Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 14th January 2014 Commons Chamber

[Jane Ellison]

Obviously, health is a devolved matter, but research goes across the United Kingdom. In 2012-13, we spent £2.3 million on research into this disease through the National Institute for Health Research. The hon. Gentleman may be aware that during the passage of the Mesothelioma Bill, which has recently passed through this House, ministerial colleagues agreed to write to the Association of British Insurers. The Department of Health is seeking to set up meetings with the ABI and the British Lung Foundation to explore how insurers can individually sponsor specific mesothelioma research.

[Valerie Vaz (Walsall South) (Lab)]

4. How much has been spent on medical locums in accident and emergency departments in each year since 2009-10.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

Staff employment is a matter for NHS trusts and we do not collect that data centrally. We recognise the challenge in recruiting and retaining A and E doctors, who can take up to six years to train. However, growth in the medical work force has kept pace with the increase in attendances since 2010.

[Valerie Vaz]

I am sure the Minister will agree that it is a grotesque situation where a trainee doctor working as a locum is paid as much as a fully qualified doctor. That is the result of not listening to legitimate concerns during the passage of the Health and Social Care Act 2012, so will the Minister not blame women in the work force or overpaid doctors but do something quickly to stop this drain on public money?

[Dr Poulter]

I hope the hon. Lady will be pleased to hear that under the current Government we have reduced locum costs to the NHS by about £400 million. That is, of course, good medical practice: it is good for patients to receive better continuity of care from permanent doctors. In A and E, specifically, we have seen the work force grow by more than 350 since 2010.

Mid Staffordshire NHS Foundation Trust

Valerie Vaz Excerpts

Tuesday 7th January 2014 Westminster Hall

[Jeremy Lefroy]

I agree. I welcome my hon. Friend’s huge support, both for Stafford and Cannock, throughout this process.

[Valerie Vaz (Walsall South) (Lab)]

I congratulate the hon. Gentleman on securing this debate. I know how hard he has worked and I echo the tribute of the hon. Member for Cannock Chase (Mr Burley).

The impact on the Manor hospital in Walsall has been immense, as the hon. Gentleman said. We have already had to open 70 beds, as well as attempting to open two wards. The hospital desperately needs £40 million. I have raised this matter frequently with the Minister. I should be grateful if the hon. Gentleman took that on board in his summing up and if the Minister looked at the Manor hospital—he has visited it, although I was not there when he did—to ensure that it gets the funds that it desperately needs, having taken the impact of the closure of accident and emergency at Stafford hospital.

[Jeremy Lefroy]

I am grateful. I place on the record my thanks to all the staff at all the hospitals—Stafford, Cannock, Wolverhampton, Walsall and Stoke—for all they have done through this difficult time.

Let me turn to the detail of the services, which comprises the bulk of the trust special administrators’ report. We have come a long way from 11 months ago. Then, the contingency planning team recommended removing A and E and all acute services from Stafford, as well as elective surgery from Stafford and/or Cannock. We now have proposals that retain elective surgery at Cannock and, indeed, foresee increased activity there. At Stafford, we retain 14/7 A and E, together with acute medicine, elective and some less serious non-elective surgery, day-case surgery and a large out-patient department.

As a result of the consultation, the administrators proposed a midwife-led unit for maternity, when their original proposals removed all childbirth from Stafford. The estimate is that some 90% to 91% of all current patient attendances would remain at Stafford and Cannock.

Accident and Emergency

Valerie Vaz Excerpts

Wednesday 18th December 2013 Commons Chamber

[Andrew George (St Ives) (LD)]

My expectations for this debate were low, having previously endured shouting matches between the former Labour Secretary of State, the right hon. Member for Leigh (Andy Burnham), and the current Secretary of State, with the usual antics of carefully selected and spun statistics thrown at each other. Those expectations were not disappointed. This issue is not helped by being dragged into the gutter of partisan politics. The fact is that the A and E crisis—if there is indeed an A and E crisis—has existed and has been endemic in the NHS before and after 2010. This is largely the result of A and E being seen as an issue that somehow needs to be treated separately and not part of an integrated NHS. Before 2010, there were ambulances queuing outside the A and E in my constituency and in the Royal Cornwall Hospitals Trust in Truro. The problem exists. From time to time, there will be those kinds of pressures, which are created by a whole set of things that are not entirely the fault of a failing A and E service.

One aspect of unscheduled care in Cornwall that I raised with the former Secretary of State is the out-of-hours GP service. The previous Labour Government were perfectly happy to see that service put out to tender and privatised, and we saw a fragmented unscheduled care service. I reported the Serco out-of-hours GP service to the CQC, because it was simply putting profit before patients by manipulating statistics to make the outcomes appear better than they were. It was announced last week that Serco will be handing that contract back early. I hope that that will result in an integration of unscheduled out-of-hours care, as that is the kind of thing we need to do. This is not an issue that should be subject to party political point scoring, because that completely misses the target.

[Valerie Vaz (Walsall South) (Lab)]

The hon. Gentleman sat on the Select Committee with me. He must surely accept that there was a top-down reorganisation that nobody wanted and that cost the NHS £3 billion.

[Andrew George]

Yes, and the previous Labour Government were involved in multiple top-down reorganisations of the NHS. The hon. Lady knows that I opposed that top-down reorganisation; I voted against the Health and Social Care Bill.

We could just bemoan the things that are going wrong, but I want, in two minutes, at least to lay on the table my prescription for what needs to be put right. The two themes have to be integration and prevention. My intervention on my right hon. Friend the Member for Sutton and Cheam (Paul Burstow) spelled out the theme of integration. Unscheduled care includes not only A and E, but minor injuries units, urgent care services, the 111 service, the ambulance service, the out-of-hours GP service, GP surgeries themselves, and, indeed, GP walk-in centres, which the previous Government created. Significant confusion is created about where the general public are supposed to take themselves if they have an urgent need for medical attention. We really need to find ways to integrate those unscheduled services in a way that does not result in the fragmentation that bedevils the service at present.

On prevention, often in acute hospitals planned work cannot go ahead because patients cannot be discharged from hospital and other patients cannot be admitted because there are insufficient beds. The health service is not integrated, because there are insufficient community beds and the primary care service is struggling and stretched to the limit, unable to provide the kind of care for people in their homes and community hospitals that would avoid them ending up in hospital as emergency cases. Those are the two themes: further integration of the service, which is not helped by the Health and Social Care Act 2012, and significant investment in preventive care and primary care.

Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 26th November 2013 Commons Chamber

[Mr Hunt]

I am delighted to do that. As these are the last Health questions before Christmas, all of us would want to pay tribute to the voluntary organisations that do an extraordinary job of making sure that vulnerable older people do not get lonely over the Christmas period. It is heroic what they do—when we are with our families, they are looking after other people—and we should salute them all.

[Valerie Vaz (Walsall South) (Lab)]

22. One way to ease the pressure on the NHS is by not handing the £2.2 billion underspend back to the Treasury. Will the Secretary of State consider using it for the NHS?

[Mr Hunt]

I wish the hon. Lady had been as diligent in asking that question of Labour Ministers, who also handed back underspends to the Treasury when they were in power.

Mid Staffordshire NHS Foundation Trust

Valerie Vaz Excerpts

Tuesday 19th November 2013 Commons Chamber

[Valerie Vaz (Walsall South) (Lab)]

The College of Emergency Medicine has consistently called for an increase in emergency doctors, because there has been a 50% shortfall over the past three years. What plans has the Secretary of State to address that concern?

[Mr Hunt]

I met the College of Emergency Medicine yesterday to discuss those issues, among others. We have 300 more doctors working in our A and E departments than we did three years ago, but the hon. Lady is absolutely right that we need more, because 1 million more people a year are going through A and E than there were in 2010. Part of the challenge is to make A and E a more attractive profession for doctors. They might work long shifts and antisocial hours, which can make it unattractive. We need to find a way of dealing with that.

Accident and Emergency Departments

Valerie Vaz Excerpts

Tuesday 10th September 2013 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for making that point. It cannot be said enough how hard A and E staff in particular work—antisocial hours in very challenging conditions. Many hon. Members will have seen that in their local hospitals. With respect to the capital allocations, I hope that the House has a sense from today that we are looking to solve the long-term problems facing A and E departments, as well as giving immediate help for this winter and next winter, so of course we will look carefully at the business case put forward by his local hospital for capital.

[Valerie Vaz (Walsall South) (Lab)]

The Royal College of Physicians, the College of Emergency Medicine and others have already come up with a 10-point plan for what to do about emergency care. That is the professional view. When will the Secretary of State act on it?

Managing Risk in the NHS

Valerie Vaz Excerpts

Wednesday 17th July 2013 Commons Chamber

[Valerie Vaz (Walsall South) (Lab)]

It is always a pleasure to follow the hon. Member for Bracknell (Dr Lee). I do not think that hon. Members have had a chance properly to mention that the NHS is 65 years old.

We now have two figureheads atop the NHS: the Secretary of State and the chief executive of NHS England. Hon. Members might have missed the change of name from the NHS Commissioning Board to NHS England. Such is the power of the chief executive that he neither had to come to Parliament nor to deal with elected representatives to achieve that. The two of them sit there like Laurel and Hardy, whose catchphrase was, “Here’s another fine mess you’ve gotten me into.” We know there is a mess, as there is a host of ongoing reviews.

Let me start by referring to the Francis report, which was produced by a leading QC who started his work in 2009 after being picked by my right hon. Friend the Member for Leigh (Andy Burnham), so that was something he got right. Some £10 million later, after sifting the evidence and hearing bereaved people give their testimony, Robert Francis produced a report with 290 recommendations. At the time, it appeared that they had been accepted in full, but all is not as it seems, because apparently there needs to be a review on its implementation.

Yesterday, we received Sir Bruce Keogh’s thoughtful review. It is actually a model report, as it gives clarity on what needs to be done. The Secretary of State mentioned Don Berwick’s report on the Francis review, which is due in the autumn. Camilla Cavendish has reported on health care and social care assistants. My right hon. Friend the Member for Cynon Valley (Ann Clwyd) and Tricia Hart will review how patients make complaints, although no date has been given for when that will report. Sir Bruce Keogh is busy again, as he is producing a further report on a plan for vulnerable older people, which I think is also due in the autumn.

You would be forgiven for thinking that that was the end of it, Mr Speaker, but that is not quite the case. The chief executive of NHS England announced to the Health Service Journal—not to the Secretary of State nor to Parliament—that he would do some work to determine what NHS England’s strategic direction might be. One would have thought that he would already know, and the process seems somewhat late given when the body was set up. He told me that the cost would be £3 million over three years, but how many doctors and nurses would that buy?

What has been the response of the Secretary of State to date? Urgent care boards and chief inspectors—PR and an extra layer of bureaucracy. The Health Committee heard evidence that urgent care boards were the management that was removed by what happened to the strategic health authorities. What are the costs? The Treasury has already clawed back £3 billion from the NHS. According to the National Audit Office, the efficiency gains of £5.8 billion that were made in the first year were a result of reducing the tariff to providers and the public sector pay freeze, but how long can that carry on?

The NAO has published interesting statistics following the passage of the Health and Social Care Act 2012. The reported cost of the reforms was £1.1 billion. The Secretary of State told the Health Committee that he had seen—he did not know—a figure of between £1.5 billion and £1.6 billion. Professor Kieran Walshe has put the figure at £3 billion.

The NAO said that of the 170 organisations closed down, 240 have been opened, and 10,094 full-time equivalent staff have been made redundant. It is a shame, when there is an underspend of £3 billion, that the College of Emergency Medicine is crying out for extra emergency doctors and consultants, and at least half a million pounds is spent on locums in A and E, and all before we have even looked at integration.

Many have endorsed what is rapidly becoming known as the Burnham plan, including the right hon. Member for Charnwood (Mr Dorrell). The Health Committee has seen the work at Torbay, which was piloted in 2004-05—by the previous Government, incidentally—but we were told that the Health and Social Care Act could affect the way it works.

I want to ask the Secretary of State to do something fairly useful: ask someone at the Department of Health to pull together and publicise best practice from across the country. The Health Committee heard evidence that some of the A and E hospitals had got it right by moving elderly people directly to consultant geriatricians.

Finally, it is very easy for those of us who are exposed to the world of NHS structures to say how we can fix it, but Robert Francis took evidence from those who use the service directly on how they came across the inaction and indifference of a large institution. Sir Bruce Keogh has done the same with his report. They talked directly to those on the front line and those who use the service, not just those in the boardroom. They are the ones who should be listened to—all those who work in the NHS and have to provide a service when their pay is frozen. The people who use our NHS want professional people who are competent at their job caring for them when they are at their most vulnerable. Only if we listen to them will we be able to wish the NHS many happy returns in future.

Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 16th July 2013 Commons Chamber

[Anna Soubry]

Of course, the overall health budget will be rising by some £12 billion by 2015, and in relation to mental health, I have to say that I am exceptionally proud of this Government for making mental health such a priority, notably through the mandate. I think we are to be congratulated on at last recognising how important mental health is. In our view, it underpins almost all public health matters and so many of the troubles and conditions that people present to GP surgeries. Therefore, I think we are doing an extremely good job on this subject.

[Valerie Vaz (Walsall South) (Lab)]

4. What plans he has to implement the recommendation of the Francis report on safe staffing levels.

[The Secretary of State for Health (Mr Jeremy Hunt)]

We agree with Robert Francis that there is a need for evidence-based guidance and tools to inform appropriate staffing levels. We have set out a number of recommended actions to support appropriate staffing levels in “Compassion in Practice”—the nursing, midwifery and care staff vision and strategy for England.

[Valerie Vaz]

I thank the Secretary of State for his answer, but Robert Francis said in his report that minimum safe staffing levels lead to helping patient safety. If the Secretary of State agrees with Robert Francis, why does he not implement that recommendation now?

Tobacco Packaging

Valerie Vaz Excerpts

Friday 12th July 2013 Commons Chamber

[Anna Soubry]

I could speak for a very long time about illegal drugs and how we make them less attractive to young people. We know, for sure, that we need a subtle mixture of different measures that persuade young people not to take substances that are harmful to them. I am more than happy to have that conversation with my hon. Friend.

[Valerie Vaz (Walsall South) (Lab)]

Apart from vending machines, what public health initiatives is the Minister going to undertake immediately to stop 570 children a day taking up smoking?

[Anna Soubry]

We have a number of measures. For example, we have some of the toughest tax and duty measures in relation to tobacco. The “Stoptober” campaign was phenomenally successful last year. We have a TV campaign that is encouraging people not to smoke in cars, for example, as well as our other continuing work. With public health being devolved back to where it always should have been—to local authorities—a number of authorities, notably up in north-east England, have taken grave measures to tackle smoking by educating young people, in particular. This is all good work that will continue through Public Health England.

A and E Departments

Valerie Vaz Excerpts

Tuesday 21st May 2013 Commons Chamber

[Mr Hunt]

My hon. Friend rightly draws attention to the importance of the ambulance service, which is also feeling the pressure on A and E departments. We need to help the ambulance service to do its job better too. One thing that it always strikes me would make a huge difference to ambulance services is if staff could access the GP records of someone they were picking up on a 999 call, so that they would know that the patient was a diabetic with mild dementia and a heart condition, for instance. That kind of information can be incredibly helpful. I hope that by sorting out the IT issues with which the last Government struggled, we can help ambulance services to do that.

[Valerie Vaz (Walsall South) (Lab)]

The Select Committee on Health heard evidence today from the College of Emergency Medicine about a 50% shortfall in trainee doctors and consultants. On average, trusts—I was going to say PCTs—spend £500,000 on locums. What does the Secretary of State intend to do about that?

[Mr Hunt]

We certainly intend to address A and E departments’ recruitment issues, which I recognise are one of the causes of the pressure. Over-reliance on locum doctors is not a long-term solution to improving the performance of A and E departments either, so those are both areas that we will be looking at.