(7 years, 7 months ago)
Commons ChamberI remember the interest with which I viewed the hon. Gentleman’s contributions to “Look East”. He is right that the Government spend money on newspaper advertising, but that is arranged by civil servants through an independent process involving the Government Communication Service. One of his colleagues tabled a parliamentary question a couple of weeks ago about the nature of the spend over the past few years, and I provided the answer, which is now in the Library.
When the former Chancellor promised us a surplus in 2020, I do not think that any of us expected him to go about achieving it in quite this manner. However, I am concerned that the right hon. Member for Tatton (Mr Osborne) might be overstretching himself. Will ACOBA take account of European working time regulations and ensure that he is not damaging his health by working excessive hours?
I am not sure that any of us complies faithfully with the European working time directive. My right hon. Friend the Member for Tatton was an industrious man when he was Chancellor of the Exchequer. He was industrious in rescuing this country’s economy, and no doubt he will continue to be industrious in whatever role he wishes to take.
(8 years, 6 months ago)
Commons ChamberI thank my hon. Friend for that intervention. It brings me neatly on to my next point, which is that the great virtue of these reforms to student finance is that we will be able to increase student finance support—maintenance support—by 25%.
The hon. Member for Lewisham East made some clear and sensible points. She suggested that training as a student nurse was different from being a history undergraduate, because student nurses have less time to take on a second job. There is therefore even more reason to provide better maintenance support for them. However, she has not come to tell the House that she will provide 25% additional maintenance support for students who do not have time to do a second job. She has not made that commitment, yet she has criticised our efforts to increase maintenance support by 25% precisely to help those people who would not otherwise be able to take time out to take on a university course. She cannot have it both ways. She cannot criticise us for the reforms we are undertaking while at the same time saying that students need greater support. It is precisely through these reforms that we are producing the support that so many students require.
The Minister talks about maintenance support, but can he clarify that that support will no longer be in the form of a grant, and will now be in the form of a loan? Does he acknowledge that that will land students in even more debt when they finally qualify?
By reforming the system so that this becomes a loan rather than a grant, we are able to produce 25% extra support for these students while they are training, much as with the rest of the student population.
The results relating to newly qualified nurses are not as the hon. Member for Lewisham East suggests. She should be very clear in the way she addresses this question, because all of us, whatever our views on this subject, have a duty to inform the public properly. It would be remiss of all of us, even those who disagree with the policy as she does, to mislead potential students into thinking that they will have to pay more than they would otherwise. She said that students would have to pay hundreds of pounds more in repayments once they had qualified. That is just not the case. We anticipate that a newly qualified nurse will pay roughly £90 a year more; that will be about the same as they are currently paying, because of the way in which student payment finance is gradated. The impact on newly qualified nurses will therefore not be anywhere near the impact that she has suggested. She should be very careful about how she addresses her points; otherwise, people could receive an impression about these loans that is not actually a fact.
(8 years, 7 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
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The credit that the hon. Gentleman has kindly given me is due to Sir David Dalton, who achieved the 90% agreement on the contract. As for the remaining 10%, his judgment was that the junior doctors committee would refuse to negotiate. At that point, the Government had to make a decision about whether to proceed or to cave in. We decided to proceed, which is why we will implement the contract later this year.
I worked for the NHS for 33 years, so I know that NHS staff do not take strike action lightly. The Government’s failure to negotiate has fuelled this crisis in our NHS. The BMA said in its statement yesterday that it wanted to end the dispute through talks. I implore the Minister to get back round that table for the sake of patients and every citizen of this country.
Back in November, the BMA said that it wished to discuss Saturday pay rates, and then went back on that promise—one that it had made at ACAS. That is something that, in my experience, normal trade unions do not do. In my experience, they hold to their word when they have made a promise at ACAS. Given that repeated breach of good faith, it is hard to understand how a return to talks would achieve what the hon. Lady thinks it would. That is why it is so important to move ahead with the vast majority that has been agreed, and introduce this contract, which is better for patients and better for doctors.
The hon. Gentleman is the last person to speak from the Opposition Benches. I note that he of all people—this saddens me—also fails to condemn this withdrawal of emergency cover. I am afraid that in the absence of that condemnation, the House will only draw the conclusion that the Labour party supports the withdrawal of emergency action in this strike.
(8 years, 7 months ago)
Commons ChamberMy hon. Friend is right, and the returns from the friends and family tests across the country show increasing patient satisfaction with the NHS.
22. How does the Minister think that staff morale is affected when people hear the Government’s constant refrain of “implementing seven-day working”, particularly among pathology staff and others who have for decades provided a 24/7 service?
Despite the best efforts of Labour Members, staff morale has gone up over the past few years. The situation is not helped when the nature of the junior doctors contract is misrepresented, as it continually is by Labour Members. If they were to give a fair account of the contract to their constituents, I am sure we would see further improvements in staff morale in years to come.
(8 years, 8 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
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I cannot possibly add to the comment made by my hon. Friend, and I just hope the shadow Secretary of State takes note.
Strike action is always a last resort, and I can say categorically, as an ex-NHS worker, that no NHS worker wants to go on strike. We have here a complete failure of negotiation. The Secretary of State’s door may be open, but the inflammatory and insulting comments he made in the media this weekend do not exactly invite people to cross that threshold and talk to him. Given that he has manifestly failed as a negotiator, is it not about time he stood aside and let a trained negotiator deal with the BMA and come to an agreement, before it is too late?
I am not sure the hon. Lady has been listening to the statements made in this House and elsewhere.
I am not sure the hon. Lady has been listening because otherwise she would have heard that the negotiations have already been taken on by leading negotiators from NHS Employers and, latterly, by Sir David Dalton, one of the leading chief executives in the country. Significant progress has been made, contrary to what she has just suggested. Negotiations have worked. We have managed to nail down—[Interruption.] The hon. Lady shakes her head, but the fact is that Sir David Dalton has managed to secure agreement on every single point of contention other than pay rates for plain time, unsocial hours and Saturdays. This dispute on Saturday and the kind of results we are going to see across the country on Wednesday will, in essence, be about pay rates on a Saturday, with the BMA wanting preferential rates over nurses, porters, cleaners and other workers in the NHS.
(8 years, 9 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
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The hon. Gentleman is an experienced Member of Parliament and, as he will know, there was a time when reorganisations and changes in the structure of the NHS, and the way that hospitals were disposed, was very much decided in Whitehall. That changed as a result of the Health and Social Care Act 2012, and such changes are now led by clinicians. The changes to which he alludes—which we will discuss tomorrow in Westminster Hall—are led by local clinicians, and ultimately the Secretary of State must defer to their opinion. An independent reconfiguration panel judges those changes, and so far the Secretary of State has always concluded that the panel and local clinicians have been correct. That is the right thing to do. In this case I hope and expect that we will do the same, but I will look carefully at the hon. Gentleman’s concerns, and ensure that I take them on board and relay them back to the CCG.
At Pennine Acute Hospitals NHS Trust, which serves my constituency, A& E attendances are at a record high, and this weekend the local paper carried the headline “Stay away from A&E unless it’s life or death.” The trust is predicting a deficit of £29 million by the end of the financial year, and although staff work hard in difficult circumstances, does the Minister truly believe that that is an example of a successfully run NHS?
There are many examples of success in the NHS, and hospitals, CCGs and community health organisations are delivering exceptional care within existing budgets. We must ensure that we spread that practice and approach to care across the NHS. Some parts of the NHS are not doing that, but with our ability to level up and “universalise the best”, as Bevan coined it, we will ensure that everyone gets the level of care that those in the best areas of the NHS already receive.
(8 years, 9 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
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The hon. Gentleman knows that I cannot commit other Ministers to debates, but I will certainly represent his concerns to the Minister for Universities and Science, my hon. Friend the hon. Member for Orpington (Joseph Johnson). He makes a strong point. It seems that I am the only person in this Chamber not to have a close acquaintance with Martin Lewis, but I will ensure that the hon. Gentleman’s points, including the one about the Delegated Legislation Committee—I sat on such Committees for a few years and never received anything nearly as exciting as student grants—are represented to the Universities Minister, so that he can answer him directly.
I wish also to address the points raised by the hon. Member for Heywood and Middleton (Liz McInnes), who talked about equality impact assessments. We have worked up an assessment of the impact that the changes will have on recruitment into nursing—of course we have—as part of our policy generation. That will culminate in a full equality impact assessment and a business case, which will be published at the time of the consultation, not long from now. I hope that that will inform the discussions that take place, so that we can have a robust and evidence-based debate.
The hon. Lady talked about housing costs, which was reflected in an intervention by the right hon. Member for Oxford East (Mr Smith). Housing costs are a considerable pressure for many students—not only those applying for nursing courses, but those in high-cost parts of the country. That is partly why we want to increase the amount of maintenance we can provide. To return to my central point, within the current spending envelope we can do that by such a considerable amount—25%—only through a reformed system. To do it in other ways would be prohibitively expensive, and I do not believe the Opposition have proposed that.
The hon. Lady asked about NMC registration fees. At the moment, they are incurred at the point of registration when the university course has finished and are tax-deductible. They have risen in the last year, which I know has caused disquiet among nurses. I have spoken to the regulators, including the NMC, and implored them to keep their fees at a sensible level and to avoid rises whenever possible. The NMC has had to deal with a considerable increase in fitness-to-practise cases, but I hope that with internal cost savings it will be able to mitigate further rises. I have certainly asked it to do that, although it is an independent body.
The hon. Lady cited someone she had spoken to who was, if I understood her correctly, halfway through a degree. It is important to state that the change is for new students only, so those on existing courses will not be affected.
The Minister has said that the equality impact assessment will be published at the time of the consultation, but what assessment has been made to ascertain the effect of the proposed changes?
The hon. Lady probes like an expert, but she should know that there has been a detailed assessment of the impact of the changes as part of the policy development, which is still taking place. When we launch the consultation, the full details of the assessment will be made public as part of the process, so she will be able to see very soon what the changes will mean.
My hon. Friend the Member for Lewes spoke with great eloquence about her own nursing experience. Other hon. Members may not know that she has a master’s degree connected with her nursing work. She certainly knows about the full gamut of the academic discipline of nursing, and I take her views with considerable seriousness. She was right to point out that the change is part of a wider package of reform.
Several hon. Members spoke clearly and, in one case, movingly, about people who want to become nurses but cannot, either because they did not achieve the necessary grades earlier in life to go to university—that was a failing of their education rather than because of an innate inability to be a nurse or to pass the exams—or because they have caring responsibilities. We want both sorts of people to be in nursing, because they care and because of their vocational call to be nurses. At the moment, a significant number of them are working as healthcare assistants and cannot progress to being nurses. They are prevented from doing so unless they leave the workforce, go to university and then come back into the system. Even under the existing arrangements, that makes it impossible for many of them, which is profoundly wrong.
That is why it is a priority for me, as I announced a few weeks ago, to open up an apprenticeship route to enable healthcare assistants to move from a band 3 position in the NHS to an intermediate new position—nursing associate—that is part of a vocational route to full nursing registration. The exciting thing about that is that it will provide a dual training route into nursing. There is the traditional nursing undergraduate route, which will still take three years, and there will be the new route—an apprenticeship—which will open up nursing to a whole new group of applicants who are currently precluded from achieving their dream of going into nursing and who do not even count in the statistics of those refused a place.
In the round, we are doing what I hope many Opposition Members want. I share their wish to see the diversity of the workforce, which is already one of the most diverse in the country, improve still further, and to see opportunity expanded, the quality of training improved and support given to people at university. Conservative Members also want all those things.
I appreciate the sensitive way in which hon. Members on both sides of the Chamber have spoken. I also appreciate that they may disagree with how the Government want to proceed to try to improve nurse training. In the absence of alternative ideas, I believe that our proposals really are the way to expand places, improve diversity, increase opportunity, especially for those from disadvantaged backgrounds, improve quality and provide support for those at university.
I would be delighted to hear alternatives, and not just via the medium of the consultation. I would very much like them to be offered within the current spending envelope, but if people wish to offer alternatives outside that envelope, they must explain how much they will cost and how they will be funded. Within that spending envelope, the reforms will allow us to expand the number of places and improve quality, support and opportunity.
The Minister mentioned introducing apprenticeships to enable healthcare assistants to move on and train as nurses. Before I left the NHS, a similar scheme was being implemented. It was called “Modernising Scientific Careers” and applied to healthcare scientists. There was a long and arduous consultation process, which to my knowledge has still not been completed. How long does the Minister envisage it will take to implement the process for nurses and healthcare assistants?
We have a commitment to have 100,000 apprenticeships across the NHS in this Parliament, a significant proportion of which will be for nurses. I am approaching this at the utmost speed, and I and the Government will be judged on whether we deliver in five years’ time. I know that the hon. Lady will hold us to account. I will happily pick up on where the consultation to which she contributed has gone—I hope there is not still someone in the basement of the Department of Health working on it—and give her an answer as to what happened as a result of it.
I want to address one final result of the reforms that we are bringing in. It was raised by my hon. Friend the Member for Isle of Wight (Mr Turner) and by the hon. Member for Scunthorpe (Nic Dakin), both of whom talked about the rurality of their areas and the impact that isolation has on recruitment. I hope that, especially through the introduction of nursing associates—an apprenticeship route through to nursing—we can help address problems of recruitment and retention in specific parts of the country. I recently floated that not far from the hon. Gentleman’s constituency, in Hull, where people were receptive of the idea of a different route into nursing that complemented the university route.
This is potentially an exciting moment for nursing. We will be able to expand the number of places and improve support, diversity, opportunity and quality—all things that have been achieved in the rest of the university sector. We will do so quickly, and we will do it even better if we have a good and robust consultation on the details. I will of course write to hon. Members who feel that their points have not been answered, and I once again thank the Petitions Committee for bringing the matter to the notice of the House.
(9 years ago)
Commons ChamberMy hon. Friend rightly points out that there are specific challenges in Northern, Eastern and Western Devon and that is precisely why NHS England has instituted the success regime and why it has moved quickly to appoint a programme director and team. I hope that with the engagement that I know he will lead with his colleagues they will come to a resolution that will ensure that the challenges cease.
9. What additional financial support he is making available to the NHS to help it deal with winter pressures.