Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 20th December 2016 Commons Chamber

[Lucy Allan (Telford) (Con)]

1. What plans he has made to improve the quality of clinical leadership in the NHS.

[The Secretary of State for Health (Mr Jeremy Hunt)]

As we wish each other a merry Christmas, the whole House will also this morning remember the people of Berlin as they face up to yesterday’s horrific suspected terrorist attack. Germany and its capital Berlin have been beacons of freedom and tolerance in modern times, and all our thoughts and prayers are with them today.

Evidence from all over the world suggests that higher standards of care for patients relate directly to the quality of clinical leadership, which was why last month I announced a number of measures to increase the number of doctors and nurses in leadership roles in the NHS.

[Lucy Allan]

I thank my right hon. Friend for his response. Clinicians in Telford have been showing real leadership by rejecting a proposal to close a brand new women and children’s unit, and elements of our emergency services. The quango responsible for this idea has spent £3 million and taken three years to come up with the proposal, which has been rejected by local people and clinicians. Will my right hon. Friend meet me and my local colleagues to bring an end to this farce, and to ensure that we do not continue in limbo any longer?

[Mr Hunt]

I recognise the extent of my hon. Friend’s campaigning on this issue in Telford, and that she expresses the concerns of many of her constituents. As she knows, service changes must be driven locally and must have the support of local GP commissioners. She will also know that the actual situation, very frustratingly, has not led to consensus between clinicians in different parts of Telford and Shropshire. I agree that the process has taken much too long, and I am more than happy to meet her and to try to bring this situation to a close as quickly as possible.

[Heidi Alexander (Lewisham East) (Lab)]

In a year when the Health Secretary has spent quite a lot of time knocking clinicians, it is good to hear him speak so positively about them. After four years in the job, what responsibility does he accept for the lack of suitably qualified individuals—not just clinicians—who are prepared to take on the top jobs in the NHS on a permanent basis?

[Mr Hunt]

I will tell the hon. Lady what I take responsibility for: more doctors, more nurses and more funding than ever before in the history of the NHS. We know that the highest standards are often achieved when there is strong clinical leadership. Only 54% of managers in this country are clinicians, compared with 74% in Canada and 94% in Sweden. That is why it is right that we do everything we can to encourage more clinicians into leadership roles.

[Andrew Selous (South West Bedfordshire) (Con)]

Does the Secretary of State agree that the clinical leadership involved in the Getting It Right First Time initiative is important, not only because it will save £1.5 billion, which could be put back into patient care, but because patients will be in less pain and will end up having fewer revision operations, and some will even survive treatment that they would not otherwise have survived?

[Mr Hunt]

My hon. Friend is absolutely right. I thank him for bringing Professor Tim Briggs to see me to explain just how superb this programme is. Infection rates for orthopaedic surgery vary between one in 20 patients in some trusts to one in 500 in others. Getting this right can transform care for patients and save money at the same time.

[Mr Ben Bradshaw (Exeter) (Lab)]

I associate myself with the Secretary of State’s comments about Berlin, my one-time home.

Does the Secretary of State accept that we have the best clinical leaders anywhere in the world? The challenge facing the NHS is not one of clinical leadership, or the dedication or skill of staff, but one of chronic underfunding by this Conservative Government.

[Mr Hunt]

We do indeed have superb clinical leaders, such as Marianne Griffiths at Worthing, which was recently given an outstanding rating. We also have superb non-clinical leaders, such as David Dalton at Salford Royal. I would gently say to the right hon. Gentleman that if he is worried about funding, why did he stand in the election on a platform that would have seen the NHS have £1.3 billion less this year?

[Mr Steve Baker (Wycombe) (Con)]

Will the Secretary of State ensure that clinical leaders are able to apply important techniques from other disciplines, such as lean production, which can drive up productivity?

[Mr Hunt]

My hon. Friend is absolutely right. Clinical leadership is important, but so is openness to the skills of other industries—particularly engineering skills, with which he is very familiar—that can help us to get processes right so that we improve care and safety for patients.

[Dame Rosie Winterton (Doncaster Central) (Lab)]

Does the Secretary of State agree that if the board of Doncaster and Bassetlaw Hospitals NHS Foundation Trust agrees to establish a teaching hospital today, that will enable the trust to train its doctors of tomorrow so that they are more able to move into clinical leadership roles as quickly as possible?

[Mr Hunt]

I thank the right hon. Lady for her question and welcome Doncaster hospital’s aspirations and ambitions. Any final decision will obviously be a matter for the NHS and Health Education England, but it is very encouraging that it is reaching for the stars in this way. Yes, we do need to train more doctors, and I hope that the hospital can make a good contribution.

[Mr Speaker]

The constituency of the hon. Member for Bassetlaw (John Mann) was just mentioned and he came in on cue. Unfortunately, he was not within the curtilage of the Chamber at the material time. No doubt we will hear from him at a later date, to which we look forward with eager anticipation.

--- Later in debate ---

[Gavin Newlands (Paisley and Renfrewshire North) (SNP)]

4. What assessment he has made of the potential effect of the UK’s decision to leave the EU on the NHS workforce.

[The Secretary of State for Health (Mr Jeremy Hunt)]

There are currently 127,000 staff from the EU doing a vital job for patients in the NHS and social care system. In this year of Brexit, we salute their excellent work and remain confident that we will be able to negotiate for them to continue it in the future.

[Gavin Newlands]

There are more than 50,000 EU nationals working as nurses and doctors throughout the United Kingdom, along with 80,000 in the social care sector. The NHS already faces extensive rota gaps owing to a shortage of senior and junior doctors. Will the Secretary of State join our First Minister in demanding an unequivocal guarantee that EU nationals who are already living here will have the right to remain?

[Mr Hunt]

That is exactly what we intend to achieve through negotiations, but we must remember the British citizens, including people from Scotland, who are living in the EU and whose rights we also wish to protect. That is why the Prime Minister has made a big point of saying that she wishes to negotiate the issue at an early stage in order to give certainty to those people.

[Sir Edward Leigh (Gainsborough) (Con)]

We are not going to leave the EU for two and a half years, but I want the Secretary of State to grip GP services in Lincolnshire now and to start training more doctors. The Pottergate surgery in Gainsborough is closing, potentially throwing hundreds of people out without a GP, and there is a shortage of 80 GPs against a target of 915 in Lincolnshire, and only six out of 30 training places were taken up recently. Will the Secretary of State now grip the GP services in Lincolnshire for the sake of our people?

[Mr Speaker]

Order. The hon. Gentleman has rather cheekily brushed aside the part of the question that does not suit his purposes. Only to focus on half a question is very cheeky; we will allow him to get away with it on this one occasion only.

[Mr Hunt]

I hope that I can reassure my hon. Friend about this because the reality is that we increased the number of GPs by 5% in the previous Parliament, and in this Parliament we are planning an increase of another 5,000, which will be the biggest increase in GPs in the history of the NHS, and will go along with considerable extra resources.

[Helen Goodman (Bishop Auckland) (Lab)]

I will focus on the half of the question that the hon. Member for Gainsborough (Sir Edward Leigh) missed out. The other day I had a meeting with some constituents who told me that they were so pleased that we were leaving the European Union because it meant that the extra £350 million could be used to reopen the A&E department at Bishop Auckland. Has the Secretary of State found that £350 million yet?

[Mr Hunt]

The hon. Lady might have noticed that I personally did not talk very much about that £350 million. Whatever resources we have post-Brexit will have to be set in the overall economic context, but of course the great thing is that, post-Brexit, that will be a decision for this Parliament.

[Richard Fuller (Bedford) (Con)]

Many members of the NHS workforce across Bedford and Kempston come from the EU, but many others come from Caribbean countries, the Philippines, India and many countries in Africa. Will my right hon. Friend make sure that, in the future, people from those countries are given equal access to work in our NHS as that for EU nationals?

[Mr Hunt]

The benefit of Brexit will be that we can take precisely such decisions in this Parliament, because we will get back control of our borders. I am grateful to my hon. Friend for mentioning the very important work done by people from outside the EU in the NHS. Because I happened to meet the Philippines ambassador last week, I want to pay credit particularly to the Filipino workers in the NHS and the social care system, who do a fantastic job.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

May I start by extending my party’s sympathies to the victims of the Berlin attack?

Much of what we have heard today is about keeping those who are already here, but BMA Scotland has said that insecurity is stopping EU nationals from taking up posts that really need to be filled. This is an urgent problem, so does the Secretary of State agree that it is time to create some certainty for EU nationals and to avoid a self-made workforce crisis?

[Mr Hunt]

I absolutely agree with the hon. Gentleman, which is why it is extremely frustrating that the current signals from the EU are that it is unwilling to bring forward negotiations about the status of EU nationals here, and indeed that of British nationals in the EU. No one from either side of the Brexit debate has ever said that there will be no immigration post-Brexit; they have simply said that we will control that immigration ourselves through this House and through decisions made by the British people at general elections.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

On behalf of the official Opposition, may I echo the words of the Secretary of State in relation to the tragic events in Berlin and send our condolences to the people there?

The Institute for Employment Studies has today warned that Brexit could make nursing shortages even worse. That follows The Times reporting that

“applications for nursing, midwifery and allied health courses were down by about 20%”

and that in some institutions applications had halved. The decision to scrap nurse bursaries is having the consequences that every expert predicted it would. With the uncertainty of Brexit looming over our workforce, now is not the time to be taking a massive gamble with our nurses so, in the light of the evidence, will the Secretary of State now agree to scrap that disastrous policy?

[Mr Hunt]

I simply say to the hon. Gentleman that the purpose of that policy was to allow us to train more nurses; in fact, we will be training 40,000 more nurses during this Parliament. We have more than 11,000 more nurses in our NHS wards, and at Countess of Chester hospital—the hon. Gentleman’s own hospital—there are 172 more nurses than in 2010.

[Rehman Chishti (Gillingham and Rainham) (Con)]

6. What progress he has made on improving hospitals in special measures.

--- Later in debate ---

[Conor McGinn (St Helens North) (Lab)]

8. What plans his Department has to help the NHS deal with pressures on services in winter 2016-17.

[The Secretary of State for Health (Mr Jeremy Hunt)]

Last year, the number of excess winter deaths was 45% lower than in the previous year, and contingency planning for this winter is well under way, with £400 million allocated to local health systems for winter preparedness.

[Conor McGinn]

This time last year, St Helens CCG told me it needed to postpone elective operations and referrals in order to get through winter. Six months later, it was £12.5 million in deficit and proposing to cancel all non-urgent surgery indefinitely. What the Health Secretary is proposing does not make the problems go away—it stores them up. When will the Government give local trusts and clinicians the funding they require? Stop passing the buck and start passing the bucks!

[Mr Hunt]

With the greatest respect, I do not think it is passing the buck to put £1.3 billion more into the NHS this year than the hon. Gentleman was proposing at the last election. A lot of actions are being taken in Cheshire and Merseyside; a local accident and emergency delivery board was set up, which is doing very important work, and the emergency care improvement programme is working very well at his local trust.

[Jeremy Lefroy (Stafford) (Con)]

There is great pressure on emergency services throughout Staffordshire at the moment. There would be even more without the accident and emergency centres in Stafford and Burton, yet the sustainability and transformation plan proposes to reduce one of them, so there will only be two left in the county. Will the Secretary of State speak to the authors of the STP to make it clear that this is totally unacceptable given the current situation?

[Mr Hunt]

No one fights harder and more eloquently than my hon. Friend for the needs of the people of Stafford. I always look with concern at proposals to change emergency services given the huge pressures that exist, so I shall happily look at the plan as he suggests.

[Derek Twigg (Halton) (Lab)]

21. The problem is not just winter pressures but pressures all year round. The Secretary of State will no doubt tell me that the Government have now allowed councils to increase the precept to allow councils to fund it better, but the fact is that that is not enough money. There is no strategy. Does anyone outside the Department—those in the Department might not either—believe that the Government has a strategy for social care?

[Mr Hunt]

All I would do is urge the hon. Gentleman to listen to what the Prime Minister said at this Dispatch Box last week. She said that we recognise the short-term pressures—indeed, the Communities Secretary came up with a package of £900 million extra over the next couple of years—but that we also need a long-term sustainable solution, on which the Government are working hard.

[Sir Simon Burns (Chelmsford) (Con)]

Does my right hon. Friend agree that one of the pressures of winter that needs improving is inappropriate admissions to A&E? Does he accept that the proposals by the Essex success regime to ensure that the three hospitals concerned will retain their A&E departments but that there will be a specialist centre for cardiothoracic care and for burns and plastic surgery care are the right way forward to improve and enhance the care for those suffering from accidents and emergencies?

[Mr Hunt]

My right hon. Friend understands these matters extremely well from his time as a very distinguished Health Minister. He is absolutely right; the truth is that we want widespread availability of A&Es but we do not serve patients best by offering identical services everywhere. That is why in the past three or four years one of the things we are most proud of is the setting up of a national network of 26 trauma centres, which has had a dramatic impact on mortality rates for the most serious cases.

[Mr Speaker]

I have just been advised by a very sagacious source that in supplementary questions and answers to this question some reference to winter is desirable.

[Jonathan Ashworth (Leicester South) (Lab)]

I associate myself with the Secretary of State’s remarks about Berlin. I wish everyone in the House a merry Christmas and I extend my best wishes for a very peaceful and joyful Christmas and new year to all NHS staff, especially those working over Christmas.

Pressures on the NHS this winter are such and the underfunding is so severe that hospitals have been ordered to close operating theatres for elective surgery over Christmas. Is this what the Secretary of State means by a seven-day NHS?

[Mr Hunt]

Let me wish the shadow Health Secretary a merry Christmas and say that despite his rhetoric I see that Santa has been quite generous to him. His local trust in Leicester has 254 more nurses and 306 more doctors than in 2010. Next year, we will have a new £43 million emergency floor at the Leicester royal infirmary. We need to ensure that there is sufficient bed capacity in our hospitals over winter—that is a very important part of winter planning—but we are also doing 5,000 more elective operations every day than when Labour was in office.

[Jonathan Ashworth]

I am delighted that the Secretary of State has done his research on Leicester, but is closing operating theatres for a month this Christmas not, in reality, a short-term fix? The truth is that when the pause ends and hospitals fill up again above the 85% occupancy recommendations, patients will be left with a simple choice: get stuck on a waiting list while hospitals try to reduce occupancy rates to safe levels, or risk going into a hospital when it is at full capacity and potentially unsafe and be exposed to higher infection risks. Which option would the Secretary of State choose?

[Mr Hunt]

May I gently urge the hon. Gentleman to be careful with his rhetoric? We are not closing operating theatres for a month over Christmas. We need to be very careful what we say in this place, because people outside are listening. The answer is to ensure that we increase capacity in the NHS, and that is why we have 11,000 more doctors and 11,000 more hospital nurses than we had six years ago. We are training 15,000 more doctors every year from 2018-19 to ensure that we can avoid these problems in the future.

[Andrew Bridgen (North West Leicestershire) (Con)]

9. What progress the Government are making on recovering money from overseas visitors and other chargeable NHS patients.

--- Later in debate ---

[Chris Green (Bolton West) (Con)]

T2. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health (Mr Jeremy Hunt)]

As we enter the challenging winter period, I want, on behalf of the whole country, to thank the 2.7 million people working in the health and care system—particularly those giving up all or part of their own Christmas day to look after patients. We are in their debt, and we wish them a merry Christmas, whenever they get the chance to celebrate it with their families.

[Chris Green]

Bolton A&E is employing new measures to cope with the staggering demand on its service. What are the Government doing to educate people that A&E is for serious and life-threatening conditions only, so that staff and resources can go where they are needed most?

[Mr Hunt]

That is an excellent question. We are doing a number of things. First, we have the Stay Well this Winter campaign, which has a lot of advice to go out to his constituents and all our constituents about how to avoid things that can lead to their having to go to A&E. However, we also urge the public to remember that accident and emergency departments are for precisely that.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

There was no new money from the Government for social care in the local government settlement—just a recycling of money from the new homes bonus to social care, and that is for 2017-18 only. Fifty-seven councils will actually lose funding owing to this recycling. Salford, which was recently praised by the Prime Minister for its integration of social care, will lose £2.3 million due to this inept settlement. Is it not time for the Secretary of State to accept that social care is in crisis and that his Government cannot just dump the issue of funding it on councils and council tax payers?

[Mr Hunt]

I do listen carefully to what the hon. Lady says, because she has campaigned long and hard for social care. However, with respect, I would say to her that she is ignoring one simple fact: there is more money going into social care now than would have been the case if we had followed her advice at the last election. What the Communities Secretary announced was £900 million of additional help over the next two years.

[Barbara Keeley]

The Government’s plans for funding social care look inept because they have tied care funding, which is related to need, to council tax and to deductions from the new homes bonus. Last week’s settlement was a pathetic attempt to deal with a funding gap of £2 billion for social care by recycling £240 million within budgets. The chief executive of the British Red Cross has described the social care crisis as

“a humanitarian crisis that needs urgent action.”

When is the Secretary of State going to take that crisis seriously?

[Mr Hunt]

The hon. Lady talks about council tax, but she does not call out Labour councils like Hillingdon, Hounslow, Merton and Stoke which complain about pressures in the social care system and then refuse to introduce the social care precept that could make a difference to their residents. We are taking the situation seriously. More was done this week and more will be done in future.

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

T7. As my hon. Friend is aware, last week the Murray report was published. When is he likely to consider it, and when will he make a statement?

--- Later in debate ---

[John Mann (Bassetlaw) (Lab)]

T4. Zac from Worksop is three years old, wheelchair-bound, unable to speak and blind, and is regularly admitted on an unplanned basis to Bassetlaw Hospital’s children’s ward. As the people of Bassetlaw are standing with Zac in opposing the proposed overnight closure of the children’s ward, which will create chaos for his small life and that of a number of other very poorly children like him, will democracy prevail, or are the Government going to pick a fight with Zac, me, and the people of Bassetlaw?

[Mr Jeremy Hunt]

First, I absolutely commend the hon. Gentleman for standing with his constituents and championing individual cases. I will happily look into the proposed changes and how they will affect people like Zac. I assure the hon. Gentleman that when we make these changes it is to improve the services of people and his constituents; that is why we are making them.

[Mr Speaker]

Alex Chalk. Where is the fella?

--- Later in debate ---

[Dr Sarah Wollaston (Totnes) (Con)]

The Health Committee has just published its interim report on preventing suicide. I thank all those who gave evidence to our inquiry and all members of the Department of Health advisory group. We support the strategy, but the clear message that we heard was that implementation needs to be strengthened. Will the Secretary of State meet me to discuss our report’s recommendations, and will he join me in thanking members of the Samaritans and other voluntary groups around the country who will be working tirelessly over Christmas, as they do every day, to support those in crisis?

[Mr Jeremy Hunt]

My hon. Friend speaks wisely. Christmas can be a very lonely time for a number of people, so we all commend the work of voluntary organisations that do so well. I would be delighted to meet her.

[Fiona Mactaggart (Slough) (Lab)]

More than a third of my male constituents live until they are over 80, and yet next door in Windsor and Maidenhead the same is true of well over half of the residents. In the 10 years before 2010, that gap narrowed. What is the Secretary of State doing to narrow the gap in future?

[Mr Hunt]

The best thing we can do to narrow the gap is make sure that we continue to invest properly in the NHS and social care system, and make good progress on public health, which often has the biggest effect on health inequalities. That is why it is good news that we have record low smoking rates.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

With acute hospital bed blocking at a record high, do Ministers agree that it is a great pity that so very few of the 40 sustainability and transformation plans now in the public domain deal directly with step-down care and, in particular, with community hospitals?

[Kerry McCarthy (Bristol East) (Lab)]

Recent figures from the Royal College of Psychiatrists show that children and adolescent mental health services are still underfunded in many parts of the country—particularly worrying for me is the fact that Bristol seems to be the 13th lowest in the country. What are Ministers doing to ensure that children across England and the rest of the UK get the health services that they need?

[Mr Jeremy Hunt]

The hon. Lady is right to highlight this issue and I agree with her. I am not happy with the service that we provide through CAMHS at the moment. It is a big area of focus for the Government. We are putting a lot of investment in, but there is lots more to be done.

[Mrs Maria Miller (Basingstoke) (Con)]

My constituency has been waiting some time for the go-ahead for a new critical treatment hospital providing 24/7 care for the sickest patients, which is very much in line with Government policy. The hospital’s chief executive, Mary Edwards, retires this month after 21 years of exceptional service. Will the Secretary of State give her a retirement present and help me to secure a decision from NHS England?

[Norman Lamb (North Norfolk) (LD)]

The Secretary of State will be aware of the horrifying case of Fiona Hollings, a 19-year-old with anorexia who for the past four months has been nearly 400 miles away from home, in a bed in Glasgow. Her family have travelled 8,000 miles in that time to see her. The Government commit to ending this horrific practice by 2020, but do families really have to put up with it until then? How would he feel if it was his child?

[Mr Jeremy Hunt]

We are taking action and I agree with the right hon. Gentleman that what has happened in that case is completely unacceptable. We are currently commissioning a record number of in-patient mental health beds, and it is a very big priority for us to eliminate the problem entirely by the end of the Parliament.

[Mark Pawsey (Rugby) (Con)]

My constituent Marie Bingham administers a drug at home using pre-filled syringes, but she is unable to dispose of the used needles, partly because they are in 2.5 litre sharps tubs rather than 1 litre sharps tubs. It is a ludicrous situation. Is the Minister aware of the problem, and are there any steps he can take to deal with it?

--- Later in debate ---

[Mr Dennis Skinner (Bolsover) (Lab)]

He is a mine of information, isn’t he? He would like to contribute, really.

Does the Secretary of State not think that it is a scandal to be shutting Bolsover hospital, with 16 valuable beds that will go for ever, at a time when people are lined up on trolleys in nearly every hospital in Britain? Why does the Secretary of State not give Bolsover a Christmas present and announce that Bolsover hospital will be saved? Come on!

[Mr Jeremy Hunt]

I add my congratulations to those of the Speaker on the hon. Gentleman’s long service, which has included campaigning for Bolsover hospital. I simply say to him that we will look very carefully at all proposals to change the services offered. I think community hospitals have an important role in the future of the NHS, but the services they provide will change as more people want to be treated at home.

[Mr Speaker]

Thank you.