Contaminated Blood

Bob Stewart Excerpts

Tuesday 12th April 2016 Commons Chamber

[Kevin Foster (Torbay) (Con)]

It is a pleasure to follow the Father of the House, the right hon. Member for Manchester, Gorton (Sir Gerald Kaufman), and to be able to follow on from all the work done to bring this debate to the Floor of the House. I congratulate the hon. Member for Kingston upon Hull North (Diana Johnson) on securing it; it was a pleasure for me, as a member of the Backbench Business Committee, to support the proposal that this debate be held today.

Contaminated blood and the impact on victims was one of the first issues to come into my inbox after I was elected. Someone came to my surgery who had had a condition but had been otherwise healthy, only to find that they were to have decades of pain and disability because of the treatment they had for that condition—that is almost heartbreaking. Virtually all their life prospects have disappeared because of a treatment they received that they thought would make them better.

It is worth examining the scale of this disaster in our NHS system. We are talking about 4,700 people with bleeding disorders and 28,000 other people becoming infected with hepatitis C; and 1,200 with bleeding disorders and 100 other individuals getting HIV. Of course these people were getting that condition at a time when the medical understanding of it was very limited and the life expectancy was incredibly short. Thankfully, many people have benefited from the advances in medical science since 1985, which have allowed them to keep living, but they still face all the issues that come with that illness and—let us be candid—the stigma that still comes with it from those ignorant about what can cause it.

The issue is about looking at the time that has elapsed. I am sure that, like me, my predecessor, Adrian Sanders, who pursued a number of cases diligently during his time as the MP for Torbay, would not have expected that after 18 years his successor would still be talking about this issue and still be having to speak up for the constituents affected by this scandal, at least one of whom is in the Gallery today. We know that a patchwork of five schemes is in place, and reference has been made to that. To be fair, £390 million has already been paid out, but the impact on these people has been so devastating that it is right that we are looking again at what the appropriate level of compensation is.

It was appropriate that last year the Prime Minister issued an apology. That is something so simple, but it took until 2015 for it to happen. I agree that we are not in a court of law today, but it is right that we seek to provide some form of justice to those who for so long have found themselves on the receiving end of life-changing conditions.

[Bob Stewart (Beckenham) (Con)]

We have used the word “justice” all the way through this debate. I have listened to it all and I was not intending to intervene, but I must say that in fact there is no justice we can give people who have contaminated blood—that has been taken away from them. All we can do is give them the best possible help, financially and in care terms. They will never get justice, and it is improper to suggest they can—we cannot do it, it is too late, they have had that taken away and money will not compensate.

[Kevin Foster]

I thank my hon. and gallant Friend for such a thoughtful intervention. We cannot give them justice; we cannot restore them back to where they were before the impact of this scandal, but we can compensate them. We can try to mitigate the impact and give them a life that is appropriate, as best we can. Today’s debate is right to focus on that.

Access to Medical Treatments (Innovation) Bill

Bob Stewart Excerpts

Friday 29th January 2016 Commons Chamber

[Chris Heaton-Harris]

Clinical research and innovation is happening across our NHS every day. Would it not be wonderful if every registered medical practitioner could see what was going on, without too much effort or work, by tapping into a database and getting a better understanding of the picture around them?

This is the crux of the matter. Treatments are not what they used to be; there is not a one-size-fits-all policy. As medicine progresses and personalises even further, the mind boggles trying to imagine the sheer number of treatments that will be available in our NHS in the future. How can we expect every clinician to know about all the possible treatment routes? How can we not, therefore, provide them with somewhere to record them and their outcomes?

As Lord Giddens stated in the debate I mentioned earlier, we are experiencing a digital revolution. Given how far technology has come in our lifetimes and what is now possible, we can truly say we are living through a different age of digital capability. It is moving at such a pace that we struggle to keep up with it ourselves. It is not unfounded to say we might be living through a period of unparalleled innovation in medicine and other frontier areas of science more generally. Thanks to the strides in treatment and the speed of technological development, we have an opportunity to create and record life-saving data like never before. It is surprising that we do not have such a database already. The Bill sends an unambiguous political signal to the Government that we would like them to get on with it.

The Bill defines innovation as a situation where a doctor departs from the existing range of accepted medical treatments for a condition. This will be well understood by doctors, who are best placed to know whether treatments are acceptable and responsible. The definition of what can go on the database is deliberately wide because I want the Minister to have as wide an ambit as possible.

I want quickly to mention another stakeholder I met, Nutricia, a company dealing with advanced medical nutrition. It kindly welcomed the Bill:

“This Bill marks an opportunity for patients managing a range of diseases and conditions to get access to the most innovative medical care, and to actively support their inclusion in patient pathways in an on-going manner. This should not simply be confined to pharmaceuticals, as patients can benefit from innovation across a range of sectors, for example medical nutrition.”

Medical nutrition—otherwise known as medical foods—describes a special category of foods designed to meet the needs of patients whose disease or health concern requires medically determined nutritional support. Medical nutrition is a scientifically formulated food that is available in many different formats. Applications can range from those with rare conditions, such a child who inherits a metabolic condition meaning that the consumption of a specific amino acid commonly found in normal foods can lead to brain damage, right through to people with common cancers who may as a consequence lose weight rapidly and be at risk of malnutrition for a period of time. Nutricia was therefore keen that we maintained the widest possible definition for how the database could be used.

Medical nutrition also provides benefits in the treatment pathways of other diseases, including various cancers, strokes, cerebral palsy and pressure ulcers. Nutricia has stated that,

“we must seek to streamline the adoption of innovative care of all kinds—not just pharmaceuticals—so that clinicians have a resource which will mean that there are no more missed opportunities, and patients have every available chance to manage their condition.”

[Bob Stewart (Beckenham) (Con)]

I am very ignorant compared with a lot of people in this Chamber, so my question is probably a question from a fool. I do not mean it to be, but when I go to a doctor and they are sitting in front of a computer, I make the assumption that if they have a question, they go into the computer and get an answer. Am I wrong in saying that cannot or does not happen, and would this new list work much better?

[Chris Heaton-Harris]

I will give way to the hon. Member for Central Ayrshire, who will give a much more informed answer.

Space Policy

Bob Stewart Excerpts

Thursday 14th January 2016 Commons Chamber

[Bob Stewart (Beckenham) (Con)]

May I just say that it is so encouraging to see the number of women pilots in the Royal Air Force, particularly women fighter pilots who are showing not just that they are the equal of men, but that, sometimes, they can beat them hands down?

[Yvonne Fovargue]

Obviously, as a female myself, I would say that, quite often in many professions, we have to be not just as good as men, but better than men to prove that we are their equal.

We cannot hope to achieve the Government’s target of growing the number of jobs in the space industry if we are not equipping the next generation with the necessary skills. Will the Minister tell the House what assessment he has made of the impact that cuts to the skills budget will have on the future success of the UK space industry? Furthermore, what is he doing to encourage young women to enter the industry?

If our space industry is to prosper globally, we must be pioneers in the field of research and development, but our public investment in R&D has not kept pace with our international competitors. We spend less on research as a share of GDP than France, Germany, the US and China, all of which are increasing their commitment to science and technology. In 2013, UK Government expenditure on civil space research and development was only seventh amongst OECD countries, well behind some of our competitors.

Investment is vital to science, but so is regulation. It is also important that the Government’s regulatory regime creates an environment that enables growth in the satellite and space sector. Will the Minister explain what is being done to enable new players, such as small and medium-sized enterprises and start-ups, to access the market? As in many UK industries, businesses’ ability to access finance remains a concern. What is the Minister doing to improve access to finance for companies in the space industry?

Throughout the debate, we have heard much about the achievements of space travel and innovation, and the considerable benefits they bring to our economy. Tim Peake’s journey to the international space station has the potential to inspire a new generation and reignite the passion for space exploration felt by my generation when we saw man first set foot on the moon. This Government have to capitalise on that in the coming months and years and continue to work in partnership with the sector, allowing us all to reach for the stars.

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

I thank you, Madam Deputy Speaker, and the Speaker’s Office for granting the debate, and congratulate the Backbench Business Committee on securing it. I think it shows the House at its very best, capturing the mood of the nation and setting out an inspiring and challenging vision of how in the years ahead this country can do so much more in this exciting field.

As many hon. Members have said, the debate is timely. Major Tim Peake floats in orbit above us, looking down, and tomorrow he will conduct the historic and serious spacewalk. He is the first British European Space Agency astronaut and the first British astronaut to enter the international space station. The debate is also timely because of the sad passing of the iconic David Bowie, whose lyrics in so many ways provided a backdrop to my generation’s childhood and captured, at the time of the Apollo missions, the existential challenge and opportunity of pushing the boundaries of space, time and culture. That provides a rather extraordinary and unpredictable but moving backdrop to this moment in space.

[Bob Stewart]

I rise as the Member for the coolest constituency in the country. David Bowie lived and played in my constituency, and we are hoping that the bandstand where he played will be saved and restored properly. That is not happening at the moment.

[George Freeman]

I am glad that my hon. Friend the Member for Beckenham (Bob Stewart), David Bowie’s constituency, rose to speak at that moment.

This debate and story is about more than the space endeavour alone. It is about business—the UK space industry is an £11.8 billion industry, employing 35,000 highly skilled people. It is about extraordinary technology in optics, communications, rocketry and engineering. It is about an activist industrial policy and strategy, for which I am delighted to confirm our support, to encourage leading technologies and industry. I pay tribute to the work done by Paul Drayson and by my great friend and colleague David Willetts, now a Member of the other place, who in 2012 was instrumental with the Chancellor in securing the £80 million for the international space station, which was crucial to securing Tim Peake’s role in it, and in securing the money for the reaction engines programme, on which this country is leading.

This debate is also about science, not just in space, but solar and earth science. Taking in rocketry, engineering, climatology, optics and communications, this is a deep science project to inspire all. It is about women in science, as others have said. Dr Helen Sharman was the first British woman in space, and the Italian Samantha Cristoforetti was the first European Space Agency woman astronaut; she did inspiring work and has become something of a legend and a role model for girls and women in science. It is also about our perception and consciousness of our environment. The “Earth dawn” photo changed perceptions of the fragility of the Earth’s ecosystem.

The debate on space is also about geopolitics. Who, in the appallingly dark days of the cold war and intercontinental ballistic missile threats in which many of us grew up, could have imagined that we would now have an international space station in which Americans, Russians and people from across the world work together for the good of all? It is about defining a new common space for all and a new approach to our defence and security through common leadership. It is not a subject I get to speak much about at the Dispatch Box, but today’s debate makes it possible to talk about mankind’s destiny—the questing spirit deep in us all and in society to inquire, discover, imagine, explore and make possible whole new worlds and opportunities.

This debate is also about the power of ambitious, positive, global, purposive and internationalist leadership to inspire and unite to produce a better politics from us all. No one spoke better on that than JFK, in his inspiring inaugural address in 1960, when he famously said, on a frosty morning in Washington at the very height of the cold war,

“my fellow Americans: ask not what your country can do for you, ask what you can do for your country.”

He launched America on a mission of internationalism, and two years later, in his Apollo speech, announced that America chose to go to the moon not because it was easy, but because it was hard. He did so in the spirit of internationalism and of appeal to the best instincts of mankind. It is a beautiful thing, I think, that on the moon is left an inscription stating that mankind came to the moon in a spirit of freedom and peace. That mission captures so much that is best about our society and what we want to achieve.

It is for those reasons that the Prime Minister asked that we harness the inspirational power of Major Peake’s mission to inspire the next generation of scientists and engineers and to bring the country together. All of us found it difficult to avoid the excitement associated with the launch and arrival of the first British ESA astronaut at the international space station. We held celebration events in Edinburgh, London, Cardiff and Belfast, at discovery centres throughout the UK, and here in Parliament. The Science Museum in London attracted almost 11,000 visitors, and if the sheer exhilaration of the 5,000-plus primary schoolchildren at the museum translates into an increase in future sciences, Tim Peake’s mission will already have achieved its goal. In all, 35% of the viewing public watched the launch, and a further 3.8 million people watched the Soyuz spaceship dock with the international space station that evening.

Our Government are providing £3 million of support to the education and engagement programme associated with Tim Peake’s mission, and we have been lauded by the ESA as the country doing the most to invest in and promote educational outreach. We will measure whether the excitement inspires young people to take up STEM subjects—several Members rightly commented on that—and increases public understanding of and engagement with science through an evaluation study being undertaken by York University. It is the first such research since the Apollo effect study in the 1970s.

The Peake mission is possible because of a decision made at the 2012 European Space Agency Council of Ministers meeting by the then Science Minister, David Willetts, which resulted in the UK joining the international space station and the related European programme for life and physical sciences—ELIPS. The UK made a further investment at the Council of Ministers in 2014. The total investment, which exceeded £80 million, provides substantial value for money, giving UK scientists access to a laboratory that has cost others up to $100 billion and is testament to international collaboration in science. The three man crew on the Soyuz, which launched on 15 December, comprised Tim Peake, the American Tim Kopra and the Russian commander Yuri Malenchenko. It is early days, and evaluation of UK involvement is ongoing, but the current results are incredibly exciting.

Experiments for the ELIPS and subsequent experiments undertaken on the space station are selected on the basis of science excellence, which plays to UK strengths. We sometimes forget that this is a massive international set of experiments up in space. In the most recent competition, the UK won more than 10% of awards for experiments, although UK involvement in the space station is at about 5% of costs, so we are punching above our weight. About 40 to 80 scientists across the UK are involved.

Space is not just about national exploration; it is about critical national infrastructure and services, such as weather forecasting, satellite navigation and satellite television. Space-based technologies are used for tackling many global challenges. Satellites can assist with tackling illegal fishing, efficient urban and rural land use, resource management, safe implementation of autonomous vehicles, and myriad further uses underpinning new technologies and new markets. For example, over half the essential climate variables needed to understand climate change derive from our satellite observations.

The UK space sector is undoubtedly a massive and growing success story. There are real prospects for the young people inspired by Tim Peake and the Rosetta mission to work in our very strong and vibrant space economy in the future. It is currently worth more than £11.8 billion to the UK economy. That is growing at about 8% a year, which is three times faster than the average non-finance sector. It is characterised by an incredibly highly skilled workforce of more than 37,000 people, half of whom hold at least a first degree. Those direct jobs each support more than two jobs in the wider economy. The sector has a general value added per job of £140,000, three times higher than the UK average.

To reflect the strategic and economic importance of the sector, my right hon. Friend the Secretary of State for Business, Innovation and Skills launched the national space policy on 13 December to coincide with the Peake mission. It showcases how deeply space now impacts on our daily lives, not least in the field of satellite data and information. It describes how the sector is a unique, strategic national capability which delivers science and innovation, national security, essential public services and prosperity. The policy spells out how the UK Space Agency has brought together the roles and responsibilities of 17 different Government organisations and other partners, such as research councils and Innovate UK which are involved with space.

Space-based activity is a long-term endeavour with international collaboration, industrial co-investment, skills development and considerable planning at its heart. Stability and certainty are important, and the national space policy is the Government’s expression of our long-term commitment to seeing it through and to putting in place a policy landscape to support that investment.

The UK’s involvement in space ranges from fundamental underpinning research into the origins of the universe, to understanding and protecting our planet, through to supporting the research that leads to UK companies launching entirely new multimillion-pound telecommunication satellites. Some 25% of the world’s telecommunication satellites are substantially built here in the UK. Satellites operated under the disaster charter and earth observation data procured commercially were critical to effectively targeting the response efforts on the ground in the recent floods.

This is an exciting time for space. In 2016 the UK will be building the main experiment on the Plato mission that will search for new earths orbiting other stars, in pursuit of answers to the profound question about life elsewhere in the universe, and will precipitate key contracts for UK companies. We look forward to a major European Space Agency Council of Ministers meeting in November/December 2016, where we will negotiate to ensure that the UK continues to play an influential part and benefits fully from European Space Agency programmes. The programmes that we are looking forward to in particular include the UK-led biomass experiment that will calculate the capacity of the world’s forests to store carbon. As well as improving our ability to control climate change, this offers a considerable opportunity as UK companies are poised to win contracts to provide the craft that will host the experiment in orbit.

2017 will see the launch of the joint European-Japanese BepiColombo mission which will set out on a voyage to Mercury, using a very efficient ion drive electric propulsion engine manufactured by UK firm Qinetiq.

In the field of space flight, through companies such as Clyde Space and SSTL, the UK has become a leader in the manufacture of smaller satellites and has largely secured cost-effective launch by arranging “piggy-back” launches with larger satellites in a competitive launcher market which is not yet sustainable but is growing fast. This is connected to the growth of commercial constellations of tens or even hundreds of low-cost small mass-produced satellites that can provide ubiquitous communications across the globe or near real-time imagery from low earth orbits.

Indeed, we believe that commercial space flight is a market which, when combined with the emerging trend to use large constellations of small satellites, could provide a cumulative economic benefit to the UK of £20 billion by 2030. This will provide new and long-term manufacturing and service jobs and will stimulate high tech growth. This includes exciting developments such as single-stage to orbit launchers, the engines for which are being pioneered by Reaction Engines, a rapidly growing company in Oxfordshire.

This is the context for the UK to explore having a launch capability. We believe there is at least a two-stage process to achieving it. The first part of our ambition is for the UK to become the European hub for commercial space flight and related space sector technologies. The initial focus is on creating the necessary legislative and regulatory framework that will enable commercial suborbital space flights alongside existing civilian and military airspace operations. Alongside this, it is the Government’s intention to select a preferred location for a UK spaceport that will be capable of operating horizontal commercial spaceplanes. We are closely examining what this process will look like, to ensure that it is fair, transparent and robust.

We will seek to draw on established Government approaches to appraisal and will ensure that the preferred location meets a number of key criteria—that it can deliver a spaceport technically capable of operating horizontal commercial spaceplanes, that it will be commercially viable, that it can ensure the safety of the uninvolved public, and that it takes into account the potential environmental impacts of the spaceport and will deliver local and national economic growth. These criteria are likely to form the core of any selection process, though we have not settled on the final criteria.

Cities and Local Government Devolution Bill [Lords]

Bob Stewart Excerpts

Monday 7th December 2015 Commons Chamber

[Mr Chope]

My right hon. Friend knows all about levers, having been a deputy Chief Whip. That is exactly how I envisage this power being used. I am sure that that is why there was an attempt to smuggle it through at the last minute. Now we are, I hope, exposing it for what it is, which is a power grabbed by the Government to try to ensure that they can have the final word and beat their stick against a council that is not doing as they wish it to do.

[Bob Stewart (Beckenham) (Con)]

I am making the assumption that my hon. Friend would support the amendment proposed by my hon. Friend the Member for North East Somerset (Mr Rees-Mogg) to have a referendum.

[Mr Chope]

Absolutely. I am very supportive of that amendment, but I have not yet had a chance to talk about it because I am so concerned about amendment 56 and amendment (a). I am not going to restate the case about the referendum, but I think it is a necessary safeguard.

If we look at the history books we see the unintended consequences that can flow from local government reorganisation. It was only because Wandsworth council started a campaign to abolish the Inner London Education Authority that education was given back to the inner-London boroughs, which were then able to gain economic growth as a result of having good-quality education within their boundaries. The same thing happened with the Greater London Council. The Greater London Council was interfering in the lives of the boroughs in inner London and outer London, so those in charge of the boroughs at the time persuaded the Conservative Government to abolish it. As a result, parks such as Battersea park are run by the local authority—Wandsworth council—rather than by a remote authority for Greater London.

If we are not going to put proposals like this to the electorate, we must have the necessary safeguards. None of this stuff was in our manifesto. There was no suggestion that a Conservative Government were going to restructure local authorities so as to try to squeeze out small councils that are closest to the people. If we are not going to test this in a general election and amendment 56 is going to be on the statute book until the end of March 2019, it is all the more important that we should be able to have the safeguard of a referendum—the very safeguard that the Poole People party and the Liberal Democrats have sought, in vain, from the leaders of Poole, Bournemouth, East Dorset and Christchurch Borough Councils.

We are on the threshold of a big spat at local government level between different councils at different tiers and different councillors with different personalities and political parties. This threatens completely to preoccupy local government for the next three or four years. We will look back and say that this all started with the Government wanting to interfere in areas where they should not be interfering at all. They should be trusting local councillors and local people to decide what is best for them. They should not be taking away from Dorset County Council or East Dorset District Council, for example, the power to veto any proposals to change the boundaries in which they operate.

I very much hope that the House will not accept amendment 56 as proposed to be amended by the Government but will push them back to their previous position, which was that this is genuinely for local councils and local people to decide, and the Government are not going to interfere.

NHS (Charitable Trusts Etc.) Bill

Bob Stewart Excerpts

Friday 6th November 2015 Commons Chamber

[Anne Marie Morris]

As ever, my hon. Friend makes an important point. It is right that the money goes towards new, far-reaching, novel pieces of equipment and medical solutions, which are exactly what we need in this country. We should be proud of that and do everything we can to enable the hospital to gain as much funding as possible.

The hospital is able to facilitate a number of different wards for a number of different treatments, and that is due to the continued contribution from donations and legacies. Barrie’s contribution has been so significant over the years that, fittingly, there is a Peter Pan ward—I am sorry that there is not yet a Wendy ward, but I am sure we can do something about that.

[Bob Stewart (Beckenham) (Con)]

The Lost Boys ward.

--- Later in debate ---

[Maggie Throup (Erewash) (Con)]

I am delighted to contribute to today’s debate on such an important issue, and I congratulate my hon. Friend the Member for Aldridge-Brownhills (Wendy Morton) on deciding to raise it in this place and to make these changes, which I am pleased to support.

Our nation would be a poorer place without the thousands of charities and their trustees who contribute their time and their expertise without fear or favour. As we have heard, this is trustees’ week, so it is appropriate to debate this issue today. Close to my heart are the many hospital-related charities that play such an important role in supporting our free-at-the-point-of-care national health service that has served us so well. It is vital that such charities are allowed to conduct their good work with as few barriers as possible.

The current structure of NHS charitable trust status has three main disadvantages. First, potential donors may perceive that the charities lack independence from government. Secondly, being bound by legislation prevents the charities from adopting different legal forms specific to their needs, particularly those offering limited liability. Thirdly, the Charity Commission believes that dual regulation under both NHS and charity legislation makes it difficult for NHS charities to achieve and demonstrate independence. It is therefore vital that NHS charities have the opportunity to move to independent charity status.

In my constituency, I have many charities that support the work of the NHS in some way, but today I want to highlight just two of them. First, Ilkeston community hospital league of friends is a dedicated group of people who do everything from making cups of tea for visitors and taking the newspaper trolley around the wards to holding extremely successful spring, summer and Christmas fairs. A recent bed push up Ilkeston’s main street, Bath street—and when I say up, I mean up the hill—raised over £1,400. These events raise valuable additional funding providing for those added extras that make such a difference to my community hospital. This has included a scanner for the Val Jackson scanner suite at Ilkeston hospital, and the list goes on and on.

Secondly, I have an amazing hospice, Treetops Hospice Care, located at Risley, but serving the wider community across Derbyshire and parts of Nottinghamshire. Only the other day, we heard a very powerful speech in this place by my hon. Friend the Member for Lewes (Maria Caulfield)about the importance of palliative care. Treetops Hospice Care is a bit unusual as it does not have any beds, but provides all its end-of-life care and support in the community. As we heard on Wednesday, up to 70% of people want to die in their own homes, yet only 30% manage to have their wishes fulfilled. The invaluable care in the community that Treetops provides is helping my constituents to fulfil their wishes, which must be comforting for their families at such a difficult time. Treetops is innovative in its fund raising, too, holding everything from dog shows and vintage fairs to car boot sales and a sponsored bike ride taking in all the different charity shops that make a contribution—and I am pleased to say that I took part on a tandem.

My constituents and the wider population give generously and freely to both Ilkeston community hospital league of friends and to Treetops Hospice Care. These two charities are not bound by the legislation that the NHS charities in question are today.

As previously mentioned, the Bill takes away one of the barriers to maximising donations for the NHS charities in question. It removes the Government’s involvement, as it removes the role of the Secretary of State in appointing trustees. This move will enable potential donors to know that the NHS charity is truly independent from the Government.

I now wish to talk specifically about Great Ormond Street hospital. I have visited this amazing hospital on numerous occasions in a professional capacity, so I felt touched by the descriptions that my hon. Friend the Member for Aldridge-Brownhills and the hon. and learned Member for Holborn and St Pancras (Keir Starmer) provided of their visits to this amazing hospital. Like them, I felt very privileged to have seen a small part of its ground-breaking work and the care that is given there. Only yesterday, we heard about the one-year old girl, Layla Richards, now in remission from leukaemia as the result of innovative gene editing, creating designer white blood cell treatment. That really was fantastic news—both for Layla and her family.

[Bob Stewart]

I have to declare an interest, as my wonderful daughter-in-law, Nicola Stewart, is a nurse at Great Ormond Street. I just want to confirm and support everything my hon. Friend is saying about the dedication of the nurses and doctors at Great Ormond Street hospital.

[Maggie Throup]

I thank my hon. Friend, and I completely agree that every doctor and nurse, and every NHS worker goes beyond the call of duty—not just at Great Ormond Street, but in hospitals throughout the country. We owe a great debt of gratitude to them for the work they do.

J. M. Barrie made a very generous and powerful donation when he gifted the rights from “Peter Pan” to Great Ormond Street Hospital Children’s Charity. I am sure the renowned author would be cheering from the Gallery, if he could, to hear that his wishes are to be continued through the mechanisms of this Bill.

--- Later in debate ---

[Kevin Foster]

Indeed. This is a bit like the reforms to school governors, where we have reduced the number of local authority appointments. Although some were very independent minded and focused solely on the school and its interests, in other areas it was almost a tradition to have a certain number from Labour, a certain number from the Conservatives and a certain number from the Lib Dems.

[Bob Stewart]

None from the Lib Dems.

[Kevin Foster]

I accept that at the moment a Lib Dem and an endangered species have something in common. I will return to the subject of the Bill, despite the generous opportunity offered by my hon. and gallant Friend to make a remark about the political situation west of Bristol.

Why, as a Devon MP, am I keen to see the Bill make progress, given that it relates particularly to Great Ormond Street? As I said in my intervention on my hon. Friend the Member for Newton Abbot (Anne Marie Morris), the hospital provides specialist services that benefit the whole of the UK. The provisions on the “Peter Pan” copyright apply to all four nations in the United Kingdom, not just to England and Wales, as some of the other provisions in the Bill do. This hospital provides services that it clearly would not be practical to provide in individual areas and individual hospitals, because that pure specialty is needed. At least one person who has been in my surgery recently has benefited from Great Ormond Street’s work even though they are a resident of Torquay, because of the specialties that the hospital brings.

It is therefore right that we should make this provision that the J. M. Barrie bequest and copyrights can be properly applied, to the benefit of the hospital. It is nonsense to have two charities in place purely because of law that made sense at the time but which now looks like a legal accident, whereby the money has to go into one pot and cannot go into another pot, even though almost any other bequest in this country would be going into the one charity. As has been said, that means that money for patients—money for services—is going to lawyers and accountants. That is not right, which is why the Bill is so timely. It seeks to resolve that anomaly and give that certainty, particularly to Great Ormond Street, and to all the other trusts.

I am very pleased to be here to support this Bill, which will make a real difference. It may sound very technical—it sounded exceptionally technical when I first read it—but it will make a real impact on the ground in providing better services and better outcomes, and helping some of the sickest and most vulnerable people in our society. That is why it is right that the Bill receives its Second Reading. I am delighted that my hon. Friend the Member for Aldridge-Brownhills decided that this subject was the right choice for her private Member’s Bill slot, given the number of choices that would have been available to her, and it is good to see so much support here this morning from hon. Members.

I look forward to hearing what the Minister will say in response to today’s debate—[Interruption.] I am glad he is looking forward to it, too. We are anticipating every moment of his speech, which I am sure will be a tour de force, given his knowledge of this area. We hope it will confirm that giving the Bill its Second Reading makes eminent sense and that it will move into Committee, so that we can turn it from a worthwhile Bill into a worthwhile Act of Parliament. I am delighted to endorse the Bill and I hope the whole House will support it.

--- Later in debate ---

[Mr Rees-Mogg]

I have great sympathy with what my hon. Friend says; it is so important that we have enough time. It is why Fridays are such a pleasure, because there is time to discuss a Bill in full and in the round, and to consider the principles underpinning it, the details of it, and what would happen to it if it were to be brought into effect. That is proper parliamentary procedure. I have such admiration for those great heroes of the 19th century—[Interruption]—talking of which I give way to my hon. Friend the Member for Beckenham (Bob Stewart).

[Bob Stewart]

I thank my great and hon. Friend, an advocate of the 16th century, for giving way. Does he consider appointments to the House of Lords to be the modern version of 17th-century baubles?

[Mr Rees-Mogg]

Madam Deputy Speaker is giving me one of her looks. As much as I would like to discuss reform of the House of Lords, I would be ruled out of order. If my hon. Friend will forgive me, I must get back to jobbery, because jobbery and avoiding jobbery are at the heart of the Bill.

I was explaining how jobbery, when it starts, is not a deliberate corruption. It is merely the recognition that it just would not do to appoint somebody on the other extreme of politics. We can hear Sir Humphrey going to the Secretary of State and saying, “It would be a little brave, Minister, to appoint such a person who is on so different a wing from you.” The next time an appointment comes up, there is the thought, “Well, if I couldn’t appoint someone who was actively opposed, perhaps I should really only appoint people who are on my side”—in other words, our mates and friends. Thus we get to the heart of jobbery. Appointments are made purely because of somebody’s political colour and context.

In the primary care trust in Bath and North East Somerset which preceded the current organisations a local Conservative had a judicial review against the previous Labour Government to get himself appointed as its chairman, because he was the most qualified person and had been refused only on the basis that he was a Conservative. Therefore, the idea that jobbery has completely left the system is false, and so too is the idea that Governments are so high and mighty and Olympian in their decision making that they do not descend to mere political jobbery.

Cities and Local Government Devolution [Lords] Bill

Bob Stewart Excerpts

Wednesday 21st October 2015 Commons Chamber

[Alistair Burt]

As the hon. Gentleman knows, we can plan to review things at any stage. For devolution to work, the different models that may be put in place, whether big urban city models or more rural models, must of course pass the test of whether they are doing something qualitatively different and better for people. It will certainly be possible and necessary to review that. I think the concern has been to make sure that national standards are not dropped in the process of innovation. That is why the ultimate duty and responsibility of the Secretary of State remain. That was much discussed in another place. The reason for tabling these amendments is to confirm that, under the overall umbrella of wanting greater innovation, national standards will be preserved and cannot be threatened. That is the idea.

[Bob Stewart (Beckenham) (Con)]

Would it be fair to say that local authorities rule on these matters, but that the Secretary of State might occasionally reign?

[Alistair Burt]

We must be clear. The Secretary of State’s overarching duty and responsibility for the NHS will not mean a definitive touch. The whole point of devolution, as indeed the whole point of integration of services between local authorities and the NHS, is to give people the powers to make their decisions locally. There will be much discussion between different constituent parts. In that, the Secretary of State will have no part. It will not be possible, however, for a devolved authority to neglect or remove a core part of the NHS and say, “Oh well, we’ve got the power to do so.” That is the reason for the safeguard to which the amendments and new clause 19 refer.

Access to Medical Treatments (Innovation) Bill

Bob Stewart Excerpts

Friday 16th October 2015 Commons Chamber

[Dr Wollaston]

My hon. Friend makes a good point. Principally, there are issues with funding and complexity. The Bill fails to recognise the science and the issues that a vast, sprawling database might cause. My hon. Friend the Member for Daventry referred to the desirability of the public being able to access a database and gave the example of male pattern baldness. There would be vast profits to be made by the quackery industry from male pattern baldness products. I envisage a vast, sprawling database of anecdotal treatments, and I am afraid it would act as free advertising for the quacks of this world. It is an invitation to quackery.

I started in medicine in the late ’80s and worked for a while in paediatrics. The prognosis for children with leukaemia was grim, but today most of the children diagnosed with the same conditions will survive and thrive, not because of access to a vast, sprawling database of unconnected, anecdotal treatments but because of the meticulous progress of medical research, whereby with thousands of people we compare existing treatments with innovative treatments and find out which are genuinely the best. Any single anecdotal treatment might be effective in one single patient, but that does not tell us whether, when applied to a population, it is better or not.

Another problem with the Bill is the danger that it would undermine medical research. In effect, it would give private clinics the opportunity to offer anecdotal treatments as a way of bypassing clinical trials. When individuals, and particularly parents, are desperate because they have a dreadful diagnosis, they are at their most vulnerable to the claims of individuals who say, for example, “Look at the database and see how it worked for Mr Smith.” They might be lured into thinking that was the best way forward. Someone in a very vulnerable place might be lured into not taking part in a clinical trial by the siren call of an anecdotal treatment recorded on a publicly accessible database. I am afraid that the Bill would undermine research, and that is why the vast majority of bodies are very unhappy about it.

My hon. Friend should reflect on all the concerns that have been expressed about the Bill, and think about how science moves us forward. We progress not by a series of anecdotal treatments but through a solid research community.

We need greater access to clinical trials. The searchable database set up by the National Institute for Health Research is a welcome step forward, but it is rather clunky. Patients need to be able to see very clearly what trials are available and be able to take part in them. There is progress, people are surviving today with treatments based on clinical trials that may have taken place 10 years ago and many go on themselves to take part in clinical trials that will benefit future generations. It is absolutely vital that we continue to support this approach.

[Bob Stewart (Beckenham) (Con)]

I thank my hon. Friend—a good friend—for giving way. Does she believe that there is no place for any sort of list whatsoever and that the system should be left as it is, or is she suggesting that a list could be made up? I understand all her inhibitions and worries about such a list, but should it be considered?

[Dr Wollaston]

As my hon. Friend the Member for Daventry pointed out, many of these bodies would like to have such a register, but they would also like to be able to guide how it should look and to have it within the existing research framework.

The Bill suggests that doctors are not already innovating, and that this is about fear of litigation. The original Bill was based on the premise that fear of litigation was stopping innovation. In fact, the position is very clear if we read what a number of bodies have said. My hon. Friend quoted some individual examples, but the vast majority of opinion from the medical community and the research community is that, genuinely, it is not fear of litigation that stops innovation. Every aspect of this Bill is based on a false premise, I am afraid. I do not want to detain the House by reading out all the various quotes on why the fear of litigation does not stop innovation, but he will know that that is the case.

We face the danger of confusing the existing legal framework. Many have expressed their concern that we will end up with a sort of Heaton-Harris defence for those who have undertaken perhaps rather dangerous experimental treatments billed as innovation. My hon. Friend cited the case of the children who suffered from Duchenne muscular dystrophy, and that is very sad, but the Bill has an underlying assumption that all innovation is a good thing whereas the lesson of history is that it can be extremely dangerous and harmful. We need to be very careful about what we mean by innovation, and to accept that there are also very dangerous innovations. If, as a result of this well-intentioned Bill, we inadvertently end up with people being, in effect, experimented on by irresponsible doctors who are able to get off scot-free, we will have to come back to this place and amend it.

I would like to give my hon. Friend an example based on the case of somebody from my constituency who wrote to me to say that he was concerned that the Government were not doing enough with regard to experimental treatments. His specific example was a bogus treatment called GcMAF. The company promoting this entirely bogus treatment—it has a number of clinics in Europe and Guernsey—is very concerned that it cannot use it in this country because it is prevented from doing so by the current legislative environment. Well, jolly good. It puts out literature saying

“we state that if you have terminal stage 4…cancer, have not had chemotherapy, and you do the GcMAF protocol, you have an 80% chance of being cancer free in a year.”

That is the kind of claim that such doctors put out. In other words, the company is not only promoting its own product, but actively discouraging people from having a treatment that could help.

--- Later in debate ---

[Heidi Alexander (Lewisham East) (Lab)]

I congratulate the hon. Member for Daventry (Chris Heaton-Harris) on securing a place in the private Members’ Bills ballot and thank him for meeting me this week.

Sometimes in this place, we need to be careful what we wish for. The process of steering a private Member’s Bill through Parliament is not only time consuming, but can become very complicated. I suspect that, after the contribution of the hon. Member for Totnes (Dr Wollaston), the hon. Gentleman may be feeling that. I should probably be honest and warn him that my contribution may add to his headache.

The very fact that we are discussing the Bill means that we are having a vital debate about the critical issue of how we can improve patients’ access to innovative and effective treatments. In putting his case for the Bill’s Second Reading, the hon. Gentleman has demonstrated that he has the right intentions, but that is probably the best thing I can say.

Many people in this House will have been in the position of seeing someone they love dying too soon. In such situations, people want hope. I understand that. They want hope that there is a treatment or drug that offers a chance of survival or of extending life that little bit longer.

If I thought that this legislation would provide genuine, well-founded hope in a safe and sound manner, I would support it, but I am not convinced that it does. In truth, I am worried that it does the opposite. I am worried that unsafe treatments could be used on dying patients. I am worried that the Bill would muddy the waters for doctors who wish to innovate about the legal route to do so, that it would reduce participation in clinical trials and that it would reduce legal redress for patients with a genuine negligence claim.

In the few weeks that I have been in this job, I have approached the Bill with an open mind. I have met a range of experts, patient groups, royal colleges and charities. It is fair to say that they are overwhelmingly opposed to the Bill. I will put some of their concerns to the promoter of the Bill and to the Minister, who I understand is actively supporting it.

The first concern that has been put to me is that the Bill attempts to remedy a problem that does not exist. I will briefly quote a few of the experts in this area. The Academy of Medical Royal Colleges has said that

“the Bill rests on the false assumption that it is fear of litigation that is holding back innovation by doctors. There is simply no evidence that this is the case”.

The British Medical Association has said:

“We are not aware of any evidence to suggest that the threat of litigation inhibits innovation or that confusion exists amongst doctors over the circumstances under which they can deviate from standard practice.”

The Royal College of Surgeons has said that

“there is no evidence that doctors are deterred from innovating due to the threat of legal action.”

The Motor Neurone Disease Association has said that

“the Bill would not remedy the problem it is aimed at, for such a problem does not exist”.

Sir Robert Francis QC, who has done so much in recent years to make sure that the NHS is focused, rightly, on patient safety, has said:

“The law of negligence does not prevent responsible innovation and never has.”

I could quote many more people, but I have probably made my point. Why do the hon. Gentleman and the Minister think that all those experts are wrong and they are right? What evidence do they have that litigation, or the fear of litigation, is preventing new treatments or hampering doctors from innovating? Even if that were an issue, does the Bill provide a robust and safe mechanism to tackle it? I am not sure that it does, but I am willing to work with the hon. Gentleman and the Minister, and anyone else who is interested, to consider how we can work on a cross-party basis to address any potential barriers to innovation.

Before setting out why I do not believe that the Bill is the right approach, I will first deal with clause 2, which provides the Secretary of State with power to establish a non-statutory database of innovative medical treatments. As the hon. Gentleman said, the clause was included as a result of concerns that were rightly raised in the other place by Lord Hunt when the previous incarnation of this Bill was debated. Lord Hunt’s amendment to that Bill would have required the Secretary of State to establish a database, but such a requirement does not exist in this Bill. As currently drafted, the Bill gives the Secretary of State “power” to establish a database, but places no obligation on them to do so.

I also question whether clause 2 is needed at all. According to the House of Commons Library, section 254 of the Health and Social Care Act 2012 gives the Secretary of State power to direct the Health and Social Care Information Centre to establish a system for the collection or analysis of information. Will the Minister confirm whether the Secretary of State already has the power to establish a non-statutory database of innovative treatments without legislation?

The Bill gives no detail about how such a database might work, but is that not crucial? A database will be effective only if it is compulsory, regulated and quality controlled. For a database to work requires participants to be just as likely to register failure as success. Will there be a requirement to remove an innovation that is not effective from the database? Will the database be quality assessed or peer reviewed? Will it be used for marketing to patients? The Bill makes no reference to those crucial points.

I am concerned about the impact of the Bill on research, and particularly on participation in clinical trials. As the Minister will know, we are a world leader in clinical research, and we must be careful not to do anything that would put that status at risk. Last December the Minister said that he hoped that the forerunner to this Bill would develop into a form that

“the vast majority of medical opinion and respectable bodies in the medical field feel able to support”.—[Official Report, 9 December 2014; Vol. 589, c. 853.]

I am not sure we have got to that point.

Let me list some of the medical research charities opposed to the Bill: Alzheimer’s Research UK, the British Heart Foundation, Cancer Research UK, the Motor Neurone Disease Association, Parkinson’s UK, the Wellcome Trust. Is the Minister comfortable supporting a Bill that those experts say could have

“significant unintended consequences for medical research”?

[Bob Stewart]

I presume that one fundamental reason why such bodies are against the Bill is that they are concerned that people who are without much hope would pin everything on something that could largely be quackery. Those poor devils will be encouraged to think that there is hope for them, when actually they should come to terms with the truth of their situation.

[Heidi Alexander]

I think that is broadly the point, but it also goes back to what the hon. Member for Totnes said about the impact on participation in clinical research trials. It seems entirely possible to me that a doctor might choose to prescribe an innovative treatment, or a patient decide to take an innovative treatment, rather than enter a clinical trial. If a patient is faced with the choice of guaranteed access to a treatment or participation in a trial in which there is a 50-50 chance that they will not be part of the group receiving the innovative treatment, why would they choose to be part of the trial? I would be grateful for the Minister’s comments on that. Does he not accept that the arrangements for clinical trials, including as they do monitoring and ongoing data collection, provide a much better mechanism for evaluating new treatments and advancing medical progress than a situation that could become more pervasive as a result of the Bill?

If the concerns I have set out so far are not enough, let me now turn to my main concern about the Bill, which, if passed, could undermine a patient’s ability to hold doctors to account when things go wrong.

--- Later in debate ---

[Philip Davies]

My hon. Friend has made a very fair point.

I now want to say something about the medical innovation database provision, which is one of the main differences between the Medical Innovation Bill and the Bill that we are discussing. Clause 2 provides for the Secretary of State to make regulations enabling the Health and Social Care Information Centre to establish a database containing information about innovative medical treatments and their outcomes. As a layman, I consider that to be a significant and fundamental part of the Bill. A central database recording all innovative treatments strikes me as a useful tool from which doctors can learn when tailoring medical treatments for their patients. Again, I speak as a layman, but I think that the creation of a system to enable that knowledge to be shared is a logical step towards medical innovation.

Having said that, I should add that the proposal is not without its worrying aspects. I wanted to raise them earlier, but the interventions from my hon. Friend the Member for Totnes delayed me. One of the main criticisms of clause 2 comes from the Royal College of Surgeons of Edinburgh, which states:

“The proposed database could only be effective if it is compulsory, regulated, has robust quality assurance and be journal-led, ethically framed and rigorously peer reviewed. It will also require an honest culture in which participants are just as likely to register failures as successes”.

The clause provides for the Health and Social Care Information Centre to specify what information should be recorded and how it should be assessed. More experienced people than me will be able to note what standards and specifics need to be recorded to make the database useful and usable. It is certainly not for me to make any suggestions. The database will also be designed in consultation with professional bodies and organisations.

The clause contains the important provision that the database will cover all individual patient innovations, not only those in respect of which doctors have chosen to rely on the steps in the Bill to demonstrate that they have acted responsibly. It is a significant inclusion, as it means that the database will include and cover all treatments and their outcomes—both positive and negative —that take place in England. That is my understanding of the clause, but if my hon. Friend the Member for Daventry wants to correct any misunderstandings, he is welcome to do so. Therefore, this national database not only spreads the knowledge of successful innovations, but also has the benefit of ensuring that innovative treatments that do not work, or perhaps have harmed patients, are not repeated by other clinicians. That should go some way towards reassuring those with concerns. It will also, therefore, create a standard practice that all innovative medical treatment should be recorded in this database, which can be a useful tool for other doctors to draw information from when they are doing their own innovation.

[Bob Stewart]

I came here to listen to my very good friend my hon. Friend the Member for Daventry (Chris Heaton-Harris) and to listen carefully to the debate. It seems to me that if Lord Saatchi’s Bill went into the sand and if this Bill does not make it into Committee and disappears, the one good thing that will come out of it is that the whole subject will be illuminated, and perhaps something good will come out of that. Therefore, the efforts of Lord Saatchi and my good friend the Member for Daventry will not be in vain. I hope very much that the medical authorities will look at this and think of it in that light.

[Philip Davies]

I take on board my hon. Friend’s point. It seems to me that he was subtly saying he had come to listen to the speech of my hon. Friend the Member for Daventry rather than mine. I had hoped he had come to listen to my speech, but I am clearly mistaken.

[Bob Stewart]

I must intervene. I always come to listen to my hon. Friend the Member for Shipley (Philip Davies). I listen to him outside this hallowed hall and also inside it, and he is always well worth listening to.

[Philip Davies]

My hon. Friend is very kind, although it would have been rather better if he had not had to be prompted to say that. Nevertheless, I will take those comments in the spirit in which I know my good friend intended.

--- Later in debate ---

[Philip Davies]

That may well be that body’s conclusion as it stands, but my point is, as I have tried to make clear, that given that it can see there are potential benefits to the Bill, which I have expressed, in dealing with poor practice in the private sector, there is an argument for getting it into Committee to see whether we can make it a Bill that it wholeheartedly supports. That may or may not be possible, but it is certainly worth having a go, given that it has said clearly that the Bill has potential benefits.

Some medical organisations and groups have expressed their concern that the Bill will have an impact on the use of research clinical trials, but that should not be a sufficient reason to stop doctors using innovative treatments on an individual level. This should not be about one or the other—as I said, we should try to do both.

I was contacted, as I am sure many other Members were, by a concerned mother who is desperate for this Bill to pass so that it can benefit her young daughter, who suffers from a rare condition. As has been pointed out, the difficulty with rare diseases and conditions is that because they are so specific, research and clinical trials are not only costly, but very time-consuming. Many people suffering from these diseases do not have this time in finding a cure. The mother who contacted me explains that her daughter, Grace, is already awaiting the commencement of two clinical trials that may, in the long run, be able to help to treat her condition. Although she is appreciative of these movements, the mother explains that if, after the six-month or 12-month clinical trial, the drug is proven to be effective, her daughter will still not be able to have access to it for several years because of the lengthy approval system used by the National Institute for Health and Care Excellence. We should not forget that in a hurry. Although I do not doubt that the trial times and approval systems that new treatment methods must go through to be considered standard medical care are necessary in order to make sure they are safe, they are far too long for many people, given their particular illness.

[Bob Stewart]

Too late.

[Philip Davies]

Absolutely, this is too late for them. Therefore, patients may be willing to use innovative treatments, or even treatments that may be used elsewhere in the world but have not been approved in the UK, because in many cases they have nothing to lose. If that is the case, doctors should be allowed, and encouraged in many respects, to make informed choices on behalf of their patients.

During my research, I contacted NICE to ask for its opinion on the Bill, but it did not really have much of one. It responded by saying:

“NICE’S Chief Executive has met with Chris Heaton-Harris to discuss the Bill and will respond constructively to any further approaches for advice and comment”.

That was NICE’s comment on the Bill, so I am not sure whether NICE supports it or opposes it—I could not get anything further out of NICE. I hope it means that NICE will be happy to work with my hon. Friend the Member for Daventry to try to make the Bill a success, although it does not say that.

Why is this Bill necessary? As we have heard, one main criticism of the Bill has been that it is unnecessary: the status quo does not currently prevent or discourage doctors from innovating, and therefore this change will not encourage further responsible innovation. The Royal College of Surgeons of Edinburgh stated:

“As existing Clinical trial regulations provide a safe and patient centred framework for innovation, there is no evidence that doctors are being deterred from testing new drugs and treatments. None of the medical Royal Colleges, patient groups or research charities have evidence that litigation, or the fear of litigation, is preventing new treatments or hampering doctors from innovating. The overwhelming experiences of our members and fellows leads us to believe that an additional, parallel structure for innovation is unnecessary”.

I hope my hon. Friend the Member for Totnes is happy with my quoting from that passage and does not claim that it is a selective quote. I am trying to be even-handed in respect of the points that people are making.

That point made by the RCSEd is echoed by other medical groups, and these points are clearly valid, but my hon. Friend, too, should be even-handed in accepting that for every organisation suggesting there is no need for these changes, probably just as many organisations and doctors support the Bill. Let us take just one. Dr Max Pemberton was reported in The Daily Telegraph in 2012 as supporting the Medical Innovation Bill and writing:

“It is a tragic indictment of modern medicine that innovation is too often jettisoned in favour of the status quo—not because it is in the patient’s best interest, but because of the fear of being sued. This defensive medicine is at the heart of so much clinical practice now.”

Furthermore, in its consultation response to the Medical Innovation Bill, the NHS Health Research Authority stated:

“We recognise that the fear of litigation may influence behaviours of clinicians”.

That shows not that every doctor who does not use innovative methods takes that approach because of a fear of litigation, but instead that it may be a possible cause for some doctors. I am not advocating that every doctor in the NHS is concerned about the fear of litigation, because to do so would be absurd, but although litigation may not be a huge barrier to some innovative treatments within the NHS, to totally disregard it as a problem, as many critics have done, is not justifiable. There is clearly sufficient concern about litigation for it to need addressing.

Princess Royal University Hospital

Bob Stewart Excerpts

Wednesday 25th March 2015 Westminster Hall

[Jim Dowd]

I broadly agree with the hon. Gentleman’s point. Clearly, financial management is an important part of running the NHS. Everybody knows that, whether it is in our part of south-east London or more broadly.

[Bob Stewart (Beckenham) (Con)]

I totally agree with everything that the hon. Gentleman has said. My worry is that the Secretary of State negated the bill. It was wiped clean, and £44 million is a huge amount of money in the very short time that King’s has apparently been mismanaging the PRUH.

[Jim Dowd]

I understand the hon. Gentleman’s point. I do not think that would be King’s view. I hold no particular brief for King’s college hospital, other than the fact that I had a heart bypass there a few years ago, so I owe them my life. However, beyond that, I have no particular indebtedness to them. I know that there is a strong feeling that it was misled about what taking on the PRUH would actually mean, and the operational and financial consequences.

[Bob Stewart]

I accept that point.

[Jim Dowd]

That is very gracious—characteristically so—of the hon. Gentleman. I have four points to make briefly: three are questions, and I would also like an assurance from the Minister.

First, I would like an indication about the time scale. How long will Monitor take to report and what is the process following the report? Who will get to review it and how will it be taken beyond that? Secondly, what are the requirements/benefits and the consequences of what Monitor and the letter I received from King’s later that day—5 March—say, which is that the legal powers that Monitor possesses are needed to underpin the changes that are necessary to King’s foundation trust and the PRUH? Thirdly, how much consultation will there be with other providers and commissioners across south-east London outside King’s College Hospital NHS Foundation Trust? Finally, I want an absolute guarantee that University hospital Lewisham and Queen Elizabeth hospital Woolwich, now the Lewisham and Greenwich trust, will not be adversely affected by any decisions that Monitor makes.

--- Later in debate ---

[Jane Ellison]

I thank my hon. Friend for that intervention. I will say more about Monitor’s role, but it is very much in line with what he said and I hope to give him the assurance that he seeks.

Monitor has been working with King’s, local clinical commissioning groups, the NHS Trust Development Authority and NHS England since the acquisition and has worked more closely with the trust recently to get a better picture of the challenges that it faces. However, Monitor has decided to take the new, formal action because King’s has not been able to tackle its challenges on its own. Monitor considers that continuing to work with the trust through more intensive and formal engagement will help to drive the necessary changes.

I want at this point to highlight the fact that, following a formal investigation into a suspected licence breach at a foundation trust, Monitor does not have the power to direct non-foundation trusts, nor does it have the power to direct neighbouring foundation trusts unless they themselves are in breach of their licence. The range of actions available to the regulator range from informal action—for example, requesting further information—to formal enforcement action, including the imposition of additional licence conditions.

Where appropriate, Monitor seeks to encourage the whole health economy to work together to reach a locally owned, consensual solution, which is very much in line with the NHS “Five Year Forward View”. Monitor has said that it recognises that King’s has been working hard, as my hon. Friend the Member for Bromley and Chislehurst (Robert Neill) has said, to improve the quality of care provided at the PRUH. However, through its close work with the trust, Monitor has discovered that achieving the necessary financial and operational turnaround at the PRUH will be a greater challenge than was initially anticipated. Therefore, the regulator has decided to open a formal investigation as part of the regulatory process, which will enable it to use its legal powers to underpin the changes that the trust needs to make. The investigation will help Monitor to decide what resources and support King’s needs to enable it to deal with its financial problems and reduce waiting times for patients. Monitor will announce in due course the outcome of the investigation and whether it will take any further action. There is no statutory time scale for the investigation, because it depends on the scale of the issues encountered. I am sure that all hon. Members would want those issues to be looked at thoroughly.

[Bob Stewart]

May I just confirm that that means that Lewisham hospital will not be touched by Monitor? Lewisham hospital was a successful hospital before the last investigation, and it appears to be a successful hospital now. If it ain’t broke, don’t fix it.

[Jane Ellison]

I have just made clear for the record what Monitor’s powers are and are not. I hope that that gives Members on both sides of the Chamber greater clarity than they had when we started. Monitor is in the process of concluding its investigation. It will announce in due course the outcome and whether it will take any further action. Key findings and any next steps will be announced by means of a press notice. Colleagues from Monitor are here in the House, and I would like to put them on notice that I expect—I am sure that they also expect this—Monitor to engage fully with local Members. Clearly, we are entering a more tricky period from that point of view, but on the other side of the election I expect there to be full engagement with local Members, particularly as the solution lies, as I think it will in other health economies that are challenged, in the whole local health economy coming together to understand how to work through the problems. That is laid out in NHS England’s “Five Year Forward View”.

Improving Cancer Outcomes

Bob Stewart Excerpts

Thursday 5th February 2015 Commons Chamber

[Bob Stewart (Beckenham) (Con)]

Will my hon. Friend give way?

[Jack Lopresti]

I had finished—

[Bob Stewart]

I will finish for my hon. Friend. This is a very brave man, because he wants to join the Royal Air Force. He is fully fit, he does marathons—he is a lunatic of course—and he wants to join the Royal Auxiliary Air Force, whose tie I am wearing in support of his bid.

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. I am sure I should reprimand the hon. Gentleman for suggesting that the hon. Member for Filton and Bradley Stoke (Jack Lopresti) is a lunatic. That is not parliamentary language, although I am sure it was meant in a kindly fashion. He was, however, absolutely right to commend the hon. Member for Filton and Bradley Stoke for the very brave speech that he has just made, which the House seriously appreciates.

National Health Service

Bob Stewart Excerpts

Wednesday 21st January 2015 Commons Chamber

[Mr Hunt]

Let me make some progress. In A and E, as everywhere in our hospitals, it is important that whatever the pressures, people are given safe, compassionate care. Our NHS is one of the safest systems in the world, but we still have around 1,000 avoidable deaths every month. We still put the wrong prosthesis on someone once a fortnight, operate on the wrong part of someone’s body once a week and leave a foreign object in someone’s body twice a week. Just five years ago, we had the tragedy at Mid Staffs, which, we should never forget—[Interruption.] I am quite shocked that people are laughing when we are talking about harm that happens in the NHS every month and about what happened at Mid Staffs. We must not forget that Mid Staffs was hitting its A and E targets for much of the period that that same department was tolerating the most horrific care. Whatever the pressure to hit targets, the Government want every vulnerable person to be treated safely and with the highest standards of dignity and respect.

Two years ago, we introduced the toughest inspection regime anywhere in the world. The result was over 6,000 more nurses on our hospital wards, cases of MRSA and clostridium difficile halved over this Parliament and more than 200 NHS organisations have signed up to halve avoidable harm and avoidable death over the next three years. Care is getting safer. While we lead the NHS through that painful process, what is the reaction from Opposition Front Benchers? They criticise us for running down the NHS and still maintain—as the right hon. Member for Leigh did in December—that it was a mistake to hold a public inquiry into Mid Staffs. He talked about listening to patients, but this is what Julie Bailey, a Mid Staffs campaigner whose mother was a patient at Mid Staffs said about his comments in December:

“The message he is sending out is that it is better to cover things up than to criticise the NHS, however bad things are. The inquiry uncovered huge failings in the NHS and he thinks it shouldn’t have taken place at all. It is very worrying because if he becomes Health Secretary again at the election it is clear we would go straight back to the bad old days of covering up.”

[Bob Stewart (Beckenham) (Con)]

One problem last month in my local hospital, the Princess Royal university hospital, was the lack of space, and ambulances were backed up. It is not just a staffing problem; it is a spatial problem. Does the Secretary of State agree that if we had more space in A and E departments, we could get people off the streets?

[Mr Hunt]

Space is a problem in some A and Es, which is why we have expanded A and E capacity. Other places have different problems, but the long-term solution is to have improved capacity outside hospitals in community care. That is the real challenge and what the “Five Year Forward View” is about.