Community Pharmacies

Baroness Laing of Elderslie Excerpts

Wednesday 2nd November 2016 Commons Chamber

[Rachael Maskell (York Central) (Lab/Co-op)]

On a point of order, Madam Deputy Speaker. Has the Secretary of State for Environment, Food and Rural Affairs given notice of whether she intends to make a statement to this House in the light of today’s High Court judgment, which found against the Government for the second time on the matter of being in breach of air quality standards and putting in place an inadequate air quality plan? I am sure that you will appreciate the level of interest in the outcome of those proceedings, given that between 40,000 and 50,000 people in our country die prematurely each year as a direct consequence of the Government’s failure to reach those air quality standards.

[Madam Deputy Speaker (Mrs Eleanor Laing)]

I understand the hon. Lady’s concern about the matter and thank her for raising it, but she and her colleagues will understand that it is not a matter for the Chair. If she wishes a Minister to come to the House, the correct procedure is to submit a request for an urgent question. I am sure that if the hon. Lady believes that she has sufficient grounds for asking for an urgent question, she will submit a request and Mr Speaker will give it due consideration.

Young People’s Mental Health

Baroness Laing of Elderslie Excerpts

Thursday 27th October 2016 Commons Chamber

[Huw Merriman (Bexhill and Battle) (Con)]

It is a great pleasure to follow the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron)—I hope I have got that correct.

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. It is pronounced “Stray-ven and Lez-ma-hay-go”.

[Huw Merriman]

Thank you, Madam Deputy Speaker. I am suitably corrected and admonished at the same time. I am glad that you did not ask me to repeat that after you.

I particularly applaud the point that has been made about making this a cross-party matter on which we can all work together. As the young people have shown us in their fantastic report, working together will help to ensure that all voices are heard and recognised.

I thank the hon. Member for Dulwich and West Norwood (Helen Hayes)—her constituency is much easier for me to pronounce—for sponsoring the debate. I apologise for going back and forth from the Chamber, and perhaps I may explain to those who are watching why there are so few MPs on the Benches. My hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) said that it would be good to hold such debates during Government time, when Members may not be in their constituencies. Of course, Thursday afternoon is also a time when Bill Committees sit, so Government and Opposition Members are required to attend those Committees. I hasten to add that I should also be in a Bill Committee, but I was so determined to speak on this matter that I have come to the Chamber. It is probably for that reason that I will always be asking Ministers for more from the Back Benches, rather than being on the Front Bench and able to deliver those things myself.

I commend the 2015 Youth Select Committee report, and I particularly applaud the 90,000 young people—many more took part in the vote—who voted that mental health services for young people should be the priority concern. They are absolutely right to focus on this subject, and I submit that they are in the best position to give their opinion on it.

I similarly decided that the subject would be a chief priority for me when I was elected as an MP in East Sussex 18 months ago. The severity of this issue, particularly among young people, became all too apparent to me. I found—I still do—the stories of carefree, confident and happy lives being shut down as young people enter a dark world of fear, anxiety and isolation to be incredibly upsetting.

As a result of my concern, I chose this issue as the topic of my question when my name was first pulled out of the hat for Prime Minister’s questions. I told the then Prime Minister that I had spent an afternoon in the small town of Battle in my constituency visiting three families, each of whom had a child who had not been given the early-stage intervention that they expected from the child and adolescent mental health services. I asked the Prime Minister for more focus on early-stage treatment so that young people’s conditions do not become more acute.

Providing such services is not only our civic duty, but an economic and social imperative. When my constituents ask me why the roads in East Sussex are in a state, I explain that I recently secured £250,000 from our county team to fund just one year of acute mental health treatment for one constituent. Fixing people has to come before fixing holes in the tarmac. The phenomenon may not have existed so openly when many of my constituents were younger, but it is now a huge financial concern to my county council colleagues.

I firmly believe that too much pressure is being loaded on to people too young. Social media and the internet, as pioneering as they are, are a curse on wellbeing, and internet service providers must be forced to do more. Every young person should have the right to have their web history expunged. Cyber-bullying is at last being recognised as a crime, but every school must ensure that its pupils are aware of good internet practice and the sanctions for abuse. We also need to be aware that young people and children are accessing graphic images and media on the internet that they cannot understand, process or cope with.

In the report’s consideration of education, I absolutely commend the recommendation

“that the Government develop and introduce statutory levels of attainment for mental health education…Schools should have autonomy to deliver mental health education flexibly but must be able to demonstrate how pupils reach the attainment levels.”

May I suggest that in so doing the Government should ensure that the curriculum combines a consideration of social media and the internet with wellbeing training?

We also need training for our GPs. The situation is summed up perfectly by the experience of a young person that is detailed in paragraph 32 of the excellent report. It is essential that the GP does not diagnose a mental health condition, but merely refers the young person to a specialist. I know that mental health specialists find it frustrating if GPs diagnose a mental health condition when the specialist does not regard it as such. Once that badge is given to someone, it is difficult to remove it. Equally, brilliant local GPs, such as those in Battle who have helped my constituents in their surgeries, have championed young people and become their advocate. They are incredibly frustrated by the delay in early intervention in mental health services. I work closely with my local CAMHS team, and I have the highest regard for the many excellent specialists who do their best. However, I am worried that constituents face lengthy waiting times and that some have been passed from pillar to post when receiving treatment.

Building up trust is a key ingredient of successful diagnosis and treatment. I hear stories about young people finding the courage and trust to open up about their condition, only to find a new practitioner at the subsequent session. It disappoints me that the young person can then regress because of that change of personnel. I would like a commitment to giving treatment on a fixed one-to-one basis. If we can do that for maternity provision, surely we can do it for mental health treatment.

When I attended the launch of the mental health taskforce, I was buoyed by the commitment of the then Minister and the chief executive of NHS England to implement the excellent “Five Year Forward View”. I was cheered by the commitment to funds to ensure that our acute hospitals have adequate mental health expertise on A&E wards to deal with those who are hospitalised as a result of mental health issues, or who have such a condition in addition to a physical illness.

My concern was driven by the experience of a family in my constituency following a suicide attempt. The NHS staff did not have the ability to deal with the mental health condition, and my constituent, a young man in his teens, was forced to wait until CAMHS staff could make their way over from another town miles away. I understand the need for specialist treatment, but it strikes me that there is a need for a culture change across the entire NHS, and that all staff should be trained to understand mental health and provide a basic level of treatment. Specialisation in health is important, but if the NHS becomes over-specialised, it can lead to a lack of general involvement in such care for patients.

I welcome the news that the Government will fund 24/7 mental health provision in our hospitals, but I was alarmed at the suggestion by the chief executive of my local trust that the funding may not stretch far enough. I also want to ensure that that specific coverage will not mean that other NHS staff with the necessary technical understanding and empathy will feel that they are not empowered to assist those many hospital patients who need help with their mental healthcare, in addition to their physical wellbeing.

Ultimately, getting early-stage intervention right is a key part of achieving a proper diagnosis for people with a mental health condition. We should not misdiagnose young people who are suffering growing pains and need the coaching and guidance of family and friends to overcome the problems of adolescence. However, I have met too many young children who face a difficult future because their mental health condition was not treated at an early stage. Funding mental health treatment is a most important investment, not only for people’s welfare and wellbeing, but to enable these amazing young people to fulfil their hopes and dreams in their careers, and to make something of themselves and their country.

I applaud the amazing work of all of those in the British Youth Council, many of whom live in my county of East Sussex, who have done so much to produce this excellent report. Those young people are leading the charge to ensure that the nation supports all those who are affected by this terrible condition. We owe it to them, and to all young people, to deliver a better mental health service, and many of the report’s recommendations will do just that.

Baby Loss

Baroness Laing of Elderslie Excerpts

Thursday 13th October 2016 Commons Chamber

[Antoinette Sandbach]

I want to pay a huge tribute to my colleagues, particularly the hon. Member for Lewisham, Deptford (Vicky Foxcroft). I know that it is incredibly hard when we sit in this place to decide whether we want to put something that is a deeply personal piece of our lives into the public domain. Any parent who is dealing with child loss deals with the same dilemma. Do they talk to their employers? Do they talk to their friends? Do they explain what has happened?

I therefore thank the hon. Lady and all other colleagues: the hon. Member for North Ayrshire and Arran (Patricia Gibson), my hon. Friend the Member for Banbury (Victoria Prentis), the hon. Members for Washington and Sunderland West (Mrs Hodgson) and for Glasgow North (Patrick Grady), and my hon. Friends the Members for Gower (Byron Davies) and for Colchester (Will Quince). We were not aware a year ago where this path would take us. I am grateful for the fact that we are breaking the silence about child loss. We need professionals in the NHS to break the silence about child loss, too. That way, we will get real change.

I certainly will join the wave of light on Saturday. There is a series of awards called the Butterfly awards whereby people can nominate good practice in their local hospitals, or a local blogger or small charity that has made a difference in this field. I urge hon. Members to think about nominating people they know for next year. I will be there, listening to the awards. I will certainly be lighting a wave of light candle, and I know that many others will, too.

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Before I put the Question, I should like to commend everyone who has taken part in this extraordinary debate, many of whom have shown incredible courage in talking about sensitive personal issues. Those who criticise this Chamber and the way it works should pay a bit of attention to how powerful it is when it operates as a unique forum for national debate, and how effective it is when it operates at its best, as it has done this afternoon.

Question put and agreed to.

Resolved,

That this House has considered baby loss.

Hormone Pregnancy Tests

Baroness Laing of Elderslie Excerpts

Thursday 13th October 2016 Commons Chamber

[Yasmin Qureshi]

My right hon. Friend is right. It is amazing how other countries reacted to the evidence. The medical association in the UK was first alerted by Dr Isabel Gal in 1967, a paediatrician who said that her research showed that there was a link between women who had taken the drug and deformities in babies. Her letters and her research were dismissed out of hand by Dr Inman, who headed the regulatory authority. In a letter the authority referred to her in a derogatory manner as a “pathetic eastern European woman”, completely ignoring what she had to say.

We know that other information was available. For example, in February 1969 a committee received a letter from a Dr Dean of the Royal College of General Practitioners, who stated that

“Primodos should be withdrawn from use”.

However, the chief scientist of that committee, Dr Inman, refused to support that and instead wrote to the manufacturer of the drug, Schering, stating that

“the opinion expressed by Dr Dean that Primodos should be withdrawn should not be taken into account. Some women deliberately use excessive doses of Primodos with the intention of ridding themselves of an unwanted pregnancy”.

We have heard that Norway and Sweden banned the drug in 1970.

Again the Committee on Safety of Medicines took no action. Similar notices were issued in Finland, Germany, the USA, Australia, Ireland and the Netherlands, but again the committee took no action. In fact, in 1974 a letter from Schering—from PGT Bye—stated that

“after discussion with the Committee on Safety of Medicines we agreed some time ago not to recommend for the use of pregnancy diagnosis. It is not recommended for early pregnancy since the possibility of virilisation of the female foetus cannot be excluded with certainty”.

Yet still the committee issued no warning.

A further letter stated that

“side effects cannot be reliably excluded”

and that

“Primodos should no longer be recommended for the diagnosis of pregnancy.”

Again the committee said nothing. There are countless such documents. One of our concerns is that panels should have sight of those documents and be given sufficient time to read them, because they must be looked at properly and not ignored.

In 1975 the Committee on Safety of Medicines issued its first warning, stating:

“A number of studies have shown a possible association between Hormone Pregnancy Tests and an increased incidence of congenital abnormalities.”

On 15 October 1975, 41 years ago, Dr Inman wrote:

“We are defenceless in the matter of the eight-year delay”.

In November 1977, eight years after the committee had first been alerted, an adverse reaction leaflet was issued to the medical profession, stating:

“Further results have now been published and the association is confirmed.”

I want to refer briefly to some of the documents, many of which were archived in Berlin and at Kew. Marie Lyon, who chairs the victims association, has painstakingly gathered the documents, and the panel has been informed of them. I want to pay particular tribute to Marie Lyon, who has been doing a considerable amount of work over the past five years. She has spent months and months working on the documents, travelling the length and breadth of the United Kingdom and visiting Germany. She has effectively been working alone, with no support from Government bodies or local authorities. She and the victims association have been on their own. The only support they have had has been from members of the all-party parliamentary group and the Members in the Chamber today who have been fighting their cause. I also want to thank Jason Farrell of Sky News, who has been instrumental in getting some of the documents from Berlin and having them translated.

Translation of the documents is another issue, because many of those that came from Berlin are in German, as is to be expected. I want to know whether all those documents will be translated into English for the panel, because clearly it cannot carry out the inquiry if they are in a different language. We need to know whether all the documents that the victims association has gathered will be looked at and presented to the panel and, if so, in what format? When I used to prepare a large case with thousands of pages, there was a way of presenting the evidence so that the jury could understand it. Will that be done for the inquiry? If not, why not?

The reason we are asking these questions is that I have tried to contact the chair of the panel, Dr Ailsa Gebbie, and written letters to her, asking her to answer numerous questions, and, to be honest, we have not received a satisfactory answer to any of them. If anything, Marie Lyon, who has observer status on the panel, has been put under what I would call a gagging clause, which means she cannot talk about anything, because if she did she would be criminally prosecuted.

One of the things I remember from our discussion with the Minister was that the purpose of the inquiry was to have transparency and openness. We accept that there is obviously a need for a degree of confidentiality when evidence is presented, but we need to know what is going on. We need transparency, because without it, what is the purpose of this?

One thing the Minister promised was that the inquiry would have the victims at its heart. Yet, how have the victims been treated in this inquiry, which has been going for over a year now? I got a letter from one of the victims who turned up, and it is so distressing. The victims were told they could come and speak for a few minutes. Some travelled for five or six hours across the country to get to the hearing. They were promised at least 15-minute slots, but some were given three minutes or five minutes. Nobody even spoke to them properly; they were just asked to get on with it and to say what they had to say.

Fortunately, the victims who gave evidence were not subject to the gagging clause, so we were able to find out a little about what happened on the one day that seems to have been allocated for the victims. The panel heard from a few of them, but it did not ask them any questions. They were not cross-examined; they were not asked for anything—they just had three minutes. One lady said she was devastated; it had taken her five hours to drive there, and she was given three minutes. The victims said they were sitting so far from the panel, where the microphones were, that they were not even sure the panel was hearing what they had to say.

How can an inquiry that has victims at its heart not take more than a day to listen to them and, when they turn up, give them just three minutes? That is why we are having this debate. Given the way this inquiry is going, I do not think that any of the Members of Parliament who are supporting and assisting the victims have any confidence in it. As in the Hillsborough inquiry and the sexual abuse inquiry, everybody accepts that it is all about the victims; it is not about protecting regulatory bodies or the scientific community—it is about the people who have been affected.

There is another thing the Minister said. Obviously, it goes without saying that any inquiry must be independent—the panel members must be independent. When I raised that in a letter to Dr Ailsa Gebbie, the chair, she said, “Well, we got the expert panel members just to declare that they had nothing to declare.” There was no independent vetting or investigation into the background of any of these people. We have to understand this: people in the medical community, scientists and people in the pharmaceutical companies often work with each other. People have been advisers or consultants to somebody, or they have gone from the pharmaceutical companies into medicine or hospitals. There is a community of people who are linked.

We do not have the resources, but our basic research has shown that one of the panel members, Laura Yates, put on her social media that she does not think that Primodos caused any defect. How can this person be part of the panel? Then we have information about Doctor Schaefer. This man has worked with the company concerned, so he is directly linked with Schering—and he is still on the panel. That is two people, just from our basic inquiry. We want to know from the Minister whether the panel members will be properly vetted to see whether they are really independent and to find out about their connections. Again, without that, we will not have any faith in the inquiry.

We have asked the inquiry how long it will go on and how many sessions it will hold. There has been no response—nothing. We have tried to find out for well over a year, but nobody knows what on earth is going on with this inquiry. That leads to another question for the Minister. How long is the inquiry going to carry on? How many days have been set aside for it? How many hours have been spent on the inquiry to date?

In addition, how have the experts been chosen? We do not even know by what methodology they have been chosen. There are about 15 people on the panel, but does it need that many? Who are they, and how relevant is their experience to what they are looking at?

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. I am sure the hon. Lady will soon be drawing her remarks to a close, in the knowledge that many other Members wish to speak this afternoon. She has vastly exceeded the guideline length of time, but I will allow her a peroration.

[Yasmin Qureshi]

I was just coming to the end of my speech, Madam Deputy Speaker.

Lastly, we are very grateful that the inquiry has been set up, but we have genuine concerns about what is happening with it and where it is going. As has been said, at the end of the day, there is no point in having the inquiry if it does not look at the things that matter, one of which must be to provide an explanation of the regulatory failures and the cover-ups in the 1960s and 1970s.

NHS Spending

Baroness Laing of Elderslie Excerpts

Wednesday 6th July 2016 Commons Chamber

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

As somebody who was in the leave campaign, I think it is important that we remember that we worked across parties on it, whichever side we were on. In Yorkshire, I worked with colleagues from the Green party, the Labour party and UKIP, although I did not work with the SNP, obviously. It is the responsibility of both camps. I have seen “Project Fear” in both camps.

We need to move on from this now. It is pure economics. If we are pulling out of the EU, as the public have voted to do and as I am personally happy that we are doing, we must make sure that we start talking Britain up; otherwise we will talk ourselves into a recession. Members on both sides of the House need to pull together and talk Britain up. At the end of the day, both sides could have handled this better.

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. Before the hon. Member for Central Ayrshire (Dr Whitford) answers the intervention, I must remind the House that this debate is not about the EU campaign. We are talking specifically about the NHS. I understand that the hon. Lady was—perfectly reasonably—using examples, but we must not stray any further.

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[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. Before the hon. Gentleman gets into the body of his speech—I do not want to interrupt his argument—I want to thank him for the point he made and for his immediate action in removing the picture that he had tweeted. For the avoidance of doubt, it is simply not allowed, but as soon as he realised that he had done something that was not allowed, he acted immediately, and I thank him for doing so.

[Mr Reed]

That is greatly appreciated, Madam Deputy Speaker.

Despite the dedicated and incredible efforts of local NHS staff in my constituency, I see health inequalities on a daily basis, and many of my constituents experience profound access challenges to health services in my constituency and elsewhere across Cumbria, caused in part by our inadequate transport infrastructure, but also by a clearly insufficient profile of investment in local services. So far, I am afraid to say, my calls for improvement have fallen upon deaf ears.

In north and west as well as east Cumbria, we are currently subject to the ongoing success regime process. Funding for the important second phase of the West Cumberland hospital has not yet been released by the Government, and the communities I represent are gravely concerned about the uncertain future facing our local health services, including beds not just at the West Cumberland, but at our local community hospitals in Keswick, Millom, Maryport and elsewhere—and that is before we even consider the profound challenges to primary care, too.

In spite of the challenges that we face and the strength of feeling in my constituency, the Health Secretary, who is no longer in his place, has paid not one visit to the West Cumberland hospital, or any of our community hospitals on whose behalf I speak tonight, in the four years in which he has held his position. Moreover, he has refused my invitation to visit West Cumbria to see for himself the unique challenges that we face in our part of the world. Without visiting the hospital, experiencing the transport inadequacies and seeing the vital work of consultant-led accident and emergency, maternity and paediatric services that the West Cumberland hospital provides, the Health Secretary cannot and does not understand the necessity for his immediate intervention in our troubled health economy.

Most recently, owing to the fact that the Health Secretary would not come to us, my constituents and I—health campaigners from across the piece—decided to go to him. West Cumbrian health campaigners, including Mike Bulman, Mahesh Dhebar, Rachel Holliday, Siobhan Gearing and the fantastic Pamela McGowan from the News & Star newspaper, planned to make a 700 mile round trip to London to meet the Health Secretary, to outline the challenges that our health economy faces and to put our case to him. However, at short notice, but coincidentally on the day after he announced his ambition to stand as leader of the Conservative party, the Health Secretary cancelled the meeting. The decision to cancel that meeting was seen by my community as the calculated insult that I am afraid it surely was.

I led the local campaigners instead to the Department of Health to meet the gracious and approachable Under-Secretary responsible for care quality—the Minister in his place today. The delegation handed to him a confidential document containing the cases given to local campaigners by local mothers about babies who were likely to have suffered fatalities—and maternal fatalities, too—if consultant-led maternity services had been unavailable at the West Cumberland hospital in Whitehaven. The Government are well aware that consultant-led maternity services at that hospital are non-negotiable and absolutely essential—whatever the successor regime that comes forward in the immediate future. Any other option would compromise the safety of local mothers and their babies.

It is clear to me, to my community and to Simon Stevens, the chief executive of the NHS, who visited my constituency only a few months ago, that consultant-led services must be retained and improved at West Cumberland hospital. Removing those services from Whitehaven would be dangerous—

World Autism Awareness Week

Baroness Laing of Elderslie Excerpts

Thursday 28th April 2016 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. A great many people still wish to speak, so I am afraid I have to reduce the time limit to five minutes.

Contaminated Blood

Baroness Laing of Elderslie Excerpts

Tuesday 12th April 2016 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. I hope that we can get through this debate without a formal time limit on speeches. The debate is not contentious, on one side of the House or the other, so I trust that Members will be courteous to each other by keeping their speeches to around seven minutes. That will allow everyone who has indicated that they wish to contribute to do so.

NHS: Learning from Mistakes

Baroness Laing of Elderslie Excerpts

Wednesday 9th March 2016 Commons Chamber

[Heidi Alexander (Lewisham East) (Lab)]

I thank the Secretary of State for his statement. The Opposition support any measures that will improve safety in our NHS and make it more open to learning from mistakes. However, we will also provide robust opposition and scrutiny when we think that the Secretary of State’s actions are having the reverse effect.

Let me start by setting out where we support the Government. On the independent medical examiners, the Secretary of State will know that that is a reform that the Opposition have long pushed for. The previous Labour Government legislated in 2009 for the introduction of medical examiners, following the inquiry into the crimes of Harold Shipman. The call to introduce medical examiners was then repeated in the Francis report and in the report of the Morecambe Bay investigation, chaired by Dr Bill Kirkup. Indeed, last year’s Kirkup report said:

“We cannot understand why this has not already been implemented in full”.

We welcome the implementation of the medical examiners system, but it is concerning that it appears to have been delayed until April 2018. Will the Secretary of State say why progress in that area is so slow? Will he reconsider the timetable for their introduction given that April 2018 is more than two years away? Will he say more about how the reform will be funded? Local government faces further cuts over the coming years and while I understand that local authorities will be reimbursed for set-up costs, they will have to collect fees to fund the service. How will that work in practice? Is the Secretary of State confident that local government, which is already having to do more for less, will be able to take on the role of administering this process?

We also support the changes to the GMC and NMC guidance that the Health Secretary is announcing today, which will recognise the importance of an apology, but it is unclear how that is different from the guidance that came into effect last August. Indeed, the GMC first announced plans to change its guidance in this way more than a year ago, so can he say how his announcement today differs from the plans that were already in place?

On the learning from mistakes league, how will the 32 trusts that have a poor reporting culture be supported to improve? We know from listening to the testimonies of Sara Ryan, the mother of Connor Sparrowhawk, that the learning culture in some trusts just is not good enough. I know, from speaking to the small number of my constituents who have experienced failures of care, that the fight to get mistakes recognised is only part of the battle. They also want to know that the failures they have experienced will never happen to anyone else, yet all too often they are faced with a system that seems as though it simply struggles to learn.

Does the Secretary of State accept that he needs to do much more to develop a positive learning culture in our NHS? How in practical terms will he support clinicians and managers to improve services? Go to any health trust and we will find a director of finance and non-executive directors with financial expertise, but rarely will we see the same attention being paid to quality. Does the Health Secretary not agree that every trust board needs someone whose focus is not short-term firefighting, but co-ordinating and bringing together staff to drive improvements in quality?

I will always support sensible steps to improve safety and transparency in the delivery of health services, but what I cannot do is stand here today and pretend that other actions taken by this Government will not have a detrimental effect on patient care. The Health Secretary’s kamikaze approach to the junior doctor contract means that no matter how the dispute ends, he will have lost the good will of staff, on which the NHS survives. How can he stand here and talk about patient safety when it is him and him alone who is to blame for the current industrial action, for the destruction of staff morale and for the potential exodus of junior doctors to the southern hemisphere? [Interruption.]

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order.

[Heidi Alexander]

Thank you, Madam Deputy Speaker. I ask the Health Secretary: how can he stand here and say that he wants the NHS to deliver the highest-quality care in the world when the people he depends upon to deliver that care for patients have said, “Enough is enough”? How can he talk about patient safety when he knows that his £22 billion-worth of so-called “efficiency savings” in the next four years will lead to job cuts and will heap more pressure upon a service that is about to break?

I know the Health Secretary has been shy about visiting the NHS front line in the past few months, but if we speak to anyone who has any contact with the NHS, the message we will hear is clear: the financial crisis facing the NHS is putting patient care at risk. The independent King’s Fund recently said:

“Three years on from Robert Francis’s report into Mid Staffs, which emphasises that safe staffing was the key to maintaining quality of care, the financial meltdown in the NHS now means that the policy is being abandoned”.

That is simply not good enough. For those people who have experienced failures of care and for those staff working in environments so pressurised that they fear for the quality of care they are able to deliver, the Health Secretary needs to get his head out of the sand. I say this to him: measures to investigate and identify harm are all well and good but there needs to be action to prevent harm from happening in the first place—fund the NHS adequately, staff it properly and you might just give it a fighting chance.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. Before the Secretary of State answers that important question, I remind the House that we have a lot of business to get through today. Shorter questions and correspondingly shorter answers would be welcomed by those who are waiting to take part in other debates.

[Mr Hunt]

As ever, I commend the right hon Gentleman’s interest in mental health. May I reassure him that this is very much about what happens in mental health and also the area of learning disabilities? In fact, some of the thoughts were prompted by what happened at Southern Health. It is absolutely vital that we investigate unexpected deaths in mental health as much as we do in physical health. The measures we take will go across those areas, and I am more than happy to meet him to discuss the very laudable aim of zero suicides.

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[Maria Caulfield (Lewes) (Con)]

I congratulate the Secretary of State on his statement this afternoon, and welcome the culture change that he is introducing to the NHS. My experience of working in the NHS under a number of Governments over the past 20 years was that when mistakes happened, a scapegoat was identified and it was thought that the problem had been dealt with. That is why people were reluctant to report problems, but often it is not one individual but a system of failure. We need to learn from that, so I welcome the Secretary of State’s comments. Relatives and patients have said to me that they do not want just to identify the problem; they want to ensure that it never happens again, which is exactly what my right hon. Friend said. I chaired a primary care seminar this morning with GPs, doctors, nurses and pharmacists—

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. I am sure that the hon. Lady will quickly come to her question, or we will run out of time.

[Maria Caulfield]

Thank you, Madam Deputy Speaker. People are fed up with the NHS being talked down by Labour Members, and there was a plea to showcase the good work that is taking place in our NHS today.

[Paula Sherriff (Dewsbury) (Lab)]

Last week I received an email that was frankly heartbreaking. My constituent’s 84-year-old father, a proud and dignified man, was admitted to hospital with symptoms of a stroke, and he had to wait 14 hours for a bed. She went to visit him later that day and found him in bed wearing clothes on only his top half. He needed the toilet, and she was given a bottle to help him urinate.

[Madam Deputy Speaker]

Order. I am sure that the hon. Lady will quickly come to her question.

[Paula Sherriff]

That was no dignified way to treat that man. Will the Secretary of State agree to an urgent investigation into safe staffing levels at Mid Yorkshire Hospitals NHS Trust, because the nursing staff told my constituent that they did not have time to fulfil her father’s basic nursing needs?

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[Mr Hunt]

My hon. Friend is absolutely right. I thank him for his work in this area. Maternity—stillbirths, neonatal deaths, neonatal injuries and maternal deaths—is the area where I hope we make the most rapid early progress in developing this new learning culture. There is so much to be gained. We can be the best in the world, but the truth is that we are a long way down international league tables in this area. None of us want that for the NHS. There is a real commitment to turn that around and I thank him for his support.

[Madam Deputy Speaker (Mrs Eleanor Laing)]

The prize for perseverance and patience goes to Mr Mark Spencer.

[Mark Spencer (Sherwood) (Con)]

I am grateful, Madam Deputy Speaker, even if my knees are not.

I congratulate the Secretary of State on providing a protected space for doctors, so they will be able to be honest and upfront when things go wrong, and on striking the right balance so that relatives and people who suffer wrongs in the NHS get to the bottom of what went wrong, why it went wrong and why it will not happen again.

NHS and Social Care Commission

Baroness Laing of Elderslie Excerpts

Thursday 28th January 2016 Commons Chamber

[Norman Lamb]

I am conscious that you may start to get slightly irritated with me, Madam Deputy Speaker —

[Madam Deputy Speaker (Mrs Eleanor Laing)]

On a point of clarification, the right hon. Gentleman is doing just fine on timing. I appreciate that he has taken a lot of interventions, and people who intervene know that, later in the debate, their speeches will be shorter as a result of their interventions. He is doing nothing wrong, and he may proceed.

[Norman Lamb]

I am relieved. I sensed that I might be getting into trouble. I will give way to the hon. Gentleman.

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[Chris Davies]

May I say what respect around the House we have for you as Chair of the Health Committee? I would therefore be very interested to hear your view of the “Five Year Forward View”—

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. I let the hon. Gentleman get away with it earlier, because I appreciate that he has not been in the House for very long, but when he uses the word “you”, he is addressing not the hon. Lady, but the Chair. I know he means his compliments not for the Chair, but for the hon. Lady, so he must refer to her as such.

[Chris Davies]

I apologise profusely, Madam Deputy Speaker. We of course have great respect for you, too.

The “Five Year Forward View” plan is already under way, led by the former Labour adviser Simon Stevens. It is looking at reforming heath and care services, and is backed by the funding that the NHS has already said it requires. Does my hon. Friend feel that setting up yet another body would benefit the NHS, or would it be a hindrance?

NHS (Charitable Trusts Etc) Bill

Baroness Laing of Elderslie Excerpts

Friday 22nd January 2016 Commons Chamber

[Wendy Morton]

Does my hon. Friend not agree, though, that funds donated to the NHS and put into these charities must be held separately from Exchequer funding provided by the taxpayer? Charities exist to support their beneficiaries, and there is a special relationship between the charities and the—

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. I am trying to be helpful to the hon. Lady in saying that I know it is a great temptation to address her remarks to the hon. Gentleman and look at him to gauge his reaction—looking at him is always, of course, a very great pleasure—but if she turns her back on the rest of the House, it does not work. It is really important that she should face the Chair. She can still speak about the hon. Gentleman and imagine him in her mind as she does so.

[Wendy Morton]

Thank you, Madam Deputy Speaker. It is wonderful just to be able to imagine my hon. Friend in my mind. I have finished my intervention, but I am grateful for your advice and reminder.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. I did not want to interrupt the excellent flow of the hon. Gentleman’s argument, but, for the sake of clarity and the avoidance of doubt, and because he referred to the numbering and order of amendments—he has not said anything wrong; I wish merely to educate the House—I wish to explain that the order in which amendments are numbered is that in which they are received in the Public Bill Office, but the order in which they appear on the amendment paper is that in which they relate to the Bill. It is actually very logical, but if one does not know why, it sometimes is not obvious.

[Wendy Morton]

As the Bill’s promoter, I rise to contribute to its Report stage.

We have listened to some interesting amendments from hon. Members, for whose submissions and contributions I am grateful, as they have enabled us to discuss, probe and question the Bill further, which is really important. It is worth reminding ourselves that, as of March 2015, there were about 206 NHS charities, with a combined income of £327 million. They do a terrific job and make a huge contribution to many patients, hospitals and NHS staff. Everyone will agree that the vast majority of them, like all charities, do fantastic work and that only occasionally does something go wrong. Sadly when it does, as has been said today, it always makes the headlines.

The vast majority of NHS charities use the corporate trustee model, whereby the Secretary of State does not appoint the trustees.