(11 years, 6 months ago)
Commons Chamber(11 years, 7 months ago)
Commons ChamberI reassure hon. Members that, unlike any Member on the Opposition Front Bench, I still work in the NHS every week and I ensure that I see what happens on the ground. That cannot be said of any Front-Bench Opposition Member. The coalition has Ministers who are in touch with what is happening in the NHS on the ground. On A and E waits, we are trusting clinicians to exercise their judgment, which is why we now have a 95% target. We are ensuring—and the statistics show—that we are meeting that target on an annual basis. Patients are being treated in a timely manner. Furthermore, we have put in £330 million to deal with winter pressures. It is wrong of the right hon. Gentleman to try and mislead the House in this way—[Hon. Members: “Oh!”]—and use figures from a snapshot in time, rather than in a generality, which would indicate—
Order. Sorry, the Minister needs to withdraw the suggestion that anybody tried to mislead the House. That simply needs to be withdrawn; that is all.
Indeed. I do withdraw that comment, Mr Speaker, and I apologise for saying that there was any deliberate attempt to mislead the House at all. I was simply pointing out the fact that the right hon. Gentleman is highlighting a snapshot in time—
No, no. Order. I must say to the Minister that when a retraction is required, that is what is required and that is all that is required. We move on.
3. What representations he has received from clinicians in Yorkshire and the Humber on the decision to close the children’s heart surgery unit at Leeds children’s hospital.
I must say to the House that if we are to get through the questions we need shorter questions and shorter answers from now on.
4. What steps he is taking to support the recruitment and training of midwives.
Order. My apologies to colleagues whom I could not accommodate but, as usual with Health questions, demand massively outstrips supply.
(11 years, 7 months ago)
Commons ChamberBefore I call the hon. Member for Wycombe (Steve Baker) to present his case on behalf of his constituents, may I appeal to Members leaving the Chamber to do so quickly and quietly, affording the same courtesy to the hon. Member that they would wish to be extended to them in comparable circumstances?
(11 years, 9 months ago)
Commons ChamberThe short answer is yes, I am more than happy to meet my hon. Friend’s constituent to discuss this matter. The figures she relies on for the amount of money going into brain tumour research are based on 2006 data, but the simple answer is that of course we can do far more. I pay tribute to the great advances made by a number of charities, including Headcase Cancer Trust, in my constituency, and others such as the Joseph Foote Trust. They are all raising considerable amounts of money specifically for research projects such as the one at Portsmouth university. I am more than happy to meet my hon. Friend’s constituent. This is an important topic on which we can do more.
I thank the Minister for her answers, including her very generous and gracious remarks. I wish her a full and speedy recovery.
Does my hon. Friend the Minister agree that Penny Brohn Cancer Care, based near Bristol, which offers a unique combination of physical, emotional and spiritual support designed to help patients live well with the impact of cancer, is an organisation that should be supported? Can she confirm that such organisations are eligible for funds from the cancer drugs fund?
The Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), is my constituency neighbour. He will know that, although the East of England Ambulance trust is hitting its targets for the entire region, it is not helping in Suffolk. Will he advise on what more we can do locally to ensure that it serves all rural patients?
The problem has affected both Suffolk and Norfolk—the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb), also takes an active interest in it. One problem was that the managers of the local ambulance trust were not listening to front-line staff on how to design and deliver services. In a staff survey, only 4% of front-line staff in the East of England Ambulance Service said they were being properly listened to, which is completely unacceptable. This Government, in contrast to the previous one, want to put front-line professionals in charge of running services, meaning that, in future, more patients will be properly prioritised and ambulance response times will be better met.
Order. These matters could be considered further in an Adjournment debate, which might be a suitable length for the subject.
T1. If he will make a statement on his Departmental responsibilities.
My hon. Friend is absolutely right, and I am very sorry to hear of the case he outlined. Clearly the care that his constituent received was more than substandard. If a patient needs immediate treatment, they should always receive it. This Government are quite rightly ensuring that we embed good care in everything we do. We have beefed up the role of the Care Quality Commission to improve the inspection of care quality throughout the NHS and the care sector. We are also introducing a friends and family test to pick up on examples of bad care, so that the NHS can properly learn from them locally and so that these things do not happen.
We are extremely grateful. Extreme brevity is now required from Back and Front Benchers alike.
On 12 November the Secretary of State gave a categorical assurance to my constituents that there was absolutely no threat to accident and emergency and maternity services at Kettering general hospital. Does he stand by it, will he repeat it today and will he specifically confirm that obstetrics and major injury and trauma services in accident and emergency are no longer at risk at Kettering general hospital?
I thank my hon. Friend for his question. He is absolutely right. I made it clear earlier that I felt there had been some heavy handedness in the way some of those trusts had behaved—although they are quite understandably exercising freedoms that the previous Government gave them. We want national pay frameworks to remain fit for purpose, which is why we endorse the national pay negotiations that are under way. I would recommend that trusts in the south-west listen to what happens in those negotiations, so that we can ensure that national pay frameworks are fit for purpose in the south-west.
Is the Secretary of State disappointed by the low number of GPs who have come forward to take on accounting officer roles in clinical commissioning groups, and can he say why he thinks that is?
I am sorry to disappoint colleagues. As they know, I could happily listen all day to them asking questions and to Ministers answering them—[Interruption.] The Under-Secretary of State for Health, the hon. Member for Broxtowe (Anna Soubry) does not seem entirely convinced of the merits of my explanation, but, in any case, time is against us and we must now move on.
(11 years, 9 months ago)
Commons ChamberThis is an incredibly important document for the NHS, and I think that we were all expecting a bit more than the same old hollow rhetoric from the right hon. Gentleman.
There could be no greater commitment to the NHS than to protect its budget at a time of unprecedented austerity. This Government have protected the NHS budget; the right hon. Gentleman said that that would be irresponsible. The Government take action; he uses words. The picture he paints of the NHS in crisis is not the picture recognised by thousands of doctors and nurses up and down the country. Of course, with an ageing population, the NHS is doing more than ever before. Nearly 1 million more people every year are in A and E than when he was Health Secretary, but it is meeting all its waiting times targets and has virtually eliminated mixed-sex wards, and hospital-acquired infections are going down. This NHS is performing exceptionally well.
Let me address some of the points that the right hon. Gentleman made. On finance, in the figures he gave, I think he was alluding to the fact that, in the first year the coalition was in power, it worked to Labour’s NHS budgets. There was an underspend in that year, as there was in each of the last four years that Labour was in control. In three of those four years, the underspend was higher than it was when my right hon. Friend the Leader of the House was Health Secretary. Let us talk about redundancy payments. The reforms introduced by my right hon. Friend will save the NHS—[Interruption.]
Order. I appreciate that there are very strong feelings on these matters, but Opposition Front Benchers must not shout at the Secretary of State as he is responding to questions. He must be heard. Everybody will have a chance—Members can rely upon me to ensure that—but the Secretary of State must be heard.
The redundancies in management and administration will save the NHS £1.5 billion every year—£1.5 billion that can be spent on the front line. We should compare that with the £1.6 billion the NHS must spend every year to deal with the right hon. Gentleman’s disastrous private finance initiative policies that left the NHS with £73 billion of debt overhang.
Let us talk about clinical networks, which are extremely important. We have four clinical networks—for cardio, cancer, maternity and mental health—and they will continue. The budget that the networks are using is increasing and not decreasing under the Commissioning Board.
The right hon. Gentleman said that ambulance services in Manchester would be run by a private bus company. I am sure the House will be interested to know who the Health Minister was when the guidelines that allow private bus companies to bid to run ambulance services were drawn up. It was the right hon. Gentleman. He was in post when that happened.
The right hon. Gentleman describes the mandate as a wish list. He should tell that to the 570,000 people who have dementia, for whom Government Members want to do a better job. He should tell it to people who suffer from cancer. They have below-average European survival rates, but we want them to have the best survival rates in Europe. He should tell it to the families and carers of people who are worried about the level of care they receive in certain parts of the system.
Government Members are determined to aim high for our NHS, because we believe in it. We believe it is doing incredibly well in difficult circumstances, but it can do even better. The right hon. Gentleman should also want an ambitious NHS. Just because he did not have those ambitions when he was Health Secretary does not mean that the Government should not aim high to make our NHS the best in the world.
Minister, may I thank you for your statement on the mandate and in particular your reference to the armed forces covenant? Mental health has been the poor relation for too long. The statement says that mental health will be elevated to parity with physical health. Can the Minister explain how those who have fought in the wars in Iraq and Afghanistan in particular and who have seen the awfulness and the brutality of war will be helped through the mandate?
Order. I always listen extremely carefully to the hon. Gentleman, who has asked a very serious question. I hope he will take it in the right spirit if I say that my medium-term ambition is to persuade him to cease to use the word “you” in asking questions in the House. But his question has been heard and it will now be answered.
The hon. Member for Strangford (Jim Shannon) may know that there is a mental health helpline specifically for veterans because we recognise the importance of this decision. He will also have seen from the mandate that mental health is mentioned in virtually every part of it, whether in the context of avoiding mortality from extreme mental illness or helping people with long-term conditions, which would also cover post-traumatic stress disorder.
(11 years, 9 months ago)
Commons ChamberI inform the House that I have selected the amendment in the name of the Prime Minister.
This debate is flushing out the Government’s position, is it not? The Under-Secretary of State keeps heckling from the Front Bench, but we now know—[Interruption.]
Order. I ask the right hon. Gentleman to resume his seat. [Interruption.] Order. Let me say once and for all to the Under-Secretary of State, the hon. Member for Broxtowe (Anna Soubry), who has been conducting a running commentary since she sat down on the Front Bench at the start of the debate, “Stop it.” I do not wish to hear it, and neither does the House. The Secretary of State will respond in due course. If the hon. Lady is dissatisfied with what has been said, her right hon. Friend will have a chance to respond. I do not want the sedentary chuntering, the finger-wagging and all the rest of it. The hon. Lady can say “pooh” if she wants, but she will accept the ruling of the Chair, and either behave or get out of the Chamber. I do not mind which it is.
The Government’s position was indeed made clear in Westminster Hall this morning, and perhaps we shall hear it again from the Dispatch Box in a moment.
The south-west trusts’ initial document stated that the consortium would explore
“radical changes to terms and conditions of the workforce”.
It went on to say that this would not be a negotiation, and that
“trusts would be obliged to dismiss and re-engage staff to secure such changes”.
That is disgraceful, and it is simply not possible for the Government to have no view on it. It is provocative, destabilising and divisive. However, it gets worse. In the vacuum left by Ministers, the chaos is spreading. We have identified a further 12 trusts across England that are actively considering opting out of “Agenda for Change”. There are five in the north-east, which gives rise to fears of a second emerging pay cartel. North Tees and Hartlepool has issued 90-day notices to 5,452 staff as a precursor to forcing them to sign new non-“Agenda for Change” contracts—staff who refuse to sign by March 2013 are threatened with the sack—and South Tees is considering a similar move.
I hope that it is a point of order rather than a point of frustration. We will hear it and I will discover whether it is.
On three occasions, the Secretary of State has said that the trade unions bankroll the Labour party. A large majority of the trade unions in the health service have no links to the Labour party whatsoever.
I am grateful to the hon. Gentleman, but that is a point of debate that he might wish to develop further if he is successful in catching my eye. We will leave it for now.
I ask the right hon. Member for Leigh, rather than irresponsibly scaremongering, to do something positive by doing everything in his power to encourage his trade union friends to work in the best interests of their members, of patients and of his constituents and mine to come to a speedy resolution. I suspect he has rather more influence with the unions than I do in that regard. Even with a protected NHS budget—something that he thought was “irresponsible”—the NHS must do significantly more within its limited means, and as its single largest expense the pay bill cannot be immune to change. It represents between 60% and 70% of total expenditure in most NHS organisations and costs more than £43 billion in the hospital and community services sector alone.
Order. In the interests of trying to accommodate as many colleagues as possible, and many wish to speak in the debate, I have imposed an eight-minute limit on each Back-Bench contribution with immediate effect. I call Mr Ben Bradshaw.
That is very kind of you, Mr Speaker, but I have had my Adjournment debate this morning and taken up enough time, so I want to let colleagues speak.
We are extremely grateful to the right hon. Gentleman for his selfless sacrifice. I call Kerry McCarthy.
Order. Let me say to the Minister once and for all—[Interruption.] No. I say to the Under-Secretary of State for Health, the hon. Member for Broxtowe (Anna Soubry)—perhaps she will have the courtesy to listen when she is being spoken to from the Chair—that it is not acceptable for any Member of the House to treat the debate as a private conversation between himself or herself and the Member on his or her feet. If the Minister is dissatisfied with what is being said, other people on her Benches can pick up those points. It is totally unacceptable to behave in this way and it will stop straight away. I hope the Whip has noticed it, and I will be speaking to others about the matter.
There is some confusion. When I wrote to the Health Secretary to get some clarity—
On a point of order, Mr Speaker. I could not help but notice that the clock did not stop during that intervention. I see that a minute has been added on, but I think it should have been more than that.
Allowance will be made. I am grateful to the hon. Gentleman for his service. Perhaps we can now proceed with the debate in an orderly way.
Does my hon. Friend agree that we were a bit surprised to hear the Secretary of State say that Labour is asking for national pay and opposing regional pay because the unions are bankrolling us? My hon. Friend said that she had received many e-mails. I am sure that, like me, other Opposition Members have received hundreds of e-mails from people who work in the health service—ordinary people, working people—who say that they do not want regional pay. That has nothing to do with any union.
Order. Interventions on both sides should be brief, and rather briefer than that.
It is sad that the Secretary of State resorted to the union bashing that we also heard from the Minister in the Westminster Hall debate. I have had a meeting with the Royal College of Nursing, and I have a briefing from the BMA about the case against the local and regional approach to pay. That has nothing to do with Labour-affiliated unions. Those organisations are speaking up for their staff, who are extremely worried. It is patronising to say that staff are concerned only because someone stoked them up and told them falsehoods or whatever. They are worried about the proposal because they work in the NHS and they know what impact it will have on them.
The south-west consortium’s explicit intention is to reduce costs by considering
“further more radical changes to the pay and conditions of the workforce”.
Yet to do this at a time when hospital budgets are under great strain and nurses are being made redundant, each trust paid £10,000 of public money to join the consortium. They have to appoint a consortium director, establish a consortium working group and commission legal advice, so it remains to be seen how much the added bureaucracy of the consortium will cost.
Even more worrying is the lack of transparency or accountability for that spending, given that we still do not know who is responsible for employing the director of the consortium or to whom they are answerable. Perhaps most disturbingly, the project initiation document explained that
“it is likely that Trusts would be obliged to dismiss and re-engage staff to secure such changes”,
which not only calls into doubt the validity of their proposals, but has serious cost and legal implications.
I can only agree with the BMA that regional pay is a
“costly and time consuming distraction”.
But of course this affects not only the NHS as an institution, but the individual staff on whom the whole service relies, who potentially face a 15% pay cut. The consortium proposes to cut sickness absence payments so that they are paid only at the base rate, yet for staff permanently on nights, the extra payments that they get for working night shifts are an intrinsic part of their salary, on which their mortgage payments often depend. It would constitute, on average, a 20% pay cut if they were ill and were paid just at the base rate.
Reducing annual leave entitlement not only amounts to a pay cut but means that staff who rely on their leave to balance caring responsibilities will face additional costs, if they can even continue to work. At the same time, extra child care costs will be even less affordable if enhanced payments for nights and weekends—payments which are intended to recognise their personal sacrifices and the additional costs that these workers incur—are changed.
The consortium is also considering increasing working hours. Once again, this is an effective pay cut, which ignores the fact that so many overworked staff already work longer hours. According to the Royal College of Midwives, 87% of midwives “frequently” or “always” worked more than their contracted hours, and more than half reported that none of those extra hours were paid for. These are emotionally and physically demanding jobs and the consortium risks leaving staff even more tired, or coming into work when they are really too ill to do so, in order not to lose their extra pay.
The south-west is a net importer of NHS professionals, but our trusts risk losing demoralised and under-appreciated staff to other regions where the terms and conditions are more favourable. NHS staff require the same training, dedication and commitment all around the country, so why should my constituents be paid less simply because of where they live, especially when there can be a greater demand for health services in the south-west because of our older population, and when the cost of living in many places is so high?
(11 years, 10 months ago)
Commons ChamberI am so sorry, Mr. Speaker.
I am very grateful to the Secretary of State for his statement. Despite the irregularity, sections 2 and 3 of the Mental Health Act give patients an automatic right to a tribunal hearing, and the tribunal will have been able to consider their applications for release.
(11 years, 10 months ago)
Commons ChamberOrder. The Secretary of State has been in the House for seven and a half years. I think he knows that we refer to Members by constituency, not by Christian name. It is not difficult.
First, may I say how delighted I am that the right hon. Gentleman and I once again have the same brief? I look forward to having a constructive relationship with him, not with total optimism, but I will try my best.
The right hon. Gentleman talked about my predecessor’s reforms and legacy. One of the finest things about my predecessor’s legacy is that he safeguarded the NHS budget—indeed, he increased it during this Parliament by £12 billion—when the right hon. Gentleman said that it would be irresponsible to increase it.
The arguments presented by the hon. Gentleman are fatuous, and the previous Government endorsed regional bandings for London workers. If today he is saying that he does not agree—[Interruption.] You might learn something if you listen. If he is saying that he does not agree with London weighting for London workers, which is a form of regional pay—[Interruption.]
If the hon. Gentleman listens, he may well learn something about what his Government did when they were in power. They endorsed the fact that in the NHS it is important to recognise that we need inducements in some parts of the country to encourage workers to work there. That is why we have central London and outer London weighting. If it was good enough under the previous Government, it should be good enough now.
Order. We are immensely grateful to the Minister, but we have a lot to get through and we really must press on with rather greater dispatch from now on.
The Government support transparency in publishing results of clinical trials, and they recognise that more can, and should, be done. In future, greater transparency and the disclosure of trial results will be achieved via the development of the European Union clinical trials register, which will make the summary results of trials conducted in the EU publicly available. Greater transparency can only serve to further public confidence in the safety of medicines, which is already robustly assured in the UK by the Medicines and Healthcare products Regulatory Agency. By law, the outcomes of clinical trials undertaken by companies must be reported to that regulator, including negative results.
Order. We are grateful to the Minister but some of these answers are simply too long. If they are drafted by officials, Ministers are responsible—[Interruption.] Order. I require no assistance at all from the Under-Secretary of State for Health (Anna Soubry). She should stick to her own duties, which I am sure she will discharge with great effect.
I thank the Minister for his answer and for recognising that missing data from clinical trials distorts the evidence and prevents patients and their doctors from making informed decisions about treatment. Will the Minister meet a delegation of leading academics and doctors who remain concerned that not enough is being done to see how we can ensure that all historic and future data are released into the public domain?
My hon. Friend raises absolutely legitimate concerns, which have been raised by others, including Ben Goldacre. I am happy for my noble Friend Lord Howe or me to meet her and experts to discuss this important issue further.
I did not have a question on this.
5. What steps the Government are taking to help people cope with conditions such as diabetes and asthma.
The hon. Gentleman has been in the House since 1987; he knows perfectly well that points of order come after statements, not before them. I feel certain that he was just teasing the House and me.
(11 years, 11 months ago)
Commons ChamberOrder. I remind the House that there is a further statement to follow. I am keen to accommodate the interest of colleagues in business questions, but if I am to be successful in doing so, brevity from both Back Benchers and Front Benchers alike is now vital.
Can we have a debate on intellectual insanity? The Labour-supporting Institute for Public Policy Research is now arguing that motorists are not suffering enough from high petrol taxes, and is calling for more taxes. Is that not surprising, given that high petrol taxes hit the poorest Britons twice as hard as the rich?
(11 years, 11 months ago)
Commons ChamberWill you, Mr Speaker, therefore reinforce to the Chancellor that it is important to appoint a Member the moment they seek to resign their seat through such an appointment?
I think it is a matter for further consideration and, on the occasions that this issue has been raised, if not in quite the same terms, I have suggested to Members concerned about it—I recall the hon. Member for Walsall North (Mr Winnick) expressing his discontent with the status quo—that it could be considered by the Procedure Committee. That is one possibility, but it certainly warrants further discussion. I note what the Minister of State, Department for Transport, has said with reference to 1963, and I feel sure that he is right.
I did not say that the hon. Gentleman was wrong—he should not look for an argument!