Health and Social Care (Re-committed) Bill

Guy Opperman Excerpts

Wednesday 7th September 2011 Commons Chamber

[Guy Opperman (Hexham) (Con)]

I wish to start by making it clear that I am a big supporter of the NHS. I probably should declare an interest, because I have spent too much of the past six months discovering it from the inside. As is commonly known, I had a brain tumour in April, which was removed by the national hospital for neurology and neurosurgery in Queen square, where I received outstanding care and treatment from the doctors and nurses.

That was not the first time that I had had my life saved by the NHS. Although my girth would deceive hon. Members, I used to be a jockey, and when I was trying to win a race at Stratford, the second last fence proved too much for the horse and me, we turned over and on my left hand side I was entirely crushed by a steeplechaser. I broke about 11 bones and cut my left kidney in half. I had a splenectomy and a very good doctor at Warwick hospital saved my life. I also wish to make the point that I have an NHS background: my grandmother was a matron in a district hospital, and we have spent an awful lot of time in the Hexham constituency supporting the Hexham hospital and the Freeman hospital, in particular.

I support the Bill, and I wish to touch on a couple of the points that have been raised. For a time I earned a living as a barrister, reviewing health care bodies and public bodies of a general nature. I hope that that qualifies me to discuss competition law briefly. If hon. Members were to read, as I have had to over the past few months, some of the representations that have been made about competition, they would believe that it is a new evil being introduced into the NHS. However, that is manifestly wrong, as the Enterprise Act 2002 and the Competition Act 1998 were introduced under the previous Government and have been operating in the health service for a considerable time. I see some hon. Members shaking their heads, but the argument supported by the shadow Minister cites that exact point: in the form of a variety of institutions and undertakings, the UK health service is subject to competition law under the 2002 Act, the 1998 Act and European community laws on competition. This is therefore not a new thing, nor should it be, because it was introduced by the previous Government and large parts of the Bill follow on from what was done previously.

I shall touch briefly on procurement, because the issue has been raised in this House. It is not a new thing for procurement matters to be challenged or to be subject to judicial process. Judicial process itself is not a bad thing. I have heard people say countless times in these past two days of debate, “This is going to be a den of iniquity for lawyers. It will be so bad that there will be lawyers all over this case. It will be really difficult for people to proceed with the health system.” I brought a case against a primary care trust in 2005, 2006 and 2007, with a view to trying to change the law and the way in which that PCT was operating. Before anyone jumps up to discuss that approach, I am pleased to say, first, that we changed the law to assist the patients, secondly, that the whole case was conducted entirely pro bono—for free—and thirdly, that two separate Labour Attorney-Generals gave me national awards to support my efforts. I do not expect that to happen again in a hurry. The point is that if we operate the process correctly—I shall talk about the process briefly in a second—we, and the commissioning consortia, will not be the subject of legal challenge.

That will always be the case with any public body: if it operates in a statutory and well-authorised way and provides the degree of consultation that it should, it is not open to challenge. It is not myself or the Government who would decide that, but a High Court judge considering a matter of judicial review. But if the public body—in the form of the NHS or the commissioning consortia—does not act properly, behaves beyond its powers or breaches natural justice in any way, it should and will be open to judicial review and other legal process. That is entirely proper.

I therefore do not believe that this will be a process through which huge numbers of judicial reviews will arise, as new issues for the NHS. I do not think that that will be the case at this stage. The hon. Member for Pontypridd (Owen Smith) talked at great length about the commissioned barrister’s opinion and 38 Degrees, but that barrister’s opinion makes the simple point:

“The Bill does nothing to make the system more amenable to challenge in the courts”.

Let me finish my points about competition and the duty to provide. I suggest that there is no fundamental change whatsoever. That is also the suggestion that the individual counsel made clear. I make the point that he is a junior counsel, not a Queen’s counsel, and there is no disclosure of instructions, the conference notes or any of the other things that would be vital to an understanding of the opinion. It has been wholly misrepresented by 38 Degrees, and there is no change—

[Owen Smith]

rose—

[Guy Opperman]

I am sorry, but I am going to keep going. The hon. Gentleman had about an hour to talk, and there are an awful lot of people who would like to talk about these matters.

I suggest that there is no fundamental change, and this is clearly a way forward that is being implemented for the benefit of patients. We are concerned with patient care and the quality of outcomes. I as a patient, like many other people in this House, am not concerned with the quality of outcomes other than to ask, “Is it a good outcome?” That is the important thing, and to suggest that private provision of the outcome and of the service provided is fundamentally bad is simply wrong. Such provision was introduced and brought in by the previous Government, and it assisted the public provision. The two can work together, and that is a good thing. I shall support the Bill, and I make this point to finish: the NHS is clearly a wonderful institution that all in the House cherish and support, and this is a Bill that supports it.

[Valerie Vaz (Walsall South) (Lab)]

It is always a pleasure to follow the hon. Member for Hexham (Guy Opperman), and it is good to see him sitting in his place. I welcome him back to the House and commend him on his great recovery. He is actually looking better than before, if I may say so.

Let me take up one point that the hon. Gentleman made. As a barrister, he will want people to go to litigation, but as a solicitor I mostly counsel people not to. It is the most terrible, prolonged and costly event—but I appreciate that he wants litigation, because that is his bread and butter.

As for the legal advice, I asked on a number of occasions for the legal advice that the Department had and it was refused on all those occasions. The hon. Gentleman can talk about 38 Degrees, but thankfully that organisation is interested in the public and knows that they need the legal advice that was not provided, even though it was paid for with taxpayers’ money. I challenge the Secretary of State to lay it in the House of Commons Library, if the other advice is so hurtful to him. What is the problem? His Bill is being discussed and there is nothing to hide. I say that he should place his legal advice in the Library.

I am a Member of the Select Committee on Health and Sir David Nicholson, the new chief executive of the NHS commissioning board, appeared before us when I was first elected. He was then on the verge of retirement—

Health

Guy Opperman Excerpts

Tuesday 21st December 2010 Commons Chamber

[Dr Thérèse Coffey (Suffolk Coastal) (Con)]

It is a great privilege to speak in this pre-Christmas debate. I have already exchanged seasonal greetings with your good self, Mr Speaker, and other colleagues.

I rise to speak about the integrated drug treatment system, which is the drug treatment system for people in prison. The issue came to my attention when I visited my local prison, Hollesley Bay. I do not want to get into the rights and wrongs of drugs today; that issue has been debated in Westminster Hall. I am more concerned about value for money and the diversion of funds from primary care trusts to the continuation of prisoners taking heroin substitutes, at the taxpayer’s expense.

In a recent Question Time, the Lord Chancellor and Secretary of State for Justice spoke of how important it is to get prisoners off drugs and to remove drugs from our prison estate. I fully endorse that view. Everybody was depressed in the mid-’90s when a judge ruled that it was against somebody’s human rights not to be allowed drugs when in prison. A number of hon. Members, including you, Mr Speaker, have raised questions on this topic. This is yet another example, dare I say it, of a conflict between the judiciary and the common sense of the general public.

The cost of the IDTS to the taxpayer for the last three years has been £23.8 million, £39.7 million and £44.4 million. I am sure that my local residents would love an increase in health spending of such an amount. Such funding for the three prisons in the Suffolk district area and the one in the Great Yarmouth borough and Waveney district area has risen from £400,000 to £555,000. In Hollesley Bay prison in my constituency, £190,000 is allocated to just one prisoner. It is astonishing that under this system, one prisoner can continue to have a heroin substitute every day, at the expense to other people of just less than £200,000. The figures show no sign of decreasing.

[Guy Opperman (Hexham) (Con)]

Does my hon. Friend agree that it cannot be right that we have inherited a system under which approximately 300 of the 1,000 prisoners in my major local prison of Durham are on methadone? The reality is that either we give them drugs on a prescribed basis, or they will obtain drugs illegally. What does she think we should do about that?

--- Later in debate ---

[Chi Onwurah (Newcastle upon Tyne Central) (Lab)]

A merry Christmas to you, Mr Speaker, and to the House.

I was born in Wallsend in the 1960s, and my mother was born in Newcastle in the ’20s. What we had in common, which we share with any child of the north, was the impact of geography on our life chances. A child born in Newcastle today is expected to die five years before one born in South Cambridgeshire, the constituency of the Secretary of State for Health.

Of my mother’s six brothers and sisters, only one survived into adulthood. We have certainly made great strides since those dark days, but health is still a critical political, social and personal issue. Newcastle has world-beating hospitals—the Royal Victoria infirmary, the Freeman and the General hospital. We also have the Campus for Ageing and Vitality, the Centre for Life, the Great North children’s hospital and the Northern Institute for Cancer Research, but what we do not have is health equality.

The people of Newcastle are more likely to die early from cancer, heart disease or stroke. We tend to die younger, are more obese as children, and are more likely to die from the cold as pensioners. We suffer more from the diseases of our industrial legacy, such as asbestosis, and we are more likely to be born into poverty, experience mental illness and commit suicide. One in 25 adults in Newcastle claims incapacity benefit for mental illness, four times the rate in the constituency of the Secretary of State for Education.

I will be frank and say that I do not believe the last Government did enough to tackle the issue of mental health. It is the responsibility not only of health care providers but of social services, educators, the police and prison officers. The lack of co-ordination and support was tragically highlighted by the case of Raoul Moat earlier this year.

As a Newcastle MP, I consider my primary duty to be to work for the health and well-being of my constituents, so the existing inequalities concern me and I am worried that they will widen under the current Government. I hope that the Minister can offer me some reassurance. The previous Government doubled health funding in real terms, reduced waiting times and improved health outcomes. Deaths from heart disease and stroke went down by 40%. They also worked hard to tackle poverty and its associated evils, such as poor housing, low aspiration and unemployment, which all have an impact on health.

Improvements in those areas benefited the mental and physical health and well-being of all our constituents, but in Newcastle, inequalities have been maintained or even increased. In 1998, early death rates from heart disease and stroke were 19% higher in Newcastle than the national average. In 2007, they were 26% above a much reduced national average.

The last Government prioritised tackling health inequalities in 2006—too late, certainly, but as a result the North East strategic health authority, primary care trusts and hospitals are all working to address the problem. However, that is all set to change. The Government’s reforms to the NHS are estimated to cost £3 billion, without counting the cost of disruption and the loss of skills. Our strategic health authority and primary care trust are being abolished and funding will be in the hands of GP consortiums, of which Newcastle will host one of the first. The Government do not like targets, but will the Minister confirm that she expects the key measures of health inequality to reduce as a consequence of those changes? Will she also confirm that Newcastle will not have to pay anything for those reforms from its health allocation?

The Secretary of State recently wrote to me to say that the 2011-12 allocation for Newcastle represented a growth of 2.8%, including a change to the funding formula. Despite written questions, however, I have been unable to clarify how the changes will address health inequalities. The Government’s changes to formulas have tended to work against us in the north-east, so will the Minister confirm that more will be invested in health services for every man, woman and child in Newcastle in every year of the comprehensive spending review period?

[Guy Opperman]

Does the hon. Lady agree that the health service in Newcastle now covers not just her constituents in Newcastle but mine in Hexham, both because they are run by the same trusts and because the services are now so interdependent?

[Chi Onwurah]

The hon. Gentleman is absolutely right. Health services in Newcastle are accessed by a wide range of people from across the north-east.

Finally, the Minister will know that health depends on many factors. The Government’s wide-ranging cuts will have a negative impact on people’s health, especially the health of the most deprived. Cuts to fuel poverty reduction programmes such as Warm Front will leave pensioners in Newcastle cold, and therefore more vulnerable to illness. Cuts to area-based grants such as Supporting People mean that there will be less investment in support services for those with mental health problems, and cuts to the working neighbourhood fund mean that my constituents will have less help to get back into work, with all the health advantages that work brings.

I shall give the Minister a specific example. In Newcastle, about £10 million a year goes to charities to help deliver services for the vulnerable. The Government’s cuts mean that that figure will go down by 75%, which will have many consequences. One charity to which I have spoken estimates that it will have to close hostels, leading to the number of rough sleepers in the city rising by up to 500%. Rough sleeping obviously has terrible consequences for the health of the individual concerned, but Newcastle as a whole will also pay the cost. The police, health services, social services and the third sector will all have to focus more resources on those sleeping in the streets, reducing the help available to others—help that supports the health of the city.

There are many similar examples. Will the Minister assure me that she has assessed the impact of the cuts on Newcastle in the broadest sense, and that she is confident that the health inequalities between Newcastle and the rest of the country will be reduced over the term of this Government?

Hospital Services (North-East)

Guy Opperman Excerpts

Tuesday 27th July 2010 Westminster Hall

[Guy Opperman (Hexham) (Con)]

I thank the hon. Member for Hartlepool (Mr Wright) for allowing me to speak in this debate. I accept and acknowledge that fundamentally he secured the debate to raise issues in relation to the role of hospitals in Hartlepool. However, as it is a debate on hospital services in the north-east and as I am the Member of Parliament for the largest constituency in the north-east and have responsibility for many rural areas that cover well over 1,000 square miles, I want to lay down a few markers in relation to the hospital services in my area.

The Government are engaged in a widespread review of everything from care to hospital facilities, but rural areas—I know that I speak for other Members who represent rural areas—have to be treated and reviewed in a slightly different way. In my constituency, I have a wonderful hospital, which was opened as a general hospital by the former Prime Minister Tony Blair, and which has been consistently downgraded over the past few years. That is a source of great upset to the people of Hexham. The hon. Member for Wansbeck (Ian Lavery) and others will know of the issues relating to the proposed Cramlington hospital, which is still in the pipeline. I have been told by health officials in the local primary care trust and the strategic health authority that there is no difficulty with the hospital going ahead because the funding is assured. Although health has not been as affected as other areas, will the Minister none the less reassure me that the hospital has survived the funding reviews?

In dealing with rural services, let me turn to the issue of the rebuilding of Haltwhistle hospital. Again, it takes the best part of an hour and a half to get there from Newcastle and the various hospitals there. There have been significant difficulties relating to the hospital, not least the fact that people have been waiting for the hospital to be rebuilt for well over 10 years and that has not yet happened. I sincerely hope that those matters will be reviewed. Will the Minister write to me over the next month with some assurances about the way forward?

I have two final points to make. I know that others wish to speak in this debate. The hon. Member for Wansbeck knows of my concerns because they have come up in discussions between ourselves. The issue of care and how it is provided in Northumberland and, I suspect, throughout the north-east has been a nightmare of bureaucracy and difficulty. Tremendous attention to detail is required to improve the situation. Regrettably, at present, care is provided by a multitude of providers, and the budgets are split and differentiated between individual providers and individual utilisers. I accept that a commission has been set up to review care, but it must consider how provision is made, particularly in rural areas such as ours. I blame no particular Government for the problem because it has developed over a period of time, but this is an area that clearly needs review.

Let me finish on an issue that relates to the way in which we review the provision of health care. We need to ensure that the healthy choice is the easy choice. My constituent, Dr Steven Ford, who ran against me as an independent candidate in the recent general election, said that we must be living in a very odd world when, in the middle of an obesity epidemic, the European Union cuts the price of sugar by more than one third. Therefore, we are trying to address the problem of obesity at the same time as we are cutting the sugar price. It seems to me that we would benefit greatly if we addressed that issue in future.

I am grateful for having the opportunity to speak in this debate. I do not need any specific replies from the Minister today, but I hope that he will write to me in due course about the points that I have raised.

--- Later in debate ---

[Phil Wilson]

That is absolutely right. Over the past 13 years, the number of apprenticeships in the region has gone up astronomically. In 1997, in my constituency, there were fewer than 30 apprenticeships, but there are more than 700 today. Obviously, anything that curtails the growth of apprenticeships in the future should be frowned on.

As far as other jobs are concerned, the hospital would be a catalyst for inward investment and private sector investment. Wynyard Park Ltd worked closely with the hospital, local universities and further education colleges because it realised that high-value medical and other research jobs would come to the area. The company estimated that 12,500 jobs would be created on top of the 3,000 jobs that the hospital would create. There would be 12,500 private sector jobs in the area on the back of the hospital development—just think of the Government’s income tax and national insurance take and all the other benefits that they would pick up on the basis of that growth in the local economy. Public sector investment would kick-start growth in the private sector.

The hospital would also have become an anchor tenant—a tenant that attracted a lot of other investment to Wynyard. In addition, it would have brought greater investment in infrastructure: the roads and transport networks would have improved, which would have brought more businesses to the park. This is not just about the hospital, as great as that would be. My family and I have used the North Tees and Hartlepool hospitals, and they are great hospitals, but it is time to replace them and to have a new hospital. The credible case put by the new hospital’s designers was that the development would be not only a hospital, but a catalyst for growth in the private sector economy in the south Durham and Tees valley area. That case has been completely ignored.

I really get annoyed when people try to say that the project was worked out on the back of a fag packet a few weeks before the general election. I have been attending meetings on the issue since I was elected in 2007, and meetings were going on before then. We need the development to happen.

The Government’s proposals prove what the Prime Minister said during the election campaign when he pointed out that the north-east would feel the brunt of the cuts. He was right to say that we rely too much on public sector jobs, so the Government should give us the opportunity to change that, but that opportunity was taken away from us when the hospital programme was cancelled.

[Guy Opperman]

The hon. Gentleman asserts that the area should be given the opportunity to address the lack of private sector jobs, but that that would not be done by spending more public sector money. We cannot address the deficit on every single occasion by creating private sector jobs through public sector spending, which is surely the basis of the hon. Gentleman’s hospital argument.

[Phil Wilson]

We are not saying that we should do that at every opportunity, but when we spend public money, we should take the opportunity to ensure that it pump-primes the local economy. That is what the Wynyard scheme was bound to do. Perhaps the hon. Gentleman does not think that the public sector is of any value, but Opposition Members do.

[Guy Opperman]

Will the hon. Gentleman give way?

[Phil Wilson]

No, several other Members want to get in on the debate.

Figures have been bandied about, such as the £5 billion and the £11,000 difference, which was actually £11 million—the Minister corrected that error, and I noticed it, too, and went up to correct it. That £11 million, over 35 years, means the difference between a new hospital and a hospital that is falling down. Surely we could have found that money somewhere to help to maintain the hospital.

I want to end with a question to the Minister. Three or four weeks ago, we brought down the foundation trust’s chief executive and the chair for a meeting, and I was pleased that the Minister could meet us. I took away from that meeting the view that the Department would look again at the development if the trust could come up with a credible scheme or initiative to get money from the private sector. If all the figures stacked up, would the Department underwrite such a proposal? We are talking about a foundation hospital. Are we saying that foundation hospitals will be around for ever? Things might change—Governments might change, policy might change—but the hospital must still be funded. Are the Government prepared to underwrite any financial arrangements with the banks and the private sector?

On that point, I will sit down and listen to what other Members have to say. The proposed hospital is a missed opportunity for growth in not only the public sector but the private sector in the region.

Minor Injuries Services (Devizes)

Guy Opperman Excerpts

Tuesday 13th July 2010 Westminster Hall

[The Minister of State, Department of Health (Mr Simon Burns)]

I congratulate my hon. Friend the Member for Devizes (Claire Perry) on securing this important debate. I know that local health services are a top priority for her and that she campaigned vigorously before coming to the House, and has done so since, as we have heard today, on behalf of her constituents to ensure that she obtains the best health care provision for the people she so ably represents. I admire her dedication and determination in fighting that battle for her constituents. I pay tribute to the NHS staff in Devizes and throughout Wiltshire for the excellent care and dedication that they provide day in, day out when looking after my hon. Friend’s constituents and those of other hon. Members in the county.

My hon. Friend is aware that my right hon. Friend the Secretary of State has launched our White Paper on liberating the national health service. It is our vision for freeing the NHS from the shackles of politicians and bureaucrats in Whitehall, giving power to people locally, and working with clinicians and general practitioners to provide those services that local communities in Devizes, Wiltshire and the country need. It is a vision for making the NHS more accountable to patients, whether my hon. Friend’s constituents in Devizes or people elsewhere. We want to free staff from excessive bureaucracy and top-down control. We want patients to be at the heart of everything that the NHS does and we want local people to have more choice and control than they have ever had and a greater say in their treatment, their needs and their health requirements. People in Devizes and the other small towns and villages that my hon. Friend mentioned will be in charge of making decisions about their care and provision of health requirements.

My hon. Friend has outlined the strength of feeling in her constituency for local minor injury services, and the support for the NHS generally. The minor injury units for Devizes and Marlborough at Savernake community hospital closed in September 2007, and my hon. Friend and her constituents were, understandably, disappointed at the decision, and have been frustrated by the difficulties and delays that have resulted from it. I am aware that people living in different parts of her constituency access different minor injury units, including those at the community hospitals at Trowbridge, Chippenham, Andover and Newbury, and that minor injury treatment continues to be available at the A and E departments in the acute hospitals in Salisbury, Bath and Swindon. As my hon. Friend rightly said, transport access causes problems for some of her constituents. I have considerable sympathy with the points she made about that.

I am also aware that my hon. Friend’s constituency covers a large rural area. She gave some interesting figures and comparisons with other rural constituencies when making her point so powerfully. I understand her desire for local minor injury units that are accessible as quickly as possible to her constituents. But I must be frank with her. Given where we are at the moment and the processes that have taken place in her county and constituency on reconfiguration of services, I am unable to ask the NHS to open previously conceded processes, or to halt those that have passed the point of no return. I know that that will disappoint my hon. Friend, but I am afraid that at the moment we are where we are because of previous decisions and the degree to which they are in process.

My hon. Friend asked what could be done, and whether pilot schemes could be introduced as a forerunner to the abolition of PCTs in 2013, and she suggested other ways of working with outside interests. I want to give her as clear a steer as possible, and unfortunately, until the PCTs are closed and cease to exist in 2013, due processes and proper procedures must be adopted to move forward. Until they are phased out from 2013, the PCTs will continue to have the same responsibilities that they have now for the provision and commissioning of health care in the areas for which they are responsible, including Wiltshire.

[Guy Opperman (Hexham) (Con)]

I pay tribute to my hon. Friend the Member for Devizes (Claire Perry) for carrying on the work that we have all been doing for a considerable period on hospitals in Wiltshire. I spent three years of my life trying to keep them open. The Minister is saying that in reality, whatever the situation, despite the Health Secretary saying in 2007 that clinical need should justify closure, despite this being fundamentally an accounting measure, and despite decisions apparently not being reviewed before 2013, people are desperate for a hospital to reopen that is pre-existing, prepaid and sitting there—

[Mr Gary Streeter (in the Chair)]

Order. I remind the hon. Gentleman that interventions should be brief.

[Guy Opperman]

It is a long question. I apologise, Mr Streeter, but the hospital is still there, and capable of being used. With the greatest respect, I fail to see why it is not being used.

[Mr Burns]

I am grateful for my hon. Friend’s intervention and I fully appreciate his frustration at the situation. I also appreciate the greater frustration of my hon. Friend the Member for Devizes, because her constituency is directly affected by the issue that we are discussing. I repeat: we are where we are. We have a vision of a health service that works from the bottom up rather than the top down. However, until the changes occur, we are in a straitjacket because of procedures currently in place that have to be adopted.

Before the intervention by my hon. Friend the Member for Hexham (Guy Opperman), I was responding to the question from my hon. Friend the Member for Devizes about the way forward. I hope to give her a glimmer of hope and I will give her some advice about how I see the situation, both as a constituency MP and as a Minister. As long as we are in what is effectively an interim period since the publication of yesterday’s White Paper, with the PCTs still commissioning services and having the lead role, I advise her to continue her spirited and dedicated campaign to get what she seeks for her constituents. She should continue seeking to persuade the PCT, local clinicians, GPs and the local community to stay onside in the desire to establish a minor injuries unit, and ensure that the other care services she mentioned are instigated for her constituents. At the moment, that route is the only way forward because the PCTs are the commissioning agents.

I urge my hon. Friend to continue her campaign in the hope that during the interim period over the next three years, she will see a change of heart if that is possible. If it is not possible, when the changes come in, she should use the new system to seek to persuade those in charge of reconfigurations and the provision of services to reinstate the services that she so passionately and rightly believes are needed and deserved by her constituents. That is my advice. It may not be as palatable as she would hope, but I know that she will appreciate and understand that under current circumstances, we have not yet changed the system. That vision was announced yesterday and it is a vision for the future.