Junior Doctors’ Contracts

Grahame Morris Excerpts

Wednesday 28th October 2015 Commons Chamber

[Dr Whitford]

I agree.

Since coming here, I have heard stories of people unable to access diagnostic imaging or to work up patients, but there is no argument about that from the profession. That is what we need to focus on, yet a lot of this seems to be about routine. There are fewer doctors at weekends because we do not do routine work. We have teams of people doing toenail and blood pressure clinics in the week. Professor Jane Dacre estimates that doing those at weekends would require 40% more doctors. We cannot do that. We need to make sure that hospitals at weekends have enough people and the right people to be secure, but junior doctors are already there—it is not they who are missing—and emergency services already have a consultant on call. We might need more discussion about their being physically in, but that is a discussion to have with the profession, whereas what we heard on 16 July, which gave the public the impression that senior doctors only worked 9 to 5, Monday to Friday, was very hurtful to the entire profession.

[Grahame M. Morris (Easington) (Lab)]

The hon. Lady is making some extremely powerful and relevant arguments. I wish to make a point about the importance of junior doctors in my region, having spoken to some of them at the demonstration on Saturday. They are essential to the functioning of the service. They have the option of going not only to the Antipodes but to Scotland, where these contracts do not apply. If we lose these valued staff, it could hurt my region more.

[Dr Whitford]

We will roll out a red carpet somewhere on the M74 and welcome them with open arms. The progression and migration in Scotland towards robust seven-day emergency care has been happening through a dialogue, not through a threat to impose a contract.

There are other things in this, such as the plan to change pay progression, which is currently on an annual basis, to recognise experience. That will be replaced with just six pay grades. Such a move will affect women in particular, because they tend to take a career break and they tend to work part-time, so they will get stuck at a frozen level for much longer. It may also be a disincentive to people to go into research, because they will be stuck on the same rung of the ladder for longer. We do not want that disincentive. We need to make sure that we are valuing how people develop and the experience they accrue along the way.

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[Grahame M. Morris (Easington) (Lab)]

I would like to relay some comments made to me when I participated with other colleagues in a demonstration in Newcastle attended by about 5,000 junior doctors. I had the great honour to be in the company of Dr Rachel King, a dedicated professional from South Tyneside district general named “doctor of the year” for her outstanding contribution in the field of care of the elderly, and some of her colleagues. I was struck by their commitment. They love the service, they want to protect it and they want to see their profession valued, and to that end they asked me to make a few points today.

For them, this debate is not about money, although I take issue with the claim from some Members that the reforms are cost-neutral and that doctors will not lose out. That might be the case overall, but the hon. Member for Finchley and Golders Green (Mike Freer) made a really good point: some individuals might lose out. They pointed out that junior doctors, en masse, do not support the reforms. These are clever people—the cream of the crop—and we should listen to them. They know how the service works and how it should be reformed.

They also pointed out that the reforms could increase the danger to patient safety because they might well not solve the problem of junior doctors working longer hours. As colleagues have pointed out, including the hon. Member for Central Ayrshire (Dr Whitford), the protections currently in place are to be removed, yet we have not had an assurance that something else will be put in their place. As we all know, tired doctors make mistakes. We need to address this issue about discouraging career breaks. Many junior doctors are women who leave to have children. Having spent a great deal of money on training them—the Secretary of State may be able to tell us the figure, but I believe it is in the order of £200,000 or £250,000—we want to encourage them to come back into the profession. There are concerns about not having enough people going into specialist areas.

We need to address the issue about recruitment and retention. Members representing constituencies in the north of England have touched on the issue of how attractive it would be for people to go to Scotland where the new contract does not apply. Over a period of two or three days, about 1,300 GPs made an application for the certification to practise abroad. That should be a real concern when we are having difficulty recruiting and retaining GPs. There is also a knock-on effect in general practice, but I will leave it there, given the shortage of time.

[Mr Speaker]

We are extremely grateful to the hon. Gentleman.

Health and Social Care

Grahame Morris Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Andy Burnham]

I remember visiting with my hon. Friend. Let us put the facts on the record. The Secretary of State said a moment ago that privatisation was not happening, but it is happening. It is affecting my hon. Friend’s constituents, where cancer scanning has now been privatised. What happened? The contract was, I believe, given to Alliance at £87 million, whereas the NHS had bid £80 million. It was given to the private sector, however, which has now subcontracted the NHS at the same price of £80 million, creaming off £7 million. That is a scandalous waste of NHS resources when the NHS is facing a £2 billion deficit this year.

[Grahame M. Morris (Easington) (Lab)]

Does my right hon. Friend think it is a matter of concern that a significant report by Lord Stuart Rose, a Conservative peer, was suppressed by the Secretary of State? It would have given an indication of failings in NHS management and allowed us to correct some of the problems identified.

[Andy Burnham]

My hon. Friend raises an important point. Again, the Secretary of State is quick to lecture about openness and transparency, but a report compiled at huge cost to the public purse by Lord Rose, former chief executive of Marks & Spencer, was not published in the last Parliament even though it was submitted to the Department months before. What possible justification can there be for that? The Secretary of State is avoiding my gaze right now. I would be very interested to hear his answer on why that report was not published, and if he wants to take to his feet now—[Interruption.] He says from a sedentary position that it was not finished. Well, if you believe that, Mr Speaker, you will believe anything. Even though Lord Rose says it was finished, the Secretary of State sent Lord Rose’s homework back and said it was not good enough. People will draw their own conclusions from what we have just heard.

We have seen a staggering deterioration in the NHS finances on the Secretary of State’s watch and a loss of financial grip across the whole system. If we are to see the finances brought under control, it means we will see more of the cuts mentioned a few moments ago.

The warning lurking behind the front page of The Daily Telegraph will not be lost on NHS staff today. The Secretary of State knows the NHS is facing very difficult times and this is an early attempt to shift the blame on to NHS staff. Basically, he is saying, “If things go wrong it’s not my fault, it’s yours because I gave you enough money.” It is the classic style of this Government and this Secretary of State in particular: “Get your blame in on somebody else first.”

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[Grahame M. Morris (Easington) (Lab)]

I am grateful for the opportunity to participate in this debate on the Queen’s Speech and on such an important subject. It is an absolute honour to follow so many excellent maiden speeches, not least that of my very good friend my hon. Friend the Member for York Central (Rachael Maskell) and some excellent contributions from all around the Chamber.

In the time available, I want to say a few things about health inequalities, cancer treatment and cancer outcomes. In my usual, inimitable style, Minister, and in the vein of the hon. Member for South Cambridgeshire (Heidi Allen), I shall endeavour to be helpful. I have some specific suggestions to put to the Minister in the context of the Government’s commitments outlined in the Gracious Speech.

I pay tribute to the excellent work done in the campaign headed up by Lawrence Dallaglio. We can now look forward to hundreds of newly diagnosed cancer patients with some of the most complex cancers being treated with advanced stereotactic ablative radiotherapy—SABR, as it is commonly known. Although SABR is widely used in the rest of Europe and, indeed, the United States, it will be the first time that patients with cancer other than lung cancers will receive treatment here in the UK. Not only does SABR treat cancers that conventional radiotherapy cannot, but the advanced nature of the treatment is such that patients have to be irradiated four or five times, rather than 25 times with conventional radiotherapy. SABR is not only more effective and will save our cancer centres money, but, more important, it can dramatically reduce the number of times patients are exposed to radiation while still destroying the cancer.

I pay tribute to the work done by Tessa Munt, who previously represented the constituency of Wells. She was a real champion and I think it was she who initially got Lawrence Dallaglio involved. It is good news for many cancer patients—and I emphasise “many”, because those of us who live north of Birmingham would have had no chance of finding one cancer centre that could treat all the cancers that the Dallaglio campaign opened the door to. Patients in my Easington constituency in the north-east of England with a cancer that had spread to secondary sites in the body—not an uncommon condition, of course—would find themselves being treated with SABR for one cancer in one hospital, and for the secondary cancer in a hospital over 100 miles away.

For the past five years, NHS policy on purchasing advanced radiotherapy machines has been to buy the cheapest conventional machines that can do a little bit of advanced work, and as a consequence we have cancer centres dotted around the country that can treat one cancer but not another, or that, because of their limited technology, treat fewer than the minimum number of 25 SABR patients required to maintain their accreditation. With the growth of SABR treatment, that approach to SABR technology is plainly a false economy. In the long run, it costs the NHS more and means that patients receive much more radiation than is needed, which is clearly not good for them.

While SABR is used to treat cancers outside the brain, stereotactic radiosurgery—SRS—is the global standard when it comes to treating brain tumours with radiotherapy. The use of the technique was increasing year on year up to 2013, but that was brought to a crashing halt when the health reforms were brought in and NHS England came into being. To justify the suppression of SRS treatment two years ago, NHS England ordered an SRS review. I remind the Minister that that review has yet to be completed; it is turning into the longest radiotherapy review in history. Meanwhile, patients are being denied treatment with the most modern SRS machines at the hospitals of their choice—for example, University College London hospitals—and are being sent elsewhere.

I do not wish to be too parochial, but the lack of provision of SABR and SRS in the north of England is a scandal. Outside Leeds and Sheffield, the north is something of a wasteland. According to NHS England’s own figures, there is no provision at all in the north-east—my region. The suppression of SRS is yet another false economy by NHS England. The most obvious reason why it is a false economy is that a non-invasive treatment, overwhelmingly given on an out-patient basis—patients come in for the day, get treated and go home—is hugely advantageous.

Five years ago the national radiotherapy implementation group said that what was needed were centres of excellence around the country to provide advanced stereotactic radiotherapy to our cancer patients. Detailed work has been carried out, and, as has been proven in other countries, it is improving the way we treat cancer patients with radiation, and we have finally started to make some progress with this next generation treatment in the UK. With the right equipment in the right place, we could do so much better, so will the Secretary of State order an independent assessment of the benefits of having one designated stereotactic centre of excellence in each English region, and of what would be the most appropriate technology to equip them with in order to treat the greatest number of patients and the greatest number of cancers?

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[Jane Ellison]

The issue of people surviving cancer and getting proper treatment at the right time is something that we all feel passionately about. We inherited some of the worst cancer survival rates in the world, and the previous Government did a great deal to address that, but of course there is more to do. We have always acknowledged that there is more to do to help our health system respond to issues such as cancer. That is exactly why we are looking forward to the report in the summer from the independent cancer taskforce, which will challenge us all to go further and faster on early diagnosis and treatment.

[Grahame M. Morris]

Will the Minister address the issue that I raised in my contribution and the advice from Lawrence Dallaglio and the experts who believe that part of the solution to the point highlighted by my right hon. Friend the Member for Slough (Fiona Mactaggart) are regional cancer centres with advanced SABR technology, which is not available in many parts of the country, including my region?

[Jane Ellison]

I am sure we will return to debating SABR and other cancer treatments, as we did often in the previous Parliament. The hon. Gentleman acknowledged in his speech the progress that has been made on radiotherapy, and we want to build on that.