Oral Answers to Questions Debate
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Jeremy Hunt
Main Page: Jeremy Hunt (Conservative - South West Surrey)Department Debates - View all Jeremy Hunt's debates with the Department of Health and Social Care
(10 years, 9 months ago)
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Valerie Vaz (Walsall South) (Lab)
4. What plans he has to implement the recommendation of the Francis report on safe staffing levels.
The Secretary of State for Health (Mr Jeremy Hunt)
We agree with Robert Francis that there is a need for evidence-based guidance and tools to inform appropriate staffing levels. We have set out a number of recommended actions to support appropriate staffing levels in “Compassion in Practice”—the nursing, midwifery and care staff vision and strategy for England.
Valerie Vaz
I thank the Secretary of State for his answer, but Robert Francis said in his report that minimum safe staffing levels lead to helping patient safety. If the Secretary of State agrees with Robert Francis, why does he not implement that recommendation now?
Mr Hunt
I do agree with Robert Francis, but as he said in Nursing Times, there is an apparent misunderstanding by many people about what his recommendations actually were. This is what he said:
“I did not recommend there should be a national minimum staffing standard for nursing. The government was criticised for not implementing one, which it is said I recommended, which I didn’t.”
Andrew Percy (Brigg and Goole) (Con)
As someone who worked in the public services before my election here, I well understand the pressure put on public servants to cover up bad news. I was contacted by a nurse yesterday who informed me that concerns that were raised at a training day were dismissed by a matron—people were told to put them in the bin. Can the Secretary of State assure us that he will do everything to ensure that nurses who are concerned about staffing levels feel free to speak out and will be protected?
Mr Hunt
What my hon. Friend says is incredibly important. We must have a culture of openness and transparency inside the NHS, which means that people at the front line feel empowered to speak up if they think there is a problem. That has not happened in the past, and we are going to put it right.
Andy Burnham (Leigh) (Lab)
The Secretary of State will make a statement shortly about the Keogh review. Two of the hospitals investigated are Basildon and Tameside. The previous Government left a warning in place on both trusts about patient safety. This Government have ignored those warnings and allowed both trusts to make severe cuts to front-line staff. Tameside has cut 128 nursing posts and Basildon an unbelievable 345. Given the warnings he inherited, why on earth has he allowed that to happen?
Mr Hunt
I am very surprised that the right hon. Gentleman wants to mention what happened at Tameside. Tameside had high death rates for eight years under Labour. The previous Government ignored a whistleblower in 2005, warnings to Parliament in 2006, a coroner’s report in 2006 and warnings from my predecessor in 2009. To cap it all, in 2009 the hospital was given a “good” rating by the Care Quality Commission. How bad is that?
Andy Burnham
I am afraid the Secretary of State is simply wrong. At the instigation of my hon. Friend the Member for Denton and Reddish (Andrew Gwynne), I ordered unannounced inspections into Tameside. The Secretary of State should get his facts straight before he comes to this Dispatch Box. He did not answer on staffing, and it gets worse, Mr Speaker. Seven of the 14 hospitals in the Keogh review have between them cut a shocking 1,117 nursing jobs on this Government’s watch. Unsurprisingly, A and E performance has plummeted at all seven. All 14 hospitals were meeting the A and E target in my time in office; none of them are meeting it under the Secretary of State. Is not the right response to the Keogh review to stop dithering and act now on safe staffing levels?
Mr Hunt
I am surprised that the right hon. Gentleman wants to talk about the Keogh review before we have made our statement. I am particularly surprised because the Keogh review is the review that Labour never wanted to have, with high death rates in all those hospitals stretching back to 2005 and a record of inaction by Labour. As former—[Interruption.] I think the House might be interested to hear this. as former Labour councillor and Mid Staffs campaigner Ken Lownds said today:
“Can you imagine a Keogh review under Andy Burnham or any Labour Health Secretary? Not a chance.”
Jason McCartney (Colne Valley) (Con)
5. Whether the new review of children’s heart surgery units will cover adult as well as paediatric cardiac surgery.
Siobhain McDonagh (Mitcham and Morden) (Lab)
9. What assessment he has made of the roll-out of the NHS 111 telephone service.
The Secretary of State for Health (Mr Jeremy Hunt)
NHS 111 is now available in more than 90% of England. Despite some problems with the sites where it was launched around Easter, performance has now stabilised significantly. NHS 111 is now the principal entry route for access to the urgent care system, and nearly 600,000 patients accessed the service in May.
Siobhain McDonagh
Let me take the opportunity to make a confession to the House. Six weeks ago on Friday, I rang 111 as I watched one of my best friends vomit. She had been vomiting for 10 days, had been to see her GP four times, and had telephoned 111 on two occasions, on each of which she was told to go away and take antibiotics.
I did what no Member of Parliament wants to do. I said to the operator, “I am an MP, and I will take this up in the House if you do not deal with it properly.” Forty minutes later an ambulance arrived, and my friend was saved from a massive heart attack. What happens to people who have no one to speak for them, and no one who can say “I am an MP”?
Mr Hunt
The hon. Lady makes a very important point and I do not want to defend that service in the instance she cited at all. It is completely unacceptable if that kind of thing has to happen. The principle of 111—which is for people to have an easy-to-remember number and to be able to be connected to a clinician directly if they need to be, which did not happen with NHS Direct—is a good one, but it is not happening in practice as much as it needs to be. We are broadly meeting our operational standards, but it is not good enough and she has given a very good example as to why.
Miss Anne McIntosh (Thirsk and Malton) (Con)
First, may I thank the Under-Secretary of State, my hon. Friend the Member for Broxtowe (Anna Soubry), for responding to the recent debate we held on this issue? When it was my own father in those circumstances, I did not say that I was an MP, as I felt that would be an abuse of the system. I am delighted that North Yorkshire has reported no problems since 111 was introduced, but there is the issue of the deficit for clinical commissioning groups, which we hope will not detract from the 111 service. Can the Secretary of State assure us that the review of funding will be brought forward at the earliest possible moment?
Liz Kendall (Leicester West) (Lab)
Ministers were repeatedly warned about problems with their 111 roll-out by the Royal College of Nursing, the British Medical Association, the Ambulance Service Network and private providers, but they ploughed on regardless. The result was patients left waiting hours for call-backs, more ambulances sent out and more pressure on already struggling A and Es. I am sure the Secretary of State is aware of the pattern of the seasons, so if he wants to avoid another A and E crisis this winter, can he explain why Bruce Keogh’s review of urgent and emergency care will not even report until next spring?
Mr Hunt
Actually, the hon. Lady is wrong, because Bruce Keogh’s review of urgent and emergency care with respect to vulnerable older people, and particularly with respect to the way the 111 service operates, will report this autumn, precisely so that we can make sure we learn any lessons we need to learn for this winter, and it is very important that we should do so.
Margot James (Stourbridge) (Con)
11. What steps he is taking to improve the care of vulnerable older people.
The Secretary of State for Health (Mr Jeremy Hunt)
We are taking a great deal of measures to improve services for vulnerable older people, who make up the bulk of the work the NHS does, and in particular to make sure they are always treated with dignity and respect.
Margot James
I thank my right hon. Friend for his answer. Earlier this year the Care Quality Commission found that people with dementia end up in hospital more often, stay longer and are more likely to die there. What can he do to encourage greater provision of good-quality specialist care places for patients with dementia in the community?
Mr Hunt
My hon. Friend makes an important point. Nearly 60% of people with dementia are in a care setting, but one of the tragedies is that many of them could continue to live healthily and happily at home for much longer if they were given the support that they needed. Often, however, that support does not arrive until it is too late, when the carer or family member is under too much pressure to be able to look after them. The dementia diagnosis rate at the beginning of this Parliament was less than 40%, but our objective is to get that up to two thirds by the end of the Parliament. Also, we want to ensure that a proper care plan is in place for the two thirds who are diagnosed, so that we can avoid the problems that my hon. Friend has highlighted.
Hazel Blears (Salford and Eccles) (Lab)
Last week, the all-party parliamentary group on dementia published its report, “Dementia does not discriminate”, which deals particularly with the impact of dementia on people from black and minority ethnic communities. There are now 25,000 people from those communities living with dementia—far more than we expected—yet they often receive their diagnoses even later than people with dementia in the rest of the population. Will the Secretary of State fund an awareness campaign through Public Health England aimed at those communities to drive up the diagnosis rates? Will he also ensure that the clinical commissioning groups are commissioning appropriate support services in those communities so that we can provide proper services for everyone living with dementia?
Mr Hunt
I congratulate the right hon. Lady, who is a long-time campaigner on dementia issues. She has raised a really important issue, and I will certainly talk to Public Health England about raising awareness. For those groups, as for everyone, we need to ensure that there is a good care plan in place when they are diagnosed. There is some resistance in the GP community to giving a dementia diagnosis, partly because many GPs worry that not much will happen as a result. We need to ensure that there is a good plan in place, and that is particularly the case for ethnic minority communities.
Mr Graham Stuart (Beverley and Holderness) (Con)
Does the Secretary of State agree that areas that are grappling with the highest burdens of chronic illness and disability should receive the highest NHS allocations? Does he have any idea why the NHS Commissioning Board has rejected the advice of the Advisory Committee on Resource Allocation and decided instead to perpetuate the systematic underfunding of areas that serve older people?
Mr Hunt
My hon. Friend is absolutely right to say that NHS resources must be allocated in a way that fairly reflects the need for the NHS in every area. Rurality and age are two important factors in that regard. I can reassure him that the current allocations are not set in aspic. The problem with the recommendations from the Advisory Committee on Resource Allocation that NHS England received before was that they would have meant increasing resources to the areas with the best health outcomes at the expense of those with the worst ones. NHS England thought that that would be inconsistent with its duty to reduce health inequalities, but it is looking at the issue this year and we all hope that it will make good progress.
Andrew Gwynne (Denton and Reddish) (Lab)
We all know that one of the most important drivers for improving the quality of care for vulnerable and elderly patients is to ensure the adequate training and regulation of health care assistants. That is something that Labour and Sir Robert Francis QC have called for, but that the Government have so far ducked. Will the Secretary of State now accept that crucial Francis recommendation to help to drive up care standards for the elderly and the vulnerable—yes or no?
Mr Hunt
The reasons that Robert Francis recommended statutory regulation of health care assistants were twofold. First, he wanted to ensure that people who had been involved in incidents of poor care could not pop up somewhere else in the system. Secondly, he wanted to ensure that everyone had proper training. We are going to solve both those problems, but I am not convinced that a big new national database of 300,000 people is the way to do it.
Heidi Alexander (Lewisham East) (Lab)
12. What recent progress his Department has made on negotiations with acute providers on the capital and revenue costs of implementing the recommendations of the special administrator of the South London Healthcare NHS Trust.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
13. What plans he has to increase the management capability of doctors elected to clinical commissioning groups.
The Secretary of State for Health (Mr Jeremy Hunt)
Clinical commissioning groups have the freedom and autonomy to determine the skills and expertise needed to enable them to deliver improved outcomes for their local communities, and NHS England is developing an assurance framework to ensure that they all have the capacity and capability to do that.
Mr Sheerman
Is the Secretary of State aware that a number of doctors, certainly the ones I have talked to, are deeply concerned about the inadequacy of their management capabilities to run these complex organisations? Is he worried that many of them are saying that they have to turn to private health care people to back them up and give them advice? Is that healthy in the NHS?
Mr Hunt
I am absolutely aware that there a lack of clinical leadership, and when we go on to the statement later today, I am sure that we will be discussing what needs to be done to improve the quality of leadership, particularly clinical leadership. Very often the best leadership in any hospital or any commissioning group comes from clinicians, and we have much work to do to make that happen. But I do not think that that means that we should duck the challenge; we just have to get on and make sure that people have the right training and can be supported to do the job we need them to do.
Mr Geoffrey Robinson (Coventry North West) (Lab)
The Secretary of State seems to be answering a different question. The question was about management training for doctors who are being put in the position, without any training and with no consultation—many are doing this against their wishes—of having to manage in a way that they have never been trained to do and are not inclined to do. Would it not be better to put in place the assurance and the training he talks about before rushing into this madcap reorganisation, which the Government did?
Mr Hunt
May I reassure the hon. Gentleman that, first, these people are not doing these jobs against their will, as they volunteered to do them? Secondly, the quality of CCGs is being assured very closely, and they are receiving a lot of support. But it is a big job because, generally speaking, we want more clinical leaders. They need support in learning management skills in order to do that job well, and across the whole NHS we need to be doing that better.
Fiona Mactaggart (Slough) (Lab)
Will the training of clinical leaders include training in legal advice about mergers? I was shocked to see a response from Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust and Poole Hospital NHS Foundation Trust showing that they had already spent more than £1.5 million on legal advice about their merger, which has been prevented by the Competition Commission, and that in future they expect to spend £6 million on this scheme. Is it right that our health money should be going on legal advice?
Henry Smith (Crawley) (Con)
14. What steps he is taking to tackle health tourism and ensure a fair system of contribution to the costs of the NHS.
The Secretary of State for Health (Mr Jeremy Hunt)
On 3 July, my Department and the Home Office launched co-ordinated consultations on a range of proposals on a new charging system for visitors and migrants in which everyone makes a fair contribution to health care. Those include making temporary migrants from outside the European economic area contribute to the cost of their health care, and introducing easier and more practical ways for the NHS to identify and charge those not entitled to free health care.
Henry Smith
I very much welcome the statement by my right hon. Friend and support the new visa fee proposal for non-EU foreign nationals who come here and receive NHS treatment. May we also have an assurance that the treatment of EU nationals will be properly audited in the NHS, so that those costs can be recovered through the European health insurance card scheme?
Mr Hunt
My hon. Friend is right to point to the fact that we estimate that we collect less than half the money for which we invoice for “overseas operations” and we identify fewer than half the people who should be invoiced in the first place—that applies in respect of those from inside the EU as well as from outside the EU. We can get refunded for the care we give EU nationals if we are sensible about collecting this money and we put those systems in place. Given the pressures in the NHS, we are absolutely determined to make sure we do so.
Jim Shannon (Strangford) (DUP)
I thank the Secretary of State for his statement. Last year health tourism cost the NHS £24 million—that was in one year alone. He has outlined the new system coming in, but will he say how it will be administered? Many of us feel that it might not be as easy to do in practice as it is on paper.
Mr Hunt
The hon. Gentleman is absolutely right. If this is to work, we need a slick system that is easy for hospitals to operate. We have done this in another area, as the NHS successfully and seamlessly invoices insurance companies for the costs of coping with road traffic accidents. At the moment, however, if hospitals declare that someone is chargeable for their NHS care, they do not get paid by the NHS for that care, meaning that they have to collect the money themselves from overseas, so the incentives for hospitals are wrong and we need to sort them out.
Mr Tobias Ellwood (Bournemouth East) (Con)
20. I welcome the Government’s initiatives to tackle health tourism, but what is being done to help hospitals on the front line, such as Bournemouth hospital, better to identify chargeable visitors?
Mr Hunt
We are considering whether something can be done with the NHS number. At the moment, people can visit any GP and, completely legally—whether or not they are entitled to NHS care—get an NHS number. That number can then become a passport that can be used throughout the system, so we are examining whether there is a way of giving people either a temporary NHS number, or a different NHS number, that can be tracked through the system so that if they undergo complex medical care that is chargeable, we are able to trace that and collect the money from them.
Steve McCabe (Birmingham, Selly Oak) (Lab)
If we are to make this work, do not we need a clearer idea about the real cost? Is it the £200 million that the Secretary of State has been quoted as using, the £10 million suggested by the Prime Minister, or the £33 million that the Under-Secretary of State for Health, the hon. Member for Broxtowe (Anna Soubry), has cited in a parliamentary written answer?
Mr Hunt
The truth is that we do not know the cost, which is why we are carrying out an independent audit this summer. The £12 million figure is the amount written off by the NHS each year because of unpaid overseas invoices, but many people think that the costs are much greater. We want an answer for the hon. Gentleman and everyone in the House, so we are carrying out that independent audit and we will publish the results later in the autumn.
Kate Green (Stretford and Urmston) (Lab)
T1. If he will make a statement on his departmental responsibilities.
The Secretary of State for Health (Mr Jeremy Hunt)
I know that the whole House will want to recognise the fact that this month marks the 65th anniversary of the NHS. This country blazed a trail by introducing universal health care coverage in 1948, and the NHS remains the single biggest reason why most people are proud to be British. The whole House will want to note that whatever failings are being exposed by a new era of transparency in NHS care, the overwhelming majority of doctors, nurses, health care assistants and managers do a remarkable job, working incredibly long hours for the benefit of us and our families, and we salute them for all they do.
Kate Green
When changes were made at Lewisham hospital, the Secretary of State refused to meet local campaigners. Following his announcement last week about changes to services at Trafford general hospital, local campaigners from Trafford would like to know if he is prepared to meet them.
Mr Hunt
That is not quite a fair representation of what happened in the case of Lewisham, or indeed for Trafford, because I agreed to meet all local MPs regarding Lewisham. These things are carefully constrained by what is legally possible so as to be fair to all sides, but I met all Lewisham MPs. As the hon. Lady knows, I have agreed to meet her—I think that we are meeting later this afternoon—and I am sure that she will express the concerns of campaigners in Trafford.
David Rutley (Macclesfield) (Con)
T5. Integrating health and social care is an especially important priority in areas with the fastest-ageing populations. With that in mind, do Ministers agree that it is vital to support joined-up initiatives such as Caring Together in north-east Cheshire, which involves the local clinical commissioning group, council and NHS trust?
Mr Speaker
Order. The hon. Gentleman should not abuse topical questions to ask two questions, and he should be asking not about the policies of the previous Government, but about the policies of the present Government, on which I know the Secretary of State will briefly reply. We are grateful.
Mr Jeremy Hunt
We will, of course, give every support to the management at Basildon to turn around their hospitals. The wonders of modern technology have informed us that the shadow Health Secretary was wrong to say that there has been a decline in nursing numbers in Basildon: they have actually gone up by nearly 100 since the last election.
Sarah Champion (Rotherham) (Lab)
T3. The Francis report recommended that the National Institute for Health and Care Excellence draw up minimum safe staffing levels that would be policed by the Care Quality Commission. It stated that NICE should develop“evidence-based tools for establishing”the staffing needs of each service in the NHS which is likely to be required“as a minimum in terms of staff numbers and skill mix.”Will the Minister tell us when the Government will act on this and all the recommendations in the report?
Mr Hunt
If the hon. Lady heard the exchange earlier, she will know that what Robert Francis was recommending was evidence-based tools, not a national minimum staffing level. The reason for that is that the number of nurses needed varies from hospital to hospital and ward to ward. We need to make sure that that happens. In the best hospitals it already does. The system that we have—this was supported by the shadow Health Secretary in his evidence to the Francis review—is not one where the Secretary of State sits behind his desk and dictates the number of nurses required in every hospital. If we did that, we would not be able to run the NHS properly, but we need to make sure that there are proper standards in place, which is why we have a chief inspector of hospitals to make sure that that happens.
Stuart Andrew (Pudsey) (Con)
T9. It is right that clinicians should speak out about safety in our hospitals, but does my right hon. Friend agree that now is probably not the right time for clinicians to be speculating in the national media about the safety at Leeds heart unit, given that the Department has yet to release the second phase of the review, as this endless speculation is causing great anxiety to already worried parents?
Mr Hunt
I agree with my hon. Friend. He has campaigned very honourably and sensibly for children’s heart services at Leeds. This is not a time for speculation. We will announce this month what the new process will be for resolving Safe and Sustainable. He and I both want this to happen as quickly as possible to remove that uncertainty. Also, we have to find a way of making sure that the data are solid and that we can trust them.
Keith Vaz (Leicester East) (Lab)
T4. Will the Secretary of State join me in congratulating Abbey primary school on becoming the first “silver star” school in Leicester for banning sugary drinks and for promoting healthy eating and exercise? Does he agree that this is the best way of preventing diabetes and obesity in later life?
Andrew George (St Ives) (LD)
Further to the question raised by the hon. Member for Walsall South (Valerie Vaz), I have met the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) regarding safe staffing levels and I provided a substantial file of evidence on behalf of the Florence Nightingale Foundation in support of its 1:8 registered nurse to patient ratio. What part of that evidence are Ministers unconvinced by?
Mr Jeremy Hunt
I am sure the evidence to which the hon. Gentleman refers is very persuasive, but I am sure he would agree that a ratio such as 1:8 cannot be applied uniformly across his local hospital or across all local hospitals. It can vary from day to day, depending on the level of illness and the age of the people going into particular wards. The best hospitals have computer models that change the numbers of nurses operating in different wards on a daily basis. Other hospitals do not do that, except on a quarterly basis. That is the change that we need to make.
Rosie Cooper (West Lancashire) (Lab)
T6. Does the Secretary of State believe that making data on individual consultants public is pointless if hospitals are using informal mechanisms to frustrate patient choice, such as having a team of specialist nurses decide which consultant a patient is referred to? Will he reinforce patient choice and dissuade hospitals from doing that?
Meg Munn (Sheffield, Heeley) (Lab/Co-op)
T7. The guidance that the Government have produced on transferring funds from the NHS to local authority social care makes it clear that the money can be used to plug gaps in social care caused by cuts. Does that not just mean that the local authorities that are under most pressure because they have had the biggest cuts will not be in a position to develop the integrated health and care services that we would all like to see?
Mr Jeremy Hunt
I hope that I can reassure the hon. Lady, because the conditions for accessing that £3.8 billion fund are absolutely clear. Local authorities will not be able to access it unless they can promise to maintain services at their current levels. They are allowed to make financial efficiencies, as is the NHS, and everyone needs to look at that, but not if it means a deterioration in services.
Jeremy Lefroy (Stafford) (Con)
Being able to be visited frequently by one’s loved ones is a vital part of improving care for vulnerable older people in acute settings. How is closeness to home being taken into account in any service changes proposed by Monitor or the NHS Trust Development Authority?
Mr Hunt
First, I congratulate my hon. Friend on the admirable way he sticks up for his constituents in Stafford in incredibly difficult circumstances. I think that the whole House recognises what he has done. Secondly, in answer to his question, there is always a balance to be found, because we all recognise that, all things being equal, people would rather be treated nearer to where they live for exactly the reasons he gave. We also need to ensure that people get the best care when they arrive at hospital, which is why it is very important to go through these difficult processes to work out where that balance lies.
Mr Kevin Barron (Rother Valley) (Lab)
Is the Secretary of State aware of the increasing problems there are in A and E because of alcohol? If so, will he tell us what he is going to do about it?
Mr Hunt
There are problems, particularly in large cities and at weekends. In fact, in the case of the reorganisation of services at Trafford general hospital, one of the things that we can invest in as a result is mental health facilities in neighbouring A and Es so that people have better access to the services they need.
Tessa Munt (Wells) (LD)
The Secretary of State will be aware of the case of Nadejah, the face of the Teenage Cancer Trust, who at the age of 23 has been refused the CyberKnife cancer treatment that could save her life. Her mother Michelle is here today. Will he intervene so that this young woman gets the treatment that her consultant, Professor Hochhauser, recommends, and will he meet Nadejah’s mother and me so that we can work together to unblock the funding so that she can get the treatment she so desperately needs?
Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)
Since 2010, thousands of NHS staff have left the NHS with big, fat redundancy cheques, only to go through the revolving door and get new jobs in the NHS, often months later. Will the Secretary of State tell us how much has been spent on redundancy payments and whether he regrets that waste of NHS money?
Mr Jeremy Hunt
The hon. Lady asks that question as if that kind of thing never happened under Labour. The answer is that it is not acceptable, which is why we are changing the rules to ensure that people cannot get payoffs and then walk straight into another NHS job. The other answer is that the reorganisation that she criticises means that we have put more money on the front line, including for 6,000 more doctors, which I think was the right thing to do.
Charlotte Leslie (Bristol North West) (Con)
Does the Secretary of State agree it is a scandal that those, such as Gary Walker, Amanda Pollard and Kim Holt, who have exposed the horrors buried in our NHS have either been fired or do not have jobs, but those who are heavily implicated in such cases, such as Barbara Hakin—about whom I have written to the Secretary of State—David Nicholson, and others, still do?
Mr Hunt
My hon. Friend has campaigned long and hard on issues of accountability, and I agree with her basic case, even if I do not agree with her about all the individuals she mentioned. One issue that will arise during today’s statement is that of how people are held accountable. That has been missing in our NHS, and we must put it right.
Grahame M. Morris (Easington) (Lab)
There has been much talk about action plans and I am sorry that the Minister of State, Department of Health, the hon. Member for North Norfolk (Norman Lamb), is not in his place. Is the Health Secretary aware that Mencap has expressed concerns that the Government’s response to the “Six Lives” progress report by the Department of Health does not set goals or time scales for tackling the issues highlighted in that report?
Richard Fuller (Bedford) (Con)
At the end of this month, the East of England Multi-Professional Deanery will remove junior doctors in paediatric services from Bedford hospital. That will reduce paediatric services, which will obviously cause major concerns for families with children in Bedford and Kempston and north Bedfordshire. Will my right hon. Friend join me and my hon. Friend the Member for North East Bedfordshire (Alistair Burt) in calling for an open and independent inquiry into why clinical supervisory failures continued at Bedford hospital and were not addressed, and into the terrible consequences that resulted from that?
John Cryer (Leyton and Wanstead) (Lab)
Further to the question from the hon. Member for Bristol North West (Charlotte Leslie), Ministers often—quite rightly—mention the importance of whistleblowers, so why have the Government weakened protection for whistleblowers through the Enterprise and Regulatory Reform Act 2013?
Mr Jeremy Hunt
We are strengthening protection for whistleblowers and are going much further by creating a culture of openness and transparency in the NHS, where people are not bullied if they speak out about poor care.
Mr Adrian Sanders (Torbay) (LD)
Torbay is often held up as a model for an integrated care service, but two important services are not fully integrated—mental health care and children’s services. Will the Government encourage the incorporation of all services into a fully integrated health care system?
Mr Hunt
My hon. Friend makes an important point and the heart of what he says is that integrated, joined-up care is most important for those who are regular users of the NHS. Children with complex needs or people with mental health conditions that can improve but not necessarily be cured can really benefit from an integrated approach. I salute what Torbay has done in blazing a trail. We are learning from that and hope that such a process will be rolled out in every part of the country as soon as possible.