Cosmetic Surgery

Kevan Jones Excerpts

Tuesday 20th October 2015 Commons Chamber

[Mr Kevan Jones (North Durham) (Lab)]

I would like to raise the case of my constituent, Mrs Dawn Knight, who lives in Kip Hill in my constituency. Mrs Knight is one of the 45,000 people in the UK who undergo cosmetic surgery each year. In 2012, she underwent a cosmetic procedure on her eyes. The operation was arranged by a company called The Hospital Group and the surgery was done by an Italian doctor called Arnaldo Paganelli. During the surgery, he removed too much skin from her lower eye lids, and as a result, the inner parts of her eyes, usually covered, are now exposed to the air. Following this botched surgery, she must now apply artificial teardrops into her eyes every two hours to minimise the pain. On the advice of specialists at the Royal Victoria infirmary in Newcastle, she must also tape her left eye closed every night when she goes to sleep to avoid further damage. While she sleeps, she must apply a thick ointment in both eyes, leaving her unable to see until it is washed out in the morning. Doctors have warned her that this serious condition might result in loss of sight altogether.

This incompetent procedure has left Mrs Knight with serious health problems and a life-changing condition, but her troubles did not cease there. A fight to get the mistake corrected and compensation for her distress have thrown up major questions about the operation of The Hospital Group and the regulation of cosmetic surgery in the UK. The Hospital Group’s website claims to run the world’s largest plastic surgery facility at its private hospital in Birmingham. It also claims to have General Medical Council-registered surgeons. Anyone looking at its adverts or website will conclude that it is running a hospital similar to a local NHS hospital, but it is not. As Mrs Knight found when she complained, she had entered into a contract not with The Hospital Group but directly with Dr Paganelli.

[Jim Shannon (Strangford) (DUP)]

Last Wednesday in Parliament, there was a public meeting at which constituents from across the UK registered their concerns about cosmetic surgery, particularly eye operations. Many people have found themselves in a similar position to Mrs Knight. Last year, 100,000 cosmetic surgery operations were performed in the UK. Is it not time for full and robust regulation to monitor and reflect the risk attached to all cosmetic surgery?

[Mr Jones]

The hon. Gentleman makes an important point. This is not just about Mrs Knight; it is about many more such cases, and I will be talking later about exactly the need for more regulation and information in this area.

Although The Hospital Group tries to give the impression it is a hospital, it is, in effect, a facilities, management and brokerage company for individuals wishing to undergo cosmetic procedures. The Hospital Group is very good at self-promotion. It even has celebrity endorsements from individuals such as Kerry Katona. I think the celebrities who appear on the website need to examine their consciences about being associated with this organisation. Clearly, their endorsements are encouraging young people to undergo these procedures, forcing people into the hands of a company that I think is, frankly, completely irresponsible. The sale of after-care packages is emphasised. In Mrs Knight’s case, hers cost £3,500, but she found that this means nothing when things go wrong. It would appear that once The Hospital Group has people’s money, it is not much interested if things go wrong.

Having tried to pursue a case against The Hospital Group, Mrs Knight then tried to pursue Dr Paganelli for redress, only to find that he is bankrupt, lives in Italy and flies into the UK to operate on behalf of The Hospital Group. What astounds me is that he is still doing this today, working in hospitals or clinics that are run by The Hospital Group, as we speak. The Hospital Group’s response is that it is nothing to do with them. Dr Paganelli was uninsured and The Hospital Group says that it is the patient’s responsibility to check whether the surgeon is General Medical Council-registered and holds insurance. If we look on the website today, however, we find the words:

“Book a free consultation today, with our GMC registered surgeons!”,

giving the impression that all the surgeons have been vetted by this organisation when that is clearly not the case. Despite this, Dr Paganelli remains licensed by the GMC, meaning that he is deemed fit and suitable to continue to operate in this country, even though he holds no insurance and if things go wrong, patients have no redress against him.

Having examined this case and the others to which the hon. Member for Strangford (Jim Shannon) referred, it would appear that a plumber who comes to fix someone’s kitchen sink is more heavily regulated than someone who is allowed to operate on your body. The current law allows any qualified doctor—not just surgeons—to perform cosmetic surgery, without having additional training or qualifications. My right hon. Friend the Member for Cynon Valley (Ann Clwyd) has raised many issues about GPs who have undertaken cosmetic surgery without any formal training. Clearly, there needs to be more robust regulation of these private companies, which stand to make a fortune out of the misery experienced by people such as my constituent Mrs Knight.

The Royal College of Surgeons believes that the GMC needs to be given new legal powers formally to recognise additional qualifications or credentials, and I fully support that call. These should be displayed publicly so that people know that the doctors are properly registered and have gone through the necessary training. Will this solve malpractice and eradicate the problem of cosmetic surgery overnight? No, it will not, but it will at least ensure that some type of regulation is in place. It would be an important and significant start, and it would allow patients and employers such as The Hospital Group to tell competent cosmetic surgeons from cowboys, or indeed from anyone who has limited or no recognised experience in cosmetic procedures.

There has not been inaction in this area. Legislation was drafted by the Law Commission at the request of the Department of Health in 2014, following Sir Bruce Keogh’s recommendations in the wake of the PIP scandal. The coalition Government failed to find the parliamentary time to take it forward in 2014. You will remember, Mr Deputy Speaker, that at that time the Order Paper was not exactly overflowing with legislation, so we need to answer the question why this was not brought forward. Both the RCS and the GMC are keen to bring in these changes. Again, the Government have failed to include such legislation in the Queen’s Speech. I ask the Minister to explain why that is the case, and when the Government intend to introduce such legislation. As I have said, it would have the support of both the Royal College of Surgeons and the General Medical Council, but it would also have cross-party support in the House.

May I also ask the Minister about the cost to the NHS? In Mrs Knight’s case, the cost of putting right the mistakes made by Dr Paganelli will have to be picked up by the NHS. As the hon. Member for Strangford said, this affects a large number of people, and the NHS is having to treat them at great expense because of the actions of organisations such as The Hospital Group and individuals such as Dr Paganelli. Is it right for the taxpayer to pick up the bill while those organisations and individuals are making absolute fortunes out of people’s misery? I do not think it is. We need to look into how the NHS can recover the cost of the treatment that Mrs Knight and others are undergoing at the taxpayer’s expense.

[Jim Shannon]

Some of the people who were at the meeting on Wednesday told horrifying stories about the ways in which in which the surgery had affected them. Some of them had partially lost their eyesight. There was the depression, there was the trauma, and there were all the other side effects of what had happened to them. Despite all that, however, some of the people who carried out those operations continue to perform this surgery. People are experiencing life-changing medical conditions. Something must be done, and perhaps the Minister needs to tell us that tonight.

[Mr Jones]

The hon. Gentleman has made a very good point. It is not just a question of the initial cost. Some people will need lifelong treatment, which will be very expensive for the taxpayer. I think that there should be a mechanism enabling the taxpayer to recover some of the cost from private companies and individuals when things go wrong.

I am also concerned about the issue of regulation. These organisations produce a great many glossy brochures, set up websites and have celebrity endorsements, but it is clear that some of the people who undergo cosmetic surgery need counselling beforehand, and there is no legal or other requirement to ensure that they receive it. Surgery that may be seen as life-changing—and, in some cases, is, for the wrong reasons—may also not be appropriate for some of those involved. They are mainly women, but, according to various reports that I have read, an increasing number of men are undergoing these procedures. They are not right for everyone, and I think that counselling and advice should be a key part of the process before anyone is convinced about going under the knife. The companies involved clearly exert a great deal of pressure to ensure that a steady flow of people enables them to make the money that they do make.

Let me finally ask the Minister about The Hospital Group itself. It gives the impression that it is a hospital group providing healthcare services, but it is clear that it is actually a facilities management company brokering details between patient and surgeon. Its material is very misleading. For instance, its website deliberately states that its surgeons are GMC-registered. It even refers to the Care Quality Commission as though that gave it the stamp of approval, and provided some type of guarantee. A misleading impression is being given.

I ask the Minister to examine the way in which The Hospital Group in particular, but other groups as well, uses terminology. I think that the average man or woman in the street may get the wrong impression from the CQC symbol or the reference to the GMC registration. The fact that when things go wrong they find that The Hospital Group wants nothing to do with it, and it is up to them to decide what to do, is another matter. That is not the impression given by the misleading publicity—deliberately so, I think—that is put out.

My constituent’s case is one of many that have highlighted the need for regulation. The legislation is there and we should press forward as a matter of urgency because if we do not more people will suffer. If there is one thing that my constituent, Mrs Knight, wants, it is that other people should avoid the awful experiences that she has gone through because of the negligence and greed for profit of both The Hospital Group and Dr Paganelli.

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

I thank the hon. Member for North Durham (Mr Jones)for securing this debate on what is clearly an extremely distressing case for his constituent and an unfortunate one more generally. I want to pick up on the specific issues he raised to do with his constituent’s case before talking about the generality of the regulation of cosmetic surgery.

The hon. Gentleman pointed out the failure of his constituent’s doctor to have insurance and he will be pleased to know that, as of July 2014, new legislation required all surgeons providing cosmetic interventions to provide insurance and proper cover. A failure to do so would render them liable to undergo the fitness to practise tests conducted by the GMC. Those doctors operating outside the UK but in the EU who would have a temporary ability to operate in this country under the directive on mutual recognition of professional qualifications would still, under GMC regulations, be required to provide evidence of insurance cover. That legislation was brought into effect in August, which was clearly too late in the case of his constituent.

[Mr Kevan Jones]

Will the Minister look specifically into the case of Dr Paganelli, as I understand that he is still practising in this country?

[Ben Gummer]

I will certainly look into that case, as it does not sound right. I cannot trespass on the realms of the GMC, but I will inquire into the specific case outlined by the hon. Gentleman.

The hon. Gentleman makes a valid point about the cost to the NHS and this is not the only area in which we have considered and continue to consider cost recovery for the NHS. It can be difficult as sometimes the cost of legal action outweighs the cost of recovery and it is not something that the service is used to doing. I am keen to explore it further, but in the context of the action we are taking, which I shall come on to, I hope that the hon. Gentleman will understand the need to take this bit by bit so that we get the process right. In principle, I certainly agree that if organisations cause a cost to fall on the NHS, as in this case, there is a good argument for seeing whether that cost can be recovered.

That takes me on to another part of the hon. Gentleman’s speech that was particularly striking, about the celebrity endorsements in this case. It is not for me to make policy announcements in an Adjournment debate, nor would I want to in the case of celebrity endorsements, but I agree with the hon. Gentleman that people should think carefully about how they endorse cosmetic surgery. It is a serious intervention and if anyone seeks to glamorise something to which careful thought should be given, people and the organisations using those endorsements should treat them with extreme care.

I would point the organisation that the hon. Gentleman is dealing with and everyone else towards the code of conduct in advertising, the Committee of Advertising Practice and the Broadcast Committee of Advertising Practice, which drew up guidance in October 2013, especially on protecting children and young people. I think it would be appropriate to make sure the organisation of which he speaks is complying with the spirit as well as the letter of that guidance, and if not I will certainly help him to ask whether anything more can be done on that.

The hon. Gentleman raises the issue of counselling. Any reputable organisation should seek to ensure that people undertake procedures only when they need to do so and have been properly counselled on the consequences of their actions so that they can make an informed decision. The Government believe that that should happen in every case for cosmetic surgery. There should be an informed decision, taken with serious thought.

Finally, on the issues to do with The Hospital Group the hon. Gentleman raised, I cannot speak without further advice, but there clearly seem to be questions about trading standards, which he raised. I hope that I and my officials will be able to meet him to look carefully at this case, to make sure if The Hospital Group is misrepresenting its position apropos its surgeons and those it seeks to represent, it is not besmirching an industry which more widely does take its duties and the way it represents itself seriously.

Post Office Horizon System

Kevan Jones Excerpts

Monday 29th June 2015 Commons Chamber

[Mr Kevan Jones (North Durham) (Lab)]

I congratulate the hon. Member for North West Leicestershire (Andrew Bridgen) on securing this debate.

My constituent Tom Brown, a postmaster for 30 years, had a post office in Newcastle. In 2008, he informed the Post Office that there was a problem with his Horizon system, and it took away one of his base units to change it. He was told by the helpline—a euphemism because it has not been very helpful to many sub-postmistresses and sub-postmasters and has actually got them into more trouble—that the system would rectify itself. It did not. The next audit said that his figures were down by £85,000. He was arrested by Northumbria police, and his car and home were searched. Subsequently, the police dropped all charges as there was no evidence against him. Then, for some unknown reason, the Post Office took out a prosecution against him to take him to court for false accounting. That process took until July 2013, when he finally appeared in court for the third time. No evidence was put forward to the court, and after that the case was dropped.

This man has lost his home, his livelihood and his good reputation. He is one of the individuals who have gone through the mediation system, even though, as the hon. Gentleman outlined, the system is a sham. He was given four different dates that were all delayed. He described this to me as six hours of wasted time. The Post Office employed top lawyers from Newcastle to represent it. It again went through what it said was the evidence, and made no offer at all. The system is a sham. As the hon. Gentleman outlined, it has been a way of delaying decisions on these cases.

[Mrs Emma Lewell-Buck (South Shields) (Lab)]

Does my hon. Friend agree that the Post Office has failed to be transparent about this process? My constituent, Mrs Carter, a sub-postmistress, asked the Post Office to audit her branch to get to the bottom of the problem, but it refused to do so.

[Mr Jones]

I will go further than that. It has not only not been transparent; it has gone out of its way to delay cases and hide evidence.

My concern about the work done by Second Sight is that it suggests that if information is returned to the Post Office, evidence will go missing. That is why I totally agree with the hon. Member for North West Leicestershire that there needs to be an independent judicial inquiry into this—as he described it—national scandal. I am pleased that my hon. Friend the Member for Hartlepool (Mr Wright), the new Chair of the Business, Innovation and Skills Committee, is present for this debate. I urge him and his Committee to look at this as a matter of urgency.

The fundamental point is this: who controls the Post Office? This organisation is out of control. It has led to people’s lives being ruined and, as we have heard, in some cases to people being given prison sentences when clearly they are innocent. It is important that we get to the bottom of this. Without a judicial inquiry, I fear that this national scandal will continue and these people’s reputations will continue to be blackened.

Child and Adolescent Mental Health Services

Kevan Jones Excerpts

Tuesday 3rd March 2015 Commons Chamber

[Grahame M. Morris]

I cannot disagree with that. I come from the perspective that we need to plan interventions on the basis of evidence, but how can we do that without current and relevant data on child and adolescent mental health? We certainly need that data. On the structure of the contracts, I am a firm believer in integration. There may well be issues with block contracts. The Health Committee received evidence from the south-west indicating that there are vast areas of the country where there is very little access to certain types of in-patient mental health provision, which is clearly unacceptable. One might have thought that a large block contract would make that less likely, but apparently that is not so. However, I am not an expert in commissioning; I am simply trying to identify the policy areas.

Having spent a number of years in local government, I have no doubt that local authorities wish to tackle some of the barriers that young people face in accessing mental health services. It is a complicated area, and we need to enable local areas—the hon. and learned Member for North East Hertfordshire (Sir Oliver Heald) just referred to larger block contracts—to commission better services, and perhaps that is better done on a more local level.

[Mr Kevan Jones (North Durham) (Lab)]

Does my hon. Friend realise that one of the problems with block contracts is that, because of their size, they freeze out small voluntary organisations that could deliver services on a local basis?

[Grahame M. Morris]

That is true. Some of the organisations that submitted evidence to the Health Committee and subsequently provided briefings made that point.

Another issue of concern is the complex commissioning landscape for CAMHS, which can result in poorly co-ordinated services and a lack of clarity about roles and responsibilities, leading to gaps in provision and poor transitions from child to adolescent and from adolescent to adult. The service is certainly underfunded. We often talk in this place about parity of esteem. As other Members have reported, CAMHS nationally is receiving about £1.8 billion of the £14 billion that is spent on mental health. Local authority-provided services, which are often having to bridge the gap, are facing huge financial challenges. My local authority, which I share with my hon. Friend the Member for North Durham (Mr Jones), has had to cope with cuts of £250 million over the lifetime of this Parliament. That is forcing councils to make extremely difficult decisions about which services are funded.

I fully understand the point made by the hon. Member for Brigg and Goole, but I also fully understand the difficult decisions faced particularly by authorities in the north that seem to be suffering disproportionate cuts. Councils are embracing their new public health responsibilities—

Child and Adolescent Mental Health Services

Kevan Jones Excerpts

Monday 2nd February 2015 Commons Chamber

[Norman Lamb]

I pay tribute to the hon. Gentleman for the work he did in his campaigning on the Mental Health Act and more recently as a Children’s Minister in the Department for Education. I know his passion for the subject and I share his view that it is intolerable that children and young people should go to adult wards. It has been a long-standing issue—it is not new—but it should not happen, just as it should not be the case that children are still placed in police cells. That is why I take the view that we need to ban it in law so that it cannot happen, and there are consequences if it ever does happen.

[Mr Kevan Jones (North Durham) (Lab)]

I do not question the Minister’s commitment to mental health. He is a great champion of parity of esteem, but he is part of a Government who are cutting money for mental health services. For young people in 2015 to be put in police cells is totally unacceptable. To pick up the point made by the right hon. Member for Sutton and Cheam (Paul Burstow) about CAMHS, is it not time not only for a fundamental review but for a new system, including the abolition of the present CAMHS system?

[Norman Lamb]

I am grateful to the hon. Gentleman for his generous remarks—perhaps he ought to talk to his Front-Bench colleagues about my commitment. He is absolutely right to highlight the fact that although there is quite a mixed picture across the country, in many areas there has been disinvestment in children’s mental health services. They are local decisions, and they are not decisions that I accept. That is why I made the serious point about the absolute importance of introducing waiting time and access standards, including in children’s mental health services. We need data so that we can monitor performance against those standards, and we need a payments system that does not disadvantage mental health. I also share his view that we need to change the way services are organised and commissioned so that we focus much more on prevention.

Oral Answers to Questions

Kevan Jones Excerpts

Tuesday 13th January 2015 Commons Chamber

[Mr Hunt]

Obviously this is very important, and that is what is happening now for the first time. We are seeing the true integration of health and social care through the better care fund and record working, and in my hon. Friend’s area, despite the pressures they have been feeling this winter, they have made some good progress. They have put an urgent care centre next to the A and E. They are seeing within four hours nearly 12,000 more people every year, and they are doing about 12,000 more operations every year as well.

[Mr Kevan Jones (North Durham) (Lab)]

In the Chancellor’s announcement last year of extra funding for the NHS, my clinical commissioning group got a 0.24% increase, whereas Windsor, Ascot and Maidenhead got 3.7%. The Secretary of State blamed the NHS for this when he responded to my hon. Friend the Member for Middlesbrough South and East Cleveland (Tom Blenkinsop), but is it not because this Government have taken need out of the formula—a similar thing to what they have done in local government—which means the movement of money from the north to the south?

[Mr Hunt]

No, we have not. The NHS funds were allocated on the basis of a formula and the extra money was given to the places that were most off-target on the basis of the number of older people, the level of social deprivation and a range of other important factors. All I would say to the hon. Gentleman is that we have increased the NHS budget in real terms in his area, whereas those on his own Front Bench wanted to cut it.

NHS (Five Year Forward View)

Kevan Jones Excerpts

Monday 1st December 2014 Commons Chamber

[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.

NHS Services (Access)

Kevan Jones Excerpts

Wednesday 15th October 2014 Commons Chamber

[Andy Burnham]

I am afraid that the hon. Gentleman is wrong, because I mentioned the cuts to mental health services earlier in answer to my hon. Friend the Member for Warrington North (Helen Jones). The talking therapies he mentioned were introduced by the previous Government —indeed by me—and in some places they are not being cut, which I am pleased about, but in others they are. The letter I referred to from the royal colleges and other organisations talked about a crisis in mental health. They say that people are being ferried hundreds of miles to find emergency beds. That is the reality on this Government’s watch. I think that a little less complacency and a little more focus on these problems would not go amiss.

[Mr Kevan Jones (North Durham) (Lab)]

My right hon. Friend should be congratulated, along with my right hon. Friend the Member for Kingston upon Hull West and Hessle (Alan Johnson), who brought in the IAPT—improving access to psychological therapies—programme. It was a revolutionary system for dealing with access to mental health services. Is not it the case that this Government, even though they obviously think that there are votes in championing mental health, are cutting not only the number of in-patient beds, but the mental health budget across the country?

[Andy Burnham]

My hon. Friend is right. We heard the commitment that the Deputy Prime Minister gave last week, and I am sure that he means it, but people will ask why they have not done anything about it in this Parliament. It is lip service. We introduced talking therapies and many other things. The key point is that they cut it faster than they cut the rest of the NHS. Worse still, they introduced a tariff decision this year that will cut it even further and make the problems even worse. It was Labour that proposed parity of esteem between mental and physical health in law. The Government accepted it, but they have done absolutely nothing about it.

--- Later in debate ---

[Mr Kevan Jones (North Durham) (Lab)]

I wish to discuss the crisis in the North East ambulance service. To do this, I will give some of the examples I have come across and others that have been backed up by the police and other agencies. But first I must pay tribute to the hard work of the staff of the ambulance service. It is not their fault they are under pressure; they are dedicated individuals who wish to do their best for my constituents and others in the north-east.

I wish to give two of many examples—other north-east parliamentary colleagues have complaints as well. The first comes from Carole Hampson, who lives in Quaking Houses, in my constituency. On 20 June, her son Christopher rang 111, the non-emergency number, because his 10-month-old son had drunk bleach. He was told, “No problem. We’ll get an ambulance to you straightaway. Don’t do anything.” An hour later, an ambulance had still not turned up. His mother then rang back and said, “Forget it. I’m taking him in a car.” The pressure and worry for both him and his grandmother must have been tremendous. Luckily, the youngster was fine. On 4 July, she again rang the ambulance service because her son was critically ill with a diabetes-related condition. She rang 999 and the operator said, “Is he still conscious?” She said, “Yes”. The operator said, “Okay, we’ll get there as soon as possible.” An hour and 20 minutes later, an ambulance turned up.

It is not just Carole Hampson’s family who have been affected. On 11 July, she was driving through Stanley in my constituency when she saw an old gentleman fall into the road and break his head on the pavement. The police arrived and she and other bystanders came by. She rang 999 for an ambulance. While they were waiting—for 30-odd minutes—blue light ambulances were going past. The police rang the ambulance service, but no response was forthcoming. In the end, the police took the old gentleman home, where an ambulance later attended. I have another constituent, who I will not name because I have not asked her permission, whose husband had an angina attack. She rang her GP, who recommended she ring 999. The operator said, “We’ll get a paramedic to you”, which she did, but three hours later the ambulance arrived to take him to hospital.

It is not just individual constituents saying there is a crisis in the North East ambulance service; there is evidence from the police. Over a six-month period this year, there were 675 incidents in which the police had to step in following the failure of ambulances to attend. I shall give just a few examples. On 2 September, the police attended a road traffic accident and asked for an ambulance to attend. Thirty minutes later, an ambulance arrived.

On 5 September, the police requested an ambulance because an individual had been assaulted and had waited 75 minutes for an ambulance to attend. On 7 September, the police transported to hospital a male patient with head injuries because the North East ambulance controller said that no ambulance was available and that there were 39 outstanding instances. On 19 September, the police requested an ambulance to attend a female patient with severe facial injuries; an hour and a half later an ambulance had not attended, so the family had to take care of the individual themselves. On 20 September, the ambulance controller told the local police that the ambulance service was in a critical situation. This needs sorting out.

There are two problems facing the NHS North East ambulance service. One is A and E. Ambulances are backing up at A and E. The other day, an ambulance driver told me that he had been directed from Chester-le-Street to Carlisle on the other side of the country. Then there is the 111 service brought in by this Government, which is failing. The system is not being managed by professionals with any background. It is a tick-box system that is leading to instances in which ambulances that are not needed have been sent out, clogging up the system. This service is in crisis, and what is the North East ambulance service that is responsible for it going to do? It is carrying out a review. It has appointed Deloitte to carry out a review into its operation, but my constituents do not want management consultants to sort it out.

[Mike Kane (Wythenshawe and Sale East) (Lab)]

I thank my hon. Friend for giving way and compliment him on his excellent contribution. Does he agree that this situation is being exacerbated where we are privatising ambulance services? That is what happened in Greater Manchester where in the last year alone, half the journeys failed to get patients to their appointments on time.

[Mr Jones]

That is right. This is what is picking up the slack.

My constituents do not want management consultants to sort the problems out; they want health care professionals to do so. If we in the north-east do not do something about this soon, people are going to die. Because of what is happening, people do not accept this system. The delays are causing a huge amount of angst to individuals and are putting huge pressure on other services such as the police and fire and rescue. In desperate situations, where people in road traffic and other accidents need urgent medical care, they are unable to get it. It is a failure in 2014 that my constituents and those of other north-east Members cannot get basic medical care.

I ask the Minister—I see he is busy talking at the moment and I would like him to pay attention—urgently to intervene in the North East ambulance service because it faces a critical situation. Management consultants are not the answer, and I have no faith in the management to sort this out, as has been said by other emergency services, local authorities and their own staff. Unless there is some central direction and intervention to put this right, people’s lives in the north-east of England will be lost.

Health

Kevan Jones Excerpts

Monday 9th June 2014 Commons Chamber

[Richard Benyon (Newbury) (Con)]

It is a great pleasure, but a daunting prospect, to follow the right hon. Member for Cynon Valley (Ann Clwyd), who is a model of dignity for the House and has shared some truly horrific experiences with us. I want to talk mainly about public health, but before I do so, I should like to raise an issue that is not unrelated to what the right hon. Lady has mentioned.

I have been fascinated by the fact that the Mid Staffs issue has not resonated as a major concern with the vast majority of people in this country. Perhaps I missed it; perhaps it is there just under the radar. To me, it should be seared on our collective conscience as a nation. If 1,200 had wrongfully died, say, in police custody or in some other area of direct Government responsibility, there would be crowds of people out on the streets. Yet this was a collective failure and a national failure. Irrespective of what has been said in certain journals by certain Members, this was not a local issue, but a national one in which neglect, incompetence and something called cognitive dissonance was allowed to fester—and people died in large numbers.

We rightly revere the NHS. As with my hon. Friend the Member for Mid Worcestershire (Sir Peter Luff), I have had recent experience of a close relative being treated in the NHS, and I have nothing but praise for the staff who treated him. Where there is failure, and when people are treated in the sort of way mentioned by the right hon. Lady and dignity and care fall by the wayside, we have to act. I believe that the implementation of the Francis report is a major step on that road. I applaud the Secretary of State for his determined approach to put patients first, by putting in place measures, individuals and safeguards so that Mid-Staffs does not happen again.

As I said, I want to talk about public health, which I believe is so important to how we are going to be able in the long run to afford a national health service. So much of that is about diverting people away from needing it. It is also about addressing inequalities. I have worked hard with other Members to make sure, for example, that rural areas are not left aside. When I was the Minister with responsibility for rural affairs, my hon. Friend the Member for Beverley and Holderness (Mr Stuart) raised the issue of stroke treatments in his constituency. It is, of course, much quicker and easier for a stroke therapy consultant to spend all their time in Hull, dealing with many more cases in one day, rather than getting out into the rural areas. Addressing those health inequalities is now, however, for the first time a statutory requirement. That is a major step forward. It does not just involve national bodies such as NHS England and Public Health England; local care commissioning groups and local authorities are ensuring that inequalities are addressed.

[Mr Kevan Jones (North Durham) (Lab)]

I agree with the hon. Gentleman that there is a specific need in rural communities. Does he support the Government’s action in taking need out of the assessment for public health funding, which has meant that areas such as mine in the north-east have lost funds that have been redistributed to wealthier areas in the south?

[Richard Benyon]

I do not know what happens in the hon. Gentleman’s part of the north-east, but I can tell him that there is now a real drive to deal with the problems in the constituency of my hon. Friend the Member for Beverley and Holderness. My hon. Friend felt that his constituents were getting a raw deal under the old system, and there is now a statutory requirement for that to be addressed.

The new responsibility for public health means a great deal to us as constituency Members. The West Berkshire health and wellbeing board, ably led by Councillor Marcus Franks, is taking the initiative locally, not just dealing with massively important issues such as reducing smoking but encouraging, through a partnership approach, lateral thinking and the tackling of disease and illness before they happen. We must ensure that that happens at local level as a result of legislation that has been introduced in the past.

I was pleased to be one of the authors of the natural environment White Paper. We worked closely with the Department of Health, with the aim of helping people to understand the healing benefits of nature and the great outdoors. Initiatives such as Walking for Health have created a virtuous circle. Improved health has led to greater companionship and less isolation, and organisations such as the University of the Third Age have improved the quality of life for lonely and, in some cases, elderly people—and, of course, there is the additional benefit of a lower health care bill for the taxpayer. All that is crucial to our objective of diverting people from health services.

About 20 years ago, a health service manager said to me, “The trouble is—from my point of view—that clever people keep inventing expensive new cures which we have to fund. People survive longer as a result, and that means yet more costs, because they will need the NHS at a later stage.” I think that he was being light-hearted, but it was probably just a half-joke. His point was this: if we, as a society, are to be able to afford the NHS that we want in the future, whichever party is in government, we must continue to divert people from it by keeping them healthier. The lateral thinking to which I referred earlier has never been more important.

I applaud the housing association that, working with its local health and wellbeing board, identified a large number of elderly people who were being admitted to hospital following accidents in the home. Simply employing a handyman to do some work in their sheltered accommodation resulted in a reduction in the number of injuries, particularly serious injuries such as broken hips, from which many people do not recover.

Another initiative in my area is “brushing for health”. Good oral health is vital, and my local health and wellbeing board has launched a programme involving Sure Start and other children’s centres, encouraging children to adopt diets that are lower in sugar and to brush their teeth more regularly, and ensuring that they will have access to a dentist. Promoting that initiative will mean that less national health dentistry will be required in the future.

On Saturday, I was delighted to launch the Newbury dementia action alliance. We know that 800,000 people in this country are living with dementia, and that it is costing the country £23 billion a year. It is great to hear that the G7 world leaders are getting together and making dealing with dementia one of their priorities, but what does that mean in our constituencies? It means, at local level, stimulating the minds of dementia sufferers, supporting their carers, ensuring that healthy living is part of the norm and involving organisations such as the fire service and the police.

That was a very quick canter around the importance of public health. I am running out of time, but let me end by saying that when we talk about health, we must not just talk about the important factors that surround the core of the national health service. We need to prevent people from becoming ill in the first place, and that is why the Government’s concentration on public health is so welcome. There is, of course, much more to be done, but a very important change has been made.

Oral Answers to Questions

Kevan Jones Excerpts

Tuesday 25th February 2014 Commons Chamber

[Norman Lamb]

I thank my hon. Friend for his question. Indeed, I share the concerns that he raises, and I have recently met my hon. Friend the Minister responsible for benefits specifically because I have those concerns. There needs to be much closer working between mental health services and the benefits system locally.

[Mr Kevan Jones (North Durham) (Lab)]

The Minister knows that early intervention therapy or talking therapies can relieve pressure not only in access to beds, but in helping individuals. He has just told the House that he will look at assessments of waiting times. Will he tell the House exactly what force or lever he will have to ensure that local trusts implement such targets?

[Norman Lamb]

I think it was a big mistake to leave out mental health when the 18-week maximum waiting time limit was introduced for physical health services. To me, that is inexplicable, so I am determined to correct it: from next year, there will be waiting times standards for mental health. Indeed, when the Care Quality Commission inspects and regulates providers, it will ensure that those access standards are met, in the same way as applies for physical health.

Managing Risk in the NHS

Kevan Jones Excerpts

Wednesday 17th July 2013 Commons Chamber

[Andy Burnham]

He seriously expects us to believe it? Why are we being told that those responsible were representatives of Conservative Central Office? [Interruption.] Yes, that is what is being said. The Secretary of State should go back and check his facts. If he does not have control of his advisers, it will not be the first time, will it? We have heard this before, have we not? “I do not know what the advisers are doing.”

The “my adviser is out of control” defence may have worked for the Secretary of State once, but it will not work for him twice. He must take responsibility for his own advisers, and for the advisers at Conservative headquarters. We were told explicitly that that is where the briefings came from, and the Secretary of State owes the House a full answer. He owes it to the House to put that on the record. [Interruption.] I will not put the name in the public domain, but I have a name. I will send it to the Secretary of State immediately after the debate, and he must come straight back to me, having asked that person whether or not he briefed the press. If the Secretary of State agrees to that, let us leave it there. I have a name, and I will put it to him straight after the debate. He must take responsibility.

[Mr Kevan Jones (North Durham) (Lab)]

If there was no organised briefing over the weekend, there must have been a coming together of some extraordinary fiction. The Keogh report itself states:

“It is important to understand that mortality in… NHS hospitals has been falling over the last decade: overall mortality has fallen by…30%”.

Keogh says that that is an improvement, even given

“the increasing complexity of patients being treated”.

Those who read the headlines, and the spin from the Conservative party, would not think that our investment over 13 years had made any difference to mortality rates.

[Andy Burnham]

My hon. Friend has made an extremely important point. The conclusion to which he has referred may well have been missed by many people up and down the country yesterday, but it is worth repeating and putting centre stage in today’s debate, because the Government certainly will not make any reference to it.

NHS hospitals in England, including the 14 covered by the review, have reduced mortality by 30% in recent years. That is an incredible achievement, which we should surely be celebrating. Of course the NHS is not perfect. It does fail people, and when it does, we are truly sorry for the effect on their families. The fact is, however, that the NHS and its hospitals have improved over the past decade, and that needs to be repeated and repeated to counter the scare stories that are emanating from the Conservatives and the fears that they are stoking among people about going into hospital.

--- Later in debate ---

[Frank Dobson (Holborn and St Pancras) (Lab)]

I do not wish to get involved in great party turmoil on this matter, but it seems to me that a characteristic of any health care system is whether it is entirely devoted to managing risk. When people are ill or injured, their lives and health are at risk, and it is also possible that any treatment they may be offered will itself be risky.

The principal problem faced by doctors, nurses and midwives is that of uncertainty, and they want to give the right diagnosis. It is statistically true, for example, that the average GP will be confronted by 1.5 patients who are suffering from meningitis in a 35-year career, yet we expect them to make the right diagnosis. It is difficult. If the GP has made the right diagnosis—I am not necessarily talking just about meningitis—we expect them to come up with the right treatment, which involves another judgment and a great deal of uncertainty. Even if the diagnosis and choice of treatment are right, it may be that the treatment will, for one reason or another, go wrong.

Nevertheless, within the national health service, most people, most of the time and in most places, get very good treatment. Over the past 15 or 16 years, there has been a big reduction in mortality in hospitals, a big improvement in people’s recovery from treatment for a serious illness, and we have been catching up with some countries that had a better record than us. Despite all the criticism, general satisfaction with the national health service remains high. If people are asked what they think of the national health service, about 60% say it is pretty good. If they are asked how the NHS treated them or a member of their family, the percentage of those who are satisfied is usually in the high 80s or low 90s. Any political party or political leader would love that sort of satisfaction rating.

People working in the NHS have very demanding jobs and they need help in doing those jobs. The first thing we must do is try not to make their lives more difficult than they are already. We should ensure, for instance, that they are not in a decrepit hospital without enough beds and that the equipment they have is reliable.

[Mr Kevan Jones]

Does my right hon. Friend agree that one of the achievements of the previous Labour Government was the capital investment we put into hospitals? In 1997, for example, the hospital in my constituency was housed in the old workhouse, and we now have a brand-new hospital thanks to Labour. That has made a difference not just to patient care but to the working environment of the people we are asking to care for those patients.

[Frank Dobson]

That is certainly the case and applies to many parts of the country, including areas represented by Government Members.

I do not think any hospital has had more money spent on it than University College hospital in my constituency, the rebuilding of which, I freely admit, was authorised when I was Secretary of State. I understand that it is the hospital in this country from which one is least likely to come out dead. It is a good place that has modern and reliable equipment and is not, generally speaking, short of staff. It is quite clear that staff shortages in parts of the country have endangered the standard of care provided.

People’s pay and conditions are also important. The Cavendish report, produced only last week by a journalist for The Daily Telegraph, Ms Cavendish, stated that she regarded the pay and conditions of large numbers of people providing services outside hospitals to people who need them as disgraceful, shocking and a condemnation of our society. She is quite right.

One thing concerns me most, however. I remember when I first became Secretary of State for Health being telephoned by a very good friend who was then a professor in the medical school at Nottingham and said—I shall have to bowdlerise this—“For Lord’s sake, leave us alone. Do not reorganise; do not distract people from their usual jobs.” That is what too many Governments have done, including this one, but I do not want to go ranting on about it.

One thing I want to talk about is not mentioned very often. It became fashionable to say that the money must follow the patient and that we did not want to hand over big lumps of money to hospitals and other parts of the health service as that did not provide the right incentives. The only trouble is that as a result NHS transaction costs went up from 4p in the pound to what is estimated now to be between 12p to 15p in the pound. That is a lot of money—about £8 billion, £9 billion or £10 billion extra, just because of the new method of funding. If we want to release funds to help people who are being treated in the health service and who want to be treated there, to provide the buildings, equipment and staff, and to encourage the staff, we must think about the money being squandered on transaction costs. Unless we do something about that, it will only get worse under the new system.