The National Health Service

Mike Penning Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Dr Whitford]

Okay; I welcome that. However, I would suggest that the Healthcare Safety Investigations Bill is about looking at mistakes after they have happened. I invite the Secretary of State again to look at the Scottish patient safety programme, which is more than 10 years old and has reduced hospital deaths, including post-surgical deaths, by over a third because the aim is to prevent harm in the first place.

I welcome the Secretary of State’s reference to whistleblowers, but it is not just about having guardians in hospitals. It is critical that the Public Interest Disclosure Act 1998 is reformed. Only 3% of employment tribunals are successful. All Members who have dealt with any cases on this issue will know that the wreckage of whistleblowers’ careers acts as an absolute brake on people coming forward. You can say what you like, but they are faced with the question, “Do I speak up and risk my career, my family income and my home?” It is not just a matter of paying lip service to this issue; we actually need change.

I welcome the ending of the private finance initiative, which was originally brought under a Conservative Government, but was really accelerated, I am afraid, under Gordon Brown. We are now facing the fact that £13 billion-worth of hospitals in England will have cost £80 billion by the time they are paid off. I call on the Secretary of State not just to end the PFI going forward, but to look at whether these contracts could be ended and renationalised to avoid another £55 billion having to be paid over the next 30 years. This problem is UK-wide, so we were saddled with these contracts in Scotland as well. There are health boards across England that are spending up to 16% of their income on their PFI contracts, and that obviously undermines patient care.

[Sir Mike Penning]

The hon. Lady is making a perfect point. I had the honour of being the roads Minister, and I desperately asked my officials to look at the PFI contracts on motorways around the country, including the M25. They found that the cost of coming out of these contracts is so formidable—simply because these companies’ lawyers were frankly a lot better than Gordon Brown’s lawyers when the contracts were written—that no Government would do it, so we are trapped. Some trusts—not least the trust in Romford, which also has a polyclinic—are trapped in debt from the private sector, which makes them completely inefficient.

[Dr Whitford]

I thank the right hon. Gentleman for that point. Of course, Governments can borrow at a much lower interest rate than any private business. Money is being sucked out of the NHS through the PFI across the UK, but there are also other ways in which money is being sucked out of the NHS, particularly NHS England—for example, through outsourcing under the Health and Social Care Act 2012. Private companies have to make a profit. Their chief executive is bound to make profit for the shareholders. They are not bound to deliver quality of care. We have seen clinical commissioning groups get trapped in this way. Six commissioning groups in Surrey tried to bring community care back into the NHS—they were not breaking a contract—but Virgin did what Virgin always does if it does not get a franchise renewed. It sued the CCGs. It is all hidden behind a commercial veil, but we know that at least one of those commissioning groups paid over £300,000 to settle out of court, and six groups together means that the figure was likely to be well over £2 million.

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[Sir Mike Penning (Hemel Hempstead) (Con)]

It is a pleasure to follow the hon. Member for Huddersfield (Mr Sheerman). I fully agree with many of the points that he made, and I think that everyone in the House would agree with them.

I am not usually confrontational politically, so I will do only a tiny bit of that. This fear thing that is being thrown around about a privatisation of the NHS is very damaging. It is not particularly damaging to my party, but it is damaging across politics. I was at the Opposition Dispatch Box as a shadow health Minister for four and a half years, and during that time all those PFIs went through. Under the private finance initiative, private companies were being paid for surgery that was not even carried out. They were contracted for 1,000 knee operations or 1,000 hip replacements which did not take place, and they were still paid. That is what happened under the previous Labour Administration.

We need to admit that we make mistakes when we are in government. We have made mistakes before. I made mistakes as a Minister when I was in seven different Departments—it will probably not be eight now. Governments sometimes make mistakes for the best of reasons. One of the great mistakes was that era of privatisation, with PFI deals that were off the balance sheets, and Darzi clinics. Lord Darzi was a great surgeon, a great medical man; I just happened to disagree completely with many of his proposals which were implemented by the Government, and which, frankly, have not worked. There are still many clinics out there to which trusts have to pay huge amounts of money, not to get out of their contracts but just so that they can carry on. That is something that we need to admit. So, in this House, let us admit that Governments make mistakes and that the PFI privatisation carried out by the Labour party was wrong, although it was probably done for the best of reasons. A PFI hospital was promised to my constituents; it never came even though the Labour party closed the A&E at Hemel Hempstead hospital, in the largest town in Hertfordshire. We were promised that that would be looked after, because St Albans had had its hospital closed. However, it was closed and the whole thing moved to a Victorian hospital in the middle of Watford, which cannot cope today and has not been able to cope since then.

Adding little bits to hospitals, as the hon. Member for Huddersfield (Mr Sheerman) said, and putting a new A&E on the front can sometimes work, but when there is serious funding around, which is what we are talking about now, a modern, new, environmentally proper hospital that can actually have sufficient footfall to enable the medics to work in their specialties is what we need.

I am one of the few Conservative MPs to have been offered the £400 million for a new hospital. I have said to the Secretary of State and to my trust that it is not a new hospital; it is a refurbishment of a Victorian hospital in the middle of Watford next to a football ground, and my community does not want that. The people of Watford might, but if they thought outside the box—I am not being rude to them—I am sure they would agree that it would be better to have a brand spanking new hospital that looks after the communities of Watford and the surrounding areas of Hemel Hempstead and St Albans in that massive growing area just north of the M25.

So I do not want my old hospital reopened. It is still sitting there boarded up; it is just sitting there like a running sore in my constituency. It was a wonderful new hospital when the new town was built, but there she sits now with two wards, out-patient facilities and a minor injuries unit that does not even open for 24 hours even though we were promised it would.

What we want is a tiny bit more money—the Secretary of State knows this; I am not saying anything to the Minister that he does not know. We should not keep frightening people by saying it will cost £750 million or £1 billion to build a new acute hospital on a greenfield site, because we know it will not. We have the experts working for the new hospital action group and I am going to meet the experts in the Department in the next couple of days. So I am saying to the Department, “Hold back for a second on this new hospital for us, because if you hold back a second, we might get a completely different result.”

[Barry Gardiner (Brent North) (Lab)]

The right hon. Gentleman is speaking very candidly and with great integrity. My mother died in the Hemel Hempstead hospital that he speaks of many years ago. He talked about PFI and some of his remarks are absolutely spot on, but does he now recognise that the money owed on the PFI liabilities is actually £9 billion, as opposed to the £11 billion, which is the backlog of what hospitals are paying to the Department itself because of the borrowings they have had to take out as a result of the financial problems they are facing?

[Sir Mike Penning]

As was said in debate with the Scottish National party spokesman earlier, the Government can borrow money much cheaper than any private organisation.

I am thrilled that there is some honesty in the Chamber, because we have argued about PFI for donkey’s years; it was a way of getting things off balance sheet, and let us move on from that. There is no more PFI—we can all agree on that—but actually we are not privatising the NHS, as everybody with an ounce of common sense knows. The NHS is perfectly safe; it has been safe under this party for the majority of its time since inception, and it will stay perfectly safe. There are massive demands on it, however, and I cannot allow all this money—taxpayers’ money—to be put into a Victorian hospital next to a football stadium in the middle of Watford. Anybody who knows our part of the world knows that Watford football club is in the premiership. It might be struggling a little bit at the moment, although it did very well against Spurs the other evening. Let us pause, get the experts around the table and stop scaring people with costs that are completely unrealistic—new hospitals were built in Birmingham for £425 million and a new one can almost certainly be built in Harlow for similar amount. Let us have a 21st-century hospital. Let us be honest with each other and move that forward.

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[Alex Norris]

Having had a long four-and-a-bit hour vigil in the Chamber, I have not had chance to see that, but I certainly will. That is the picture up and down the country, including in Nottingham. The key thing is that as well as being absolutely dreadful for the individuals affected, it is terrible for the system not to have those good, often early, interventions on drugs and alcohol. If we let those things spiral, the impact on the individual and the costs related to the system grow exponentially. These are really bad value choices and we could do much better on public health.

I will finish with a point about cannabis on prescription. We have had important conversations on this today, and it is good that both the right hon. Member for Hemel Hempstead (Sir Mike Penning) and my hon. Friend the Member for Gower (Tonia Antoniazzi) are here. Their leadership on this has been absolutely crucial. I heeded what the right hon. Gentleman said about how to describe it, and I changed my speech from saying “medicinal cannabis” to “cannabis on prescription” as a result. I have had a case in my constituency, as many have, with a very, very frustrated parent who could not understand why their child did not fit the criteria.

[Sir Mike Penning]

The hon. Gentleman is making a really important point, and I thank him for changing his speech slightly. The reason why it is so important is that we need the observational trials. We need to know about the THCs and the chemicals that come from the cannabis oil; we need to know the strengths and what it is. That is why talking about the prescribed medical use of cannabis oil is crucial when we make this argument; otherwise, we will lose the public will.

[Alex Norris]

I am grateful to the right hon. Gentleman for improving the quality of my speech by adding that to it. I am very confident about this matter, and this afternoon has only increased my confidence. He will have heard the shadow Secretary of State say that if primary legislation is needed—

[Sir Mike Penning]

It’s not.

[Alex Norris]

Clearly not. Whether it is regulations, or whatever, we are very capable in this place of having a grown-up conversation on this and finding a solution. That is what my constituent and her mother are desperate for us to do.

We are very grateful in Nottingham for our excellent health and social care staff. They do an incredible job, keeping our communities going and bringing hope and enjoyment of life to many people struggling with profound challenges, but they want us to do better. The social care Green Paper would be a good chance to do that, and I hope we can do it quickly. Integrated health and social care promises many virtues. We just need to get around the table and have a proper conversation about it. I hope we can do that.

[Mark Pritchard (The Wrekin) (Con)]

I don’t know about you, Madam Deputy Speaker, but I am delighted that the age of austerity is over. We have heard from the Government today a commitment to record investment in the NHS. In my political lifetime, I cannot think of any Government of any political colour that was so committed to the NHS or a Prime Minister and Secretary of State similarly committed. And of course that must come on the back of a strong economy, not the magic money tree we hear about so often in politics.

I am also delighted that we are talking about something other than Brexit. I hope that we can get the withdrawal agreement and Bill through so that we can pass the Queen’s Speech and legislate to make sure that these improvements to the NHS actually take place.

I want to go local for a moment and thank the Minister and all the team at the Department for ensuring that Shropshire and the borough of Telford and Wrekin have not lost out in this record investment in the NHS. In fact, in Shropshire we are seeing the largest investment in the NHS in its 70-year history: £312 million. That is fantastic news. What does it mean locally? For my constituents, it means that most of the planned surgery—the majority—will take place at the Princess Royal University Hospital in Telford. My constituents will no longer have to take a journey to Shrewsbury for the majority of their visits to their local hospital trust. That is good news.

There is a debate about the accident and emergency award, but I am delighted that today we have heard from the Secretary of State that the A&E has been saved at the hospital in Telford. In fact, it will be the very latest in modern thinking on how A&E services are provided, under the banner of “A&E local”. Of course, some cynics say, “Maybe that’s ‘A&E lite’”. Well, it will not be as long as I and my hon. Friend the Member for Telford (Lucy Allan) are on the case, working in tandem for local people to ensure that we have an A&E that provides what local people need.

I am glad that the Secretary of State, in releasing the £312 million to Shropshire and the borough of Telford and Wrekin, said it was conditional upon the A&E at the Princess Royal University Hospital being adequately run and sufficiently resourced, with the right staffing levels and expertise and with the clinical and medical cover it requires to service the people of Telford and Wrekin. I and, more importantly, my constituents welcome that commitment.

I am also delighted that new services will be coming into the hospital. There is a lot of doom and gloom in some parts of the local media in Shropshire, which one would expect from Opposition voices in other parties, but the good news is that we are going to see a new cancer unit; the good news is that we are going to see a new MRI scanner; the good news is that we are going to see an extra £7 million spent on a completely modernised radiology service; the good news is that we have just recruited 180 nurses to the trust; the good news, further to that other good news, is that we have now recruited 17 extra A&E doctors to the trust.

May I digress for a moment and raise the issue of recruitment, which overlaps with that of social care? I hope that the Ministers will work closely with Home Office Ministers on the points-based migration system to ensure that we attract not just highly skilled doctors from around the world, but others with fewer qualifications and skills— whether it be from India, the Philippines, or other Commonwealth and non-Commonwealth countries —so that we can provide that expanded social care service. Indeed, I hope that we will continue to retain and recruit the very best from the European Union, when we cannot recruit domestically.

Many positive developments are resulting from the Future Fit programme in Shropshire. Let me also say briefly that I am delighted by the Secretary of State’s announcement today of the immediate provision of an additional £400 million, which will enable us to expand our women and children’s unit and ensure that we have a high-quality, modernised, midwife-led unit. That is good news as well.

Finally, let me issue an appeal to Ministers on the subject of mental health, which I raised earlier today. Can we ensure that veterans who are leaving the military and making the transition into civilian life have a pathway of care?

[Sir Mike Penning]

My hon. Friend has touched on an issue that I did not have time to raise because of the time limits which, understandably, have been imposed. The danger of putting ex-military personnel into one box is that, as I mentioned earlier, some will react almost immediately to what they have seen and done, while it will take others years and years. I have close friends who fought in the Falklands war and who are only now being diagnosed with post-traumatic stress. It is important that in local communities around the country, and particularly in The Wrekin, the NHS understands the mental health needs of those who may have served in the armed forces many years ago

[Mark Pritchard]

My right hon. Friend is absolutely right to underline that. He has served in the armed forces himself, and has been a shadow Health Minister and a Minister in many other Departments. I also think that serving doctors should be given more encouragement to go into the reserves to help to stop this problem. As my right hon. Friend says, if post-traumatic stress is not dealt with by means of early intervention, it can turn into the much more difficult and complex condition of post-traumatic stress disorder.

I am sure that my right hon. Friend will, like me and like other Members on both sides of the House, pay tribute to Combat Stress, which has a unit in my constituency and which does a great job, and to Help for Heroes, whose current campaign is intended to ensure that people who are leaving the military under medical discharge with mental health conditions in particular, but with other conditions as well, have the pathway of care that I mentioned through local NHS trusts in all our constituencies.

This is good news for Shropshire. There are still some battles with the Minister ahead, and I will fight those battles with my hon. Friend the Member for Telford, but overall, this is good news.

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[Tonia Antoniazzi]

I thank my hon. Friend; I look forward to keeping on working with him.

It has been an uphill struggle. While thousands of people across the world have access to medicinal cannabis, the law was preventing patients in the UK from accessing it.

We have worked with the amazing families of the End Our Pain campaign, spearheaded by the amazing Hannah Deacon, who is mum to Alfie Dingley. Hannah’s campaigning meant that she got a special licence for Alfie to continue to use the cannabis that had transformed his life in the Netherlands. Then Sophia Gibson and Billy Caldwell were given prescriptions for medical cannabis. The highlight came last year, on 1 November, when there was a change in the law to reclassify cannabis so that it was available for medical use.

At the time, we thought that would mean that the children who were suffering would be able to have cannabis prescribed by specialist consultants. It turned out that that was not the case, so many other children were not given access to this life-changing medicine. Children from all over the UK continue to suffer because the Government are dragging their feet. The medicine is proven to work for many types of sufferers, but children are still being pumped full of steroids and unlicensed drugs that leave them severely impaired. The effect on the families has been terrible—on the children, the siblings and the parents. It is just not fair.

No one claims that this is a miracle drug. It is not a cure for epilepsy, but it does make a huge difference to the quality of children’s lives. Everyone has a right to live their best life.

I have worked closely with the parents of Bailey Williams from Cardiff, Rachel and Craig. I have seen at first hand the difference that this medicine has made to their son. When I called at their house one evening, Bailey got out of the chair, picked up a bunch of flowers and brought them to me. I actually cried to see a child who previously could not get out of bed get up out of a chair and give me a gift of thanks.

A lot of other children have the same story. Alfie has been riding a bike and a horse—something that would never have happened when he was on his previous drugs. The problem is that Alfie is getting to a point where the efficacy of this type of medicinal cannabis is dulling. As with all long-term medication, he needs a review and to be put on a new strain. However, the strict restrictions mean that even Alfie will not be able to access a new strain. As his tolerance to his medication builds, he is beginning to have more seizures. What next for Alfie? What will the Secretary of State do?

As we approach the anniversary of the law change, I want to reflect on what has happened to the lives of the families I have worked with, as co-chair of the all-party group on medical cannabis under prescription along with the right hon. Member for Hemel Hempstead (Sir Mike Penning). At the End Our Pain campaign event on 19 March, the Secretary of State told the families that he would make sure they got the medicine they needed. However, more than six months on from that promise and nearly a year on from the law change, not one new NHS prescription has been made, not one child has benefited from medical cannabis, and not one family have been able to move on with their lives.

[Sir Mike Penning]

Will the hon. Lady give way?

[Tonia Antoniazzi]

I will give way, but I will not take the extra time.

[Sir Mike Penning]

This issue shows the House how people from different parties, with very diverse views on politics, can work together for the good of children. There are children who are getting medical cannabis on prescription, but their parents or grandparents are paying for it. The NHS is free at the point of delivery. Surely that is how it should be.

[Tonia Antoniazzi]

I absolutely agree with the right hon. Gentleman.

I made a personal choice to go to the Netherlands with some of the parents to pick up the cannabis they need for their children—parents such as Emma Appleby who has a prescription for her daughter, Teagan, that costs thousands of pounds. She can afford to fly to the Netherlands to get the prescription because it costs less over there. The Government have created a two-tier system. Parents are forced to fundraise for medicines. One mother has put her house up for sale to pay for the next round of drugs. These families have run out of time, run out of money and run out of patience. All 20 families will go on hunger strike because they are at the end of the line.

I will move on swiftly. On 19 September, six months after the Secretary of State had made his promises, the families were continuing to fight for their kids. They took a bill to the Secretary of State showing the money they had spent on their private prescriptions, and they have delivered letters to the Prime Minister begging him to do something, but they have been ignored. They have not had a response, and that is absolutely disgraceful.

These families are being pushed to the end of their tether, and I honestly believe that it is time for the Secretary of State either to consider his position or to get this sorted. As a mother, if I was faced with this inaction, I would be fighting and fighting to get these life-saving drugs from the NHS—for free. I would be doing everything I could, and that is why I will continue to do everything I can to help these children who are needlessly suffering. I will raise this at every opportunity, and I will not stop until we have the good news that we need.