Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 22nd March 2016 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for his persistent campaigning on behalf of his local trust. He is right that there are big issues there. He is also right generally that the NHS has too rapid a turnover of chief executives. There is a new one, Stephen Eames, who is one of the top-rate NHS chief executives. The Care Quality Commission says that things are improving and mortality rates are going down. I will support my hon. Friend in every way I can to resolve the situation as quickly as possible.

[Valerie Vaz (Walsall South) (Lab)]

As the Manor hospital is in special measures, Walsall mothers-to-be are being denied the right to choose to have their babies at that hospital. Will the Secretary of State confirm that there are safe staffing levels at the Manor and at other hospitals?

[Mr Hunt]

What I can tell the hon. Lady is that we have 83 more doctors and 426 more nurses at Walsall Healthcare NHS Trust than we did in May 2010. The trust has a quality improvement plan, and it has had an improvement director since February.

Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 9th February 2016 Commons Chamber

[Mr Hunt]

The advantage of the special measures programme is that we tend to make much faster progress in turning round hospitals in difficulty than used to happen in previous years. My hon. Friend will know that, in the past five years, his local trust gained nearly 50 more doctors and more than 100 more nurses. We are making progress, but we need to do it much faster. The hospital will have my full support in getting these problems dealt with quickly.

[Valerie Vaz (Walsall South) (Lab)]

Walsall NHS trust has been placed into special measures, so what immediate action can the Secretary of State take to ensure that the Manor hospital can recruit the vital staff in paediatrics and A&E that it now needs—not agency staff, but long-term fully employed staff?

[Mr Hunt]

The hon. Lady is absolutely right that one thing that can tip hospitals into special measures is having too high a proportion of staff from agencies so that a trust cannot offer the continuity of care that other trusts can. There have been an extra 83 full-time doctors at Walsall Healthcare NHS Trust over the past five years, along with 422 full-time nurses. An improvement director started this week and we are looking to find a buddy hospital, which is what I think will help most. When it comes to turning hospitals round the fastest, we have found that having a partner hospital can have the biggest effect, as with Guy’s and St Thomas’s for the Medway.

NHS and Social Care Commission

Valerie Vaz Excerpts

Thursday 28th January 2016 Commons Chamber

[Valerie Vaz (Walsall South) (Lab)]

It is always a pleasure to follow the hon. Member for Stafford (Jeremy Lefroy), who is a great defender of the NHS, both locally and nationally. I congratulate the right hon. Member for North Norfolk (Norman Lamb), who was a very assiduous Minister; my hon. Friend the Member for Leicester West (Liz Kendall), who is not in her place but who was an assiduous shadow Minister; and the hon. Member for Central Suffolk and North Ipswich (Dr Poulter), who unfortunately cannot be here but who was also an assiduous Minister and a member of the Health Committee.

It is with great difficulty and a bit of sadness that I say that I do not support the motion. I know that it comes with great heavyweight backing from public figures—MPs and former Ministers—but I do not think that it will take the debate forward. When we set up a commission, it can feel like we are kicking something into the long grass, and that is what it feels like we are doing today. This issue has been going on for a long time, and it is, I feel, a lack of political will that is failing to drive the changes forward.

We have had the evidence. There has been a pilot scheme, which was set up by my right hon. Friend the Member for Leigh (Andy Burnham) in Torbay in 2009. The integrated care trust is operating. A former Secretary of State for Health, Stephen Dorrell, who was a very good Chair of the Select Committee on which I served, gave an interview on 22 January in The House magazine in which he recalls asking an adviser:

“What is the oldest quote from a health minister saying how important it is to join up health and care services?”

This answer came back:

“Dick Crossman, the Health Secretary in the late 1960s.”

That is how long this issue has been going on, and it has cross-party support.

I want to touch on what some hon. Members have been saying about cross-party support. Perhaps I have been on a different planet, or perhaps, a bit like Bobby in “Dallas”, I have woken up and it is all a dream, but I recall being on a cross-party Health Committee, ably chaired by Stephen Dorrell, that produced many reports, but never a minority report. We came up with a number of conclusions that Members are now saying that we should consider.

In our report on public expenditure, we said that very little of the money spent by the NHS on people with long-term conditions was spent in an integrated way, which meant that significant amounts of money were wasted. In our report on commissioning, we said the NHS Commissioning Board should work closely with local commissioning bodies

“to facilitate budget pooling and service integration to reflect patient priorities.”

In our 12th report of the 2010-12 Session on social care, we said that efficiency savings would not be possible without further integration between health and social care. That has been an aim of successive Governments, but has not been properly achieved.

In our 11th report of the 2012-13 Session, “Public Expenditure of Health and Social Care”, we said that

“health and wellbeing boards and clinical commissioning groups should be placed under a duty to demonstrate how they intend to deliver a commissioning process which provides integrated health, social care and social housing services in their area”

and that there was

“evidence, for example, that 30% of admissions to the acute sector are unnecessary or could have been avoided if the conditions had been detected and treated earlier through an integrated health and care system.”

In our seventh report of the 2013-14 Session, “Public Expenditure on Health and Social Care”, we said that

“fragmented commissioning structures significantly inhibit the growth of truly integrated services.”

In our second report of the 2014-15 Session, “Managing the care of people with long-term conditions”, we said that

“in many cases commissioning of services for LTCs remains fragmented and that care centred on the person is remote from the experience of many”

and that an integrated approach was necessary to relieve pressure on acute care.

Members of the Health Committee, including the hon. Member for Totnes (Dr Wollaston) and my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), who unfortunately had to leave this debate to go to a young carers’ meeting in her constituency, have all sat through that evidence. I know it is real, because it will be on the website of the Health Committee. There are pages and pages of evidence on where we can get things right.

In particular, our report on “Social Care” said:

“Although the Government has ‘signed-up’ to the idea of integration, little action has taken place... The Committee does not believe that the proposals in the Health and Social Care Bill will simplify this process.”

We called for a single commissioner with a single pot of money who would bring together the different pots of money and decide how resources would be deployed.

One thing we did as part of our inquiry into health and social care was to visit Torbay, which has not been mentioned today, where we saw integrated care in action. Mrs Smith, who is fictitious but could be any one of our constituents, has one point of contact: she only has to make one phone call. Mrs Smith has seamless social care up to the health service and back again. The health service workers have been upskilled and can help her through the whole system. The local authority and the local hospital worked together so that when Mrs Smith is unwell and has to go to hospital, she can be tracked through the whole system. That is integrated care in action in Torbay. One concern was what would happen and whether such integrated systems would work under the Health and Social Care Act 2012, but I have seen it working.

There is another interesting area where integrated care is working. Another visit we made was to look at integrated care in Denmark and Sweden. In Denmark, we saw the most fabulous building in which elderly people could be cared for, and where they could be visited by GPs. It looked more like a hotel than a home. We were told, “We are looking at your system. We are looking at Mrs Smith.” At that point, we nearly fell off our chairs, because we had come to Denmark to find out how its system works.

[Norman Lamb]

I appreciate the hon. Lady’s kind words. She is talking about all the various initiatives and the need for political will, but the conclusion is that none of those things has happened. There has not been the political will because of the acutely partisan environment in which we all work. Does that not make the case for a process—which the Government could buy into and all the parties could commit to—that will deliver change in a defined period?

[Valerie Vaz]

I think that the Health Committee structure has such a purpose.

[Norman Lamb]

The Government have not bought into it.

[Valerie Vaz]

Well, they have. The Government have a responsibility to respond to the Health Committee. If the right hon. Gentleman waits until the end of the speech, he will see where I am heading. I agree with his idea that something needs to be put together. I do not like knocking good ideas on the head; I like to see such things taken forward. As the hon. Member for Stafford (Jeremy Lefroy) said, it is either “a commission or whatever”. It may be that the right hon. Member for North Norfolk has a good role to play in pulling all this together and taking forward the idea somehow, but at the end of the day, it is a political decision for the Government of the day to consider.

I want to move on to discuss my local hospital, Manor hospital, and the local authority. In Walsall, we are lucky to have a settled community, and we have one local authority dealing with the local hospital. Work is carried out by the local authority and the hospital together, and they can talk things through. When difficulties arose at the hospital in Stafford—the A&E closed, and we had to take on extra maternity services—it was much more difficult, taking on patients from different areas, to deal with local authorities in different areas. Such relationships had not been built up, but they can be built up and, with the best will in the world, I am sure they will be. We know that workers in the health service work very hard and extremely well together to ensure that such relationships exist. If that works for one local authority, I am sure it can work for other neighbouring authorities.

Interestingly, the right hon. Member for North Norfolk has involved two former Secretaries of State for Health, Alan Milburn and Stephen Dorrell, in his commission. If I was really cruel, I might say that they were Secretaries of State for Health, so why did they not do something about it then and why do they think they can do something about it now? As I have said, there is a way forward. Many Members have alluded to the myriad reports. The King’s Fund has produced a report, the Nuffield Trust has produced one and many universities have produced reports. There have been lots of words, but we need a little more action.

My only difficulty with the proposed commission is the accountability structure. I am not sure who it would report to and there would be no obligation on the Government to respond to it in the way that they have to respond to the Health Committee.

I want to touch on the issue of money. We had a reorganisation of the health service that cost £2 billion and counting. If the Government can sit down with a company to reduce its tax liability and, hence, what flows into the coffers of the Treasury, that has an enormous impact on the Mrs Smiths of this world and on all of us. That is why, as our second report of 2014-15 stated, the Government said in evidence to the Select Committee that

“the ambition of achieving integrated health and care services by 2017 had been given ‘quite a turbo charge’ by the introduction of the Better Care Fund”.

The then Minister of State, the right hon. Member for North Norfolk, said that

“by 2015 the whole country will be starting to see a significant change.”

That may be something that the Health Committee could look at and produce a report on or even that the “commission”—in inverted commas—or whatever it is that the right hon. Gentleman and his colleagues extract from the Government could consider.

We have the evidence—we have the care trust and the pilot—and, in the Government’s own turbo-charged words, we have the will, hopefully. Finally, I am not persuaded that a commission will bring about the change that all of us so desperately need.

Infected Blood

Valerie Vaz Excerpts

Thursday 21st January 2016 Commons Chamber

[Jane Ellison]

I thank the hon. Gentleman for that question and his sustained interest over such a long time, speaking on behalf of people from his area. Based on our previous conversations, I recognise there might be aspects of the proposals that the hon. Gentleman does not feel meet his own aspirations, so again I invite him to respond to the consultation. I will take note of his—and all other Members’—views. These are our proposals. Some of the questions are very open and people can give us their views. I recognise that something different happened in the Republic of Ireland, and it is down to another Government to make those decisions. The circumstances were different for reasons I have gone into previously from this Dispatch Box.

[Valerie Vaz (Walsall South) (Lab)]

The Minister will know that some of the cases go back many years and the medical records may have been destroyed. Can she say in a little more detail what evidence is required both at the assessment stage and for those applying to the discretionary fund?

[Jane Ellison]

In truth, it is a little too early for me to give that level of detail. We want to ask for expert advice on that in order to get it right and, as I said in the statement, we are looking at the impact on people’s health now. We do not want this to be an invasive or onerous process for the people, who have gone through so much already, so we envisage involving people’s own clinicians as well as gathering other evidence. This is something we will ask experts to advise us on and we will come back at the end of the consultation.

Junior Doctors Contract

Valerie Vaz Excerpts

Monday 30th November 2015 Commons Chamber

[Mr Hunt]

I agree with my hon. Friend, who has great knowledge of NHS matters. I simply say to junior doctors that this is not just about contracts and pay; it is also about training. Having consultants more available at weekends will help improve training for junior doctors. We will also need to look at continuity of training, which I think has been undermined in recent decades. If junior doctors are looking for a visible reflection of this Government’s commitment to the NHS, they should look at last week’s spending review statement and the extra resources we are putting into the NHS in very tight circumstances. This Government are backing the NHS, and we are doing everything we can to back junior doctors as part of that.

[Valerie Vaz (Walsall South) (Lab)]

Thank you, Mr Speaker—I was standing.

The Secretary of State referred in his statement—in the last line of page 1 of the copy we have been given—to a “time-limited period” during which negotiations will take place. Is that a day, a week or a month? Will the contract be imposed after that?

[Mr Hunt]

I hope that the hon. Lady will understand that, because I very much hope that the BMA’s junior doctors executive committee will agree to go ahead with the agreement we have made with its negotiators, I do not want at this stage to go into further details about its contents. Obviously, the agreement will be published as soon as it is made, but I think that I would be pre-empting that decision by going into detail. It is a reasonable period of time for negotiations to take place.

Care Homes (Regulation)

Valerie Vaz Excerpts

Wednesday 4th November 2015 Westminster Hall

[Several hon. Members rose—]

[Valerie Vaz (in the Chair)]

Order. I intend to start the winding-up speeches at 10 past 5.

NHS (Contracts and Conditions)

Valerie Vaz Excerpts

Monday 14th September 2015 Westminster Hall

[Valerie Vaz (in the Chair)]

A digital debate took place on Twitter, ahead of today’s debate. Mr Speaker has agreed that for this debate members of the public can use handheld electronic devices in the Public Gallery, provided that they are silent. Photos, however, must not be taken.

[Helen Jones (Warrington North) (Lab)]

I beg to move,

That this House has considered the e-petition relating to contracts and conditions in the NHS.

It is a pleasure to serve under your chairmanship, Ms Vaz, and, in particular, to be debating the first petition to reach the debate stage under the new system for dealing with e-petitions. The original petition on the joint Government and Parliament website called for a vote of no confidence in the Secretary of State for Health. Fortunately for him—or unfortunately, depending on how people want to look at it—the Petitions Committee does not have the power to initiate a vote of no confidence, and so we decided that the debate should be on the issue underlying the petition, which was the contracts and conditions of NHS staff.

I might be joking about motions of no confidence in the Secretary of State, but the morale of NHS staff is not a joke. It is a long time since I last saw dedicated doctors, nurses and ancillary staff so demoralised and, sometimes, despairing. If we look at the current state of the NHS we can see why. A&E departments are in crisis and missed waiting time targets for the whole of last winter. GP services are struggling to cope, and patients find it harder and harder to get appointments. Last year, the deficit across trusts was nearly £1 billion; this year, that is predicted to double.

Yet despite all that, NHS staff work miracles every day. Who could not be proud of some of the achievements of our surgeons? Who could sit in an A&E department, as I unfortunately had to during the election, seeing the endless patience of NHS staff, and not be grateful to them? Who could watch paramedics dealing with an accident or reassuring a frail and confused elderly patient and not be ever grateful for the NHS? After the Olympic opening ceremony, I remember one American reporter said, “Oh, it’s just like praising UnitedHealthcare.” No, it is not. The NHS is not like UnitedHealthcare, thankfully, and that is why we value it.

NHS staff have been badly treated by this Government. Since 2010 pay increases have been deliberately kept low and last year we saw some staff being told that they could not have even a 1% increase if they were due to get an increment as well. The Government often talk about public services as if they were a drain on the economy, but they are not. Services such as the NHS are a huge contributor to our economy. It is completely wrong that, under this Government, tax is cut for millionaires but dedicated NHS staff are not even entitled to a decent pay rise.

Indeed, in the previous Parliament the NHS was told to make £20 billion of what the Government call efficiency savings but the rest of us call cuts. That is due to rise to £30 billion by the end of this Parliament. The NHS is struggling to cope with fewer and fewer resources but more and more patients. Many of the difficulties being encountered are of the Government’s own making. Ministers criticise spending on agency staff, but the Government’s first act on coming into office in 2010 was to cut nurse training places by over 3,000 a year.

--- Later in debate ---

[Maria Caulfield]

I declare an interest as a former NHS nurse—in fact, I still work as a nurse. I do not want to be political about this, because I want progress to be made on supporting the NHS, and particularly staff, but one of the single biggest factors in demoralising nurses and leading many skilled nurses to leave the practice was the last Labour Government’s change to the skill mix. That was crucial, because we were forced to cut our budgets, particularly on the wards, and junior nurses were left in charge of wards, instead of experienced senior staff nurses and sisters—

[Valerie Vaz (in the Chair)]

Order. I remind Members that interventions should be brief.

[Maria Caulfield]

Can I just say that it is the change to the skill mix that has demoralised nurses, and that did not happen under this Government?

--- Later in debate ---

[Mary Robinson]

Will my hon. Friend give way?

[Valerie Vaz (in the Chair)]

I believe that the hon. Lady had just finished.

NHS Reform

Valerie Vaz Excerpts

Thursday 16th July 2015 Commons Chamber

[Mr Hunt]

I thank my hon. Friend because he leads by example as a first responder and does a fantastic job in his constituency—indeed, that role takes place at weekends. Paramedics and ambulance services operate a seven-day service. Nurses, paramedics and others who work in hospitals currently do not have an opt-out; consultants are the only ones who do. These measures will give ambulance services confidence that if they take someone to hospital at the weekend, there will be a proper senior consultant present and their patient will get in front of the right person. That will make their job all the more rewarding.

[Valerie Vaz (Walsall South) (Lab)]

The Secretary of State has not outlined what steps should be taken to recruit, train and retain front-line staff who are key to patient safety.

[Mr Hunt]

We have big plans to recruit and retain staff, and those are being worked up by Health Education England. We think that we will need extra doctors to deliver seven-day care, just as we will need more GPs. We think we can afford that within the extra £10 billion that we are putting into the NHS, and we are ensuring that all the numbers add up. I am sure that I will inform the House once we have come to a conclusion.

Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 7th July 2015 Commons Chamber

[Mr Hunt]

I am sorry that my hon. Friend had to go to hospital at the start of the election campaign, but I congratulate her on being probably the only Member of the House to have launched their campaign from an NHS hospital ward. I trust that all the nurses voted for her as a result.

Inexplicably, the trust that my hon. Friend talked about was made a foundation trust in 2008, despite a number of problems that were not recognised. Since then, it has made dramatic improvements in its care, with more doctors and more nurses. I am delighted that it is on track to deliver better care.

[Valerie Vaz (Walsall South) (Lab)]

How many of the hospitals in special measures have implemented recommendation 13 of the final Francis report on fundamental standards?

[Mr Hunt]

I would expect that all trusts have done so. If they have not, they will not come out of special measures. That is the benefit of a rigorous, independent inspection regime. Seven trusts have come out of special measures. I hope that the others will come out in due course, but that is not a decision for me; rightly, it is a decision for the chief inspector of hospitals.

Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Mr Hunt]

I share my hon. Friend’s concern about what is happening at the Royal Stoke. Some of the care there was totally unacceptable; there should be no 12-hour trolley waits anywhere in the NHS. I have said that I support a full 24/7 A&E service at County hospital as soon as we can find a way of doing it that is clinically safe, and I will certainly work hard to do everything I can to make that happen.

[Valerie Vaz (Walsall South) (Lab)]

Will the Secretary of State ensure that other local hospitals, such as the Manor hospital, which have had to take up the slack following the closure of A&E and maternity services also get some support?

[Mr Hunt]

We absolutely will take a whole health economy view of that, and look at all hospitals that are affected by the changes.