Oral Answers to Questions
John Bercow Excerpts(8 years, 8 months ago)
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Mr Speaker
As I have often had cause to observe, repetition is not a novel phenomenon in the House of Commons.
Mr Philip Hollobone (Kettering) (Con)
In Northamptonshire, 80% of end-of-life patients die in hospital, whereas 80% of end-of-life patients want to die at home, assisted by the hospice movement. I have discovered that GPs are ticking the end-of-life box on the quality outcomes framework form, but that that information is not being passed automatically to local hospices. What can the Department do about that?
Alistair Burt
I meet regularly, as does the Department, with our partners in the provision of social care. A new recruitment and retention strategy has been launched by the Department of Health and Skills for Care on how to ensure more care is provided by more skilled and more valued workers in the home environment. My hon. Friend is right to raise this issue.
Barbara Keeley (Worsley and Eccles South) (Lab)
The ResPublica report, “The Care Collapse”, states that our residential care sector is in crisis. It says:
“Providers are being faced with an unsustainable combination of declining real terms funding, rising demand for their services, and increasing financial liabilities.”
It also states that a £1 billion funding gap in older people’s residential care would result in the loss of 37,000 care beds, which is more than in the Southern Cross collapse. No private sector provider has the capacity to take in residents and cover the lost beds, so those older people will most likely end up in hospital. What is the Minister doing to protect the care sector from catastrophic collapse?
Mr Hunt
I gently say to the hon. Lady that we have to find efficiencies in every part of the NHS, and we are asking the public health world to find the same efficiencies as hospitals, GP surgeries and other parts of the NHS, but that should not be at the expense of services. I completely agree with her about childhood obesity, on which we will announce some important plans shortly.
Mr Speaker
Forgive me colleagues, but what we need at Topical Questions is short inquiries, without preamble, if we are to make progress. Let us be led in this exercise by Fiona Bruce.
Fiona Bruce (Congleton) (Con)
T3. This is alcohol awareness week. In Scotland, the number of drink-driving offences dropped by 17% in the first three months after the introduction of a lower drink-driving limit. In the light of this encouraging evidence, is the Minister’s Department looking at the public health implications of reviewing the drink-driving limit in England and Wales as part of its alcohol review?
NHS (Charitable Trusts Etc.) Bill
John Bercow Excerpts(8 years, 8 months ago)
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The Minister for Community and Social Care (Alistair Burt)
Before we leave the Scottish dimension, may I say that my granny was born in Angus, fairly close to where J. M. Barrie comes from?
Mr Speaker
Order. We are learning quite a lot about Members’ family circumstances, and it is very illuminating.
Wendy Morton
That is the beauty of being in the Chamber on a Friday, Mr Speaker.
Anne Marie Morris (Newton Abbot) (Con)
I congratulate my hon. Friend the Member for Aldridge-Brownhills (Wendy Morton) on bringing her private Member’s Bill before the House for its Second Reading. I also congratulate her on her election in May, which ensured that a seat that has long been Conservative remained blue.
I am pleased that the Bill is to receive its Second Reading today. It aims to allow Great Ormond Street hospital to continue to benefit from J. M. Barrie’s generous and noble gesture. It would allow all royalties derived from public performances, commercial publications or communication to the public of “Peter Pan” to be donated to Great Ormond Street hospital. It is not known precisely how much those royalties have raised over time, because apparently a condition in Mr Barrie’s will stated that he wanted the amount raised to remain unknown. The charity itself states that
“it’s enormously valuable—not only in financial terms, but as a symbol and as an icon—and has brought a fair amount of income to the hospital.”
To give some context to the value of the royalties, I draw attention to the fact that Disney donated more than £10 million to the hospital in just seven years, between 2008 and now. That money does not come directly from royalties and reaffirms the value of Barrie’s connection to the hospital.
The Bill makes provision in relation to two main subjects. First, as my hon. Friend the Member for Aldridge-Brownhills has explained, it would remove the Secretary of State’s powers to appoint trustees for NHS bodies in England. That would make good a commitment made by the Government in 2014. It would therefore allow for greater independence of NHS charities, which has been a concern for a number of generally larger NHS charities, which therefore support this reform. The Charity Commission, for example, said that dual regulation under both NHS and charity legislation made it difficult for NHS charities to achieve and demonstrate independence. Those concerns will be made better if we remove the Secretary of State’s power to appoint trustees on behalf of NHS trusts and foundations. I know the Department of Health is in favour of that.
Secondly, the Bill amends the Copyright, Designs and Patent Act 1998, notably sections 301 and 304 and schedule 6. Clause 3(3) changes the relevant words from
“on trustees for the benefit of the Hospital for Sick Children, Great Ormond Street, London”
to
“GOSH Children’s Charity for the benefit of Great Ormond Street Hospital for Children”.
The Bill permits the accumulation of all royalty rights to the trustees for the benefit of Great Ormond Street Hospital, London. It will allow the transfer of royalty rights to Great Ormond Street Hospital Children’s Charity of any performance or publication of the play “Peter Pan” in the UK. In doing so, Great Ormond Street hospital is free to move, in full, to become an independent charity under the regulation of the Charity Commission without the risk of losing its protection under the Copyright, Designs and Patents Act. This, as my hon. Friend made very clear, removes the dual legislation that may be perceived by some to be rather burdensome. Direct transfer of royalties will promote efficiency and, as she correctly says, reduce red tape and drive down costs, which all good Conservative Governments endeavour to achieve.
This Bill is not the first step that the Government have made towards reviewing the regulation and governance of NHS charities. In 2011, the Department of Health conducted a review of NHS charities and consulted on proposals to change the policy on their regulation and governance. In the response, charities welcomed the opportunity to seek greater independence by removing dual regulation requirements. It was clear from their responses that the current regulatory system was of considerable concern. The trustees of the Oxford Radcliffe Hospitals Charitable Funds gave the following favourable response:
“The Trustees are not likely to want to move in this direction proposed by the consultation paper in the near future, but have no objection to the Department making the transfer to an independent charity possible, providing there is no compulsion to do this.”
Sheffield Teaching Hospitals NHS Foundation Trust was also in favour, provided that the Department of Health ensured that the appropriate safeguards are in place. It said:
“The Trust has no objection in principle to NHS charitable trusts being transferred to a nominated charity outside of NHS Legislation subject to appropriate safeguards being in place to ensure that the interests of NHS patients and the relationship with the individual NHS provider bodies are preserved.”
Similarly, UCL Hospitals Charitable Foundation said:
“Yes, as this would allow the charity to be established under an incorporated model and remove the current unlimited liability for individual trustees and the freedom to appoint trustees without the constraints of the current set up.”
Mr Speaker
Order. Let me very gently say to the hon. Lady that I understand the natural temptation to look in the direction of a sizeable coterie of colleagues, but she is addressing her speech to the House as a whole and through the Chair.
Anne Marie Morris
I am appropriately reprimanded, Mr Speaker. I shall ensure that, in particular, I give you the focus and attention you clearly deserve, and indeed Members on the Opposition Benches.
I will continue with the history behind this valuable Bill. The Bill addresses concerns about the Secretary of State’s powers to appoint trustees of NHS foundations and trusts. In 2012, Barts and The London Charity and the Royal Brompton & Harefield Hospitals Charity said that it was
“unclear as to why the Department seems at pains to preserve the Secretary of State’s…ultimate control over the appointment and removal of trustees”.
They added:
“We broadly agree with the stated aims of the review and would welcome the outcomes listed in”
the report,
“particularly those that would result in NHS charities being able to deliver improved services to NHS patients as their beneficiaries.”
In “Review of the regulation and governance of NHS charities”, the Government’s response to the consultation, the Secretary of State said that he was
“willing to seek to remove those specific legislative provisions as soon as possible.”
The Bill allows him to fulfil that promise.
The Bill refers not only to past consultation, but to past legislation. Following the expiry of the copyright on “Peter Pan” in 1987—50 years after the death of J. M. Barrie—it was concluded that Great Ormond Street hospital should continue to benefit from Mr Barrie’s gesture, and legislation was enacted to do so under the Copyright, Designs and Patents Act 1988. Sections 301, 304 and schedule 6 briefly became redundant, due to a European Union directive on copyright, which meant that copyright law was
“harmonised at 70 years after the death of the author or 70 years after the work is lawfully made available to the public”.
The directive was implemented on 1 July 1995, giving Great Ormond Street hospital extra copyright until 2007. The 1988 Act then came into force and that unique Act remains in place to this day.
The Bill builds on this House’s commitment to Great Ormond Street hospital to benefit from the royalties from “Peter Pan”—as laid out in the 1988 Act—by effecting a change in the identity of the person on whom the right is conferred. That is because, under charity law, the trustees have converted from being special trustees appointed by the Secretary of State to being an independent charity.
There is much more to the relationship between Barrie and Great Ormond Street hospital than a benevolent gesture. Barrie’s brother was the inspiration for the play after his tragic death just before his 14th birthday. His mother was said to take comfort from the fact that her son would remain a child forever, and thus the seed was planted for “Peter Pan”.
“Peter Pan” is the story of how a young family travel to a magical land—Neverland—with the help of a little bit of fairy dust. They learn that family is a very important concept, and I have no doubt that many of the visitors to Great Ormond Street hospital and many hon. Members can relate to that. They encounter numerous perils in the shape of a hook-handed pirate, a crocodile that has swallowed an alarm clock and a jealous fairy named Tinker Bell. The story concludes with Peter Pan, the boy who did not want to grow up—I know many other boys who do not want to grow up, many of them quite old—being unable to connect with his friends as they grow older and he remains a child.
Great Ormond Street hospital works to make sure that children do get that opportunity to grow up, but without losing the comfort and experiences of being a child and enjoying their young lives. Sadly, some visitors to Great Ormond Street do not grow up, much like Barrie’s younger brother David, and the connection to Peter Pan is therefore strong ever more.
Since its completion in 1904, “Peter Pan” has formed the basis of nine films, including a spin-off series on Tinker Bell, one radio adaptation and nine TV shows since 1955, the first of which was a stage adaption aired on NBC. Seven video games contain characters from the “Peter Pan” universe. Not only that, but “Peter Pan” has continued to be reproduced in countless plays, books and comics. According to the Great Ormond Street website, between now and next March, 23 runs of “Peter Pan” will be performed across the country—north, south, east and west—including in the northern powerhouse, which is a testament to the fantastic work and its legacy.
Barrie was a great supporter of the work Great Ormond Street hospital did then; it continues to do such work to this day. In 1929, he was approached to sit on a committee to buy some land so that the hospital could build a much needed new wing. Barrie declined to serve on the committee, but said that he hoped to find another way to help. Two months later, the hospital board was stunned to learn that Barrie had handed over all his rights to “Peter Pan”. At a Guildhall dinner later that year, Barrie, as host, claimed that Peter Pan had been a patient in Great Ormond Street hospital and
“it was he who put me up to the little thing I did for the hospital.”
It therefore seems fitting that such a gesture was made to the hospital to continue its great work.
As my hon. Friend the Member for Aldridge-Brownhills said, Great Ormond Street Hospital Children’s Charity raises money to enable the hospital to provide world-class care and to pioneer treatments and cures for childhood illnesses, with an estimated 255,000 patients coming through its doors every year. The hospital originally had just 10 beds and two doctors.
Anne Marie Morris
The hon. Gentleman raises a very important point about drugs. The Government are absolutely focused on that issue. Far be it from me to take words out of the Minister’s mouth, but I am sure that he may well cover the hon. Gentleman’s comments on drugs in his response. Among other things, the special cancer drugs fund has made a considerable difference to many people suffering from cancer.
On that note, I will carry on talking about this really important piece of legislation, and to explain to hon. Members a little more about the history of the hospital. As I originally stated—[Interruption.] Mr Speaker, you are looking querulous. May I continue?
Mr Speaker
The hon. Lady has the floor, but I am sure that she will want to have some regard to the fact that several other hon. Members wish to speak. I am cautiously optimistic that she is approaching her peroration.
Anne Marie Morris
Mr Speaker, this is such a fascinating subject that I want to ensure it gets the air time it deserves. I know that my hon. Friends also have a lot to say. I am sure that we will manage to have an interesting and long debate.
Junior Doctors’ Contracts
John Bercow Excerpts(8 years, 8 months ago)
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Grahame M. Morris (Easington) (Lab)
I would like to relay some comments made to me when I participated with other colleagues in a demonstration in Newcastle attended by about 5,000 junior doctors. I had the great honour to be in the company of Dr Rachel King, a dedicated professional from South Tyneside district general named “doctor of the year” for her outstanding contribution in the field of care of the elderly, and some of her colleagues. I was struck by their commitment. They love the service, they want to protect it and they want to see their profession valued, and to that end they asked me to make a few points today.
For them, this debate is not about money, although I take issue with the claim from some Members that the reforms are cost-neutral and that doctors will not lose out. That might be the case overall, but the hon. Member for Finchley and Golders Green (Mike Freer) made a really good point: some individuals might lose out. They pointed out that junior doctors, en masse, do not support the reforms. These are clever people—the cream of the crop—and we should listen to them. They know how the service works and how it should be reformed.
They also pointed out that the reforms could increase the danger to patient safety because they might well not solve the problem of junior doctors working longer hours. As colleagues have pointed out, including the hon. Member for Central Ayrshire (Dr Whitford), the protections currently in place are to be removed, yet we have not had an assurance that something else will be put in their place. As we all know, tired doctors make mistakes. We need to address this issue about discouraging career breaks. Many junior doctors are women who leave to have children. Having spent a great deal of money on training them—the Secretary of State may be able to tell us the figure, but I believe it is in the order of £200,000 or £250,000—we want to encourage them to come back into the profession. There are concerns about not having enough people going into specialist areas.
We need to address the issue about recruitment and retention. Members representing constituencies in the north of England have touched on the issue of how attractive it would be for people to go to Scotland where the new contract does not apply. Over a period of two or three days, about 1,300 GPs made an application for the certification to practise abroad. That should be a real concern when we are having difficulty recruiting and retaining GPs. There is also a knock-on effect in general practice, but I will leave it there, given the shortage of time.
Fabian Hamilton (Leeds North East) (Lab)
On a point of order, Mr Speaker. You might recall that on Monday you granted me an urgent question about the arrests of a Chinese dissident, who is now a British citizen, and two Tibetan students following demonstrations against the Chinese President during his visit last week. Can you advise me whether there is any way in which I can record the fact that all charges have been dropped against the two students and the dissident Chinese British citizen?
Mr Speaker
There is, and the hon. Gentleman has found it. On reflection, he will know that he has found it. The matter is on the record forever thanks to the ingenuity of the hon. Gentleman.
Oral Answers to Questions
John Bercow Excerpts(8 years, 9 months ago)
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Several hon. Members rose—
Mr Speaker
Order. May I just gently advise the hon. Member for Croydon South (Chris Philp) that he should not stand at this point? He has Question 3. It will be very easily reached, so he should not stand before then. There is no merit in doing that at all.
Dr Andrew Murrison (South West Wiltshire) (Con)
Unfortunately, every time I open a page of my local newspaper these days I am met with the beaming face of yet another general practitioner in his mid-50s who has decided to throw in his hand after many, many years of serving his community. These doctors are best placed to manage patients in primary care and ensure that they do not have to go to secondary care or A&E. What analysis has my right hon. Friend made of the reasons these experienced professionals are leaving the profession prematurely, and what will his reforms do to stem the tide?
Andrea Jenkyns (Morley and Outwood) (Con)
Infection control in the community is a great way to reduce preventable illness. In November, I will launch a handwashing campaign in Parliament that I hope will have cross-party support. Will the Minister inform the House what his Department is doing to promote infection control outside the hospital setting?
Mr Speaker
Order. I listened carefully because I wished to hear the development of the question, but it did not appear to relate to mental health services.
Mr Speaker
Never mind. These things can always be recycled on subsequent occasions. I have been there and I have done it, and the hon. Lady should fear not.
Norman Lamb (North Norfolk) (LD)
The Minister referred to the additional money for eating disorders in the autumn statement last year, the purpose of which was to introduce a maximum waiting times standard from next April. We all know that early intervention is critical. It is a condition that kills too many people. Will he confirm that he remains committed to introducing a maximum waiting times standard for eating disorders from next April?
Alistair Burt
May I welcome the hon. Lady to her position, not least her Cabinet position—he said carefully—and welcome the prominence that mental health now has among all parties? Let me say rather gently in response to the tirade that I have just received that under this Government we have for the first time introduced parity of esteem for mental health on waiting times and national access targets. We are spending more money—£1.25 billion over the next five years. We have the highest number of beds for young people in emergency situations; we have the first dedicated education Minister for young people’s health; we have £75 million for perinatal health; and in her own constituency, the hon. Lady will be pleased to welcome from her shadow Cabinet position an extra £1.1 million going to Liverpool for mental health treatment for children and young people. I think that is a significant response.
Mr Speaker
I do not know who writes a lot of this screed, but sometimes a blue pencil needs to be taken to it. The Minister is immensely capable and experienced, but a distillation or an abridged version rather than a “War and Peace” version would be appreciated.
Chris Philp (Croydon South) (Con)
3. What progress his Department has made in delivering seven-day-a-week NHS services.
Mr Speaker
I think the thrust of the hon. Gentleman’s view is very clear, and he has expressed it with unmistakable force.
Several hon. Members rose—
Mr Speaker
Order. As in the health service under any Government, demand on these occasions always tends to outstrip supply. I apologise to colleagues who did not get in, but we must now move on.
NHS: Financial Performance
John Bercow Excerpts(8 years, 9 months ago)
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Urgent 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
Ben Gummer
My hon. Friend is right to point to this area of health policy as one that is of interest. That is why the Law Commission reported on professional regulation before the last election. It is being kept under close review within the Department.
Mr Speaker
We are straying a tad from the relatively narrow terms of the urgent question, to which I know colleagues will be eager to return, and none more so than the hon. Member for Strangford (Jim Shannon).
Jim Shannon (Strangford) (DUP)
I thank the Minister for his statement. This is a question for Members across the whole of the United Kingdom of Great Britain and Northern Ireland, where there are pressures on the NHS, because while we all have passion and love for the NHS, we must ensure that there is enough money for it. Will the Minister confirm the amount of money that will be there for accident and emergency departments and say what will be done on waiting lists?
NHS Reform
John Bercow Excerpts(9 years ago)
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Dr Philippa Whitford (Central Ayrshire) (SNP)
I have to declare an interest: like most doctors, I am a member of the British Medical Association.
I commend the Secretary of State for his announcement about a national officer for whistleblowers. Shona Robertson, Scotland’s Cabinet Secretary for Health, announced this in June, and we are taking action on the Francis report in the same direction. It is vital that members of staff feel they have someone to speak to if things are not going well, and that if they are not being responded to locally there is an independent voice that they can go to.
With regard to seven-day services, the excess deaths of people who are admitted at weekends is recognised and abhorred by the vast majority of doctors. I do not know anybody who gets up and works the hours we do and does not care that someone did not do well. However, I think we are blurring the lines between the elective and emergency systems. The sickest people the Secretary of State mentions—those who run the risk of dying if admitted on a Friday or a Sunday—are not part of the elective system but of the out-of-hours emergency system. It is suggested that hospitals are like the Mary Celeste and there are no doctors. In fact, any service with an emergency component runs 24/7, but there is a multi-disciplinary team. Sometimes patients will be stuck on a ward because they cannot get access to a scan or there is no physiotherapist to help them recover from their stroke.
We are already working towards solving this in Scotland. We are doing so in a more collaborative way, and that is important. There is no resistance to that, because it is recognised that we need all parts of the service. This is different from people coming in for a routine check-up on a Sunday when that does not result in a detriment to them if it is not available. The biggest shortage we have is in human resources—doctors, nurses, physios, occupational therapists and radiographers. I recommend that the Secretary of State separate these two aspects. The first is that hospital consultants did not get the option to opt out of 24/7 care for emergency patients in the contract, whereas GPs did. It is a matter of providing, funding and setting up a full service with all that is behind it to deal with ill patients seven days a week, no matter when they come in.
The other aspect is trying to get value for money. If we have invested in expensive machines and theatres, we want them to work as many days a week as possible so that we get value for money, but that must be secondary to the first priority, which is looking after sick people. I suggest that the Secretary of State starts talking about the two aspects on separate tracks and not crossing backwards and forwards, and that this should be collaborative. I echo the hon. Member for Totnes (Dr Wollaston) in saying that we require the money to be front-loaded so that we get it to start changing the service now.
Mr Speaker
Order. May I gently say that from now on we are going to have to enforce the time limits on Opposition responses to ministerial statements much more strictly? Otherwise they eat into the time available for other colleagues. The shadow Secretary of State has five minutes in response to a 10-minute statement and the third party spokesperson has two minutes. That really does have to be adhered to as a matter of course from now on.
Mr Hunt
The hon. Lady speaks with the authority of someone who works in hospitals, and I always listen to her very carefully. I do not think it is easy to make a rigid distinction between elective and emergency care. The opt-out in emergency care does apply, for example, to accident and emergency doctors. Sometimes when people are admitted to hospital because they are ill—they would not be admitted if they were not—their condition may not appear to be life-threatening on a Friday afternoon but then, over the course of the weekend, they deteriorate, and by the time they are seen by a senior consultant on a Monday or a Tuesday, it is too late. The trouble is that we have a culture in which a lot of major services are available only from Monday to Friday, and that is what is causing these avoidable deaths. The hon. Lady is right to say that this is not just about senior consultant cover; it is also about diagnostic care, handovers and many other things, and we are working at those. The Royal Edinburgh Infirmary has done a very good job of eliminating the difference between weekday and weekend mortality rates, as have Salford Royal and Northumbria hospitals in England. We need other hospitals to follow those examples.
Mr Bernard Jenkin (Harwich and North Essex) (Con)
I thank my right hon. Friend very much for his extraordinarily embracing response to the Public Administration Select Committee report on clinical incident investigation. We started less than a year ago with the germ of an idea, and it has turned into what amounts to a radical reform of safety investigation in the health service. That is a tribute to him and to the Committee’s witnesses, but it is a tribute to the health service itself that it has embraced the idea, which is a big change that I believe will be transformative.
May I pick up on the Secretary of State’s reluctance to provide special legislation for the immunity of those giving evidence to the new patient investigation body? Will he keep an open mind on the subject? If he wants that body to be truly independent and to have a special status, he should remember that the marine accident investigation branch and the air accidents investigation branch have specific legislation to provide for such immunity. Public interest disclosure protection must not be challenged by freedom of information requests, given that freedom of information has been extended into areas where we never imagined it would go. We have to be specific in legislation that that cannot happen in this instance.
Mr Hunt
It will, Mr Speaker.
My hon. Friend’s idea is really interesting, and I am happy to take it up and explore whether we need to replicate that immunity so that we can get to the truth more quickly in a no-blame context.
I thank my hon. Friend for the work of the Public Administration Select Committee. I think it is true to say that we would not have the new patient safety investigation service, modelled on the air accidents investigation branch, which has worked so well in the airline industry, if it had not been for the work of PASC. It brought the idea to my attention and it was a good idea, and I know that he will help me make sure that it is a success in practice as well.
Oral Answers to Questions
John Bercow Excerpts(9 years ago)
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Ian Austin (Dudley North) (Lab)
Will the Minister conduct a review of car parking charges? Patients in Dudley are absolutely furious after the people running Russells Hall hospital put up prices by as much as 50% for a short stay. Will he get together with NHS civil servants and the people running the hospitals to sort this out?
Mr Speaker
Because of the impact of parking charges on those seeking to access acute services.
Ben Gummer
Thank you Mr Speaker—helpful as ever.
The hon. Gentleman is entirely right that those who seek to access acute services on a regular basis require special treatment. That is why we issued guidance in the previous Parliament. I very much hope that his local hospitals will be looking at that with due care and attention.
Harry Harpham
As revealed in Muscular Dystrophy UK’s “Right to breathe” report published in February 2015, in some areas of the country patients have access to cough-assist machines which the local clinical commissioning group will not fund in other areas, despite a clinical need being clearly identified. These machines can help to prevent potentially fatal respiratory problems and to reduce costs and lengthy, unplanned hospital visits. A cough-assist machine costs £4,500, whereas a long stay in an intensive care unit can cost more than £13,000. [Interruption.] Will the Minister meet me and representatives of Muscular Dystrophy UK to discuss how better consistency in provision of vital respiratory equipment—
George Freeman
My answer of a few moments ago stands. Decisions on the commissioning of those machines are taken on a case-by-case basis locally. The National Institute for Health and Care Excellence has set out in guidance that cough-assist machines may be appropriate for some patients, but not in every area.
Richard Harrington
My constituent Mr Shabir Ahmed, whom I have visited, was repeatedly recommended, by the optician he went to for his NHS eye test, to have an eye operation involving complex refractive laser surgery. Over two years, the optician called him every month, bringing the price down until it was half what it was originally. It did not work out: the surgery led to a significant deterioration in his eyesight, and the company denies all responsibility and liability. It seems to me—
Richard Harrington
Mr Speaker, please bear with me for two sentences. Surgery as complex as that needs the same kind of regulation as if it were in hospital.
Mr Speaker
Questions do need to be shorter, otherwise they will eat into everyone else’s time.
Ben Gummer
There are two parts to my hon. Friend’s question. The first is about the high-pressure tactics employed by providers. They will be covered by the new regulations brought in on 1 April by my right hon. Friend the Member for Bromsgrove (Sajid Javid), who is now the Secretary of State for Business, Innovation and Skills, by which we have given powers to the Information Commissioner. I suggest that my hon. Friend refers his question to our right hon. Friend. On the second point about failed procedures, refractive eye surgery operators are governed by the same regulators as hospitals, and achieve exactly the end that my hon. Friend wishes.
John McDonnell (Hayes and Harlington) (Lab)
The regulatory procedures are not working. Ten years ago, our late colleague Frank Cook introduced a ten-minute rule Bill calling for regulatory reform, and I reintroduced that Bill three years ago. The Keogh report called for regulatory reform two and a half years ago, and nothing has happened. People are losing their eyesight as a result of some of the companies operating in this field. Will the Minister meet me and the hon. Member for Watford (Richard Harrington) to talk about progress in this field?
Heidi Allen (South Cambridgeshire) (Con)
T7. This is a request really: will the Secretary of State please meet me and GPs from the surgery in Cambourne—which we could call a new town—who are significantly underfunded? The funding model does not work for them; they are at breaking point, and they need your help.
The Parliamentary Under-Secretary of State for Life Sciences (George Freeman)
I can confirm that the Minister for Community and Social Care will be delighted to meet my hon. Friend. NHS England is looking into how the fair funding formula works between different clinical commissioning groups, which is the reason for the uncertainty, and I, too, would be happy to meet my hon. Friend and confirm the process.
Alistair Burt
I will look at the issue my hon. Friend raises. Clearly, in the first place, we want to make sure that more beds are available more locally, so that the issue does not arise. Greater concentration is being given not only to that, but to the level of care that can be provided before in-patient treatment is considered. I will take the point he makes about benefits and raise it with the relevant Department.
Jim Shannon (Strangford) (DUP)
A recent study suggests that the NHS is starting diabetics on insulin much later than in other countries. What will the Department do to address that issue?
Mr Jeremy Hunt
My hon. Friend is absolutely right and has great experience in this area. We are now having a lot of transparency at an institutional level, but individual doctors and nurses in primary and secondary care are still finding it too hard to speak out if they have concerns. Getting that culture right has to be a big priority for this Parliament.
Greg Mulholland (Leeds North West) (LD)
Thank you, Mr Speaker. On 22 June, the Life Sciences Minister said in a written answer:
“The decision on the interim funding of Vimizim…will be made by NHS England by the end of June 2015.”
The families involved, and also families affected by Duchenne muscular dystrophy and tuberous sclerosis, were then told that there would be a decision on 30 June and 1 July—
Mr Speaker
Order. The hon. Gentleman will resume his seat. It is a discourtesy to the House to be long-winded, especially when exhorted not to be. The hon. Gentleman has got—[Interruption.] Order. Do not argue the toss with the Chair, Mr Mulholland. Don’t shake your head, mate. I am telling you what the position is: you were too long. [Interruption.] Leave, that is fine—we can manage without you. [Interruption.] You were too long and you need to learn. That is the end of it. I call Mr Peter Bone.
Mr Peter Bone (Wellingborough) (Con)
Does the Secretary of State agree that hospital parking charges are unfair?
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
When will the Minister do more for parents whose children are on the autism scale?
Mr Speaker
Order. May I say thank you to colleagues? I am sorry but demand always exceeds supply—as it does in the health service—[Interruption.] Under any Government.
For the avoidance of doubt, I hope that colleagues will understand that I appreciate—I have been on those Benches—that all Members’ questions are important. Of course Members feel very strongly about them. I am sympathetic to that and I respect that, but people cannot simply take the attitude, “My question is important and therefore I can be much longer” because that is not fair on other Members. I am simply trying to be fair to all Members.
Bill Presented
Health Services Commissioning (Equality and Accountability) Bill
Presentation and First Reading (Standing Order No. 57)
Rehman Chishti, supported by Tom Brake, Yasmin Qureshi and Jeremy Lefroy, presented a Bill to make provision to reduce inequalities in the commissioning of health services for people with mental illness and learning disabilities; to require commissioners of health services for people with mental illness and learning disabilities to make an annual report to the Secretary of State on the equality of service provision to, and the health outcomes for, such people and of their qualitative experience of health care services; and for connected purposes.
Bill read the First time; to be read a Second time on Friday 11 September, and to be printed (Bill 49).
NHS Success Regime
John Bercow Excerpts(9 years, 1 month ago)
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Urgent 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
Mr Speaker
Order. I understand that there is a high-spirited atmosphere in the Chamber and a great deal of interest in this subject, but I remind Members that brief questions and brief answers should be on the subject of the urgent question—namely, the success regime. It is with that matter that we are dealing this morning.
Dr Sarah Wollaston (Totnes) (Con)
I welcome the additional support for struggling health economies, even if it is a classic example of NHS newspeak to call it a success regime. Will the Minister reassure the House that, in looking at a wider approach to health economies, he will also look at the funding formulae for health and for social care, which do not adequately take into consideration the impact of age or rurality?
Mr Speaker
Order. I must say that it is a pleasure to welcome back to the House the right hon. and learned Member for Rushcliffe (Mr Clarke), who when he celebrates 45 years in the House this month will I think be approaching the mid-point of his parliamentary career.
Mr Kenneth Clarke (Rushcliffe) (Con)
At this crucial mid-point, thank you very much, Mr Speaker, for that unusual way of calling me.
Does my hon. Friend the Minister recall that the whole purpose of introducing the purchaser-provider divide many years ago, which was developed by the Labour party and is now known as local commissioning, was to concentrate on patient care, patient outcomes and local priorities? Will he therefore, with this welcome announcement, continue to stick by NHS England, allow it to do that, and resist the blandishments of the shadow Health Secretary, who seems to pine for the days of centralised bureaucracy and is still feebly trying to weaponise the NHS for party political purposes?
Jeremy Lefroy
Thank you, Mr Speaker. Will my hon. Friend confirm that at the heart of the success regime will be the provisions of the Health and Social Care (Safety and Quality) Act 2015 on integration and quality?
Oral Answers to Questions
John Bercow Excerpts(9 years, 1 month ago)
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Mr Ronnie Campbell
Is the Minister aware of the case of my constituent, little George Pegg? At one time he could not walk, but this drug has made his life 100% better and he can now walk. Why are we dithering? This has been going on for at least a year, so why don’t you get off that backside of yours and get it approved?
Mr Speaker
Order. May I just exhort Members to have some regard to considerations of taste? This is a new Minister. I call Minister Gummer.
Ben Gummer
I thank the hon. Gentleman for his question. In relation to posteriors, it is good to see his in its rightful place. I have heard of his constituent’s case, which is as distressing as that of Jagger and of all those suffering from Duchenne muscular dystrophy. It is a terrible disease that causes lasting pain to the sufferers and their families. That is precisely why we are pushing hard for a decision from NHS England by the end of this month—it could not have come as quick as he had hoped—and for interim NICE guidance by the end of this year. I am pushing officials to move as quickly as they can on this.
Mr Speaker
Order. I remind the House at the start of the Parliament—this might be of particular benefit to new Members—that topical questions are supposed to be significantly shorter than substantive questions: the shorter the better, and the more we will get through.
Mr Jamie Reed (Copeland) (Lab)
The Secretary of State has said that safe care and good finances go together, but clinical negligence claims are up by 80% since 2010, while trusts are posting huge deficits. Does he think that finances have deteriorated because care quality has deteriorated or that care quality has deteriorated because finances have deteriorated?
Mr Hunt
I think that is harsh. Let me tell the hon. Gentleman some of the progress that was made under the last Government, and that this Government will continue, to reduce the pressure on police, particularly with regard to the holding of people with mental health conditions in police cells. We are in the process of eliminating that; it has seen dramatic falls. We recognise that the NHS needs to work more closely with the police, particularly in such circumstances, and he should recognise the progress that has been made compared with what happened before.
Mr Speaker
Order. I am genuinely sorry that some colleagues were disappointed today; I ran things on a bit, but we need to move on. In one respect, Health questions is analogous to the national health service, under whichever Government, in that demand always exceeds supply, but I have noticed colleagues who were trying to take part today and I will seek to accommodate them on a subsequent occasion.
Health and Social Care
John Bercow Excerpts(9 years, 1 month ago)
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Mr Speaker
Order. No fewer than 41 Members are seeking to catch my eye today, the consequence of which is that there must be a seven-minute limit on Back-Bench speeches, which will have to be rigorously enforced.
Dr Wollaston
I thank my hon. Friend for his points. There is an important piece of work that can be done by the next Health Committee in looking at all the wider workforce issues across the NHS, including those to which he refers.
I shall now touch on seven-day access for the NHS. Such a service is vital, but we must focus on safety. The primary focus of seven-day access must be eliminating the unacceptable variation in mortality rates across the NHS on different days of the week. It is important that we address the issue of reducing avoidable and unnecessary hospital admissions. Perhaps the Minister could look at the frailty service in Newton Abbot which considers how GPs can work together to prevent unnecessary hospital admissions. If we broadened access to general practitioners at the weekends, we might be able to reduce unnecessary admissions to hospital, for example of children with asthma. There is much that can be done, but if we are prioritising providing 8 till 8 access in very rural areas there might be unintended consequences in general practice. If we are diverting funding into areas where we are providing a service in which several practices over a large geographical area have to federate, we could inadvertently end up with patients having to travel further than they would to visit a local out-of-hours service.
Will the Minister carefully consider the unintended consequences when we implement seven-day access to ensure that we do not divert essential funds that could be used for safety and avoiding unnecessary admissions into something that is worth while in theory but that might not give the best outcomes for patients? I hope that the Minister will be able to reassure me that the Government will allow local CCGs to look carefully at what is best, while consulting local communities, and to be as flexible as possible.
I also ask the Minister to consider the importance of volunteering across the NHS. In all our constituencies there will be extraordinary organisations that work as partners with the NHS, but I have some concerns, one of which I would like to share with the Minister. In my area, a wonderful charity called Cool Recovery worked with users of mental health services and their families to provide an extraordinary level of support. Sadly, particularly given that I was a patron of this charity, I have to report that it is having to fold for the want of a relatively small amount of stable long-term funding. The voluntary sector—those partner organisations across the NHS—is calling out for access to stable long-term funds. Newly set-up charities gain access to very valuable funding sources, but when they apply for funds once they are established, the response is that it should be provided by commissioners. I ask the Minister to consider carefully how we can sustain some of the extraordinary charities working across the country by giving them access to stable long-term funding so that they can carry on with their work. This issue was raised with the Select Committee by the voluntary sector during our inquiry into children and adolescent mental health services, so it is an issue across the NHS that is causing real problems.
Mr Speaker
Order. I am listening intently to the hon. Lady, as always, and as I know the House will be. It is by accident that the clock is not operating as I had intended it to. In short, I had intended the seven-minute limit to apply to the hon. Lady. It would be unfair suddenly to apply it, but she ought to operate according to its spirit, and I know she is approaching what will be a very impressive peroration.
Dr Wollaston
A flourish! I apologise, Mr Speaker. I was indeed looking at the clock.
As a final flourish, let me mention prevention. We cannot address the financial challenges that face the NHS without considering prevention, and I congratulate the Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison), on everything she achieved in this regard during the previous Parliament. I hope that she will give us further detail on her plans to tackle childhood obesity, particularly as we face a tsunami of health inequality and need in our young people unless we go further.