Junior Doctors Contract

Valerie Vaz Excerpts

Monday 30th November 2015 Commons Chamber

[Mr Hunt]

I agree with my hon. Friend, who has great knowledge of NHS matters. I simply say to junior doctors that this is not just about contracts and pay; it is also about training. Having consultants more available at weekends will help improve training for junior doctors. We will also need to look at continuity of training, which I think has been undermined in recent decades. If junior doctors are looking for a visible reflection of this Government’s commitment to the NHS, they should look at last week’s spending review statement and the extra resources we are putting into the NHS in very tight circumstances. This Government are backing the NHS, and we are doing everything we can to back junior doctors as part of that.

[Valerie Vaz (Walsall South) (Lab)]

Thank you, Mr Speaker—I was standing.

The Secretary of State referred in his statement—in the last line of page 1 of the copy we have been given—to a “time-limited period” during which negotiations will take place. Is that a day, a week or a month? Will the contract be imposed after that?

[Mr Hunt]

I hope that the hon. Lady will understand that, because I very much hope that the BMA’s junior doctors executive committee will agree to go ahead with the agreement we have made with its negotiators, I do not want at this stage to go into further details about its contents. Obviously, the agreement will be published as soon as it is made, but I think that I would be pre-empting that decision by going into detail. It is a reasonable period of time for negotiations to take place.

Care Homes (Regulation)

Valerie Vaz Excerpts

Wednesday 4th November 2015 Westminster Hall

[Several hon. Members rose—]

[Valerie Vaz (in the Chair)]

Order. I intend to start the winding-up speeches at 10 past 5.

NHS (Contracts and Conditions)

Valerie Vaz Excerpts

Monday 14th September 2015 Westminster Hall

[Valerie Vaz (in the Chair)]

A digital debate took place on Twitter, ahead of today’s debate. Mr Speaker has agreed that for this debate members of the public can use handheld electronic devices in the Public Gallery, provided that they are silent. Photos, however, must not be taken.

[Helen Jones (Warrington North) (Lab)]

I beg to move,

That this House has considered the e-petition relating to contracts and conditions in the NHS.

It is a pleasure to serve under your chairmanship, Ms Vaz, and, in particular, to be debating the first petition to reach the debate stage under the new system for dealing with e-petitions. The original petition on the joint Government and Parliament website called for a vote of no confidence in the Secretary of State for Health. Fortunately for him—or unfortunately, depending on how people want to look at it—the Petitions Committee does not have the power to initiate a vote of no confidence, and so we decided that the debate should be on the issue underlying the petition, which was the contracts and conditions of NHS staff.

I might be joking about motions of no confidence in the Secretary of State, but the morale of NHS staff is not a joke. It is a long time since I last saw dedicated doctors, nurses and ancillary staff so demoralised and, sometimes, despairing. If we look at the current state of the NHS we can see why. A&E departments are in crisis and missed waiting time targets for the whole of last winter. GP services are struggling to cope, and patients find it harder and harder to get appointments. Last year, the deficit across trusts was nearly £1 billion; this year, that is predicted to double.

Yet despite all that, NHS staff work miracles every day. Who could not be proud of some of the achievements of our surgeons? Who could sit in an A&E department, as I unfortunately had to during the election, seeing the endless patience of NHS staff, and not be grateful to them? Who could watch paramedics dealing with an accident or reassuring a frail and confused elderly patient and not be ever grateful for the NHS? After the Olympic opening ceremony, I remember one American reporter said, “Oh, it’s just like praising UnitedHealthcare.” No, it is not. The NHS is not like UnitedHealthcare, thankfully, and that is why we value it.

NHS staff have been badly treated by this Government. Since 2010 pay increases have been deliberately kept low and last year we saw some staff being told that they could not have even a 1% increase if they were due to get an increment as well. The Government often talk about public services as if they were a drain on the economy, but they are not. Services such as the NHS are a huge contributor to our economy. It is completely wrong that, under this Government, tax is cut for millionaires but dedicated NHS staff are not even entitled to a decent pay rise.

Indeed, in the previous Parliament the NHS was told to make £20 billion of what the Government call efficiency savings but the rest of us call cuts. That is due to rise to £30 billion by the end of this Parliament. The NHS is struggling to cope with fewer and fewer resources but more and more patients. Many of the difficulties being encountered are of the Government’s own making. Ministers criticise spending on agency staff, but the Government’s first act on coming into office in 2010 was to cut nurse training places by over 3,000 a year.

--- Later in debate ---

[Maria Caulfield]

I declare an interest as a former NHS nurse—in fact, I still work as a nurse. I do not want to be political about this, because I want progress to be made on supporting the NHS, and particularly staff, but one of the single biggest factors in demoralising nurses and leading many skilled nurses to leave the practice was the last Labour Government’s change to the skill mix. That was crucial, because we were forced to cut our budgets, particularly on the wards, and junior nurses were left in charge of wards, instead of experienced senior staff nurses and sisters—

[Valerie Vaz (in the Chair)]

Order. I remind Members that interventions should be brief.

[Maria Caulfield]

Can I just say that it is the change to the skill mix that has demoralised nurses, and that did not happen under this Government?

--- Later in debate ---

[Mary Robinson]

Will my hon. Friend give way?

[Valerie Vaz (in the Chair)]

I believe that the hon. Lady had just finished.

NHS Reform

Valerie Vaz Excerpts

Thursday 16th July 2015 Commons Chamber

[Mr Hunt]

I thank my hon. Friend because he leads by example as a first responder and does a fantastic job in his constituency—indeed, that role takes place at weekends. Paramedics and ambulance services operate a seven-day service. Nurses, paramedics and others who work in hospitals currently do not have an opt-out; consultants are the only ones who do. These measures will give ambulance services confidence that if they take someone to hospital at the weekend, there will be a proper senior consultant present and their patient will get in front of the right person. That will make their job all the more rewarding.

[Valerie Vaz (Walsall South) (Lab)]

The Secretary of State has not outlined what steps should be taken to recruit, train and retain front-line staff who are key to patient safety.

[Mr Hunt]

We have big plans to recruit and retain staff, and those are being worked up by Health Education England. We think that we will need extra doctors to deliver seven-day care, just as we will need more GPs. We think we can afford that within the extra £10 billion that we are putting into the NHS, and we are ensuring that all the numbers add up. I am sure that I will inform the House once we have come to a conclusion.

Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 7th July 2015 Commons Chamber

[Mr Hunt]

I am sorry that my hon. Friend had to go to hospital at the start of the election campaign, but I congratulate her on being probably the only Member of the House to have launched their campaign from an NHS hospital ward. I trust that all the nurses voted for her as a result.

Inexplicably, the trust that my hon. Friend talked about was made a foundation trust in 2008, despite a number of problems that were not recognised. Since then, it has made dramatic improvements in its care, with more doctors and more nurses. I am delighted that it is on track to deliver better care.

[Valerie Vaz (Walsall South) (Lab)]

How many of the hospitals in special measures have implemented recommendation 13 of the final Francis report on fundamental standards?

[Mr Hunt]

I would expect that all trusts have done so. If they have not, they will not come out of special measures. That is the benefit of a rigorous, independent inspection regime. Seven trusts have come out of special measures. I hope that the others will come out in due course, but that is not a decision for me; rightly, it is a decision for the chief inspector of hospitals.

Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Mr Hunt]

I share my hon. Friend’s concern about what is happening at the Royal Stoke. Some of the care there was totally unacceptable; there should be no 12-hour trolley waits anywhere in the NHS. I have said that I support a full 24/7 A&E service at County hospital as soon as we can find a way of doing it that is clinically safe, and I will certainly work hard to do everything I can to make that happen.

[Valerie Vaz (Walsall South) (Lab)]

Will the Secretary of State ensure that other local hospitals, such as the Manor hospital, which have had to take up the slack following the closure of A&E and maternity services also get some support?

[Mr Hunt]

We absolutely will take a whole health economy view of that, and look at all hospitals that are affected by the changes.

Epilepsy

Valerie Vaz Excerpts

Thursday 26th February 2015 Commons Chamber

[Valerie Vaz (Walsall South) (Lab)]

It is a pleasure to follow the hon. Member for Wycombe (Steve Baker). I am sure I speak on behalf of all hon. Members in asking him to pass on the sympathy of the House to his constituents, whose case he has so ably put forward.

I start by paying tribute to the hon. Member for South Thanet (Laura Sandys) for her work as chair of the all-party parliamentary group on epilepsy, and for fulfilling her final task of securing this debate before leaving the House. She will be sadly missed; we shall also miss her enthusiasm and her commitment to epilepsy and to her constituents, for whom she has been an assiduous MP.

[Laura Sandys]

I am absolutely thrilled that the all-party group’s chairmanship has been handed to my hon. Friend the Member for Walsall South (Valerie Vaz), who I know will put a huge amount of passion and energy into continuing the fight and ensuring that the voice of those with epilepsy is very much heard.

[Valerie Vaz]

I am grateful to the hon. Lady. I hope to be as good as her, but I am not sure that I will be.

This is a timely debate, in that it comes between two important dates. The World Health Organisation adopted a resolution on 2 February this year, and world epilepsy day is on 26 March, when we are all urged to “colour it purple”. It is just an accident that I happen to be wearing purple today. This debate is taking place 12 days after 14 February, and most people probably know that St Valentine is the patron saint of epilepsy. The WHO launched a campaign on 9 February to improve the epilepsy treatment gap and it urged member states to look into the matter. It set out a number of clauses, and I shall mention just a few of them. Member states were urged: to ensure public awareness of and education about epilepsy; to integrate epilepsy management; and to introduce and implement national health care plans of action for epilepsy management. There are many more clauses and I urge hon. Members to look at them. A number of excellent reports have been published recently and I will touch on those in a moment.

I want to deal with three different stages of services: those for young people; the transition from young person to adult; and adult services. Here are some background facts. The brain is the most complex organ in the body with more than 100 billion neurones passing messages around it. The vast majority of the brain’s activities are subconscious. Epilepsy is a life-threatening neurological condition that can affect anybody at any age without warning. There are 40 different types of epilepsy and at least 40 different types of seizure, and 87 people are diagnosed with the condition every day. Epilepsy now accounts for more deaths than cervical cancer and is among the top 10 causes of amenable deaths.

I want to turn first to young people. The report “Improving epilepsy care for children and young people”, published by Young Epilepsy, University college London and Whittington Health highlighted unacceptable levels of misdiagnosis, inadequate communication, a variation in care and a fragmentation of services. There are 112,000 children and young people who have epilepsy, which is one in every 200. The report made seven recommendations. They include creating an individual plan for every child and young person—as one parent has said, a one-size-fits-all approach is wrong; designing a year-of-care tariff for epilepsies; and creating an audit and annual review of relevant outcomes for each child and young person. Dr Amit Bali, who was involved in producing the report, has said that only small steps have been taken in areas that require big leaps forward.

I was at the launch of Epilepsy12 at the Royal College of Paediatrics and Child Health a few years ago. A number of charities were also involved in that, including Epilepsy Action and Young Epilepsy. Epilepsy12’s report revealed variations in the level of care and available resources such as the specialist nurses and clinics that are needed to provide care across the United Kingdom. Amazingly, it also found that some services were not even meeting NICE guidelines. In a later report, published in 2014, Epilepsy12 said that some progress had been made, and that two thirds of units had specialised epilepsy nurses and more clinics were being held. However, only two in every three units reported holding a weekly epilepsy clinic just for children and young people.

The way in which young people are treated is important because it affects their education as well as their lifestyle. A three-year population-based study by Children with Epilepsy in Sussex Schools—CHESS—found that 95% of the children affected had difficulty in at least one of the assessed areas and that most of the children had several problems. The CHESS study found that 60% of the children met the diagnostic criteria for at least one behaviour or motor disorder, but only one third had previously been diagnosed. We have heard about the difficulties that children on anti-epileptic drugs have. A study by the Epilepsy Society showed that AED drugs have a detrimental impact on processing speed and memory work.

On the transition period, Epilepsy12 found that there were inadequate services and transition arrangements for young people. So more attention needs to be given to handover clinics, which could comprise both adult and paediatric health professionals. The loss of the continuity of care at transition needs to be addressed to ensure that new relationships with the clinicians are established.

Let me now discuss adults. The report by Epilepsy Action on clinical commissioning groups and commissioning in November 2014 found that only three out of 140 health and wellbeing boards are making plans for people with epilepsy. Some 78% of CCGs have not developed and do not intend to develop a written needs assessment for people with epilepsy—that must change. Evidence also shows that people with epilepsy have poor access to epilepsy specialists and epilepsy specialist nurses, and do not have regular reviews of their epilepsy. My hon. Friend the Member for Vauxhall (Kate Hoey) was kind enough to mention my ten-minute rule Bill, in which I called for direct referrals to a tertiary specialist. That has not been taken up yet, so we need to have referrals from a GP specialist to a tertiary specialist without the need to go through a generalist consultant.

The sudden unexpected death in epilepsy is an important issue, as was highlighted by SUDEP Action. The national sentinel audit of epilepsy deaths in 2002 found that 42% of such deaths were potentially avoidable. Brain surgery is another area where there is a lack of availability, with only 300 operations being carried out on adults each year. It is estimated that approximately 5,000 adults could and should benefit from the only cure there is for their epilepsy. I also wish to add my voice to those of other hon. Members on the outrage at the sacking of the young person at London Underground.

But there is hope for the future. The Epilepsy Society is undertaking active research. Its report highlighted a number of firsts, such as the first brain and tissue bank for epilepsy. It has created the first multilingual digital information resources for epilepsy, and it hopes to unravel the genetic architecture of the epilepsies and bring new hope for people with the condition. We should consider ourselves lucky in this country, because not only do we have committed practitioners who are desperate to help their patients, but we have areas where pioneering work is going on, such as that being done by Professor Cross, who has pioneered the ketogenic diet. In the US, until there was “Obamacare” those with epilepsy could not be covered by insurance because they had a pre-existing condition. We take all that for granted, which is why this debate fulfils the important role of highlighting awareness of this condition.

Hon. Members will remember the drama “The Promise”, where the lead character, Erin, not only was a heroine, but had epilepsy, which was incidental to her life: Its writer, Peter Kosminsky, lately the director of “Wolf Hall”, said that he wanted to show someone being brave and getting on with her life without letting her epilepsy circumscribe her actions, in the hope of de-stigmatising the condition. On de-stigmatising, let us also not forget the roll call of creative successful people who have or have had the condition: musicians Neil Young and Prince; and the writers Dostoevsky; Charles Dickens and Lord Byron. I hope we have today brought epilepsy out of the shadows of stigma and discrimination, and into the spotlight of knowledge, awareness and hope for the future.

[Several hon. Members]

rose—

Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 24th February 2015 Commons Chamber

[Dr Poulter]

My right hon. Friend asks an important question. We can of course support the existing model, and the innovation that comes with GPs being small businesses, and that is exactly what we are doing with the £1 billion investment fund for GP infrastructure and technology. We are supporting those GPs as small businesses to develop better patient services.

[Valerie Vaz (Walsall South) (Lab)]

On what is his last outing, will the Minister tell us how many GPs, in addition to those who have retired, have left the profession and how many have gone to work abroad?

[Dr Poulter]

It has always been the case—it was certainly the case among many of my medical contemporaries—that many people from our NHS go and work overseas for some time. They often come back to the NHS, bringing broader experience and skills. As I outlined earlier, there are now 1,000 more GPs working and training in our NHS than there were five years ago.

Francis Report: Update and Response

Valerie Vaz Excerpts

Wednesday 11th February 2015 Commons Chamber

[Mr Hunt]

The hon. Gentleman makes an important point, but I hope I can reassure him, because NICE has published guidelines on safe staffing levels, although they are different for different parts of a hospital: in intensive care, it is 1:1; for less severe illnesses, it is one nurse to eight patients; and in other parts of a hospital, it is one nurse to four patients. Those are all published, and I hope they will help whistleblowers in Cornwall and elsewhere.

[Valerie Vaz (Walsall South) (Lab)]

What support will the Secretary of State give to trusts to ensure that safe staffing levels are implemented, given that they might need extra resources?

[Mr Hunt]

We have protected—indeed increased—the NHS budget in real terms at the time of the biggest financial crisis since the second world war, so I think the Government have done what they can to make resources available. However, improving care is not always about money, and some hospitals manage to staff their wards safely and achieve financial balance. In fact, hospitals that practise safe care tend to be in a better financial position than ones that do not, so safe care and good finances actually go together.

NHS Major Incidents

Valerie Vaz Excerpts

Wednesday 28th January 2015 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. I have spoken to the chief executive of the hospital, and I must say that she and her staff are doing a good job in turning around a very difficult situation. What they want is support. We have issued sensible guidance that tells hospitals that if they declare a major incident, they must take account of the impact on the rest of their local health economy. A responsible Opposition would support such guidance, and not to try to turn it into a political football.

[Valerie Vaz (Walsall South) (Lab)]

The Manor hospital had to declare a major incident due to inordinate pressure from the closure of Stafford A and E. That is not a local issue, but a national one. When will the Secretary of State provide the hospital with the extra money to absorb the closure of Stafford A and E?

[Mr Hunt]

I can reassure the hon. Lady that we have provided a huge amount of extra money to deal with the problems in the wake of what happened at the former Mid Staffs Trust. We are continuing to give every support we can to Walsall and Stoke and other trusts. We have more doctors and more nurses and major changes are happening. The problem in Mid Staffs went on for four long years, and we do not want to wait that time before sorting out the problems.