Augmentative and Alternative Communication Services

Lindsay Hoyle Excerpts

Thursday 6th June 2013 Commons Chamber

[Cathy Jamieson (Kilmarnock and Loudoun) (Lab/Co-op)]

On a point of order, Mr Deputy Speaker. I apologise to hon. Members for having to raise this point of order at the end of a passionate speech in an important debate. I seek your guidance, Mr Deputy Speaker. Today I had a telephone call from someone in the press asking me to comment on a parliamentary question I had asked and for which they had the answer. Unfortunately I was not party to that answer, as it had not been delivered to me. When I contacted the Table Office, it could not elucidate either. I was, however, able to obtain a scanned copy from the press. Would you agree, Mr Deputy Speaker, that this is not the way to conduct business and ensure that Members are appropriately briefed?

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

It certainly is not good form; in fact, it is very bad form. The Member should always know at least at the same time, but preferably before. The matter is now on record and I hope that those on the Front Bench will pass it on, so that we can get to the bottom of it.

Accident and Emergency Waiting Times

Lindsay Hoyle Excerpts

Wednesday 5th June 2013 Commons Chamber

[Andy Burnham]

That is a laudable aim. I do not think it is going to solve the A and E crisis right here, right now, but I do not disagree with it as an aim.

Drawing on what was said at the summit, I have developed an A and E rescue plan with five practical proposals. [Interruption.] Government Members do not want to hear it. Okay, later on they can give me their plan. I am putting forward a plan and calling this debate. They are not calling this debate. Why are they not doing something to take a grip on the situation? It is no good just sitting back and saying, “Oh”—[Interruption.]

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. I want to hear the right hon. Gentleman, as I am sure that people on both sides of the House do, and all the shouting is not going to allow any of us to do that.

[Andy Burnham]

It has been left to us to call this debate, and now Government Members sit there and groan. Well, it is not good enough. They are going to hear what I have to say because they need to do something about what is happening.

--- Later in debate ---

[Robert Flello (Stoke-on-Trent South) (Lab)]

I am grateful to my right hon. Friend for giving way; he is being very generous with his time. He is absolutely right: areas such as Stoke-on-Trent have had their budgets slashed and destroyed year on year under this Government. In Stoke-on-Trent, which is the third hardest hit area, the local authority is expected to spread the money it does have even more thinly across a population that is not only deprived, but ageing. The sniping and comments from those of the Government Front Bench are totally inappropriate. Does my right hon. Friend know when the Government got the NHS to write to accident and emergency departments to ask for their plans?

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. A lot of Members want to speak, so we need very short interventions.

[Andy Burnham]

That is part of my point. NHS England wrote to clinical commissioning groups on 9 May. What is going on here? They were all in the chaos of reorganisation until then—no one could have received a letter, because CCGs were not in place. In the crucial period between January and March, when the NHS was under intense pressure, primary care trusts were on the way out and CCGs were not in place. As a result, the NHS was in limbo; at the precise moment that it needed grip and leadership, it was drifting. That is absolutely shocking.

As I have said repeatedly, the Government must act to shore up social care in England, which is collapsing. Our solution is for the Secretary of State to use about half of last year’s underspend in the NHS, £1.2 billion, to provide emergency support to councils over the next two years to maintain integrated, home-based support. As he knows, the Budget revealed a £2.2 billion underspend in last year’s Department of Health budget. No use was made of the budget exchange scheme. In other words, he handed that money back to the Treasury. I call on him to reconsider his decision, reopen negotiations with the Treasury and act to prevent a social care emergency.

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[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. [Interruption.] Mr Karl Turner, thank you for your advice, but we can manage without it today. I make this appeal to both sides: I want to hear what the Secretary of State has to say, just as I wanted to hear what the Opposition had to say.

[Mr Hunt]

Thank you, Mr Deputy Speaker.

I repeat: it was one of the poorest speeches ever given by an Opposition on the NHS, and I predict that the right hon. Member for Leigh (Andy Burnham) will bitterly regret choosing to make an issue of A and E pressures, because the root causes of the problem have Labour’s fingerprints all over them.

The right hon. Gentleman was right on one thing, however: there is complacency on this issue—not from the Government, who have been gripping it right from the start, but rather from Labour, which still does not understand why things went so badly wrong in the NHS on its watch.

Labour’s narrative has, I am afraid, a single political purpose at its heart: to undermine public confidence in one of our greatest institutions—an institution which, in challenging circumstances, is performing extremely well for the millions of vulnerable people who depend on it day in, day out.

Labour’s story today is a totally irresponsible misrepresentation of reality. One million more people are now going through A and Es every year than in 2010, which creates a lot of pressure, so how are A and E departments actually performing? The latest figures show performance, against the 95% target, of 96.7%. The week before it was 96.5%, then before that 96.3%, 96.6% and 95.6%. Yes, we had a difficult winter and a cold Easter, and I will come to the causes of the problems we had then, but, thanks to the hard work of NHS doctors and nurses, our A and E departments are performing extremely well.

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[Wayne David]

Will the Secretary of State give way to a Welsh MP?

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. We want a little more calm. Mr David, you are getting far too excited. It is not good for you and it is not good for the Chamber—[Interruption.] Order. I do not want you to repeat your point. I have just explained to you that I need you to be a little calmer. It is up to the Secretary of State whether he wishes to give way and at the moment he is not doing so. It is his choice and shouting will not make any difference whatsoever.

[Mr Hunt]

Thank you, Mr Deputy Speaker—

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[Andy Burnham]

On a point of order, Mr Deputy Speaker. The Secretary of State has just said at the Dispatch Box that the budget for the NHS has increased in real terms. In December, I referred the Secretary of State’s comments to the UK Statistics Authority and I received a letter back saying that they were incorrect. Will you ask the Secretary of State to correct the parliamentary record and ensure that when the statistics commissioner makes a ruling it is adhered to by the Secretary of State?

[Mr Deputy Speaker]

That is not a point of order, but the right hon. Gentleman has certainly made his clarification for the record.

[Mr Hunt]

I thought that the shadow Health Secretary might try to do that, so let me give him the figures. I have the figures provided by the Department of Health finance department, based on the latest GDP deflators, as published at the Budget. Spending in the NHS—not the budget—in 2009-10 was £99.7 billion and for 2012-13 it is forecast to be £106.6 billion. That is a cash increase of £6.9 billion and a real-terms increase of £0.6 billion, so there is a real-terms increase in the NHS budget. The shadow Secretary of State does not agree with the real-terms increase of £600 million in the NHS today; there would be a Labour cut in NHS spending and I suggest that he might want to correct the record, as I am afraid he has got this wrong.

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[Several hon. Members]

rose—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. We have 19 speakers to get in, so we are introducing a four-minute limit.

Mental Health

Lindsay Hoyle Excerpts

Thursday 16th May 2013 Commons Chamber

[Paul Burstow]

rose—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Can I help the right hon. Gentleman? We said that he would have 15 minutes, but we are now on 20 minutes and other people are waiting to speak.

--- Later in debate ---

[Mrs Moon]

The hon. Lady is making some very interesting points, but the focus of this debate is mental health. Perhaps she could conclude by pointing out the mental health messages—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. It is for the Chair to decide what is in order and what the debate is about. I need no help from the Back Benches, although it was very kind of the hon. Lady to intervene.

[Jane Ellison]

I have clearly outstayed my welcome, so I will conclude. I realise that time is short.

The point that I want to make is that there is a significant mental health aspect to FGM, but that it is not well documented. Not many of our front-line professionals have it at the front of their minds when trying to explain other problems. I just want to put that on the record so that the Minister and the Department of Health can reflect on it and so that it starts to become a normal thing for mental health professionals to talk about and think about, particularly when they see people from communities that practise FGM and who might have suffered it.

Many of the young girls and women who talk about FGM speak of a silent scream for help. All I wanted to do today was to give that scream a voice in the House of Commons.

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[Norman Lamb]

Yes, absolutely; I understand the importance of that. Incidentally, I visited children and adolescent services in Oxford and I was very impressed by the work under way there. I am getting a message that I am under some pressure from Mr Deputy Speaker to make some progress—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

I may be able to help the Minister there. It is not a question of pressure from me; it is a question of the Backbench Business Committee suggesting that Front-Bench contributions should be up to 15 minutes. If he looked at the clock, he would recognise that he has spoken for more than 20 minutes. He should not suggest that the Chair is interfering; it is the Backbench Business Committee.

[Norman Lamb]

I am sorry for putting the blame in the wrong place; I take full responsibility; I have tried to be responsive to Members as I have proceeded.

We are working with NHS England to decide how best to measure progress in these areas. Because, as we all know, words are not enough, we have to be certain that the objectives we have set out on paper actually translate into better, more accessible care for those who need it.

Thirdly, I mention the three outcome frameworks: for the NHS, adult social care, and public health. These frameworks will enable us to hold the health and care system to account for achieving what matters most—good outcomes for the people who use services and for the population as a whole. In the NHS outcomes framework, there are four measures that relate specifically to mental health and many others that include mental health just as much as physical health. The other outcomes frameworks contain other measures designed to ensure that we improve well-being and tackle the wider determinants of mental health, and that we provide the best possible care and support to those people with mental health problems who need it.

Finally, I want to mention our continuing commitment to the IAPT programme. Since the programme began, it has treated more than 1 million people with depression and anxiety, and as a result nearly 75,000 people have moved from benefits into work. Nevertheless, we need to do more. We are currently involved in a joint programme with the Department for Work and Pensions, which involves commissioning work to find a way of providing much speedier access to psychological therapies for people with mental health problems who are out of work. It seems crazy that we are spending money on benefits when giving those people access to therapy might help them to recover and return to work.

Health and Social Care

Lindsay Hoyle Excerpts

Monday 13th May 2013 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

Will you confirm, Mr Deputy Speaker, that I may speak until 9.40?

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

The hon. Gentleman has eight minutes, and if two interventions come along that will give him 10 minutes.

[Jim Shannon]

I am sure that my colleagues will intervene.

I thoroughly enjoyed the opening of Parliament. It always fills me with a sense of optimism to look forward to another Session and what we can do. As the DUP Health spokesman, that optimism was dulled when I noted, with some dismay, that the Government had not included standardised cigarette packs in the Queen’s Speech. It would have been great to see essential measures on that.

I am reminded of the dance, the hokey-cokey: they are in for packaging, they are out for packaging, they are in for packaging, they are out for packaging, and they swing it all about. I cannot do the hokey-cokey, but I know who can. The Government can do the hokey-cokey and nobody can do it better. Bruce Forsyth often says, “Didn’t they do well?” If he ever retires, there are two hon. Members who will be vying for his position.

I am encouraged that some hon. Members have had the courage of their convictions. The hon. Member for Salisbury (John Glen) has taken a clear stance on plain packaging, as have other Members. I appreciate that.

I have received many e-mails from constituents on this issue. One stated:

“Since tobacco advertising became illegal in the UK, the tobacco companies have been investing a fortune on packaging design to attract new consumers. Most of these new consumers are children with 80% of smokers starting by the age of 19.”

Other Members have made it clear that we must stop smoking being an attraction for young people. About 200,000 children as young as 11 years old are smoking already and the addiction kills one in two long-term users. A recent YouGov poll showed that 63% of the public back plain packaging and that only 16% are against it.

Last week, I asked the Prime Minister whether he would introduce plain packaging. He said:

“On the issue of plain packaging for cigarettes, the consultation is still under way”.—[Official Report, 8 May 2013; Vol. 563, c. 24.]

That is not exactly accurate because the standardised packaging consultation started on 16 April last year and ended nine months ago on 10 August 2012. I am keen to hear from the Government just what is happening.

Accountability and Transparency in the NHS

Lindsay Hoyle Excerpts

Thursday 14th March 2013 Commons Chamber

[Charlotte Leslie]

rose—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. Before the hon. Lady responds—[Interruption.] I am sorry, but does the Opposition Whip have something to say?

[Lyn Brown (West Ham) (Lab)]

No.

[Mr Deputy Speaker]

Thank goodness for that.

We need short and concise interventions, because many Members wish to speak and I do not want to have to reduce the time limit further, but that is what will happen if we are not careful.

[Charlotte Leslie]

I congratulate the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson) on seeking to defend his Government’s record. I will address his point fully later in my speech.

Don Berwick’s report was commissioned by Ministers, led by Lord Darzi and with the support of David Nicholson, to celebrate the 60th anniversary of the NHS. It states:

“The NHS has developed a widespread culture more of fear and compliance… It’s not uncommon for managers and clinicians to hit the target and miss the point”.

It highlighted the inadequacy of quality-control mechanisms in the NHS, stating that the priorities that are emphasised by these assessments are

“seen as being motivated by political rather than health concerns”.

It also highlighted the anger felt by many conscientious medics at Government changes to their employment and at being pressurised to put targets ahead of patients:

“The GP and consultant contracts are de-professionalising... Far too many managers and policy leaders in the NHS are incompetent, unethical, or worse.”

The report warns that

“this… must be alleviated if improvement is to move forward more rapidly over the next five to ten years.”

But those warnings were ignored, and we know that the improvements never happened. The report’s conclusion on a decade of health care reform is that

“the sort of aim implied by Lord Darzi’s vision…is not likely to be realised by the 1998-2008 methods.”

Don Berwick’s report was not alone; let me reveal what the other two reports said. They referred to

“the pervasive culture of fear in the NHS and certain elements of the Department for Health”

and stated:

“The Department of Health’s current quality oversight mechanisms have certain significant flaws”.

Perhaps the most damning indictment of all is that the politicians are responsible:

“This culture appears to be embedded in and expanded upon by the new regulatory legislation now in the House of Commons.”

Instead of being acted on with urgency, this was all buried. We know of the existence of Don Berwick’s report and the other reports only because a medic was so concerned that Berwick’s warnings and solutions had been buried that he tipped off a think-tank, Policy Exchange, which had to use a freedom of information request to bring them to public light in 2010, two years later. They were not even available to the Health Committee.

Let us get one thing clear. The NHS is a huge, monolithic organisation with an exceptionally difficult and, some might say, almost impossible task. In reality, things will go wrong, sometimes very wrong. The crime is not so much that things were going wrong, bad as that is, but that instead of immediately focusing on tackling it, the priority was to cover up an awful truth that was uncomfortable for Ministers and chief executives. All too often, Dispatch Box appearance mattered more than the reality of patients’ lives, leaving whistleblowers and patient groups such as Julie Bailey’s, which was disgracefully dismissed by David Nicholson as a “lobby group”, screaming into a vacuum, often at great personal cost. The crime is the smothering of the truth which costs lives—the deadly silence.

What was the cost of suppressing Don Berwick’s urgent prescription for the NHS? The clinical director of NHS Scotland recently suggested that in following Don Berwick’s recommendations it has experienced an estimated 8,500 fewer deaths since January 2008. We may well ask what was the cost in lives for our NHS of the previous Government’s decision to bury the truth. Across the 14 trusts now being investigated as well as Mid Staffs, there were 2,800 excess deaths between the time that the reports by Don Berwick and others were presented to Ministers and their final revelation in 2010. If the previous Government had been urgently implementing Don Berwick’s recommendations for those five years, who knows how many of those lives might have been saved?

How was this allowed to happen? I have put in freedom of information requests asking what meetings took place to discuss the reports and who was present. Although David Nicholson was working closely with Lord Darzi on the next stage review, he said in front of the Health Committee that, incredibly, he

“knew nothing about the reports”.

That is the Select Committee, so we must take him at his word. The question that then remains is who did read and suppress these vital reports. Was it Ministers? Was it officials? If officials, how was this allowed to happen? If the Department of Health is to move away from a culture of cover-up, I expect a full and accurate response to my request to know who was responsible, and I ask the Secretary of State to assist me in that.

Former Labour Ministers will complacently say, as they already have, that these reports fed into Lord Darzi’s next stage review and informed the report, “High Quality Care For All”. I ask the House whether a document that starts with the then Secretary of State, the right hon. Member for Kingston upon Hull West and Hessle, beamingly saying

“On its 60th anniversary the NHS is in good health”

reflects the content of the reports that we have just heard about. It certainly does not. Indeed, while the Department of Health claims that it “drew heavily” on the three reports in putting together “High Quality Care For All”, a source close to the authorship of those reports said that they found that claim to be “disingenuous at best”. David Flory, the deputy chief executive of the NHS, later told the Francis inquiry that he at least had some responsibility for what happened to the reports, as he had read them, but insisted that they were “caricatures”. That would help to explain why they were not acted on, but it makes the Department of Health’s insistence that it “drew heavily on them” rather odd.

Further indication that the documents were not acted on is the fact that they raise issues almost identical to those highlighted five years later in the Francis report. If Don Berwick’s warnings had been acted on five years ago, there would be no need to ask him to come back now to step in to sort things out and implement his recommendations.

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[Several hon. Members]

rose—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. I remind Members that there is a seven-minute limit.

Social Care Funding

Lindsay Hoyle Excerpts

Monday 11th February 2013 Commons Chamber

[Several hon. Members]

rose—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. Many Members wish to get in, as this is a very important subject for all our constituents, so can we please have brief questions and short answers?

Accident and Emergency Departments

Lindsay Hoyle Excerpts

Thursday 7th February 2013 Commons Chamber

[Dame Joan Ruddock (Lewisham, Deptford) (Lab)]

On a point of order, Mr Deputy Speaker. In his statement on 31 January, the Secretary of State for Health said that he had asked Professor Sir Bruce Keogh, the NHS medical director, to review the recommendations of the trust special administrator to replace Lewisham’s accident and emergency department with an urgent care centre. The Secretary of State then said of Sir Bruce Keogh:

“He believes that overall these proposals, as amended, could save up to 100 lives every year through higher clinical standards.”—[Official Report, 31 January 2013; Vol. 557, c. 1075.]

The serious implication of that was that lives were currently being lost. We now know that nowhere in his report to the Secretary of State did Sir Bruce mention the saving of 100 lives per annum. The Secretary of State has been made aware of the disputed facts, and I therefore wonder whether you, Mr Deputy Speaker, have had any indication that he will return to the House to explain his statement of 31 January.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

I have had no such request to come to the Chamber, as the right hon. Lady would expect. She has, however, put her point of order on the record and I am sure that people will have taken note of it.

Suicide Prevention

Lindsay Hoyle Excerpts

Wednesday 6th February 2013 Commons Chamber

[Simon Hughes]

The hon. Gentleman is covering lots of bases. One of the issues that we face as a society is that young people can become isolated from contact with other young people, other than through the internet or texting. That is a real danger zone. They retire to their bedrooms and they are not seen from one night to the next. Their communication with others is limited. The exercise of parental and family responsibility, to ensure that youngsters are out and being monitored so that people can pick up signs that they might be led to suicide sites, is as important as dealing with the sites themselves.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. May I point out to Members, in relation to those last two interventions, that such interventions should come through the Chair? Instead, they have been focused on the hon. Member for South Antrim (Dr McCrea), whom we all wish to hear.

[Dr McCrea]

I agree with the point that the right hon. Member for Bermondsey and Old Southwark (Simon Hughes) makes. I was talking to folks at the weekend about how young people isolate and withdraw themselves. If we set our minds back to just a few years ago, we remember that we used to see children playing football on the streets, and little girls out with their prams. If we look at our streets today, we see very few children out there. So where are they? They are in their rooms. They are not with their families. In many cases, the internet has taken over their lives, and that leads to the isolation that the right hon. Gentleman mentioned.

When online discussions or communities emerge around harmful behaviours, there is a risk of what the Samaritans describe as an “echo chamber”, in which users reinforce each others’ behaviour and negative feelings about themselves. In a communication to me, the Samaritans stated that

“there are some aspects of the ways that individuals interact with one another online, through social networking sites or online chat rooms, that can place vulnerable people at risk by exposing them to detail about suicide methods or conversations that encourage suicide ideation. Indeed in recent years there have been several widely reported cases of individuals taking their own lives having used websites that have provided explicit information on suicide methods or have been used to facilitate suicide pacts. Restriction of access to information about suicide methods is an established component of suicide prevention. However, this is particularly difficult to achieve online not least because suicide related websites hosted abroad are legal in most other countries”.

The Samaritans have worked in partnership with major companies to develop practical initiatives to support people at risk from suicide online. In November 2010, an initiative was launched in partnership with Google to display the Samaritans helpline number and a highly visited telephone icon above the normal Google search results when people in the UK use a number of search terms related to suicide. The Samaritans also worked closely with Facebook to allow users to get help for a friend they believe is struggling to cope or feeling suicidal. We must express our appreciation to the Samaritans for doing this excellent work.

These pioneering initiatives are to be commended, but more must be done. The Department of Health suicide prevention strategy in England recognises the need to continue to support the internet industry to remove content that encourages suicide and to provide ready access to suicide prevention services. In Northern Ireland, the refreshed “Protect Life” strategy includes a new objective to develop and implement internet guidelines that seek both to restrict the promotion of suicide and self-harm and to encourage the circulation of positive mental health messages.

Online risks must be managed more effectively, and advertisements with hyperlinks to support services must be displayed whenever users discuss or search for information about harmful behaviour if we are to ensure that people in distress can access useful resources quickly.

I acknowledge that the Byron review calls for a shared culture of resilience with families, industry, Government and others in the public and third sector all playing their part to reduce the availability of potential harmful material, to restrict access to it by children and to increase children’s resilience. There needs to be a greater understanding of how young people use modern technologies and communications if they are to be engaged in respect of suicide awareness and prevention, and mental health and well-being.

In conclusion, the causes of suicide are multiple and complex, and they cannot be addressed by any one Government Department working in isolation. Recent years have seen a commitment by Government to deliver suicide prevention strategies throughout the UK, but these must be adequately resourced on a sustainable basis if the progress already made is to be maintained. While we must acknowledge the good work already taking place, there is, of course, always room for improvement, and I believe that efforts must be concentrated on making the internet a safer place for our young people.

I recognise that this is a particularly complex matter and that the challenges it presents are indeed multiple. None the less, they are challenges that must be overcome, for children have the right to be protected from all forms of abuse, violence and harm. Enhanced internet safety is only part of the solution to the growing problem of suicide and self-harm. Through a co-ordinated approach, we must effectively address the issues impacting on emotional health so that we reach a point where so-called “suicide” sites will no longer be attractive to vulnerable individuals and will be made naturally obsolete or unattractive to view. We need to think innovatively about what more can be done across government and the community to reduce the rate of suicide in the UK.

I trust that my right hon. and hon. Friends will deal not only with the issues I have touched on, but with the families of those who have experienced suicide, because they also need help.

[Dr McCrea]

rose—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. I wish to be helpful to the Chamber, and point out that Members are meant to speak through the Chair rather than to the individual Members concerned. I know that some Members have not been on the Back Benches for a while, but I hope that they are back into the swing of being in opposition and will remember to speak through the Chair.

[Dr McCrea]

I concur with the remarks of the right hon. Member for Wythenshawe and Sale East (Paul Goggins). I can honestly say that there was no better person than himself to introduce and bring in this sort of measure from the beginning. He certainly did sterling work on it, and we in Northern Ireland appreciate what he did, and want to carry it forward to the next step. Thus families in their grief, bewilderment and loss need help and should be at the very heart of whatever next step is taken. The emphasis on suicide prevention must remain, for as the Stamp Out Suicide! website plainly notes:

“once a suicide is completed, very sadly, there is no cure.”

NHS Funding

Lindsay Hoyle Excerpts

Wednesday 12th December 2012 Commons Chamber

[Robert Flello (Stoke-on-Trent South) (Lab)]

I enjoy every moment in which a blow is landed on the Government; they squirm and try to come back. Will my right hon. Friend comment on how much of the budget is being thrown away and wasted on top-down reorganisation, redundancy payments and everything else that is going on?

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

We need short interventions. There are a lot of Members who wish to speak. I am a little bothered by the comments made; I am sure that the right hon. Member for Leigh (Andy Burnham) did not want to suggest that the Prime Minister conned people.

[Andy Burnham]

I am coming to the point made by my hon. Friend the Member for Stoke-on-Trent South (Robert Flello), because the context is that £1.6 billion, on the Government’s own figures, was spent on the back office, and taken away from the front line. The Chair of the Select Committee says that the cut was a little one, as though that is okay—“It’s really an increase, because it’s only a little cut”—but one has to add £1.6 billion to that to see the full extent of the diversion of funds from the NHS front line.

As the chair of the UK Statistics Authority has established, NHS spending was lower in the first two years of this coalition than when Labour left office. [Interruption.] The Secretary of State says that it is the same. Let us have some honesty here. Mr Dilnot says that it was a cut; accept what he says, and get on with the job. If the Secretary of State starts being a bit more honest at the Dispatch Box, he might get a bit more respect from the public.

The Prime Minister has cut the NHS—fact; but just as he airbrushed his poster, he has tried to airbrush the statistics, and he has been found out. To be fair, the Conservatives admitted it and corrected the Tory party website, but the problem is that we have a long list of similarly false claims made in the House that, as of now, stand uncorrected. Today, we invite the Secretary of State to correct the parliamentary record in person.

I am not surprised to see a few sheepish looks on the Conservative Benches, because we have been checking Conservative Members’ websites, and we found that the hon. Members for South West Bedfordshire (Andrew Selous), for North Herefordshire (Bill Wiggin), and for Hendon (Dr Offord), the hon. and learned Member for Sleaford and North Hykeham (Stephen Phillips), and the hon. Member for Mid Derbyshire (Pauline Latham)—

--- Later in debate ---

[Chris Skidmore (Kingswood) (Con)]

On a point of order, Mr Deputy Speaker. Has the right hon. Member for Leigh (Andy Burnham) informed the hon. Member for Mid Bedfordshire (Nadine Dorries) that he would be making comments about her in the debate today?

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

That is not a point of order.

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[Dr Sarah Wollaston (Totnes) (Con)]

I am very disappointed to hear the right hon. Gentleman talk down the NHS. As he has just acknowledged, before the election the NHS knew that it was facing an unprecedented efficiency challenge. He will also know that under Labour productivity in the NHS fell continuously. I wonder whether—[Interruption.] Okay, but for almost every year—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. The hon. Lady needs to ask a sharp and punchy question as an intervention, and very quickly.

[Dr Wollaston]

Will the right hon. Gentleman acknowledge the NHS’s achievement in making a productivity gain?

[Andy Burnham]

The hon. Lady just made another untrue statement. She talks about talking down the NHS, but productivity has not fallen. I am sorry, but let us have some honesty. We are not just going to sit here and take one statement after another—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

We all know that all Members are very honest in this House.

[Andy Burnham]

Inadvertent claims are being thrown around the House all the time.

Fourthly, and finally, cuts and reorganisation are resulting in a crude drive to privatise services, prioritising cost over clinical quality. Across England, deals have been signed to open up 396 community services to open tender under any qualified provider, but those deals are not subject to proper public scrutiny because they are held back under commercial confidentiality. In Greater Manchester, plans are advanced to hand over patient transport services to Arriva, despite the fact that an in-house bid scored higher on quality and despite the fact that the CQC recently found serious shortcomings with the same provider in Leicestershire. The trouble is that nobody has asked the people of Greater Manchester, or more importantly the patients who rely on that service, whether they want that change.

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[Mr Graham Stuart (Beverley and Holderness) (Con)]

Does my right hon. Friend agree that it is disingenuous, should it be allowed by the Deputy Speaker to say that, of the shadow Secretary of State and Labour Members—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. We are not going to be disingenuous, are we? We are going to be friends together, and I am sure that a good experienced Member like you, Mr Stuart, could word it better.

[Mr Stuart]

Thank you, Mr Deputy Speaker, for that correction, which I required. Obviously, it is an inadvertent tendency towards disingenuousness on the subject. I would like to apologise for pointing out, on behalf of patients right across the country, that for the Opposition to have a debate on health funding, when they were proposing to cut it—when they are actually cutting it in Wales—and when productivity fell, is the height of hypocrisy.

[Mr Deputy Speaker]

Order. I do not think we can have “hypocrisy” either, so we will have the Secretary of State instead.

[Mr Hunt]

The simple truth that Labour Front Benchers cannot understand is that spending is related to budgets, and they wanted the budgets to be lower than they currently are.

--- Later in debate ---

[Mr Hunt]

In that case, I will give way.

[Mr Deputy Speaker]

Order. I am sure that the hon. Member for Broxbourne (Mr Walker) is not going to walk out after his intervention and will stay a little longer.

[Mr Walker]

The meeting is in thirteen minutes.

My right hon. Friend knows that it is not just about funding but about good management. He cannot be responsible for management across the NHS, but in the East of England ambulance service there are question marks over the quality of its senior management. Will he find time to cast his eye over those senior managers?

--- Later in debate ---

[Mr Hunt]

The right hon. Lady’s party has been saying that spending has been cut, and it had the foolishness to call an Opposition day debate on the basis of a letter from Andrew Dilnot that states that, broadly speaking, spending has remained unchanged. That is why, at its heart, the motion is bogus.

The sad fact is that this is not the debate that the Opposition planned to have, two years into this Parliament. The right hon. Gentleman dreamed of coming to the House to remonstrate about an NHS that was on its knees and that was not delivering for the public. He wanted to argue about waiting times, but they have gone down, with fewer people waiting a long time for an operation than at any time under Labour. He wanted to argue about treatments, but there are more people getting new hips and knees and many other treatments than under Labour. [Interruption.] Opposition Members should listen to this. He wanted to argue about cancer, but 23,000 people are now getting drugs under the cancer drugs fund that Labour refused to set up.

Today, the right hon. Gentleman has tabled a motion criticising the decisions taken by the coalition and my right hon. Friend the Member for South Cambridgeshire (Mr Lansley) on NHS spending in our first two years in office. This is also about how we spend the money, as many of my hon. Friends have said. What are the decisions that the right hon. Gentleman is criticising? They are precisely the decisions that mean that the NHS is now performing at record levels, and vastly better than at any time under Labour.

Let us look at those decisions. There was the decision to reduce the number of managers by 7,000 and transfer resources to the front line. There was also the decision to cancel Labour’s disastrous attempt to embrace the technology revolution that cost billions and set the NHS back by years. Then there was the decision to end the wasteful consultancy spend, which has now been cut by 39%. [Interruption.] The right hon. Gentleman needs to listen to this. There was the decision to stop the scandal of unsustainable private finance initiative projects that left the NHS with a £73 billion debt and £1.6 billion-worth of repayments every year. [Interruption.]

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. Christmas is coming. Let us show a little bit more Christmas spirit towards each other. Members on both sides of the House want to hear the Secretary of State.

[Mr Hunt]

I could not agree with you more, Mr Deputy Speaker. I am trying to give the House some good news, but it is difficult for the Opposition to take it in.

There was also the decision, championed by both coalition parties, to transfer that money to the front line, so we now have more clinical staff, including 5,000 more doctors; better access to drugs, including £600 million invested in the cancer drugs fund; 500,000 more elective admissions every year than under Labour; over 3 million more out-patient appointments every year than under Labour; nearly 1 million more going through accident and emergency every year than under Labour; and 1.5 million more diagnostic tests every year than under Labour. On top of all that, we have 60,000 fewer people waiting longer than 18 weeks than under Labour; 90% fewer people waiting more than a year than under Labour; clostridium difficile down more than a third compared with under Labour; MRSA halved compared with under Labour; and the number of people facing the indignity of mixed-sex wards down by 98% compared with under Labour.

Of course the NHS faces huge challenges with an ageing population and increasing demand, but we are now facing up to those challenges with ambitious plans to tackle dementia, to reduce mortality rates for the big killer diseases to the lowest in Europe, to embrace the technology revolution—but getting it right this time—and to improve the quality of care which, in parts of the system, has been allowed to become shockingly poor for far too long. All those priorities were ignored by Labour in office and, even worse, they have been rejected by Labour today as a “meaningless list”. Those were Labour’s words. Well, tell that to the 157,000 people who die from cancer every year, or the 800,000 people who have dementia, or the people whose families suffer from the poor care that we read about every week in the newspapers.

None of the improvements to the NHS, and none of the ambitions for our NHS, would be possible without the extraordinary dedication of our doctors, nurses and front-line professionals, to whom I pay tribute today. But none of them would have been possible either if we had not increased the NHS budget and NHS front-line spend, contrary to what Labour intended and wanted. Labour’s plans would have meant less spending in real terms on the NHS, and vastly less spending on the NHS front line. No clever fiddling with baselines can obscure the harsh reality that Labour’s policy towards the NHS is a mass of contradictions that fools nobody—certainly not the brilliant doctors, nurses and professionals who have given their lives to saving and improving the lives of others. I urge the House to reject this ridiculous motion.

[Several hon. Members]

rose—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. The time limit on Back-Bench speeches is displayed on the annunciator screen.

Regional Pay (NHS)

Lindsay Hoyle Excerpts

Wednesday 7th November 2012 Commons Chamber

[Kerry McCarthy]

I agree entirely. There is a danger of even greater fragmentation so that we move from national pay to regional pay to very localised pay, with everyone competing against each other—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. The hon. Member for Coventry South (Mr Cunningham) said “paymasters”. I am sure that he would not want that to be on the record, and that he would want to withdraw it—[Interruption.]

[Mr Cunningham]

We were accused of being in the hands of the trade unions as paymasters.

[Mr Deputy Speaker]

Not individuals? I was worried that the hon. Gentleman was referring to individuals.

[Kerry McCarthy]

During the first two years of this Government, the south-west’s nursing work force has fallen by more than 3.5%, which is three times the national average. According to the 2011 national NHS staff survey, 11 of the 20 trusts involved in the south-west consortium are in the worst 20% for people feeling satisfied with the quality of work and patient care. The consortium arrangements will not alleviate these pressures and can only make working conditions worse.

These statistics are reflected in the often heartbreaking comments that I have received from constituents, who report on increased work loads, under-staffed wards, and friends and families they rarely get to see. They are considering leaving the south-west, or the NHS altogether. The consortium’s proposals are the last straw when morale is already at an all-time low. One constituent told me:

“I now feel as disposable as the equipment I use. Nursing is on the cusp of disaster.”

When the Prime Minister claimed to lead

“the party of the NHS”,

I do not think my constituents knew whether to laugh or cry.

Health Ministers’ answers on the consortium, like the Secretary of State’s speech today, frequently hide behind “Agenda for Change”, a framework that was agreed only after lengthy negotiations, as my hon. Friend the Member for Birmingham, Erdington (Jack Dromey) said. This prevented there being damaging competition for staff, avoided the risk of ratchet bargaining and minimised the costs of pay negotiation. It meant that nurses were no longer paid as little as £12,000 just because of where they lived. Significantly, “Agenda for Change” has largely eradicated equal pay challenges, so I hope Government Members do not want to replicate the larger gender pay gap that we see in the private sector.

National negotiations on “Agenda for Change” are now being undermined by the consortium, especially when the chair of NHS Employers, who also runs a trust in the south-west, was reportedly instrumental in establishing it. I would be interested to know what conversations Ministers have had with the chair of NHS Employers before she played a leading role in setting up the consortium. The Royal College of Nursing warns that the NHS is simply not equipped for the added bureaucracy, time and expense needed to negotiate pay on a more local basis, and that this ultimately would take the more experienced staff away from the front line.

Health Ministers have sought to defend the possibility of regional pay in the NHS by pointing to its potential under “Agenda for Change”. The inclusion of high cost area supplements and the recruitment and retention premiums, as we have already tried to explain to those on the Government Benches, were designed to help trusts recruit in high cost or low supply areas. They were not intended to drive down pay and drive away staff.

NHS staff in Bristol are having to work more, with fewer staff and when their pay is frozen. They are stressed at work and stressed at home as they try to make ends meet each month, and now there is a conspiracy to reduce their pay and conditions. My constituents need answers from Ministers. When did the Department of Health first find out about the consortium? I do not mean when it first found out that the documents had been leaked to the public. Who is responsible for appointing the consortium’s director and for its budget? Most importantly, will the Government intervene to prevent the consortium undermining the progress made under “Agenda for Change”, local health services and the NHS as a national service?

My constituents deserve to be paid according to the work they do, not where they live. The proposals for regional pay risk undermining our national health service and undervaluing the work done by those who have dedicated their lives to it. The proposals should be scrapped, and scrapped now.