Lord Darzi and I are already discussing a range of issues with staff, patients, the public and key stakeholders including the trade unions both locally and nationally to ensure their full involvement in the NHS next stage review.
I thank the Secretary of State for his response. I advise him that the work of the trade unions in the past 10 years in helping to put in place the NHS plan and “Agenda for Change” is a model that should be adapted in the review, so that the unions continue to play a comprehensive and supportive role in making the NHS even better than it is today.
I agree with my hon. Friend. Indeed, Lord Darzi was in his constituency yesterday, while visiting Gateshead PCT, which might be just outside his constituency. He has also met the leaders of all the major trade unions, and I very much agree with my hon. Friend that the trade union input has been positive throughout the NHS plan and all the events over the past 10 years. This is a huge opportunity for us to re-engage with the work force, which includes, of course, their trade unions.
Representatives of the midwives told the Oxfordshire health overview and scrutiny committee the other day that proposals to downgrade services at Horton hospital from consultant-led to midwife-led were utterly unacceptable. Will the Secretary of State and his team listen to the advice of the Royal College of Midwives and the Royal College of Nursing on those reconfiguration proposals, or will they simply be brushed to one side?
They will not be brushed to one side, and the hon. Gentleman knows full well that those proposals are local and are led by clinicians locally. I announced in my first week in this role that I would pass on all cases referred to me by the overview and scrutiny committee to the independent reconfiguration panel, which is clinician-led, because it is very important that those issues are driven locally, by clinicians in the area. The Royal College of Midwives, which has been to see me already, has very eloquent spokespeople on this issue, and they will be listened to—of course, they will—but as for my involvement, it is right that politicians stay back and allow those working in the health service and those responsible for health care to lead the proposals.
May I inform my right hon. Friend that one of my local newspapers claims to have a leaked e-mail from a middle manager of the Queen Mary’s hospital trust that sets out plans to downgrade accident and emergency services, close maternity and paediatric services and make cuts of £60 million? Such headlines will make it very difficult for Lord Ara Darzi to enter into a meaningful dialogue with local people and consult on the shape of future local services. What is Lord Darzi doing to address those speculative headlines, which are making it very difficult to have a meaningful dialogue about the future of our services?
I understand the point that my hon. Friend makes, because such headlines are totally unhelpful. [Interruption.] Of course, they are driven in part by the Conservative party’s opportunism. I shall give an example of the paradox. A couple of weeks ago, the hon. Member for South Cambridgeshire (Mr. Lansley) used an Opposition day to debate the very important issue of stroke care—it is absolutely essential that we debate such issues—and he quoted a National Audit Office report that came out in 2006 and said that, as a result of more efficient practice, £20 million could be saved annually, 550 deaths avoided and more than 1,700 people would fully recover who would previously have been disabled for life. We therefore have to change the health service to provide those kind of services. However, at the same time as pushing that, the Conservatives ask us for a moratorium on any change whatsoever. There cannot be such a moratorium, and we need to deal with the issues that my hon. Friend raises, not in headlines but in proper deliberative debate. That is what the Darzi review is all about.
Will the Secretary of State encourage Lord Darzi to engage one to one with all MPs in whose areas things are likely to change?
I will encourage Lord Darzi to deal on a one-to-one basis with all MPs. I am writing to all MPs to let them know where Lord Darzi, David Nicholson and the other 60 clinicians will be over the summer period, so that if any MP wants to turn up and perhaps give up a couple of days in Tuscany, he or she can go there and chat to him at leisure.
May I refer the Secretary of State to his Department’s press release on ministerial responsibilities? Under Lord Darzi’s name, it says:
“Lords business is being covered by a Lords Whip.”
I understand that Lord Darzi intends to spend little time in the other place, not to deal with any legislation and to answer few questions. Given that he is embarking on a fairly fundamental review of how the health service operates, dealing with the sort of issues raised by the hon. Member for Blaydon (Mr. Anderson), how on earth is Parliament supposed to hold him to account? Is this not precisely the sort of arrangement that the new Prime Minister indicated he opposed, whereby, effectively, Parliament is being sidelined?
With due respect to the hon. Gentleman, I do not think that that is the primary concern about health services. My belief is that Baroness Royall will cover many of the questions. She will be accountable on behalf of the Government. I know that the hon. Gentleman thinks a lot about these things. It is to everyone’s benefit to have someone of the reputation and skill of Lord Darzi, who will continue to practise two days a week, as well as meeting MPs individually and doing all the other things. He will continue to be a leading clinician in the health service and he will carry out the review, which will take up an awful lot of his time. It is innovative that not only do we have a clinician of his standing to lead the review—along with many other clinicians—we also have him as a Minister to ensure that, unlike with the Turner report or the Leitch report, we have someone in Government to carry the report through. That is of more interest to the public than who is answering questions in the Lords.
May I draw the Secretary of State back to the original question and ask him about his discussions with Unison in relation to the cuts around the country? Recently, the Secretary of State was quoted in the Health Service Journal as saying:
“We have listened a bit too much to the British Medical Association and not enough to unions like Unison.”
Interestingly enough, I agree with him. Perhaps he would like to listen to Karen Jennings, who is Unison’s head of health, and who said:
“These 600 compulsory redundancies will resonate across the NHS and strike fear into the hearts of local communities.”
The cuts are based on deficits, not clinical care. Will the Secretary of State step in and stop those cuts, which are affecting care in our hospitals?
First, may I welcome the hon. Gentleman, who is making his first outing at the Dispatch Box? I disagree profoundly with him and with other Opposition Members on this issue. As I understand it, they are asking for a moratorium on any change. [Interruption.] Yes, I read the seven steps. Step one was to have a moratorium on reconfigurations. Indeed—[Interruption.]
Order. Let the Secretary of State reply.
Indeed, the right hon. Member for Witney (Mr. Cameron), who I believe represents David Cameron’s Conservatives—I am not sure whether that is the same party as the one to which the hon. Member for South Cambridgeshire (Mr. Lansley) belongs—called at Prime Minister’s questions, on the back of the London review, for absolutely no further changes. Of course Opposition Members like to put out scare stories—that is part of their politics at the moment. However, the policy issue is that, with advances in medical science and new technology, and with changes in demography, we have to change our health service when it comes to issues such as stroke care, which we debated a couple of weeks ago, in order to save more lives. It would be perverse if we were to put a moratorium on saving lives.