Junior Doctors Contract

Andrea Jenkyns Excerpts

Wednesday 6th July 2016 Commons Chamber

[Mr Hunt]

I am happy to give that assurance. One of the most exciting things in the NHS, despite a lot of the doom and gloom in the headlines, is that we are seeing a transformation in safety culture. Even though we are now doing about 4,500 more operations every day, the proportion of patients being harmed is down by about a third in just three years. I think there is a transformation, but of course there is a lot more to do, as I am no doubt going to hear.

[Andrea Jenkyns (Morley and Outwood) (Con)]

I am shocked that we are here yet again. If we look at the history, 90% of the contract has been renegotiated. There have been years of negotiations. This contract is far safer for patients. Regardless of what the Opposition say, it cannot be laid at the Secretary of State’s door if the junior doctors decide to take strike action. We should stop using patients as pawns and put patients first. I would like to thank the Secretary of State for his perseverance. Does he agree that, through its relentless pursuit of partisan politics, the BMA has backed itself into a corner and put patients at risk?

[Mr Hunt]

The way patients have suffered—there have been over 20,000 cancelled operations during this process—has been very disappointing. My hon. Friend is absolutely right to campaign on issues of hygiene and cleanliness, which lead to so many tragedies when they are not properly attended to. I hope we can move on now. I do believe that, despite the disappointing rejection of this deal in the ballot, some trust has been established between the leaders of the BMA and the Government, and we have had a productive dialogue. We have made a number of changes to the May contract since announcing it—things that they suggested and that we agreed to. I would like to continue that process and build that trust.

Oral Answers to Questions

Andrea Jenkyns Excerpts

Tuesday 5th July 2016 Commons Chamber

The Secretary of State was asked—

[Andrea Jenkyns (Morley and Outwood) (Con)]

1. What plans the Government have to lead the international response to the recommendations of the final report of the Review on Antimicrobial Resistance, published in May 2016.

[Maggie Throup (Erewash) (Con)]

16. What plans the Government have to lead the international response to the recommendations of the final report of the Review on Antimicrobial Resistance, published in May 2016.

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

The O’Neill AMR review is galvanising global awareness, as I have seen for myself, and it is greatly to the Prime Minister’s credit that he showed the foresight to commission it. The UK continues to play a global leadership role on antimicrobial resistance. We co-sponsored the World Health Organisation’s 2015 global action plan on AMR, we created the Fleming fund to help poorer countries to tackle drug resistance, and we are now championing action, including taking forward the O’Neill review’s recommendations, through the United Nations, the G7, and the G20.

[Andrea Jenkyns]

I recently met biotech firm Matoke Holdings, which has developed a new technology—reactive oxygen technology. It has found that this technology forms the basis of a whole new generation of antibiotics that has been proven to combat multi-resistant bacteria, including MRSA. This is an incredibly exciting development. Will my hon. Friend and her team agree to meet Matoke Holdings to hear about the new technology and the pace at which it has developed? What are the Government doing to support research into new antibiotics?

[Jane Ellison]

My hon. Friend will be aware that a key focus of the O’Neill review was how to incentivise the development of new antimicrobials. It is scary to think that there has not been a new class of antibiotics for some decades now. The Government are funding an extensive AMR research programme. Matoke Holdings has been in contact with the Department, and we are in the process of arranging a meeting to discuss reactive oxygen technology in the coming weeks. My ministerial colleague the Under-Secretary of State for Life Sciences has indicated that he would also be happy to have such a meeting.

--- Later in debate ---

[Jane Ellison]

As Members will know, the Department has asked the Advisory Committee on the Safety of Blood, Tissues and Organs—SaBTO—to review the donor selection criteria for blood donation that relate to men who have sex with men. SaBTO has approved the remit, the terms of reference and the work streams, and it is cracking on. It has a second meeting coming up later this month. The chair of the working group has written to the chair of the all-party group, welcoming its inquiry and inviting it to contribute evidence during the autumn.

[Andrea Jenkyns (Morley and Outwood) (Con)]

T7. To expand on the question asked by the shadow Secretary of State, I too would like to raise the case of my constituent Abi Longfellow who suffers from dense deposit disease and is awaiting a decision by the NHS’s specialised commissioning body. She and her family have been subjected to frequent delays and miscommunications. I first met Health Ministers, NICE and NHS England a year ago to discuss Abi’s situation. What steps will the Government take to ensure that decisions on treatments such as this are taken in a timely fashion and that families are kept updated on the progress of those decisions?

[The Parliamentary Under-Secretary of State for Life Sciences (George Freeman)]

My hon. Friend raises an important point. NHS England is currently unable to take final decisions on this year’s new treatments, including this particular drug, until the courts have decided whether pre-exposure prophylaxis HIV prevention should compete with other candidate drugs. She makes an important point about timeliness, and that is why I am leading an accelerated access review to speed up the way in which such decisions are taken.

Junior Doctors Contracts

Andrea Jenkyns Excerpts

Monday 25th April 2016 Commons Chamber

[Mr Hunt]

I have to say that the right hon. Gentleman never whispered sweet nothings in my ear, and he certainly has not done so since being in opposition. With regard to doing what it takes, let me tell the hon. Gentleman directly that we have been trying to solve this problem for three years, with 75 meetings, 74 concessions and three independent processes. We have been doing everything we possibly can to solve this problem. What we have is a very intransigent and difficult junior doctors committee of the BMA, which has refused to negotiate sensibly. In that situation, the Health Secretary has a simple choice: to move forward or to give up. When it comes to patient safety, we are moving forward.

[Andrea Jenkyns (Morley and Outwood) (Con)]

Patient safety is a matter close to my heart. Tomorrow, doctors will shout that this strike is not about pay or Saturday working, but about patient safety. They will march under banners declaring the contract to be unsafe and unfair. Will the Secretary of State reassure the House that there is absolutely no prospect of the Government giving into this naked attempt by the doctors’ union to hold vulnerable patients as hostage in a row over pay? Patients must always come first.

[Mr Hunt]

My hon. Friend is absolutely right. The truth is that being Health Secretary is never easy, whichever Government they are in, but where they have made mistakes in the past is where they have been too willing to compromise on vital issues of patient safety, and a seven-day NHS is one of those issues. When it comes to safety, Channel 4’s “FactCheck”, which is not a known supporter of the Government, has compared the new contract with the old one and said that, on the face of it, the new one is safer. That should reassure many doctors that this is the right thing for the NHS to do, and they should work with us, not against us.

Junior Doctors Contracts

Andrea Jenkyns Excerpts

Monday 18th April 2016 Commons Chamber

[Mr Hunt]

I am very happy to do so. We are introducing a new contract from this August, and it will be for all junior doctors. It will go progressively through the different ranks of junior doctors and, over the course of the next year, the vast majority of new doctors will move on to the new contracts. The reason that we did not use the word “impose” in the original statement was not a matter of semantics. We are proceeding with this new contract and everyone will move on to it, which is the gist of what most people mean by this. What we are not doing is changing existing contracts, so when people move trust or move to a new position, they will move on to a new contract. That is why we have used the term “introduction” of new contracts. However, it would have been much better if the introduction of the new contracts had been done through a negotiated process. That is why we took such trouble: we went to 75 meetings and made 73 different concessions in order to try to do this on a negotiated basis. Very regrettably, that proved not to be possible, which is why we took the difficult decision to proceed with these new contracts anyway.

[Andrea Jenkyns (Morley and Outwood) (Con)]

Does the Secretary of State agree that it is totally unjustified for doctors to demand higher premium rates at weekends when almost all other NHS workers, and indeed most other working people across the economy, do not get them? It is completely disrespectful for the BMA to suggest that doctors’ lives are somehow uniquely disproportionately inconvenienced by Saturday shifts and that those of other people are not.

[Mr Hunt]

It is true that the BMA rejected Saturday premium pay that was more generous than the Saturday premium pay offered to nurses, healthcare assistants or paramedics working in the same hospitals and operating theatres as those doctors. Many people will ask whether that was a reasonable position to take, given that the doctors’ overall pay was protected. I think they will also ask whether, even if the doctors disagreed with the Government on that point, it was appropriate or proportionate for them to withdraw life-saving emergency care from patients in the pursuance of their disagreement. I wonder whether that is something that will shape many people’s confidence in what the NHS stands for.

Contaminated Blood

Andrea Jenkyns Excerpts

Tuesday 12th April 2016 Commons Chamber

[Dr Monaghan]

I absolutely agree with my hon. Friend. It is a tragic case that he outlines, and I will come to his specific point shortly.

On 21 January 2016, the Health Minister stated that the UK Government wanted to increase the amount of money on offer for victims of infected blood by £100 million, in addition to the £25 million announced in March 2015 by the Prime Minister. This takes the total to £225 million over the five years to 2020. As we know, there is a 12-week consultation on these proposals that closes this week, on 15 April. However, the proposed payment schemes have been heavily criticised by many of those affected for being outdated and confused in structure. That is my experience of them too. They also appear unfair.

The UK Government have estimated that the Department will spend a further £570 million over the projected lifetime of the reformed scheme, but analysis shows that the Department wants to cap annual payments for victims in England at £15,000 and that these will no longer be index linked and so will not increase with the cost of living. The UK Government also want to remove regular discretionary payments, including the winter fuel allowance and the £1,200 per child annual payment.

[Andrea Jenkyns (Morley and Outwood) (Con)]

On the point about the cost of living, I have several constituents in the same situation. One suggested that pension payments be increased to at least the level of the living wage. What does the hon. Gentleman think of that idea?

[Dr Monaghan]

I would absolutely support that suggestion. I would also note that many victims in England now face cuts of up to £7,000 a year, together with cumulative losses from the freezing of six annual payments to patients of £15,000 a year, time-limited support for partners and spouses after patients’ deaths, and the ending of help for the children and parents of those affected. Moreover, victims will no longer have access to grants for support with such things as mobility issues and modifications to property; nor will they have access to free expert advice.

The Haemophilia Society, which campaigns on behalf of victims of this scandal, has said that it has deep concerns about the proposals for England. It compared the proposals for England to those in Scotland, saying:

“These concerns are compounded by the fact that similar proposals in Scotland offer more generous payments to its affected community. There is a risk that, if both sets of proposals are accepted (as they currently stand), affected people in England will receive much lower incomes that those in Scotland.”

The Scottish Government have already provided £32 million over the last 10 years to the current UK-wide schemes, so they are already committed to support those infected in Scotland. Nevertheless, on 18 March this year, the Scottish Government announced a substantial package of increased financial support for those affected by infected NHS blood and blood products in Scotland, amounting to an additional £20 million over the next three years alone. The new Scottish scheme will see annual payments for those with HIV and advanced hep C nearly double from £15,000 to £27,000 a year, and those affected with both HIV and hep C will have their annual payments increase from £30,000 to £37,000.

Junior Doctors: Industrial Action

Andrea Jenkyns Excerpts

Thursday 24th March 2016 Commons Chamber

[Ben Gummer]

I thank the hon. Lady for her question, but I suggest that listening to junior doctors on their need to have a better work-life balance, to ensure that the contract is safer for patients and to address their legitimate complaints about the way the existing contract works is significantly different from listening to the junior doctors committee, whose actions seem to have ulterior motives. All I would say is that we have listened consistently to the concerns of junior doctors both through the negotiators they have appointed and in relation to those they have raised on the ground. That is why we have come to an agreement on 90% of the contract.

Many of the issues settled within the contract were not requested by the BMA. For instance, one of the complaints made by junior doctors for many years is the fact that they have to book leave so far in advance that they often have to miss important family events. We sought to change that, and we did so in the new contract of our own accord. It is one of myriad changes that will make this contract better for junior doctors. That is why the sooner they have it in front of them—we are working very hard to make sure that happens soon—the sooner they will see that this contract is better for them and that they have been misled.

[Andrea Jenkyns (Morley and Outwood) (Con)]

I thank the Minister for coming to the House today to set out the Government’s position on this dangerous and irresponsible strike. Quite frankly, I am appalled by the fact that the Labour party has not condemned these strikes. Throughout the negotiation, the Government’s door has been open, and the BMA was given more than enough notice before the Government were forced to impose the contract. In this negotiation, the BMA got 90% of what it wanted, so this strike is essentially about pay for working on Saturdays. What other essential public servants, from firefighters to the police, would get such terms for working on a Saturday? Will my hon. Friend please tell me what impact the strikes will have on patient safety?

[Ben Gummer]

We will do everything in our power to ensure that patients are protected. We have a very robust assurance programme, conducted by NHS Improvement and NHS Employers. We will do everything we can to ensure both that the number of elective operations cancelled is as low as possible, consistent with the needs of safety, and that emergency cover is provided. Withdrawing the number of doctors that the BMA will withdraw in this action means that there is an increased risk of patient harm, and I am afraid that the BMA and its members need to consider that very carefully in the weeks ahead.

BMA (Contract Negotiations)

Andrea Jenkyns Excerpts

Monday 21st March 2016 Westminster Hall

[Andrea Jenkyns (Morley and Outwood) (Con)]

Thank you, Sir David, for calling me to speak in this incredibly important debate.

There is no denying that this strike is totally unprecedented. No group of doctors has ever before been willing to walk out and put patient safety at risk over a dispute about pay, which is essentially what the dispute is about. It is about pay, about unsociable hours at weekends, about working the sort of hours that other people across the public and private sectors work every week. That is not to do down the incredible work that our junior doctors do. They work incredibly hard and entirely selflessly to keep us fit and healthy and I thank them for that but, like any other body of workers, doctors are not infallible.

Like the rest of us, doctors are driven by considerations of making enough to get by and to support their families, and of getting a fair reward for the work they do. Historically, they have got a pretty good deal, and like any other body of workers they have the right, through their union, to seek a better deal in pay and conditions. Seeking that better deal requires, as the petition notes, a meaningful negotiation between both sides in the debate.

I would like to cite the definitions of the two words that are so crucial in today’s debate. Meaningful is defined as “serious, important or worthwhile” and a negotiation is a “discussion aimed at reaching an agreement”. My argument is that it is the British Medical Association, and not the Secretary of State, the Department of Health or any of their negotiating team, that has failed in its duty to hold a proper, meaningful negotiation.

The history of the dispute is littered with resentment and half-truths. The BMA has repeatedly had the chance to negotiate with the Government and come to an agreement that is acceptable to all sides and, most importantly, that is safe for patients. Patient safety should be at the centre of the debate but, unfortunately, it has fallen by the wayside in the BMA’s entirely partisan quest to defeat the Government.

For many months we heard from the BMA that it was the Government and not the union who were not willing to come to the negotiating table. That is untrue, and it is backed up by the House of Commons Library’s account of the dispute, which I will not rehash in the short time we have available. Time and again the BMA has walked away from the negotiating table and balloted for industrial action, while the Department of Health negotiators have offered it the chance to come back to talks. The BMA even balloted for industrial action on the basis of the Government’s being unwilling to talk, when the Government had set a clear deadline for the BMA to come back to the table or risk imposition of the new contract. The BMA knew that imposition was a possibility, yet time and again did as little as it could to avoid it, all because it is driven by a desire, according to one of the doctors involved, to

“be the first crack in the edifice of austerity”.

Again, I do not want to go over old ground, but it is well documented that the BMA’s senior medics are Corbynites of the most militant kind. [Laughter.] Dr Chand, the association’s deputy chair, tweeted:

“Goebbels must be turning in his grave when he hears the lies and propaganda of Cameron.”

Dr Tom Dolphin congratulated the right hon. Member for Islington North (Jeremy Corbyn) on his victory and told him to take the fight to the Tories—if that is not partisan, I do not know what is. The BMA so misled its members when it put an utterly wrong pay calculator on its website, suggesting that doctors were in line to lose thousands of pounds, that the tool had to be taken down. Does that suggest that the BMA is taking the negotiation seriously? I would say that it does not. All the while, the Secretary of the State waited, and appointed the head of Salford’s trust to lead the negotiations, to ensure they were being led as well as possible by an expert in the field.

[Andy Slaughter]

Is the hon. Lady aware that 98% of junior doctors supported the BMA’s decision, and that her rather desperate attempt to portray the BMA as some sort of Scargill–like extremist organisation simply makes her look risible?

[Andrea Jenkyns]

I thank the hon. Gentleman. I think he needs to learn his facts. I think that it was 98% of BMA junior doctors, not junior doctors in their entirety.

The imposition of the contract is not something that the Health Secretary wanted. He wanted to reach a meaningful resolution. He wanted the union, which got 90% of the things it asked for, to put its political gripes to one side, do what was best for patient safety and follow the will of the millions.

[Helen Jones]

Will the hon. Lady give way?

[Andrea Jenkyns]

I am sorry—I am carrying on. I am talking about the millions who voted for a proper seven-day NHS in the general election. The seven-day NHS is not some distant pipe dream. Several trusts across the UK, including Northumbria’s, have established consultant-led care across seven days. The only reason the rest of the country cannot enjoy the benefits of that is the BMA’s political posturing. The Labour party’s suggestion that the Government have not negotiated well is difficult to take, when it was the party that signed off on the consultant contract in 2003 that gave an opt-out on weekend work, and gave GPs the ability to opt-out of out-of-hours care in 2004.

[Helen Jones]

Will the hon. Lady give way?

[Andrea Jenkyns]

I am going to finish. Can a policeman say that he does not want to cover a Friday night? Can a firefighter turn down a shift because it is a Sunday morning? No.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

I thank the hon. Lady for giving way. I want to point out that the opt-out clause for consultants is for routine work at the weekend. If they run an emergency service they are not allowed to opt out of emergency care.

[Andrea Jenkyns]

I thank my hon. Friend for that. We work together closely on many matters. At the end of the day, life has moved on from the time when the NHS was set up. Life has got to change.

Moving on to my next point, firefighters cannot turn down shifts. They are public servants, just like doctors. The new contract proposed by the Government is safe and fair. No doctor working legal hours will get a pay cut thanks to the 13.5% increase in basic pay and the unsociable hours pay for nights, Saturday evenings and Sundays. The NHS must adjust to the modern world if it is to survive. Seven-day working is vital to that, and the BMA needs to recognise that. The Government and the Secretary of State have gone out of their way to talk to the BMA and to accommodate its demands. A negotiation in which someone gets 90% of what they want would seem pretty successful to me, and it is a shame that the BMA does not see it that way.

--- Later in debate ---

[Andrea Jenkyns]

First, the Select Committee on Health is on an away day today, otherwise there would have been more Members here. I should have been on the away day, but this is an important debate and I wanted to be here.

On the allegation that I have accused all junior doctors of being Corbynites, I said that key members of the BMA are strongly linked to the Leader of the Opposition. I was talking about not junior doctors but people on the BMA council.

[Andy Slaughter]

I will move on, because when someone is in a hole, they should really stop digging.

End of Life Care

Andrea Jenkyns Excerpts

Wednesday 2nd March 2016 Commons Chamber

[John Howell (Henley) (Con)]

It is a great pleasure to participate in this debate today. A number of common themes run through the debate, the first of which is the fact that most people want to die in their own beds. Before coming to this debate, I tried to find some statistics on the subject. I trawled through a whole lot of figures on the internet, and what I came up with was the fact that 70% of us want to die in our own beds, yet 60% of people die in hospital.

Why is there such a discrepancy in the figures? Is it a ridiculous aspiration for 70% of us to want to die in our beds, or do we need to be better at organising end-of-life care services? The evidence from the Netherlands suggests the latter In particular, there needs to be more emphasis on the social care aspect, the reorganisation of that and its delivery.

What does that come down to in practice? The issue came to the fore in my constituency with the re-provision of a hospital in Henley, the Townlands hospital. The hospital will be re-provided with a greater range of services for people to access and a limited number of beds at the side of the hospital in a care home. The gap is being taken up by a system that has come to be called ambulatory care, involving greater use of social care packages. This follows a change in practice, where the aim is to reduce the number of beds and keep people out of hospital for as long as possible.

[Andrea Jenkyns (Morley and Outwood) (Con)]

My own father died at home. The Government’s response to the report states that a priority is to ensure that families are kept in the loop in the final days, but in our case, we did not know it was my father’s final days. A nurse turned up on the last day with an end-of-life care kit. In front of my father she said, “Here’s the end-of-life care kit,” and he died a few hours later. Does my hon. Friend agree that better communication is needed with those who want to die at home?

[John Howell]

I thank my hon. Friend for making that point. As many hon. Members know, I recently lost my mother. Contrary to what I said earlier, she died in hospital, but I have to say that the services provided were exemplary. We were taken into the thinking of the clinicians as her illness progressed, we were told exactly what would happen, and this led to a greater feeling of comfort with the whole process when she eventually died. I am reconciled with the idea that it was what she wanted. That fits in with the idea of personal choice, where that is possible. In my mother’s case it was not possible because of the illness, but I do not know the circumstances of my hon. Friend’s case. It is something that needs to be borne in mind.

There are still those locally who cannot see that the best interests are served by reducing unnecessary admissions to hospital and moving people out of hospital as soon as possible. I have listened to the clinical advice and the clinical evidence that this is the best way to go. Hospitals, contrary to what they may seem, are not necessarily healthy institutions. Even a short stay reduces the ability of muscles to function and affects quality of life. I spoke to the Alzheimer’s Society about this. The evidence was clear: although admission to hospital or, better still, to care homes will inevitably be required, the best advice was to keep people out of hospital for as long as possible. That was true even in the case of people suffering from Alzheimer’s.

This approach is not just about providing services to those who need periodic treatment, especially end-of -life care. It demands a revolution in the way social care is provided. I am a great advocate of integrated social care and healthcare, and I have heard from doctors about the way in which they decide on the services to be provided. When somebody presents to them with an illness, whatever it might be, the choices are a medical solution—they can be shipped off to hospital or given a prescription—or a social care solution. The feedback I have received from doctors is that they do not have control over the social care aspect, they cannot provide the services and it is very difficult for individuals to access those services, particularly at weekends.

We need this revolution for better control of social care by clinical commissioning groups. We need this revolution for the better use of providing medicine in the home, for example by using internet services, as has been mentioned, which I think is a magnificent way to go. We need this revolution for the timeliness of the provision of services. I agree with my hon. Friend the Member for Poole (Mr Syms) that we need to work across organisations to get this right, including those in the charity sector. If we do that, we can get a really integrated approach.

Oral Answers to Questions

Andrea Jenkyns Excerpts

Tuesday 9th February 2016 Commons Chamber

[Mr Speaker]

Well done.

[Andrea Jenkyns (Morley and Outwood) (Con)]

By refusing to condemn the junior doctors strike, the hon. Member for Lewisham East (Heidi Alexander) has shown that she has little regard for patient safety. [Interruption.] Will my right hon. Friend repeat his condemnation of this strike, which will seriously endanger patient safety, and assure me that he will continue to press for the new contracts, which will guarantee safer patient care and a better contract for doctors?

[Mr Hunt]

I think my hon. Friend got a bit of a reaction with those comments. The Labour party is saying that if a negotiated settlement cannot be reached, we should not impose a new contract—in other words, we should give up on seven-day care for the most vulnerable patients. There was a time when the Labour party spoke up for vulnerable patients. Now it is clear that unions matter more than patients.

Care Homes: England

Andrea Jenkyns Excerpts

Wednesday 13th January 2016 Westminster Hall

[Joan Ryan (Enfield North) (Lab)]

It is a pleasure to follow the hon. Member for Bexhill and Battle (Huw Merriman). I echo what he said about some of the excellent care that we see in care homes.

I congratulate my hon. Friend the Member for Hove (Peter Kyle) on securing an important and timely debate. He highlighted many of the key concerns of care providers in the UK. One is the current funding crisis in social care. Over the past five years we have seen social care budgets across the country cut by almost 11%. In Enfield, the local authority has had to deliver net savings in its adult social care budget of 16% over the past four years, and by 2019, the savings requirement that the council will need to initiate will further reduce the budget by £19.8 million, from £80.8 million this year to £61 million. That is equivalent to another 25% reduction in the net budget. How do the Government seriously expect local authorities such as Enfield to cope with a cut of that level?

[Andrea Jenkyns (Morley and Outwood) (Con)]

I have been a councillor, so I know that budgets have been quite tight in local authorities over the years. A care home in my constituency, Siegen Manor, is possibly due to close. Does the right hon. Lady agree that we need to look at the way councils spend money? In my new city council, there is a lot of wastage. We need to look at how councils spend their money, because I could give a lot of examples of how they could—

[Mrs Anne Main (in the Chair)]

Order. I call Joan Ryan.