Oral Answers to Questions

John Bercow Excerpts

Tuesday 16th April 2013 Commons Chamber

[Dr Poulter]

My hon. Friend will be aware that local authorities are now receiving 40% of the public health budget. That allows local authorities to have a much more nuanced approach to how and where they direct their budgets. It is of course desirable to focus on the early years to give each and every child the best start in life, to set good and healthy eating patterns and to support the work being done in the health service in expanding the health visitor programme. This also allows local authorities to address other public health challenges in the area by focusing, for example, on areas with high rates of teenage pregnancy, smoking or cardiovascular disease death.

[Mr Speaker]

I am grateful to the Minister, but we do have quite a lot to get through, so shorter answers would help.

[Mr Peter Hain (Neath) (Lab)]

What sort of early intervention have the Government ordered to prevent a contagious spread of measles from the outbreak in the Neath and Swansea area of more than 700 serious cases? Thousands of parents across Britain will have been tormented by the choice of whether to vaccinate their children for measles, mumps and rubella because of the scare. Surely the Minister should take serious action to instruct public health officials to combat this issue.

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[Norman Lamb]

My hon. Friend makes an extremely interesting point. Although I have not agreed to meet her, I would be happy to have an informal discussion with her at some later stage.

[Mr Speaker]

I think we will take that as a meeting.

[David Morris (Morecambe and Lunesdale) (Con)]

17. Whether there are plans to close the accident and emergency department at the Royal Lancaster Infirmary.

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[The Minister of State, Department of Health (Norman Lamb)]

I am tempted to say no, but I would not get away with it—so, yes, of course the hon. Lady can join all the rest and arrange to meet me. I would be very happy to discuss her concerns. While I am at the Dispatch Box, may I pay tribute to the International Centre for Life, which does really important work?

[Mr Speaker]

The Minister can report to his family just how popular a fellow he is.

[Annette Brooke (Mid Dorset and North Poole) (LD)]

T3. The all-party group on global tuberculosis has just published a report on rising rates of drug-resistant TB. One recommendation is for a national strategy for TB in the UK. Will the Minister comment on that? The officers of the all-party group would also be grateful if he fitted us into his very busy schedule of meetings.

Heart Surgery (Leeds)

John Bercow Excerpts

Monday 15th April 2013 Commons Chamber

[Mr Hunt]

Whenever he receives information, the medical director is under an absolute obligation to act. What he did was absolutely correct: he said that he would look at the data and get to the bottom of them and that if it turned out that the data were not as accurate as they should have been, surgery would resume. That is exactly what happened.

[Mr Speaker]

The hon. Member for Kingston upon Hull East (Karl Turner) is a very excitable fellow—he might remind some people of his predecessor in the House in that respect.

[Meg Munn (Sheffield, Heeley) (Lab/Co-op)]

A baby born with a heart condition in Sheffield who needs a complex intervention would normally go to Leeds. One of the concerns about the Safe and Sustainable review was that children from my constituency would have had to travel further. The decision to suspend the Leeds unit created that very situation. The Secretary of State needs to acknowledge that children could, as it turns out, have been put at risk unnecessarily by closing a unit that was in fact safe, because they would have had to travel further, which for very ill babies is a risk in itself. At the heart of this has been a lack of transparency and a failure to put information into the public domain. I have had to table parliamentary questions to try to get information about what is happening. Nobody wants an unsafe situation. Will the Secretary of State now commit to complete transparency in respect of all the information?

Community Pharmacies

John Bercow Excerpts

Monday 15th April 2013 Commons Chamber

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

[Mr Speaker]

Perhaps after waiting a moment for a suitably attentive and perhaps even respectful audience, the hon. Member for Ealing North (Stephen Pound) can rise from his seat to offer the House the benefit of his eloquence.

Mid Staffordshire NHS Foundation Trust

John Bercow Excerpts

Tuesday 26th March 2013 Commons Chamber

[Several hon. Members]

rose—

[Mr Speaker]

Order. Dozens of colleagues are seeking to catch my eye, but I remind the House that the Government have scheduled today three ministerial statements on important matters, and colleagues will note that there are three Back Bench-inspired debates to follow, in which 48 hon. Members are interested in speaking. There is therefore a real premium on time, and I must appeal for single, short supplementary questions and characteristically pithy replies.

[Mrs Cheryl Gillan (Chesham and Amersham) (Con)]

I thank the Secretary of State for coming to the House and making a statement that helps to restore our confidence in the NHS, which has been so badly undermined by Labour’s appalling stewardship. Will he take steps to ensure that any complaints procedure provides protection to patients and relatives who raise concerns?

Immigrants (NHS Treatment)

John Bercow Excerpts

Monday 25th March 2013 Commons Chamber

[Several hon. Members]

rose—

[Mr Speaker]

I have a choice on the Lib Dem Benches between two doctors. Let us hear from the good Dr Julian Huppert.

[Dr Julian Huppert (Cambridge) (LD)]

The former public health Minister, the hon. Member for Guildford (Anne Milton), revealed in a written answer on 17 March 2011 that the sums not collected from overseas patients totalled less than £7 million a year. If we double that and double it again, as the Health Secretary suggests, that is £28 million. Private finance initiative schemes cost the NHS that much every two weeks. Which issue is more important in ensuring that we have a properly funded NHS?

Medical Implants (EU and UK)

John Bercow Excerpts

Wednesday 6th March 2013 Commons Chamber

[Thomas Docherty (Dunfermline and West Fife) (Lab)]

On a point of order, Mr Speaker. You, of course, are the guardian of good debate. You will have heard the comments of the hon. Member for Southport (John Pugh) about not being clear about what is and what is not in order to discuss on estimates day. Do you have any advice for Members on how we can stay in order when discussing estimates?

[Mr Speaker]

On that particular matter, the Liaison Committee made a determination, which the House approved. On the basis that the hon. Gentleman and other right hon. and hon. Members are familiar with the determination of the Liaison Committee and with the fact and terms of its approval by the House, I cannot imagine that this will be a matter of doubt or uncertainty in the mind of any hon. or right hon. Member, and certainly not in the mind of a Member so demonstrably perspicacious as the hon. Member for Dunfermline and West Fife (Thomas Docherty). In one respect, and one respect only, the hon. Gentleman has erred, however understandably. He suggests that I will have heard the comments of the hon. Member for Southport (John Pugh). I have not yet experienced that joy, but a study of Hansard will disclose the necessary to me, and I look forward to that, as the hon. Gentleman can imagine, with eager anticipation.

NHS Commissioning Board

John Bercow Excerpts

Tuesday 5th March 2013 Commons Chamber

[Helen Jones (Warrington North) (Lab)]

Last week, the Leader of the House insisted that the regulations did not—

[Mr Speaker]

Order. I apologise for interrupting the hon. Lady, but there is too much noisy chuntering from both sides of the House, including from Members whom I have previously told to keep it to themselves. They cannot think that they are different or separate because they feel strongly about something—that way, we get to cacophony. Members should keep the chuntering to themselves, ask a question and listen to others with a degree of courtesy.

[Helen Jones]

Last week, during business questions, the Leader of the House said that the regulations would not introduce compulsory competitive tendering in the NHS; today the Minister has said that he will have to revise them in case they do. Is it not a fact that the Government actually do not have a clue about what they are doing? If the Minister wishes to disprove that, will he tell us exactly what changes he will make to the regulations—or will this just be like the pause in the Health and Social Care Bill, after which it carried on regardless?

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[Norman Lamb]

I apologise, but I simply did not hear the question.

[Mr Speaker]

We wish it to be heard. The hon. Member for Strangford (Jim Shannon) must always be heard when he is on his feet. Let us hear it.

[Jim Shannon]

Perhaps I should give a lesson in Northern Ireland-speak. Will the Minister assure us that competition will be at the core of what he is trying to achieve and that the Government will prioritise clinical outcomes, with targets to deliver and an increasing number of patients to be looked after?

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[Norman Lamb]

I thank the hon. Gentleman for the question. I spoke directly to Steve Field about this yesterday and I am absolutely satisfied that the amended regulations will totally meet the commitments made during the passage of the Bill in the other place.

[Mr Speaker]

I am grateful to the Minister and to colleagues.

Health Professionals: Regulation

John Bercow Excerpts

Monday 4th March 2013 Commons Chamber

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

I thank the Minister for his courtesy in giving way. It might be helpful, Mr Speaker, if you would give us guidance on whether pre-notification is still required. What the Minister says is all well and good but why is it, after so many people died in such an unacceptable way, that nobody seems to have carried the can or taken responsibility?

[Mr Speaker]

Order. I thought, in the circumstances, that I would let the debate flow, but for clarification I ought to say that there is a requirement that a Member who wishes to make a speech in someone else’s Adjournment debate secures agreement in advance, but there is no such requirement—this point is widely misunderstood—in respect of an intervention. It is purely for the Minister to decide whether to take an intervention. No impropriety has been committed by the hon. Member for Bristol North West (Charlotte Leslie); her virtue is unassailed.

[Dr Poulter]

Indeed, and thank you, Mr Speaker. I will, of course, do my best to take as many interventions as possible, but my hon. Friend the Member for New Forest East (Dr Lewis) will be aware that I have been generous so far and that the time allotted to Adjournment debates means that it is difficult to give as full an answer as possible to interventions. For that reason, it is useful to have some notice that an hon. Member intends to intervene.

My right hon. Friend the Prime Minister made the point clearly, as did Robert Francis in his report, that it was not for the Francis report to highlight individuals or blame them for what happened; the report was about ensuring that there was a clear acknowledgement that there had been systemic failure, which I talked about earlier. It was a failure of professionalism on the front line; a failure of the trust’s board; a failure of regulation and the regulators; and a failure of management at the trust. When systemic failure occurs, it is right that we put in place systemic solutions, and that is what my right hon. Friend the Secretary of State will do later this month.

My hon. Friend the Member for North East Cambridgeshire made the key point that a real culture change was required, and that that is about having transparency and openness in the NHS. He is right to highlight those points. If we want transparency and openness, we need to look at some of the steps that have already been taken. We know that the Public Interest Disclosure Act 1998, which in theory gives protection to whistleblowers and people who want to speak out, has not been effective. Legislative approaches have not been enough to ensure that people feel free to speak out. Legislation has so far not been effective in creating that culture of openness and transparency that we all believe is necessary.

However, we have seen two things in the past six months that will make a real difference, the first of which is the contractual duty of candour, which will be introduced in the NHS for hospital trusts. It will mean that there is support for openness and transparency as part of the NHS contract. The second is the strengthening of the NHS constitution, which brings direct support to the cause of whistleblowers. Those things will be further strengthened in our further response later in the month to what happened at Mid Staffordshire.

Oral Answers to Questions

John Bercow Excerpts

Tuesday 26th February 2013 Commons Chamber

[Mr Hunt]

No. What Sir Bruce Keogh did—

[Mr Speaker]

Order. Just before the Secretary of State replies, I ought to say to the right hon. Member for Lewisham, Deptford (Dame Joan Ruddock) that she is perhaps suggesting that the Secretary of State may have inadvertently, rather than deliberately, misled the House. Could she just confirm that? A nod of the head would suffice.

[Dame Joan Ruddock]

I am happy to do that, Mr Speaker.

[Mr Speaker]

That is the right hon. Lady’s suggestion, and it is for the Secretary of State to respond as he thinks fit.

[Mr Hunt]

Thank you, Mr Speaker.

Sir Bruce Keogh accepts the calculations that were made in the proposals put forward by the trust special administrator that the plans would be likely to save about 100 lives a year, because they would allow the hospitals in south-east London to move towards the London quality standard, which would mean reducing excess mortality at weekends. Sir Bruce Keogh accepted that, and I accepted his view of it.

[Patrick Mercer (Newark) (Con)]

rose—

[Mr Speaker]

Order. Many London hospitals and the representatives thereof have an interest in the question. Newark is some distance away, but I feel sure that the hon. Gentleman’s supplementary question will be not about Newark but purely about these London hospitals. On that basis, I am delighted to hear from him.

[Patrick Mercer]

indicated dissent.

[Mr Speaker]

I am disappointed, but never mind. We will hear from the hon. Gentleman ere long on another matter, I feel sure.

[Heidi Alexander (Lewisham East) (Lab)]

Demand for A and E services at Guy’s and St Thomas’ and at King’s will go through the roof if Lewisham’s full A and E closes. The Secretary of State may claim that he is keeping a smaller A and E at Lewisham, but that is nothing more than dangerous spin. No blue-light ambulances will call at Lewisham under his plans, and even the College of Emergency Medicine says that they do not meet its definition of an emergency department. How on earth can the Secretary of State be so confident that other hospitals in south-east London will be able to cope once he has taken the axe to Lewisham?

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[Dr Poulter]

I had thought that the hon. Gentleman had risen on a consensual note, raising his constituents’ concerns—and he was right to do that. The review is about making sure that any failings in care in local trusts are picked up and improved. The fact of the matter is that waiting times are down under this Government in comparison with the previous Government and many more additional clinical staff are working in the NHS—about 2,000 more than under the previous Government. At the same time, we have cut 18,000 administrative and management posts, and the money from that is being reinvested in front-line patient care.

[Mr Speaker]

If the hon. Member for Crawley (Henry Smith) wishes to come in on this question, he may, but he is not obliged to do so.

[Henry Smith (Crawley) (Con)]

On Question 13, sir.

[Mr Speaker]

We will get to No. 13 in due course. Never mind.

[David Mowat (Warrington South) (Con)]

10. What assessment his Department has made of the effect of hospitals built under the private finance initiative on the work of neighbouring hospitals.

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[Dr Poulter]

The right hon. Gentleman is in dangerous territory talking about PFI schemes to which the previous Government signed up. No hospital operates in isolation. The South London Healthcare NHS Trust was paying out 13.9% of its turnover on the PFI. That was unsustainable. It has caused huge difficulties in the local health care economy and affected patient care, which was a very bad thing to do. The right hon. Gentleman needs to recognise that this Government are providing £1.5 billion-worth of support to many trusts that have struggled under these PFI agreements—

[Mr Speaker]

Order. I am grateful to the Minister, but we have many questions to get through and the answers are sometimes just too long.

[Priti Patel (Witham) (Con)]

12. What steps his Department is taking to increase the availability to patients of GPs and specialist health services.

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[Mr John Baron (Basildon and Billericay) (Con)]

T9. The cancer drugs fund has been a huge success and has helped up to 25,000 patients, but the negotiations between the Government and the pharmaceutical companies on its replacement—value-based pricing—is causing real uncertainty for cancer patients and clinicians alike. For example, will new medicines be available to new patients under the new system and what guidance is being given to local cancer drugs funds as they wind down? Can we please have clarity urgently?

[Mr Speaker]

I think the hon. Gentleman was seeking an Adjournment debate and is disguising his request as a question, for which we are grateful.

[Norman Lamb]

I thank my hon. Friend for that question. I am happy to discuss it further with him. Value-based pricing will be primarily for new drugs, but obviously I understand his concern. It is the concern of the Government to ensure good access to cancer drugs for patients in the future.

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[Several hon. Members]

rose—

[Mr Speaker]

Order. We now come to the ten-minute rule Bill.

Accident and Emergency Departments

John Bercow Excerpts

Thursday 7th February 2013 Commons Chamber

[Several hon. Members]

rose—

[Mr Speaker]

Order. The limit on Back-Bench speeches will have now to be reduced to seven minutes, with immediate effect.

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[Several hon. Members]

rose—

[Mr Speaker]

Order. We are extremely grateful to the hon. Gentleman for his contribution. The next speaker, to whom, unfortunately, a six-minute limit will have to apply, a fact of which I was about to notify him, is Mr Gavin Barwell.

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[Mr Andy Slaughter (Hammersmith) (Lab)]

May I first thank my hon. Friend the Member for Ealing, Southall (Mr Sharma) for picking up the baton and sponsoring the debate? It was first proposed to the Backbench Business Committee before Christmas by me and colleagues from other parties as a London debate, and it has had the feel of a London debate. However, colleagues from elsewhere in the country should not feel excluded, because a lot of what is being tried out in London will soon be spreading to the rest of the country if they are not careful.

I had to attend the Justice and Security Public Bill Committee, which meant that I was not here at the beginning of the debate, but I am grateful for the opportunity to speak. Balancing whether to oppose the Government’s attacks on civil liberties or the Government’s attack on the health service is difficult, so it is nice to be able to deal with both in one day.

I will not get involved in a hierarchy of misery. Many Members have spoken passionately about their own experiences, but I will say that both the A and E departments at the world-class hospitals—Hammersmith and Charing Cross—in my constituency are marked for closure. Charing Cross hospital, which in many ways has the best site and some of the best facilities in north-west London, is marked for almost complete closure. All 500 beds will go, the A and E will go and the specialist services will go, leaving an urgent care centre and other services high and dry, such as the Maggie’s cancer centre and the mental health services. To its shame, Imperial College Healthcare NHS Trust is supporting those closures because it will provide a very valuable piece of real estate for it to sell and thus improve other campuses.

As my hon. Friend the Member for Harrow West (Mr Thomas) said, it is not the case that community services have been improved before these closures will take place. Indeed, the White City collaborative care centre, which should have been the first polyclinic in the country is, thanks to a Conservative council, six years late and with a fraction of the services it should have. It is still not open and will not adequately replace any of those services.

What is happening in north-west London flies in the face of the facts. Most hospitals in the area do not meet the four-hour target, owing to the demand on their services. Ambulances are less safe and effective than A and E care. For patients, it is clearly better to be in A and E than in an ambulance. Longer journeys and journey times need to be avoided. There is no evidence that when a good A and E closes most cases get dealt with better via centralisation. There are good data suggesting the opposite is true, as local A and Es have the capability to select patients who require more specialised care, easing the pressure on large units, and to stabilise those patients in the critical intermediate period.

In a nutshell, my constituents are being offered a second-class service. There is no clear demarcation. The health service itself cannot tell us which conditions should go to an urgent care centre and which should go to an A and E. The majority of my constituents will have a worse health service, and that particularly applies to poorer constituents who do not have access to private transport.

Let us look briefly at the process we have gone through, which has been utterly scandalous. As soon as the coalition Government came in they started preparing these closures. They gave millions of pounds to McKinsey to draw up the plans, yet when I asked it about those plans I was lied to about the fact that hospital closures were being prepared and was even told that I had been consulted when I had not. We have heard already about the phoney consultation, the 80,000 signatures that were ignored and the 3,000 or 4,000—

[Mr Speaker]

Order. I am sure the hon. Gentleman was not suggesting for one moment that he was lied to in the House of Commons.

[Mr Slaughter]

Absolutely not. As part of the consultation process that was undertaken, it is on the record in the documentation that I was consulted. I was not consulted on those matters.