience of the Leeds unit have been in touch since the announcement on 4 July.
Stuart Andrew (Pudsey) (Con)
I am grateful for the opportunity to speak in this debate, Mr Deputy Speaker. May I offer you my congratulations on the honorary degree that you received yesterday from Swansea university?
I recognise that I may repeat many of the things that have been said, but this is such an important issue for constituents in Yorkshire and Lincolnshire that I make no apology for doing so. I am going to talk about the Safe and Sustainable review as well. We have received a number of e-mails from charities yesterday, one of which said:
“As some MPs look to reignite”
the debate about changes to children’s heart units
“we urge MPs to think about the children.”
Frankly, I found that rather offensive, because throughout the whole campaign I have only ever thought about the children.
When I worked at Martin House children’s hospice, I saw the effect on families when they were driven apart because the poorly child had to be a long distance away. On my visit a week or so ago to the unit in Leeds, I met a family who live in Sheffield. They brought their baby who was a few days old into the unit when the baby suddenly went very blue. Thankfully, because of the excellent work at the unit, that baby’s life was saved. That child was described as “marginal” in the review meeting on 4 July. That is not my description, but that of the decision makers. That is a shocking statement in my opinion. I also met another family who live in Sheffield. The father is making three trips a day between Leeds and Sheffield because there are other siblings at home. How on earth are such people expected to travel three times a day up to Newcastle?
I recognise that the review has been independent of Government, but I have grave concerns over the way in which it has been run. I support a review, because I want the best services for our children. I was grateful for the Minister’s comments earlier, when he said that the call-in process means that the matter will go to an independent panel. I would be grateful for clarification of whether that panel is independent of the JCPCT.
Mr Simon Burns
May I reassure my hon. Friend that the Independent Reconfiguration Panel is nothing to do with the JCPCT, my right hon. Friend the Secretary of State or me? It is an independent organisation that is there to look at reconfigurations across the country that are referred to it by my right hon. Friend following an oversight and scrutiny committee writing to him.
Stuart Andrew
I am extremely grateful to my right hon. Friend for that clarification. I hope that the independent review body will look at the issues that I raise.
Logical health planning clearly dictates that services should be based on where the population live. Doctors should travel to where the patients are, rather than the other way around. Even the British Congenital Cardiac Association has said that:
“Where possible, the location of units providing paediatric cardiac surgery should reflect the distribution of the population to minimise disruption and strain on families.”
After all, it is not buildings that perform operations, but the doctors and surgeons within them. That definition seemed okay in the case of Birmingham. The review stated:
“The Birmingham centre should remain in all options due to the high level of referrals from the large population in its immediate catchment area.”
Why on earth does the argument about the large immediate population not apply equally to Leeds?
The independent analysis of patient flows states that many of the people in west and south Yorkshire and in Lincolnshire will probably go to Birmingham, Liverpool or even London instead. The JCPCT reaches the figure of 403 surgical procedures for Newcastle on the basis of only 25% of the patients going there. Even that is doubtful. How was the figure of 25% arrived at?
The Minister of State, Department of Health (Mr Simon Burns)
This has been an interesting and diverse debate, giving hon. Members an opportunity to raise a range of different subjects affecting their local communities and the health and well-being of their constituents. If there has been a main theme, it has been the Safe and Sustainable review of paediatric heart surgery. I fully recognise the strength of feeling and emotion on that difficult and sensitive subject, which is why so many Members have talked about it. They have included the hon. Member for Leeds North West (Greg Mulholland); the hon. Member for Hammersmith (Mr Slaughter), who mentioned the Brompton hospital in London, which is part and parcel of that review; the hon. Member for Leicester South (Jonathan Ashworth), who took interventions from the hon. Member for Leicester West (Liz Kendall); and my hon. Friends the Members for Pudsey (Stuart Andrew), for Colne Valley (Jason McCartney) and for Loughborough (Nicky Morgan).
I fully accept that the reorganisation of children’s cardiac services is a matter of real concern for the families involved, as indicated by the strength of feeling shown in the contributions of all the Members who have taken part in the debate. I know that some families have been disappointed by the outcome of the JCPCT’s recent decision. As hon. Members will know, children’s heart surgery has been a subject of concern for more than 15 years. Clinical experts and national parents groups have repeatedly called for change, and there is an overwhelming feeling that change is long overdue.
As passionately as people want to defend their local hospitals, it is far more important to ensure safety and quality of care for all children with congenital heart disease. We must ensure that those children continue to receive the very best care that the NHS can deliver, and I know that no Member would disagree with that overarching principle. That was what the NHS Safe and Sustainable review was aimed at, and as I have told many Members over the past 22 months, it was wholly independent of Government.
The review was led by clinicians and had the support of the Royal Colleges and national charities. Its conclusions were clear: for children with congenital heart disease to receive the very best care, specialist surgical expertise needs to be concentrated in a smaller number of centres. That will mean that surgeons have sufficient clinical work to maintain and develop their skills; that they can provide those services around the clock; and that they can train and develop the next generation of surgeons. I must stress that the JCPCT’s decision is not about closing or cutting back on children’s heart services—quite the opposite. It is about ensuring that the whole range of children’s heart services can deliver the very best care now and in future.
I thank in passing my hon. Friend the Member for Loughborough and the hon. Member for Leicester South for meeting me earlier this afternoon to discuss the important issue of ECMO and how it directly affects Glenfield hospital in Leicester.
Keith Vaz (Leicester East) (Lab)
I am afraid other duties in the House prevented me from being at the meeting. Had I been there, I would have supported what the hon. Member for Loughborough (Nicky Morgan) and my hon. Friend the Member for Leicester South (Jonathan Ashworth) said.
Mr Burns
I am extremely grateful to the right hon. Gentleman. Not only am I sure he would agree with every word that my hon. Friend the Member for Loughborough and the hon. Member for Leicester South said, but I have considerable sympathy with him, as he was unable to attend the meeting owing to other pressing parliamentary duties in his role as Chair of the Select Committee on Home Affairs. To be even fairer to the right hon. Gentleman, the meeting was originally planned for 3 pm or 3.15 pm, but unfortunately, neither my hon. Friend, the hon. Gentleman nor I would have been able to attend because we were at that moment in the Chamber.
I understand from the nature of our discussions, as they will, that this is a difficult issue, because there are a number of complicated parts to the problem. I hear what they and other hon. Members have said about the Safe and Sustainable review, but I stick to my original position. The review is independent and is carried out not by the Government, but by the JCPCT. It would be inappropriate for me to become directly involved, to take sides or to pass comment because it would be felt that I was interfering. If hon. Members’ local authorities disagree with the decisions or recommendations of the JCPCT, their overview and scrutiny committees can write to my right hon. Friend the Secretary of State for Health to express their disagreement with the decision as it affects their local community or local hospital, and to request that the matter be referred to the independent reconfiguration panel, so that it can consider it independently and come up with a decision.
As my hon. Friend the Member for Colne Valley said, his local authority has today done just that. It may be helpful to him if I explain the procedure. My right hon. Friend the Secretary of State receives the representations and communication from the local authority overview and scrutiny committee specifying that it believes that the decision and recommendation as they affect the local hospital—Leeds, in my hon. Friend’s case—are wrong. The overview and scrutiny committee then asks my right hon. Friend whether he will refer the matter to the independent reconfiguration panel. I do not want to prejudge, but it is almost certain that my right hon. Friend will refer the matter. It will be then be up to the IRP, which is independent, to look at the recommendation and the criticisms made by the overview and scrutiny committee, and to reach a conclusion, which will be an independent conclusion, on whether it agrees with the recommendation or the criticisms of it and perhaps of the procedures involved. The IRP will then make my right hon. Friend aware of its independent view of the complaint.
Jason McCartney
Will the Minister clarify the time scale of the procedure he has described and also tell us who has the final say?
Mr Burns
It is difficult to give a time scale for this reason: as soon as my right hon. Friend receives representations from the overview and scrutiny committee, he will consider as quickly as he can whether to make a referral. As I have said, in the life of the IRP, every request for a referral has been granted—that is certainly true of my right hon. Friend’s time in office, but I believe it is also true of previous Secretaries of State under the previous Government. It is up to the IRP. I know of one example of my right hon. Friend requesting that the IRP respond within a certain time frame, but that was on a single issue. It is possible, with regard to the Safe and Sustainable review, that a number of referrals could be made by different OSCs in relation to the recommendations—I do not know but it is a possibility.
Stuart Andrew
Will the independent panel have the power to request all the documentation that the Safe and Sustainable review and the JCPCT have been looking at? Will everything be released so that it can look at the evidence in detail?
Mr Burns
I think I can assure my hon. Friend that the IRP will have available to it all the evidence, in all shapes and forms, to help it to form its final opinion of the complaint referred to it. I hope that that reassures him. I say to my hon. Friend the Member for Loughborough and the hon. Member for Leicester South that the same can apply with regard to the decision about ECMO. I have no doubt that Leicester city council will give consideration to that.
I shall briefly respond to the remaining issues. My hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) made several extremely interesting suggestions. Some of them might not be in line with current Government thinking, but I shall certainly refer her ideas and views to the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton), who deals with our alcohol strategy. Similarly, my hon. Friend the Member for South West Bedfordshire (Andrew Selous) raised an important issue, and again I will refer it to the Under-Secretary of State.
The hon. Member for Mitcham and Morden (Siobhain McDonagh) mentioned the potential reconfiguration at St Helier hospital. As she will know, the proposals are still being worked on. There has not yet been a consultation process, but the decisions have been taken locally by the local NHS. I trust that, if and when there is a consultation process, she will get involved.
Mr Burns
I thought she would say that. That is very good. After the consultation, the due processes of reconfiguration can move forward.
My hon. Friend the Member for Hendon (Dr Offord) asked about Avastin. A study is being done into its effects. We are following that closely, and when we find out more we will consider the matter and potentially reach a judgment, but I cannot give him any commitments at the moment.
Finally, I turn to my constituency neighbour, my hon. Friend the Member for Witham (Priti Patel). I am sorry to hear about the problems that she highlighted on behalf of her constituents. I do not want to disappoint her, because she is my neighbour and I have to live with her on a weekly basis, but given the background to the case, I think it is a matter for the GP practice as the employer of the GP whom she mentioned. I encourage her to engage with Mid Essex PCT, even though it has no direct powers or role in this matter, and the clinical commissioning group in the mid-Essex area, because they are best placed to address the concerns about the provision of services for her constituents, which I know she is fearless in defending, protecting and promoting.
NHS (Rationing of Care)
Simon Burns Excerpts(12 years, 4 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Minister of State, Department of Health (Mr Simon Burns)
I congratulate the hon. Member for North Tyneside (Mrs Glindon) on securing this debate and the shadow Minister, the hon. Member for Copeland (Mr Reed), for more or less keeping a straight face during the course of it.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
Will the Minister give way?
Mr Burns
No, I will not; I am going to make some progress. This is not the hon. Lady’s debate and I have only just started.
If the hon. Member for North Tyneside or any other member of her party or of the public brought forth genuine evidence of cost-based rationing—blanket bans on treatment—this Government would act decisively to stamp it out, but the fact is that so far we have been brought no such convincing evidence of that.
The core principle underpinning the NHS is that it is a comprehensive health service, available to all, free at the point of use and based on need and not ability to pay. That principle is enshrined in the NHS constitution and reaffirmed in the Health and Social Care Act 2012.
Mrs Glindon
Does the Minister therefore disagree with all that has been said by the BMA and other professionals about their concerns about the rationing that is taking place? Does he doubt them? Does he think that the thousands of people who have contacted Labour’s health check are not telling the truth?
Mr Burns
It is not a question of not telling the truth. If the hon. Lady waits, I will deal with the NHS health check that she has mentioned. I am not sure whether she was here for the earlier debate, so she might not have heard me describe it as being as worthless as the piece of paper that Chamberlain brought back from Munich. In the course of my comments, I will outline why that is.
As I said, the core principle of the NHS is that it is a comprehensive health service, free at the point of use for all those eligible to use it. That principle remains as true and relevant today as it was when the NHS legislation was passed in 1946 and enacted in July 1948, and it will remain true in the years and decades to come for as long as the three main political parties continue to subscribe to that core belief.
Before I move on to the specific accusations of rationing that the hon. Lady makes, may I first point out that it is this Government who are protecting NHS budgets and increasing the amount of money available to the NHS by £12.5 billion over the course of this Parliament? It was the right hon. Member for Leigh (Andy Burnham) who described such a commitment as “irresponsible”—a comment that I find particularly bizarre coming from a Labour shadow Health Secretary.
May I ask what the hon. Lady’s party is doing where it is in control of the NHS? Is it increasing spending, or is it cutting it by 6.5%? The lucky escape of the NHS in England is that it has growing budgets under this Government compared with the falling budgets it would have had had her party won at the last election. If the hon. Lady, who looks a bit perturbed, does not understand what I am talking about, I can tell her that I am referring to what is happening under a Labour Government in Wales who are cutting the NHS budget—a warning to anyone living in England.
Of course the financial challenge is a difficult one. On its own, the extra £12.5 billion will not be enough to cover the growing demand for NHS services. It is vital that we get the most value—the very best health outcomes, as we like to say—out of every single penny that taxpayers spend, by cutting out waste and focusing more on prevention. It is true that the hon. Lady’s party recognised this too. When Labour was in office, it established NICE—the National Institute for Health and Clinical Excellence—to help the NHS to improve patient care within the finite resources available to it in order to ensure value for money. Through its world-class commissioning programme, it rewarded commissioners for setting priorities. Furthermore, it first recognised the scale of the £20 billion gap between funding and demand that emerged in 2009. The result was the QIPP agenda—quality, innovation, productivity and prevention—with its focus on improving patient care, increasing innovation and gaining greater accountability.
Since then, the world has changed. Thanks to the horrendous mess in which the hon. Lady’s Government left the nation’s finances, the NHS faces one of the toughest financial settlements in its history, even with its protected budget. That is one reason why the Health and Social Care Act was so vital. To get the best care for patients during a difficult financial settlement, we needed to put clinicians in control—making the connection between clinical and financial decisions, always putting patients’ interests first, and always looking for value for money.
In future, local priorities will be determined by local clinicians, not by administrative organisations that lack sufficient clinical input and are cut off from patients. Commissioning decisions will be based on a far deeper understanding of local need, with clinical commissioning groups working with health and wellbeing boards, local authorities and key community organisations to meet the needs of their local population. There will be better, more effective, more efficient care for patients.
Let me address directly the accusations of rationing. We are clear that it is completely unacceptable for commissioners to impose blanket bans on treatments. That is set out in case law and in Department of Health policy, which requires commissioners to allow exceptions in individual circumstances. We are also clear that commissioners must never restrict access to treatments on the basis of cost alone. That message was reiterated in a letter from Professor Sir Bruce Keogh, the NHS medical director, to the medical directors of strategic health authorities as recently as September 2011. He emphasised that any decision to restrict access to a treatment or intervention must be justified by a patient’s individual circumstances. By that, I mean not their financial circumstances, but their clinical circumstances and condition.
Since then, my ministerial colleagues and I have reiterated the message in our communications with the service that treatments available on the NHS are based on clinical need; that there should never be any arbitrary rationing based on cost, either locally or nationally; and that we will take action against any organisation found to be arbitrarily restricting treatment without clinical justification.
As hon. Lady said, the Labour party recently made a series of serious accusations in its NHS health check—accusations that services are being restricted or decommissioned without clinical justification. Had the hon. Lady done some rudimentary checking of her own, she would quickly have come to the same conclusion that we did: that such claims are nonsense dreamed up in Labour party headquarters.
The NHS health check claimed that there was a blanket ban by NHS Hull on the removal of wrist ganglia. We spoke with NHS Hull. There is no such ban. The health check claimed that 11 out of 100 primary care trusts or clinical commissioning groups restricted laser revision surgery for scars, but such cosmetic surgery has never been routinely available on the NHS, either in the lifetime of the coalition Government or in the 13 years of the last Labour Government. The position has not changed one iota since the Government came to power.
The NHS health check claimed that weight-loss surgery is restricted. It states:
“patients generally have to be over 18 and have a BMI over a certain level to receive weight loss surgery”.
Incredibly, people have to be overweight before they will be considered for weight loss surgery. To me, that seems perfectly logical. Why would the NHS want to treat people who were not overweight? From reading the Opposition’s NHS health check, it appears that the Opposition define rationing as a clinician denying treatment to a patient who has no clinical need for it. That is patently ridiculous. Treatments available on the NHS are based on clinical need. As I said, there should never be any arbitrary rationing based on cost, either locally or nationally. Such practices are totally unacceptable.
Julie Hilling
I have listened very carefully to the Minister, who is saying that he does not believe the reports are true. Does he feel, however, that he ought to do more investigation? The BMA’s research and other research makes these points, whereas he simply says he has spoken to one commissioning group. They say that there is no smoke without fire, and it seems to me that the Government ought to take these allegations seriously and investigate properly what is happening.
Mr Burns
Of course the Government take these allegations very seriously, which is why my officials rang NHS Hull to ask about wrist ganglia and were amazed to be told that there were no restrictions as described in the Labour party’s political leaflet. [Interruption.] If the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) will just hush for a minute, I will answer the question. I am always very pleasant to her, as she knows from experience.
I have personally made checks on two allegations about rationing, one in south-east Essex, south of my constituency, and one that I believe from memory was in Bedfordshire. My officials investigated both claims, which arose out of a meeting that I had with a clinician, and both claims were untrue. There had been a mistaken understanding of what was going on, and there was no rationing based on cost. The conditions in each trust were quite specific, and cases were determined on clinical grounds.
I also looked into one example after reading a story in my local newspaper about what was allegedly going on in the mid-Essex primary care trust, which is now part of the north Essex cluster. It was to do with the treatment of people suffering from overweight. Again, the story was inaccurate. There was no truth in the allegation that the trust was refusing to treat smokers or people who were overweight. They were treated, providing that it was clinically safe to do so. The three specific allegations that I have investigated, both myself and through my officials, have proved to be untrue.
As I said earlier, we have had officials look at the Labour party’s political document because, on the face of it, it raised serious allegations that merited investigation. I am afraid that the examples that I have given have not met the reality of the headline claims.
Mr Reed
I appreciate the confidence that the Minister is showing in refuting the evidence put to him based on freedom of information requests to the PCTs in question. He mentioned three cases out of 125. When will he assess the remaining 122, and will he publish that assessment?
Mr Burns
This debate is half an hour long, and I have been fortunate enough to have 15 minutes. We have investigated all the claims, but it would not be in the interests of the hon. Member for North Tyneside, or possible in the time allowed, for me to go through all of them. I have been assured that the evidence that Labour claimed to have in its party political document does not live up to the hyperbole of the hon. Member for Copeland or the shadow Secretary of State.
Appropriate, clinically based decisions about the setting of priorities will continue to be taken by commissioners in the NHS. However, by shifting decision making to local clinicians, we will ensure that those decisions are fair, transparent and based on the best clinical evidence. Treatment should never be restricted without clinical justification, and I say again that we will take action should any genuine evidence emerge that that is occurring. We regard it as unacceptable as Opposition Members do; the trouble is, the evidence that they have come up with so far does not live up to the claims that they make about it.
Question put and agreed to.
National Health Service
Simon Burns Excerpts(12 years, 4 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Andy Burnham
I will give way to the Chair of the Select Committee in a moment.
Wherever we look, we see warnings of an NHS in increasing financial distress, yet according to Ministers everything is fine. The gap between their complacent statements and people’s real experience of the NHS gets wider every week. They are in denial about the effects of their reorganisation on the real world. That dangerous complacency cannot be allowed to continue.
The Minister of State, Department of Health (Mr Simon Burns)
In the light of what the right hon. Gentleman has just said, will he clear up this confusion? His leader, the right hon. Member for Doncaster North (Edward Miliband), has said that he would keep clinical commissioning, yet the shadow Secretary of State has just said that he would repeal the Act in toto, which would include the provisions on clinical commissioning.
Andy Burnham
I have heard the same from staff throughout the system. Morale has never been lower. People have been badly let down by a Government who promised them no top-down reorganisation, a moratorium on hospital changes, and real-terms increases. None of those things has been delivered. During the run-up to the general election the Conservatives cynically used the NHS to try to gain votes, and they will pay a heavy price for breaking the promises that they made then.
Andy Burnham
I will give way to the Minister one more time, and then to my hon. Friend the Member for Eltham (Clive Efford), but after that I must make some progress.
Mr Burns
I am grateful to the right hon. Gentleman. Although he did not answer the question that I asked him earlier, he did spread more confusion. If he were ever in a position to repeal the entire Act and did so, given that the strategic health authorities and the primary care trusts will have long since gone, how does he envisage care being commissioned for patients?
Andy Burnham
The Minister seems to equate removal of the Act with bringing back PCTs and SHAs. I do not have a problem with clinical commissioning, and I said as much during the Bill’s passage. I introduced it myself. I do not have a problem with clinical commissioning groups; my problem is with the job that they are asked to do, and the legal context in which they are asked to operate. We reject the Secretary of State’s market, and that is why we will repeal his Act.
The Minister of State, Department of Health (Mr Simon Burns)
The motion that we are debating today is typical of the Opposition. Rather than praising the NHS in a year of change, they seek to denigrate it. Rather than commending the hard work and dedication of NHS staff, they undermine their efforts and belittle their results. Rather than supporting the parts of the NHS that are dealing with long-term financial challenges—challenges that were partly of the own making of the right hon. Member for Leigh (Andy Burnham)—they attempt to scaremonger.
In truth, this has been a year that has tested the NHS, which has dealt with significant financial pressures as well as the transition to the new system, but it is also a year in which the NHS has proven its mettle. Far from the meltdown that some gleefully predicted, we have seen a robust and resilient NHS delivering better care for patients.
Mr Burns
In a minute.
I know that waiting times mean a great deal to the right hon. Member for Leigh, so let us have a look at the numbers. Despite what he peddles around the country, waiting times remain low and stable—in fact, below where they were at the last general election. In May 2010 more than 18,000 people waited more than a year for treatment. Today that figure is just 4,317. Today 55,335 people wait more than six months for treatment—almost half the figure of 100,979 at the last general election. There are 149,912 people now waiting more than 18 weeks, compared with 209,411 in May 2010. The median wait for admitted patients has fallen in that time from 8.4 weeks to 8 weeks, and for non-admitted patients from 4.3 weeks to 4 weeks. Across the country, all NHS waiting time standards for diagnostic tests and cancer treatment have been met.
Mr Slaughter
The Minister talks about scaremongering. For seven years my constituents put up with scaremongering from his party that Charing Cross hospital was going to close. The services there expanded. After two years of his Government, the hospital, 500 beds, and the accident and emergency department are closing and being replaced by an urgent care centre, which will treat only minor injuries. What will that do to his statistics?
Mr Burns
I am slightly surprised that the hon. Gentleman made that intervention because it rather proves my point about scaremongering. He said that is going to happen. The truth is that the local NHS has determined locally what it believes is the best reconfiguration of services. That is going out to public consultation and so far no decisions have been taken because the consultation process has only just started. It will last for 14 weeks and then the results of that consultation will be considered.
Mr Burns
I will now make progress.
To return to waiting times and the record as a fact, rather than the fiction that Opposition politicians like to peddle, 96% of patients wait for fewer than four hours in accident and emergency, and every ambulance trust in England meets its core response times.
Andy Burnham
On accident and emergency waiting times, let us be clear. In the 2013 year to date, has the NHS met the 95% target or not?
Mr Burns
I shall make a little more progress.
Let us not stop at waiting times. The £600 million cancer drugs fund that has helped more than 12,500 patients to access the drugs previously denied to them, the screening programmes for breast and bowel cancer, potentially saving an extra 1,100 lives every year by 2015, the world-leading telehealth and telecare whole systems demonstrator programme, which saw a stunning 45% fall in mortality and is set to transform of 3 million people with long-term conditions over the next five years—
Henry Smith (Crawley) (Con)
Earlier this year I was delighted to be able to open a new digital mammography unit at Crawley hospital, a hospital which under the previous Government saw its accident and emergency unit closed down. Does my right hon. Friend find it odd that the Opposition refuse to match the spending commitments on the NHS that this Government are delivering?
Mr Burns
My hon. Friend is right. As he would probably expect, I shall deal with that issue later in my speech. While I am responding to his intervention, let me say that not only was his hospital fortunate in having that fantastic equipment to look after his constituents, but I had the pleasure last week to be in his constituency to visit Elekta and Varian, which are world leaders in making equipment to help with radiotherapy.
Valerie Vaz
The Minister is very fond of statistics. Can he say whether GP referrals have gone up, and whether A and E admissions have gone up or down?
Mr George Howarth
The Minister said in his opening remarks that Opposition Members are denigrating NHS staff and their achievements. Does he accept that if he has any conversations with NHS staff, he will find the reverse—they feel that they are being denigrated by this Government and their reforms?
Mr Burns
I do not like to contradict the right hon. Gentleman, but I will. What I said was slightly different from what he accused me of saying. What I said was that rather than praising the NHS in a year of change, the Opposition denigrate it. That is slightly different.
To pick up on a point that the right hon. Member for Leigh mentioned from a sedentary position, GP referrals for 2011-12 were 1% lower than in the previous year, but outpatient referrals were, as I said, slightly higher.
Mr Burns
If my hon. Friend will allow me, I would like to make some progress. If the opportunity arises, I will give way to him then.
I could stop after reporting all that good news, but I do not see why I should when there is so much more to praise the NHS for. It gets little praise for its performance from the Opposition. I want to praise the fact that patients are reporting better outcomes for hip and knee replacements and for hernias, and the fact that the latest GP patient survey showed that 88% of patients rated their GP practice as good or very good. MORI’s independent public perceptions of the NHS survey shows satisfaction with the NHS remaining high at 70%.
In the patient experience survey, 92% of patients who had used the NHS in the past year rated their care as good, very good or excellent. Mixed-sex accommodation breaches are down an incredible 96% since we came to power, although of course the Opposition often claimed to have eradicated that problem—not so, alas. MRSA infections are down 24% in the year, and C. difficile infections down 17%. More than a million more people have an NHS dentist. No reasonable person could look at the performance of the NHS over what has been a challenging year with anything but admiration and pride. I, too, would like to take this opportunity to praise NHS staff for their hard work and dedication and the excellent results they are delivering for patients.
Angie Bray (Ealing Central and Acton) (Con)
Will my right hon. Friend give way?
Andrew Percy
Will the Minister condemn Labour party representatives in Goole who, despite the fact that under Labour we saw ward closures and mental health in-patient beds go, recently gave the media incorrect waiting list times, and will he confirm that in North Lincolnshire 93% of patients are seen within 18 weeks, which is far ahead of the national target? The Labour party needs to stop talking down our local hospital.
Mr Burns
If hon. Gentlemen and Ladies will bear with me, I would like to make some progress, because this is a short debate and many hon. Members would like to participate, but I will give way later.
The motion, like the right hon. Member for Leigh, mentions a fall in spending on the NHS of £26 million in 2011-12. I will give him one statistic: £12.5 billion. There will be £12.5 billion extra for the NHS in this Parliament, £12.5 billion that would never have been made available had he had his way, as he said that to do so would be irresponsible. That is exactly what his party is doing in Wales, where it is in control of the NHS. It is cutting the NHS budget in Wales by 6.5% in real terms from 2011-12 to 2014-15. His motion talks about a £26 million underspend, but what he does not understand is that there has been a real-terms increase in funding for the NHS this year. Because we are no longer wasting hundreds of millions of pounds on a bloated bureaucracy and the national programme for IT, we have been able to save an extra £1.1 billion in real terms from the back office and put it into front-line care.
Andy Burnham
So that there is no confusion, because this is a very important matter, I will quote from a Department of Health press release of Friday 6 July:
“PESA figures released today show that in real terms NHS spending has reduced slightly by 0.02%.”
For the record, will the Minister say whether NHS spending rose or fell over the last financial year?
Mr Burns
Just wait. But, as he has said, and as I have said about the £26 million—[Interruption]—there was an underspend in the NHS and that money, as he will know, because of the financial arrangements his party put in place for the NHS in 2004, will be ploughed back into the NHS over the next three or four years as extra spending. We will put in more money for front-line clinical staff, including more than 4,000 doctors—more money for doctors and treatments and for improving patient outcomes. Spending on front-line NHS services has increased by £3.4 billion in cash terms, or 3.5%, compared with last year.
Mr Burns
Not at the moment.
The motion states that seven out of every 10 acute hospital trusts in England missed their savings targets for the first half of 2011-12, referring to their cost improvement plans. Not only did the right hon. Gentleman use out-of-date figures—figures for the whole year are now available—but he again misrepresented what they mean for the performance of the NHS. Across the NHS, acute NHS trusts plan to save £1.3 billion during 2011-12. In the end, they saved £1.2 billion. More than half—57%—of the shortfall was concentrated in just 10 NHS trusts in significant financial difficulties— 10 NHS trusts that he ignored when he was Health Secretary but that we are getting to grips with. I would point him instead to the £4.3 billion of efficiency savings made in 2010-11 and the further £5.8 billion of efficiency savings made in 2011-12. Primary care trusts and strategic health authorities have reported a surplus of £1.6 billion in 2011-12, money that is being carried forward and made available for 2012-13 and thereafter.
Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)
Will the Minister give way?
Angie Bray
As my right hon. Friend is aware, the proposal is to downgrade four accident and emergency departments across London that are all right beside my constituency. Does he agree with my constituents that losing four accident and emergency departments is disproportionate and will mean a significant loss of service for them locally?
Mr Burns
What I will say to my hon. Friend is similar to what I said to the hon. Member for Hammersmith (Mr Slaughter): that is a reconfiguration that is in progress and has been put together locally by the local NHS. It has just gone out to consultation and, obviously, when the process is complete the responses will be considered before any final decisions are made on the best way to provide care for her constituents and those of Opposition Members so that they can get the quality of care and the relevant care in their area. At the moment, when there is a consultation process going on, it would wrong of me to comment on a local decision, but I certainly urge my hon. Friend, her constituents and others to get involved in the consultation so that all views can be considered.
Mr Burns
I will now make some progress.
The motion seeks to give the impression that NHS care is being rationed. That is worse than inaccurate: it is scurrilous nonsense and scaremongering on a grand and somewhat desperate scale. [Interruption.] I will come to cataracts in a moment. We did some rudimentary checking of our own into the veracity of those claims, which were originally made as part of the Labour party’s NHS health check. It was not long before it became abundantly clear that that was not worth the press notice it was printed on. It claimed that there was a blanket ban by NHS Hull on the removal of risk ganglia. We spoke with NHS Hull and found that there is no such ban. It claimed that 11 out of 100 PCT clinical commissioning groups restrict laser revision surgery for scars, but such cosmetic surgery has never been routinely available on the NHS, under either this Government or the previous Government, when the right hon. Member for Leigh was Secretary of State. It claimed that weight-loss treatment is restricted, stating that
“patients generally have to be over 18 and have a BMI over a certain level to receive weight loss surgery”.
Amazing—people actually have to be overweight to be entitled to weight-loss surgery. I would have thought that that was startlingly obvious, but obviously the right hon. Gentleman does not think so.
Andy Burnham
Is the Minister aware that the National Institute for Health and Clinical Excellence guidance recommends that bariatric surgery should be offered only to people with a BMI of 40? Is he also aware that numerous PCTs all over the country are restricting access to that surgery by introducing their own arbitrary limits? That is evidence of the rationing I am talking about. He will know that the NHS constitution guarantees people access to NICE-approved treatments, so why does he not take action on those PCTs that are standing outwith the NICE guidance?
Mr Burns
What the right hon. Gentleman rather cunningly does not mention—[Interruption.] I am answering the question, if the hon. Member for Copeland (Mr Reed) can just keep quiet for a second. The right hon. Gentleman says that the NICE guideline refers to a BMI of 40, and that is absolutely correct, but I point him in the direction of one area in central London that does not go by that guideline, because it uses a BMI of 35, which is lower.
Mr Graham Stuart
Is my right hon. Friend as confused as I am by the Labour party’s policy? The right hon. Member for Leigh (Andy Burnham) could not explain where public health would go; he wants to repeal the Health and Social Care Act 2012, although he wants the services to be shaped as the Act says; and on funding he said in June 2010:
“It is irresponsible to increase NHS spending in real terms”.
That is the Labour party’s policy: it is chaotic and makes no sense. Can my right hon. Friend please tell us whether he sees more sense in it than I do?
Mr Burns
I am afraid that I cannot help my hon. Friend, because the policy is contradictory and does not make sense.
The right hon. Gentleman talks about repealing the 2012 Act, which includes the clinical commissioning groups, but if he abolishes them there will be no other mechanism from 1 April next year to commission care for patients, so there will be no one available to commission care for patients, which seems stunning.
The right hon. Gentleman talks about funding, and his quotations—my hon. Friend the Member for Beverley and Holderness (Mr Stuart) mentions one—are quite clear: he disapproves of giving real-terms increases in funding to the NHS. In Wales, the Welsh Labour Government have taken him at his word and are cutting spending, which we are not very enthralled by.
Mr Burns
I will now make progress.
Treatments available on the NHS are based on clinical need. There should never be any arbitrary rationing based on cost either locally or nationally—[Interruption.] The right hon. Member for Leigh shouts from a sedentary position, “There is”, and waves a piece of paper a little like Chamberlain on his way back from Munich, but if the piece of paper that the right hon. Gentleman is waving is his NHS health check, which officials in my Department have looked at, it is as worthless as the piece of paper that Chamberlain brought back from Munich.
If the right hon. Gentleman has any genuine evidence based on the cost of care, I and the Department of Health will certainly investigate it. Such practices are totally unacceptable, and we will take them very seriously indeed, but until then, although the motion talks about “the evidence presented”, the truth is that there is none.
The right hon. Gentleman claims that the number of cataract operations has fallen significantly since we came to power, but the reason for the fall is that clinicians have advised that the surgery is inappropriate in many cases—on clinical grounds. Surgery is available, however, for those patients who are clinically eligible, and they will receive it when there is a clinical reason.
Barbara Keeley (Worsley and Eccles South) (Lab)
Will the Minister give way?
Mr Burns
No, I am making progress.
The motion notes the growing involvement of the private sector, insisting that it represents evidence of growing privatisation. Not only is that unadulterated tosh, but I personally find it offensive to be accused of seeking to privatise the NHS, when in my political philosophy one of my core beliefs is in an NHS free at the point of use for all those eligible to use it.
Not only does the right hon. Gentleman have some difficulty understanding the meaning of “privatisation”, but he forgets his own record in government. The only plan to increase the private provision of NHS services came under the previous Government when he was Minister, when his hon. Friend the Member for Leicester West (Liz Kendall) was the special adviser and when Patricia Hewitt was Health Secretary. In May 2007, the right hon. Gentleman said:
“Now the private sector puts its capacity into the NHS for the benefit of NHS patients, which I think most people in this country would celebrate.”
Those are his words. It was his Government who saw private companies paid 11% more than NHS providers for doing the same work, and who wasted £297 million on operations that never happened at independent sector treatment centres. Given that he may have forgotten, I must tell him that the Labour party manifesto in 2010, when he was the Secretary of State for Health, stated:
“Foundation trusts will be given the freedom to expand their provision into primary and community care, and to increase their private services—where these are consistent with NHS values”.
That suggests that, as Secretary of State, he was prepared to have in his own party’s manifesto a policy allowing and encouraging foundation trusts to attract more work from the private sector.
This Government’s Health and Social Care Act 2012 specifically prohibits the Secretary of State, Monitor or the NHS Commissioning Board from favouring any type of provider, be they from the NHS, the charitable sector or the independent sector. It does so because this Government understand something that the right hon. Gentleman’s never did—it is not the nature of the provider, but the quality of the outcomes that matters most to patients.
Mr Burns
No, I will not.
The motion speaks of the
“increasing number of cost-driven reconfigurations of hospital services”.
The reconfiguration of NHS services must always be led by a desire to improve patient care and patient outcomes. As lifestyles change, as needs and expectations grow and as technology develops, the NHS must respond. This Government are very clear that the reconfiguration of services is a matter for the local NHS, and that the best decisions are those taken closest to the front line and tailored to the needs of the local population. But, when making those decisions, it is imperative that the NHS carries the support of local people, patients, carers and clinicians.
The principle is enshrined in the four tests that my right hon. Friend the Secretary of State set out in 2010: all local reconfiguration plans must demonstrate support from clinical commissioners, strengthened public and patient engagement, clear clinical evidence and support for patient choice.
Mr Burns
The right hon. Member for Leigh equates the coalition agreement’s promise of a temporary moratorium on changes to hospital services, with a commitment to hold the NHS in a permanent state of suspended animation. The moratorium was needed to put a stop to the arbitrary reconfigurations that his Government instigated—reconfigurations that lacked the support of local clinicians, lacked a clinical evidence base and lacked basic democratic legitimacy. This Government and the Secretary of State have put that right.
Now I turn to another issue that the right hon. Gentleman raised and which is of considerable importance, given what has—
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. Hon. Gentlemen, the Minister has given way quite a bit, and I am sure that if he wishes to give way he will let you know. You do not need to keep standing and hovering for so long.
Mr Burns
Thank you, Mr Deputy Speaker. Because I want to make progress so that other people can contribute, I will not accept any more interventions.
On the South West Pay Consortium—[Interruption]—an issue on which I hope the right hon. Member for Leigh will listen, given that during his speech he seemed keen to hear the Government’s response—the Government’s position is clear: it is for employers, not for the Government, to lead negotiations on the terms and conditions of their staff, and to do so with the agreement of staff.
This Government are committed to the principles of “Agenda for Change”, a national framework. The ongoing negotiations on “Agenda for Change” are about ensuring that patients and taxpayers get the maximum value for money from every penny spent on the NHS, and that it is spent efficiently and effectively. The negotiations are not about a pay cut, and we would not support one.
The Health Act 2006, brought in by the previous Government when the right hon. Gentleman was the Minister of State in the Department of Health, gives NHS trusts the power to set their own terms and conditions. Although they are free to opt out of the national pay framework, they cannot do so unilaterally; they must consult and seek agreement with their staff and representatives.
Almost all trusts have until now chosen to stay on national terms and conditions. I believe that most still want to, but that has to be fit for purpose and fit for the future. Only one trust—Southend—has opted out of “Agenda for Change”. [Interruption.] The hon. Member for Middlesbrough South and East Cleveland (Tom Blenkinsop) may be a Whip, but he is rather foolish to fall into the trap that I have just set. That trust opted out of “Agenda for Change” under the last Labour Government. Perhaps he would like to apologise.
Pay is the largest element of NHS costs, and pay systems must evolve. The trusts in the south-west wish to work and negotiate with the trade unions to agree changes, not to dismiss and re-engage staff.
Mr Burns
The hon. Lady only recently walked in. She has not been here from the beginning.
I call on the unions to respond positively to the issue and the national discussions on “Agenda for Change”. I also hope that the Opposition will support the policies that they put in place when in government.
The Opposition have used this debate to make yet another sorry attempt to paint a distorted picture of the NHS. That is wrong. The shadow Secretary of State pours scorn on the performance of the NHS, while we admire the excellence of the staff; he belittles their achievement while we laud them; he scaremongers, while we present the truth more transparently than at any other time in the history of the NHS.
The accusations in the motion are simply wrong, and I ask my right hon. and hon. Friends to join me in the Division Lobby at the end of the debate to defeat the motion.
Plasma Resources UK Ltd
Simon Burns Excerpts(12 years, 4 months ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Minister of State, Department of Health (Mr Simon Burns)
I am announcing today that the Government will be exploring new opportunities for the future development of our government-owned limited company, Plasma Resources UK Ltd (PRUK).
The Department has successfully completed the first stages of the combination of its plasma products companies; which consist of the UK based fractionation facility Bio Products Laboratory Ltd (BPL) and the US based plasma supply company, DCI Inc. These two companies have been brought together under the Department of Health owned parent company PRUK.
Looking forward to the next phase of development, we have carefully examined the strategic options that will best allow the companies to grow and be successful in an established global industry, whilst also seeking to ensure jobs are maintained in the bioscience sector of the economy.
To ensure the continued success of PRUK, the future business strategy should address the need for investment in BPL’s specialist plant and skilled workforce in order to create more advanced products. PRUK should also continue to harness the potential of the US-based operations at DCI Inc which is well placed to develop its own portfolio. This requirement for further investment comes at a time when the Department of Health and the NHS is facing ever-increasing demands on its resources and must focus on delivering its front-line services.
Our conclusion is therefore that we will now assess development opportunities in conjunction with the private sector, seeking to gain a valuable contribution from not only a financial perspective, but also their operational expertise.
We have therefore appointed financial advisers to consider the most appropriate level of department ownership to deliver the Department’s objectives. This work will examine, in detail, the sale of all or part of the business, as well as other structures, to determine the best solution for the business, its employees, the NHS and taxpayers. Any future partner or investor would be chosen through a fair and open process and will be able to demonstrate the necessary skills, experience and resources to work with the companies to help them realise their potential and to develop their range of products.
As part of this process, we will be ensuring that any option continues to safeguard the interests of patients, that supplies of current products are secure and that resources are available to develop new products, such that NHS patients continue to receive the best possible care.