Junior Doctors: Industrial Action

John Bercow Excerpts

Monday 5th September 2016 Commons Chamber

[Ms Abbott]

rose—

[Mr Speaker]

Order. For clarification, I must emphasise that there is no concept of giving way in respect of a statement. Although this might resemble a debate to those who are attending our proceedings from beyond the confines of the Chamber, it is a statement with a response. There are no interventions.

[Sir Peter Bottomley (Worthing West) (Con)]

She is new to her job.

[Mr Speaker]

We are always grateful to the hon. Member for Worthing West (Sir Peter Bottomley) for whatever counsel he might wish to proffer, even if it is done from a sedentary position.

[Mr Hunt]

Thank you, Mr Speaker.

The shadow Health Secretary needs to recognise that working people, the people her party claims to represent, need a seven-day NHS. The vulnerable people that Labour claims to represent get admitted to hospital at the weekends, and in industrial disputes patients should always matter more than politics. The next time she meets a constituent who has suffered because of not having a seven-day service or because their operation has been cancelled because of a strike, she and her colleagues should hang their heads in shame.

The hon. Lady has used some very strong words. She used words such as “vilifying” and “demonising” in relation to the junior doctor workforce, and that is a very serious thing to say. I challenge her to find a single piece of evidence that has come from me or anyone in the Government, and if she cannot do so, she needs to withdraw those comments and apologise to the House. The fact is that the single most demoralising thing for the NHS workforce is strikes, because they entrench and harden positions, which results in people getting very angry, and it becomes much harder to find consensus.

The hon. Lady also talked about the use of statistics. She does not have to listen to what I say—and I understand, given the sparring that goes on between us, that she might not want to—but we have had eight academic studies in the past five years that describe increased mortality rates for people admitted to hospitals at weekends. Her response to this, in a phrase she used in another context, was that there was “zero empirical evidence” for a weekend effect. I would caution her on this, because taking that approach to hard data is exactly what happened at Mid Staffs, where hard evidence was swept under the carpet year after year because it was politically inconvenient. This Government will not make that mistake.

Finally, the hon. Lady said that my civil servants had apparently advised me that this policy would not work. Not at all. What happens with every Government policy, as you would expect, is that smart civil servants kick the tyres of every aspect of the policy to enable us to understand the risks involved. She did not mention the fact that the same document to which she referred actually says that we are on track to deliver the four clinical seven-day standards to 20% of the country by next April. I think that her constituents will welcome that, even if she does not. These strikes are going to harm patients, damage the NHS and make it harder, not easier, to resolve the challenges facing junior doctors. Labour has chosen political opportunity today, but we will do the right thing for patients.

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[Mr Speaker]

As always, I am keen to accommodate everybody who wants to take part, but I think it not unreasonable, given the relatively small number, for me to hope that we might conclude these exchanges by 10 past 7—quarter-past at the latest. Brevity is of the essence. We do not need long narratives. We just need questions and short answers. We will be led in that mission by the Chair of the Health Committee.

[Dr Sarah Wollaston (Totnes) (Con)]

I welcome the BMA’s suspension of next week’s damaging industrial action. It is clear from its statement that thousands of doctors had been in touch to say that they wanted to keep their patients safe. Doctors know that they cannot do so with full, rolling, five-day walkouts. Will the Secretary of State therefore join me in asking the BMA to ballot its members to hear their views before they proceed with the other proposed, damaging, five-day walkouts?

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[Several hon. Members rose—]

[Mr Speaker]

I call Dr (post-war strategic military planning) Julian Lewis.

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

In other words, I am totally unqualified as a medical doctor. Therefore, may I ask a question about democratic mandates? I appreciate that, unlike a referendum, a general election does not give an entirely specific mandate on every proposal put forward, but will the Secretary of State take the opportunity to remind the House and the country of how central the proposal for a seven-day NHS was to the Conservative manifesto as far as his Department was concerned?

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[Philip Davies (Shipley) (Con)]

I was just reading an article from earlier in the year from The Guardian newspaper, which said that Saturday working is the major sticking point in the junior doctors’ dispute. Does the Secretary of State agree that any doctor who goes on strike over premium rates of pay on a Saturday, which most people in this country do not get when they work on a Saturday, should hang their heads in shame? Will he give a commitment that he will not make any further concessions, as he has already given far too many. Is it not time to look at whether we stop doctors from going on strike altogether in the NHS, as is the case with other emergency services?

[Mr Speaker]

It may be the first occasion upon which the hon. Member for Shipley (Philip Davies) has vouchsafed to the House that he is a Guardian reader.

[Mr Hunt]

I was nervous mentioning the fact that the Government have made 107 concessions when I saw that my hon. Friend might be in the Chamber because I knew that, for him, that would be 107 too many. His broader point is absolutely spot on. The working terms and conditions for Saturdays for junior doctors in this new contract are better than they are for nurses, police officers, fire officers and for those in many other parts of the economy. That is why I think it is a fair deal that everyone should recognise and welcome.

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[Mr Hunt]

I am very surprised to hear that. If my hon. Friend wants to pass me the details, I will happily look into it. On the ground, the management of hospitals are working very closely with not just junior doctors, but BMA representatives to try to do everything they can to keep patients safe if these strikes go ahead.

[Mr Speaker]

Order. I am most grateful to the Secretary of State and to colleagues.

Finance Bill (Programme) (No. 2)

Ordered,

That the following provisions shall apply to the Finance Bill for the purpose of supplementing the Order of 11 April 2016 in the last Session of Parliament (Finance (No. 2) Bill: Programme)):

1. Paragraphs (11) and (12) of the Order shall be omitted.

2. Proceedings on Consideration shall be taken on the days shown in the following Table and in the order so shown.

3. The proceedings shall (so far as not previously concluded) be brought to a conclusion at the times specified in the second column of the Table.

NHS Spending

John Bercow Excerpts

Wednesday 6th July 2016 Commons Chamber

[Mr Hunt]

I am very happy to do so. I have visited that hospital, where the challenges very much reflect what the hon. Member for Tooting (Dr Allin-Khan) said about links to the social care system. It was clear to me that the staff in the A&E department are working incredibly hard getting people through it, but struggling to discharge people from the hospital, which is why they were not hitting their target.

I have just been handed a note by a ministerial colleague, Mr Speaker, which I hope you will indulge me and let me read out, because I have never been handed such a note before. It says: “Apparently everyone wants to go and watch Wales play, so Whips happy if you felt you wanted to shorten your remarks.” On that basis, I will conclude by thanking the shadow Health Secretary for bringing this motion to the House and for her comments in support of it.

[Mr Speaker]

The right hon. Gentleman is not only an experienced member of the Cabinet but a very seasoned parliamentarian, and I think he is well attuned to the feeling in the House, as I am sure that other colleagues will now also be—not that I am hinting or anything.

Oral Answers to Questions

John Bercow Excerpts

Tuesday 5th July 2016 Commons Chamber

[Several hon. Members rose—]

[Mr Speaker]

Order. Progress has been rather slow today, but I want to accommodate one further inquiry. I call Karin Smyth.

[Karin Smyth (Bristol South) (Lab)]

14. What steps he is taking to ensure that forward budget planning in his Department is robust.

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[George Freeman]

May I first make it clear, as the Prime Minister has done, that nothing immediately changes? We are still full voting-right members of the European Union, and nobody in the system needs to worry about any immediate changes. The Government are putting together a plan for handling the negotiations that now need to be taken forward, and for my own part I as a Minister in the Department have convened a workforce to look at the issues around medicines access. There are three things we need to do: first, to reassure people that this country has a very strong life science and healthcare research system and economy; secondly, to make sure that we negotiate our new relationship with the EU in a way that works; and thirdly, to take advantage of the regulatory freedoms that we now have to make sure that this country is the very best country in the world in which to develop those innovations.

[Mr Speaker]

We are most grateful to the Minister for his thesis.

[William Wragg (Hazel Grove) (Con)]

T1. If he will make a statement on his departmental responsibilities.

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[Several hon. Members rose—]

[Mr Speaker]

Order. Despite the fact that we are late, I am keen to try to satisfy the inquisitorial appetite of colleagues, but can do so best if they are each now very brief.

[Emma Reynolds (Wolverhampton North East) (Lab)]

What is the Health Secretary doing to ensure that the NHS gets the £350 million a week that it was promised during the referendum campaign?

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[Mr Jeremy Hunt]

Of course, and we will take every step necessary to protect the NHS throughout the country, because it remains our most important public service. I am sure that, economically, the period ahead will be difficult, but now that we have had the argument and the British people have made their decision, it is also important that we talk up the opportunities from the new relationships that we may have in the future, and the extra funding that those could generate for the NHS, and I certainly hope that that is what happens.

[Mr Speaker]

Last, I call Mhairi Black.

Point of Order

John Bercow Excerpts

Tuesday 5th July 2016 Commons Chamber

[Valerie Vaz (Walsall South) (Lab)]

Further to that point of order, Mr Speaker—

[Mr Speaker]

I will come to the hon. Lady’s point of order, but first let me say that although that is a relatively unconventional way of expressing appreciation, the Minister of State was typically courteous in signalling in advance to me his wish to do so, and I simply want to say to the right hon. Gentleman—I think I can say it without fear of contradiction, and it was evident from the response to his point—that he is an extremely popular and respected Minister who commands widespread affection and loyalty in all parts of the House. We very much look forward to his continuing contributions, albeit in the future from the Back Benches. I thank him for what he said and the way in which he said it.

[Valerie Vaz]

Exactly on that point, Mr Speaker, may I, on behalf of everyone on the Opposition Benches, pay tribute to the right hon. Gentleman? He has been an absolutely fantastic Minister and he is a brilliant MP. Long may he continue.

[Mr Speaker]

That is extremely welcome and I thank the hon. Lady for what she has said.

Land Registry

John Bercow Excerpts

Thursday 30th June 2016 Commons Chamber

[Relevant documents: Tenth Report from the Public Administration Select Committee, Session 2013-14, Statistics and Open Data: Harvesting unused knowledge, empowering citizens and improving public services, HC 564.]

[Mr Speaker]

I inform those attending to our proceedings that the debate on today’s motion is the first under the auspices of the Backbench Business Committee. I call Mr David Lammy to move the motion.

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[Several hon. Members rose—]

[Mr Speaker]

Order. At this stage there is no formal time limit. The first of the 11 Back-Bench Members I shall call is Mr John Stevenson.

NHS Commissioning (Pre-Exposure Prophylaxis)

John Bercow Excerpts

Tuesday 7th June 2016 Commons Chamber

[Jane Ellison]

As I have mentioned, Truvada is not yet licensed for use as PrEP in this country. We have set out a process by which we can understand far more about how PrEP might fit into the landscape. The right hon. Lady mentioned undetected HIV. The Government have invested significant effort and funding into detecting HIV. We have the world’s first home testing service and last year we launched the major HIV innovation fund, which has come up with some new and extremely cutting-edge ideas on how to improve HIV detection and diagnosis. I fully accept that this is a major challenge in her area, but PrEP is only one part of a wider programme of work. [Interruption.]

[Mr Speaker]

I think his Whips are pleased to see the arrival of the right hon. Member for South Holland and The Deepings (Mr Hayes). He has never knowingly been keen to be hurried on anything.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

Will the Minister clarify the timescale for the decisions? Evidence reviews and trials can take months and years, but clearly, as other Members have said, people do not have months and years. Will she tell us what the process and the timescales will be, so that we can be reassured—or not?

Points of Order

John Bercow Excerpts

Tuesday 7th June 2016 Commons Chamber

[Andy McDonald (Middlesbrough) (Lab)]

On a point of order, Mr Speaker. As you know, the SSI plant on Teesside closed, with the loss of 9,000 jobs. Lord Heseltine, the Secretary of State for Communities and Local Government and the northern powerhouse Minister, the Under-Secretary of State for Communities and Local Government, the hon. Member for Stockton South (James Wharton) are in my constituency at the Riverside stadium, launching the noble Lord’s much-awaited report in response to that crisis. I received notification of that by email at 3.33 yesterday and a copy of the report at 6.20 this morning. In fairness, having contacted the Secretary of State, I accept that he is under the impression that I was contacted properly. However, I assure the House that I was not. I have searched for those emails. Colleagues have received them, but I have not.

All I am asking for is some guidance, Mr Speaker. A report about my constituency is going to be delivered in my constituency. Can better direction be given to Ministers on how best they can communicate such activity to Members of Parliament, rather than assuming that it has been properly communicated through emails?

[Mr Speaker]

I say to the hon. Gentleman and the House that there is a firm convention that if a Member intends to visit the constituency of another Member on official business, as opposed to purely private or personal business, the Member whose constituency is being visited should be notified in advance. Nothing is written down anywhere, but it would be a courtesy to notify the Member sufficiently in advance that he or she could be present, or at least in the vicinity, in his or her constituency if it was so wished. That would rather depend on the circumstances of the event, but there should be proper notice.

In the case of Ministers, the requirement is stipulated in the ministerial code. If that has not been complied with in this case, it is regrettable. The hon. Gentleman has made his point and it will have been heard by those on the Treasury Bench. Doubtless it will be communicated, in the forceful terms in which he typically expresses himself, to the Secretary of State.

I hope that it will not be necessary for this point constantly to be raised and then underlined by me from the Chair. It is an elementary courtesy and I think that a lot of people who are listening to our proceedings will think, “Surely colleagues can treat each other in a civil and grown-up way, as would happen in other institutions.” Indeed, I note in the distance some agreement with the point I have just made.

[Melanie Onn (Great Grimsby) (Lab)]

On a point of order, Mr Speaker. I fear that I am going to disappoint you, because my point of order follows on from that exact point, although it does not relate to Ministers. I discovered that the hon. Members for Wellingborough (Mr Bone) and for Corby (Tom Pursglove) were in my constituency last week with the Grassroots Out campaign. They were not on official business, but were campaigning, and they failed to advise me in advance. Will you remind all Members that, by convention, we notify each other in advance? I might not have wished to be there alongside them, however.

Another issue is that factually incorrect information was shared with my constituents. I am sure that the hon. Member for Wellingborough would be horrified to learn that he misled my constituents, in the same way that I am horrified. How can he correct that?

[Mr Speaker]

I am very grateful to the hon. Lady for her point of order. With reference to her last point about allegedly factually incorrect information being disseminated to her constituents, I am bound to say to her that that is a matter of politics. Although I do not know the people of Great Grimsby, I dare say they can bear with stoicism and fortitude the proffering of views to them with which their locally elected Member of Parliament may disagree. That is not a matter for the Chair. [Interruption.] I do not think it is fishy. However, a visit was undertaken, admittedly not by Ministers, but by Members engaged in professional business, and the hon. Lady should therefore have been notified.

Given the context of the EU referendum campaign, I recognise that there will be Members—including doubtless the hon. Members for Wellingborough (Mr Bone) and for Corby (Tom Pursglove)—who may well visit a great many constituencies in a concentrated period. Nevertheless, the convention is an important courtesy and should continue to apply. It is not very difficult or time consuming to comply with it, so I hope that colleagues on both sides of the House will do so from now on.

[Stewart Malcolm McDonald (Glasgow South) (SNP)]

On a point of order, Mr Speaker. The issue we have just discussed in the urgent question on pre-exposure prophylaxis is one that I and many other Members consider to be of huge national importance. Despite the effect of the drug, the numbers of people involved and the great national interest, Parliament has not actually substantially debated the issue aside from that urgent question. As a new Member of the House—I confess that I am still trying to get my head around this place, although I suspect I never will—may I ask whether it would be in order to seek a debate on PrEP under Standing Order No. 24 and, if it would be in order, how one might go about that?

[Mr Speaker]

It is certainly open to the hon. Gentleman to seek such a debate—there is nothing improper about it—but I know that he would not seek advance agreement from me in respect of an application that has not yet been made, the terms of which therefore cannot be known to me and upon which it would therefore be wholly unreasonable to expect me to adjudicate. Apart from that, his point was all right.

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

It is devolved.

[Mr Speaker]

I also say to the hon. Gentleman that, as the Minister mentioned perfectly properly from a sedentary position, the issue is a devolved matter and can therefore be considered elsewhere, as well, but it is perfectly proper for it to be considered here. There are a range of opportunities for its consideration. The mechanism he mentions is a possible approach; there are also Backbench Business Committee debates, Adjournment debates and debates in the name of the relevant Opposition party. I am sure that the hon. Gentleman is on very good terms with the powers that be in his own party; if they judge it a sufficient priority, they might choose to nominate it as a subject for such a debate. Knowing the Minister as I do, I am sure that she would very courteously come along, if it was her responsibility to do so, to listen to the hon. Gentleman’s sonorous tones and speak as appropriate.

[Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)]

Further to that point of order, Mr Speaker. You might be interested to know, as might other Members, that the all-party parliamentary group on HIV and AIDS is holding its own debate and inquiry on the issues under discussion in the urgent question this afternoon and tomorrow. I encourage all Members to attend.

[Mr Speaker]

What a helpful soul the hon. Gentleman is. He is a purveyor of public information, and we owe him a debt of gratitude.

Bill Presented

Wales Bill

Presentation and First Reading (Standing Order No. 57)

Secretary Alun Cairns, Secretary Stephen Crabb, Secretary David Mundell, Mr Oliver Letwin and Greg Hands, presented a Bill to amend the Government of Wales Act 2006 and make provision about the functions of the Welsh Ministers, and for connected purposes.

Bill read the First time; to be read a Second time tomorrow, and to be printed (Bill 5) with explanatory notes (Bill 5-EN).

Excess Winter Deaths

John Bercow Excerpts

Monday 6th June 2016 Commons Chamber

Motion made, and Question proposed, That this House do now adjourn.—(Guy Opperman.)

[Mr Speaker]

I am sure that colleagues who—unaccountably—are leaving the Chamber will do so quickly and quietly, so that the hon. Gentleman who has the Adjournment debate can make his case and be heard with courtesy and attentiveness.

Dietary Advice and Childhood Obesity Strategy

John Bercow Excerpts

Monday 23rd May 2016 Commons Chamber

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

I thank the right hon. Gentleman for the question. The Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison), is principally responsible for this issue, but as she is on Government business in Geneva—a cruel twist of fate— I am pleased to respond to his question.

Tackling the unacceptable level of childhood obesity in this country is a major priority for all of us in this House and for the Government. We know that obese children are much more likely to become obese adults. In adulthood, obesity is a leading cause of serious diseases, such as type 2 diabetes, heart disease and some cancers. Tackling obesity and improving diet, especially in children, is therefore one of our major priorities and an issue that we made a commitment to tackle in our manifesto.

Evidence shows that obesity is a complex issue to which there is no single solution. Tackling childhood obesity requires a full package of bold measures and collective action by Government, businesses, health professionals and individuals. Our comprehensive childhood obesity strategy, which is being launched this summer, will be a key step forward in helping our children to live healthier lives. It will look at the range of factors that contributes to a child becoming overweight and obese, and it will also set out what more can be done by all. Our cross-Government approach, led by the Department of Health, is based on the latest scientific evidence from Public Health England and the Scientific Advisory Committee on Nutrition.

As for the views expressed today by the National Obesity Forum on how to prevent obesity and type 2 diabetes, Public Health England has described them as irresponsible, as they do not reflect the totality of the evidence base. By contrast, Public Health England’s dietary advice is based on advice from independent experts on the Scientific Advisory Committee on Nutrition, which, in turn, is based on all available evidence. SACN conducts full-scale consultations on draft reports and goes to great lengths to ensure no bias. International health organisations agree that too much saturated fat raises cholesterol, increasing the risk of heart disease, and that obesity is caused by consistently consuming too many calories.

[Mr Speaker]

Order. It should now have become clear, but for the avoidance of doubt, in particular for the benefit of those attending our proceedings who are not within the Chamber, that these matters should be self-contained and readily intelligible. The request from the right hon. Member for Leicester East (Keith Vaz) was to the Minister to provide a statement on dietary advice and the childhood obesity strategy. All is now magnificently clear.

[Keith Vaz]

May I thank you, Mr Speaker, for granting this urgent debate and the Minister for his answer to the question?

The National Obesity Forum’s report published today has led to a public outcry and confusion. Indeed, the conclusions of this report contradict much of the health and lifestyle advice issued by the Government and the NHS over the past decade. Ordinary people are now caught in a whirlwind of conflicting advice at a time when they desperately need clarity, consistency and straight talk. Quite simply, they do not know where to turn. The Royal College of Physicians, the Faculty of Public Health and the British Heart Foundation have all raised concerns about this report. Some have claimed that local authorities, schools and the NHS are receiving guidance from organisations whose funding and motivations are not known. I welcome the use by the Minister of the word “irresponsible” in respect of this report.

The critical issue, however, is the delayed publication of the childhood obesity strategy. We were first told that this would be published in December 2015. We were then told that it would be February 2016. It is now expected at the end of the summer. No doubt you will confirm, Mr Speaker, that there is no clear indication from the Government as to when the end of the summer will be. Amid the delays, other voices are filling the vacuum. Clearly, a strategy is required on what steps are needed to prevent and tackle the growing levels of obesity, which, at current rates, are expected to reach 60% of the adult population by 2025. We need a definitive date for the publication of the strategy. Will the Minister give us a date today? In the Queen’s Speech last week, the introduction of a sugar tax was confirmed, which I warmly welcome. That could prevent 2.7 million people from being obese, by 2025.

Finally, obesity is a leading cause of type 2 diabetes, as the Minister has said. Just as the rates of obesity are set to increase, the number of people with diabetes is expected to rise to 5 million by 2025. As a type 2 diabetic and chair of the all-party group for diabetes, I live with how stark the situation is. Sadly, today’s information tsunami has demonstrated a lack of leadership in public health. Although the Public Health Minister should be commended for all the work she has done, the Government must go further. Failure to act now will jeopardise the future of our nation’s health and the solvency of our national health service.

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[Alistair Burt]

In accordance with the last answer I made to the last question when I was last at the Dispatch Box, the answer is yes.

[Mr Speaker]

Order. We now come to an urgent question to be asked by Mr Bernard Jenkin. Not here. Where is the fella?

[Hon. Members]

Brussels.

[Mr Speaker]

I find it very hard to believe that the hon. Gentleman is in Brussels. [Interruption.] Order. Given that I have granted the hon. Gentleman’s application for an urgent question, it is a considerable discourtesy for him not to be here at once. He should have been in the Chamber. This must not happen again. The hon. Gentleman is a very serious and conscientious parliamentarian. If you put a question in, man—be here. Let us hear it. I am sorry to be annoyed, but I am annoyed, because the House’s interests are involved. This is not just about the hon. Gentleman; it is about all the other Members who have bothered to be here on time and about the interests of the House. The Minister was here well in time, which is good, and the shadow Minister has toddled in—the hon. Member for Wolverhampton South West (Rob Marris) beetled into the Chamber just in time. Let us hear from the hon. Member for Harwich and North Essex (Mr Jenkin).

[Mr Bernard Jenkin (Harwich and North Essex) (Con)]

Thank you, Mr Speaker. I accept your admonition with good grace.

Junior Doctors Contract

John Bercow Excerpts

Thursday 19th May 2016 Commons Chamber

[Mr Speaker]

Let’s hope that Mummy Howlett is satisfied. If not, I dare say that we shall hear about it.

[Danny Kinahan (South Antrim) (UUP)]

I congratulate the Government and everyone involved on getting this deal in place. It will have a knock-on effect in my constituency in Northern Ireland. When I went around Antrim Area hospital, the concern was to do with the number of doctors, which we have heard about from other Members, and how to get seven-days-a-week cover from everything else that needs to go into the health service. Will the Secretary of State comment on how we will deal with that, and how we will work with the devolved Parliaments?