(7 years, 9 months ago)
Commons ChamberThe hon. Gentleman speaks very wisely about this, and he is one of a number of people who say we need to look at the training we give GPs on patient safety, on growing, new areas like mental health, and on things like the identification of cancers. This is something we are having an ongoing discussion with the Royal College of General Practitioners about.
Given the importance of training new doctors and nurses to the future of the health service, will my right hon. Friend welcome the building, which will commence later this summer at the Anglia Ruskin University in Chelmsford, of a new medical school that is solely there to train doctors to meet the needs of people in Essex and beyond its borders?
I absolutely welcome that, and I know my right hon. Friend has personally championed it as a local MP. The historical mistake that those on both sides of the House have made is not to do long-term workforce planning for the NHS, and that is something we want to put right.
(8 years ago)
Commons ChamberAll I would do is urge the hon. Gentleman to listen to what the Prime Minister said at this Dispatch Box last week. She said that we recognise the short-term pressures—indeed, the Communities Secretary came up with a package of £900 million extra over the next couple of years—but that we also need a long-term sustainable solution, on which the Government are working hard.
Does my right hon. Friend agree that one of the pressures of winter that needs improving is inappropriate admissions to A&E? Does he accept that the proposals by the Essex success regime to ensure that the three hospitals concerned will retain their A&E departments but that there will be a specialist centre for cardiothoracic care and for burns and plastic surgery care are the right way forward to improve and enhance the care for those suffering from accidents and emergencies?
My right hon. Friend understands these matters extremely well from his time as a very distinguished Health Minister. He is absolutely right; the truth is that we want widespread availability of A&Es but we do not serve patients best by offering identical services everywhere. That is why in the past three or four years one of the things we are most proud of is the setting up of a national network of 26 trauma centres, which has had a dramatic impact on mortality rates for the most serious cases.
(8 years, 1 month ago)
Commons ChamberDoes my right hon. Friend agree that without that investment since 2009-10 to last year there would not have been the 1.6 million more operations within the NHS that benefit all our constituents?
My right hon. Friend is right. I congratulate him, because he was part of the shadow Health team that persuaded the then shadow Chancellor and Leader of the Opposition that we needed to make that investment, thanks to which the NHS is doing 5,000 more operations every single day.
(8 years, 7 months ago)
Commons ChamberAs 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.
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.
(8 years, 7 months ago)
Commons ChamberI 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.
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?
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.
(8 years, 7 months ago)
Commons ChamberThat 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.
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?
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.
(8 years, 8 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
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.
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?
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.
(9 years, 1 month ago)
Commons ChamberI 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.
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.
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.
(9 years, 2 months ago)
Commons ChamberI 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.
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.
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.
(9 years, 6 months ago)
Commons ChamberI will tell the hon. Gentleman what we have done: on my watch, there are 8,000 more nurses in our hospitals to deal with the tragedy of the legacy of poor care left behind by his party. That is what we have done. As part of that, trusts also recruited temporary staff. They have become over-dependent on them, which is why we have taken the measures we announced this morning.
T6. What measures are being taken to improve A and E departments such as that at Broomfield hospital in Chelmsford?
(10 years ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
First, may I thank the shadow Health Secretary for bringing this matter to the attention of the House? As a former Health Secretary, he knows that operational pressures are one of the biggest challenges facing any Health Secretary. Indeed, he had many examples of very, very poor care on his own watch and he is absolutely right to give the House a chance to hear more about our plans for winter.
The shadow Secretary of State asks whether we have a plan. It seems to me that he prepared his comments before he listened to the statement. We have put in more money than ever before. Plans were announced in June. NHS England had a press conference in which it went through the plans relating not just to the £400 million, but the extra £300 million that was agreed in September and allocated through October. That is a record amount. Let us consider what is happening in his own constituency. In Wigan borough, since 2010, because of spending that he opposed, Wrightington, Wigan and Leigh NHS Foundation Trust has taken on 78 more doctors, 149 more nurses and 209 more clinical—[Interruption.] He says, “Does this help?” These are extra doctors and nurses on the front line, helping patients in his own constituency.
The right hon. Gentleman talked about care homes. The £3.3 million going to help his own constituents with winter pressures is to monitor the mental and physical health of patients in care homes and to help reduce the number of emergency admissions. We have a winter plan that is working in his own constituency to help improve the lot of his constituents. He needs to acknowledge that.
The right hon. Gentleman talked about the publication of figures over Christmas. We have never published figures over the Christmas period because it would mean forcing NHS staff to work over Christmas, whereas, where possible, we would like them to be able to go home for Christmas, just like Members of this House. When he was Health Secretary, did he publish performance or weekly A and E figures over Christmas? He did not. He did not publish them at Christmas or Easter; he did not publish any weekly A and E figures at all, so to come to the House and call it a news blackout says to me that he is more interested in political opportunism than in care for patients.
It is disappointing that the right hon. Gentleman did not take this opportunity to disown his own leader’s instructions to weaponise the NHS. The NHS is not, and never should be, a political weapon. This is what third parties say. Dr Mann, president of the College of Emergency Medicine, whom the shadow Secretary of State mentioned, said yesterday that
“the system is under pressure but it’s working pretty well”.
The Foundation Trust Network said:
“NHS providers prepared for this Winter earlier and more fully than ever before”
and that—he should listen to this bit—the
“NHS needs support not criticism”
please. The NHS Confederation said the NHS was pulling out all the stops on urgent care and A and E, and that earlier planning and extra money were helping.
The right hon. Gentleman wants to draw comparisons. Nine out of 10 people are being seen within four hours in this country, which is a higher proportion than in any country anywhere in the world that measures A and E performance—faster than Australia, New Zealand, Canada, Scotland, Northern Ireland and, yes, faster than Labour-run Wales. Eight people out of every 100 wait more than four hours in A and E in England; in Wales, that figure is 15 hours. He should concentrate on saving the NHS in Wales, rather than running it down in England, where it is doing so much better.
Finally, if the right hon. Gentleman is worried about poor care, why is he still saying it was wrong to have a public inquiry into Mid Staffs? This is what Julie Bailey, the Mid Staffs campaigner, said this week about his comments:
“It is very worrying, because if he becomes Health Secretary again at the election it is clear we would go straight back to the old days of covering up.”
The NHS is performing well under great pressure. He should commend the efforts being made by front-line staff, not undermine them by trying to turn the NHS into a political football.
Will my right hon. Friend join me in congratulating the staff of Broomfield hospital in Chelmsford and the GP surgeries in mid-Essex on the fantastic job they are doing to look after patients in difficult circumstances because of the significant increase in the number of patients needing and accessing care? Furthermore, does he agree that it is rather demoralising for staff and sad that Labour seeks to turn the NHS into a party political football simply—
(10 years, 2 months ago)
Commons ChamberActually, the question is: when did it become an all-private shortlist, and why did the right hon. Gentleman allow that to happen if he is now saying that the privatised running of hospitals is such a bad thing? I think that we have found him out, and he will want to correct the record and the impression that he gave to my hon. Friend the Member for Selby and Ainsty.
Will my right hon. Friend confirm that in March 2010, when the right hon. Member for Leigh (Andy Burnham) was Secretary of State, the number of bidders for Hinchingbrooke hospital—a process that took place under legislation passed by the previous Labour Government—went from five to three? Two of those bidders were private companies; the third bidder was a private company in conjunction with an NHS trust, but at a later stage as the process developed—as my right hon. Friend said—it went down to one bidder. The right hon. Gentleman said in response to my hon. Friend the Member for Selby and Ainsty (Nigel Adams) that there was a preferred bidder and that it was not a private company but the NHS. It was not the NHS; it was an NHS trust in conjunction with a private company.
(10 years, 5 months ago)
Commons ChamberI completely agree, and that is one of the big lessons. The shadow Home Secretary was absolutely right to say that this issue raises serious questions about the nature of celebrity in our society. One of the reasons that totally inexcusable things happened—such as being given the keys to Broadmoor—was that somehow on the basis of Savile’s image people made wrong assumptions about him. The hon. Lady is absolutely right. One of the things that will change as a result of this investigation is that people will be more willing to challenge those who previously were not challenged. But there is a long way to go.
I totally agree with the Secretary of State’s belief that there should be more openness, and an increased sense of need to report concerns, but is he satisfied that, particularly with regard to NHS staff who may report concerns or whistleblowers, there is enough protection within the system to encourage more people to be more open?
No, I am not. That is why earlier this week we asked Sir Robert Francis to do a follow-up review to his public inquiry to determine what else needs to be done to create a culture of openness and transparency in the NHS. We have come a very long way as a society in terms of our understanding, but there is more work to be done. It is also very important, as I said in my statement—I know everyone would agree with this—that we do not undermine the brilliant work done by volunteers in hospitals and that we do not create a kind of bureaucratic morass that makes it impossible for that really important work to be done. However, I know we can do better than we are at the moment and important lessons need to be learned.
(10 years, 8 months ago)
Commons ChamberAs Simon Stevens is starting today, I think that this is a good moment to welcome him to his post. He is an outstanding individual, and I know that we all wish him well in what will be a challenging but incredibly important job.
As for the reorganisation, the official figures make it clear that it is saving more than £1 billion every year during the present Parliament—money that is being reinvested in the provision of 1,600 more nurses, 1,700 more midwives, 1,800 more health visitors and nearly 8,000 more doctors than we had under Labour. I am afraid that that shows that Labour has not learned the lessons of Mid Staffs. Labour Members still want to turn the clock back and spend all that money on administration.
Does my right hon. Friend agree that savings that have been made through greater effectiveness and efficiency, and that can be ploughed back into patient care, should be warmly welcomed? Does he not think that such action is far preferable to the bizarre suggestion by a former Labour Health Minister that people should be charged £10 a month to visit their GPs, which would compromise Nye Bevan’s founding principle of a free health service?
I do think that that is a bizarre suggestion. Given our ageing population, we need to make it easier rather than harder for people to see their GPs. I also think it bizarre of the Opposition to set their face against the reforms that my right hon. Friend helped to pilot through the House. Because money has gone to the front line, 800,000 more operations are being performed in the NHS year in, year out than were performed under Labour. We are putting money where it is needed, with doctors and nurses.
(10 years, 11 months ago)
Commons ChamberBecause 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.
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?