(10 years, 9 months ago)
Commons ChamberOn a point of order, Mr Speaker. Last week we learned that insurance actuaries had been able to obtain 13 years of hospital medical records on every NHS patient in the country. A report on the use of the data said that the 188 million records were at individual episode level, and the hospital data obtained had many identifiers, including diagnosis, age, gender, area where the patient lived, date of admission and discharge. On Thursday, in a debate in Westminster Hall, the public health Minister, who is in her place, said that she wanted to put it on the record that the data released to the insurance actuaries were publicly available, non-identifiable and in aggregate form. The Minister’s comments on the data released are at complete variance with the reported facts, which were also discussed extensively at the Health Committee last week. There is now a further damaging story in the news that that released patient data were made available online. I understand that the Health and Social Care Information Centre has today had to ask a company to take down a tool that used that hospital patient data online.
May I ask you, Mr Speaker, whether the public health Minister has sought your permission to correct the record from Thursday’s debate. Furthermore, has the Health Secretary asked to make a statement about NHS patient data being made available online?
Not at the moment. I can say to the hon. Lady that the public health Minister did indicate to me a willingness to respond to her intended point of order. The Minister is in her place, and we should hear from her now.
Further to that point of order, Mr Speaker. I thank you for giving me the opportunity to respond directly. In responding to the Westminster Hall debate on Thursday 27 February and in relation to the points made by the hon. Member for Leeds East (Mr Mudie) concerning the release of information to the Institute and Faculty of Actuaries, I did say that the data that were used were
“publicly available, non-identifiable and in aggregate form.”—[Official Report, 27 February 2014; Vol. 576, c. 212WH.]
I was made aware on Friday 28 February that the information I had to hand during the debate did not include the latest clarification received from the Health and Social Care Information Centre. I therefore wrote to the Chair of the debate, my hon. Friend the Member for Southend West (Mr Amess), on Friday to inform him of that. I have today formally written to him and the Members who were present at the debate to correct the statement, and I have copied that to the House of Commons Library.
The correct position was that the faculty requested pseudo-anonymised information and said it would publish it only as anonymous information with all identifiers stripped out. My assertion that the data provided to the faculty were anonymised and publicly available was therefore incorrect, for which I offer my apologies to the House, the shadow Minister, who is in his place, and Members who attended the debate. In handling this request, the NHS information centre did not treat this as a request for sensitive information.
Once again, I thank you, Mr Speaker, for affording me this opportunity and I apologise for the fact that my comments during the debate provided an incorrect impression of the actual events.
I am extremely grateful to the Minister for what she said. It does seem to constitute a most full apology to and an explanation for the benefit of the House. We will leave the matter there. [Interruption.] We will not have a “further to” I am afraid. This matter has been fully addressed. If Members have totally unrelated points of order on completely different subjects, we will hear from them—in other words, for the avoidance of doubt, on matters not appertaining to that which has just been said. The hon. Member for Huddersfield (Mr Sheerman) intends to embark on entirely new terrain.
On a point of order, Mr Speaker. As you know, I have been in this House a reasonable length of time, but something happened to me last Thursday that I do not recall having experienced before. I tabled a question, which in the preliminary agenda was signified as being question No. 7 for the next day. It was a question about my calling for the setting up of a royal commission on the link between climate change and flooding. By the time I got here on Thursday, the full agenda for the day—the Order Paper—had eliminated that question, and transferred it elsewhere. It was clearly a question to a climate change Minister. Why did it disappear and who allowed it to disappear?
What I would say to the hon. Gentleman, who has indeed been in the House for a goodly number of years—it will be 35, to be precise, on 4 May this year—is as follows, and I hope that he will take it in the appropriate spirit. It is entirely a matter for Ministers as to whether they make transfers. The transfer that took place, though immensely disagreeable to the hon. Gentleman, was entirely orderly, and I conclude by saying in the friendliest possible way to him that there are Members who do have something about which to complain but are disinclined to do so and there are Members who sometimes have very little about which to complain but make a very considerable meal out of doing so. It is my firm conviction that the hon. Gentleman has precious little about which to complain, and he is doing his best to make a very large mountain out of an extremely small molehill. [Interruption.] The hon. Gentleman is chuntering from a sedentary position about what I did when I was a Back Bencher, but that was then and this is now.
(10 years, 9 months ago)
Commons ChamberOrder. Time is up. As usual, demand has exceeded supply. Before we come to the ten-minute rule motion, we have a point of order.
(10 years, 10 months ago)
Commons ChamberI advise the House that I have selected the amendment in the name of the Prime Minister.
Perhaps I may help my right hon. Friend by saying that the campaign in North Norfolk began on the Minister’s website after the excellent campaign run by the Labour prospective parliamentary candidate, Denise Burke, who pointed out how deficient local services were—[Interruption.]
Order. I have been watching carefully. Dr Coffey, I fear that you are catching what I can describe only as Gove-itis. You are normally regarded as a rather cerebral soul, and I invite you to try to contain your irascibility for a period, if you can.
Will my right hon. Friend join me in condemning the Government for still classing A and Es as such when, like the one at Charing Cross, they are in practice closing and turning into GP-run clinics? The Government are still calling them A and Es, and people are misled. That will lead them to go to the GP-run centres when they should be going to properly staffed A and Es, and we will get tragedies such as the one at Chase Farm.
The hon. Gentleman should climb off his high horse for a moment. In answer to an important point made by my hon. Friend the Member for Stretford and Urmston (Kate Green), I pointed to the increase in cases of scurvy, rickets and malnutrition. If he wants—[Interruption.] If he wants to deny that that is the case, that is up to him—[Interruption.] If he speaks to A and E staff, he will hear that people who are not eating properly are turning up in ever greater numbers—[Interruption.] I have answered his point and I will now make some progress.
It is the case that too many older people are arriving at hospital in the first place. A recent Care Quality Commission report found avoidable emergency admissions for pensioners topping 500,000 for the first time—[Interruption.]
Order. The exchange between the hon. Member for Liverpool, Walton (Steve Rotheram) and the hon. Member for Taunton Deane is most unseemly. I remind the latter that he is a distinguished former member of Her Majesty’s Government and he should comport himself with appropriate dignity. That is what we look for in an hon. Member who aspires to be a statesman.
Order. I am not dismissing the statesmanlike potential of the hon. Member for Taunton Deane, but I think his journey has some way to go.
The beard is certainly helping. I suggest that the hon. Member for Taunton Deane (Mr Browne) visit Liverpool Walton, because he will see more food banks there than anywhere else in the country. He will meet families who cannot afford to put enough food on the table to give their kids a decent diet. He will see the direct effects of some of his Government’s policies on some of the most deprived communities in the country.
(10 years, 11 months ago)
Commons ChamberA and E is in crisis across the country, but getting people out of hospital in a suitable time frame is also important. What is the Secretary of State doing to better connect the health service with other social care providers? Does he acknowledge that, in places such as Telford and Wrekin, there has been a substantial cut in continuing health care funding, which means the system is in danger?
The first warnings about the challenges facing A and E were put to the previous Government in 2004. The shadow Secretary of State was a Health Minister in 2006 and Secretary of State in 2009-10, but he failed to act adequately to deal with the shortages. It takes six years to train A and E consultants, so it will take six years to deal with the problem. The good news is that under this Government enough doctors are entering acute care common stem training to fill the places available.
Order. I do not wish to be unkind to the hon. Gentleman, but his answers almost invariably suffer from the failing of being far too long. It is nothing to be smug about; he really has to improve.
Mr Speaker, sometimes it takes a long time to rewrite history, which was what the Minister was just doing. The first warnings did not come in 2004. Dr Mann said:
“The first warning signs were three years ago when we failed to recruit 50% of our posts. Those concerns were raised at the time.”
Why does he believe his concerns were ignored? He blames “decision-making paralysis” caused by a top-down reorganisation no one wanted and nobody voted for. Ministers dismantled work force planning structures, making redundant the very people who could have done something to stop the locum bill spiralling out of control. Will he now concede that breaking the coalition agreement promise of no top-down reorganisation has weakened the NHS and made the A and E crisis worse—[Interruption.]
It is the right hon. Gentleman who needs a lesson about not rewriting history. Dr Mann said that this issue had been building for the past decade. When the right hon. Gentleman was Secretary of State and before that a Minister in the Department, he failed to make those long-term work force decisions and also signed up to the European working time directive, which exacerbated the problems on medical rotas. Those were decisions that he made. He created this crisis; we are fixing it and increasing the number of doctors working in A and E.
The point I made earlier is that the number of cases of bed blocking due to social care delays has decreased under this Government. Also, it was the previous Government who began to change the eligibility criteria. Labour Members talk about a crisis in social care, but per-head funding for social care fell in the last term of the previous Government. That is the legacy that we are dealing with, and we are sorting it out—
Order. I do not wish to be unkind to the Minister, but I am quite interested in making progress with Back-Bench Members, who have had to wait too long.
My right hon. Friend is right to feel frustrated. The report did not find any one individual responsible; it found systemic failings. What really matters is what has been done to ensure that this sort of thing does not happen again, or that the chances of it happening again are minimised. Following the publication of the report, NHS London wrote to all the primary care trusts outlining the lessons to be learned, and my right hon. Friend will be relieved to hear that all clinical commissioning groups’ chief financial officers have been subject to a rigorous independent assessment and appointment process.
We come now to topical questions. It would be good to get through the list and beyond, so may I just remind Back Benchers and Front Benchers alike that topical questions and answers are supposed to be brief?
T1. If he will make a statement on his departmental responsibilities.
I think that social isolation, if we are honest about it, has got worse over quite a long period, particularly as extended families have been dispersed far and wide. The answer has to be for the whole of society and must involve statutory services working together with the voluntary sector. In Cornwall, one of the pioneers in integrated care, there is a fantastic collaboration between the voluntary sector and the statutory sector to ensure that they directly address the problems with loneliness.
What steps is the Secretary of State taking to ensure that the number of cancer indications treated in this financial year by stereotactic ablative radiotherapy does not fall below the number of treatments delivered in the 2012-13 financial year?
(11 years ago)
Commons ChamberI should inform the House that I have selected the amendment in the name of the Leader of the Opposition.
On a point of order, Mr Speaker. Is it in order for the Secretary of State to misrepresent the views of the previous Government and previous Ministers, and refuse to take interventions? He has just said that I refused to change and strengthen the regulation system of hospitals in England—that is factually incorrect. I brought forward a new system for the registration of all hospitals in England in autumn 2009, on the back of recommendations from the CQC. Again, he should get his facts straight at that Dispatch Box.
I am grateful to the right hon. Gentleman for his point of order, and I make two points in response. First, every Member and every Minister must be responsible for his or her comments in the Chamber—the accuracy and appropriateness thereof. I am afraid that, however angry people feel, on either side of the argument, these are matters of debate. Secondly, the situation would be greatly helped if the Secretary of State now, immediately, turned his mind to the presentation of the argument in support of the introduction of the Bill, which is, ordinarily, the matter upon which one anticipates a Secretary of State will focus his remarks. This is not an occasion for a historical legerdemain; it is an occasion for the presentation of the case for a Bill, to which I know that, without delay, the Secretary of State will turn his mind.
I am delighted to do so, Mr Speaker, and I know that you would think it was legitimate of me to hold the Labour party to account for its decision if it is voting against today’s Bill or declining to support it, as its amendment clearly states.
However, today is a day to rise above party political considerations, as Mr Speaker has just said, and recognise that putting these things right is overwhelmingly in the interests of patients. If the Labour party continues its stubborn refusal to support legislative underpinning for a new chief inspector of hospitals, which is in today’s Bill, how will it ever be able to look patients in the eye again? Perhaps the most shocking thing about Mid Staffs, which is one of the reasons we have so many provisions in the Bill, was not just the individual lapses in care but the fact that they went on for four long years without anything being done about them.
Order. I should give notice to the House that there will almost certainly have to be quite a tight time limit, but I await the conclusion of the Front-Bench speeches before determining what that time limit should be. I mentioned to the House that the amendment has been selected.
I thank the Minister for eventually giving way. I am surprised and disappointed that he is repeating the same type of inaccurate information that we heard from the Secretary of State earlier. Will he think about the point that I made in my speech? How hollow is it to talk to carers in Salford, 1,000 of whom are involved in families who are losing their care packages, about new rights? What rights are there for someone whose family member has lost their care package? That is what people face this year.
The Minister has also just repeated the ridiculous notion of the £3.8 billion for the integration of health care. That is not new money. It includes care—
I note the position in Salford, and I recognise that finances in local government are tight. However, the Opposition have not recognised that 108 councils were already providing social care with substantial need as the eligibility criterion before the general election. They never mention that, but it is the truth.
Baroness Campbell has called the continuity of care provisions a “landmark reform”. Although we have heard the suggestion that we have somehow moved away from what Andrew Dilnot suggested, he has said:
“For the first time you don’t have to be terrified of the consequences of needing care…this system will radically reduce anxiety…It doesn’t seem to me that it’s so different from what we wanted.”
Several references have been made to the funding of social care, and as I have said, I fully recognise the tough financial settlement that local government has faced. However, that has been necessary because of the dire state of the public finances that we inherited from the Labour Government, and we have sought to protect social care. Despite what the hon. Member for Easington (Grahame M. Morris) and others have said, a recent budget survey by the Association of Directors of Adult Social Services showed that most of the savings that local councils have made have come through efficiency changes, and that services have largely been protected. [Interruption.] Well, that is what the survey showed.
As the population continues to age, our health needs become more complex, and it is essential that we continue to adapt. We need to ensure that the care and support system is sustainable, and the Bill lays the foundation for that sustainable system. At the top of the agenda has been the issue of how we pay for care. The current system simply does not work and is not fit for the 21st century. Too many people have faced catastrophic care costs and had to make impossible financial decisions at a time of huge personal crisis. It is deeply unfair. If someone who has worked hard all their life and budgeted carefully is unlucky enough to be diagnosed with dementia or some other condition, they lose pretty much everything they have ever worked for.
Through the Bill, we are putting an end to that unfair system. We have addressed how people can plan and pay for their care, following on from Andrew Dilnot’s recommendations. We have listened carefully to what he and his colleagues have said, and we have been absolutely consistent about how these reforms will support people to plan for their future effectively. From April 2016, extending the means-test support to £118,000 will immediately result in 35,000 more elderly people receiving financial help with their care costs. That figure will rise to 100,000 people getting extra help by 2024-25.
(11 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
Order. I gently say to the House that the Minister is among the most courteous of Ministers, and in fairness she deserves also to be treated with courtesy. There are strong views, but let us hear the Minister.
The Government have held a consultation, but we have not had a review before. We said in July that we would pause to consider the emerging evidence base, and that is exactly what we have done. I am happy to account for my actions, but it appears that I am being asked to account for the cynicism of the Opposition, too. This weekend sees the anniversary of the passing of the legislation in Australia, and new evidence is emerging rapidly, as was pointed out in the very good Back-Bench business debate to which I responded earlier this month, as well as in the other place, so this is the right time to do this.
Of course we have listened to what Members of the other place have said. They rightly take extremely seriously such an important public health issue as stopping children from smoking, but we have to proceed in a measured, step-by-step way to ensure that, if and when a decision is made, it will be robust and will deal with all the inevitable challenges that might come its way.
Order. We are dealing with an extremely important matter, which I judge as urgent, but we have business questions and two ministerial statements to follow, so the model is what might be called “the Gibraltar model” of Mr Nigel Evans, whereby a good exchange was had, but it was a brief one. I will not be able to accommodate everybody who wants to speak.
Idiotic, nanny state proposals such as the plain packaging of tobacco are what we expect from the Labour party. What we expect from Conservative Ministers is for them to believe in individual freedom and individual responsibility, and to stand up to the health zealots and nanny state brigade who, if they could, would ban everything and have everything in plain packaging. Will the Minister commit to sticking to those Conservative principles and to ignoring the nanny state brigade of Labour Members?
The hon. Member for Southport (John Pugh) may be aware that there has been a challenge to the policy in Australia, so it is important to proceed in a measured and evidence-based way.
The sedentary remarks of the hon. Member for Shipley (Philip Davies) are almost as entertaining as those he makes when he is on his feet.
I sometimes feel sorry for the Government. We have an excellent Minister at the Dispatch Box who is listening to Parliament and asking for an independent report, yet she gets Members of Parliament complaining about that. That is ridiculous. I think I understood her to say that if regulation is to be introduced, it will be done by statutory instrument. I hope that the Government are not going to proceed in that way, because we can only reject or approve a statutory instrument—we cannot amend it. Will she think again on that point?
My hon. Friend is right to draw attention to the issue. He may or may not know that when I responded to a recent Adjournment debate that was secured by the hon. Member for Solihull (Lorely Burt), we discussed that point, and I invited trading standards officers to submit evidence on the enforceability of just those sorts of measures. I will be interested to hear from Members and others about how they think those might work.
(11 years ago)
Commons ChamberI congratulate the Minister and the Government on the work that is being done to integrate social and NHS care. Does my hon. Friend agree that, for the many elderly patients moving between hospital care and community social care, integrated patient records across the two areas will significantly improve elderly care? Will he meet me and campaigners following Health questions to discuss my ten-minute rule Bill?
My hon. Friend is absolutely right to highlight that these are local decisions that need to be made by local commissioners, because what looks good in Crawley will be very different from the needs in Bradford. That was the very reason that underpinned the previous Government’s decision to transfer responsibility for these services to local commissioners, but we often need more co-located services, because the Monitor survey picked up the fact that in the past, far too often, walk-in centres were isolated in the community; people did not know how to access them, or when they could do so. Monitor also recognised that there was duplication of effort, and sometimes patients who needed to be seen in accident and emergency were treated, inappropriately, in walk-in centres.
16. What recent consideration he has given to banning the use of NHS funds for provision of alternative therapies.
May I thank the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), for recently opening a walk-in centre in Morecambe? May I also set the record straight, because the centre had been closed under the previous Government? Does he not think that it is a shocking indictment that in 2006 the NHS was cut by 9% in the region—
Order. First, topical questions are supposed to be brief. Secondly, the Minister is not responsible for what happened in 2006. We will have a very brief reply and then perhaps we can move on.
In the past two weeks I have had to visit accident and emergency units in Redditch and in north Wales, unfortunately with members of my family. Although health is a devolved matter in Wales, will my right hon. Friend the Secretary of State invite his counterpart in Wales to spend some time at the great A and E unit in Redditch to see for himself the stark differences between the two services?
I would be delighted to do so. He will see the impact of not cutting the NHS by 8%, which is what Labour has done in Wales, which means that in this country we are hitting our A and E targets and in Wales they have not hit them since 2009.
I am sorry to disappoint colleagues, but we must move on. Demand usually outstrips supply.
(11 years, 1 month 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
In January this year, the board of NHS England launched a review of urgent and emergency care in England. Urgent and emergency care covers a range of areas, including accident and emergency departments, NHS 111 centres and other emergency telephone services, ambulances, minor injury units, and urgent care centres. The review is being led by Professor Sir Bruce Keogh, NHS England’s medical director. A report on phase 1 of the review is being published tomorrow, and it is embargoed until then. [Interruption.] This is an NHS England report, and NHS England is an independent body, accountable to me through the mandate. The report that will be published tomorrow is a preliminary one, setting out initial thinking. [Interruption.]
Order. There are highly charged feelings on this matter, but the Secretary of State has been asked a question, and his reply must be heard.
I should underline the fact that this morning’s briefing was under embargo, an embargo which, to my knowledge, has been respected. The final version will be published in the new year.
Sir Bruce has said that he will outline initial proposals and recommendations for the future of urgent and emergency care services in England, which have been informed by an engagement exercise that took place between June and August this year. There will be further consultation on the proposals through a number of channels, including commissioning guidance and demonstrator sites. Another progress report will be produced in the spring of 2014.
Decisions on changing services are made at a local level by commissioners and providers, in consultation with all interested parties. That is exactly as it should be, as only then can the system be responsive to local needs. It is vital to ensure that both urgent and emergency care and the wider health and care system remain sustainable and readily understandable to patients. A and E performance levels have largely been maintained, thanks to the expertise and dedication of NHS staff. A and E departments see 95% of patients within four hours, and the figure has not dropped below the 95% target since the end of April. However, urgent and emergency care is falling behind the public’s needs and expectations.
The number of people going to A and E departments has risen historically, not least because of an ageing population. A million more people are coming through the doors than in 2010. Winter inevitably challenges the system further, which is why we are supporting the most under-pressure A and Es with an additional £250 million. Planning has started earlier than ever this year, and the NHS has been extremely focused on preparing for additional pressure.
We will look at Sir Bruce’s report extremely carefully. Reform of the urgent and emergency care system may take years to complete, but that does not mean that it is not achievable. We are exceptionally fortunate in this country to have in the NHS one of the world’s great institutions. NHS staff are working tirelessly to ensure that the care that people need will continue to be available to them, wherever and whenever they need it.
Order. I can scarcely hear the Secretary of State’s answers, and I want to hear them. Let us hear the response.
Thank you, Mr Speaker.
The hon. Member for Lewisham East (Heidi Alexander) will know that her constituents have some of the best stroke survival rates in England because we reduced the number of hospitals in London offering stroke services from 32 to eight. I am not going to stand in the way of those changes if they save lives.
Last week, the Secretary of State assured—[Interruption.]
Order. I apologise to the hon. Gentleman, but there was a lot of noise. I am sure that the House will wish to hear his question—let him start again.
Last week the Secretary of State assured me that A and E at Ealing hospital is safe, but since then we have heard very confusing and contradictory statements in the local area. First, will the Secretary of State reassure us today that the A and E department at Ealing hospital is safe in the future? Secondly, will he meet me and my colleagues from the west London area—I have written to him—to discuss our concerns and so that we can express our feelings?
(11 years, 1 month ago)
Commons ChamberUnder the order of the House of 29 October, this debate must conclude at 3 pm. I should point out that we need to put a time limit of 10 minutes on Backbench speeches in view of the level of interest and the constraints of time. The limit does not of course apply to the person introducing the debate, but I know that he will wish to tailor his remarks to take account of the number of his colleague who wish to participate.
(11 years, 1 month ago)
Commons ChamberThe Secretary of State is destroying services in four great London hospitals, two of which are in my constituency, in the biggest closure programme in the history of the NHS. Why is he closing A and Es in two of the most deprived communities in London—Brent and White City—and why, rather than certainty, is he installing chaos into Ealing and Charing Cross hospitals? What is happening to the 500 beds at Charing Cross? What is happening to the best stroke unit in the country? What does he mean by A and Es that are different in size and shape? When will he answer those questions? This is a cheap political fix. How can anyone have confidence in the Secretary of State—
Order. We understand the general drift of the observations—[Interruption.] Order. I understand how strongly the hon. Gentleman feels, but he should really ask one question. The Secretary of State is a man of dexterity and no doubt will meet the hon. Gentleman’s needs as he sees fit.
Thank you, Mr Speaker. I will. The hon. Gentleman does no credit to himself or his party with such hyperbole. Let me remind him that the leaders of the clinical commissioning groups, including the ones in his area, which are there to look after his constituents, have said that
“delivering the Shaping a Healthier Future recommendations in full will save many lives each year and significantly improve patients’ care and experience of the NHS.”
That is what the doctors are saying, which is what I want to follow.
I cannot find the words to express how disappointed the residents in my constituency, and elsewhere in west London, will be on hearing the statement. We are not clear about what will happen to Ealing hospital. You are not clear in your statement, before the final decision is made, about the range of services that will be provided from Ealing and Charing Cross hospitals. What work will be done? Will you consider or ignore, like you totally ignored the thousands of people who marched in the rain outside Ealing hospital in west London two weeks ago—
Order. I am extremely grateful to the hon. Gentleman, but may I just say to him that I will not be doing any of the things that he suggested? I think his inquiry was directed at the Secretary of State, rather then me. I have no responsibility for health services in London or anywhere else.
I am disappointed that the hon. Gentleman is disappointed. I am interested to know what his definition of “totally ignored” means, because we have decided that we will not close Ealing A and E, and that is a big decision. With respect to how his constituents feel, I completely understand that many people will be nervous about any changes. I hope he will become a big advocate of these changes, because his constituents will be among the first in the country to have seven-day access to GPs and a seven-day NHS, which means there will not be a higher mortality rate for admission to hospitals at the weekends and that there will be 24/7 consultant obstetric cover for people who need it when giving birth. They are big and important changes that will benefit his constituents.
Order. I should just say to the House, almost as a courtesy, that I am prioritising London Members. However, non-London Members should take heart. If they exercise their knee muscles they may have an opportunity in due course.
The hon. Member for Hackney North and Stoke Newington (Ms Abbott) was absolutely spot on in her question to the Secretary of State, not least with regard to variability and accessibility of GP services. A few months ago, I asked him whether he would make it a requirement for plans to expand out-of-hospital care to be in place before hospital changes occur. Can I take it from his statement that it is his intention that, when recommendations from the Independent Reconfiguration Panel are before him, he will require plans to build capability for community health services and primary care services to be in place before they go ahead?