Dalton Review
Jeremy Hunt Excerpts(10 years, 5 months ago)
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The Secretary of State for Health (Mr Jeremy Hunt)
Today I am announcing the publication of Examining new options and opportunities for providers of NHS care —The Dalton Review. In February 2014, I commissioned Sir David Dalton, Chief Executive of Salford Royal Foundation Trust, to lead this independent review into how we enable the best leaders and organisations in the NHS to expand their reach and do more for patients.
Sir David, the expert panel and the review team sought evidence and engaged widely across the NHS, with patients and system leaders, international health systems and other sectors to inform the work of the Review. This open and consultative approach is reflected in the publication alongside the report of the evidence packs, case studies and engagement findings which informed the analysis and recommendations aimed at continuing to secure the clinical and financial sustainability of providers of NHS care through offering new options for organisational forms.
The Report notes that while the NHS has a number of world-leading providers and has achieved remarkable successes over the past 10 years, not all NHS providers have improved at the same rate, resulting in variation in quality of care across the country. This variation in standards of care across the country, alongside the wider challenges faced by all providers of NHS services, must be addressed.
Sir David’s Report examines a range of organisational forms that are relevant to all providers of NHS care, providing options for them to drive the spread of improvement methodologies, quality systems and operating models they have developed to other organisations. The Report also provides options for providers who may not currently be delivering services at the standards they and we all expect. The recently published NHS Five Year Forward View, accepted by all parties, provided new and innovative models of care to meet the demands and challenges of the future; the recommendations and organisational forms of the Dalton Review complement the NHS Five Year Forward View, providing a range of organisational forms to help deliver these new models of care.
Sir David has highlighted five key themes in his Report, which are that: one size does not fit all; quicker transformational and transactional change is required; ambitious organisations with a proven track record should be encouraged to expand their reach and have an impact across the sector; overall sustainability for the provider sector is a priority; and, change must happen through supported implementation. The Report suggests that addressing these five key themes will accelerate the transformational change that is required to help overcome the challenges facing the NHS. To do this, the Report makes recommendations to the national bodies and leaders across the NHS, the wider system and to the Government.
Sir David highlighted the importance of funding and support for implementation of new care models and organisational forms. That is why I am delighted that the Government have announced £200 million funding to support these new models and transform challenged health economies as part of the Governments two billion pounds additional investment in the NHS in 2015-16.
The Government welcomes the Review and its recommendations, encourages all those working in or with the NHS to consider the options and recommendations of the Review and will take a close interest in their adoption and implementation over the coming months.
I would like to thank Sir David Dalton, the expert panel members and the Dalton Review team for their hard work and commitment.
Examining new options and opportunities for providers of NHS care - The Dalton Review has been placed in the Library of the House. Copies are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office.
Attachments:
1. The Dalton Review (Dalton-Review.pdf)
Attachments can be viewed online at http://www.parliament. uk/business/publications/written-questions-answers-statements/written-statement/Commons/2014-12-05/HCWS63/
NHS (Five Year Forward View)
Jeremy Hunt Excerpts(10 years, 5 months ago)
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The Secretary of State for Health (Mr Jeremy Hunt)
I wish today to make a statement on the future of our NHS, one that I hope everyone in this House will welcome. In October, NHS England and its partner organisations published an ambitious “Five Year Forward View” that was welcomed across the political divide. Today, I will announce how the Government plan to implement that vision.
Our response has four pillars. The first pillar is to ensure that we have an economy that can pay for the growing costs of our NHS and social care system: a strong NHS needs a strong economy. Some have suggested that the way to fund extra cost pressures is through new taxes, including on people’s homes. However, through prudent economic policies the Government can today announce additional NHS funding in the autumn statement without the need for a tax on homes. The funding includes £1.7 billion to support and modernise the delivery of front-line care, and £1 billion of funding over four years for investment in new primary care infrastructure. That is all possible because under this Government we have become the fastest growing economy in the G7.
The NHS itself can contribute to that strong economy in a number of ways. It is helping people with mental health conditions to get back to work by offering talking therapies to 100,000 more people every year than four years ago. The NHS can also attract jobs to the UK by playing a pivotal role in our life sciences industry. We have already attracted £3.5 billion of investment and 11,000 jobs in the past three years, as well as announcing plans to be the first country in the world to decode 100,000 research-ready whole genomes. Today, I want to go further by announcing that we are establishing the Genomics England clinical interpretation partnership to bring together external researchers with NHS clinical teams to interpret genomic information so that we go further and faster in developing diagnostics, treatments and therapies for rarer diseases and cancers. Too often, people with such diseases have suffered horribly because it is not economic to invest in finding treatments. We want the UK to lead the world in using genetic sequencing to unlock cures that have previously been beyond our reach.
The second pillar of our plan is to change the models of care to be more suited to an ageing population, where growing numbers of vulnerable older people need support to live better at home with long-term conditions such as dementia, diabetes and arthritis. To do that, we need to focus on prevention as much as cure, helping people to stay healthy without allowing illnesses to deteriorate to the point where they need expensive hospital treatment. Some have argued that to do that we need to make clinical commissioning groups part of local government and force GPs to work for hospital groups, but because that would amount to a top-down reorganisation we reject that approach. We have listened to people in the NHS who say that more than anything the NHS wants structural stability going forward, and, even if others do not, we will heed that message.
We have already made good progress in improving out-of-hospital care. This year, all those aged 75 and over have been given a named GP responsible for their care, something that was abolished by the previous Government. From next year, not just over-75s but everyone will have named GPs. Some 3.5 million people already benefit from our introduction of evening and weekend GP appointments, which will progressively become available to the whole population by 2020. The better care fund is merging the health and social care systems to provide joined-up care for our most vulnerable patients. Alongside that, the Government have legislated, for the first time ever, on parity of esteem between physical and mental health. To deliver world class community care, we need much better physical infrastructure. Today, I can announce a £1 billion investment fund for primary and community care facilities over the next four years. This will pay for new surgeries and community care facilities in the places where people most want them: near their own homes and families. These new primary care facilities will also be encouraged to join up closely with local job centres, social services and other community services.
Additionally, from the £1.7 billion revenue funding we are also announcing, we will make £200 million available to pilot the new models of care set out in the “Forward View”. To deliver these new models, we will need to support the new clinical commissioning groups in taking responsibility, with partners, for the entire health and care needs of their local populations. So as well as commissioning secondary care, from next year they will be given the opportunity to co-commission primary care, specialist care, social care, through the better care fund, and for the first time, if local areas want to do it, public health. The NHS will therefore take the first steps towards true population health commissioning, with care provided by accountable care organisations.
A strong economy and a focus on prevention are the first two pillars of our plan. The third pillar is to be much better at embracing innovation and eliminating waste. We are making good progress in our ambition for the NHS to be paperless by 2018, and last month the number of A and E departments and ambulance services able to access summary GP records exceeded a third for the first time, while from next spring, everyone will be able to access their own GP record online. However, today, I want to go further: £1.5 billion of the extra £1.7 billion revenue funding will go on additional front-line activity. To access this funding, we will ask hospitals to provide assured plans showing how they will be more efficient and sustainable in the year ahead and deliver their commitment to a paperless NHS by 2018.
We also have to face the reality that the NHS has often been too slow to adopt and spread innovation. Sometimes this is because the people buying health care have not had the information to see how much smart purchasing can contain costs, so from next year CCGs will be asked to collect improved financial information, including per-patient costings.
The best way to encourage investment in innovation is a stable financial environment, so I can today announce that the Government, in collaboration with NHS England, will give local authorities and CCGs indicative, multi-year budgets as soon as possible after the next spending review. We expect NHS England and Monitor to follow this by modernising the tariff to set multi-year prices and make the development of year-of-care funding packages easier.
The NHS also needs to be better at controlling costs in areas such as procurement, agency staff, the collection of fees from international visitors and reducing litigation and other costs associated with poor care. I have announced plans in all these areas, and we will agree the precise level of savings to be achieved through consultation with NHS partner organisations over the next six months. This will lead to a compact signed up to by the Department, its arm’s length bodies and local NHS organisations, with agreed plans to eliminate waste and allow more resources to be directed to patient care.
The final pillar of our plan is the most important and difficult of all. We can find the money; we can support new models of care; we can embrace innovation, but if we get the culture wrong, if we fail to nurture dignity, respect and compassionate care for every single NHS patient, we are betraying the values that underpin the work done every day by doctors and nurses throughout the NHS. We have made good progress since the Francis report: a new Care Quality Commission regime, six hospitals turned around after being put into special measures, 5,000 more nurses on our wards, the My NHS website, and 4.2 million NHS patients asked for the first time if they would recommend to others the care they received.
In the next few months, however, we will go further, announcing new measures to improve training and safety for new doctors and nurses, launching a national campaign to reduce sepsis and responding to recommendations made in the follow-up Francis report, tackling issues of whistleblowing and the ability to speak out easily about poor care.
Under this Government, the NHS has, according to the independent Commonwealth Fund, become the top-ranked health care system in the world. In 2010, we were seventh for patient-centred care, and we have now moved to the top. Under this Government, we have also become the safest health care system in the world. But with an ageing population, we face huge challenges.
How we prepare the NHS and social care system to meet those challenges will be the litmus test of this Government’s ambition to make Britain the best country in the world in which to grow old. We are determined to pass that test, and today’s four-pillar plan will help us to do just that. Our plan will need proper funding, backed by a strong economy, so I welcome yesterday’s comment by Simon Stevens that when it comes to money, the Government have played their part.
However, we also need ambitious reforms of the way we deliver care, focusing on prevention, innovation and a patient-centred culture that treats every single person with dignity and respect—proper reforms not as a substitute for proper funding, but as a condition of it. A long-term plan for the economy; a long-term plan for the NHS—I commend this statement to the House.
Andy Burnham (Leigh) (Lab)
This weekend a 16-year-old girl in need of a hospital bed was held for two days in a police cell because there was not a single bed available for her anywhere in the country. As we have warned before, this is by no means an isolated example: the BBC reported on Friday that seven other people had died recently waiting for mental health beds. But it is not just mental health: last week I told the House of a stroke patient ferried to hospital by police on a makeshift stretcher made from blinds in his house. That patient later died. This is one of a number of alarming reports of people waiting hours in pain and distress for ambulances to arrive.
Listening to the Secretary of State for over 10 minutes today, one would have no idea that any of that was happening in the NHS right now—and that is the problem: nothing he has said today will address those pressures ahead of this winter. On mental health, does he not accept that there is an undeniable need to open more beds urgently —right now, this week—to stop appalling cases like the one we heard about at the weekend? What assessment has he made of the ability of the ambulance service to cope this winter? Is there a case for emergency support, on top of what has already been announced?
This statement offers no help now to an NHS on the brink of its worst winter in years, but there is another major problem with it. The weekend headlines promised £2 billion extra for the NHS, but the small print revealed that it is nothing of the sort. I note that the Secretary of State did not use the figure of £2 billion once in his statement, but that is what the NHS was led to believe it was getting. False promises and cheques that bounce one day after they are written are of no use to doctors and nurses struggling to keep services going. We all remember the omnishambles Budget unravelling the day after it was given, but an autumn statement unravelling three days before it has been delivered is a first even for this Government.
Will the Secretary of State confirm that £700 million of the £1.7 billion he talked about is not new money, but already in his departmental budget? A few weeks ago his Department told the Public Accounts Committee that it expects to overspend this year by half a billion pounds. His Department is in deficit right now. If that is the case, would he care to tell us where this £700 million is coming from and what services he will be cutting to pay for it? He mentioned research. At the weekend we exposed NHS England’s plans to cut the funding for clinical trials, which would have affected thousands of very poorly patients. Was that one of his planned central cuts to pay for this funding? Will he now guarantee that funding for research and clinical trials will not be cut?
But it gets worse. Not only is £700 million recycled; we gather that the other £1 billion will be funded by cuts to other Departments. The Institute for Fiscal Studies has warned of “staggeringly big cuts” to local government in the next Parliament. The NHS Confederation has said:
“If additional NHS funding comes at the expense of tough cuts to local government budgets, this will be a false economy as costs in the NHS will rise.”
Have the Government not learnt the lessons of this Parliament: that the NHS cannot be seen in isolation from other services, particularly local government, and that cutting social care only leads to extra costs for the NHS? Figures released on Friday revealed record numbers of older people trapped in hospital because the care was not there for them at home. That is happening on the Secretary of State’s watch.
This is the human consequence of the severe cuts to social care in this Parliament, and it is clear that this Government are preparing to do the same again in the next Parliament if they are re-elected. This is why hospital A and Es have missed the right hon. Gentleman’s own target for 71 weeks running. We also have cancer patients waiting longer for treatment to start, and everyone is finding it harder and harder to see a GP.
Is it not the case that most of what the Secretary of State has announced will go to patching up the problems he has created, leaving less than a quarter for the new models of care outlined in the “Forward View”? Let me remind him that policies such as a year of care for vulnerable patients and having accountable care organisations were developed by the Opposition, and for him to stand there today and lecture us about reorganisations of the NHS—well, I did not think that even he would have the nerve to do that.
The truth is that what the Secretary of State has announced provides nothing for the NHS now and is not what it seems, and because of that it will not be enough to prevent the NHS from tipping into full-blown crisis if the Tories are re-elected next year. They will not be able to find any more money for the NHS than this, because they have prioritised tax cuts for higher earners and have not yet found the money to pay for them. That explains their desperate attempts to inflate these figures and make them sound more than they are. Is it not the case that to deliver the “Five Year Forward View”, the NHS needs truly additional money on the scale proposed by Labour—an extra £2.5 billion over and above everything the Secretary of State has promised today, and an ambitious plan for the full integration of health and social care.
They said they would be the Government who cut the deficit, not the NHS, but it is the Health Secretary who has created a deficit in the NHS. It is because of that deficit that cancer patients are waiting longer, A and E is in crisis and children are being held in police cells, not hospital beds. He had nothing to say to those people today. They deserve better than a Chancellor fiddling the figures and a Health Secretary spinning the facts.
Mr Hunt
This is the day on which Labour’s attacks on the NHS have been shown up for what they are—every bit as shallow as their attacks on the economy. The country knows that we are addressing the squeeze on NHS funding caused by Labour’s wrecking of the British economy.
The right hon. Gentleman called today’s announcement “patching up the problems”. If growing the economy so that we can put more money into the NHS is patching up problems, how would he describe shrinking the economy and then cutting the NHS budget, as he wanted to do? He said that £2 billion of new money was a false promise. It was not a false promise: it was the truth—£1 billion of additional funding from the Treasury and £1 billion from the forex fines. That is £2 billion of new money, which has been welcomed by the King’s Fund today as a big step forward, and by the NHS Confederation, the Foundation Trust Network and Simon Stevens, the head of NHS England and former Labour No. 10 health adviser. This is a very significant moment when, after years of taking painful decisions to get the economy back on track, we can at last put more money into the NHS. The right hon. Gentleman should welcome it, not scorn it.
The right hon. Gentleman talked about deficits in the NHS. We will take no lessons on deficits from the Labour party—the party that left the country its biggest level of unfunded spending commitments in peacetime history. The truth is that now, with a strong economy that Labour could never deliver, we are putting things right.
The right hon. Gentleman talked about problems with care in the NHS, and the one thing that no one ever says about me is that I am a Health Secretary who shies away from those problems. The trouble is that every time I talk about problems with care in the NHS, he says it is running down the NHS. It is not running down the NHS to confront the problems of poor care. He also talked about the issue of police cells, but we are on track to reduce the number of mental health patients using them by 50% over the next few months.
As for pressures on the NHS front line, it is not that all Health Secretaries do not have to confront them; it is whether or not we sort them out. When it comes to poor care in hospitals such as the Medway and hospitals in Colchester, Basildon and Burton, this Government are sorting out those problems, while the previous Government swept them under the carpet. The right hon. Gentleman used the word “spin”, but he might like to reflect on the massive harm done to patients when under a Labour Government poor care was covered up by Labour spin—surely it was Labour’s darkest period ever when it came to running the NHS.
Government Members have a long-term plan for the economy, and a long-term plan for the NHS. By contrast—[Interruption.] Opposition Members might listen to the truth about the NHS. By contrast, the Labour leader said recently that he wanted to “weaponise” the NHS. He wanted to turn the NHS into a weapon—a weapon to get Labour votes. No, Mr Speaker, the NHS is not a weapon for political parties. It is there to help patients and to save lives, not to save political spins. Under this Government, it will always be there for patients: that is what this Government will deliver.
Mr Speaker
Order. For the avoidance of doubt—because there was some consternation about this matter—let me say that I am sure the Secretary of State is not making an allegation of any personal dishonesty on the part of any Member. It would simply not be legitimate to do so.
Mr Speaker
The Secretary of State confirms that he is not making any allegation of personal dishonesty against any individual. Enough: we are grateful. We will leave it there for now.
Dr Sarah Wollaston (Totnes) (Con)
I warmly welcome the statement. The extra funds for the NHS constitute a clear endorsement of Simon Stevens’s excellent “Five Year Forward View”. I particularly welcome the announcement of multi-year budgets and investment in patients’ ability to control their own records. Will the Secretary of State confirm that the process of creating paperless NHS hospitals will move seamlessly from primary to secondary care, and will be controlled by patients themselves?
Mr Hunt
The commitment to a paperless NHS is not a commitment to the creation of paperless hospitals by 2018; it is a commitment to the creation of a paperless NHS so that, with patients’ consent, information can flow seamlessly between different parts of the system. The interface between primary care and secondary care, and social care, is a very important part of that process.
Frank Dobson (Holborn and St Pancras) (Lab)
Will the Secretary of State tell the House how much money is now being diverted from patient care to the negotiation of legally binding contracts between commissioners and suppliers of services, or will he confirm that he cannot do so because he does not bother to collect the information?
Mr Adrian Sanders (Torbay) (LD)
May I focus for a moment on a constituency case? Last Thursday, a 16-year-old was placed in the custody centre at Torquay police station. What is of concern is that there is nothing new about that. In Devon and Cornwall alone, there have been 700 cases of people with mental health problems being placed in police cells. The problem for this young woman was that, at that point, not a single facility could be found anywhere in England to meet her needs. It really is outrageous that that could happen to a 16-year-old girl in this day and age. Where does the statement mention the fourth-tier funding to provide facilities that are clearly needed, and have been needed for years?
Mr Hunt
The hon. Gentleman is absolutely right. It is totally unacceptable for someone with severe mental health problems to be placed in a police cell. We are making very good progress in reducing the use of police cells for that purpose, with the active support of the care services Minister, my right hon. Friend the Member for North Norfolk (Norman Lamb). In the specific case to which the hon. Gentleman has referred, a bed was available but there was poor communication on the ground, which is why we were not able to solve the problem as quickly as we would have liked. As soon as NHS England was informed of the problem, it was able to find a bed within, I think, about three hours. However, as he says, this is a problem that we must eliminate.
Glenda Jackson (Hampstead and Kilburn) (Lab)
If that amount of new money is indeed going into the NHS, will the Secretary of State tell us how much of it will be dedicated to—perhaps even exclusively used for—better delivery of mental health services, not least services for child and adolescent mental health patients?
Let me point out to the Secretary of State that this is not the first occasion on which the House has raised with the Government the total failure to provide adequate services for people with mental health issues. The matter was most recently highlighted at the weekend, but it has been highlighted in the Chamber more than once in the recent past. What the Secretary of State has said today certainly does not calm my fear that if my constituents need a mental health bed, they will not find one in London, and heaven only knows how many hundreds of miles they may have to travel before they do find that security.
Mr Hunt
I hope I can reassure the hon. Lady, because today’s announcement includes £1.5 billion extra for the NHS front line next year. That will include mental health services, and we would expect commissioners to observe parity of esteem as they decide how to allocate those additional resources. It also includes £1 billion to improve primary care facilities, which will be used by many mental health patients. There is a lot in today’s announcement that I hope will relieve pressure. She is right to say that we need to do better on child and adolescent mental health services. This has been a long-standing problem, but we have been taking forward some important work to make a reality of our commitment to parity of esteem, which is something we are very proud to have legislated for.
Sir Nicholas Soames (Mid Sussex) (Con)
May I report to my right hon. Friend that, despite the dismal rant he heard from the shadow Secretary of State, the Princess Royal hospital in Haywards Heath and the Royal Sussex county hospital in Brighton, and their doctors and nurses, are doing a magnificent job in treating local people? Will he also accept that the problem with mental health services in this country goes back a long way? It will not be fixed overnight. I have had the same problem in my constituency of someone being put in a police cell. The problem fell entirely on the staff of the local trust, who simply did not deal with the matter properly. This is going to take a long time to fix, and I greatly welcome my right hon. Friend’s statement.
Mr Hunt
I thank my right hon. Friend for his comment, because the use of police cells is not an issue with which we should be playing party political games. As it happens, their use was much higher under the last Labour Government. We are starting to address that issue, and he is right: even one person spending a night inappropriately in a police cell is one person too many. That is why we are making good progress, but in the end it will require people who purchase health care in local areas to look at people with mental health needs in a holistic way—not just trying to solve issues problem by problem, but looking at and addressing the whole problem and making sure they get the treatment they need.
Mr Ben Bradshaw (Exeter) (Lab)
The Secretary of State should not be at all surprised by this terrible case of the young girl kept in a police cell in Devon over the weekend, because I and other Members have been raising this personally with him for at least the last three years. What has he been doing over that period to address the scandal of young people’s mental health services in Devon and nationally?
Mr Hunt
I will tell the right hon. Gentleman what I have been doing: I have been putting in place a strategy that will see over the next few months a reduction of 51% in the number of mental health patients who use police cells. That is progress. It still means that there are too many people in police cells, but I would just gently urge him not to try to make party political capital out of this, because a higher number of them were used under the last Labour Government. We are addressing a long-standing problem in a responsible way, and are determined to go further.
Mr Bernard Jenkin (Harwich and North Essex) (Con)
I welcome every word of my right hon. Friend’s statement, not least because his fourth pillar on culture change echoes the work done by the Public Administration Committee on complaints handling and the need for openness. His statement addresses all the needs and challenges we face in north-east Essex: the problems of openness and transparency in the local hospital and the need to transfer more of what the hospital does back to the community providers—to the multidisciplinary providers that need to be in the community. I welcome the £1 billion fund for developing community facilities, but how is he going to persuade the CCGs to transfer some of their commissioning power to these units? A hospital in Harwich, which was built under the last Labour Government, has two operating theatres that have never been used because the CCG, and its predecessor the primary care trust, would not commission services through those facilities.
Mr Hunt
I thank my hon. Friend for his long-standing support for the importance of transparency in driving up standards in health care. He has championed that for his own hospital, which has had particular issues on that front, but also through his role in this House, and he is absolutely right to do so. On his substantive point, we will get CCGs to do what he suggests through the reforms that I have announced, which will encourage them to take a holistic view of the health care received by the patients for whom they are responsible. In particular, we have got to move away from commissioning care piecemeal—commissioning a certain number of hips or a certain number of mental health consultations—and start looking at patients and all their needs in the round. If we commission in that way, we can avoid a number of the human tragedies that have come to light.
Lady Hermon (North Down) (Ind)
Will the Secretary of State kindly confirm that the Chancellor will include in his autumn statement on Wednesday an obligation on the Northern Ireland Executive to ensure that if, as we expect, further funding for health is devolved to Northern Ireland, it is ring-fenced so that it is spent exclusively on health? In that way, GP beds in community hospitals such as mine in Bangor—in North Down, not north Wales—can be reopened. Those beds were closed today, 1 December, causing enormous trauma and distress to the patients and staff there.
Mr Hunt
The system involves Barnett consequentials. As a result of today’s announcement, extra money will go to the devolved Administrations and we hope that they will use it for health purposes, but they do have a choice. The hon. Lady has just made the case extremely elegantly for that money to be put into health. She mentioned north Wales, and I know that Members on this side of the House will be hoping that the Welsh Government will also use the extra money for the NHS, given the profound problems in the Welsh NHS.
Richard Fuller (Bedford) (Con)
Dementia care for our parents, grandparents and loved ones is a growing issue for my constituents, and I congratulate my right hon. Friend on putting dementia care at the centre of what he is trying to do. I also congratulate the Bedfordshire clinical commissioning group on its recent review. Will he tell us what today’s announcement will do to help to support those parts of the country that are trying to make progress on dementia care?
Mr Hunt
I am happy to do so. We have made good progress during this Parliament, increasing by 10% the proportion of people with dementia who receive a diagnosis. This is not just about getting a diagnosis, however; it is the care and support that people get when the diagnosis is made that really matter. That is the reason for giving the diagnosis. Let me characterise the change that we want to see for people with dementia over the next few years. When someone gets a diagnosis, we want to wrap around them all the care and support that they and their family need to help them to live healthily and happily at home for as long as possible, so that they do not get admitted to hospital in an emergency or need to go into residential care until the very last moment. Of course that will cost the NHS less, but it is also far better for the individual concerned.
Mr Kevan Jones (North Durham) (Lab)
The Secretary of State talks about party politics, but he cannot get away from the fact that the number of mental health beds in this country has dropped by 1,500 on his watch. We have heard about the scandal in Devon last week, and my hon. Friend the Member for Hampstead and Kilburn (Glenda Jackson) has told the House how some patients have to travel up to 200 miles to access an emergency bed. What is the Secretary of State going to do to deliver those beds where the mental health patients who are in crisis actually need them, which is close to their homes?
Mr Hunt
I agree with the hon. Gentleman that we need to address the issue of availability of mental health beds for crisis care, but we also need to recognise that the model of care for people with mental health needs is changing. We think that it is much better to avoid long-term institutionalisation if we possibly can, and that is why there has been a process of reduction in the number of beds. That happened under the Labour Government as well. If he wants to know what I am doing, I will tell him. I am part of the Government who are delivering a strong economy, which means we can put more money into the NHS.
Mr Mark Hoban (Fareham) (Con)
I commend my right hon. Friend for securing £1 billion from the Chancellor to modernise primary care services. I know that the GPs in my constituency will welcome that, because they often cannot provide additional services owing to capacity constraints. May I urge him to ensure that, when money is spent from the fund, it is linked to delivery in relation to the proposals set out by Simon Stevens for improving primary care, for better provision locally and for closer integration with hospitals?
Mr Hunt
My hon. Friend is absolutely right. This will help to improve primary care premises and facilities. I know that there is an urgent need to upgrade a number of GP surgeries and primary care facilities, but this is not essentially about buildings. It is about new models of care. The single big change that we need to see over the next five years is in the role of GPs, so that they have the capacity and the desire to take proactive responsibility, particularly for the most vulnerable people on their lists, including people with long-term conditions such as dementia, diabetes and asthma. To do that, they will need better facilities—bigger facilities—and the ability to carry out more diagnostic tests in their surgeries, and I think that this funding will make a big difference.
Mr Andy Slaughter (Hammersmith) (Lab)
Will the Secretary of State confirm a report in The Guardian today that he shelved the downgrading of the majority of accident and emergency departments in England under the Keogh review because that is “political suicide” and because of criticisms from the College of Emergency Medicine, the Care Quality Commission and chief executives of trusts? Will this mean that he can now suspend Shaping a Healthier Future and remove the threat to the Charing Cross and Ealing A and Es?
Mr Hunt
I am always happy to confirm that a Guardian story is wrong. Let me tell the hon. Gentleman that there was no plan to downgrade the majority of A and Es. The plan is to invest in A and Es—to continue with broadly the same number of A and Es as we currently have but to recognise that some of them will need to specialise in different things. We will stick to that plan—it is a good one.
Paul Burstow (Sutton and Cheam) (LD)
I very much welcome the statement and, in particular, the Secretary of State’s ambition that Britain should become the best place in the world to grow old in. Given that home care is an essential part of maintaining frail older people and enabling them to remain in their own homes, and given that well-paid, well-trained and well-motivated home care staff enable people to stay in their own homes and families to juggle work with caring responsibilities, will he direct some of the extra £2 billion to the better care fund, so that it goes directly into social care so that these services can actually be provided?
Mr Hunt
First, I agree with the point that my right hon. Friend is making: home care is going to become an increasingly important part of what the NHS and social care systems deliver. I want them to deliver it in an integrated, joined-up way, and £200 million of the £1.7 billion going to the NHS front line is to help develop new models of care. I think that improved home care could be a very real way we do that.
Keith Vaz (Leicester East) (Lab)
The “Five Year Forward View” recommended a five-year programme to prevent type 2 diabetes that is evidence-based. How much of the money that the Secretary of State has announced today will be specifically about preventing diabetes, so that in the long run we will save even more money? At the moment, health and wellbeing boards are under no obligation to spend any part of their budget in a specific way on diabetes.
Mr Hunt
First, I congratulate the right hon. Gentleman on his campaigning on diabetes. I have looked at this carefully as Health Secretary and I looked at the possibility of ring-fencing certain sums in the budget for conditions such as diabetes, but the advice I received was that the broader change we need to make is in the whole mentality across the NHS for dealing with all long-term conditions, not only diabetes, but arthritis, dementia and chronic obstructive pulmonary disease. That is because within a couple of years we will have 3 million people who have three or more long-term conditions, one of which is often diabetes. Will a real focus of the change we want to see in the NHS be on people with long-term conditions? Yes, I would say that that is the biggest focus of all in the change we want to see over the next five years.
Sarah Newton (Truro and Falmouth) (Con)
I welcome today’s announcement of the national sepsis prevention campaign, which will make a such a difference to people in Cornwall and all around the UK. Will my right hon. Friend continue to work with the all-party group and the UK Sepsis Trust to implement the sepsis six, which it is estimated will save 12,500 lives and £2 billion for the NHS every year?
Mr Hunt
Yes, I will. I have to say to the House that the importance of being better at tackling sepsis was brought home to me personally by two moving meetings with Scott Morrish, the father of Sam Morrish, who was from the west country—perhaps near my hon. Friend’s constituency. His son’s tragic death from sepsis was avoidable, so this is an absolute priority for me in the next couple of months.
Clive Efford (Eltham) (Lab)
Two weeks ago, the Secretary of State could not muster enough Conservative MPs in this House to defend the Health and Social Care Act 2012, particularly those elements of it that have allowed competition regulators into the NHS to second-guess decisions of local commissioners. If he wants to save money in the NHS, he can do away with that element of the 2012 Act and stop money being diverted from patients to pay for lawyers and accountants to oversee a tendering process that is wasting money.
Richard Drax (South Dorset) (Con)
I congratulate my right hon. Friend on his remarks and thank him for the extra £1 billion for primary care. In South Dorset, I hear many complaints about the agency fees for recruiting staff, which is one reason why trusts tend to recruit nurses from abroad—from places such as Spain. Will he look at that and see if there is some way we can save a bit of money and act a little more efficiently?
Mr Hunt
We are spending too much on agency staff. It is fair to acknowledge that one reason why NHS trusts are doing that is in reaction to the Francis report. They want to ensure that they have proper staffing on their wards and proper staffing quickly. We have introduced transparency to encourage them to do that. As things settle down, they need to transfer more of those staff on to proper permanent contracts, because it costs the NHS too much to pay those exorbitant agency fees.
Ann Coffey (Stockport) (Lab)
I welcome any extra funding for the NHS, but will the Secretary of State ensure that it is fairly distributed, as on the current funding formula, Stockport is 4.9% from target, and that is affecting the ability of the clinical commissioning team to develop health services in the community as an alternative to emergency admissions to Stepping Hill hospital?
Mr Hunt
I recognise the hon. Lady’s concern about the way funding is allocated, and it is a concern that is shared in all parts of the House. It has been very difficult to get that right in a period when NHS funding has not been going up by large amounts, but that matter is now decided at arm’s length from Ministers by NHS England. It will make its decisions at a board meeting on 17 December, and I will make sure that I relay to it her concerns.
Margot James (Stourbridge) (Con)
Does my right hon. Friend agree that all patients, especially older and vulnerable patients, deserve the security of an NHS funded out of general taxation rather than part-funded by an unpredictable and opportunistic tax on people’s homes as proposed by the Labour party?
Mr Hunt
The trouble with a mansion tax is that, in the end, it will apply not to mansions but to homes, flats and people on low incomes. That is why it is the wrong way to put more funding into the NHS. The right way to do it is to have a strong economy, and only this Government can deliver that.
Karl Turner (Kingston upon Hull East) (Lab)
Up until her retirement, my mother was a very proud and committed nurse in the NHS. The Secretary of State wears a lapel badge pretending his love for the NHS. Today, my mother asked why, if the Secretary of State had £700 million in his Department, could he not have afforded the measly 1% pay rise for our committed nurses in the NHS, which would have cost £200 million.
Mr Hunt
It really demeans debate in this House to go on about some phoney argument that one side of the House cares about the NHS while the other does not. We have shown our commitment to the NHS by announcing today £2 billion of additional funding. That is a big deal and it shows our commitment. We have also given all nurses a 1% pay rise.
Andrew George (St Ives) (LD)
I welcome the additional money. My right hon. Friend is right that health providers need a stable financial environment, but many of them have been left with a debilitating legacy of debt. The Royal Cornwall Hospitals Trust in my own area has a legacy of debt, which is just a fraction of the amount by which the Government have admitted that they have underfunded the local health economy over many years. Rather than having distorting activity going on in that trust, would it not be better for it to start with a clean sheet of paper and to build for the future rather than constantly having to work from a position of debt?
Mr Hunt
I sympathise, because the previous Labour Government left hospitals with more than £70 billion of PFI debts. Those debts must be paid off and that money cannot be spent on front-line patient care. We have done what we can on a case-by-case basis to help trusts deal with those debts. It is extremely difficult when resources are tight and of course I will consider the trust’s particular case.
Mr Angus Brendan MacNeil (Na h-Eileanan an Iar) (SNP)
Any new money for health is, of course, welcome, but it has only come because of acute need in the English NHS. If there had been acute need in the Scottish NHS or further acute need in the Welsh NHS, we could whistle for it. Surely this is one reason for us to have full fiscal autonomy in Scotland so that we can control the spending and raising of money in Scotland rather than relying on mismanagement in England or on electoral advantage. What will be the consequences of this announcement for the Scottish NHS, the Welsh NHS and the Northern Irish NHS per annum?
Mr Hunt
I am very happy we devolve responsibility for the NHS to the devolved Administrations, because it means that people can compare performance and that we can learn from each other. For example, patients wait a shorter time for operations in England compared with in Scotland and Wales.
Sir Tony Baldry (Banbury) (Con)
Giving clinical commissioning groups the opportunity to commission GP services as well as secondary care will provide an amazing opportunity for there to be whole-population commissioning. Does it not also provide an opportunity for health and wellbeing boards? It provides an opportunity for elected councillors to work with clinical commissioning groups to try to design health care services, both primary and secondary, for the whole of the local population.
Mr Hunt
It absolutely does. My right hon. Friend makes his point very powerfully. This year, the better care fund—a programme derided by the Labour party, which said that it would not work—has been a huge success, with a £5 billion integration of the health and social care systems. The enthusiasm that that unleashed encouraged me to propose today that we should go further, so that where both parties are willing, local authorities and the local NHS should consider jointly commissioning public health as well. There would be huge benefits if they chose to do that.
Mr Nicholas Brown (Newcastle upon Tyne East) (Lab)
Is it still the Government’s case that the emerging deficits across the English hospital trusts can be dealt with by efficiency savings alone?
Mr Hunt
There are huge pressures in the NHS. By the time of the election, we will have nearly 1 million more over-65s than there were at the last election. That means that people have to redouble their efforts to live within their means. At the same time people are trying to deliver the higher standards of care that we have talked about following the Francis review of what happened in Mid Staffs. It is challenging, but we expect all trusts to live within their budget. In all cases, they have recovery plans that we expect them to stick to.
Sir Bob Russell (Colchester) (LD)
I pay tribute to the medical and support staff at Colchester hospital for their work to bring it out of special measures. Twice the Secretary of State referred to focusing on prevention. May I suggest that a contribution to that admirable aim would be for first aid to be included in the national curriculum for schools?
Mr Hunt
No one campaigns more for first aid than my hon. Friend. I would certainly encourage all schools to teach first aid, as I think it is a very important skill and we should consider that as part of the prevention agenda. There is also a broader point, which is that we can do a lot with the Department for Education on this agenda.
Derek Twigg (Halton) (Lab)
In my constituency, people are increasingly finding it difficult to access GPs and the local hospital, Warrington and Halton, is in deficit and is missing its A and E targets. I therefore have a simple question for the Secretary of State. How many additional GPs will this money find, over and above the number of GPs who are in post today?
Mr Hunt
It takes seven years to train a GP, so the long-term solution is to train an additional 5,000 GPs, which is what the Government have decided to do and have announced. While they come on stream, this additional money will fund up to 20,000 additional posts, a number of which will be in the community.
David Tredinnick (Bosworth) (Con)
I congratulate my right hon. Friend on his emphasis on prevention. Has he had a chance to read Public Health England’s report “From evidence into action”? It encourages him to place greater emphasis on risk factors that contribute to an early death, such as tobacco, blood pressure, diet, inactivity and alcohol, rather than the actual conditions that people die from. That would cut demand for services.
Mr Hunt
That document is very powerful and I have said before that I hope that in our lifetimes this will become a smoke-free country. It is shocking that we still have 85,000 deaths every year linked to smoking. However, we are a free country so this is about supplying the information, incentives and nudges and not about compelling people.
Fiona Mactaggart (Slough) (Lab)
The right hon. Gentleman knows that GPs in my constituency have, on average, 4,500 patients on their list, which is about twice the average for England. Earlier he told my hon. Friend the Member for Stockport (Ann Coffey) that in constituencies such as hers and mine, where funding is so far from the target, we have to depend on NHS England, not him, to remedy the gap. How can we influence NHS England? What pressure is he putting on it to get fair funding for every area?
Mr Hunt
The reason we decided to give that decision to NHS England—it is now decided at arm’s length from Ministers—was to remove the worry people had that politicians might make these decisions for political purposes, rather than for what is right for the NHS. I encourage the hon. Lady to make representations to NHS England before its board meeting on 17 December.
Charlotte Leslie (Bristol North West) (Con)
I very much welcome the “Five Year Forward View” and the new investment, but does the Secretary of State agree that it is not so much a five-year forward view we need as a 20 or 50-year forward one, if we are to begin to meet the tsunami of demand we face? We will have to work together across the House as we face the tough questions on how to fund and manage the NHS. Otherwise, we will be accused by future generations of bickering while our NHS burns.
Mr Hunt
I hear what my hon. Friend says, but it is also important to have a clear plan of action to take us in the right direction over the next six years, which is what the plan from NHS England and Simon Stevens provides and what the Government have said we support. She is right that the demographic trends will get worse. By 2030 the number of over-80s will have doubled to 5 million. That is the sobering reality that we all have to face up to.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
Is the Secretary of State aware the some of us on the Opposition side feel a bit sorry for him? This is the third “pie in the sky” statement we have had recently—we have heard statements on rail, on roads and now on health—which basically say that things might get better in future, and of course the election is in five months. The fact of the matter is that when I go back to Huddersfield, I see a health service in which all the players, who used to work together in partnership for something they believed in, are now at each other’s throats, as a result of his reforms: not collaborating, but fighting, disagreeing and making bids against each other.
Mr Hunt
Let us take one example. The better care fund has meant that for the first time—this did not happen in 13 years under Labour—local authorities are sitting around a table with the local NHS, working out how to jointly commission care for the most vulnerable patients in the community. That is a huge step forward. The hon. Gentleman should talk with the people in his local authority, because he will hear about the incredible progress that is being made. This is not pie in the sky; it is £2 billion of new money for the NHS. That will make a big difference to doctors and nurses in Huddersfield, just as it will everywhere else.
John Stevenson (Carlisle) (Con)
I welcome the announcement of additional funds for the NHS and give my support to the Minister for putting patients first and driving up the quality of care. However, does he agree that it is not all about money and that quality, committed and motivated staff are central to a successful NHS, as is good leadership and management, particularly at the local level?
Mr Hunt
My hon. Friend is absolutely right. For every hospital in difficulty—he has had many discussions with me about his hospital, which is going through a very difficult period—there is another with the same funding settlement that is able to deliver good care with motivated staff. Leadership is extremely important for motivating staff, and the one thing that staff say matters most to them is having leaders who listen to what they say and, when they have concerns, take them seriously. That is a change that we are beginning to see throughout the NHS.
Mr David Anderson (Blaydon) (Lab)
On that subject, I can advise the Secretary of State that last week I spoke to nurses in the hospital near my constituency, and they told me that as a result of the cuts in their pay, which have been going on for many years, they are seriously considering setting up shoebox collections to help their members get through this Christmas. At the same time, the chief executive of that trust has had a 17% pay increase, and the governors have had an 88% increase in their allowances. Is that what he means by all being in this together?
Mr Hunt
I am afraid we will not take any lessons from the party that increased managers’ pay at double the rate of nurses’ pay when in office. I will tell the hon. Gentleman what this Government have done: because of our increases in the tax-free threshold, the lowest paid NHS workers have seen their take-home pay go up by £1,000 a year.
Mr David Nuttall (Bury North) (Con)
Despite all the claims and counter-claims, does the Secretary of State agree that in the long term, with a taxpayer-funded NHS, Government will only ever be able to increase resources and meet the public’s expectations if UK plc is thriving and we have a growing economy?
Mr Hunt
My hon. Friend is absolutely right. The Labour party thought it would win this argument by pledging extra money for the NHS at its party conference, but that will not actually happen until the second half of the next Parliament and it may not happen at all if it has got its sums wrong. The public reaction was simply not to believe it, because they know that what Labour does to the economy actually puts all NHS funding at risk, which is something we must never allow to happen.
Mark Reckless (Rochester and Strood) (UKIP)
Earlier this year, the Secretary of State announced a welcome £6.12 million grant for Medway, and on Tuesday he referred to the extra doctors and nurses being taken on in a special measures regime for Medway hospital. Could he assure us that extra and recurring funding will also be available to cover the costs in future?
Mr Mark Spencer (Sherwood) (Con)
What impact will the extra money have on hospitals in special measures, such as the Sherwood Forest Hospitals NHS Foundation Trust? Could he assure the House that any extra moneys will reach clinicians and patients and will not be swamped by the disastrous private finance initiative that the previous Government signed?
Mr Hunt
Of course, that has been a huge problem for Sherwood Forest Hospitals NHS Foundation Trust. I have met the chief executive, who is doing a very good job in turning around the trust, but there are huge challenges. What doctors and nurses in failing hospitals or hospitals in special measures want to know is that they have a Government with a long-term commitment to the NHS and who will deliver the economy that can fund the NHS. They also want to know that they have a Government who will tell the truth about problems so that they get sorted out, which never used to happen before.
Mrs Madeleine Moon (Bridgend) (Lab)
Last week, as chair of the all-party group on motor neurone disease, I took evidence from professionals and patients who had been promised that £14 million would be available for communication support from April this year. Not a penny has been spent yet on equipment or new staff. I took phone calls from people who are end-stage kidney diseased who are frightened by the announcement that kidney dialysis is to go from NHS England to clinical commissioning groups. Will the Secretary of State get a grip, make sure that the money that is there is spent, and stop the disastrous move of kidney dialysis to CCGs, which are not functioning?
Mr Hunt
With the greatest respect to the hon. Lady, I will very happily look into the concerns she raises, but what we are talking about today is more money going into the NHS because the Government got a grip of public finances and got the economy growing. That means more money for people with long-term conditions, including people with motor neurone disease. The hon. Lady should therefore welcome today’s announcement.
Andrew Bridgen (North West Leicestershire) (Con)
According to clinicians in charge of health care and budgets, this Government have done much to take the politics out of running the NHS. Will my right hon. Friend confirm that average productivity in the NHS has improved under this Government, and does he agree that, given the outrageous comments of the Labour leader, it is clear that Labour is happy to see the NHS used as a political football?
Mr Hunt
I think what the public find very perplexing about this is that the Labour party opposed reforms that mean we have 10,000 more doctors and nurses on the front line. Labour is now not welcoming additional financial investment in the NHS that means we will have even more doctors and nurses, and it does not recognise the fundamental point that affects the whole NHS, which is that, in employing those extra doctors and nurses, we have to back them with a culture of safety and compassionate care that we never saw under Labour.
Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)
Our NHS is indeed reliant on a strong economy, but we should note that the UK’s state deficit is the worst in the European Union at the moment and our state debt has more than doubled since May 2010. Can I take it from the Secretary of State that I can go back to the constituents of Middlesbrough South and East Cleveland and tell them that their acute hospital trust will have its £91 million deficit removed; that its PFI, which was opened up in the Major years, will be dealt with properly; that Hemlington, Park End and Skelton medical centres will stay open: and that minor injuries units in Guisborough and Brotton will remain open?
Mr Hunt
I warmly congratulate the hon. Gentleman on being the first Labour Member to say in this House that a strong NHS needs a strong economy. May I encourage him to transmit that message to those on his Front Bench, and perhaps to the shadow Chancellor, who might then understand why people in the NHS are backing this Government because they know that we will deliver a strong economy? I do not know whether we can do all the things the hon. Gentleman talked about, but we will have a better chance with the fastest-growing economy in the G7.
Rehman Chishti (Gillingham and Rainham) (Con)
I thank the Secretary of State for his statement and for the support that he has personally given to Medway Maritime hospital in my constituency, including, at a meeting last week, a commitment of £5.5 million to increase its A and E capacity. Can he assure me that hospitals in special measures that have problems going back to 2006 with high death rates will be given extra resources from the funding announced today to ensure that they are turned around as quickly as possible?
Mr Hunt
I assure my hon. Friend, who has campaigned very hard to improve standards at Medway hospital, that, first, we want to support its doctors and nurses, who are more passionate than anyone about putting this difficult period behind them; and that secondly, I have no greater focus than on making sure that we do turn around these hospitals in difficulty. It is a challenging process, but the extra funds that I have announced today will benefit all hospitals, including Medway.
Mr Jim Cunningham (Coventry South) (Lab)
The Secretary of State has boasted about the numbers of doctors and nurses coming through on his watch, but that actually started on Labour’s watch because, as he has said, the process takes seven years. What proportion of this new investment in the national health service is to be invested in Coventry, particularly given the disparity regarding doctors’ surgeries and the loss of doctors?
Mr Hunt
The training may have started under Labour, but if we do not have enough money in the NHS budget, we cannot pay for these doctors and nurses. We can do that because we took a decision, bitterly opposed by Labour, to disband the primary care trusts and the strategic health authorities and to lose 21,000 administrators so that we could pay for 10,000 extra doctors and nurses, including in Coventry.
James Morris (Halesowen and Rowley Regis) (Con)
The achievement of parity of esteem between mental and physical health in the NHS is absolutely fundamental to its future. As the Secretary of State will know, the Government have a reasonably good record on moving towards parity of esteem. Does he agree that we need not only more investment in mental health services, but, more importantly, better commissioning and a change of culture towards viewing patients as a single whole?
Mr Hunt
My hon. Friend has campaigned incredibly hard on this issue. I totally agree that the key aspect is a change in the approach of commissioners. People with mental health needs often have physical health needs and different needs relating to gambling and alcohol addictions, for example, that are connected to their mental health problems. Unless all these issues are tackled together, we are unlikely to make progress. We are very proud to have enshrined in legislation parity of esteem as something that we must achieve in the NHS. Today’s announcement will help this to go further.
Mike Kane (Wythenshawe and Sale East) (Lab)
Given that delayed discharges have reached a record high, what guarantee can the Secretary of State give that this money will not be paid for by further cuts to local government social care budgets?
Mr Hunt
The hon. Gentleman will have to wait to see what the Chancellor says on Wednesday about the Department for Communities and Local Government settlement. This Government have recognised that the fate of the social care system and the fate of the NHS are closely entwined, and that we cannot support the NHS at the expense of the social care system because the two go together. That is why we see close working with the Better Care fund.
Robert Jenrick (Newark) (Con)
As my hon. Friend the Member for Sherwood (Mr Spencer) highlighted, Sherwood Forest Hospitals NHS Foundation Trust remains in special measures. I know that the Secretary of State has taken an interest in this. The trust has many failings, but it also has one hand tied behind its back in the form of a particularly egregious PFI deal that takes up 16% of its budget every year. Is there anything he can do to review trusts that are in special measures and have particularly difficult PFI settlements?
Mr Hunt
I remember visiting Newark hospital with my hon. Friend before he was elected, and I know that he campaigns very hard on the issues facing the trust. I will happily take that issue away and look at it. It is worth saying that the doctors and nurses at that hospital are working incredibly hard to turn things around, and they have already made great progress.
Andrew Stephenson
Thank you, Mr Speaker; I am honoured.
I very much welcome the £2 billion of additional funding announced today. This morning, I was at Airedale hospital for the preview of its new £6.3 million A and E department, which will open to the public this Wednesday. Will the Secretary of State join me in paying tribute to all the hospital’s NHS staff and management, and its patients, who have been involved from the start of the process in making sure that the new A and E department, which is more than double the size of the old one, is now a reality?
Mr Hunt
I am happy to do so. It is an absolutely brilliant hospital. I was really impressed when I saw that it has integrated its IT systems with those of local GPs better than anywhere else I have seen in the UK, and it is now looking at integrating those systems with local residential care homes. It has a fantastic Skype system for patients who are vulnerable and have mobility problems. It is an amazing place, and my hon. Friend is absolutely right to draw attention to it.
Mr Marcus Jones
The previous Labour Government left my constituents with one of the worst health funding allocations in England. Despite the extra investment that this Government have put in, the issue still has not been properly resolved. Having heard my right hon. Friend’s advice earlier, I will be making representations to NHS England. Will he join me in supporting my constituents in getting a fairer funding deal?
Mr Hunt
I want everyone to have a fairer funding deal, and today’s announcement is significant in that respect. One of the reasons it has been difficult to help people to move closer to their target funding allocations is that the increases in the NHS budget have been only 0.1% every year, so we have not had the margins necessary to make changes. Precisely by how much, and where, we make those changes is a matter for NHS England, but I will happily refer my hon. Friend’s concerns to it.
Oral Answers to Questions
Jeremy Hunt Excerpts(10 years, 5 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Grahame M. Morris (Easington) (Lab)
3. What representations he has received on exemption of the NHS from the provisions of the transatlantic trade and investment partnership.
The Secretary of State for Health (Mr Jeremy Hunt)
The Government will not allow TTIP negotiations to harm the NHS. Any suggestion to the contrary is both irresponsible and false. I am grateful to the former Labour shadow Health Secretary for confirming that.
Grahame M. Morris
That is an interesting answer but, without specific exemption from TTIP, how can the Secretary of State give any reassurance that predatory organisations such as the Hospital Corporation of America, which was prosecuted for fraud in the US, will not use the TTIP provisions to seek contracts in our NHS?
Mr Hunt
The best assurance I can give the hon. Gentleman is not what I have said, but what the EU Trade Commissioner, Karel De Gucht—I challenge colleagues in Hansard to spell that correctly without looking at my notes—has said. In an interview in September, he said:
“Public services are always exempted—”
from TTIP—
“there is no problem about exemption. The argument is abused in your country for political reasons but it has no grounds.”
Mr Speaker
Colleagues in Hansard may not even rely on the Secretary of State’s notes; they may have their own source material. They are very special people those reporters.
David Morris (Morecambe and Lunesdale) (Con)
I thank my right hon. Friend for that concise answer. I reiterate the message to the unions, which are sticking up billboards in my constituency, that Cameron and Hunt are not selling off the NHS.
Mr Hunt
I thank my hon. Friend for his comments. I was quite amused to see that I have a future career as an estate agent, along with the Prime Minister, when our hopefully long careers in politics are over, but the point is that this is scaremongering and it is wrong to scaremonger about something as important as the NHS. To suggest that the NHS is being privatised is fiction. What is not fiction is Labour’s legacy of poor care.
Clive Efford (Eltham) (Lab)
The Secretary of State’s definition of “harm” is not the definition that Labour Members have. My Bill, which was passed overwhelmingly on Friday, would require the Secretary of State to bring the matter back to this House should TTIP apply to the NHS in any way whatsoever. Will he support my Bill going into Committee without delay, so that we can discuss the detail and answer the questions he has?
Ms Margaret Ritchie (South Down) (SDLP)
Given the uncertainty of the French and German Governments on the investor-state dispute settlement mechanism, as well as the indication by EU Commission President Juncker that he will not back it, why have this Government not done more to protect the health service from a practice that would leave it vulnerable to private sector intervention?
Mr Hunt
This is what the EU chief negotiator said to the former Labour shadow Health Secretary, who is chair of the all-party group on TTIP:
“the rights of EU Member States to manage their health systems according to their various needs can be fully safeguarded…There is no reason to fear either for the NHS as it stands today or for changes to the NHS in future as a result of TTIP.”
It could not be clearer than that.
Mr Philip Hollobone (Kettering) (Con)
4. How many patient episodes there were at Kettering General Hospital in (a) 2010 and (b) the last year for which figures are available; and what assessment he has made of the reasons for the change in the number of such episodes.
David T. C. Davies (Monmouth) (Con)
6. How many patients have received treatment through the cancer drugs fund since the inception of that fund.
The Secretary of State for Health (Mr Jeremy Hunt)
More than 60,000 patients in England have received treatment through the cancer drugs fund since its inception in October 2010. They and their relatives will be very concerned at the suggestion made by the shadow Health Secretary last month that a Labour Government could abolish the fund.
David T. C. Davies
I congratulate the Secretary of State on that very high figure. Is he aware that some of those people who are being treated have had to sell up their homes and move here from Wales, where they are routinely denied life-prolonging cancer drugs by the Labour-run Welsh Assembly Administration. What does that teach us about the respective differences between the health services in England and Wales?
Mr Hunt
I thank my hon. Friend for raising that point. The last Labour Government did leave us with one of the lowest cancer survival rates in western Europe, which is one of the reasons why we introduced the CDF. Unfortunately, the current Labour Government in Wales are continuing with those policies, which is why 6,500 Welsh cancer patients were admitted for treatment in English hospitals last year. [Official Report, 12 January 2015, Vol. 590, c. 5-6MC.]
Valerie Vaz (Walsall South) (Lab)
So will the Secretary of State then publish the assessment of the CDF by the chemotherapy intelligence unit before 7 May 2015?
Mr Hunt
We are, on the NHS, the most transparent Government in history, and I can see no reason why we would not publish that. We are very proud of what the CDF has achieved. We are very proud that the level of cancer diagnoses has increased by more than 50% compared with what it was under the previous Labour Government, and so we are finally starting to win the battle against cancer.
Andrew Percy (Brigg and Goole) (Con)
We all remember the horror stories before the CDF existed locally, and all Government Members certainly support its continued use. Before any drugs are delisted from the CDF, will the Secretary of State make available the scoring of those drugs? Will he also outline what the provisions will be for consultation with patients and their families?
Mr Hunt
We will absolutely go through a transparent process on that. My hon. Friend is right to talk about the CDF’s success, which is why we have put its budget up by 40%. As part of the fund’s success, we want to make sure that it is allowing access to the latest drugs and to drugs that really work. Obviously, science has moved on since the fund was set up four years ago, which is why we want to make room for new drugs and take off existing drugs where there is evidence that they are not working as well as possible. However, the process must be transparent.
Liz Kendall (Leicester West) (Lab)
Last Wednesday, the Prime Minister denied that there is a problem with cancer care, yet the target for cancer patients to start their treatment 62 days after a general practitioner referral has been missed for nine months in a row. Cancer Research UK says that this target is vital for ensuring swift diagnosis and treatment so that we have the best survival rates in the world. Some 15,000 patients have already waited too long. This is a serious problem requiring serious action, so what is the Secretary of State going to do?
Mr Hunt
I think cancer patients in the hon. Lady’s constituency will welcome the fact that under this Government Leicester hospital has 194 more nurses and 120 more doctors, many of them involved in cancer care.
Let me answer the hon. Lady’s question directly. There is pressure on one of the cancer standards, and that is because every year we are now diagnosing 460,000 more people than happened under the last Labour Government, who left us with such a disappointing survival rate. When that many people are being diagnosed, it of course puts pressure on the diagnostic labs and the people doing those processes. But Cancer Research UK is also saying that we are seeing record increases in survival from cancer, and that is happening because of this Government’s policies.
John Robertson (Glasgow North West) (Lab)
7. Whether the Government have made a final decision on whether to introduce standardised packaging of tobacco products.
Lorraine Fullbrook (South Ribble) (Con)
12. What progress has been made in improving access to GPs.
The Secretary of State for Health (Mr Jeremy Hunt)
The Prime Minister’s £50 million challenge fund is improving GP access for more than 3 million patients across England, helping them to get evening and weekend appointments.
Lorraine Fullbrook
Many people in South Ribble will be able to see their GPs in the evening and at weekends, thanks to a locally led initiative by Chorley and South Ribble clinical commissioning group and Greater Preston CCG to extend GP surgery opening hours this winter. Does my right hon. Friend agree that such initiatives, which will give greater flexibility to patients and alleviate pressures on other areas of the NHS, particularly A and E, are exactly what is needed in the busy winter months?
Mr Hunt
I do agree with my hon. Friend. I took my own children to an A and E department at the weekend precisely because I did not want to wait until later on to take them to see a GP. We have to recognise that society is changing and people do not always know whether the care that they need is urgent or whether it is an emergency, and making GPs available at weekends will relieve a lot of pressure in A and E departments.
Andrew Gwynne (Denton and Reddish) (Lab)
I am afraid it is yet more spin from the Government. Everybody knows that it is getting harder not easier to see a GP under this Health Secretary. He has as much as admitted today that emergency departments across England have failed to hit the Government’s A and E target for 70 consecutive weeks, and that is in part because people are struggling to get a GP appointment in the first place. Will he now get a grip on this problem, and call on his Chancellor of the Exchequer in next week’s autumn statement to use £1 billion from banking fines to help ease pressure on the NHS this winter, as the Labour party has pledged?
Mr Hunt
We will not take any lessons from the Labour party about general practice. It is not just the disastrous 2004 GP contract. The president of the Royal College of General Practitioners says that the shadow Health Secretary’s plans
“could destroy everything that is great and that our patients value about general practice and could lead to the demise of family doctoring as we know it.”
David Tredinnick (Bosworth) (Con)
13. What steps he is taking to increase patient choice.
The Secretary of State for Health (Mr Jeremy Hunt)
This Government are committed to patients having greater choice and control over their health care, and decisions as to which treatments are available on the NHS are taken by GPs on the basis of available scientific evidence.
David Tredinnick
Does my right hon. Friend have any plans to increase personal health budgets, and will he ensure that there is greater awareness of the health professions that are regulated by the Complementary and Natural Healthcare Council, the Health and Care Professions Council and the Professional Standards Authority, which has recently accredited the Society of Homeopaths and the British Acupuncture Council?
Barbara Keeley (Worsley and Eccles South) (Lab)
With regard to reducing patient choice, can the Secretary of State explain the sudden move to remove dialysis from being regarded as a specialised commissioning service, which is of great concern to a constituent of mine who is a renal patient and to the renal community? Will the Secretary of State now agree to a proper consultation—not over the Christmas holidays—and will he think again about that risky move?
Mr Hunt
We hope to have a public consultation on the matter. We are not seeking to restrict access to dialysis—far from it. We want to make it easier for people to access those vital services, and we have been putting more money into the NHS budget because we recognise just how important they are.
Yasmin Qureshi (Bolton South East) (Lab)
T1. If he will make a statement on his departmental responsibilities.
The Secretary of State for Health (Mr Jeremy Hunt)
As we look forward to world AIDS day next Monday, the whole House will want to pay tribute to the 30 NHS volunteers who left for Sierra Leone at the weekend to help in the fight against Ebola. They stand for the very best of the NHS and make us all proud. Last week I formally launched the MyNHS website. It contains 395,000 pieces of information and is the first website of its kind anywhere in the world. It will help people compare vital information about the performance of their local hospitals, GP surgeries, councils, mental health trusts and residential care homes. It will be a vital way to ensure that patients are not kept in the dark about the quality of their NHS services.
Yasmin Qureshi
Further to the Secretary of State’s answer to the hon. Member for Worsley and Eccles South (Barbara Keeley), he must know that treating renal failure requires complicated, integrated care and that no one part of it can be separated. He must also know that there are 23,000 dialysis patients in the UK, and transplant patients have overlapping clinical needs. Handing responsibility for commissioning dialysis to commissioning groups is unacceptable, especially as it has been done without any consultation. Can he explain the rationale for all this, and will he meet me and colleagues from the all-party kidney group to discuss the matter?
Mr Hunt
I am happy to arrange a meeting between either me or one of my Ministers and members of the APPG to discuss the matter. I stress that we recognise how important those specialised services are. We want to get the benefits of nationally co-ordinated commissioning with the local integrated care that CCGs are in the driving seat to deliver. That is why we are having this discussion.
Sarah Newton (Truro and Falmouth) (Con)
T2. Public Health in Cornwall has estimated that 300 people in Cornwall might die from the cold this winter because they are living in cold homes. Last week the Government introduced the first proper fuel poverty strategy to eradicate that totally unacceptable situation by 2030. Will my right hon. Friend join me in praising the work being done in Cornwall by a partnership of over 30 organisations in the Winter Wellness programme to ensure that people stay warm and well this winter?
Andy Burnham (Leigh) (Lab)
Two weeks ago, news emerged of serious problems at Colchester hospital. People there still do not know the precise details, as Ministers have not made a statement and the Care Quality Commission has not published its report. But Colchester is not the only hospital in difficulty; we have learnt that hospitals in Scunthorpe, Middlesbrough and King’s Lynn have been turning patients away and others are already on black alert, and that is before winter has even begun. We do not have an accurate picture of what is happening in the NHS right now, because NHS England was due to begin publishing weekly reports on 14 November but has failed to do so. Why has that information not been published, and will the Secretary of State today instruct NHS England to do so without delay?
Mr Hunt
That information is published at the decision of NHS England—[Interruption.] It has said that it will publish it in a fortnight’s time. Let me just say to the right hon. Gentleman that it was this Government who decided to publish that information on a weekly basis, something he never did when he was Health Secretary.
Andy Burnham
I am afraid that is just not good enough. Who is in charge here? It is not just A and Es that are under pressure; there is a knock-on effect on ambulance services. Reports are now surfacing of serious failures in patient care. Last month, a six-year-old girl from Sunderland was left for three hours with a suspected broken back despite five 999 calls. At the weekend, it was reported that a 56-year-old stroke patient from Huyton was taken to A and E by police on a makeshift stretcher made from window blinds from the man’s home, and he later died. Yesterday, it emerged that a 57-year-old cancer patient from Bishop Auckland died after three ambulances were diverted to other calls. Is it not clear that the situation in the NHS right now is far more serious than the Government have acknowledged, and should not the Secretary of State now make an urgent statement to Parliament setting out what he is doing to reduce the risk of harm to patients this winter?
Mr Hunt
There are huge pressures in the NHS. That is why we have put a record £700 million into the NHS to help it to get through this winter. May I gently suggest to the right hon. Gentleman that he should not try to politicise every single operational problem? When the NHS is all about politics, patients get forgotten—as he should know, because that is what happened when he was Health Secretary. Whether in Medway, Colchester, Burton or George Eliot, patients were forgotten because for Labour it was politics before patients every time.
Eric Ollerenshaw (Lancaster and Fleetwood) (Con)
T6. Will the Secretary of State look again at the funding formula for hospital trusts so that some adjustment can be included to recognise the issues in trusts such as University Hospitals of Morecambe Bay NHS Foundation Trust which cover large and difficult geographical areas?
Mr Hunt
I recognise those issues, and I am very happy to take that suggestion away. I particularly want to put on the record that the scare stories put out by Labour in Lancaster about the potential closure of Royal Lancashire Infirmary are false. It is totally irresponsible to scare people in Lancaster in that way.
Alex Cunningham (Stockton North) (Lab)
T3. My constituent Corron Sparrow was left lying in the road for two hours with a compound fracture of his leg despite a call from a policeman to the North East Ambulance Service pleading for help. Eventually the service responded by sending an ill-equipped St John Ambulance team who then had to call for professional assistance. There are many more failures. It is now three weeks since I wrote to the chief executive, Yvonne Ormston, asking for an inquiry into this, but she has not even acknowledged my letter. Will the Minister intervene and tell the North East Ambulance Service that it cannot just ignore these matters?
David Rutley (Macclesfield) (Con)
T7. Eighteen NHS trusts have been placed in special measures, while so far six have come out. What progress is being made with the other 12?
Mr Hunt
I am happy to answer that, because for the first time we have a proper independent inspection regime. Labour tried to vote that down so that we could not have it, but we pressed on. A third of these trusts have been turned round. We are making good progress across most of the other 12 hospitals in special measures, including 1,500 more nurses, 200 more doctors, and 53 changes at board level. Where there were problems before, we are sorting them out.
Hugh Bayley (York Central) (Lab)
T4. Patients with mental health problems who are referred for psychological therapies wait, on average, less than 40 days for treatment, but in York the wait is 125 days. My constituent, Laura Goodacre, has now waited nearly 350 days. Will the Minister look at this worrying case and the need for our mental health trusts in York to reduce waiting times?
Charlie Elphicke (Dover) (Con)
T8. After all the cover-ups of the past, what is being done to ensure that the culture of the NHS is always improving, particularly in that patients are treated with dignity and respect and always have the highest standards of safety?
Mr Hunt
I thank my hon. Friend for his question. After the Francis report, we now have 5,000 more nurses on our hospital wards. The scores that patients themselves are giving for whether they are treated with dignity and respect are up by 10%. We want to put poor care behind us and behind the NHS. It is time that Labour got on board with this agenda instead of constantly saying that we are running down the NHS by sorting out poor care.
Ann Coffey (Stockport) (Lab)
T5. Recent reports indicate that the extent of child sexual exploitation and abuse is more widespread than previously recognised. The trauma of sexual abuse can have massive, life-long consequences on the physical and mental health of victims. Will Ministers consider designating child abuse and child sexual exploitation as a public health priority in the same way as smoking, alcohol, drug use and obesity?
Mr Ben Bradshaw (Exeter) (Lab)
T10. When I asked the Prime Minister two weeks ago about the financial crisis facing Devon NHS, he seemed completely unaware of it, so could the Health Secretary please explain why Devon NHS faces an unprecedented £430 million deficit and what he is doing to stop the rationing, cuts and total withdrawal of some services that is now being proposed?
Mr Hunt
We are not rationing services. In fact, we are doing 1 million more operations every year than were done under the previous Government. I will tell the right hon. Gentleman why that financial pressure exists: we have an ageing population, with nearly 1 million more over-65s than four years ago, and huge pressure to deliver good care in the wake of the Francis report. The NHS will be supported if we have a strong economy that can fund real-terms increases in health spending—something that never happens if the deficit is forgotten.
Greg Mulholland (Leeds North West) (LD)
My constituent, six-year-old Sam Brown, is one of 100 people with the rare disease Morquio. His family live in a state of anxiety because they do not know whether the drug Vimizim will be approved for further use on 15 December. Will a Minister please meet me and Katy and Simon, Sam’s parents, to give Sam the Christmas present he needs and to keep Sam smiling?
Mark Reckless (Rochester and Strood) (UKIP)
Last month one patient waited 35 hours in Medway’s A and E, and in the past year 10 patients have waited more than 24 hours. I was grateful to the Secretary of State for taking up my invitation to visit the hospital. What progress has been made specifically on turning around the A and E department?
Mr Hunt
There are more doctors and more nurses operating at Medway hospital and I know that when the hon. Gentleman was sitting on this side of the House he was very pleased with the progress that was being made in turning it around from special measures, but, like UKIP’s policy on the NHS, everything changes.
Alec Shelbrooke (Elmet and Rothwell) (Con)
May I welcome the recent launch of MyNHS? Does my right hon. Friend agree that transparency of NHS performance, whether it be that of hospitals, GPs or surgeons, will be a major driver in improving patient care, as international evidence suggests, and help us avoid a scandal such as Mid Staffs, which happened under that lot over there?
Caroline Lucas (Brighton, Pavilion) (Green)
Do Ministers agree that it is a scandal that cold homes are costing the NHS in England more than £1.3 billion every year, with kids growing up in cold homes twice as likely to contract diseases such as asthma? Do they also agree that it is hugely disappointing that not one penny of Treasury infrastructure funding is devoted to energy efficiency? Will they speak to their Government colleagues about that?
Savile Investigations (NHS)
Jeremy Hunt Excerpts(10 years, 6 months ago)
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The Secretary of State for Health (Mr Jeremy Hunt)
Further to my oral statement on 26 June 2014, Official Report, columns 482-498, I wish to update the House about the investigations into Jimmy Savile and the NHS.
A total of 28 investigation reports into the activities of Jimmy Savile on NHS premises were published on 26 June 2014. We expected the remaining NHS investigation reports, including that relating to Stoke Mandeville, to be published later in the year.
At the request of the Crown Prosecution Service, the publication of the NHS investigations into Jimmy Savile is being delayed until the conclusion of ongoing legal proceedings. Therefore, I wish to advise the House that there will be a delay in the publication of the outstanding NHS investigation reports. We now hope trusts will publish their reports in January 2015, alongside Kate Lampard’s lessons learnt report.
The remaining investigations reports that were not completed in June and are still to be published are:
Hospital | Relevant Trust | |
|---|---|---|
1. | Stoke Mandeville Hospital | Buckingham Healthcare NHS Trust |
2. | Rampton Hospital | Nottinghamshire Healthcare NHS Trust |
3. | Springfield Hospital | South West London and St Georges Mental Health NHS Trust |
4. | Crawley Hospital | Sussex Community Trust |
Alongside these reports further reports will be produced by new NHS investigations that have come to light since June 2014. The NHS Savile legacy unit, chaired by Sue Proctor, is providing independent oversight and assurance of these new NHS investigations. Information provided to the NHS Savile legacy unit by victims, and from the Metropolitan Police Service, has been passed on to the following 12 trusts that have responsibility for the relevant hospitals as set out in the table below:
Hospital | Relevant Trust | |
|---|---|---|
1. | Leeds General Infirmary | Leeds Teaching Hospitals NHS Trust |
2. | Stoke Mandeville Hospital | Buckinghamshire Healthcare NHS Trust |
3. | Birch Hill Hospital Rochdale | Pennine Acute NHS Trust |
4. | Scott House Hospital Rochdale | Calderstones NHS Foundation Trust |
5. | Bethlem Royal Hospital | South London and the Maudsley NHS Trust |
6. | Shenley Hospital | Central and North West London NHS Trust |
7. | West Yorkshire Ambulance Service | Yorkshire Ambulance Service |
8. | St Martins Hospital Canterbury | Kent and Medway NHS and Social Care Partnership Trust |
9 | Queen Elizabeth Hospital Gateshead | Gateshead Health NHS Foundation Trust |
10. | Royal Victoria Infirmary | Newcastle upon Tyne NHS Foundation Trust |
11. | Meanwood Park Hospital | Leeds and York Partnerships Foundation Trust |
12. | Calderdale Royal Hospital | Calderdale and Huddersfield NHS Foundation Trust |
Names of the hospitals are taken from the information received. These include hospitals that may have closed in which case the information has been passed on to the legacy organisation. Members interested in particular investigations should contact the relevant trust.
As a consequence of the CPS request there will also be a corresponding delay to the investigations into Savile in children’s homes and schools, which are overseen by the Department for Education, and to the lessons learnt report by Lucy Scott-Moncrieff.
I will update the House once the legal proceedings conclude.
Five Year Forward View
Jeremy Hunt Excerpts(10 years, 6 months ago)
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Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Andy Burnham (Leigh) (Lab)
(Urgent Question): To ask the Secretary of State for Health if he will make a statement on the “Five Year Forward View” for the national health service.
The Secretary of State for Health (Mr Jeremy Hunt)
NHS England, along with other NHS organisations, has today published its independent “Five Year Forward View”, which sets out its view of how the health service needs to change over the coming years. It is a report that recognises the real challenges facing the NHS, but it is essentially positive and optimistic. It says that continuing with a comprehensive tax-funded NHS is intrinsically do-able, and that there are
“viable options for sustaining and improving the NHS over the next five years.”
The report says that the challenges of an ageing population can be met by a combination of increased real-terms funding, efficiencies and changing the models of care delivered. It also says that
“decisions on these options will need to be taken in the context of how the UK economy overall is performing.”
In other words, a strong NHS needs a strong economy.
The report proposes detailed new models of care, putting out-of-hospital services front and centre of the solution, delivered through greater integration between primary, community and specialised tertiary sectors alongside national urgent and emergency networks. These can help to reduce demand significantly for hospital services and give older people in particular the personal care that we would all want for our own parents and grandparents.
The report talks about continued opportunities for efficiency savings driven by innovation and new technology, and suggests that they could be increased above the long-term run rate of efficiency savings in the NHS. It talks about reducing variation in the quality of care, in the wake of the tragedy in Mid Staffs, and about how the new Care Quality Commission inspection regime is designed to drive up standards across the system. It says that to do this we will need to move to much greater transparency in outcomes across the health and social care system. Finally, the report makes important points about better integrating the public health agenda into broader NHS activity, with a particular focus on continued reductions in smoking and obesity rates.
The Government warmly welcome the report as a blueprint for the direction of travel needed for the NHS. We will be responding to its contents in detail in due course, but we think it is an important contribution to the debate. We are proud of how the NHS has coped with the pressures of financial constraint and an ageing population in the last four years, but we also know that to sustain the levels of service that people want, the NHS needs to face up to change—not structural change, but a change in the culture of the way we care for people.
Given that the report has been welcomed on both sides of the House, I also hope that this can be the start of a more measured debate about the future of the NHS in which those from all parties in the House recognise our shared commitment to its future and focus on the best way to achieve the strong and successful NHS that the whole country desires.
Andy Burnham
A five-year forward view for the NHS, involving more than £550 billion of public spending, briefed to the media but not to Parliament—what clearer illustration could there be of the serious loss of public accountability arising from the Government’s reorganisation? The Secretary of State is in his place today only because he was dragged here by us. I do not know who runs the NHS these days, but I do know that it is certainly not him. We know why he wants to distance himself from this report: because it endorses key planks of Labour’s plan and leaves him with big questions to answer.
First, on GP services, does the Secretary of State agree with the report that primary care has been under-resourced and that people are struggling to get appointments? Will he accept its recommendation to stop his cuts to the GP budget, stabilise funding and match Labour’s plans to recruit 8,000 more GPs?
Secondly, on cancer, the report makes it clear that “faster diagnosis” is needed—we agree. So why did the Prime Minister yesterday dismiss Labour’s proposals for one-week cancer tests?
On integration, the report endorses Labour’s vision for new models of care, including hospitals evolving into integrated care organisations with more salaried GPs. Can the Secretary of State tell the House why he has spent the last few weeks attacking that plan, and is he now prepared to drop his opposition? On public health, is the report not right that the time has come for radical action on obesity, and will he now concede that his voluntary responsibility deal is simply not working?
It will not have escaped people’s notice that the report does not give one mention to competition—that is because it creates fragmentation, when the future demands integration. So will the Secretary of State commit to reviewing his competition rules and vote with Labour in four weeks’ time to repeal them?
Finally, on funding, the report could not be clearer: simply protecting the NHS budget in the next Parliament, as the Conservatives propose, will not prevent it from tipping into a full-blown crisis. As the hon. Member for Totnes (Dr Wollaston), the Chair of the Health Committee, has said, current Tory funding plans raise the spectre of rationing, longer waits and charges. Will he now drop them and match Labour’s plans for more money for the NHS? Labour has set out its plan, and today the NHS endorses that plan. The big question people are asking is: where on earth is his?
Mr Hunt
I talked about having a more measured debate, but I think I was speaking a trifle too soon, judging by what we have just heard. The right hon. Gentleman obviously was not listening to what I actually said, so let me just repeat to him that the Government warmly welcome this report. I talked about it as a “blueprint” for the future. He did not agree with setting up NHS England, and I do not think he agreed with the appointment of Simon Stevens as the chief executive, but we did that so that we would have a body that would think strategically about the long-term future of the NHS at arm’s length from the Government. That is what it has done, and the report is excellent.
The right hon. Gentleman and I have a sometimes slightly fractious relationship, but I would like to congratulate him this morning on his Houdini-like spin in the way he is approaching this report. He has been constantly telling this House that the NHS is on the point of collapse, but the chief executive of NHS England says that the NHS has been “remarkably successful” in weathering the pressures of recent years. The right hon. Gentleman has told this House constantly that the biggest threat to the NHS is privatisation and competition. This report, a five-year forward view, by bodies at arm’s length from the Government, contains not one mention of competition and privatisation as a threat, yet he says this report endorses Labour’s plans.
The right hon. Gentleman says, as has his leader, that the first thing he would do in government is repeal the Health and Social Care Act 2012 and strip clinical commissioning groups of their powers. He really should read the report carefully on that. He now says he welcomes the report, but it begs him not to carry out further big structural changes; it does not call for the repeal of the 2012 Act, and this is the report which he warmly welcomes today.
Then we need to consider money. The right hon. Gentleman told this House repeatedly that it was irresponsible to increase spending on the NHS, but now we have a report that says that the NHS needs real-terms increases, along the lines that this Government have been delivering in this Parliament. What does he say? He says, “It is great to have our plans endorsed by NHS England.” This report does not endorse Labour’s narrative; it exposes it for the shallow party politicking that we have had from him.
Let me say to the right hon. Gentleman that the really important message of this report is something we can agree on, and he should be talking about that. We both agree about the integration of health and social care, which is now happening. We both agree about improving investment in primary care. We both agree that we need more GPs. We both agree that we need more care closer to home. I think the public would say that we would have a more measured, intelligent and sensible debate—the kind of debate they want to hear—if we started talking about the things we agree on a bit more instead of constantly pretending there are vast disagreements.
David Tredinnick (Bosworth) (Con)
My right hon. Friend has welcomed this report, which says, among other things, that there have to be new ways of working and breaking down barriers. The Royal London Hospital for Integrated Medicine—part of the University College London Hospitals NHS Trust—which is about a mile away from here, is Europe’s largest public sector provider of integrated medicine. Will he go there and see its 13 care pathways, which use qualified complementary and mainstream practitioners, because then it will be clear to him how we can reduce costs in the health service and take the pressure off practitioners? Will he make that part of his package?
Mr Hunt
I congratulate my hon. Friend on finding every opportunity to promote integrated care. What the report says is that we need much more person-centred care. It welcomes the kind of models that we see in Tower Hamlets, where the new clinical commissioning groups, led by inspiring leaders such as Sam Everington, are carrying out social prescribing. GPs are actually prescribing social solutions to problems as well as medical ones. This report is a big stepping stone towards that type of integrated care.
Liz McInnes (Heywood and Middleton) (Lab)
In my constituency last year, 23,000 people were unable to see their GP within a week. What, if anything, will these plans do to address that crisis?
Mr Hunt
I welcome the hon. Lady to her place. This report says something with which this Government very strongly agree, which is that we need to reverse the shift that there has been over many decades of investment away from community care towards hospital care. It is really important that we focus on the role of GPs. We do not want to force all GPs to become employees of hospitals, but we would like to back them, so we have brought back personal responsibility for GPs for every single NHS patient as an important first step in that direction.
Paul Burstow (Sutton and Cheam) (LD)
This is an important report, which must not turn into another political football. We should focus on what it says and make that the basis for a real debate about our NHS. There are 23 references in this report to mental health. Parity of esteem is an established idea, but it has not yet been incorporated into NHS practice, so we still have further to go. Does the Secretary of State agree that another area in which we need to go further is perinatal mental health, where the cost to society, to mothers and to generations runs into billions? If the NHS could do a bit more in that regard, it would make a big difference.
Mr Hunt
My right hon. Friend is absolutely right. We know that perinatal mental health problems have a big impact on the child as well as on the mother. This report says that we must stop looking at conditions such as mental health as separate to physical health conditions. We need to look at people’s whole condition in the round. If we start to do that, we will make the NHS sustainable by making the kind of investments that will bring down the overall cost of treatments. Putting mental health centre-stage in that approach will be an important part of our strategy.
Mr Dennis Skinner (Bolsover) (Lab)
The NHS has been a political football ever since the 1947 Government decided to take it under public control. The Tories fought against it then, and they have fought against it ever since. The important thing to remember is that this report does not commend the Government for carrying out their reconstruction of the health service, which has cost billions. What we did when we were in power for 13 years was increase the amount of money for the health service from £33 billion to £100 billion—a threefold increase in real terms. Had we continued with that approach over the past five years, people would not be dying of cancer because they had not been tested early enough. The Tories talk about all-party agreement, but it is high time that they understood that since 1947 the Secretary of State and his posh people on millionaires’ row have opposed the very essence of the health service, which is why it will be the biggest political issue at the next election. It will also help us to win and get this lousy mob out.
Mr Hunt
I think that is the kind of rhetoric that does the whole country a massive disservice. If the Government had the kind of views about the NHS that the hon. Gentleman talks about, we would not have protected its budget during the most difficult recession we have had since the second world war. We actually increased the NHS budget over that period, because we believe in the NHS. With regard to what he says about the report, the chief executive of NHS England, a former Labour special adviser, said this, and it is a fact: “Over the past five years, despite growing pressure, the NHS has been remarkably successful.” That is what Labour people are saying.
Steve Baker (Wycombe) (Con)
I very much welcome the plans for urgent and emergency care set out on page 4, in paragraph 10, which ought to produce a solution that could be welcomed in Wycombe hospital and more than 20 similar hospitals across the country. When the proposals are taken forward, will my right hon. Friend ensure that they are explained to people in such a way that they can have real peace of mind that urgent and emergency care will be there for them?
Mr Hunt
My hon. Friend, as ever, makes an important point. I do not think that we have been as good as we should have been in the NHS about explaining changes to urgent and emergency care, and people are understandably worried if they think that there is any risk that they will not be able to see a doctor in an emergency, which is what the NHS is there to do. I think that we now have a better blueprint for urgent and emergency care, but the report also recognises that it is not sustainable to say that all urgent and emergency care will always be dealt with in A and E departments. We have to find a way to improve the capacity of primary care and make it easier for people to see their GP so that we can reduce the pressure on hard-pressed A and Es.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
Will the Secretary of State take on board the fact —I invite him to visit Calderdale and Huddersfield NHS Foundation Trust to have a look—that the reforms that his Government introduced have fragmented the health service? It is very difficult to find in the health service one common purpose or one common voice. The fact of the matter is that whether it is A and E closures or NICE—National Institute for Health and Care Excellence—prescriptions being handed down by GPs, everywhere I try to find an answer, instead of one voice, one team and one leadership, I find fragmentation and no real positive movement.
Mr Hunt
Let me try to reassure the hon. Gentleman. The reality is that those reforms, by getting rid of the huge bureaucracies of the primary care trusts and strategic health authorities—19,000 administrators—have allowed us to hire an extra 10,000 doctors and nurses. We are doing nearly 1 million more operations every year. I will write to him with the details, and I think that he will find that there are more nurses and doctors employed in his constituency now than there were before the reforms.
Oliver Colvile (Plymouth, Sutton and Devonport) (Con)
May I thank my right hon. Friend for appointing me to be the Government’s pharmacy champion? What role does he perceive pharmacies playing in this, because I think that they are an important part of the whole NHS?
Mr Hunt
I had a very enjoyable evening at the pharmacy business awards last night. Pharmacies have an important role to play, because they could save a significant number of A and E and GP visits. The single most important change—my hon. Friend and I have talked about this—is to make it possible, if a patient gives permission, for pharmacists to access their GP record so that they can see their medication history and ensure that they give them exactly the right drugs.
Mr Nicholas Brown (Newcastle upon Tyne East) (Lab)
In the light of this report, is it still the Government’s case that the emerging English hospital trusts’ deficits can be dealt with by efficiency savings alone?
Mr Hunt
The Government believe that the NHS has to live within its means, as do individual hospitals. We recognise that that is challenging, and one of the reasons it is challenging is that in the past it has been too easy for hospitals trying to balance their books to cut corners, for example on nursing numbers in elderly care and dementia wards. We have a new inspection regime that has made it much harder to do that, which I think is a good thing, because it means that older people are getting the care they need. It also means a harder road to getting those deficits under control, however.
Chloe Smith (Norwich North) (Con)
Page 26 of the document refers to
“an equal response to mental and physical health”.
Despite my right hon. Friend’s good leadership on this topic, I suspect that the document’s authors do not operate an equal funding formula for mental and physical health. Can my right hon. Friend give me any guidance on that?
Mr Hunt
We are looking at the issue very closely, and I think that we have made very good progress. We have introduced maximum waiting time targets for some mental health conditions, which has never been done before, and we have made a clear commitment to applying those targets to all mental health treatment during the next Parliament. However, my hon. Friend is right: ultimately, we need to look at funding differently. We need to look at it holistically. We need to understand that it is a false economy not to invest in proper mental health care, because it will only make the overall costs to the system greater in the long run.
Heidi Alexander (Lewisham East) (Lab)
The Health Secretary will know that one of the biggest challenges facing the NHS is our ageing population. Thousands of lonely people are living in unsuitable accommodation and are not receiving the care that they need. What proportion of the NHS land that will be sold off over the next five years will be used to create more suitable accommodation for older people, and to create communities of care where they can be given the service and attention that they need?
Mr Hunt
The hon. Lady has made an important point. We would like more NHS land to be sold off for precisely those purposes.
There is a broader point to be made about housing, which is also important, and which I thought the hon. Lady was going to make. If we are to think about care in a more integrated way, we shall need to reform the NHS so that we look at people’s problems holistically, and that will include looking at their housing, which has a direct impact on their health. I think the structures that feature in the five-year plan begin to make such an approach possible for the first time, and I find that very exciting.
Rehman Chishti (Gillingham and Rainham) (Con)
Does the Secretary of State agree that the key aim of our reforms is to support hospitals which have not been fully supported before? Medway Maritime hospital, which is in my constituency, had one of the highest mortality rates in 2005-06, but nothing was being done. I thank the Secretary of State for putting the hospital into special measures, so that it can secure the support that it needs to turn things around and my constituents can have an excellent hospital that delivers for them. I also thank him for visiting the hospital recently and meeting its excellent front-line staff, who do a great job.
Mr Hunt
I thank my hon. Friend for what he has done for Medway Maritime. That was a very good visit: I met both management and staff, and gained a better idea of the challenges faced by the hospital.
The report makes it clear that we must become much better at tackling variations in care. Never again must we have a system in which hospitals are struggling and delivering poor care, and that poor care is swept under the carpet and nothing is done about it. The Government have put 18 hospitals into special measures—more than 10% of all the hospitals in the NHS—and that has been very challenging. We have been accused by Opposition Front Benchers of running down the NHS when we have done it, but do you know what has happened? Six of those hospitals have now come out of special measures, and nearly all the others have improved dramatically. It is time that the Labour party got behind what is a really good inspection programme, based on openness, honesty and transparency about problems.
Julie Hilling (Bolton West) (Lab)
Bolton clinical commissioning group is putting mental health services out to tender, which seems to involve a cut of between a half and a third on the basis of current spending. Are such cuts in mental health services what the Secretary of State means by his vision?
Mr Hunt
No, and that is why the Government legislated for parity of esteem between mental and physical health. As I said earlier, we have introduced maximum waiting times for some mental health conditions, and we have focused on improving access to psychological therapies—IAPT—and on dementia. Anxiety and depression and dementia are two of the most common mental health conditions in respect of which we can make a real difference, and we are doing more all the time.
Margot James (Stourbridge) (Con)
May I remind the Opposition that the primary care trusts that the clinical commissioning groups replaced sat above primary care, and were remote from it? Let me give an example of how much more integrated the system is now. Our clinical commissioning group has joined our hospital to fund the opening of an urgent care centre, which will relieve pressure on accident and emergency departments and give more patients a chance to gain access to the hospital from primary care. Does my right hon. Friend agree that that is an example of integration, not fragmentation?
Mr Hunt
Exactly—that is precisely the point. This report has example after example of how the new structures—clinical commissioning groups—are integrating care. That is why it makes it so clear that it would be wrong to do what Labour wants to do, which is to repeal the Health and Social Care Act 2012 and to strip CCGs of their powers when they are providing precisely the integrated care that we all think is important.
Nic Dakin (Scunthorpe) (Lab)
Northern Lincolnshire and Goole Hospitals NHS Trust has made significant progress over the past two years, but it remains financially very challenged and in significant deficit. What, if anything, in these plans will help to remedy that challenging situation?
Mr Hunt
Two things. I have had a very interesting visit to Goole hospital. It was very impressive to see how it has responded to the special measures programme and how, as a result of the new inspection regime, which Labour Front Benchers tried to vote down, it has made real improvements in care on the front line for the hon. Gentleman’s constituents. Those at the hospital will be pleased to see that this report endorses the new transparent approach to dealing with variations in care. It also says that we need to continue with increases in real-terms funding for the NHS, which we only get with a strong economy.
Andrew George (St Ives) (LD)
The theme of integration is re-emphasised in this plan, but how can commissioners ensure that they achieve that integration if they are forced against their will to outsource many services and also fear that their commissioning decisions will be challenged for being anti-competitive?
Mr Hunt
They are not forced against their will to outsource. They make the decisions as to where they want to purchase services from, and they do so on the basis of what is best for patients. Just like the primary care trusts that they succeeded, they have to follow European law in the way that they do that.
Alex Cunningham (Stockton North) (Lab)
The growing funding gap over the next five years is a real cause for concern. Can the Secretary of State tell me whether, after five years of changing plans, scrutiny and prevarication, we will finally get approval from his Department and the Treasury for the new North Tees and Hartlepool hospital, or will I have to wait for my right hon. Friend the Member for Leigh (Andy Burnham) to approve it after the election?
Sir Tony Baldry (Banbury) (Con)
The Commonwealth Fund’s recent study of 11 national health systems, including those of Sweden, France, Germany and the United States, found that the NHS in England was ranked top for a safe, effective, co-ordinated, efficient, patient-centred care system. Against that background, is it not rather unedifying for Labour Members constantly to try to pretend that the NHS in England is in some form of crisis, particularly given the deplorable performance of the NHS in Wales, which is run by Labour? Would not the shadow Secretary of State do rather better to remember the words,
“Or how wilt thou say to thy brother, Let me pull out the mote out of thine eye; and, behold, a beam is in thine own eye”?
Mr Hunt
I welcome the King James Bible reference. The independent Commonwealth Fund report that my right hon. Friend mentions contained one very startling fact, which Labour Members would do well to remember when they go on about the NHS—when they left office, we were seventh out of 11 countries on patient-centred care, whereas this year, now that we are in office, we came top. That is a huge improvement in patient-centred care. Under the new Care Quality Commission regime, his own hospital, John Radcliffe, got a “good” rating, which is an extremely impressive result.
Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)
The ambulance trust in the north-east has quadrupled the use of private ambulances, increasing its costs, and South Tees Hospitals NHS Foundation Trust is in deficit. In my constituency, two urgent care wards and a minor injuries unit are to be closed. A medical centre in Skelton has been closed, a medical centre in Park End has been closed, and a medical centre in Hemlington is to be closed. Does the Secretary of State take any responsibility for any of these health services in my constituency or across England? Every single response we get from him, every single time, is that somebody else is to blame.
Mr Hunt
Not at all—I take full responsibility for the NHS. Given the pressures created by having nearly 1 million more over-65s than we had four years ago, and the fact that the Government have had to cope with the deepest recession since the second world war, I believe that the NHS is doing remarkably well, and this document gives it a blueprint for the future that we can all welcome.
Bob Blackman (Harrow East) (Con)
Under this Government, the number of young people taking up smoking has fallen dramatically to some 3% and the number of people giving up smoking has increased. I welcome that very good news. We can now aspire to a smoke-free Britain over the next five years. Personally, I would like to see the tobacco companies taxed out of existence, but is it not irresponsible to base future spending plans on the basis of a tax on companies that will cease to exist?
Mr Hunt
That is a very good point and I agree with my hon. Friend that we should aspire to a smoke-free Britain. We are making remarkable progress. The point the report makes—this goes alongside what my hon. Friend has said—is that we need to integrate our thinking about public health with our thinking about the services the NHS delivers. The better care fund has shown how it is possible to get excellent collaboration between local authorities and the local NHS for the delivery of social care. Transformational things are happening up and down the country right now. I would like to see the same thing for public health as well.
Lilian Greenwood (Nottingham South) (Lab)
Alcohol abuse costs the NHS in Nottinghamshire more than £55 million a year and cuts in social services are making the pressures worse, especially for emergency departments. Dr Stephen Ryder, consultant hepatologist at Nottingham University Hospitals NHS Trust, wrote to me recently to express his deep concern that the Government are not taking forward the introduction of minimum unit pricing. Why are this Government ignoring advice and clinicians and ducking the issue of dealing with cheap alcohol?
Mr Hunt
We are doing a number of things to tackle alcoholism. Alcoholism rates have continued to fall under this Government, so we are making good progress. The approach to alcohol is different from that to cigarettes, because responsible drinking is perfectly okay for a person’s health; it may even be good for their health, depending on which doctor they speak to. We want to be careful that our alcohol policies do not penalise responsible drinkers who may not have large salaries and worry very much about the pennies their shopping basket costs.
Julian Smith (Skipton and Ripon) (Con)
Women chief executives now lead every one of the three hospitals serving my constituency. We have to thank all members of the NHS for this report, but will the Health Secretary comment in particular on the role of women in delivering NHS change and development?
Mr Hunt
I am absolutely delighted to do that. The new hospital inspection regime we have introduced has shone a light on some outstanding leadership. One of the best examples is Basildon hospital, which had terrible problems, including blood-stained floors, blood on the carpets and syringes left lying around in wards. That failing hospital has been turned around by an inspiring chief executive, Clare Panniker, and in the space of just 18 months it has now officially been rated as a “good” hospital by the CQC. We welcome the brilliant leadership of a growing number of female chief executives.
John Woodcock (Barrow and Furness) (Lab/Co-op)
GP commissioners in Morecambe bay are doing exactly the kinds of things mentioned in the report by shifting their focus from primary care to prevention. They know, however, that all the things they could do will not come close to closing the £25 million deficit. The Government say that they have to close it, but doing so would decimate hospital services. Will the Health Secretary listen to our case about the special funding needs of the area?
Mr Hunt
I am very happy to look into that. I recognise that all clinical commissioning groups face very real financial challenges to balance their books. That is why the report is so important, because it says that we cannot go on like this for ever and we have to look at changing the model decisively. It addresses the three things that could give hope to the hon. Gentleman’s CCG: increased real-terms funding based on a strong economy; more imagination in looking for efficiencies; and innovation and technology. We are absolutely committed to doing those things.
Charlie Elphicke (Dover) (Con)
In my constituency Deal hospital was left under threat of closure. It has now been safeguarded. Our acute hospitals had a Care Quality Commission inspection to identify problems, which have been dealt with; they were not covered up. Dover hospital, which was wrecked, is now being rebuilt. Will my right hon. Friend take a forward view of his diary and consider reopening that hospital at the opening ceremony in the spring?
Mr Hunt
If I possibly can, I will be delighted to do so. This is the pattern in many parts of the NHS that we do not hear from the Opposition Benches—where there have been problems in care year after year, they are finally being addressed. In my hon. Friend’s constituency and the hospitals that serve it he will be seeing more nurses and more doctors being employed and giving a higher standard of care, particularly to vulnerable older people. That is the kind of NHS that we should all welcome wholeheartedly.
Graham Jones (Hyndburn) (Lab)
The Secretary of State talks about holistic care and a range of issues that affect people, but active participation in sport, recreation and cardiovascular activity is declining. In constituencies such as mine, that is a real problem. What will he do to integrate CCGs with district councils? He seems to be saying nothing about this.
Mr Hunt
In my earlier comments I spoke a bit about childhood obesity, which is a very important issue. I was the Secretary of State responsible for the Olympics, and as part of the Olympic legacy we set up the school games movement, which now has about two thirds of schools in the country doing Olympic-style games every year, and we have put an extra investment into school sport. We need to work closely with the Department for Education on this, and I agree that it is very important that we do so.
David Morris (Morecambe and Lunesdale) (Con)
May I invite my right hon. Friend to come to my local hospital and to my constituency to see what good works have been done in my area? A £25 million health centre has opened, we have a new walk-in centre that was opened by the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter). May I ask my right hon. Friend’s views on the talk about top-down reorganisation? [Interruption.] We walked into a shambles of an NHS after 13 years of Labour government and a debacle of a CQC policy that we had to reconfigure. What are his thoughts—[Interruption.]
Mr Speaker
The hon. Gentleman has had a very full tilt. On the whole, it is a good idea to face the House, rather than the Government Front Bench. We are grateful.
Mr Hunt
Of course I would be delighted to visit my hon. Friend’s constituency. Morecambe Bay hospital is one of the hospitals whose problems we are looking at in a way that should have happened before but did not. We are turning round that hospital. We are determined to do it and we want his constituents to have absolute confidence in the quality of hospital care they receive.
Sheila Gilmore (Edinburgh East) (Lab)
The Secretary of State told us that a strong NHS needs a strong economy, so I presume he is extremely worried about the fact that reduced tax revenues have led, on this Government’s watch, to higher borrowing this year.
Mr Speaker
Order. The hon. Member for Kingston upon Hull East (Karl Turner) keeps calling out “Ah!” as though he is sitting in the dentist’s chair. It is quite unnecessary. He can exercise his vocal chords later.
Mr Philip Hollobone (Kettering) (Con)
The report makes it clear that with an increasing population and increasing proportion of elderly patients, the role of GPs will become even more important, yet the demographics of the GP profession mean that we will lose thousands of GPs to retirement in the next few years. What can be done to address this very important problem?
Mr Hunt
That is a very important issue and we need more GPs. We have about 1,000 more full-time equivalent GPs during this Parliament but we face the demographic issue that my hon. Friend identifies. That is why we are looking at how we can make it easier for GPs who have stopped practising, perhaps to have a family, to come back into the profession, and how we can make it easier for GPs to do part-time work. We are looking at all those issues because we are committed to reducing the burn-out that many GPs experience by improving and increasing the number of GPs actively practising.
Mike Kane (Wythenshawe and Sale East) (Lab)
General practitioner managers throughout the land will be tearing their hair out at the complacency of the right hon. Gentleman’s statement today. According to the patient survey, 39% of people could not see their preferred GP. That is an increase of 1.2 million. My general practice managers in Sale are saying that the situation is at crisis point. Why does the Secretary of State’s view differ from theirs?
Mr Hunt
As I have just told the House, I welcome a report that says we need to invest more in general practice. There has been historical under-investment over decades, which is why more and more resources have been sucked into the hospital sector. We are calling time on that and saying that we have to invest more in primary care, community care and out-of-hospital care. It is a big change for the NHS, and I think that the hon. Gentleman’s practice managers will be thrilled to hear it.
Andrew Stephenson (Pendle) (Con)
The Secretary of State may be aware that the excellent Airedale hospital, which he has visited, in the neighbouring constituency to mine, has been highlighted in “BBC News” coverage today, especially for its telemedicine service, as an example of what the future of evolving heath care may look like. Will he join me in congratulating the excellent staff at Airedale hospital on embracing change and pioneering new models of care?
Mr Hunt
I am delighted to do so. Airedale is mentioned in the “Five Year Forward View” as an example of how technology can be transformative. It has a system under which older people in the locality are given a red button, and as long as their TV is turned on, all they have to do is press the red button and they are talking to a nurse. That is immensely reassuring for them, and it means that they are more likely to stay healthy and happy and to live at home for longer. That is better for them and for the NHS, and it is a real model.
Oral Answers to Questions
Jeremy Hunt Excerpts(10 years, 6 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Karl Turner (Kingston upon Hull East) (Lab)
8. How many patients waited longer than four hours in A and E departments in 2013-14.
The Secretary of State for Health (Mr Jeremy Hunt)
Of the 21.7 million attendances at all A and E departments in England in 2013-14, 939,000 were not seen and treated within four hours, meaning that 95.7%—0.7% above the national target—were. I am pleased to inform the House that hospitals will have an extra 260 A and E doctors this winter, bringing emergency medics in the NHS to a record high.
Mr Thomas
The reason for the big rise in A and E admissions in my area is the weekday closure of the hugely popular Alexandra Avenue polyclinic. Will the Secretary of State look again at Harrow’s NHS funding formula to determine whether that popular service could be reopened?
Mr Hunt
I am happy to look at the point that the hon. Gentleman raises. I have visited the Northwick Park A and E department, where the clinicians on the front line are working incredibly hard. As he knows, the funding formula is decided independently—at arm’s length from politicians—but we have ensured that everyone gets a real-terms rise.
Karl Turner
Data published last Friday show that A and Es have missed their waiting targets for 64 weeks on the bounce. They are in a worse state now than they were last winter. What is going on?
Mr Hunt
First, I caution the hon. Gentleman on his use of statistics, because he is referring to a subset of A and Es, not all of them. Last year we hit our A and E target. I say gently to Labour Members that they need to be careful if they try to politicise operational issues, because people will note that in every year of this Parliament we have hit our A and E targets in England and Labour has missed its targets in Wales.
Andrew Bridgen (North West Leicestershire) (Con)
Does the Secretary of State agree that the figures show that the average wait before assessment in A and Es in England is now down to 30 minutes, as opposed to 77 minutes under the previous Labour Government?
Mr Hunt
My hon. Friend makes an important point. I just say to the Labour party that the time people wait to be seen at A and Es has reduced while the number of people going to A and Es has increased, but in the end it will not be sustainable unless we invest in out-of-hospital care, which is why we need more personal care by GPs. That is why we have brought back named GPs and why we have 1,000 more GPs than we did four years ago.
Charlie Elphicke (Dover) (Con)
May I welcome the outstanding treatment provided at the A and E at the William Harvey hospital—part of East Kent Hospitals University NHS Foundation Trust—which I attended on a family emergency during the summer, and note that the Care Quality Commission is getting striking improvements in East Kent, rather than the sort of cover-ups we used to see in the past?
Mr Hunt
My hon. Friend is absolutely right. Under this Government, with the new inspection regime, we have had to take the difficult decision to put 18 hospitals into special measures, including East Kent. Six have now come out of special measures. We are tackling these problems in the NHS by being honest about them. I gently say to the Labour party that if it wants to be the party of the NHS, it has to give the country confidence that it will be honest about poor care when it comes across it.
Andrew Gwynne (Denton and Reddish) (Lab)
On A and E, does the Secretary of State accept that we must do more to address the appalling statistic that one in four cancers is diagnosed in A and E departments? At the weekend, Labour outlined plans dramatically to reduce the wait for tests and results, paid for through a tobacco levy, which are supported by Macmillan, Cancer Research UK and the Royal College of Radiologists. Will he now back those plans?
Mr Hunt
I welcome the fact that Labour is thinking about how to improve our performance on cancer, because in 2010 we had the worst cancer survival rates in western Europe. I gently say to the Labour party that the issue is only partly about the amount of time it takes to get a hospital appointment when one has a referral; a much bigger issue is the fact that we are not spotting cancers early enough in the first place. That is why I hope that Labour will also welcome the fact that in this Parliament we are on track to treat nearly 1 million more people for cancer than we did in the previous Parliament. That is real progress of which the whole House can be proud.
Mr Philip Hollobone (Kettering) (Con)
While it is working with one of the most outdated A and Es in the NHS, and one that will require fresh capital investment, does the Secretary of State recognise the tremendous improvement at Kettering general hospital’s A and E, which in the past year has gone from one of the worst performing to one of the best performing in the country?
Mr Hunt
I absolutely recognise that, and I congratulate my hon. Friend on the very close interest he takes in what is happening at Kettering hospital. I have visited the hospital, as he knows, and think that it is working very hard and that it offers a very good example of how, even when times are tough, finances are tough and there is increasing pressure from an ageing population, it is possible to increase and improve A and E performance. It has done a terrific job.
Ian Austin (Dudley North) (Lab)
4. What estimate he has made of the number of NHS trusts forecasting a deficit.
The Secretary of State for Health (Mr Jeremy Hunt)
Eighty-six NHS trusts are forecasting a deficit this year.
Ian Austin
Jobs at Russells Hall hospital are at risk as managers battle with a £12 million deficit that the chief executive says is critical. Staff are working flat out, but people are still waiting too long in A and E, and too long for other treatment. What will the Secretary of State do to ensure that patients in Dudley and the hard-working staff at Russells Hall get the support they need?
Mr Hunt
I will tell the hon. Gentleman exactly what we are doing. The Dudley Group NHS Foundation Trust has 350 additional nurses this Parliament, and it has got them because this Government took the difficult decision to protect and increase the NHS budget, because those of us on the Government Benches know that a strong NHS needs a strong economy. We are taking measures, but there is more to do. I recognise that the staff on the front line are working very hard, but I think that he should also give credit when things are starting to move in the right direction.
Stephen Mosley (City of Chester) (Con)
My right hon. Friend will be aware of the strains placed on the budgets of the Countess of Chester NHS Trust because of the need to treat thousands of patients every year who are fleeing the disastrous management of Labour in Wales. What action is my right hon. Friend taking to ensure that hospitals on the English side of the border get a fair share of resources?
Mr Hunt
My hon. Friend is right to talk about that intolerable pressure on hospitals on the England-Wales border. For every one English patient admitted for treatment in a Welsh hospital, five Welsh patients are admitted for treatment in an English hospital, which creates huge pressure for them. I have written to the Welsh Health Minister to say that the NHS is happy to treat more Welsh patients, but the trouble is that NHS Wales is not prepared to pay for it. That is why Welsh patients get a second-class health service. [Interruption.]
Mr Speaker
Order. The hon. Member for Caerphilly (Wayne David) is normally a very calm and reserved fellow—almost statesmanlike. This curious behaviour is quite out of character. He should take some sort of sedative. The hon. Member for Cardiff South and Penarth (Stephen Doughty) can probably advise him.
Liz Kendall (Leicester West) (Lab)
With hospitals set to be £1 billion in the red this year, the Secretary of State should be getting a grip of NHS finances. Instead, he is starting on yet another reorganisation. First, he put NHS England in charge of commissioning primary and specialist care. Now, NHS England wants to hand this back to clinical commissioning groups. Ministers have already wasted three years and £3 billion of taxpayers’ money. How much will this Secretary of State’s second reorganisation cost?
Mr Hunt
It is lovely spin from the party that carried out nine reorganisations in 13 years. The difficult truth for the Labour party is that this reorganisation that they fought so hard against has been a success. We are saving this Parliament £5 billion. We have reduced the number of administrators by 19,000. We have hired 10,000 more doctors and nurses with the money, and the result is that our NHS, in very difficult circumstances, is doing nearly a million more operations every single year. That is something that we on both sides of the House should welcome and be proud of.
David T. C. Davies (Monmouth) (Con)
14. How many patients resident in England have written to him to request that they be treated in Wales.
The Secretary of State for Health (Mr Jeremy Hunt)
Given the perilous state of the NHS in Labour-run Wales, my hon. Friend will not be surprised to know that not a single English patient has written to me asking for funding to be treated in Wales.
David T. C. Davies
My hon. Friend is correct. That will come as no surprise to anyone who has had dealings with the NHS in Wales. In the light of that, will he assure us that he will do everything possible to push ahead with the OECD comparison report into the health systems in Wales and England, on which the Welsh Assembly Government are disgracefully trying to obfuscate and cause delay because they are afraid of what might be discovered?
Mr Hunt
I am afraid that that says it all. Opposition Front Benchers tell us continually that they are not prepared to condemn what is happening in Wales and that the health service in Wales is performing well, yet here is an opportunity to prove it—an independent study by the OECD of the four NHS systems in the UK—and Labour is trying to block it. This issue matters, because the policies in Wales are what Labour wants to do in England.
Hywel Williams (Arfon) (PC)
Will the Secretary of State concede that for many decades people from north Wales have had to travel to England for treatment? In that respect, both Government and Opposition Front Benchers are culpable.
Sir Oliver Heald (North East Hertfordshire) (Con)
17. My right hon. Friend will be aware that his new website, My NHS, is providing much more openness and transparency for patients from England. To what extent does the extra information and ability to improve standards in hospitals as a result also apply to Wales?
Mr Hunt
This is the big lesson that we have learned after the tragedy of Mid Staffs. The Francis report said that the NHS had become over-dependent on a targets culture that was damaging for patients, and the Government think that the way to improve standards is through transparency, openness, and the pressure of peer review. We have embraced that lesson wholeheartedly, and it is such a shame that the Welsh Labour Government have taken a different tack.
Wayne David (Caerphilly) (Lab)
Has the Secretary of State seen today’s Western Mail? If he has, he will know that the Western Mail, which is not a Labour supporting paper, totally condemns the scaremongering of the Conservative party.
Mr Hunt
When I started speaking out about poor care in England—one of the first things I did in this job—those on the Labour Front Bench said that I was running down the NHS. The result of my speaking out is that we are turning around failing hospitals and have 5,000 more nurses on our wards. The NHS in England is getting safer and better, and we want exactly the same thing for Wales.
Barbara Keeley (Worsley and Eccles South) (Lab)
15. How many training posts for nurses were commissioned in England in each of the last three years.
Heidi Alexander (Lewisham East) (Lab)
T1. If he will make a statement on his departmental responsibilities.
The Secretary of State for Health (Mr Jeremy Hunt)
Last week, the Care Quality Commission published its “State of Care” report. This affirmed that the pace and scale of change to improve care in the NHS last year has been unprecedented, but it also contained some hard truths. It found that the variation in the quality of health in adult social care was too wide, and that too many hospitals have not got to grips with the basics of safety. This Government want every NHS patient to have confidence that their care will be both safe and compassionate. We have turned around six hospitals put into special measures, and people saying that their care is safe and compassionate are at record highs. We are determined to change the culture of the NHS away from secrecy towards transparency, and away from targets towards personal care where patients’ needs always come first.
Heidi Alexander
In August 2014, 10,616 patients had to wait longer than six weeks for a key cancer test. That is five times the number of people who had to wait that long in May 2010. If the Government do not support Labour’s commitment to a one-week cancer test guarantee, what action will they be taking to reduce waiting times?
Mr Hunt
As I said earlier, we welcome the fact that Labour is now interested in cancer policy. If we look at the reason for those delays, which we are working hard to address, it is because the number of cancer referrals—[Interruption.] Labour left this country with the worst cancer survival rate in western Europe; we are doing something about it. The reason for the delays is that the number of people being referred for cancer tests has gone up by 50% since 2010. We are treating record numbers of people with cancer because we want to do something about that survival rate.
Philip Davies (Shipley) (Con)
T2. The Public Health Minister is pursuing a long list of nanny state proposals that we might have better expected from the Labour party, including plain packaging of tobacco, outlawing parents smoking in cars and having higher taxes on alcohol. Will she give us a list of which policies, if any, she is pursuing that have a Conservative flavour to them?
Andy Burnham (Leigh) (Lab)
At their conference, the Tory party promised flat funding for the NHS in the next Parliament, but experts say that the service is at breaking point now and that the funding promised is not enough. Now, the Secretary of State’s own side are saying the same thing. The Chair of the Health Committee said last night:
“The Chancellor is going to have to write a bigger cheque”
or we will
“see reductions in services or waiting times increase”
and
“go down the route of top-ups and charges”.
Does the Secretary of State agree with her, and will he concede that a flat budget for the NHS in the next Parliament will not stop it tipping into a full-blown crisis?
Mr Jeremy Hunt
I am afraid that the shadow Health Secretary is misrepresenting what was said at the Conservative party conference. We promised not just to protect the NHS budget but to protect and continue to increase the NHS budget in real terms. I gently say to him that we have increased the NHS budget spend this Parliament by double the amount that Labour promised at its conference. We did that because on this side of the House we understand a simple truth: a strong NHS needs a strong economy.
Andy Burnham
The House will have noticed that the Secretary of State did not answer my question. There is a very simple reason why the Secretary of State cannot answer my question: his party has prioritised unfunded tax cuts for higher earners, leaving a large black hole in the public finances. There will be nothing left for the NHS if the Tories are re-elected. We on the Labour Benches, in contrast, have promised £2.5 billion over and above what they are committed to. Does that not make the choice on the NHS now clear: under Labour, more money for the NHS; under the Tories, tax cuts for some but an NHS crisis for all?
Mr Hunt
The right hon. Gentleman cannot have it both ways. The tax cuts the Government have prioritised are for lower-paid people, many of whom work in the NHS. When we had a strike last week, he was criticising the Government for not being more generous, but we have been generous—with the tax cuts he is now criticising. The NHS is facing the biggest financial squeeze in its history partly because of an ageing population but partly because the last Labour Government forgot about the deficit.
Caroline Dinenage (Gosport) (Con)
T3. In my constituency, waiting times for GP appointments remain long and practices are struggling to recruit enough doctors. Will my right hon. Friend reassure me as to when the improvements he is making elsewhere in the country will take effect in Gosport, and will he meet me to discuss the matter?
Mr Hunt
I would be delighted to discuss it with my hon. Friend, who is right to focus on the role of GPs. If we are to transform the NHS by the end of the next Parliament, we need fundamentally to improve out-of-hospital care, and GPs are at the heart of that. We have recruited 1,000 more GPs during this Parliament, but we need many more, and that will definitely include her constituency.
Derek Twigg (Halton) (Lab)
We have a shortage of GPs in Halton. Constituents tell me it is more difficult to get an appointment, and in recent months, two GPs have told me that there are major problems with GP services in Halton and the country as a whole. Despite what the Secretary of State says about increased numbers of GPs, that is not happening in Halton. What is he doing to address the problem, particularly in areas of great deprivation, such as Halton?
Mr Hunt
There is pressure throughout the NHS because there are nearly 1 million more over-65s than there were four years ago, which puts pressure on GPs, as it does on any department or hospital providing elective care. However, this is not just about getting an appointment; it is also about ensuring that GPs have personal responsibility for the patients on their list and are accountable for the care of some of the most vulnerable people. We have brought back named GPs with personal responsibility for over-75s, and I hope the hon. Gentleman welcomes our going further and bringing it back for everyone.
Neil Carmichael (Stroud) (Con)
T4. Meningitis Now, based in my constituency, is a keen supporter of the Men B vaccination for infants. Given the Joint Committee on Vaccination and Immunisation’s recommendation that it start, will the Minister update us on how the roll-out is progressing?
Valerie Vaz (Walsall South) (Lab)
Will the Secretary of State explain why NHS England has entered into a contract with a company based in Kent to provide GP services, when my constituents have just seen a string of locum GPs at a higher cost to the NHS?
Mr Jeremy Hunt
Wherever we can avoid it, we do not want to use locum GPs or nurses or agency doctors, because they are much more expensive—our spend on that is far too high—but sometimes when there are issues of patient safety we need a quick solution. That is what has happened in response to the Francis report: as well as recruiting 5,000 additional nurses on a permanent basis, we are using extra agency nurses. However, we hope to bring those numbers down.
Simon Wright (Norwich South) (LD)
T5. I congratulate the Minister of State, Department of Health, my right hon. Friend the Member for North Norfolk (Norman Lamb), who has responsibility for care and support, on securing the introduction of NHS waiting times for mental health for the first time next year. How will he ensure that the resulting treatment is not only timely but evidence-based and effective?
Charlie Elphicke (Dover) (Con)
T6. Can the Secretary of State confirm to the House whether there are any plans to sell off the NHS and will the NHS remain free at the point of delivery?
Mr Jeremy Hunt
I can confirm that there are no such plans and it will remain free at the point of delivery. Nor do we have any plans to pay private providers 11% more than NHS providers, as happened under the previous Labour Government.
Sheila Gilmore (Edinburgh East) (Lab)
In response to my amendment to the Care Bill earlier this year about the portability of care packages to the countries of the UK, the Minister of State, Department of Health, the right hon. Member for North Norfolk (Norman Lamb), promised that a voluntary framework would be in place by November. It is 10 days until November, so how is progress going?
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)
Will the Secretary of State join me in paying tribute to Eilish Hoole, who sadly passed away in July from ovarian cancer. She was only 47 and the mother of five children. Following her diagnosis of late-stage ovarian cancer she campaigned tirelessly in Parliament with Target Ovarian Cancer, which led to the recent successful pilot of the awareness campaign in the north-west. Will the Secretary of State commit to roll that out to the rest of the country so that other women in her position get to see their children grow up?
Mr Jeremy Hunt
I am very happy to pay tribute to Eilish Hoole, to the many cancer campaigners and to the many people who have survived cancer and put their lives back together again. There is still a huge job to do in getting earlier diagnosis. I think there is agreement across the House about the need for much earlier cancer diagnosis, particularly for ovarian cancer, which makes a huge difference. I know that we would all like to pay tribute to her work.
Tim Farron (Westmorland and Lonsdale) (LD)
NHS England has identified south Cumbria as one of just three places in England where travel times to receive radiotherapy are unacceptably and debilitatingly long. Will the Secretary of State meet me and NHS England to talk about how Kendal hospital can be the place for a new radiotherapy centre this autumn?
Fiona Mactaggart (Slough) (Lab)
I assume that the Secretary of State has read the National Audit Office’s report on local funding for health care. In the 17 years for which I have been Member of Parliament for Slough, we have never reached our target for funding and now the gap between Slough’s target and our actual funding is greater than ever before. What is he going to do to ensure that areas get the funding they need to provide the health care their residents require?
Mr Jeremy Hunt
First, we have made the decision an independent one, taken at arm’s length from Ministers, to try to take the party politics out of it. Secondly, we protected the NHS budget. Thirdly, one of the most important and significant things for the hon. Lady’s constituents has been the way in which the Heatherwood and Wexham Park NHS Trust has been turned round from failing and being in special measures to being taken over and run by Frimley Park NHS Trust—the most successful trust in the country.
Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)
The Secretary of State makes great play of protecting the NHS budget, but NHS England, the Nuffield Trust and his hon. Friend the Chair of the Health Committee all agree that it needs another £30 billion investment, so how can he tell people that the NHS is safe under his watch?
Mr Jeremy Hunt
We have not just protected the NHS budget, but increased it in real terms, which I think is a huge achievement given the state of the economy we inherited. [Interruption.] I simply say to the hon. Lady that the way to protect and secure NHS funding for the future is by making sure that there is a strong economy to pay for it. That is the single most important thing of all.
NHS Services (Access)
Jeremy Hunt Excerpts(10 years, 6 months ago)
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Andy Burnham
My hon. Friend puts it very well. If mental health is the poor relation of the NHS, then child and adolescent mental health services are the poor relation of the poor relation. How can that be the case when we are talking about children who need the best possible support—the most vulnerable children—being denied the services that they need? My hon. Friend the Member for Leicester West (Liz Kendall) discussed at a shadow health team meeting a constituency case where a family were trying to find a bed for a child who was in a crisis and not one bed was available for that child in the whole country—not one bed. She is nodding. That is the reality. I wish that Government Members would focus on that rather than making complacent statements.
No amount of spin from the Government can disguise the fact that the NHS is heading for the rocks and urgently needs turning around, so the question is how we get it back on track. I have two positive proposals to put before the House on policy direction and on funding. Let me take each in turn. Instead of just admitting privately that the reorganisation was a mistake, the Government should be actively working with us to begin to put it right—and they will soon have a chance to do so. In five weeks, my hon. Friend the Member for Eltham (Clive Efford) will bring a Bill before this House to repeal the worst aspects of the Health and Social Care Act 2012. When the Government’s reorganisation was going through, their mantra was “Doctors will decide.” The Prime Minister repeated this in his “Today” programme interview during the Conservative party conference when he said:
“there’s nothing we’ve done which makes it more likely there’ll be private provision in the NHS”.
Andy Burnham
The Secretary of State says that it is true, but that is not how people see it in the real world. Doctor after doctor tells me that their legal advice under section 75 of the Act mandates them to run open tenders for services. Today we see the evidence of how the NHS is changing under that regime. The BBC reports that more than half of contracts awarded by clinical commissioning groups are going outside the NHS. Why is this a problem? Because it is wasting NHS resources on tenders and leading to fragmentation of care when the future demands integration. We need Government Members to tell us today whether they will vote with us on 21 November to repeal mandatory tendering and thus be true to what they originally said they wanted to do, which was to let doctors decide how services are provided.
The Secretary of State for Health (Mr Jeremy Hunt)
I do not think I have ever heard such a misuse of statistics and facts in this House as we have heard today.
I am delighted to debate the NHS, which has been independently rated—[Interruption.] Labour Members do not like to hear this. The NHS has been independently rated by the Commonwealth Fund this year as having become, under this Government, the best out of 11 industrialised countries. It is a better health care system than those in France, Germany and Australia. [Interruption.] Labour Members do not like to hear this, but the independent experts in Washington have said that the NHS has become the best in the world under this Government. The most uncomfortable thing of all for the Labour party is that the NHS has become better than it ever was under the previous Labour Government, when the right hon. Member for Leigh (Andy Burnham) was Health Secretary.
If the right hon. Gentleman wants to talk about Government mistakes, we will do so, but he will find that, on Mid Staffs, the private finance initiative, botched IT projects, a disastrous GP contract, unsafe hospitals, low cancer survival rates and little action on dementia, it is the Labour party, not this Government, that must be held accountable for mistakes in running the NHS. Indeed, after years of mismanagement it is this Government who are finally putting high-quality patient care back at the heart of what the NHS stands for.
Mr Hunt
I will give way in a moment, but I want to make some progress.
I want to go through the arguments of the right hon. Member for Leigh in detail, but let me start with the elephant in the room: the massive financial pressure facing the NHS if it is to meet our expectations in the face of an ageing population. There are now nearly 1 million more people over 65 than when this Government came to office. Our economy then was nearly bankrupt. Despite those extraordinary challenges, this Government have been able to increase spending on our NHS—including on Leigh infirmary in the right hon. Gentleman’s constituency—because of our difficult decisions, which were opposed at every stage by the Labour party. Government Members know one simple truth: a strong NHS needs a strong economy.
On the day that unemployment fell below 2 million and the claimant count fell below 1 million, there was nothing in the right hon. Gentleman’s speech about the need for a strong economy to support our NHS and nothing about learning from the Labour Government’s disastrous mistakes, which were so bad that they were in fact planning to cut the NHS budget had they won the election. We should remember that countries that forgot about the deficit ended up cutting their health budgets—Greece by 14% and Portugal by 17%. [Interruption.] Well, these are the facts. We must never again in this country allow the poor economic decisions that have been the hallmark of every Labour Government in history.
Barbara Keeley
It is interesting that the Secretary of State is claiming credit for things where the data are based on Labour’s achievements with the NHS, while anything else is our fault. He talked about older people and the demographics of an ageing population, but what good does he think he is doing to that section of the population with £3.7 billion of cuts to social care? Particularly as we move to integration, how does he think that will help those people? In my local area, 1,000 people will lose their care package this year. How does he think that will help the NHS in Salford?
Mr Hunt
I will tell the hon. Lady what we are doing: we are integrating the health and social care systems through the Better Care fund—a £3.9 billion programme—which is something that Labour could have done in 13 years in office but failed to do. That will make a massive difference to the social care system. Let us move on to some of the detailed arguments.
Andy Burnham
This is the most important part of the debate. The Secretary of State is right about the elephant in the room. This is the thing that people in the NHS will pay most attention to today. He has gone through his record in this Parliament, but the problems in the next Parliament will be large, as I am sure he would agree. He needs to say today whether he thinks the ring fence will be sufficient, or does he think that the NHS will need more money over and above the ring fence if it is to avoid crisis in the next Parliament?
Mr Hunt
First, let me just correct for the record what the right hon. Gentleman has said. The Prime Minister’s commitment was not just a continuation of the ring fence; he has committed to continue to increase funding in real terms for the NHS. If the right hon. Gentleman looks at the record of this Government, he will see that we have increased spending on the NHS by more, in real terms, than Labour’s promises at its conference. The point about promises is whether the people making them are credible. Which party will deliver the strong economy that can fund the NHS?
David T. C. Davies
Will my right hon. Friend confirm that this Government have increased spending on the NHS in real terms by 3%? In Wales, where Labour is in control, there has been an 8% cut in real terms. How can we possibly trust a word Labour says on funding for the NHS?
Mr Hunt
That is the point. We get all sorts of rhetoric from Labour, but when we look at its record of running the NHS—whether its disastrous record in England previously, or its disastrous record in Wales today—we see the real face of Labour policies on the NHS, and no one should ever be allowed to forget it.
There has been a lot of discussion about reorganisation. The right hon. Gentleman criticised reorganisation as if it were the last thing in the world that a Labour Government would do, but the previous Labour Government had nine reorganisations in just 13 years. Following the conference season, we know that Labour wants to have yet another one by effectively abolishing clinical commissioning groups in all but name and making GPs work for hospitals. There is widespread opposition to that policy across the NHS.
The right hon. Gentleman has repeatedly claimed that the reforms have cost £3 billion, but the audited accounts show that the reforms will save nearly £5 billion in this Parliament and £1.5 billion a year thereafter. These are the words of the National Audit Office—[Interruption.] He should listen to this, because this is about an independent audit that relates to a key part of his case. These are the words of the National Audit Office in its 2013 report:
“The estimated administration cost savings outweigh the costs of the reforms, and are contributing to the efficiency savings that the NHS needs to make.”
Will he publicly correct the record and accept what the National Audit Office has said, which is that the reforms saved money? The man who is never short of a word is suddenly silent. I have the National Audit Office report here, so he can see for himself. The reforms saved money.
If the right hon. Gentleman wants to talk about wasting money, I am happy to do so. The management pay bill doubled under Labour, compared with a 16% drop under this Government. The private finance initiative schemes left the NHS with £79 billion of debt. The IT fiasco wasted £12 billion. We will take no lectures on wasting money from the party that was so good at wasting it that it nearly bankrupted the country, let alone the NHS.
Mr Hunt
I will make some progress.
The right hon. Gentleman said that the reforms have made it harder to access NHS services. The opposite is true. Scrapping the primary care trusts and strategic health authorities meant the introduction of clinical leadership, which he wants to abolish, and allowed the NHS to hire 6,100 more doctors and 3,300 more nurses. Those members of staff are helping the NHS to do 850,000 more operations every single year compared with when he was in office. How can he possibly stand before the House and say that access to NHS services is getting worse, when nearly 1 million more people are getting operations every year compared with when he was Health Secretary?
John Glen (Salisbury) (Con)
What is more, the evidence from Labour’s last years in office shows that the number of managers was increasing at three times the recruitment rate for nurses. What does that say about Labour’s priorities in office?
Mr Hunt
My hon. Friend is absolutely right. That is why the management pay bill doubled under Labour and why we took the difficult decision, which the Opposition bitterly opposed, to get rid of 19,000 administrators and managers so that we could recruit the extra doctors and nurses. I notice that Opposition Front Benchers are very quiet on that point because they cannot answer the simple question of how they would pay for those extra doctors and nurses if the Health and Social Care Act 2012 was reversed. [Interruption.] Ah! They would pay for the extra doctors and nurses by bringing in new taxes that the country is not paying at the moment.
The right hon. Gentleman talked about structural reforms. We ought to discuss the structural reforms that he chose not to talk about, such as making the Care Quality Commission independent, with new chief inspectors for hospitals, adult social care and general practice. He tried to vote down that legislation in this House. So far—[Interruption.] I know that this is uncomfortable for Labour Members, but they should listen, because the new inspection regime has put 18 hospitals into special measures. Five of them have been turned around completely and have exited special measures, and important improvements are being made at the others.
The motion talks about Government mistakes, so will the right hon. Gentleman finally accept the catastrophic mistakes that he made as Health Secretary, such as failing to sort out the problems at those hospitals, even though there were warning signs at every single one of them? Does he accept that because Labour ignored those warning signs, patients were harmed and lives lost? Will he finally apologise to the relatives of patients at Mid Staffs whom he made wait outside in the cold because he refused to meet them and hear their concerns? Will he make that apology now? He has not apologised and it is clear that he does not want to do so today.
The right hon. Gentleman talked about A and E. Just as when he was Health Secretary, there have been weeks when the target has not been met. What he did not tell the House is that, thanks to our reforms, we have 800 more A and E doctors than four years ago and nearly 2,000 more people are being treated within four hours every single day than when he was Health Secretary.
As the motion refers to Government mistakes, perhaps the right hon. Gentleman might like to acknowledge some of his own mistakes on A and E, such as the 2004 GP contract that removed personal responsibility for patients from GPs, making it more likely that people would end up in A and E, or the failure over 13 years to integrate the health and social care systems, meaning that many vulnerable older people continue to end up in A and E unnecessarily—something that we are putting right through the Better Care programme.
When the right hon. Gentleman spoke about NHS performance, he talked repeatedly about missed targets. That is a really important issue and is perhaps the biggest dividing line between his approach to the NHS and mine. Of course targets matter in any large organisation, but not targets at any cost. That is why the Government have been careful to ensure that in the new inspection regime, waiting time targets are assessed not on their own, but alongside the quality and safety of care.
Andy Burnham
The Secretary of State makes an important point, and as Health Secretary, I said that over-reliance on targets was not right. I accept that point, but he now needs to answer a question of mine. He has not removed our targets for A and E or for cancer. Does he consider it acceptable that the NHS is missing the national cancer target? If not, what will he say to reassure families that that will get better soon?
Mr Hunt
The right hon. Gentleman may want to forget that, when he left office, we had the worst cancer survival rate in western Europe, but why did we have that? We had the worst cancer survival rate in western Europe because we were not diagnosing cancers quickly enough. Under this Government—this is the inconvenient truth for the Labour party—we have treated for cancer nearly three quarters of a million more people than in the last Parliament. We have done that because, as the Prime Minister said, we are referring 50% more people. Access to cancer care has dramatically improved under this Government, and we are starting to climb back up the European league tables.
Mr Hunt
Let me finish my point about targets because it is important. The NHS over which the right hon. Gentleman’s Government presided was, as the former NHS chief executive Sir David Nicholson said, an NHS where
“patients were not the centre of the way the system operated.”
Labour’s NHS was obsessed with targets, and we have still not had an apology for the policy mistakes that led to Mid Staffs. We have got rid of a number of targets; we are happy to keep a few benchmark targets, but we will not be obsessed with targets at any cost.
May I gently suggest that the Labour party re-read the Francis report? These are Sir Robert’s words about the culture during the Mid Staffs period, when the right hon. Gentleman was a Minister. He described an
“insidious negative culture involving a tolerance of poor standards”
resulting from
“a focus on reaching national access targets”.
If the right hon. Gentleman does not want to listen to Sir Robert, will he listen to families who suffered in Mid Staffs, Morecambe Bay, Basildon and countless other hospitals, all of whom are simply incredulous that Labour wants to put him back in charge of the NHS, while he refuses to acknowledge the terrible problems caused by Labour’s NHS target culture?
The right hon. Gentleman also talked about privatisation. That may hit the spot for his trade union supporters, but it does not stand up to scrutiny. He knows that the use of the private sector for secondary care has grown more slowly under this Government than it grew under Labour. He knows that the biggest single privatisation decision in NHS history—the decision to contract out a whole district general hospital to the private sector—was allowed not by me, but by him when he was Heath Secretary. Let us set the record straight, because he tried to give the impression to my hon. Friend the Member for Selby and Ainsty (Nigel Adams) that that decision was not taken—[Interruption.] Let me make my point, and then I will give way. The right hon. Gentleman approved a shortlist for Hinchingbrooke hospital, which had on it two private sector providers and an NHS provider. He did not tell my hon. Friend that the NHS provider then pulled out, and that he accepted the continuation of that process with an all-private shortlist—[Interruption.] That is what happened, and if he wants to deny it, I will give way to him now.
Andy Burnham
The question is: when was that contract signed? Will the Secretary of State answer that question?
Mr Hunt
Actually, the question is: when did it become an all-private shortlist, and why did the right hon. Gentleman allow that to happen if he is now saying that the privatised running of hospitals is such a bad thing? I think that we have found him out, and he will want to correct the record and the impression that he gave to my hon. Friend the Member for Selby and Ainsty.
Mr Simon Burns (Chelmsford) (Con)
Will my right hon. Friend confirm that in March 2010, when the right hon. Member for Leigh (Andy Burnham) was Secretary of State, the number of bidders for Hinchingbrooke hospital—a process that took place under legislation passed by the previous Labour Government—went from five to three? Two of those bidders were private companies; the third bidder was a private company in conjunction with an NHS trust, but at a later stage as the process developed—as my right hon. Friend said—it went down to one bidder. The right hon. Gentleman said in response to my hon. Friend the Member for Selby and Ainsty (Nigel Adams) that there was a preferred bidder and that it was not a private company but the NHS. It was not the NHS; it was an NHS trust in conjunction with a private company.
Andy Burnham
The right hon. Member for Chelmsford (Mr Burns) has contradicted the Secretary of State. The right hon. Gentleman said that the bidder withdrew at a later stage, but the Secretary of State said that the bidder withdrew earlier. The Secretary of State cannot have it both ways. The right hon. Gentleman flatly contradicts him.
Mr Hunt
The right hon. Gentleman is quite wrong. My right hon. Friend said that there was a list of three providers, all with private provision involved. When the right hon. Gentleman was Health Secretary, he accepted that all-private shortlist for the Hinchingbrooke decision. In other words, the biggest privatisation in NHS history happened because of a decision taken by the shadow Health Secretary.
Government Members are not ideological. We believe there are times when we can learn from the independent sector, but, normally, people use the private sector when they are looking for innovation or better value. Only a Labour Government would sign deals with the private sector, paying 11% more than the NHS rate, and ending up paying more than £200 million for operations that never happened. What a shocking waste of money. When the right hon. Gentleman next talks about privatisation, instead of inventing a privatisation agenda that does not exist, will he apologise for a botched one that existed when Labour was in office?
Finally, there is a comparison that Labour never wants to make when talking about NHS performance: what happens over the border in Wales. That is where the policies that the right hon. Gentleman supports are put into practice. Let us see the difference. A record one in every seven Welsh people find themselves sitting on an NHS waiting list, compared with just one in 17 people in England. The urgent cancer waiting time target has not been met once since 2008 in Wales, but it has been missed in England in only two quarters in the whole period. A and E waiting times have been met every year in England, but they have not been met since 2008 in Wales.
Mr Hunt
No, I will finish this point.
The British Medical Association, no friend of the Conservative party, described the NHS in Wales as being in a state of imminent meltdown. The point is that the NHS in England, like the NHS in Wales, faces huge pressure, but politicising operational problems in England, while denying much greater failings in Wales, is the worst kind of opportunism. For Labour Members, good headlines for Labour matter more than poor care on Labour’s watch. They are playing politics with our NHS. That not only scares people in England, but betrays people in Wales.
I shall conclude—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. The right hon. Gentleman is not giving way. He must be allowed to speak.
Mr Hunt
The Government are proud of our record on the NHS in England: more operations for more people; three quarters of a million more people getting the cancer treatment they need; record numbers being seen promptly in A and E; record numbers getting treatment for dementia; and the first ever introduction of maximum waiting times for mental health conditions. It is an NHS under pressure, yes, but it is an NHS preparing for the future, with higher-quality care in hospitals, integrated health and social care, and personal care driven by a much bigger role for GPs.
Some of those changes need money, and we have delivered that, but some of them need a change in culture, different ways of working, more transparency and a more patient-centred approach. That can mean challenging the system, which the right hon. Member for Leigh has never been prepared to do, but which this Government will always do if it is right for patients. We want an NHS building for the long term and an NHS with the confidence of a strong economy behind it. Under this Government, the NHS is independently rated as the best in the world. I oppose the motion.
Kevin Barron
I will give way to the right hon. Gentleman in a bit, because I may mention him, as he was a Minister at the time. This Government came to office and passed a Bill through Parliament that was going to introduce competition into the national health service and mean a massive reorganisation, and billions of pounds were going to be spent in doing that—billions of pounds that could have been spent elsewhere—and the case for the defence is, “We’ll make a billion pounds a year in this Parliament.” Well, it is not there yet, Ministers.
It was not just the reorganisation of the national health service that was mentioned. The Government also told us at the same time that they had got to make efficiency savings of 4% a year, something that the health service had never done, and something the public sector had never done. Indeed, people said at the time that the private sector had never done it either.
That is the situation we had when that Bill went through Parliament. They were warned about the consequences of that not just by politicians in the House, but by people who gave evidence to the Public Bill Committee. I served on it. The Bill was stalled and came back in again. Evidence after evidence came in saying what has happened was going to happen.
We have had massive reorganisation. I just wonder if the Secretary of State—if he is prepared to listen—will tell us how many of the 4,000 NHS staff who were laid off and paid redundancy were then re-employed by the NHS, some of them on massive six-figure sums. How much did that cost the NHS? How much did that take away from mental health services or other services that our constituents rely on? None of this is in the debate at all, and Ministers all know perfectly well what the situation is.
Week after week, we hear these platitudes from Ministers. The Secretary of State said not too long ago, “When you go into hospital, you’ll get a named consultant,” but what does having a named consultant matter to most people? Are they going to work seven days a week, 24 hours a day so we can phone and say, “Can we come and see you?” No one has mentioned the latest one we have had, which I thought was wonderful—
Kevin Barron
The Secretary of State can come in in a minute. This latest one is a consequence of a speech made by the Prime Minister: we are going to be able to see GPs seven days a week. Well, the Royal College of GPs does not think so. I say this to the Secretary of State: “We could see a GP, not far from this place, seven days a week until you lot got in.” We could do so in the Victoria NHS walk-in centre, and I used to go in there, as my GP is elsewhere, but it closed years ago.
We put in walk-in centres—sometimes in the face of opposition from GPs, I have to say. A GP objected to them in my constituency, as I raised in the House at the time, so some of them were saying they did not want them. They gave seven days a week access to GPs.
I understand that my time is up, Madam Deputy Speaker, but I want to finish by saying this: whatever happened at Hinchingbrooke or anywhere else, we never ever had to have competition law on the statute book. We have now. Do not tell me or anybody else out there that the Secretary of State has not got plans to privatise properly the national health service, because I am convinced that he has.
Liz Kendall
I will not. [Interruption.] If the hon. Gentleman is going to talk about Wales, 90% of patients get their treatment within that target, compared with 84% here, so let me save him some time and bother.
The Government’s failure to keep people out of hospital and keep waiting lists under control, means the NHS is facing a looming financial crisis, too. Two-thirds of all acute hospitals are already in deficit to the tune of £500 million. They predict they will end the year £1 billion in the red, piling on the pressure for even greater service cuts and worse standards of care in future.
The tragedy is that it did not have to be this way. After 13 years of investment and reform, the previous Labour Government left the NHS with the highest ever patient satisfaction rates and the lowest ever patient treatment waits. But we were not complacent. We understood that the NHS had to face up to even bigger challenges: our ageing population, the increase in long-term conditions and huge medical advances, at a time when there is far less money around. For that reason, we had a plan in every region to reform front-line services, through Lord Ara Darzi’s NHS next stage review, by delivering some services in specialist centres so that patients got expert treatment 24/7 and by shifting other services out of hospitals and into the community. It was a move towards prevention joined up with social care to help people stay living at home. Instead of going ahead with our reforms, however, the Government scrapped them and forced through the biggest backroom reorganisation in the history of the NHS, wasting three years of time, effort and energy, and £3 billion of taxpayers’ money that should have gone on patient care.
The Health Secretary told the House today, and said on the “Today” programme, that the Government had saved £1 billion.
Liz Kendall
I actually picked up the copy of the report he left behind, and I found his highlight. It reads:
“The estimated administration cost savings outweigh the costs of the reforms”,
but it does not mention the £1 billion figure. In fact, paragraph 4.10, on the reliability of the Department of Health, states “we found…limited assurance” in the figures. It also states that
“strategic health authority staff did not verify the figures submitted to them by primary care trusts”
and that it
“saw no evidence that the”
Government
“challenged these figures.”
Far from being independently verified, as the Health Secretary claims, they have been made up on the back of an envelope. [Interruption.]
Government Members can complain, but we have constantly argued that the NHS reorganisation has been the single biggest mistake made by the Government, and now we find out that members of the Cabinet agree. An ally of the Chancellor told The Times:
“George kicks himself for not having spotted it or stopped it”.
A former No. 10 adviser says that
“no one apart from Lansley had a clue what he was really embarking on—certainly not the prime minister”.
So we have a Chancellor, who is meant to safeguard public money, failing to stop billions of pounds of waste and a Prime Minister who claimed the NHS was his top priority, but was too confused or complacent to bother to understand his own plans. The Conservative party still does not get it. One Downing street adviser is quoted as saying:
“A lot of work had gone into persuading people that David Cameron believed in the NHS, had personal experience and cared about it. Then the Conservatives came in and forgot all about reassurance. Lansley managed to alienate all the professional people in Britain who were trusted on the NHS.”
The Government’s NHS reorganisation was not just terrible politics; it is terrible in practice for patients, taxpayers and NHS staff. I remind hon. Members that the Health and Social Care Act 2012 did not just create 221 CCGs, 152 health and wellbeing boards, NHS England, Public Health England and Health Education England; it also created four regional NHS England teams, 27 local area NHS England teams, 16 specialist commissioning units—well, there were 19, but at least two have already been merged—and 10 specialist commissioning units. That is on top of Monitor and the Care Quality Commission. It is a system so chaotic and confusing that no one knows who is responsible or accountable for leading the changes patients want and taxpayers need.
And now, just when we thought it could not get any worse, another major new reorganisation is under way. NHS England was commissioning primary care and specialist services, but in May it announced it wanted to give primary and specialist commissioning back to CCGs to try and patch up the fragmentation created by the Government's own plans. How much will this second reorganisation cost patients and staff?
Patients, staff and taxpayers cannot afford another seven months, let alone another five years, of this Government. They need a clear plan to restore care standards and restore care services so that they are fit for the future. Opposition Members would use the savings from scrapping the cost of competition in the NHS to guarantee new rights for patients to see their GP at a time that is convenient for them. We would raise £2.5 billion from a mansion tax, clamping down on tax avoidance and a levy on the tobacco companies to fund more GPs, nurses, midwives and homecare workers to transform services, particularly in the community. We will support carers with new duties on the NHS to identify family carers, a single point of contact for information and services and ring-fenced funding for carers’ breaks. Our plan for whole-person care would ensure the full integration of physical and mental health and social care services into one service with one team to meet all of a person’s needs.
At the next election, there will be a real choice on the NHS: a choice between care going backwards and money wasted under the Conservatives or Labour’s plans to fully join up services to get the best results for patients and the best value for money. It will be a choice between the Conservatives who have broken their promises to protect the NHS, throwing the system into chaos and blaming staff, or Labour who will make the real reforms we need so that people get personalised care in the right place at the right time. It will be a choice between the Conservatives’ unfunded plans to cut taxes for the wealthiest or Labour’s fully funded plans to reform the NHS and care services on which we all rely. I commend the motion to the House.
Ebola
Jeremy Hunt Excerpts(10 years, 6 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health (Mr Jeremy Hunt)
With permission, Mr Speaker, I would like to update the House on the Government’s response to the Ebola epidemic in west Africa.
I shall start with the chief medical officer’s assessment of the current situation in the affected countries. As of today, there have been 4,033 confirmed deaths and 8,399 confirmed, probable and suspected cases of Ebola recorded in seven countries, although widespread transmission is confined to Liberia, Sierra Leone and Guinea. The number is doubling every three to four weeks. The United Nations has declared the outbreak an international public health emergency.
The Government’s first priority is the safety of the British people. Playing our part in halting the rise of the disease in west Africa is the single most important way of preventing Ebola from infecting people in the UK, so I would like to start by paying tribute to the courage of all those involved in this effort, including military, public health, development and diplomatic staff. I would particularly like to commend the 659 NHS front-line staff and the 130 Public Health England staff who have volunteered to go out to Sierra Leone to help our efforts on the ground. You are the best of our country and we are deeply proud of your service.
Among the three most affected countries, the UK has taken particular responsibility for Sierra Leone, with the US leading on Liberia and France focusing on Guinea. British military medics and engineers began work in August on a 92-bed Ebola treatment facility in Kerry Town, including 12 beds for international health workers. In total we will support more than 700 beds across the country, more than tripling Sierra Leone’s capability. With the World Health Organisation, we are training more than 120 health workers a week and piloting a new community approach to Ebola care to reduce and, hopefully, stop the transmission rate. We are also building and providing laboratory services and supporting an information campaign in-country.
We are now deploying the Royal Navy’s RFA Argus and its Merlin helicopters along with highly skilled military personnel, bringing our military deployment to 750. They will support the construction of the Kerry Town Ebola treatment centre and other facilities, provide logistics and planning support, and help establish and staff a World Health Organisation-led Ebola training facility to increase training for health workers.
Taken together, the UK contribution stands at £125 million, plus invaluable human expertise: that is the second highest bilateral contribution after the US’s. However, we do need other countries to do more to complement our efforts and those of the US and France. On 2 October, the Foreign Secretary held an international conference on defeating Ebola in Sierra Leone during which more than £100 million and hundreds of additional health care workers were pledged.
I now move on to the risks to the general public in the UK. The chief medical officer, who takes advice from Public Health England and the Scientific Advisory Group for Emergencies, has this morning confirmed that it is likely that we will see a case of Ebola in the UK. This could be a handful of cases over the next three months. She confirms that the public health risk in the UK remains low and that measures currently in place, including exit screening in all three affected countries, offer the correct level of protection. However, while the response to global health emergencies should always be proportionate, she also advises the Government to make preparations for a possible increase in the risk level. I can today announce that the following additional measures will take place.
On screening and monitoring, rapid access to health care services for anyone who may be infected with Ebola is important not only for their own health, but to reduce the risk of transmission to others. Although there are no direct flights from the affected region, there are indirect routes into the UK, so next week Public Health England will start screening and monitoring UK-bound air passengers identified by the Border Force as coming in on the main routes from Liberia, Sierra Leone and Guinea. This will allow potential Ebola virus carriers arriving in the UK to be identified, tracked and given rapid access to expert health advice should they develop symptoms. These measures will start tomorrow at Heathrow terminal 1, which receives about 85% of all such arrivals across the whole airport. By the end of next week, they will be expanded to other terminals at Heathrow and Gatwick, and to the Eurostar, which connects to Paris and Brussels-bound arrivals from west Africa.
Passengers will have their temperature taken and will complete a questionnaire about their current health, their recent travel history and whether they might be at potential risk through contact with Ebola patients. They will also be required to provide contact details. If neither the questionnaire nor the temperature reading raises any concerns, passengers will be told how to make contact with the NHS should they develop Ebola symptoms within the 21-day incubation period, and allowed to continue on their journey. It is important to stress that a person with Ebola is infectious only if they are displaying symptoms. Any passenger who reports recent exposure to people who may have Ebola or symptoms, and any passenger who has a raised temperature will undergo a clinical assessment and, if necessary, be transferred to hospital. Passengers identified as having any level of increased risk of Ebola but without any symptoms, will be given a Public Health England contact number to call should they develop any symptoms consistent with Ebola within the 21-day incubation period. Higher risk individuals will be contacted daily by PHE. Should they develop symptoms, they will have the reassurance of knowing that this system will get them first-class medical care—as the NHS demonstrated with nurse William Pooley—and the best possible chance of survival.
We expect these measures to reach 89% of the travellers we know have come to the UK from the affected region on tickets booked directly through to the UK, but it is important to note that no screening and monitoring procedure can identify 100% of people arriving from Ebola-affected countries, not least because some passengers leaving those countries will not be ticketed directly through to the UK. Today, I can therefore announce that the Government, working with the devolved Administrations, will ensure that highly visible information is displayed at all entry points to the UK, asking passengers, in their own best interests, to identify themselves if they have travelled to the affected region in the past 21 days. This information for travellers will be available by the end of this week.
We are taking other important measures. We tested operational resilience with the comprehensive exercise that took place on Saturday, which modelled cases in London and the north-east of England. Local emergency services across England will hold their own exercises this week and share lessons learned. It is vital that the right decisions on Ebola are made following any first contact with the NHS, so we have put in place a process for all call handlers on NHS 111 to ask people who report respiratory symptoms about their recent travel history so that appropriate help can be given to higher risk patients as quickly as possible. During recent months, the chief medical officer has issued a series of alerts to doctors, nurses and pharmacists setting out what to do when someone presents with relevant symptoms. We will also send out guidance to hospital and GP receptionists.
The international profile of the UK as a favoured destination inevitably increases the risk that someone with Ebola will arrive here so, working closely with the devolved Administrations, a great deal of planning has gone into procedures for dealing with potential Ebola patients in the UK. All ambulances are equipped with personal protective equipment. If a patient is suspected of having Ebola, they will be transported to the nearest hospital and put in an isolation room. A blood sample will be sent to Public Health England’s specialist laboratory for rapid testing. If they test positive for Ebola, they will be transferred to the Royal Free hospital in north London, which is the UK’s specialist centre for treating the most dangerous infectious diseases. We also have plans to surge Ebola bed capacity in Newcastle, Liverpool and Sheffield, making a total of 26 beds available in the UK.
I will always follow medical advice on whether any measures that we adopt are likely to be effective and are a proportionate response to the risk. However, I believe that we are among the best and most prepared countries in the world.
Lastly, we are harnessing the UK’s expertise in life sciences to counter the threat from Ebola. The UK Government, alongside the Wellcome Trust and the Medical Research Council, have co-funded clinical trials of a potential vaccine, which might be pivotal in the prevention effort. We are working actively with international partners to explore how we might appropriately make further vaccine available.
We should remember that the international community has shown that if we act decisively, we can defeat serious new infectious disease threats such as SARS and pandemic flu. The situation will get worse before it gets better, but we should not flinch in our resolve to defeat Ebola both for the safety of the British population and as part of our responsibility to some of the poorest countries on the planet. Our response will continue to develop in the weeks and months to come, guided by advice from the chief medical officer, Public Health England and the Scientific Advisory Group for Emergencies.
I commend the statement to the House.
Andy Burnham (Leigh) (Lab)
I thank the Secretary of State for the advance copy of his statement and commend him for making it at the first opportunity.
We have all been horrified by the devastating scenes from west Africa and our hearts go out to the communities that are confronting this threat on a daily basis. Public concern about Ebola is rising here and it is important that people have reliable facts and regular updates.
There are parallels between the current situation and the 2009 swine flu pandemic with which I dealt. I was grateful for the helpful approach of the then Opposition, particularly the right hon. Member for South Cambridgeshire (Mr Lansley), and I aim to provide the Secretary of State with the same approach. However, we do have a role in scrutinising the Government’s approach and I will do that today in a constructive spirit.
I echo the Secretary of State’s tribute to the many NHS staff, Public Health England staff and members of the armed forces who have helped on the ground in west Africa. We have a duty to protect them in any way we can. I want to start with the advice that is given to those who are treating people with the disease. People will be worried by the reports of a second case of Ebola in a health worker, this time in Dallas. We have seen protests in Spain by clinical staff who feel that a colleague has been unfairly exposed to infection. In the light of that, will the Secretary of State say whether he has confidence in the official advice that is being given to those who are treating the disease, and whether it needs to be reviewed?
Let me turn to the risk to the public here. The Secretary of State says that it remains low and the chief medical officer predicts a handful of cases. A handful is not a very scientific term. Will he be more precise and give the House the full range of figures that the advisory group has considered, including the worst case scenario? I recall agonising over whether to publish the official predictions for swine flu and about the risk of worrying the public unnecessarily. However, I think that the public interest lies in openness. Will the Secretary of State confirm that he is planning for the worst case scenario, so that there is no sense of complacency?
Let me turn to our preparedness to deal with an outbreak. There has been confusion about screening at point of entry. Last Thursday, the Department of Health said:
“Entry screening in the UK is not recommended by the World Health Organization, and there are no plans to introduce entry screening for Ebola in the UK.”
Screening was also ruled out by the Secretary of State for Defence. However, just 24 hours later, we were told that screening was to be introduced. Will the right hon. Gentleman say what prompted that about-turn? What official advice has he received from the chief medical officer and Public Health England on entry screening? Based on the science, do they think that it is necessary? Do the arrangements he has announced for temperature checks fully comply with that advice?
As there are currently no direct flights from the affected countries, will the Secretary of State say exactly who will be screened? Will it be all arrivals from those countries? How many people a day or week do we expect that to be, and how will they be identified? Have front-line Border Force staff been properly briefed about what is expected of them, and are they being trained in what to look for and in screening procedures? Why is there only partial coverage of ports of entry? What about sea ports and other UK airports? Will he say where the checks will take place on Eurostar, given that it stops at a number of places en route to London?
On the exercise this weekend, as the Secretary of State will know, a patient was transferred from Newcastle where there are beds in negative pressure isolation units to the Royal Free hospital, which has Trexler isolators. Do the Government believe that Ebola is better handled in Trexler beds, and is the Secretary of State satisfied that the two NHS beds—both at the Royal Free—are sufficient? Given that in addition to the two Trexler beds there are already 24 negative pressure isolation beds, which make up the 26 beds he referred to, will he say what he means by “surge Ebola bed capacity”? If it becomes necessary to treat Ebola cases more widely in isolation beds, is he satisfied that there is adequate provision across England? Is he satisfied that all relevant NHS staff, including GPs, ambulance and 111 staff, know how to identify Ebola, the precautions to take in any potential presentation, and the protocols for handling it? He mentioned symptoms a few times in his statement. For the public watching this statement, will he tell the House simply what those symptoms are?
On treatment, the British nurse who was successfully treated here was offered and took an experimental medication called ZMapp. Will it be standard practice to offer all affected patients ZMapp, and if so, are there sufficient supplies in the NHS to do that? The Secretary of State rightly focused on a vaccine, which would of course be the best reassurance we could give the public. During the swine flu pandemic, huge effort went into compressing the timetable for the development of a vaccine. Is he confident that everything that can be done is being done to speed that up?
Finally, as the Secretary of State said, the best way to protect people here is to stop Ebola at source. The UK has rightly pledged £125 million to assist Sierra Leone, but with cases doubling every three to four weeks there is wide agreement that the response of the wider international community has been slow and inadequate. The window to halt Ebola before it runs out of control altogether is closing fast. What assessment has been made of the resilience of neighbouring countries such as Guinea and Liberia, and what help is being offered to them? The International Development Committee report was clear that the lack of proper health coverage allowed the outbreak to grow unchecked for so long. Does the right hon. Gentleman accept that improving global health systems is the best way to prevent these outbreaks, or at least ensure that they are caught before they get out of control? Many countries support placing universal health coverage at the centre of global development, yet the UK is currently opposing such plans at the UN. Will he say a little more about the Government’s position on that, and whether they are prepared to reconsider it in the light of recent events? Knowing from my experience how difficult these situations are, I assure the Secretary of State that the offer of help is genuine, but on behalf of the House I ask him for regular updates and maximum openness in the weeks and months to come.
Mr Hunt
I thank the shadow Health Secretary for the constructive tone of his comments. That is totally appropriate and I am grateful. I will start with the point on which he finished, because the most crucial thing we can do to protect the UK population is deal with the disease at source and contain it in west Africa. That is why I am working extremely closely with the International Development Secretary, and she is working closely with me because the role of NHS volunteers is important. The right hon. Gentleman is absolutely right: the initial international response has focused on taking the three worst affected countries and giving them a partner country in the developed world to help them—we are helping Sierra Leone, America is helping Liberia, and France is helping Guinea.
That has worked up to a point, but we need more help from the rest of the international community. I had a conversation earlier today with US Health Secretary Burwell. We talked about a co-ordinated international response for the whole of west Africa, because we will not defeat this disease if we operate in silos. We need to recognise that this disease does not recognise international boundaries; the right hon. Gentleman was absolutely right to make that point.
Let me try to give the right hon. Gentleman some of the information he requested. First, he is absolutely right to raise the issue of the protection of health workers. That has to be our No. 1 priority both here in the UK and abroad. That is why we are building a dedicated 12-bed facility in Sierra Leone that will give the highest standards of care, equivalent to NHS standards of care, for health care workers taking part in the international effort to contain the disease there. That is also very relevant to health care workers here: events in both Spain and the US will have caused great concern.
I am satisfied that the official advice to health care workers is correct. The Centers for Disease Control and Prevention in the US, the US equivalent of Public Health England, believes that breaches in protocol led to the infection of the US nurse—the case we have seen in the media recently—but it is investigating that. The advice is always kept under review and if that advice changes we would, of course, respect that. It is important that we follow the scientific advice we have, but that the scientists themselves keep an open mind on the basis of new evidence as it emerges. I know that they are doing that.
The right hon. Gentleman talked about the full range of figures. He is absolutely right to say that we will maintain public confidence in the handling of this by being totally open about what we know. The reason we have stuck carefully to the formula of “a handful of cases” is because it is genuinely very difficult to predict an accurate exact number. Let me say this: we would not have used the formula of “a handful of cases” if we thought that the number of cases over the next three months would reach double figures. However, it is also important to say that that was a current assessment. That assessment may change on the basis of the evidence. I will, of course, keep the House informed if it does change.
The right hon. Gentleman talked about screening. It is important to deal with a misunderstanding. Why did the policy change on Thursday? The answer is that it changed because the clinical advice from the chief medical officer changed on Thursday. Her advice changed not on the basis that the risk level in the UK had changed—she still considers it to be low—but because she said that we should prepare for the risk level going up. That is why we started to put in place measures, but they are not measures primarily intended to pick up people arriving in the UK who are displaying symptoms of Ebola. We think that most of those people should be prevented from flying in the first place. The measures are designed to identify people who may be at risk within the incubation period of developing the disease, so that we can track them and make sure they get access to the right medical care quickly.
As I mentioned, we think we will reach 89% of people arriving in the UK from the affected countries. We will continue to review that. If the numbers increase and the risk level justifies it, we have contingency plans to expand the screening, for example to Birmingham and Manchester. The reason we have included Eurostar at this early stage is because there are direct flights from those three countries to Paris and Brussels, from where it is easy to connect to Eurostar. We will use the tracking system for people who are ticketed directly through to the UK in order to identify, where we can, people who then independently get a Eurostar ticket. It is important to say that because they are changing the mode of transport in Paris and Brussels, tracking is not as robust as it would be for people taking a direct flight to the UK. We will not be able to identify everyone, which is why we need to win the support of people arriving in the UK from those countries, so that they self-present, in their own interest, to give us the best possible chance of helping them if they start contracting symptoms.
I am satisfied that the Trexler beds and the negative isolation rooms are safe both for health care workers and in preventing onward transmission. They use different systems—one of them is a tented system and the other is based on people wearing personal protective equipment —but I am satisfied that both of them are safe. I will continue to take advice on that. It is very important that ambulance staff know that someone is a potential Ebola case, so that they wear the PP equipment.
As we will not be able to identify everyone who comes from the affected countries, it is important that the 111 service knows to ask people exhibiting the symptoms of Ebola whether they have travelled to those affected areas. The right hon. Gentleman asked what those symptoms are. They are essentially flu-like symptoms, but they are not dissimilar to the symptoms someone might exhibit if they had, for example, malaria. That is why it is important to ask for people’s travel history and whether they have had or may have had contact with people who have had Ebola, in order to identify the risk level.
We would like to continue using ZMapp for people in the UK who contract the disease, but that is subject to international availability. It might not be possible to get it for everyone, because there is such high international demand, but we will certainly try.
In terms of the development of a vaccine, we are doing everything we can to work with GSK to bring forward the date when a vaccine is available. Indeed, we are considering potentially giving indemnities if the full clinical trials have not been conducted.
Dr Sarah Wollaston (Totnes) (Con)
May I welcome the Secretary of State’s statement and pay tribute to all the staff who are giving him professional detailed scientific advice? I join him in paying tribute to all the NHS personnel, our forces personnel and diplomatic staff putting their own lives at risk in west Africa.
I am particularly pleased to hear that those individuals returning to the UK or coming to the UK from west Africa will be able to access support in a timely manner and in a manner that does not put other individuals at risk in crowded health care settings. Will the Secretary of State say more about the testing arrangements, which I hear are going to be at Porton Down? Does he have any plans to make further testing centres available so that testing can happen more rapidly?
Mr Hunt
I thank my hon. Friend for her comments and her support for the statement. I want to pay particular tribute to the chief medical officer and Dr Paul Cosford at Public Health England, who have done an enormous amount to make sure we develop the right policies, which are both proportionate and enable us to prepare for the future. The Government are hugely grateful for their contribution.
We are satisfied that the testing arrangements at the PHE facility at Porton Down are adequate to the level of risk, but one of the reasons why I wanted to announce to the House the current estimate of the number of Ebola cases we are dealing with in the UK was to make the point that we will continually keep those arrangements under review should the situation change. We need to recognise in a fast-moving situation such as this that it might well change, and I will keep the House updated, but in such situations the resilience of all those very important parts of the process will be checked.
John McDonnell (Hayes and Harlington) (Lab)
In May the Government announced the closure of the health control unit at Heathrow airport in my constituency. It contained the staff who undertook the monitoring, screening and treatment of passengers who were sick. I believe many of those staff have now been made redundant, so can the Secretary of State tell me what the staffing arrangements will now be at Heathrow airport? Also, will a training programme be developed for airport staff themselves, including cabin crew and others?
Mr Hunt
The hon. Gentleman makes a very important point. In terms of the staffing arrangements, a total of about 200 people will be employed in the screening process, working at both Heathrow and Gatwick airports in the hours when they are open, and potentially at other airports if we expand the screening. It is a comprehensive facility.
The hon. Gentleman’s most important point is that we must make sure that those who might come into contact with people who might have Ebola—airport staff and people working on aeroplanes, and people working at receptions at GPs’ surgeries, at A and E departments and at hospitals—have basic information about how the virus spreads, so that we can avoid any situations of panic. The virus is transmitted through exchange of bodily fluids. It is not an airborne virus, so it is not transmitted as easily as something like swine flu. The advice is that those doing physical examinations of patients need to wear the protective equipment, but that that is not necessary when having a conversation with a patient, for example. That advice will always be kept under review, but the hon. Gentleman is absolutely right to say that we need to make sure everyone knows that advice.
Sir Malcolm Bruce (Gordon) (LD)
The work that the British Government have done in Sierra Leone and Liberia to build health systems has been extremely important, but those systems were clearly inadequately developed to cope with this kind of problem. I welcome the joined-up thinking across government, but will the Secretary of State give me an assurance that the legacy of this situation will be not only that we have contained Ebola but that we have built health systems in those countries that are capable of dealing with future outbreaks? The long-term legacy must be stronger health systems, as well as the protection of British citizens, which is of course important.
Mr Hunt
I remember working with the right hon. Gentleman on the International Development Select Committee many years ago, when we had many conversations about strengthening the resilience of local health care systems. He is absolutely right to say that that must be our long-term goal, and I will ask the Secretary of State for International Development to write to him to explain how our efforts in Sierra Leone will help to strengthen its local health care system in the long run. The simple point I would make is that this illustrates the dual purpose of our aid budget more powerfully than any example I can remember. First, our aid budget gives humanitarian assistance to some of the poorest countries in the world and, secondly, it protects the population at home in the UK. Those two aims go hand in hand.
Ian Paisley (North Antrim) (DUP)
I welcome the Secretary of State’s statement and I appreciate having been given an advance copy of it. He mentioned the devolved regions. First, will he tell us which Minister in Northern Ireland will take personal responsibility for this matter? Secondly, he will know that the main point of entry for potential victims of this terrible disease is the Republic of Ireland. What special measures are being put in place to stop people using those points of entry to travel from the Republic to Northern Ireland when there are no apparent protective measures in place?
Mr Hunt
The Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison), has been in touch with Jim Wells in the Northern Ireland Assembly and she will take up that issue. The broader point that the hon. Member for North Antrim (Ian Paisley) makes is that there are many points of entry into the UK, and it is important for us to recognise that our screening and monitoring process will not catch absolutely everyone who comes from the affected regions. That is why we need to have other plans in place, such as the 111 service, and to have encouragement at every border entry point for people to self-present so that we can protect them better, should they develop symptoms.
Mr Andrew Lansley (South Cambridgeshire) (Con)
I welcome the Secretary of State’s statement to the House, and I am also grateful to the shadow Secretary of State for what he said. All Members share the Secretary of State’s admiration for the staff of the NHS and Public Health England who are assisting in the front-line treatment and care of those in west Africa. In that context, he is right to try to tackle the virus in west Africa, but this is not just about the availability of much better treatment facilities; it is also about working in the community in short order to try to stem the continuing transmission of the disease. Work has clearly been done on that; will he tell us how we might scale it up?
Mr Hunt
My right hon. Friend makes an important point. I discussed this with United States Secretary Burwell today. The US is piloting a programme in Liberia, and we are doing the same thing in Sierra Leone. We are both providing the same response, which is to tackle the disease at source. We know that, if we can get 70% of the people who develop Ebola symptoms into treatment and care, we will contain the disease. At the moment, the disease is replicating at a rate of 1.7, which means that every 10 people infected are going on to infect another 17 people. That is why the virus is spreading so fast, and we can halt it only if we get people into treatment very rapidly. Community treatment centres are therefore an important part of the Department for International Development’s strategy to help to contain the virus, and that is why we are supporting the development of 700 beds in Sierra Leone.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
May I beg the Secretary of State to work across Europe and all the countries that can help? I have a daughter who has just returned from west Africa and she has reported to me and the family that the situation is critical—it is desperate. There is a lack of any kind of facility to control this disease. Parents are dying, leaving children with nobody to care for them. The situation is very grave, so will he redouble his efforts to persuade Europe, the World Health Organisation, the UN—all of us—to do something more significant and to do it now?
Mr Hunt
The hon. Gentleman speaks movingly and well about the incredible gravity of the situation, and he rightly says that we need full international support on it. In such a situation there are a number of things we are much better tackling as part of an international effort; we are very proud of our 659 NHS volunteers, but volunteers from the whole of Europe could go out and play a part. They need reassurance that they will be safe if they end up contracting the virus, because the truth is that there is no 100% guarantee of safety, even for people who follow the correct procedures—that is why these people are so brave. The hon. Gentleman is absolutely right in what he says, and I reassure him that that is exactly the conversation I have been having with international colleagues: we do need a co-ordinated effort.
Bob Stewart (Beckenham) (Con)
The military have superb experience of dealing with contaminated areas. Are contingency plans in place to bring the military services into line to help, should that be required?
Mr Hunt
We are doing that already: we have made a commitment of 750 military personnel, who will be going to the affected region to help; we have military engineers helping to build the 92-bed facility in Kerry Town; and Royal Fleet Auxiliary Argus is on the way to Sierra Leone. We are tapping into that expertise, and it has a vital role to play.
Michael Connarty (Linlithgow and East Falkirk) (Lab)
Following on from the question put by my colleague from Northern Ireland, the hon. Member for North Antrim (Ian Paisley), clearly the nearest hospital to Scotland with provision is in Newcastle. Who is the responsible person with whom the Secretary of State has been working in Scotland? What arrangements are taking priority in Scottish towns, because someone who has 21 days to travel in the UK might not wish to stay in England alone?
Mr Hunt
The hon. Gentleman is right in what he says. This morning, my hon. Friend the Under-Secretary spoke to Alex Neil, the Scottish health Minister, and on Wednesday we will have a Cobra meeting with the devolved Administrations to test how resilient the structures are between the constituent parts of the UK. That is a very important part of our effort.
Martin Horwood (Cheltenham) (LD)
Perhaps I should declare a non-pecuniary interest, Mr Speaker, as my wife works for Public Health England. I join the Secretary of State in applauding all of her colleagues and the others who are putting themselves in harm’s way in the front-line battle against Ebola. Given his predecessor’s reorganisation of the NHS and of public health, does the Secretary of State need to check whether there are now sufficient local directors of public health in post and whether they have sufficient resources, qualified staff and seniority within local authorities to take a local lead, should that be necessary, in the fight against Ebola?
Fiona O'Donnell (East Lothian) (Lab)
I do not know whether the Secretary of State has any plans to speak to the hon. Member for Clacton (Douglas Carswell), but if he does will he ask him why he now supports a party that would decimate the UK’s aid budget? Does the Secretary of State, like me, feel a great sense of pride in being part of a family of nations whose aid budget is saving lives in Liberia and Sierra Leone, and, in turn, keeping people in the UK safe?
Mr Hunt
The hon. Lady speaks extremely wisely and there is cross-party agreement on that matter. That shows why it is so wrong to make an artificial division between helping people abroad and helping people at home. I think we have a moral responsibility to help people in the poorest countries abroad in any case, but in my time in this House there has been no better example than this one of how doing so is in the interests of people in the UK, too. It helps to make us more secure, and we can be incredibly proud of the work we are doing as a result.
Mr Nigel Evans (Ribble Valley) (Con)
The Secretary of State has spoken about multiple points of entry, and major connection points are via Schiphol, Charles de Gaulle, Madrid and Frankfurt. Has he spoken to his opposite numbers in those countries to see whether they are following the best practice that is being rolled out in the United Kingdom? Will he ensure that those who are manning the points of entry in the UK have the ability to deal with children, because if a parent is detected with symptoms, their children will have to be properly looked after?
Mr Hunt
My hon. Friend makes an important point. I am sure that those arrangements are already in place, but I will ensure that they are. Yes, we are in touch with colleagues in other countries. It is important to say that there are only a very few direct flights to Europe from the affected region, and indeed there are none to the UK. At the moment, it is possible to be fairly confident that we will reach the vast majority of people who come from those affected areas. But part of what I am trying to convey in this afternoon’s statement is that the risk level could change—for example, there could be a breakdown in public order in the affected countries—which is why we need to be prepared for a much more porous situation, with people coming from many different points of entry.
Ms Gisela Stuart (Birmingham, Edgbaston) (Lab)
Is the Secretary of State talking to our universities, as a number of them must have overseas students from west Africa returning for their studies in October? Is he focusing on them in particular, and what provisions are we making to cater for them?
Mr Hunt
The hon. Lady makes a very important point. Clearly, it is important that anyone who comes from those countries, whether a student or a visitor, is treated with the same screening and monitoring process. Screening and monitoring people simply on the basis of their passport would not work. There will be people who have indefinite leave to remain in the UK but who have a Sierra Leonean passport, and it would not be appropriate to put them through that process. It is most important that we have a system in place in which we can check and find out who has been to the Ebola-affected areas in the past three weeks, so that we can give them help if they need it.
Jason McCartney (Colne Valley) (Con)
My right hon. Friend has given details of plans for extra Ebola bed capacity in regional centres such as Sheffield. Will he confirm that those regional centres will be used alongside the Royal Free hospital in London, or will they be used only when capacity there has been reached?
Fiona Mactaggart (Slough) (Lab)
Will the Secretary of State ensure that British citizens fleeing Ebola-affected countries are not left destitute and homeless? My constituents Mr and Mrs Mahmood have been working in Sierra Leone for the past four years. When they returned, they were told that they were not eligible for income-based jobseeker’s allowance or housing benefit. Will the Secretary of State speak to his counterparts at the Department for Work and Pensions to ensure that no British citizen is left in such a state when they have to flee a country that is affected by Ebola?
John Hemming (Birmingham, Yardley) (LD)
A systemic lacuna in the Government’s proposals relates to the lack of monitoring of lower-risk travellers. Will the Secretary of State consider having daily contacts with such travellers on the basis that identifying erroneous risk assessments at the first stage is the key to bringing things under control in the interests of the travellers as well?
Mr Hunt
The judgment on how effective we are at identifying higher-risk passengers must be made by the scientists and the doctors involved. Their view is that we are currently going further than we need to given the current risk level, but that it is prudent to do what we are doing because that risk level might increase. I will always listen to their advice.
Ms Margaret Ritchie (South Down) (SDLP)
I thank the Secretary of State for his statement on Ebola. Given that one of the busiest air routes within these islands is that between London and Dublin—the hon. Member for North Antrim (Ian Paisley) has already referred to the role of the Republic of Ireland—will he outline what discussions have taken place between him and his officials and the Minister for Health and his officials in the Republic of Ireland?
Mr Hunt
The hon. Lady makes an important point. The Under-Secretary of State for Health, my hon. Friend the Member for Battersea, has been in contact with the Northern Ireland Health Minister, and we will pursue discussions with the Republic of Ireland. Although the hon. Lady’s concern is legitimate and it is right that she has asked the question, it is important to say that the current assessment is that the risk level to the UK is low. I would imagine that the risk level in Ireland is similarly low, but that is ultimately a matter for the Irish authorities. At the moment, we are following a precautionary process just in case the risk level increases. We will of course involve colleagues in the Irish Republic in our assessment of those risks.
David Rutley (Macclesfield) (Con)
I am pleased that my right hon. Friend is focusing on the protection of health care workers in the vital work he is taking forward. Given that lessons are still being learned from cases in Texas and Madrid, what mechanisms are in place to update procedures when any new findings are brought into the public domain?
Mr Hunt
My hon. Friend is absolutely right that what happened in Dallas is of great concern. We need to listen to our colleagues in the Centre for Disease Control in the US as they try to understand exactly what happened. If they decide that we need to change the protocols for protecting health care workers, we will of course take that advice extremely seriously. At the moment, their scientific assessment is that there was a breach in protocol, not that the protocols were wrong. Until we identify what those breaches were, we cannot be 100% sure. We are working very closely with them and we have a good and close working relationship. We will update our advice to UK health care workers accordingly.
Barbara Keeley (Worsley and Eccles South) (Lab)
I thank the Secretary of State for the answers he has given so far, but my right hon. Friend the Member for Leigh (Andy Burnham) asked whether he was satisfied that all relevant NHS staff, including all GPs, know how to identify Ebola, know the precautions to take with patients presenting, and know the protocols for handling Ebola. I did not get a sense from the Secretary of State’s reply of how complete that knowledge is. He has talked a lot about receptionists, and that is important as they are in the front line of risk, but hospital cleaning staff and cleaning staff in GP practices are also at risk if such patients present.
Mr Hunt
The hon. Lady makes an important point, but I reiterate the point I made earlier to another hon. Member. The risk level to the UK general population remains low, so the measures we are taking are precautionary because of a possible increase in that risk level. As part of that, we are sending advice to everyone we think might be in contact with anyone who says that they have recently travelled to the Ebola-affected areas and who displays those symptoms. That is why alerts have gone out to hospitals, GP surgeries and ambulance services to ensure that they know the signs to look for and are equipped with that important advice.
Mr Philip Hollobone (Kettering) (Con)
To cross a typical western international border illegally, one needs a passport and passports are meant to have stamps in them. What steps are we taking with the seven most affected west African countries to ensure that they stamp the passports of people who go into and leave those countries so that we can readily identify the stamps in their passports should they come to the UK? What extra resources is Border Force putting into checking the stamps in people’s passports when they come to the United Kingdom?
Mr Hunt
I will get back to my hon. Friend with the exact details of what is happening with passport stamps, but I reassure him that we are working very closely with Border Force officials and we have a high degree of confidence that we will be able to identify the vast majority of people who travel from the most directly affected countries within the recent incubation period of the virus. It is important to remember that that incubation period is 21 days, so we are looking at the previous three weeks. We have a high degree of confidence, but I will get my hon. Friend information on whether passport stamps could be an additional source of security.
Keith Vaz (Leicester East) (Lab)
I join others in congratulating the Secretary of State on initiating screening, as he did on Thursday. That is the right approach, as is targeting it at certain ports. As he knows, viruses do not wait for direct flights and it is extremely important that there is a synergy between our screening processes and those of Sierra Leone and other west African countries. Did we supply the screening equipment, and if we did not, is he satisfied that it is fit for purpose? The same goes for the screening in other hubs throughout Europe.
Mr Hunt
We have absolutely checked the screening equipment that is being used in those three countries, and in Sierra Leone, which is our more direct responsibility, that is being done by Public Health England officials. The reports that we are getting back say that people are checked not just once, but several times. It is really important to say that the main purpose of the screening that we are introducing—I call it screening and monitoring, rather than screening—is to identify passengers who may be at higher risk. We are not particularly expecting to identify people showing symptoms because they should have been prevented from leaving the country in the first place, but we want to keep tabs on them while they are in the UK, in their own interests, and that is the purpose of the process.
Mr David Nuttall (Bury North) (Con)
I thank the Secretary of State for his statement. Given the large number of languages in use in that part of west Africa and the consequent practical difficulties in producing notices and posters that travellers can actually read for the purposes of self-presenting, may I ask my right hon. Friend in what circumstances he would reconsider the decision not to introduce the screening and monitoring of passengers arriving at Manchester airport?
Mr Hunt
We have not yet made a decision on Birmingham and Manchester, and we will continue to review the risk advice from the chief medical officer and PHE on whether such action would be appropriate. It is important to say that the measures we take must be proportionate, but they must also look forward to potential changes in the risk, so that we can react very quickly were that risk to increase dramatically, and that is exactly what we are doing at other UK airports.
Jeremy Corbyn (Islington North) (Lab)
I thank the Secretary of State for his statement and for the support given to health services in west Africa, but does he not agree that this terrible time shows the massive health inequalities that exist all around the world and that, although there will be a big international effort to deal with Ebola, it calls into question the effectiveness of the millennium goals on preventive health measures, not just in west Africa, but in a much wider sense? Do we not need to redouble our efforts to reduce health inequalities around the world for the protection of everyone?
Mr Hunt
The hon. Gentleman is right, although the millennium development goals have been successful in making a start on the process of reducing health inequalities. We can see that in other areas, such as the provision of antiretroviral drugs to HIV-positive patients in Africa, and that has been completely transformed in the past decade. But he is right: while some countries have very underdeveloped health care systems, the risk of such public health emergencies is much higher and therefore the risk to the UK is higher.
Chi Onwurah (Newcastle upon Tyne Central) (Lab)
I should like to echo the tributes paid to our NHS volunteers and to all health workers. Today of all days, it is important to recognise the sacrifices that they make. The Secretary of State has indicated that Newcastle’s Royal Victoria infirmary in my constituency is next in line after the Royal Free to receive Ebola victims. Will he say a little more about what measures are or will be in place for public awareness, training, equipment, staffing and basic hygiene procedures to enable that to happen?
Mr Hunt
I am happy to let the hon. Lady have full details of what is being planned at the RVI, which is an excellent hospital. It was one of the hospitals that was part of the exercise that we did on Saturday to test preparedness. In that exercise, we modelled what would happen if someone became sick and vomited in the Metro centre and was then transferred to the RVI. We modelled the decisions about whether they would be kept there or transferred to the Royal Free, and so on. I am very satisfied with the measures in place at that hospital, but I will happily send her the details.
Roberta Blackman-Woods (City of Durham) (Lab)
I am one of a group of parliamentarians who returned from a visit to west Africa on Friday. We were quite surprised to be asked no questions about where we had travelled, and to be offered no screening at either the EU or UK border; I came back to Newcastle from Brussels. Will the Secretary of State reassure us that all regional airports will offer screening and advice to people who might be affected? Will he redouble his efforts, in partnership with other agencies, to stop the spread of this disease, which is devastating parts of west Africa?
Mr Hunt
We are absolutely redoubling our efforts, and we are looking at what screening procedures are needed at regional airports. The screening and monitoring procedures that I outlined are starting at Heathrow terminal 1 tomorrow; they will be rolled out progressively across Heathrow, Gatwick and Eurostar terminals over the next two weeks. We are satisfied that that will reach the vast majority of people travelling from the affected countries. Any decision to expand those arrangements to other regional airports will be taken on the basis of the scientific advice that we receive about risk.
Mrs Louise Ellman (Liverpool, Riverside) (Lab/Co-op)
Liverpool university’s Institute of Infection and Global Health, and the Liverpool School of Tropical Medicine, have done a great deal of work to address the problem of the transmission of Ebola. Does the Secretary of State’s work involve their recommendations, and do his proposals for combating Ebola, particularly as regards international travel, address the issues that those institutions raise?
Mr Hunt
The hon. Lady is absolutely right to say that we have fantastic research on the spread of infectious diseases at a number of institutions in this country, including in Liverpool, and we are not only using that research in the battle that we are leading in Sierra Leone, but making it available to partner countries leading the battle in other parts of west Africa. The advice that I get from my experts, from Public Health England and from the chief medical officer takes full account of the research done in places such as Liverpool.
Kevin Brennan (Cardiff West) (Lab)
In his statement, the Secretary of State said that the screening measures would reach 89% of passengers from the three affected countries; it is therefore hoped that one in 10 will self-identify. Will he tell the House the numbers that the estimate is based on, not just the percentage, so that we have an idea of how many people will be involved in these screening measures?
Mr Hunt
For the month that we looked at, September, we are talking about around 1,000 people arriving from the directly affected countries, which is about 0.03% of all Heathrow travellers for that month. It is important to say that the vast majority of those will be low-risk passengers, but those are the people with whom, initially, we would want to have a conversation, so that we could understand whether they had been in contact with Ebola patients or had been in the areas particularly affected by Ebola, and so that we could decide whether we needed to put in place tracking procedures to allow us to contact them quickly, should they develop symptoms.
Heidi Alexander (Lewisham East) (Lab)
The Secretary of State may be aware that this weekend Lewisham hospital dealt with a suspected Ebola case. Thankfully, tests have shown that the individual is free from the virus, but may I press the Secretary of State further on the advice given to staff on the NHS front line? When was the guidance to NHS hospital and general practitioner receptionists sent out, and what steps have been taken to ensure that the guidance has been read and understood, and will be acted on?
Mr Hunt
First, on what happened in Lewisham hospital, the moment the individual was identified as a potential Ebola case, he was put into isolation. We learned, from what happened there, the importance of making sure that the guidance is widely understood. Making sure that everyone on the NHS front line knows what happens is an ongoing process. It is important to say, as I did in my statement, that the chief medical officer is satisfied that the arrangements in place right now are correct for the level of risk. The additional processes that I talked about are to make sure that we are ready for an increase in that risk.
Mr Iain McKenzie (Inverclyde) (Lab)
Did I hear correctly that the Secretary of State said that 21 days is quite a lengthy time for the incubation of this particular disease? Will he commit to putting a further screening in place towards the end of that 21 days so that he can be assured that those entering the country are free of Ebola?
Mr Hunt
I am not sure that I entirely understood the hon. Gentleman’s question, but the incubation period is 21 days, so if we identify through the screening and monitoring process someone who is higher risk, we will want to stay in touch with them for that period of 21 days on a daily basis to make sure that we are monitoring their temperature and that we get help to them as quickly as possible if they need it.
Mr Stephen Hepburn (Jarrow) (Lab)
I welcome the introduction of screening at various London locations, but what about Newcastle, which runs numerous flights every day to the airports that act as hubs for these west African countries, and obviously there is passage that way?
Mr Hunt
The hon. Gentleman is absolutely right. We have numerous ports of entry to the UK. We are one of the most international countries in the world, and London is one of the most international cities in the world, so the actions that we take must be proportionate to the risk. The risk is currently low, so the advice is that having no screening procedures at those airports is proportionate to the risk now, but we are taking this precautionary approach, starting with the Heathrow, Gatwick and Eurostar terminals, because we want to prepare for a possible increase in that level. Were that to happen we would of course look at whether that screening process should be expanded to regional airports.
Andy Sawford (Corby) (Lab/Co-op)
In a recent film of medical workers treating people in west Africa with Ebola, a young doctor said that the one benefit of her protective mask was that people could not see her cry. Even as the media focus inevitably moves on, we know that this will go on for months and months, so will the Secretary of State give us all an absolute assurance that we will continue, even though we cannot see her cry, to hear her voice and do whatever we can to help people in west Africa?
Mr Hunt
If that is the last question today, it is a fitting one on which to end. The hon. Gentleman is absolutely right: this is an appalling human tragedy. There have been more than 4,000 deaths so far, in countries that are already, in many ways, the unluckiest in the world in terms of the levels of poverty that they already have to cope with daily. We can be incredibly proud of the 659 NHS volunteers, and the military, diplomatic and development staff who are stepping up to the plate, and we should always remember our humanitarian responsibility never to forget those countries’ plight.
NHS England and the NHS Outcomes Framework
Jeremy Hunt Excerpts(10 years, 9 months ago)
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The Secretary of State for Health (Mr Jeremy Hunt)
Today, I laid before Parliament my first “Annual Assessment of the NHS Commissioning Board (known as NHS England) 2013-14”. The “National Health Service Commissioning Board Annual Report & Accounts 2013-14” was also laid (HC408). Together they describe an organisation that has established itself and made progress in delivering the Government’s mandate, but has more to do to deliver all of its objectives. Copies of both documents are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office.
The mandate to NHS England sets the Government’s ambitions for the NHS as well as the funding available to achieve and deliver the care people need and expect. The Health and Social Care Act 2012 requires the mandate to be reviewed on an annual basis to ensure that it remains up to date.
It has never been more important to provide the NHS with stability and continuity of purpose than now. And that is why the Government proposes to uphold all of the existing objectives in the current mandate, and maintain a stable mandate for 2015-16, to enable the NHS to build on its achievements and make further progress on the ambitious agenda already set.
Meanwhile, the challenges facing the NHS and wider health and care system for 2015-16 remain, with an ageing population and an increase in the numbers of people with long-term conditions. We want to see the NHS make further progress in transforming primary care to improve services for older people and those with the most complex needs, and on delivering a system-wide response to the Francis inquiry recommendations, while from 2015-16 joining up health and social care through the better care fund will be key to transforming care.
Within the stable mandate, as part of its existing objective to make progress towards parity of esteem for mental health, NHS England is working with the Department to fulfil its commitment to develop a range of costed options for new access and/or waiting time standards for mental health services, in order to implement these standards starting from April 2015, with a phased approach depending on affordability.
The NHS has generally been performing well and meeting demand despite increasing pressure on services. A stable mandate will allow the NHS to focus on maintaining its performance in providing high-quality, compassionate, and joined-up care now and in the future.
In addition, this summer we will be reviewing the NHS outcomes framework. The review has two aims: to update the framework for 2015-16 by improving, adding and removing existing indicators, and to indicate a direction of travel for future indicator development. Reviewing the NHS outcomes framework this year is also an opportunity to increase alignment between the framework and the objectives in the mandate given the commitment to stability for the mandate for 2015-16.
We have been working closely with NHS England on the approach to the mandate and the review of the outcomes framework, and will be engaging with stakeholders over the summer, ahead of publication in the autumn.
NHS Modernisation (Costs and Benefits)
Jeremy Hunt Excerpts(10 years, 9 months ago)
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The Secretary of State for Health (Mr Jeremy Hunt)
I announced in July 2013 that the costs of implementing policies in the Health and Social Care Act were likely to be closer to the estimate in the business case for the programme—£1.5 billion in today’s prices—rather than the £1.6 billion to £1.7 billion estimate reported in October 2012.
I can today confirm today that I am expecting the costs of NHS modernisation to be no higher than £1.5 billion.
Up to 31 March 2013, costs of £1,096 million had been incurred across the health and care system on developing and establishing the new arrangements. During 2013-14 organisations in the new system reported that they had incurred a further £220 million to continue this work. Some of these costs will relate to the continuous improvements that all organisations are expected to make. So, at most, the costs to 31 March 2014 were £1,316 million, comprising:
£456 million on staff redundancies;
£75 million on IT for the new organisations;
£88 million on estates costs of closing bodies and setting up new organisations;
£26 million on internal departmental costs—for example, programme management;
£323 million on setting up clinical commissioning groups—excluding items above; and
£348 million on other costs of closing bodies—for example, PCTs—and setting up new organisations.
In the impact assessment, long-term annual savings arising from the changes were estimated at £1.5 billion per year from 2014-15 onwards. Gross savings over the transition period—2010-11 to 2014-15—were estimated at £4.5 billion.
As I announced last year, annual savings are still expected to be £1.5 billion from 2014-15.
The reductions in administration costs up to 31 March 2014 are set out below. These are calculated on a basis consistent with the impact assessment for the Health and Social Care Bill—with the figures set aside any administrative spending on implementing the reforms.
2010-11 £m | 2011-12 £m | 2012-13 £m | 2013-14 £m | Total £m |
|---|---|---|---|---|
240 | 1,341 | 1,587 | 1,794 | 4,962 |
The cumulative savings in administration costs arising from the reforms over the period 2010-11 to 2014-15 are therefore expected to be at least £6.4 billion.