(13 years, 6 months ago)
Commons ChamberI am pleased to hear what my hon. Friend has to say, and I welcome what he said about Holmfirth high street. Indeed, we have accepted and implemented virtually all Mary Portas’s review recommendations. I hope that the pilots will show how we can extend some of the lessons further to invigorate high streets across the country—something that, as my hon. Friend illustrates, can be achieved.
I welcome the Leader of the House to his new position and place on record my thanks to the right hon. Member for North West Hampshire (Sir George Young) for the helpful and courteous way in which he dealt with Back Benchers. I hope that that will continue.
Can we have an urgent debate on the Sunday trading laws, given that the announcements outside this House are at variance with the undertakings given inside it? If there is any consultation, will the Leader of the House ensure that retail staff, the unions, the Churches and the Association of Convenience Stores are included?
I am grateful to the hon. Lady for her kind words about my predecessor. I do hope to emulate in many respects the way in which he fulfilled his responsibilities so wonderfully. As to Sunday trading legislation, however, I do not accept the premise of her question. I do not think there is any variance between what the Government said when we introduced the legislation about the extension of Sunday trading hours during the summer and what has been said subsequently.
(13 years, 8 months ago)
Commons Chamber
Mr Burns
I shall make a little more progress.
Let us not stop at waiting times. The £600 million cancer drugs fund that has helped more than 12,500 patients to access the drugs previously denied to them, the screening programmes for breast and bowel cancer, potentially saving an extra 1,100 lives every year by 2015, the world-leading telehealth and telecare whole systems demonstrator programme, which saw a stunning 45% fall in mortality and is set to transform of 3 million people with long-term conditions over the next five years—
Mr Burns
My hon. Friend is right. As he would probably expect, I shall deal with that issue later in my speech. While I am responding to his intervention, let me say that not only was his hospital fortunate in having that fantastic equipment to look after his constituents, but I had the pleasure last week to be in his constituency to visit Elekta and Varian, which are world leaders in making equipment to help with radiotherapy.
The Minister is very fond of statistics. Can he say whether GP referrals have gone up, and whether A and E admissions have gone up or down?
(13 years, 8 months ago)
Commons ChamberOne reason why the NHS continues to deliver such significant improvements in performance is that through the transition, we are increasing clinical leadership, which will make an important, positive difference, and can already be shown to have done so. For example, we are managing patients more effectively in the community, and reducing reliance on acute admission to hospital. The number of emergency admissions to hospital in the year just ended went down, which is a strong basis on which to develop services in future, and that is happening not least because of leadership in the primary care community. I hope that my hon. Friend from Cornwall, along with other Members, supports the assumption of clinical leadership through clinical commissioning groups by those clinicians.
Like my right hon. Friend the Member for Rother Valley (Mr Barron), the former Chair of the Select Committee on Health, I have not had sight of the report, but will the Secretary of State say what the cost to the public purse of the pause and the reorganisation will be?
(13 years, 9 months ago)
Commons Chamber
Mr Speaker
On both the Front Benches and the Back Benches in all parts of the House, I suspect.
How do the Government intend to ring-fence the public health money that will be given to local authorities?
Quite literally, by putting it in a ring fence. That money can be spent only on improving public health among the local population. There are 66 supporting indicators in the outcomes framework. The money will be given to local authorities on the basis that they will make progress towards achieving those outcomes.
(14 years ago)
Commons Chamber
Mr Speaker
The Minister’s power to anticipate what will be said to him is extremely impressive, and I congratulate him immensely warmly.
One year on, are the pledges under the responsibility deal working?
One year on in the responsibility deal we are seeing successes, including the elimination of artificial trans fats, further reductions in salt in manufactured foods, and over 8,000 high street outlets sharing and showing calorie information. The monitoring and evaluation of the deal is vital. We are committed to this and we are making up to £1 million available to fund an independent evaluation.
(14 years ago)
Commons ChamberIt is always a pleasure to follow the right hon. Member for Charnwood (Mr Dorrell), the Chair of the Select Committee. He said that Members on our side were looking raptly at my right hon. Friend the Member for South Shields (David Miliband). Members of the right hon. Gentleman’s party were looking raptly at him, wishing he was the Secretary of State for Health.
It is an important day when both Houses are discussing the Health and Social Care Bill, and the Prime Minister is in America. When they meet, President Obama will remind him that he said the NHS was
“something that Brits take for granted—a health care system that ensures you don’t go bankrupt when you get sick”.
The President’s stepmother said that she owed her life to the NHS, without which she would not have been alive to see him become President.
There is a kind of double-speak about the Bill. If the Bill was so good in the first place and so necessary, why did we need to have a pause and a rethink, and why were there so many amendments—almost 2,000? The Secretary of State says that the GPs are in control. If the GPs are in control, why are there commissioning support groups? Who are they accountable to? Who voted for the GPs to be in control of a business dealing with public funds? If GPs are so happy about this, why did a GP in Walsall tell me that they are demoralised, disengaged and uninspired? Maybe because they were not consulted.
Robert Flello (Stoke-on-Trent South) (Lab)
Will my hon. Friend give way on that point?
Robert Flello
I am most grateful to my hon. Friend. My persuasive charms work. Does my hon. Friend share the concerns of my constituents? They often find it difficult already to get a GP appointment. With GPs spending so much time with commissioning boards and more to come, will that not make it even harder to get time in front of a GP?
My hon. Friend makes an important point. He should read the front page of the left-leaning newspapers, and he will see how much money is being spent on locums.
The GP in Walsall said that the pace of change is too fast. GPs are being forced into larger organisations. They have no experience of managing a business model. The Secretary of State says he wants to cut the numbers of managers. If the number of managers has been cut, why are the management consultants crawling all over the NHS? A group of consultants including McKinsey, KPMG and PricewaterhouseCoopers sealed a £7.1 million contract with 31 groups of GPs. Pulse found that four in 10 clinical commissioning groups across England have begun to enlist commissioning support from the private sector. That was the work that the PCTs did.
The Secretary of State says that change is happening anyway. So why have the Bill? The Secretary of State says that Monitor did not have a duty to promote competition. So why did the Government not approve the amendment tabled by Lord Clement-Jones that sought to designate the health service as
“a service of general economic interest”,
taking it out of EU competition law? That was not accepted.
The Government said that the role of Monitor is like that of Ofgem, Ofwat and Ofcom. David Bennett said:
“We did it in gas, we did it in power”.
Who are the shareholders? Look at Centrica. Its shareholders include Bank of New York Mellon, the Government of Singapore, the Government of Norway, the state of California, the Government of Saudi Arabia, and Goldman Sachs. The shareholders of the NHS are the people of Britain—but for how long?
The Secretary of State says he wants integration, but the Bill will effectively repeal the integration that started with the Health and Social Care Act 2001. Torbay is a classic example of that. What about the cost, which is £1.2 billion and counting?
I am sorry, but I have nearly finished my speech and must press on.
There was a chorus of disapproval from professionals when the White Paper was published, as they wanted more information. As Rogers and Walters say in the sixth edition of “How Parliament Works”, if there is pre-legislative scrutiny, Ministers have less political capital at stake and changes are not seen as defeats; the scrutiny of a Bill in draft gives higher quality legislation. That is not a description of the Health and Social Care Bill. The pre-legislative scrutiny was in the Secretary of State’s head, not in a draft Bill.
What about my constituent Stephen Wood, who went to his local GP’s surgery only to be told that doctors would only refer him to a consultant privately, not on the NHS, as he had apparently used up his budget?
It is true. This has become personal. The NHS is an organisation in which miracles sometimes happen, which is why people are fighting to protect and save the very essence of its existence. Those who have paid their taxes do not want the Bill, and the health professionals do not want it. From all parties, professionals and patients in the NHS, we can say that we oppose the Bill, and when the NHS unravels, as it is now beginning to, we can say, “We told you so.” I support the motion.
(14 years, 1 month ago)
Commons ChamberIt is always a pleasure to follow my hon. Friend the Member for St Ives (Andrew George), a fellow member of the Select Committee on Health.
I thank the Minister for making his sedentary intervention.
Obviously, I rise to speak in favour of the motion and I humbly request the Secretary of State for Health to publish the risk register, as recommended by the Information Commissioner. I thank my right hon. Friends the Members for Wentworth and Dearne (John Healey) and for Leigh (Andy Burnham) for taking up this issue. As most people will know from their e-mail inbox and their postbag, and from letters that have gone into various newspapers, the professionals are behind us, as are the public.
I have an image of the Cabinet sitting round the table singing the classic Irving Berlin song, “Anything you can do, I can do better”, as each Secretary of State tries to please the Prime Minister by showing how far they can go beyond what was agreed in the manifesto and the coalition agreement. The Secretary of State for Health, who obviously does not want to hear a good argument, is not so much nudging the NHS—to use his favourite phrase—but giving the NHS a great big shove off the end of the cliff; this is more about the chaos theory than the nudging theory. There is a fundamental flaw at the heart of his reasons not to publish the risk register, which is that it contains the information that the public need to see whether the decision that he has reached in the Bill is without risk to the NHS. The Information Commissioner has deemed this to be in the public interest but the Secretary of State chooses to hide it from the public. The public have a right to know that when a decision is taken in their name the relevant considerations have been taken into account. If this reorganisation goes wrong, as it is doing—the good people in the NHS who are working hard are leaving now—could that possibly amount to misfeasance in public office?
In the Health Committee, we have seen what can be done with co-operation. We visited Torbay and saw public sector leadership at its best. I have absolutely no idea who the staff there voted for—nor do I particularly care—but I know that they saw a system for elderly people that was not working, and they worked hard, not thinking about their pensions or asking for overtime, to devise a system in which there was one point of contact for elderly people. Under the system, the risk is shared, 50% with the NHS and 50% with the local authority. They devised a system with consistency of leadership and long-standing good relations across the system. A care package that might take eight months to deliver elsewhere can now be delivered in two hours. By spending £l million on community care, they saved the hospital £3 million. A seven-step referral is now down to two steps. All of that is at risk, however. The NHS and local authorities could learn from that good practice and evolve in that way.
Some people say that, as a result of the Bill, the people around the table will be the same; they will just have different titles. People need to know that the risk is not just about getting rid of managers. The Secretary of State might say that he is reducing the number of managers by making them redundant, but the NHS still needs some managers—so step forward McKinsey and KPMG to help the GPs who do not have, or might not want, management skills. Members of the public need to know the risk associated with the loss of expertise that has stayed in the public sector for the common good, but which will now be lost by the dismantling of structures.
My hon. Friend says that there is a danger that we will end up with the same people sitting around the table. Does she agree that the Government should publish the number of people who have been made redundant and received redundancy payments from PCTs, only to be re-engaged to work for clinical commissioning groups? What has that cost the NHS so far?
I absolutely agree with my hon. Friend. I have asked about this in a written question, and I have not had an answer. This is fiscal incompetence.
The public need to know that this is not GP fundholding revisited. They also need to know that, when they visit their GP, as my constituent Inayat did, the decision whether to prescribe antibiotics will be made on the basis of clinical need, not as a result of financial pressures. When Mrs Bennett needs to go to the Manor hospital, she needs to know that she will be next on the list, and that she will not be giving her place to someone who is able to pay, as a result of the cap being raised to 49%.
People need to know that when Nick Black wrote in The Lancet that productivity in the NHS had risen in the past 10 years, he ended his article by saying that he had no conflicts of interest. He was right, and the Secretary of State is wrong. The Secretary of State might not have taken into account relevant considerations when he declared that productivity had fallen. The public need to know of the risk that the Bill will be taking in replacing lines of management. At the moment, we have the Secretary of State, the Department of Health, strategic health authorities and PCTs. We are going to have the Department of Health, the NHS Commissioning Board, clustered SHAs, 50 commissioning support groups, 300-ish clinical commissioning groups, clinical senates, Health Watch—and, I could add, a partridge in a pear tree.
Thanks to the House of Commons Library and the Public Bill Office, I can tell the House that the Bill has had 1,736 amendments: 474 in Committee, 184 on recommittal and 1,078 on Report. The Bill Committee divided 100 times—the first time that that has ever happened. This is a bad piece of legislation. The public need to know the risks to the taxpayer. They need to know that costs have been saved, and not just shifted to another level or outsourced.
We are in this place to serve the people of this country. History does not judge kindly those who do not act in the public interest, and people will not forgive those who save face by continuing with the Bill only for reasons of vanity. The risk register associated with the Health and Social Care Bill should be published. The Information Commissioner has decided that that is in the public interest. The people want it and should have it. I support the motion.
(14 years, 1 month ago)
Commons ChamberThe hon. Gentleman will recall that his foundation trust was looking to receive more than £400 million in capital grant from the Department, which went completely contrary to the foundation trust model introduced under the previous Government. I pay credit to North Tees and Hartlepool NHS Foundation Trust, which is developing a better and more practical solution than that which it pursued before the election—many of the projects planned before the election were unviable. The hon. Gentleman will know that projects are going ahead, and last November, together with the Treasury, we published a comprehensive call for reform of PFI. We achieve public-private partnerships and use private sector expertise and innovation, but on a value-for-money basis.
John Appleby of the King’s Fund says that PFI represents less than 1% of the total annual turnover of £115 billion. Does the Secretary of State agree?
I gave the hon. Lady the figure: £67 billion of debt. Seven NHS trusts and foundation trusts are clearly unviable because of the debt that was left them by the Labour Government.
(14 years, 1 month ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to speak in this debate with you in the Chair, Mr Caton, and I congratulate the hon. Member for Totnes (Dr Wollaston) on securing it. She is a doughty campaigner on the issue and a valued colleague on the Select Committee on Health. Who would have realised that alcohol would be such a hot topic this week? I am not going to name the beer concerned, but clearly certain beers need a name and a photograph to endear themselves to the punters.
The issue is not about responsible drinking or drinking responsibly; it is about dealing with a problem that is getting out of hand both for society and the health and well-being of members of society. One has only to look at the awful images of young people in the street—I do not know why, but it is more offensive when females are involved—lying down and not knowing where they are or who they are. There is a tension between the people who want to make a living and—dare I say it?—effectively, people who want to live.
If people are offered two for the price of one, they find it difficult to resist the offer. A can of beer can be bought with 38p. A packet of M&M’s is 60p and if someone goes to Portcullis House, they can buy a banana for 40p. That is more expensive than a can of beer. The fact is that alcohol is a poison; it has an effect on the physiology of a body. For young people who see adverts of people enjoying themselves by drinking, it is very difficult to resist peer pressure. My niece is a doctor who has worked in A and E. She says that the majority of cases are a result of people who are drunk and who become very abusive. I suggest that any hon. Members who do not believe that that happens should visit their local A and E departments. Let us also consider other public servants, such as the police, who have to clear up the mess on Saturday evenings at a cost of £13 billion. Such problems affect my constituency, too.
The facts are simple. The medical profession believes that almost 250,000 lives can be saved over the next 20 years if strong action is taken. I have checked on the Department of Health’s website and it links drugs with alcohol and tobacco. It must therefore believe that alcohol is an issue. If it is an issue, the Department of Health must act; a do-nothing strategy does not work.
Sir Richard Doll made a link between lung cancer and smoking. It is only now that people believe that link. What about the link between alcohol consumption and other diseases? I can go through a list: alcoholic hepatitis, oral cavity cancer, hypertension, acute intoxication with loss of consciousness, psychiatric problems, suicidal ideation, depression, anxiety, loss of libido, fetal alcohol syndrome, impaired performance at work and relationship problems. The list goes on: violent crimes, domestic violence and antisocial behaviour. According to the website patient.co.uk, one in 16 hospital admissions are due to alcohol-related illness, with a cost to the NHS of £2.7 billion. In peak times in A and E, that accounts for 70% of admissions. The hon. Member for Totnes mentioned that England is number three in the top 10 drinking countries. Why can we not be the Eddie the Eagle of drinking countries?
Clearly, something has to be done. The hon. Lady should be supported in her attempts to introduce minimum pricing for alcohol. Other measures have been proposed by Alcohol Concern and a coalition of Churches, which have already written to the Prime Minister. There should be a change in licensing hours and pubs should shut at 10 pm again—people knew when they were supposed to go home. Gone is that clarion call of last orders; I urge the Minister to call last orders on binge drinking and to support the hon. Lady.
(14 years, 2 months ago)
Commons ChamberAs my hon. Friend points out, to that extent the NHS has always stood behind the private sector provision of health care. If things go wrong, people have the right to access NHS treatment as they must be looked after on the basis of clinical need. Referring back to points I made earlier, the Health and Social Care Bill gives us an opportunity to look more systematically at continuity of care for patients both in the NHS and the private sector and at the responsibilities of providers under their licence.
I thank the Secretary of State for coming to the House and making this statement. How many clinics will the CQC be reviewing, and what will happens in respect of any clinics that are no longer practising? Presumably the CQC will not have access to their records.
I cannot tell the hon. Lady how many clinics the CQC will visit, but it will be a sample of providers, not all of them. As she may know from the material we published last Friday, there were 93 private providers. The operations were heavily concentrated in that a lot of them were carried out by a small proportion of providers, but about 87 other small providers, or even single-handed providers, are involved and accessing data from all of them will be difficult. I also recognise that, as the hon. Member for Edinburgh East (Sheila Gilmore) said, some may not be in business any longer, or there may be surgeons who have retired.