Oral Answers to Questions

Sarah Wollaston Excerpts

Tuesday 25th November 2014 Commons Chamber

[Norman Lamb]

I completely agree with the hon. Gentleman about the importance of children and young people being able to access treatment and support. If the truth be known, it has always been like this. It has always been the Cinderella of the Cinderella service, which is why we established a taskforce this summer, bringing in a whole load of experts and, importantly, consulting children and young people so that we can develop a modern health service for the mental health problems of children and young people. We hope to report early next year.

[Dr Sarah Wollaston (Totnes) (Con)]

19. As the Cabinet taskforce sets out on this important work, will the Minister reassure me that it will bear in mind the important finding of the Health Committee’s inquiry into CAMHS—Child and Adolescent Mental Health Services—that it is the tier 1 and tier 2 services that really make the difference in preventing the need to access the service when children are much more unwell?

[Norman Lamb]

I very much appreciated and supported the findings of the Health Select Committee report into children and young people’s mental health services. The hon. Lady is absolutely right that we need to focus far more on preventing ill health and preventing a deterioration of it. If we can get into schools and work much better at maintaining people’s mental well-being, we can achieve much better results.

Ebola

Sarah Wollaston Excerpts

Monday 13th October 2014 Commons Chamber

[Mr Hunt]

I thank the shadow Health Secretary for the constructive tone of his comments. That is totally appropriate and I am grateful. I will start with the point on which he finished, because the most crucial thing we can do to protect the UK population is deal with the disease at source and contain it in west Africa. That is why I am working extremely closely with the International Development Secretary, and she is working closely with me because the role of NHS volunteers is important. The right hon. Gentleman is absolutely right: the initial international response has focused on taking the three worst affected countries and giving them a partner country in the developed world to help them—we are helping Sierra Leone, America is helping Liberia, and France is helping Guinea.

That has worked up to a point, but we need more help from the rest of the international community. I had a conversation earlier today with US Health Secretary Burwell. We talked about a co-ordinated international response for the whole of west Africa, because we will not defeat this disease if we operate in silos. We need to recognise that this disease does not recognise international boundaries; the right hon. Gentleman was absolutely right to make that point.

Let me try to give the right hon. Gentleman some of the information he requested. First, he is absolutely right to raise the issue of the protection of health workers. That has to be our No. 1 priority both here in the UK and abroad. That is why we are building a dedicated 12-bed facility in Sierra Leone that will give the highest standards of care, equivalent to NHS standards of care, for health care workers taking part in the international effort to contain the disease there. That is also very relevant to health care workers here: events in both Spain and the US will have caused great concern.

I am satisfied that the official advice to health care workers is correct. The Centers for Disease Control and Prevention in the US, the US equivalent of Public Health England, believes that breaches in protocol led to the infection of the US nurse—the case we have seen in the media recently—but it is investigating that. The advice is always kept under review and if that advice changes we would, of course, respect that. It is important that we follow the scientific advice we have, but that the scientists themselves keep an open mind on the basis of new evidence as it emerges. I know that they are doing that.

The right hon. Gentleman talked about the full range of figures. He is absolutely right to say that we will maintain public confidence in the handling of this by being totally open about what we know. The reason we have stuck carefully to the formula of “a handful of cases” is because it is genuinely very difficult to predict an accurate exact number. Let me say this: we would not have used the formula of “a handful of cases” if we thought that the number of cases over the next three months would reach double figures. However, it is also important to say that that was a current assessment. That assessment may change on the basis of the evidence. I will, of course, keep the House informed if it does change.

The right hon. Gentleman talked about screening. It is important to deal with a misunderstanding. Why did the policy change on Thursday? The answer is that it changed because the clinical advice from the chief medical officer changed on Thursday. Her advice changed not on the basis that the risk level in the UK had changed—she still considers it to be low—but because she said that we should prepare for the risk level going up. That is why we started to put in place measures, but they are not measures primarily intended to pick up people arriving in the UK who are displaying symptoms of Ebola. We think that most of those people should be prevented from flying in the first place. The measures are designed to identify people who may be at risk within the incubation period of developing the disease, so that we can track them and make sure they get access to the right medical care quickly.

As I mentioned, we think we will reach 89% of people arriving in the UK from the affected countries. We will continue to review that. If the numbers increase and the risk level justifies it, we have contingency plans to expand the screening, for example to Birmingham and Manchester. The reason we have included Eurostar at this early stage is because there are direct flights from those three countries to Paris and Brussels, from where it is easy to connect to Eurostar. We will use the tracking system for people who are ticketed directly through to the UK in order to identify, where we can, people who then independently get a Eurostar ticket. It is important to say that because they are changing the mode of transport in Paris and Brussels, tracking is not as robust as it would be for people taking a direct flight to the UK. We will not be able to identify everyone, which is why we need to win the support of people arriving in the UK from those countries, so that they self-present, in their own interest, to give us the best possible chance of helping them if they start contracting symptoms.

I am satisfied that the Trexler beds and the negative isolation rooms are safe both for health care workers and in preventing onward transmission. They use different systems—one of them is a tented system and the other is based on people wearing personal protective equipment —but I am satisfied that both of them are safe. I will continue to take advice on that. It is very important that ambulance staff know that someone is a potential Ebola case, so that they wear the PP equipment.

As we will not be able to identify everyone who comes from the affected countries, it is important that the 111 service knows to ask people exhibiting the symptoms of Ebola whether they have travelled to those affected areas. The right hon. Gentleman asked what those symptoms are. They are essentially flu-like symptoms, but they are not dissimilar to the symptoms someone might exhibit if they had, for example, malaria. That is why it is important to ask for people’s travel history and whether they have had or may have had contact with people who have had Ebola, in order to identify the risk level.

We would like to continue using ZMapp for people in the UK who contract the disease, but that is subject to international availability. It might not be possible to get it for everyone, because there is such high international demand, but we will certainly try.

In terms of the development of a vaccine, we are doing everything we can to work with GSK to bring forward the date when a vaccine is available. Indeed, we are considering potentially giving indemnities if the full clinical trials have not been conducted.

[Dr Sarah Wollaston (Totnes) (Con)]

May I welcome the Secretary of State’s statement and pay tribute to all the staff who are giving him professional detailed scientific advice? I join him in paying tribute to all the NHS personnel, our forces personnel and diplomatic staff putting their own lives at risk in west Africa.

I am particularly pleased to hear that those individuals returning to the UK or coming to the UK from west Africa will be able to access support in a timely manner and in a manner that does not put other individuals at risk in crowded health care settings. Will the Secretary of State say more about the testing arrangements, which I hear are going to be at Porton Down? Does he have any plans to make further testing centres available so that testing can happen more rapidly?

[Mr Hunt]

I thank my hon. Friend for her comments and her support for the statement. I want to pay particular tribute to the chief medical officer and Dr Paul Cosford at Public Health England, who have done an enormous amount to make sure we develop the right policies, which are both proportionate and enable us to prepare for the future. The Government are hugely grateful for their contribution.

We are satisfied that the testing arrangements at the PHE facility at Porton Down are adequate to the level of risk, but one of the reasons why I wanted to announce to the House the current estimate of the number of Ebola cases we are dealing with in the UK was to make the point that we will continually keep those arrangements under review should the situation change. We need to recognise in a fast-moving situation such as this that it might well change, and I will keep the House updated, but in such situations the resilience of all those very important parts of the process will be checked.

Regulatory Reform

Sarah Wollaston Excerpts

Tuesday 9th September 2014 Commons Chamber

[Dr Sarah Wollaston (Totnes) (Con)]

I apologise for missing the opening speeches, but I was chairing the Health Committee. I am delighted to have been here to hear my hon. Friend the Member for Bedford (Richard Fuller). I absolutely agree with him, and am grateful to him for raising this issue of the tension that exists between localism and the decisions that are being made in good faith by clinical commissioners. There is a need for us to engage local people in decision making to ensure that we get the best possible outcome for them.

I am sure that other Members have raised concerns about Healthwatch and the possibility of the local voice being squeezed out. Will the Minister address the issue of the time scale that is often given to local people to consider quite detailed proposals? Indeed, detailed proposals will be given to local health and wellbeing boards at Devon county council with only a day’s notice, and there is no obligation to include local healthwatch. We need guidance in that area, especially if we are to have committees in common, which I support.

I will support the regulatory reform order, as it is a good thing. Like my right hon. Friend the Member for South Cambridgeshire (Mr Lansley), I think that we could go further and involve other groups in these permissive arrangements. As he will know, for people living on the boundaries of clinical commissioning groups, such arrangements do not always appear to be logical. This will allow commissioning to take place over a wider area with better outcomes for patients and often with great saving. I absolutely support the measure, but the concerns expressed by Healthwatch, which have also been expressed to me, need to be addressed.

Community Hospitals

Sarah Wollaston Excerpts

Wednesday 3rd September 2014 Westminster Hall

[Dr Sarah Wollaston (Totnes) (Con)]

It is a pleasure to serve under your chairmanship, Mr Owen.

I, too, congratulate my hon. Friend the Member for Dover (Charlie Elphicke). I cannot remember a more encouraging debate in this House about community hospitals. The success stories we have heard—not just from Dover, but the extraordinary success in Andover outlined by my right hon. Friend the Member for North West Hampshire (Sir George Young), and those in Vale, Congleton, Maldon and other places—show what community hospitals can achieve.

I was encouraged by what Simon Stevens had to say. He talked about how we should learn from other countries in providing care closer to home, but we do not need to go to other countries. The Health Committee has visited Scandinavia, and in Denmark and Sweden I was shown slides from Brixham community hospital. There we go: we actually have wonderful examples in this country. I pay tribute to the four community hospitals in my constituency: Brixham community hospital, Totnes community hospital, South Hams hospital in Kingsbridge, and finally Dartmouth hospital. They are wonderful services.

I do not want to reiterate the excellent points that have been made by my hon. Friend the Member for Dover, but community hospitals do not exist in isolation. The debate should consider not just community hospitals, but all the volunteers and services that surround them and enable them to fulfil their role. I talk not just about the wonderful leagues of friends, which work so hard for our communities and in community hospitals, but about the wider networks that help community hospitals to prevent hospital admissions, to facilitate early discharge and to prevent readmission. I will focus on why that is so important.

Simon Stevens has said that the greatest challenge facing the NHS is the rising elderly population and how we care for them. It is good news that we are living longer. That is sometimes presented as if it is gloomy news when it is great news. However, with that comes an increased number of people living with long-term conditions. From our recent Health Committee inquiry, we know that long-term conditions now account for 70% of our entire NHS and social care spending. The number of people aged over 85 will double in the next 20 years. Again, I stress that that is a good thing, but it needs some forward planning.

I ask the Minister how we will ensure that the resources from the better care fund support our community hospitals and the wider webs around them. Last month, Simon Stevens heard an important message when he visited Dartmouth hospital and met with representatives from staff, community volunteers and patients. The message was how frustrating the complications of tendering rounds can be for these volunteer groups. Sometimes those groups spend their time trapped in endless cycles competing for small pots of money. Those funds tend to go to new projects and often do not provide the ongoing funding that well-established, excellent community services provide. Will the Minister look at the mechanisms that sometimes lead to national organisations receiving funding because they can put forward flashier bids, at the expense of excellent local services? Those national bodies might have no local-facing presence.

We need to look at how we can ensure that the arrangements get money to the local services and the right people, and at how to make the processes simpler and less bureaucratic. There is nothing that drives out volunteers quicker than being trapped in endless contracting rounds, rather than doing what they really want to do: provide services to people. I hope the Minister will look at what is happening on the ground in local communities and try to sweep away some of that bureaucracy. That will help our community hospitals to deliver better services.

As my right hon. Friend the Member for North West Hampshire said, we need to demonstrate value for money, not just excellent care. I have worked in community hospitals and I know, from patients and colleagues, how important they are to local communities. We know that, but we also have to be able to demonstrate that they are financially viable. That viability often comes from adjusting the way financial drivers in the NHS work. If the Minister wants to help community hospitals, my message to him is to look at what is happening on the ground and make those adjustments happen.

I have concerns about the way consultations about changes to services take place. We need honesty about changes to community hubs. If that means losing beds in community hospitals, we need to be clear about that with communities. Where other arrangements are going to be put in place, such as using nursing home beds rather than community hospital beds, we need to be clear that there is an evidence base that that provides the services people want. We sometimes lose the heart of our community hospitals if we lose their beds. Community hospitals work better if we can retain those step-down, step-up intermediate care beds. That is crucial for communities. If there are to be changes, we need to have honesty during consultations.

Adequate notice also has to be given. This morning I was very concerned to see in an e-mail that Northern, Eastern and Western Devon clinical commissioning group proposes to close some community hospital beds. The detailed consultation will be given to the health and well-being scrutiny panel only the day before. That is not adequate time to scrutinise the plans. Will the Minister ensure that a clear message comes down that, if we want to have local democratic accountability, people must be given adequate time to scrutinise proposals? We must try to avoid terms such as “the direction of travel” in consultations with local communities. People do not know what that means. They want to be clear on what the proposals are and to be given an opportunity to feed back.

Finally, on community ownership, putting the “community” back into community hospitals is important. We need flexibility so that communities that want to take that on can take over from NHS PropCo. That issue, which I would like the Minister to comment on, was raised in a previous debate. I also have a word of caution on social enterprise. I fully support social enterprises but, in some rural communities, a change from NHS terms and conditions of service can place community hospitals under threat if NHS staff do not wish to work there. If people have the choice to work at a hospital where they will have NHS terms and conditions of service or at a hospital where they will not, I can tell the Minister where they will choose to work. That can pose a threat. No one can campaign to keep open a hospital with no nurses. Can the Minister touch on that? If we are going to shift to a social enterprise, we have to be mindful of the impact on future recruitment.

I pay tribute to all the community hospitals in my constituency, their staff and volunteers. They are valued beyond belief by their local communities. I wish them well for the future.

Mitochondrial Replacement (Public Safety)

Sarah Wollaston Excerpts

Monday 1st September 2014 Commons Chamber

[Dr Sarah Wollaston (Totnes) (Con)]

I rise to urge the Minister not to delay bringing forward the regulations, and I urge the House not to lose sight of the children and their families who are devastated by mitochondrial diseases. Of course it is absolutely right that the House debates the ethics, as so many Members have pointed out, but at times the language used has clouded those arguments. We have heard terms such as “eugenics”, “three-parent babies”, “designer babies”. This is not about wanting to create a child who is more beautiful or more intelligent. This is about wanting to spare families and children from a lifetime of devastating medical problems. We have the potential to do that. I fully respect those who oppose this on ethical grounds—they are entirely consistent in their view—but I am concerned that there has been selective misquoting from the scientific evidence. The House is not really qualified to examine the evidence in detail, and that is why we have expert panels, and bodies such as the HFEA, to advise and regulate this, and they do so with a great deal of thoughtfulness and expertise.

We have to be clear that the third scientific review, the expert panel, which I regret has been selectively misquoted, has looked at that evidence and has concluded that it does not show that the technique is unsafe. We will not know whether the technique is effective until we allow trials in a human context—it may be that there are complications; we have to be honest about that, and we have to be honest that this is not the same as a blood transfusion—but we do know absolutely for certain that families and children are suffering now from these diseases. That is why, on the balance of the safety issues and the advice from the expert panels, we should not reject this on safety grounds.

The point made by the hon. Member for North Antrim (Ian Paisley) about the child sitting in front of him in his surgery whose parents would not change that child was particularly powerful. No one is asking to change a child. What we are asking is for future generations of children to be spared that part of them that creates the suffering, but to keep within them all the personality and everything else in their genetic make-up that makes them who they are.

I am also concerned to point out that if I were to donate my mitochondrial—

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order.

--- Later in debate ---

[Fiona Bruce]

I thank all hon. Members who have contributed to this debate. The number who have contributed and the serious intent and concerns expressed highlight the grave concern that Members feel about this issue, which I believe reflects public concern. That is why it is so important that the final decision on this issue is brought back to the House. Full debate and consideration should be available to us after the critical research recommended by the Human Fertilisation and Embryology Authority has been conducted, published and peer reviewed.

My hon. Friend the Member for South Derbyshire (Heather Wheeler) said that we should listen to the science, and that is precisely my point. It is said that the Government intend to lay regulations this autumn, before the pre-clinical research recommended by the HFEA in its three reports has been concluded, written up and assessed in peer reviewed journals. I simply say that it cannot be right to ask the House to make such a decision before the tests have been concluded. As my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) said, there has always been an understanding that we must proceed only when the safety of these issues has been properly assessed.

As a mother, I know that no mother would want to conceive a child with mitochondrial disease, but neither would they want to conceive a child with potential genetic abnormalities because adequate safety tests on maternal spindle transfer and pro-nuclear transfer were not carried out.

Question put and agreed to.

Resolved,

That this House takes note of the Human Fertilisation and Embryology Authority’s most recent scientific review into the safety and efficacy of mitochondrial replacement techniques which highlights concerns for subsequent generations of children born through maternal spindle transfer and pronuclear transfer; welcomes the recent comments of scientists including Professor Lord Winston that, prior to the introduction of such techniques, more research ought to be undertaken and a full assessment conducted of the potential risk to children born as a result; and calls upon the Government, in light of these public safety concerns, to delay bringing forward regulations on mitochondrial replacement.

[Dr Sarah Wollaston (Totnes) (Con)]

On a point of order, Madam Deputy Speaker. Is it in order to ask whether Professor Lord Winston was consulted before his name was added to the motion on the Order Paper?

[Madam Deputy Speaker (Mrs Eleanor Laing)]

It is in order to ask the question. I cannot give the hon. Lady an answer, but I have heard what she said, and I am sure that those who were involved in that have heard what she said. If the noble Gentleman was not consulted, I would consider that to be most discourteous.

Oral Answers to Questions

Sarah Wollaston Excerpts

Tuesday 15th July 2014 Commons Chamber

[Norman Lamb]

The hon. Lady raises an important point, which she and I have discussed before: the fact that very many people who end up taking up their own lives have had no contact at all with statutory services. I would be happy to discuss further with her what additional steps we can take to ensure that those people get the support they need.

[Dr Sarah Wollaston (Totnes) (Con)]

I am delighted to see all the members of the Front-Bench team in their places this morning—or this afternoon, I should say. The principle of parity of esteem should also apply to consent to treatment. Does the Minister agree that the offer of talking therapies and other therapies must always be based on the principle of informed consent? Has he held any discussions with his colleagues in other Departments?

[Norman Lamb]

I completely agree with my hon. Friend. It seems to me to be inherent in the nature of therapy that people go into it willingly. The idea that we could frogmarch them into therapy against their will simply would not work. We could end up with a dangerous and costly tick-box exercise that achieved nothing, so there is no plan to introduce compulsion to access therapy.

NHS Investigations (Jimmy Savile)

Sarah Wollaston Excerpts

Thursday 26th June 2014 Commons Chamber

[Mr Hunt]

I thank the shadow Health Secretary for the constructive tone of his comments. Many of the suggestions he has made are very sensible. We will take them away and look at them, but I will go through a number of them now. First, we will indeed make sure that all Savile’s victims get the counselling they need. I think that it has been made available to them, but it is absolutely right to double-check that they are getting every bit of help they need and that we are taking all reasonable steps.

I hope that what has happened today will be, in its own way, another landmark for all victims of sexual abuse in giving them the confidence that we are changing, not just as an NHS but as a society, into being much better at listening when people come forward with these very serious allegations. It hits you time and again when reading these reports how many people did not speak up at the time because they thought that no one would believe them. We are not going to change that culture overnight, but we have to be a society that listens to the small person—the person who might get forgotten and does not feel they are important in the system.

On the claims for compensation, the right hon. Gentleman is absolutely right to say that the first draw for those claims will come from the Savile estate. I hope I can reassure him, however, that, as we have said, the Government will underwrite this so that if there are any claims that are not able to be met by the estate we finance them from the public purse. We think it is important that we should do that, although Savile’s estate is the first place to start, for obvious reasons.

The right hon. Gentleman is right to say that if there is evidence that people have criminally neglected claims that were made at the time or behaved inappropriately—even if it is not a matter for the law and they behaved in a way that could make them subject to disciplinary procedures in NHS organisations—that should be addressed. We will urge all NHS organisations to look carefully at anyone who is mentioned in the reports. Of course, the police will, naturally, look at the evidence against any individuals, who of course have the right to due process, which everyone in the House would accept.

On the specific point about the behaviour of one Minister and what it suggested about the motivation for Savile’s approval for his job at Broadmoor, my right hon. and learned Friend the Member for Rushcliffe (Mr Clarke), who was Secretary of State at the time, has said that that behaviour would be indefensible now and that it would have been indefensible at the time. I agree with him. Everyone must be held accountable for the actions they took.

We are doing a great deal to make sure that all NHS staff are trained to feel more confident about speaking out. The Mid Staffs whistleblower Helene Donnelly is now working with Health Education England to see what needs to change in the training of NHS staff in order to change that culture.

On the new disclosure and barring scheme, we are already doing work to examine the reason for the drop in the number of people who are being barred from working with children. The Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb) is looking into that. I have given this a lot of thought and it is important to say that in the current environment, were we to have another Savile, it is likely that the disclosure and barring scheme would bar him from working with children and in trusts, but that is not certain because he was never convicted of a crime. The Criminal Records Bureau checks would not have stopped that, but it is possible for the disclosure and barring scheme to prevent people from working with children and vulnerable adults even if they have not committed a crime. For example, their employment track record may show that they were dismissed for doing things that raised suspicions. It is also important to make the point—I think everyone in the House will understand this—that it is not possible to legislate to stop all criminal vile activity. What we depend on for the disclosure and barring scheme to work is a culture in which the public and patients feel able to speak out and staff listen when they do so, in order that these things surface much more quickly.

Finally, the question of whether any further inquiries are necessary will, of course, be considered. The first step is to let Kate Lampard do her full report. At this stage, she has not drawn together all the different inquiries and tried to draw lessons from the system as a whole. I asked her to do two things. The first was to verify independently that the reports of NHS organisations were of the necessary quality, and I think she has done that superbly. The second stage of her work is to see what lessons can be drawn from the system as a whole. We need to hear what she has to say about that and, indeed, what the Department for Education and the BBC learn from their reports, and then we will come to a conclusion about whether any further investigations are needed.

[Dr Sarah Wollaston (Totnes) (Con)]

May I join the Secretary of State in paying tribute to the victims? They were not silent. What today’s reports show is that very many people witnessed—even directly condoned—some deeply inappropriate behaviour. How could it ever be acceptable for a celebrity to be able to watch female patients showering? Will the Secretary of State join me in sending a message to NHS staff that they should always raise concerns if they witness such behaviour and that they will be protected if they do so?

[Mr Hunt]

I am absolutely happy to do that. I wholeheartedly agree with my hon. Friend’s comments. The NHS needs to move to a system where it is the norm rather than the exception to report, and where NHS staff feel comfortable that reporting any concerns is an absolutely normal part of their job. She is right to say that one of the most disturbing things in the reports is the clear evidence that some people helped Savile in what he did—for example, that people were escorted to his private room in Broadmoor—which is very shocking. That is why it is very important that everyone is vigilant. I totally agree with what she said.

Patient Safety

Sarah Wollaston Excerpts

Tuesday 24th June 2014 Commons Chamber

[Mr Hunt]

We talk about many things and there will always be political differences between Opposition and Government Members, but I would have thought that on patient safety, on saving patients’ lives, on dealing with the issue that once a week in the NHS we operate on the wrong part of someone’s body and on other terrible issues, there might be a degree of consensus. It is incredibly disappointing that, again, the right hon. Gentleman has chosen to make a political football out of something that should be above party politics.

Let me go through the right hon. Gentleman’s points. This morning in the radio studios, I talked about fulfilling a pledge that I made to the House in my response to Francis—that we would publish staffing data, something that he never did when he was in power. We have done that for 6,700 wards throughout the country, because we want to end the scandal of short staffing that happened on his watch and directly led to Mid Staffs.

I am delighted to come to the House. I have made a written ministerial statement. I often come to the House and I am delighted that the right hon. Gentleman has raised this issue. As he has raised some specific points, I need to address them. He quoted what the outgoing president of the Royal College of Psychiatrists said, but he failed to mention what the incoming president said this morning, which was to praise the remarkable work done by this Secretary of State and his Ministers to raise the issue of mental health.

The right hon. Gentleman talked about the Commonwealth Fund. Let us look at that. When he was Secretary of State, we fell from being top-rated in the world to being second. We are now back on top. He has spent the past four years saying that under the coalition Government the NHS is going to rack and ruin. Someone who is independent has now looked at it and said that we are the best in the world. The right hon. Gentleman should reflect on that before he starts to criticise and run down the NHS.

Let us talk about agency nurses. I am very proud of the fact that, in just over a year, we have 5,900 more nurses on our wards. That is an increase of 4,000 nurses across the system compared with when Labour was in power. Why is that? It is because we are doing something about the issue of safety and compassionate care—issues that the right hon. Gentleman repeatedly swept under the carpet when he was Health Secretary.

Finally, let me make this point. We are doing something that is a world first today: we are publishing staffing data on a hospital-by-hospital, ward-by-ward basis. Yes, we are also publishing which hospitals do not have an open and transparent reporting culture. Creating transparency about failures has, I am afraid, become one of the biggest dividing lines in this House. I think it is a very great shame that every time I raise the issue of poor care in the NHS, the right hon. Gentleman accuses me of running down the NHS and softening it up for privatisation, when what I am actually doing is standing up for patients, which is what he should have done when he was Health Secretary.

[Dr Sarah Wollaston (Totnes) (Con)]

I welcome today’s announcements. Unsafe care in the NHS carries not only a terrible personal cost, but a terrible financial cost—£1.3 billion a year in litigation alone—and I welcome the announcement of Sir Robert Francis’s review. Will the Secretary of State use this opportunity to reassure NHS staff that they do not need to wait for the outcome of that review, and that if they raise concerns about unsafe practice, not only will they be protected, but they would be failing their patients if they failed to do so?

Oral Answers to Questions

Sarah Wollaston Excerpts

Tuesday 10th June 2014 Commons Chamber

[Jane Ellison]

We want people in England to have the best cancer outcomes, and to bring those outcomes up to the best in Europe. We know we are not there yet, but we have done a range of things to try to make that happen, including putting a lot of money into early diagnostics. In my area of public health there are award-winning public campaigns such as Be Clear on Cancer, and I know that the cancer drugs fund has been appreciated by many people. I hear what the hon. Gentleman says about the Northern Ireland example.

[Dr Sarah Wollaston (Totnes) (Con)]

High-quality data will play an essential role in improving cancer outcomes. Will the Minister confirm that NHS England has addressed the concerns raised about the care.data programme, and that we are on track for a successful roll-out?

[Jane Ellison]

I confirm that we are.

Health

Sarah Wollaston Excerpts

Monday 9th June 2014 Commons Chamber

[Dr Sarah Wollaston (Totnes) (Con)]

May I start by paying tribute to my predecessor, Anthony Steen, for his tireless work in bringing in a modern slavery Bill?

Today, however, is for talking about health, which is a great passion for me in this place and outside it. The NHS touches people’s lives 1 million times every 36 hours, which is a staggering figure. I believe that the NHS is worth every penny of the nearly £110 billion that we spent on it in the last financial year. I am very proud that this Government have protected the health budget, but that does not of course mean that there are not enormous financial pressures. We are now in the fifth year of effectively near-flat funding, and the issues set out by the hon. Member for Ilford South (Mike Gapes) are part of those pressures. We know that whichever Government were in power, there would have been serious challenges.

If the NHS is to be sustainable, we need to listen to the new chief executive of NHS England, Simon Stevens, who has called on all staff members to think like a patient and act like a taxpayer—we must do that to get every ounce of value out of our NHS—and to address issues of patient safety and of how we keep people out of hospital in the first place and get on with implementing the measures. The nature of the challenge has been set out in exhaustive detail; now we need to get on with the measures that have been put in place to help to prevent hospital admissions, to treat people at the right time in the right place, and to integrate health and social care. I want us to look carefully at the better care fund and the plans for getting best value out of it, and at the issues of patient safety that were mentioned earlier.

Given the absence of much legislation in the Gracious Speech, there is one regret that I want to point out: the absence of the Law Commission’s draft Bill on the regulation of health and social care. I hope that in summing up this debate, the Minister will give some reassurance that he can use secondary legislation to bring forward at least some of the measures in that draft Bill. It covers issues that touch 1 million people across 32 professions that are covered by nine regulatory bodies. Unless we clarify the language so that there is a common language in respect of patient safety across all those regulators, it will be difficult to implement some of the core messages from Francis and to act quickly in response to emerging threats to protect the public.

Every year for three years, the Health Committee has called on the Government to allow the General Medical Council to appeal panel decisions that clearly have not protected the public. Likewise, the Nursing and Midwifery Council would like powers to reopen cases in which it has been judged there is “no case to answer” if serious new evidence emerges. Alongside that, the General Pharmaceutical Council would like to implement transparency and to be able to take enforcement action. Those are all simple measures that I hope the Minister will mention in summing up. I also want the unacceptable level of delays to be addressed.

[Norman Lamb]

I want to give a quick confirmation that we will do what we can through secondary legislation to do what the hon. Lady requests.

[Dr Wollaston]

I am very pleased to hear that.

There will not be an absence of debates on health in this place. Two Bills will probably come here from the Lords in this Session: the Medical Innovation Bill and the Assisted Dying Bill. I will briefly put some of my concerns about the Medical Innovation Bill on the record while there is time for it to be amended. I have no doubt that it was introduced with the best of intentions to bring forward innovative treatments. However, I fear that it will have the reverse effect: it could undermine research and open the door to the exploitation of people when they are at their most vulnerable.

Currently, clinical negligence law provides redress for patients who have been harmed as a result of treatments that would not be supported by anybody of medical opinion. There is insufficient evidence that doctors are not introducing new treatments or are put off from doing so because of the fear of litigation. The NHS Litigation Authority has made it clear that doctors are protected from medical litigation in that respect. However, the briefing note for the Saatchi Bill talks about a doctor being able to use a novel treatment if he is “instinctively impressed” by it. In other words, doctors will be able to use an anecdotal base for treatments, rather than a clear evidence base. There are dangers in going down that route.

There have been some amendments to the Bill. Lord Saatchi has accepted that a doctor should have to consult colleagues and their medical team, but not that they should consider a body of opinion or consult ethics committees. I fear that we could be turning the clock back. We should rightly be proud of the advances that we are making in the field of medical research. We should rightly be proud of the push towards greater transparency, particularly in respect of open data and drug trials. However, I fear that if we allow people to access innovative treatments that have no evidence base, we will open the door to the purveyors of snake oil, rather than those who want to allow patients to enter controlled trials to establish a clear medical evidence base.

We should not underestimate the extent to which the purveyors of snake oil are out there. I put on the record my congratulations to Westminster city council and its trading standards department on fighting two successful prosecutions under the Cancer Act 1939 against two individuals, Errol Denton and Stephen Ferguson, for peddling so-called nutritional microscopy to people who were at their most vulnerable—cancer patients and patients with HIV—and telling them that it was an alternative to evidence-based treatments.

We must therefore be careful in how we move forward with such legislation. We should take more notice of the concerns of the Medical Research Council, the Wellcome Trust and the Academy of Medical Royal Colleges, who feel not only that the Bill is unnecessary, but that it could turn the clock back on evidence-based medicine. I hope that the Government will look at the concerns that have been expressed about the Bill in its current form.

Finally, Lord Falconer’s Assisted Dying Bill would enable competent adults who were terminally ill to have assistance to end their lives, but it would require the involvement of a medical practitioner. Although the Bill comes under the responsibility of the Ministry of Justice, it would have profound implications for end-of-life care and medical practice. It would fundamentally change the relationship between doctors and patients. There is a risk that the right to die would slide into a duty to die. I have seen how often patients who are towards the end of their lives fear being a burden on their families, and they often go through periods of profound depression. I do not feel that this Bill is the way forward.