Junior Doctors Contracts

Diana Johnson Excerpts

Thursday 11th February 2016 Commons Chamber

[Mr Hunt]

The biggest threat to morale for doctors is not being able to deliver the care that they came into the profession to deliver. That is why we are sorting out a proper seven-day NHS, particularly for junior doctors who work in A&E departments at weekends, where they often do not have the support they would get during the week and do not have as many consultants around as there would normally be. That is what we are trying to put right. I appreciate that it is very difficult when the counter-party in the dispute does not want to negotiate, but in the end Governments have to decide what is right for patients and what is right for the service, as well as what is right for doctors.

[Diana Johnson (Kingston upon Hull North) (Lab)]

Hull has traditionally struggled to recruit doctors in specialties such as A&E, general practice and psychiatry. I am concerned about the royal colleges’ warning that the imposition of the contract will have a detrimental effect on staff morale and staff retention in the NHS. Will this not make things even more difficult for areas such as Hull, which struggle to recruit in the first place?

[Mr Hunt]

We want more doctors and more nurses in the NHS, but in the end, if we are putting extra money in to recruit these extra doctors and nurses, it is fair to the public who are paying for their salaries to have reforms that mean their care gets better. That will apply to the hon. Lady’s constituents in Hull, who want a seven-day NHS, just as my constituents in Surrey do.

Junior Doctors’ Contract Negotiations

Diana Johnson Excerpts

Monday 8th February 2016 Commons Chamber

[Ben Gummer]

It would make a significant difference. Now that the Leader of Her Majesty’s Opposition is sitting on the Front Bench, he might like to take note of the fact that if we have a united political response condemning strikes that affect patients and their safety, it helps to bring negotiations to a more profitable end.

[Diana Johnson (Kingston upon Hull North) (Lab)]

Hull royal infirmary is under a black alert, which means that local people have been told not to attend the hospital unless it is a matter of life and death. Will the Minister tell me how the insults the Secretary of State has been throwing around over the weekend, and those that he himself has made today about hard-working and dedicated junior doctors, will help people in Hull, who need a functioning NHS? How will those insults improve the morale of those doctors?

[Ben Gummer]

The hon. Lady does dangerous work if she tries to conflate the comments that I and others have made about the leadership of the BMA with the motivations of junior doctors, none of whom I have impugned. I recognise that junior doctors work incredibly hard, care passionately about their patients and have a vocational drive to do the best for the people they care for, but that is different from an organisation that refuses to talk, refuses to negotiate, lies to its members and is very slippery in the statements it puts out to the press.

NHS Trusts: Finances

Diana Johnson Excerpts

Monday 1st February 2016 Commons Chamber

[Ben Gummer]

The hon. Lady is wrong. The CQC is not downgrading any trusts. It provides a very important function in the NHS that did not exist before, which is to give open and transparent accounts of how good the quality is in individual trusts. For the first time, patients can see whether their trust is safe, well led and effective. That means that there can be a proper and solid response where there are failings. In too many parts of the NHS, there is not the level of quality that other parts deliver. The CQC shines a light on where we need to improve. Our job, as part of the system with NHS Improvement, is to make those areas measure up.

[Diana Johnson (Kingston upon Hull North) (Lab)]

My trust in Hull is predicting a deficit of £21.9 million by the end of the financial year. Following a CQC report a few years ago that criticised the staffing levels in Hull, a huge amount of effort has gone into increasing the staffing levels, but that has come at a cost, especially given the premium that is paid for medical staff. Will the Minister reassure my constituents that we will not return to the staffing levels that the CQC criticised in the past when dealing with the deficit of nearly £21.9 million?

[Ben Gummer]

I can give the hon. Lady that reassurance. When I was in Hull a few months ago, I had a fantastic series of conversations with clinicians—not just those who are leading the hospital, but those on the frontline in the wards—about how to address the staffing challenges in Hull and east Yorkshire. It is tailored responses to the problems in individual localities that will provide the quality of service in Hull that she wants for her constituents. I am committed, as are the staff in Hull, to ensuring that she sees it.

William Mead: 111 Helpline

Diana Johnson Excerpts

Tuesday 26th January 2016 Commons Chamber

[Mr Hunt]

I am grateful to my hon. Friend for raising that issue, which has not been raised so far this afternoon. He is right. We have a pressing global need—not just a UK need—to reduce the inappropriate prescribing of antibiotics. That is why training of clinicians is so important. In the case of sepsis, not only is the prescribing of antibiotics appropriate but it is essential and it is essential to do it quickly. We need to make sure that, as we train GPs to reduce their prescribing of antibiotics so that we do not develop the resistance to antibiotics that could be so disastrous for global health, they do not avoid prescribing them when they are absolutely essential.

[Diana Johnson (Kingston upon Hull North) (Lab)]

The Health Secretary said that NHS 111 was a victim of its own success. I agree with what my right hon. Friend the Member for Exeter (Mr Bradshaw) said, which is that it is used because it is so difficult to see a doctor. On 2 January, the Hull Daily Mail reported that Hull Royal Infirmary was telling people not to come to A and E but to use services such as NHS 111. In the light of the findings of this investigation, which have national implications, does the Secretary of State agree that there should be more clinicians at NHS 111?

[Mr Hunt]

I do agree that we need more clinicians in primary care. We also need to invest in secondary care, which is why the hon. Lady has a new A&E centre opening in Hull, which I am sure she welcomes. We need more clinicians in primary care so that we can deal with these issues more quickly, before people need hospital care and to spot conditions such as sepsis. This Government are investing £10 billion in the NHS annually in real terms in order to step up the improvement in the services that we offer.

Infected Blood

Diana Johnson Excerpts

Thursday 21st January 2016 Commons Chamber

[Jane Ellison]

I assure my hon. Friend that we will make every effort to reach people. My officials have already put in place extensive plans to publicise the consultation—they have met the heads of the charities and those running the current schemes, and will be writing to those who are registered with those schemes—and we will make it as easy as possible for people to get involved. One of our reasons for organising a 12-week consultation is that we recognise that some people may not be online, and we want to make sure that everyone has a chance to comment.

I will reflect on what my hon. Friend has said about direct contact. That may already be being pursued through some of our plans, but, as I have said, we have extensive plans to publicise the consultation, and it goes live today. Of course I shall welcome Members’ contributions on behalf of their constituents.

[Diana Johnson (Kingston upon Hull North) (Lab)]

I thank the Minister for her statement. I am sure that the all-party parliamentary group on haemophilia and contaminated blood will want to study the details in the coming weeks, and to take part in the consultation.

At first glance it appears that the Minister’s proposals are not as generous as those that are being discussed in Scotland, although I accept that as yet the Scottish Government have not accepted those proposals. However, I want to raise the specific issue of health assessments of those who are in stage 1 of hepatitis C. A number of those people have been living with the condition for a great many years, and even if their viral load is now cleared, they will not be able to resume their lives as if they had never been infected. Will the Minister assure me that that will be taken into account in any health assessments and in any subsequent financial arrangements?

[Jane Ellison]

Let me first thank the hon. Lady for all the campaigning work that she has done, for which she has rightly been recognised by others. Although we have not always been able to agree on everything, I have been greatly informed by what she has brought to our discussions, and I take on board many of the reports that the all-party group has produced over the years.

The recommendations that are being discussed in Scotland were made by a reference group and not by the Scottish Government, who have yet to respond to them. Shona Robison indicated that they would respond in due course, but that, obviously, is a matter for them.

It is a little too early to specify exactly how the individual health assessments will be carried out, but we will be asking an expert advisory group to advise on the criteria and the evidence. As I said in my statement, it is a question of recognising the impact of ill health, and also the fact that some people’s health fluctuates. I think that we can be assured that everyone will be included in the scheme, and that everyone will receive an annual payment. I should add that we expect people’s own clinicians to be involved in the individual assessments.

Victims of Contaminated Blood: Support

Diana Johnson Excerpts

Wednesday 16th December 2015 Commons Chamber

[Diana Johnson (Kingston upon Hull North) (Lab)]

(Urgent Question): To ask the Minister responsible for public health to make a statement on Government plans to reform the support for victims of contaminated blood.

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

I recognise that I committed in earlier debates to consulting on proposals to reform the current payment schemes before the end of the year. Despite our best efforts to meet that commitment, we are unfortunately not ready to publish the consultation before the recess. However, I confirm today that it will be published in January.

The delay will, I know, be disappointing for many who were anticipating the consultation before the end of the year. I apologise for the delay, in particular to Members of the House who have been campaigning tirelessly for a resolution on behalf of their constituents and to those who are directly affected, who continue to wait patiently for our proposals.

In the Westminster Hall debate in September, I explained that any consultation would happen within the context of the spending review and that payments for the reformed scheme would come from the Department of Health budget. The House will know that the outcome of the spending review was communicated to us only a few weeks ago.

The infected blood tragedy and reform of the payment schemes remain a priority for us. We are assessing what can be allocated above and beyond the additional £25 million to which we have already committed. That, of course, is in addition to the existing baseline spend on the payment schemes, which will remain.

Over my two years as public health Minister, I have heard regularly from those affected by this tragedy. Every week, I read a large number of letters, both to me and to the Prime Minister, from campaign groups, individuals and their families, all of whom have been affected by the tragedy in different ways. While considering our proposals for consultation, I want to ensure that all those views are reflected and that I do not miss the thoughts of those with the quieter voices.

We are currently working towards publication of the consultation, and, as part of that, we arranged an independently facilitated event with representatives of some of the leading campaign groups. The report from that event is available through those groups.

I have worked to keep Members of the House updated—you know how seriously I take my duties in that regard, Mr Speaker—and last month I invited members of the all-party group on haemophilia and contaminated blood to a meeting to discuss this issue. I told colleagues that my intention was to consult as soon as possible, but I said that that could be in January, given the timing of the comprehensive spending review.

As discussed with the all-party parliamentary group on haemophilia and contaminated blood, I am also interested in the opportunities offered by the advent of simpler and more effective treatments that are able to cure some people of hepatitis C, and which present a welcome new opportunity to make some people well. I assure the House that that work continues to establish a way forward, and a consultation will be published in January. At that time I will seek to make an oral statement.

In conclusion, because my priority is to get this issue right, I have taken the decision to take a little more time and publish the consultation in January.

[Diana Johnson]

Mr Speaker, your decision to grant this urgent question is recognition of the long campaign for justice for this group of people, and it is appreciated by everyone who has been involved. I am, however, disappointed that I have had to ask for an urgent question. On three occasions, Ministers promised a statement before Christmas, and they should not have been forced to come to the Chamber for the second time this year. When the Minister speaks about a consultation in January, I assume that she means January 2016. I would like clarification on that, because dates always seem to slip, and such action from the Government fuels distrust and resentment among people who have been let down for too long.

I have four questions for the Minister. First, she proposes a consultation that will run for 12 weeks and that she will need to assess before launching a new scheme. Will she explain how that is feasible before the start of the next financial year? Secondly, she claimed that it will be the first full public consultation, but the APPG ran a full consultation—with the same consultees—earlier this year. Can she assure me that she has considered the APPG report and all the evidence presented in it? Thirdly, as she said, the Government delayed making a statement until after the comprehensive spending review, in order to determine the total “financial envelope” available. I understand that the Department of Health currently pays out about £14 million a year, with a total future financial commitment of £455 million. Will the Minister tell the House how much more is now available following the comprehensive spending review?

Fourthly, lump-sum payments were a key issue raised in response to the APPG inquiry, but it now appears that those are off the agenda. That is a major disappointment because lump-sum payments would allow those affected to make real choices about their own lives—something they have been denied for far too long. Will the Minister support a separate request to the Treasury to use funds equivalent to the £230 million raised from the sale of Plasma Resources UK to fund lump-sum payments to those who have been affected?

[Jane Ellison]

I thank the hon. Lady for her response. Of course I understand the disappointment that we are not able to consult before the end of the year, but I informed her and her colleagues who came to the meeting on, I think, 5 November, that it was unlikely that we would be able to do so. That was recorded in the note made at the meeting, and published through the all-party group. I have tried to keep colleagues informed, and only last night I spoke to a number of campaigners about this issue, including the hon. Member for Foyle (Mark Durkan) and my hon. Friend the Member for Colne Valley (Jason McCartney), and informed them personally about the delay. I would, of course, have informed the hon. Lady today or tomorrow, along with the other Members who attended that meeting. I have done my best to keep people informed.

I understand the hon. Lady’s point about the consultation. I will consider the issue she raises, but I have always been clear that the transition to a new scheme must be done in a way that does not compromise the safety of payments to people in schemes—again, we discussed that at the meeting in early November. I therefore see no problem with consulting and then moving towards a transition, because that transition will be a gradual process anyway for some people. I want to ensure a safe transfer from the current scheme to any reformed scheme, and I do not see a real problem in that regard.

This will be the first full consultation by the Government, and the hon. Lady is right to say that the all-party group—and others, including my right hon. Friend the Member for North East Bedfordshire (Alistair Burt)—garnered many views. All views, including those put to the all-party group in its very good report, can be reiterated as part of the response to the consultation.

I made a statement on the issue of money in my response to the urgent question. I understand the point the hon. Lady makes on lump sum payments, but it would not be appropriate for me to comment at this time. I can talk about that more when I make an oral statement at the time we launch the consultation. She reiterated in her questions the principle of individual choice and treating people as individuals. Many Members have stressed to me the importance of that principle. We will very much recognise it in what we bring forward in the new year.

Southern Health NHS Foundation Trust

Diana Johnson Excerpts

Thursday 10th December 2015 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. That is why Professor Sir Bruce Keogh is developing a methodology to help us understand the number of avoidable deaths and the reporting culture at a trust level. We have a good methodology for understanding the number of avoidable deaths on a national level. The Hogan and Black analysis says that about 3.6% of deaths have a 50% or more chance of being avoidable. However, we will not get real local action until we localise it, and that is the next step.

[Diana Johnson (Kingston upon Hull North) (Lab)]

Is the Secretary of State satisfied that families seeking truth and justice for their loved ones are having to rely on pro bono lawyers for advice and representation, and on crowdsourcing to get legal advice?

[Mr Hunt]

I am afraid that that probably does happen. We all, in all parts of the House, passionately believe in and support the NHS. It should never come down to lawyers. When there is a problem, we need a culture where the NHS is totally open and as keen as the families are themselves to understand what happened, whether it could be avoided, and what lessons can be learned. If nothing else, that is the big lesson that we need to make sure we act on as a result of today’s leaked report.

Contaminated Blood

Diana Johnson Excerpts

Monday 20th July 2015 Commons Chamber

[Diana Johnson (Kingston upon Hull North) (Lab)]

(Urgent Question): To ask the Secretary of State for Health to make a statement on the support available to victims of contaminated blood.

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

I apologise for the fact that the Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison), the Minister with responsibility for public health, cannot be here to respond to this urgent question. She is returning from an international tobacco control summit, which she attended at the request of the French Government, and could not be back in time.

In the 1970s, 1980s and early 1990s, thousands of patients contracted HIV, hepatitis C or both infections from NHS-supplied blood or blood products. This is rightly described by many as one of the great tragedies of modern healthcare. I would like to start by echoing the apology made by the Prime Minister in March and to say, on behalf of this Government, how sorry we are for what happened.

Since 1988, five ex-gratia support schemes have been set up to support those affected. While the current schemes of financial support have made a significant difference to the lives of many beneficiaries, we acknowledge that many people remain unhappy with the current system of support. I also know that many will have anticipated a more comprehensive statement on progress.

Ministers have listened to many of the criticisms of the current schemes. This is a very difficult issue, and many different voices on this matter will need to be taken into consideration in the context of the spending review. We then plan to give individuals affected by scheme reform the opportunity to express their views via a public consultation. That has never been done before in the history of the schemes.

The four UK Health Departments have been working together closely on this matter and will continue to do so. As a result of the direct links established between the Scottish Government and patient groups in Scotland following the publication of the Penrose inquiry, the Scottish Government are undertaking their own consultation with patient groups in Scotland. We look forward to seeing the results of that activity. When we launch our consultation later this year, we will continue to work with Scotland. That will enable all four countries to share their learning and therefore have far more robust information to inform the shape of any future reformed scheme.

As was previously announced, up to £25 million was allocated to support the transition to a reformed scheme. I confirm that we do not intend to use that for the administrative costs that might be associated with reforming the existing schemes. We expect to announce our plans for that money in the light of the consultation and once we have an understanding of how a new scheme might be structured. We intend to consult on proposals for a reformed scheme later this year.

--- Later in debate ---

[Diana Johnson]

Thank you, Mr Speaker, for granting this urgent question. I am mindful that I have just two minutes to deal with 30 years of injustice in this case. Members will know that this is the worst treatment scandal in the history of the NHS.

On 14 January, the all-party parliamentary group on haemophilia and contaminated blood published a report about how the current support is wholly inadequate. After the publication of the Penrose report on 25 March, the Prime Minister told the House that

“it is vital that we move as soon as possible to improve the way that payments are made to those infected”.

He added:

“if I am Prime Minister in May, we will respond to the findings of this report as a matter of priority.”—[Official Report, 25 March 2015; Vol. 594, c. 1423.]

On 3 June, the Prime Minister promised

“a full statement…before the summer recess”.—[Official Report, 3 June 2015; Vol. 596, c. 584.]

At 2 pm last Friday, a written statement was laid in the other place. In short, it means no extra help for victims for at least two more years. Tabling it in the other place when the Commons was not sitting was very shabby indeed.

I have four specific questions. First, when will we see a timetable for consultation on a reformed scheme of compensation? Will any of the £25 million be spent in 2015-16, as was promised by the Prime Minister?

Secondly, two years ago the Government sold an 80% stake in Plasma Resources UK, the company that creates plasma products for the NHS, to Bain Capital for £200 million. Was that capital receipt ring-fenced to compensate those affected by contaminated blood? If not, why not?

Thirdly, on 2 June the Secretary of State for Health wrote to one of his own constituents:

“Any additional resources found for a settlement will be taken away from money spent on direct patient care for patients in the NHS.”

Is that really the Government’s intention? Will the Minister comment on the starkly different approach the Government took in compensating Equitable Life victims?

Fourthly, there are now drugs available that would allow people like my constituent Glen Wilkinson to clear hepatitis C, but they are not available automatically on the NHS. The NHS gave him the infection and the NHS could now treat him. Where is the justice in withholding those drugs?

I cannot overstate the feelings of anguish that have been caused by the Government’s conduct in recent days. Many victims feel that they are being left to die in misery so that the costs of any eventual settlement scheme become more affordable. Before the election, the Prime Minister promised urgent action. Now is the time to deliver.

[Ben Gummer]

The hon. Lady has been a doughty campaigner on this issue for many years, along with others. I have a constituent who has been affected by this appalling tragedy. I know that many Members come to the House with similar experiences of talking to their constituents, so I understand the issues that she has raised today.

The hon. Lady is right to say that there is a long history behind this appalling series of events. We are seeking to address that now in the consultation that we are about to take forward. We are moving with some speed, compared with what has happened before. We had the Penrose report; then the election intervened, as she will understand, but it was one of the first items on the agenda that I was party to on returning to the Department of Health after the election. We are moving at speed to construct a consultation that will take into account the views, feelings and wishes of the beneficiaries for the first time ever, so that we hear their personal stories and give them a voice in a way that they feel has not happened so far.

The hon. Lady has rightly identified that there is a monetary implication. This matter has to be considered within the bounds of the spending review—it could not be otherwise—and it will come within the parameters of the Department of Health budget.

The hon. Lady asked about the timetable. The £25 million identified by the Prime Minister has been identified for this financial year. Should it not be allocated this year, it will be rolled over to the next year, so it will not fall if it is not spent. She also asked about the compensation fund, and I shall return to her with a written reply on that. She correctly made the point that some people will feel that time is running out and that they need a resolution quickly. That is why, within a few months, we intend to launch a consultation that we want to be completed very quickly—preferably within eight weeks, but should beneficiaries prefer, within 12 weeks. We will then launch the revised parameters of the schemes by the end of the year. We are moving quickly, and we intend those provisions to be in place so that people can feel the benefit, and feel that their voice is being heard and reflected in the changes that the Government have made, fulfilling their promises to do so.

NHS Reform

Diana Johnson Excerpts

Thursday 16th July 2015 Commons Chamber

[Mr Hunt]

We do need more doctors and more nurses. We saw an increase of about 8,000 nurses and 10,000 doctors in the previous Parliament. We will need more for the simple reason that we will have 1 million more over-70s by the end of this Parliament. That said, the NHS is admired in the other countries my hon. Friend talks about for our models of care, which are sometimes less hospital-centric and therefore inherently more efficient than what happens in some other systems. The learning should go both ways.

[Diana Johnson (Kingston upon Hull North) (Lab)]

My question is about whistleblowers. I want to know whether the Secretary of State is really satisfied that the fit and proper person test for managers is working, when it allows a chief executive who bullies and mismanaged, as happened in Hull, as the Secretary of State knows, to move with the help of the Trust Development Authority to another job as a chief executive, paying £170,000, and yet the whistleblower has to fight for her rights. When the fit and proper person test was invoked, the TDA investigated and the new trust, unsurprisingly, said that that chief executive was okay. I do not think that that is independent, transparent or in the spirit of Francis.

[Mr Hunt]

I recognise that the hon. Lady has legitimate concerns about the way that the whistleblower, who I think is one of her constituents or is near to her constituency, was treated. I have, as she requested, looked into that very carefully. She will understand that it would not be right or proper for me to comment on an individual case. She knows that, as a result of requests by her and fellow MPs, I looked into whether due process was followed in the case that she mentioned. All I will say is that bullying behaviour should not happen anywhere in the NHS. That is a very important part of the culture change that I want to see.

NHS Success Regime

Diana Johnson Excerpts

Thursday 4th June 2015 Commons Chamber

[Ben Gummer]

They will not just be involved; they will be central to the discussions. The jeers and taunts from Opposition Front Benchers give the game away: they expect a decision to be made centrally—that is what they want. That is the only way they think. Conservative Members believe that local people should be central to that decision and that we should fix the whole local health economy, as opposed to trying to deal with individual trusts as they encounter problems.

[Diana Johnson (Kingston upon Hull North) (Lab)]

Will the Minister explain how the problem of chief executives who are not performing properly will be dealt with under this regime? Let me give him an example. Under the coalition Government’s watch the chief executive at Hull, who was disastrous, was moved to Harlow where he is now earning £170,000 a year. He had the help of the TDA in that move and left a disastrous situation in Hull.

[Ben Gummer]

I was not aware of that situation and would very much like to talk to the hon. Lady about it afterwards. If the facts she states are true, that is indeed wrong. The whole point of the success regime is to get away from the idea of being able to change one chief executive or commissioner in one provider in a challenged health economy while expecting to see a change to the whole system. We are trying to correct the system so that local care for local people is improved.