Junior Doctors: Industrial Action

Richard Drax Excerpts

Monday 5th September 2016 Commons Chamber

[Mr Hunt]

That is absolutely right. What my hon. Friend is alluding to is the fact that, in the new contract, we are reducing the maximum hours that any doctor can be asked to work in any one week from 91 hours to 72 hours. There are all sorts of other safeguards that benefit safety. He is right. This should not be happening, and I urge the BMA to reconsider.

[Richard Drax (South Dorset) (Con)]

May I offer my support to my right hon. Friend. I have never heard him vilify the doctors, as he was accused of doing. That language was not appropriate in this debate. Is he aware—I have heard this from one chief executive—that hospitals have been told not to speak to the junior doctors to try to resolve the dispute within the hospitals and the foundation trusts themselves? If there has been such an instruction, does he agree that it will not help solve the dispute for the future?

[Mr Hunt]

I am very surprised to hear that. If my hon. Friend wants to pass me the details, I will happily look into it. On the ground, the management of hospitals are working very closely with not just junior doctors, but BMA representatives to try to do everything they can to keep patients safe if these strikes go ahead.

Land Registry

Richard Drax Excerpts

Thursday 30th June 2016 Commons Chamber

[Richard Drax (South Dorset) (Con)]

It is a pleasure to speak in this debate and to follow the hon. Member for City of Durham (Dr Blackman-Woods). I thank the Backbench Business Committee and the right hon. Member for Tottenham (Mr Lammy) for securing this debate, which I have co-sponsored. My name would not usually appear alongside the others on the list, which shows that this is very much a cross-party debate.

I feel sorry for the Under-Secretary of State for Life Sciences, my hon. Friend the Member for Mid Norfolk (George Freeman). I thought that he would be somewhere else at midday, seeking help from colleagues to go for the top job, but he is here instead, listening to us talk about the Land Registry. It is a pleasure to see him in his place.

I thank Andy Woodgate, our union representative in Weymouth, which is in my constituency. The Weymouth office is one of 14 in the country. That number has come down from 22 over the past 10 years, due to efficiencies and reorganisations, including digitisation and computerisation, which many hon. Members have mentioned. Weymouth has certainly gone down that road: it has made huge advances and is meeting the technical challenges in the computer age. In fact, it has been described as a “beacon” of the civil service. It is ironic that a beacon of the civil service should be proposed for privatisation, but there we go.

The office occupies one floor of a building that once held 600 members of staff over three floors. There are now 200 members of staff working on one floor, yet their workload is increasing, not decreasing. It is one of the biggest employers in my constituency and I am proud to represent those 200 members of staff. I have spoken to them and listened to their concerns. I am acting, as we all should be, without fear or favour. Having listened to their views, I concur with and share their concerns about the Government’s proposal to privatise. Given everything that is going on in the country, I hope that the issue can be shovelled aside and—dare I say it?—that we can get on with the bigger issues facing the country at this very exciting time.

An Englishman’s home is his castle. The very territory that we live on is the biggest investment that any of us makes. This sell-off would undermine that absolute, fundamental basis of security.

The proposal and consultation fail to register the fact that the Land Registry is quasi-judicial. The integrity of the organisation’s database is paramount. Its quasi-judicial nature is one very good reason why it should not be sold off, and it is on that basis that all other activities occur. That is why it should be allowed to continue its excellent work. Land Registry data are fully accessible to Ministers and the public, with all the checks and balances required. It is the largest database in western Europe. It underpins the housing and property market, and it is a cornerstone of our economy. A sell-off could destabilise the housing market for a short-term return—there is no point in doing that.

The Land Registry is self-financing, returning approximately £100 million to the Treasury, although that was never intended because it is a non-profit-making organisation. Privatisation would inevitably introduce a profit-seeking motive, which might lead any new owner to take short cuts to reduce costs and to maintain the database less well, thereby leaving its integrity at risk. Once those data are corrupted, the situation would be irretrievable.

The Land Registry is a public monopoly. As every speaker has asked, why should it now become a private monopoly? That just does not make sense. Hedge funds and overseas buyers are not interested in the greater good or the stability of the country—that is the risk. They want to make a return. I have nothing against privatisation per se—I run a business myself, and if we did not make a profit, we could not reinvest in the business—but this business should not be put under that sort of speculation. Selling to a foreign company might well be against the national interest.

Interestingly, only the Treasury thinks that this is a good idea; no one has even asked for it. Yet the consultation is written in such a way that submissions must choose between alternative sale models—in other words, the status quo is not represented. Nowhere is it suggested that the whole idea may be wrong. As we have heard, of the 30,000 responses to the consultation, sampling shows that about 95% of them are against the proposal.

At present, Land Registry mistakes or errors that result in owners suffering a loss are underwritten or insured by the Government through a state guarantee fund. Big mistakes could cost millions in compensation—in effect, the figure is unlimited. What new company would be willing to underwrite that risk? That would be factored into the sale price, thereby lowering it.

The Land Registry has been valued at just over £1 billion, which is only 10 times the current revenue it produces. That is not enough. Once the indemnities and the safeguards are factored in, would a private buyer spend that sort of money anyway? I suggest not; I think they would ask for a lower price because of all the indemnities that would have to be in place.

The proposal also makes a false distinction between a land register and the Land Registry. The register is the database of 20 million-plus titles, to be kept in public ownership according to consultation document. The registry is the operational arm that creates and maintains the database, which would be sold off. There is no suggestion as to how that separation could be achieved or how it could make money.

Land Registry fees are kept reasonable and are constantly reviewed. If new owners must make a profit, they will inevitably rise, as will conveyancing costs. There is very little slack in the system, given that the Land Registry has already been pared down over the past 10 years from 10,000 to 4,000 employees.

The employees that I have met are extremely skilled and knowledgeable, and it takes at least two years to train them in conveyancing law, ordnance survey maps, digital learning and all the rest. The situation is complex, because the decisions they make are quasi-judicial decisions at a basic level, in that once ownership is registered it is guaranteed.

Interestingly, I understand that the Land Registry is going to employ 200 more staff, which suggests that there is more, rather than less, need for the organisation. A private employer is likely to look at cutting costs, so there is a risk that staff, who would be most vulnerable—they are certainly the most expensive part of any business—could be laid off at a time when more are needed.

The Law Society—a highly respected organisation with no vested interests—has opposed the proposed sell-off in a submission. So too does the Competition and Markets Authority, which says that a sell-off would introduce a profit motive that would affect the Land Registry’s ability to provide a good service at a low price.

The UK Land Registry is world-renowned and respected. It consults on establishing land registries in developing nations and abroad through its international arm. We must be most careful not to bring it into disrepute. That is particularly pertinent now, when the UK is taking a leading role in tackling corruption and money laundering. Offshore investment in UK properties must be very carefully monitored. Currently, we have free public access to freely available information in the Land Registry in cases of investigation. If it were privately owned, would that be the case? I doubt it. Interestingly, some tenders have reportedly already come in from interests in offshore tax havens—a subject that is particularly volatile in this House—and I do not think that they would be apt owners of an organisation such as the Land Registry.

Many excellent points have been made by other speakers. I will conclude at this stage, because others wish to speak. I urge the Minister, with all that is happening to this great country—with the wonderful opportunities that lie ahead and the far bigger fish that we will have to fry—to ensure that this little tiny fish is left alone to swim in the sea for years to come, as it has done successfully.

Junior Doctors’ Contract Negotiations

Richard Drax Excerpts

Monday 8th February 2016 Commons Chamber

[Richard Drax (South Dorset) (Con)]

Whatever the arguments in this case, I can think of no one more honourable, decent and honest to run the negotiations than my right hon. Friend the Secretary of State. It is reported that graduating medical students applying to be foundation year 1 and 2 junior hospital doctors are seeking work in Northern Ireland, Scotland and Wales to avoid the new contract. Is that true, and if it is, what can be done to stop this drain of our best medical students?

[Ben Gummer]

We do not see any particular evidence of the movement of juniors at present, but what we would most like to see for juniors is the introduction of the new contract, so that they can recognise that it will be better for their working practices than the current one. It is in everyone’s interests—not just those of juniors, but those of patients—to ensure that juniors work safe hours. That is why the new contract involves reductions in the number of consecutive nights and long days, and it is why we want to reduce, and eventually eliminate, the excessively long hours in the week.

NHS: Financial Performance

Richard Drax Excerpts

Monday 12th October 2015 Commons Chamber

[Ben Gummer]

I thank the right hon. Gentleman, who was an exceptional care Minister in the coalition Government, but I am a little confused by his question. He was in post when the five-year forward view was delivered by the chief executive. Within that five-year forward view is a commitment to £22 billion of efficiency savings, and he did not raise his concerns at that stage. It is precisely those efficiency savings, presented by the NHS itself and on which we have embarked, that will allow the transformation to better care that we know is possible within the service.

[Richard Drax (South Dorset) (Con)]

We all have huge admiration for all the staff who work in the national health service. Visiting two community hospitals in my constituency in the past week, I saw that work at first hand. However, we are baffled by the bureaucracy that still exists in the NHS. Does my hon. Friend agree that we can go much further and be far more radical in cutting bureaucracy, not least, for example, by cutting the number of trusts? Is that going to be looked at as a whole to see if we can provide more money for front-line services?

[Ben Gummer]

My hon. Friend is entirely right. Every penny that we can save in bureaucracy and administration is a penny that we can spend on patient care, which is why the Secretary of State commissioned Lord Carter to look at the administration and bureaucracy that surrounds hospitals especially. Lord Carter has identified many billions of savings that can be made, and I anticipate that there will be more to come.

Health and Social Care

Richard Drax Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Richard Drax (South Dorset) (Con)]

I start by congratulating all those who have made their maiden speeches today. I have listened to some and they have been excellent, as one would expect, from all parts of the House.

I welcome the broad thrust of the Queen’s Speech. Unfettered by coalition partners, we are now free to pursue a most welcome Conservative agenda. As it would take too long to cover every point in the Queen’s Speech, I have highlighted a few and I shall speak about them in the order in which they were presented in the Gracious Speech.

The first, and without doubt the most important, relates to the economy. Her Majesty referred to

“bringing the public finances under control and reducing the deficit”.

This must be right and we made great strides in the previous Parliament to prevent our beloved country from falling into an economic abyss.

During the election, I could not help but notice the level of vitriol, mainly from the left. The word “austerity” was hijacked and repeatedly and contemptuously spat out to delude voters into thinking that some belt-tightening and control of Government spending was almost evil. Balancing the family budget is not evil, nor is attending to the country’s. In the case of the latter, it was imperative, lest we leave our children and grandchildren saddled with debt and the inevitable misery that goes with it.

Secondly, on apprenticeships, our record has been second to none and the Government are to be congratulated on pursuing this important policy even further. Perhaps promising millions more apprenticeships could be reworded along the lines of “We aspire to create more apprenticeships”. I am always uncomfortable with promises, as so often factors outside our control conspire to make the target an impossible one. However, having helped to establish our first two apprenticeship fairs at Weymouth College in my constituency, I have a lot of feedback from local employers. They, too, welcome the general thrust, but agree unanimously that the reward for taking on an apprentice should be higher. May I suggest to the Treasury team that perhaps some money from the welfare budget could be better targeted at apprenticeships?

Thirdly, on the vexed question of giving housing association tenants the right to own their own home, I have some reservations. I agree in principle but have concerns about it in practice. As I understand it, tenants could buy their house at a large discount. The money would then be used by the association to build more homes. It all sounds very enticing and brings back memories of Mrs Thatcher’s successful and empowering policy of allowing tenants to buy their own council house. There is no doubt that the first generation would be extremely grateful, but what about those who follow? In seats such as mine, which is dominated by the green belt, there are few places to build new homes, and selling off the association homes that we have could surely lead to a shortage of affordable housing stock. Will the Government add some flexibility to this policy, particularly in rural seats such as mine?

Fourthly, I welcome plans to ensure that decisions affecting England, or England and Wales, can be taken only with the consent of the majority of MPs representing those constituencies.

Fifthly, the long-awaited EU referendum is now imminent. For me, and I think for many in the country, the question is simple: do we wish to be a truly sovereign nation, with our own identity and laws, or do we want to be consumed by a federalist state run from Brussels? I have no doubt that the majority of British people want the former. With the referendum now promised by the end of 2017, our negotiating hand has been strengthened enormously. I am sure that I am not alone in hoping that the Prime Minister’s demands are stringent and meaningful, and aimed at repatriating powers that for too long have been signed away, not least control of our borders. It is time, after 40 years, to have our say.

Finally, I want to talk about defence. As a former soldier, my heart sank when I read that defence spending is to be reduced by a further £1 billion. Quite apart from upsetting me—and, I am sure, every man and woman who serves in our wonderful armed forces—it caused US Defence Secretary Ashton Carter to speak out. I know from friends who work closely with Americans in the political field that they do not like speaking out against the United Kingdom unless they have a genuine reason for doing so. We should therefore listen to what they are saying. He calls on us to commit to spending at least 2% of our GDP on defence, which is the NATO minimum. It is an arbitrary target, and in my view it should probably be closer to 5%, as it was in my day, back in the ’80s and during the Falklands campaign. Of course, the kit is now far more expensive, and our manpower has been depleted to the point that some generals and admirals seriously question whether we have enough men and women to man all the new kit we are going to get.

How on earth can we ring-fence the overseas aid budget when we cannot afford to defend our nation and dependants and meet all our responsibilities? I just do not understand the Government’s thinking. It is beyond me and everyone else I speak to on the subject—everyone else. They just cannot understand it. Have we not learnt the lessons of history? It is no good having all this wonderful kit if we do not have the manpower to operate it. Even if we did, this further cut is bound to affect training, which is key if our troops, sailors and airmen are to be the best. I call on the Government to change tack before it is too late.

How sad I am to end my first speech of the new Parliament on a downbeat note, but I am afraid that I, like many others, am disillusioned, disappointed and angry that our armed forces and the defence of the realm are being treated in such a short-sighted way.

Human Fertilisation and Embryology

Richard Drax Excerpts

Tuesday 3rd February 2015 Commons Chamber

[Luciana Berger]

I do not believe that that is what is being proposed, but I shall deal with my hon. Friend’s very specific point later in my speech.

[Richard Drax (South Dorset) (Con)]

I know from a meeting that I attended before the debate that the HFEA has said, “PNT involves genetically modifying a human embryo”.

[Luciana Berger]

That point was raised in an earlier intervention. I think it is clear from reports following reviews by the expert panel that it has already been specifically addressed, but I shall deal with it in more detail later.

--- Later in debate ---

[Andrew Miller (Ellesmere Port and Neston) (Lab)]

The hon. Member for Congleton (Fiona Bruce) set out her case clearly and I respect her beliefs, but I do not agree with her conclusions. If we took them to the logical point, we would ban any intervention that introduces some part of one person to another. It would mean boycotting blood and organ transfers, simply because—[Interruption.] I listened with courtesy to the hon. Lady and I hope that my hon. Friend the Member for Stoke-on-Trent South (Robert Flello) will listen to me with courtesy. When these pioneering techniques started, nobody knew the answers for certain. People made judgments—scientific judgments—on the best available evidence, and it turned out that people’s fears were ill-founded.

The trials that have been undertaken on this work have led the scientific community—a powerful group of scientists with an extraordinary degree of knowledge in this area—to conclude that the risks are small but worth taking because the benefits on the other side of the equation are enormous. In all cases where there are risks, we need to consider the risks as against the benefits. I put it to the House that there are potential benefits for the about 2,500 families affected by mitochondrial disease up and down this nation, and they deserve our support. Of course we have to assess the risks, as we do with all risks, but that has to be done in a rational and balanced way.

[Richard Drax]

I am listening carefully to the hon. Gentleman. Everyone in this House wants the best for these families—there is no doubt about that—but it is the speed of the introduction of the regulations that concerns us. As for experimentation, I heard today that no trials are being carried out on primates, which are as close to us as can be. This process has proved successful on mice, but on primates—a standard part of this procedure, apparently—it has not been carried out, and that is interesting.

[Andrew Miller]

The hon. Gentleman makes an interesting point, but there are plenty of occasions when such tests are not carried out. In central Africa we have been testing Ebola vaccines without first testing them on primates, because the benefits outweigh the risks. We are in that position already. My hon. Friend the Member for Stoke-on-Trent South referred to research undertaken in China 10 years ago. He rightly said that that work took place, but I put it to Members of this House that the ethical and scientific rigour applied to experimentation in the UK far exceeds anything in China 10 years ago. Indeed, the technologies have also moved on to a very high degree since then.

NHS Major Incidents

Richard Drax Excerpts

Wednesday 28th January 2015 Commons Chamber

[Mr Hunt]

Yes, we have other measures in place. At every stage, trusts should do what is right for patients. Sometimes they declare an internal major incident, sometimes it is an external major incident, but what is important is that they take account of the impact on the rest of the local health economy. At Medway hospital, which the hon. Gentleman mentioned, things are getting better. It has been through a difficult period. We have been honest about the problems, we have given it a lot of external support, and I hope that the news will continue to get better.

[Richard Drax (South Dorset) (Con)]

As we know, one cap does not fit all. That applies to the NHS as much as to anything else. In Dorset the clinical commissioning group is reviewing health services and looking for local solutions to local problems. Does my right hon. Friend agree that that is the long-term solution for the NHS, rather than politicians sticking their noses in where, frankly, they should not be?

[Mr Hunt]

I absolutely agree with that. What I will not do is go round the media and say that the problems that the NHS is facing in Dorset, as it faces everywhere, are due to the fact that the area is very rural, which is the excuse that we heard over the weekend from the shadow Health Secretary for the poor performance of the NHS in Wales. We want local solutions and the highest possible standards—what we can do is give guidance and funding from the centre and make sure that patients are always put first.

NHS (Five Year Forward View)

Richard Drax Excerpts

Monday 1st December 2014 Commons Chamber

[Mr Hunt]

If we stopped the NHS using the private sector, which seems to be Labour’s direction of travel, 330,000 people every year would have to wait longer to have their hips or knees replaced. We will make decisions on the basis of what is right for patients, and not of ideology.

[Richard Drax (South Dorset) (Con)]

I congratulate my right hon. Friend on his remarks and thank him for the extra £1 billion for primary care. In South Dorset, I hear many complaints about the agency fees for recruiting staff, which is one reason why trusts tend to recruit nurses from abroad—from places such as Spain. Will he look at that and see if there is some way we can save a bit of money and act a little more efficiently?

[Mr Hunt]

We are spending too much on agency staff. It is fair to acknowledge that one reason why NHS trusts are doing that is in reaction to the Francis report. They want to ensure that they have proper staffing on their wards and proper staffing quickly. We have introduced transparency to encourage them to do that. As things settle down, they need to transfer more of those staff on to proper permanent contracts, because it costs the NHS too much to pay those exorbitant agency fees.

Community Hospitals

Richard Drax Excerpts

Wednesday 3rd September 2014 Westminster Hall

[Charlie Elphicke]

The hon. Gentleman anticipates the direction of my speech. I wholly support it; it is a great idea. Mr Stevens also said:

“A number of other countries have found it possible to run viable local hospitals serving smaller communities than sometimes we think are sustainable in the NHS”

and that

“Most of western Europe has hospitals which are able to serve their local communities, without everything having to be centralised”.

In a speech to the NHS Confederation annual conference in June 2014, he outlined his plans for reform of community health services, reiterating the problems of the ageing population and the increasing number of long-term conditions, such as obesity and dementia, as well as more expansive and expensive treatments and the need for more localised health services to tackle these problems.

Mr Stevens is right. Community hospitals have an important role to play and perform best in respect of intermediate, step-down and step-up recovery beds, particularly for people recovering from an operation who need round-the-clock care, and in respect of helping older people get better and continue to live independently, keeping them out of end-of-life or long-term nursing home care.

[Richard Drax (South Dorset) (Con)]

I, too, congratulate my hon. Friend on this excellent debate. Does it not surprise him that the acute hospitals are not clamouring to keep the community hospitals, which could free up their beds, allowing patients to go home to their local communities, where they are going to get better, not worse? That, of course, would cost the Government less in the long term.

[Charlie Elphicke]

I agree. I congratulate my hon. Friend on his hard campaigning in his constituency to secure the future of his own community hospitals. I understand that the campaign has met with great success, showing how fortunate his constituents are to have such a diligent, effective Member of Parliament. He is right; community care beds are more cost-effective and reduce the pressure of bed blocking on acute hospitals, meaning that acute hospitals can do more of what they are best at and that community hospitals can do more of what they, in turn, are best at.

Community hospitals are good at creating a friendly, personal and home-like environment, well suited to older people, particularly those who suffer from dementia yet live independently; such people have better health outcomes and a lower rate of readmission following rehabilitation and recovery. Community hospitals can be localised hubs for less complex health care and can have minor injury units, diagnostic provision, clinics for various specialities and even out-patient services and day surgery, and they are more cost-effective, when compared with acute hospitals, in respect of post-acute recovery. It is hard to see why we ever went down the route of centralisation, because it cost us more money and gave us less effective care. The move to putting the community hospital back at the heart of things will be more cost-effective and will give better care and better health outcomes.

I welcome Ministers’ comments in answers to oral and written questions, as well as the comments of Mr Stevens. Ministers have recognised that community hospitals are important in improving patients’ discharge from acute hospitals and in increasing access to treatment in the community. I welcome their acceptance that community hospitals are good bases for respite, palliative and intermediate care, and step-up and step-down care close to home. Community hospitals are also strong resources for people in rural areas, who have to travel long distances to reach general hospitals. Much of what I am saying is in line with the direction of travel of Ministers. I welcome that.

An important aspect of community hospitals is as providers of recovery beds. Study after study has shown that community hospital recovery beds are effective at getting people well, meaning they are less likely to be readmitted to hospital than if they recovered in an acute hospital. Older patients are more likely to enjoy continued independent living, and a friendly home life environment is preferred by patients.

I will cite a few studies and a bit of evidence in support of what I am saying. There was a study in Bradford in 2005, a study in the midlands and the north of England in 2007, research from 2009 into patient-reported experiences and research into intermediate care in Norway in 2007, so there is a significant evidence base. In addition, the NHS Confederation recently used Department of Health evidence to conclude that closer-to-home care produced a fall of 24% in elective admissions, a 14% reduction in bed days, a 21% drop in emergency admissions, a 45% reduction in mortality and a 15% fall in visits to accident and emergency. Those are encouraging figures. Community hospitals are more cost-effective, according to a 2006 research paper published in the British Medical Journal, so there is strong evidence to back up what I have set out.

The case is made in certain quarters that it is somehow easier and possibly cheaper to have intermediate beds in nursing homes. Nursing homes play an important role in long-term care and end-of-life care, but community hospitals are more suitable for recovery, rehabilitation and continued independent living. It is in their interest to get people out, but the nature of nursing homes is that people are not expected to leave very quickly. With an ageing population, community hospitals are particularly well suited to keeping older people healthier and more well. The clinical commissioning group covering Dover and Deal, ably led by the local GP, Darren Cocker, is building on that in creating an integrated care organisation. It sees the local hospitals in Dover and Deal as essential to the success of its vision.

Moving on, let us look at how we can put the community more into community hospitals. Many community hospitals were established and funded, as colleagues will know, through public subscription by locally based community trusts before the NHS came into existence. The trusts managed effectively and the move to nationalisation and centralisation saw those hospitals taken from communities and taken over by the NHS in Whitehall. Many communities want to be given the chance to have a greater say over what happens to their local hospitals. Allowing local communities to own, lease or manage their hospitals would be a clear way to accommodate the concerns many have and enable people to have the greater say they would like to have.

Reforging the strong link that GPs had with their local hospitals is important as well. My local GPs are up for that, and I want to encourage and support them in that move. Communities should also have greater influence over the provision of health care in their areas; that would allow them to give greater priority to the needs of their specific community. I hope that Ministers will take the opportunity to promote community ownership or management of community hospitals.

In conclusion, much progress has been made on community hospitals, but more can be done. They could be embraced and put more closely at the heart of Government health care policy, and I look forward to hearing from the Minister what steps he will take in four key areas. First, what steps will he take to enable communities to have a greater say in running their local community hospitals: to own, to lease, or to manage? How can we have stronger links among GPs, GP-led clinical commissioning groups and community hospitals, as used to happen many years ago and could happen again?

What about the potential for community hospitals to be hubs for the integration of social care and the policy support that might be given for that? Finally, we need to accept that it is not always best just to drop off people at home after acute hospital treatment and that intermediate recovery beds are often a key element in the path to recovery, distinct from nursing homes, which are better suited to longer-term and end-of-life care.

--- Later in debate ---

[Neil Carmichael (Stroud) (Con)]

It is a great pleasure to serve under your chairmanship, Mr Owen, and to speak in a debate instigated by my hon. Friend the Member for Dover (Charlie Elphicke), because it is such an important subject, in particular in my constituency. It is also a great pleasure to be present for the first performance of the new Minister—I congratulate him on his appointment.

Approximately 10 years ago, our hospital in Stroud was under threat, in essence because the previous Labour Government were obsessed with “big is better”, rather than small and local. The whole town and the wider community rallied together to ensure that their love of their hospital was understood and the fundamental case for keeping it open was made. Today, it is still open—quite right too.

At the same time, the Stroud maternity unit was under threat for much the same reasons. It also received a huge amount of support locally. It, too, is still open—again, quite right too. If I do nothing else, it would be to pledge my total support for those two institutions, as well as the Vale community hospital in Dursley, because it really matters to people that such hospitals—our community hospitals—are protected and allowed to thrive. That is a key priority for me in my constituency.

When I was first elected, it was a great pleasure to dig the first hole for the building of the Vale community hospital. It is now thriving, with 20 beds, and providing an increasing number of valuable services to my constituents.

That is the overall package that we have in the Stroud valleys and vale; it is one that we want to build on, to protect and to hand over to our successors, children and grandchildren in future. It is the core of our health care.

It is great that the reforms that we introduced early on in the Parliament have enabled general practitioners to have more say in community health provision. It is absolutely right that CCGs are able to direct patients more effectively and more easily to local community hospitals. That is certainly happening in my patch, because our local doctors know and understand the value of our community hospitals. The reforms that we introduced to localise decision making, and to put clinicians in charge rather than managers, have made a big difference. We should continue in that direction of travel.

The key word is “signposting”, to ensure that the patient gets to the place where he or she should be, rather than automatically assume that a large, city-based hospital is the place to go. We need to make it clearer that community hospitals are there and should be used as often as possible. It is a matter of signposting. Unless we make that clearer, from time to time we will find ourselves wondering why there are queues in big trust hospitals and, possibly, empty beds in community hospitals. We need to do signposting.

[Richard Drax]

I am listening attentively to my hon. Friend’s excellent speech. Dare I say, reorganisation in the NHS is not something that I particularly want to address, but is it not common sense for trusts to look again at how best to use what they have, rather than to play with what they have inherited? Community hospitals should be incorporated with the district or acute hospitals to ensure that they all work together in their relative areas to look after the people living in those areas.

[Neil Carmichael]

I thank my hon. Friend for that helpful intervention. It is absolutely right that we need a holistic approach to the use of hospitals. Such an approach would be better informed and implemented if more information were available. That is the essence of my point, which will be helped precisely by what he was talking about, which is having more and better relationships between the different types of hospital.

May I say a few words about the investment that the coalition Government have managed to provide for our hospitals? I have already said that the Vale community hospital was built during the early years of my time as Member of Parliament. We have also seen huge improvement in the Stroud maternity unit, with significant investment in access, the entrance area and a complete revamp of corridors and facilities. As a result, it is a very attractive place for expectant mothers to go. The questions are, do we have enough expectant mothers, and do we have enough of them who want to go that particular unit? I am not going to add to the baby count myself, as I have three children already, but those are questions we need to address.

Stroud general hospital can now boast improved diagnostics and excellent out-patient services. That is good for those situations, which we often see, that involve someone needing to go into a hospital, but not necessarily to stay overnight. The recently opened out-patient facility is therefore a good example of valuable and useful investment.

I want to pay tribute to the leagues of friends in Stroud hospital and in Vale community hospital. In particular, I want to single out one individual, David Miller, who has contributed a massive amount to our hospital over many years. He should be recognised as a powerful force for augmenting investment in our hospitals through very good use of locally raised funds.

In essence, I am utterly and absolutely determined to ensure that our hospitals are supported properly—financially, locally and in every other way. Secondly, the key thing is to signpost the patient to the right place and to recognise the powerful role of community hospitals in promoting public health, dealing with care after major operations and enabling out-patient activity to work, all in conjunction with general practitioners across my patch. That is the message that the Government must hear; that is the theme that the Government must pursue; and it is certainly what I will do in the Stroud valleys and vale.

Care Bill [Lords]

Richard Drax Excerpts

Tuesday 11th March 2014 Commons Chamber

[Jim Dowd]

The short answer is no, I do not wish to comment.

Lewisham was stitched up from day one. In 40 years as a public representative I have rarely come across anything so disreputable, so devious, so mendacious, so dishonest and so duplicitous as the process that was employed regarding south London health care. It started on 13 January 2012 when the then Secretary of State, the right hon. Member for South Cambridgeshire (Mr Lansley), now Leader of the House, laid an order before the House entitled the South London Healthcare National Health Service Trust (Appointment of Trust Special Administrator) Order 2012, alongside an explanatory memorandum that included the case for applying the regime for unsustainable NHS providers—the first time it had been done. There was also an additional order that extended the consultation period for the trust special administrator. As I say, it was called the South London Healthcare National Health Service Trust. When the administrator got on with his work and produced a report, it was entitled, “The Trust Special Administrator’s Report on South London Healthcare NHS trust and the NHS in South East London”. Parliament did not authorise an inquiry into the NHS in south-east London, but, by that cover, they attempted to shut down a perfectly well-functioning district general hospital in Lewisham because it was administratively more convenient.

On 16 July, Mr Matthew Kershaw was appointed as the trust administrator. I had numerous dealings with Mr Kershaw. Personally, I found him to be a perfectly reasonably, sane and sensible person, but he was commissioned by the Department to do a job. His priority, quite plainly and self-evidently, was not to decide what was in the best interests of the people of south-east London, but to do the bidding of Richmond House.

[Richard Drax (South Dorset) (Con)]

May I just clarify my concern that administrators can reach out, far beyond where we initially thought they could, into such areas as community hospitals, of which there are several in my constituency? The NHS is in such a financial mess, and getting worse, that these powers will inevitably provide a temptation to interfere more, and the Secretary of State will be able to close hospitals against the will of local people.

[Jim Dowd]

I accept absolutely the hon. Gentleman’s point. The wording of the clause is such that the powers are virtually unfettered—they are untrammelled. It does not say that an administrator can make recommendations about neighbouring trusts or nearby trusts; it says that they can make a recommendation about any trust anywhere in the entire health economy. It will be a threat to every single Members’ community willy-nilly, because it will be the new norm.

I will come on to what Lewisham experienced previously, but there used to be clinically led reconfiguration panels. This Government seem to have eschewed them. They are difficult and complicated, but they need to be so because this is a premier public service that matters so much to people in every part of this country. They are eschewing that in favour of an administrative route that will give them untrammelled powers.

--- Later in debate ---

[Mr Dorrell]

Saying that a trust is in deficit is not the same as saying that it is heading into administration. It lies within the power of the commissioners and the trust management regime to avoid administration, which everyone in the House agrees is the preferred outcome. Indeed, it is striking that each of the Members from Lewisham and from Staffordshire identified the difficulties that the TSA regime creates and the difficult circumstances that arise when a TSA is appointed. Some Labour Members have suggested that this is a back-door means of driving change without consultation by appointing TSAs to trusts all around the country. If I thought that that was anywhere near to being anybody’s intention, I would oppose clause 119. However, the important point about clause 119 is that if it were the Government’s intention, which I do not remotely believe that it is, they could pursue that policy whichever way the Division goes.

The point about clause 119 is that it raises an extremely narrow question: should the TSA take into consideration only the institution that has been demonstrated historically to be unsustainable, or should the TSA look outside that immediate health economy for solutions that will better serve the needs of patients in that area? It seems to me that we need only pose the question in that precise and, I believe, accurate way for it to be seen to be a rhetorical question.

[Richard Drax]

Rather than looking at administrators and what can be done in the event of a disaster, let us look at Dorset county hospital as a classic case of what to do. It was in trouble and has been turned around, and local clinicians and managers are now talking to the GPs in Weymouth. They are now thinking—don’t laugh—of integrating their services. Well, whoopee doopee, this is huge common sense: not an administrator in sight and, more to the point, not a politician in sight either.

[Mr Dorrell]

I do not always agree with every word my hon. Friend says, but I agree with everything he said in that intervention, so I am delighted that I gave way to him. His argument is that commissioners and the trust management should get ahead of the trust administrator. Nobody should sit around waiting for an administrator to be appointed; the objective should be to avoid trust administration along precisely the lines identified by my hon. Friend.

--- Later in debate ---

[Nick de Bois]

I am grateful for my hon. Friend’s intervention and I understand where he is coming from. Certainly in the early days under the tenure of the predecessor of the shadow Health Secretary, we were presented with consultations that listed 10 options for the reconfiguration of Chase Farm, one of which included retaining the A and E services. It disappeared from the list before anyone had had a chance to consult. A selected group of stakeholders was then invited to a meeting that, funnily enough, was not held in Enfield or Barnet. It was held in central London during working hours, meaning that very few people could attend—certainly not the public. I share the shadow Health Secretary’s view that that consultation was utterly flawed and it led to the decision to downgrade my hospital being made by his predecessor in 2008. Hopes were raised with the moratorium that was introduced by the coalition Government, but they were then sorely dashed. I have described my displeasure and the distress of my constituents who had their hopes raised in that shameful episode, the likes of which litter the history of Chase Farm over the past 10 years.

[Richard Drax]

In Swanage, we too had a consultation that was a disaster. It was binned, thank God, but another one has been started. It is taking a year, if hon. Members can believe it—a year of waiting, cost, experts and so on. This is another problem with the NHS: unfortunately, people do not trust consultations and when they happen they cost a fortune.

[Nick de Bois]

And the answer is not just with consultations. The issue facing us today, and why I cannot support clause 119, is simply this: the argument on reconfigurations, with the greatest respect to all hon. Members, will not be won by politicians or even by senior managers in the NHS. There has to be a clinically led argument from GPs upwards throughout the acute sector. For many, many years they have not made the case. The process has been littered with broken promises over the years, regardless of the good intentions of politicians. I can do nothing tonight that would suggest a further breach of trust by weakening the power of consultation, even though I accept that consultation has not had its finest hour—or, in my case, its finest 10 years.

I have faith that the voice of the British public, and the intent behind the Health and Social Care Act 2012 in particular, on which I was engaged over many weeks, is to bring clinical decision making to the front line and to empower local people, local authorities and patients further. That has been a great step. The second reason why I find it difficult to run with clause 119, and why I support the amendment tabled by the right hon. Member for Sutton and Cheam (Paul Burstow), is that he recognises the need to extend the consultation to all key stakeholders, not least to those in trusts that could be affected through no fault of their own, to extend their powers as well. That went to the heart of the 2012 Act. Indeed, we are blessed with two former Ministers in the Chamber, with whom I spent many happy hours on those Benches—it was not acrimonious at all. This was a core principle behind what we were trying to do.

Let us deal with the exceptional cases. I accept entirely that there is no master plan to run through configurations on the basis of the proposed changes, but I cannot ignore the fact that the proposed legislation we are being asked to approve allows for changes to be made in circumstances that would leave a democratic deficit and subjugate clinical judgment because of a stressful financial situation.

--- Later in debate ---

[John McDonnell (Hayes and Harlington) (Lab)]

I apologise for arriving so late, Mr Deputy Speaker. I have been stuck in a meeting.

Let me begin by saying, without party rancour, that I shall vote against any measure that puts further power in the centralised hands of the Secretary of State. I apologise for going down memory lane as well, Mr Deputy Speaker, but 40 years ago, when I first represented my constituency as a local councillor, we had what I thought was a very effective health service consisting of local GPs’ surgeries, two cottage hospitals and a district hospital. In the 1980s the two cottage hospitals were closed, because a new Secretary of State—let us leave aside the party to which he belonged—decided that we did not need them, that all the services should be centralised in the district hospital, and that there should be some investment in the GPs’ surgeries. We occupied Hayes cottage hospital in an attempt to keep it open, but we lost the battle. However, it became a residential home in the end, so we had some success.

What happened next was that other Secretaries of State came along and moved some of the services from the district hospital to more centralised hospitals in central London. Then a new Government were elected and a new Secretary of State decided that we needed to devolve again, so we had Darzi polyclinics, which looked awfully like cottage hospitals to me. If you stand still for long enough, it all comes round again.

All that was basically a result of what we heard about from the hon. Member for Enfield North (Nick de Bois): a lack of trust in local people. I believe that local people supported the original model of GPs’ surgeries, cottage hospitals and a well-resourced district hospital. If they had been listened to at the time, we would not have gone round in a huge contorted circle to get back to what was virtually square one. As I have said, I am very anxious about any measure that puts further power in the hands of the Secretary of State and overrides the wishes of local people.

[Richard Drax]

In my experience, cottage hospitals are the gold standard of the national health service, and should be preserved at all costs.

[John McDonnell]

I entirely agree. There are still members of the community who, like me, deeply regret the fact that we lost two cottage hospitals in my constituency and another in the constituency of the right hon. Member for Uxbridge and South Ruislip (Sir John Randall). We lost a whole network of cottage hospitals. I do not remember who was Secretary of State in the 1980s under the Thatcher Government, but that Secretary of State was obsessed with closing them down, and they were closed down as a result of central diktat rather than listening to people.

As other Members have said, there were consultations, and, in every case, nearly 100% of local people wanted to keep the local cottage hospital. The hon. Member for Wycombe (Steve Baker) said that we were running a socialist health service. Well, my socialism is grass-roots socialism—community socialism—which means listening to local people and respecting their wishes. Local people often know intuitively what is right, and that is why I am so anxious about any further powers being put in the hands of the Secretary of State.