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Topical Questions

Volume 566: debated on Tuesday 16 July 2013

I know that the whole House will want to recognise the fact that this month marks the 65th anniversary of the NHS. This country blazed a trail by introducing universal health care coverage in 1948, and the NHS remains the single biggest reason why most people are proud to be British. The whole House will want to note that whatever failings are being exposed by a new era of transparency in NHS care, the overwhelming majority of doctors, nurses, health care assistants and managers do a remarkable job, working incredibly long hours for the benefit of us and our families, and we salute them for all they do.

When changes were made at Lewisham hospital, the Secretary of State refused to meet local campaigners. Following his announcement last week about changes to services at Trafford general hospital, local campaigners from Trafford would like to know if he is prepared to meet them.

That is not quite a fair representation of what happened in the case of Lewisham, or indeed for Trafford, because I agreed to meet all local MPs regarding Lewisham. These things are carefully constrained by what is legally possible so as to be fair to all sides, but I met all Lewisham MPs. As the hon. Lady knows, I have agreed to meet her—I think that we are meeting later this afternoon—and I am sure that she will express the concerns of campaigners in Trafford.

T5. Integrating health and social care is an especially important priority in areas with the fastest-ageing populations. With that in mind, do Ministers agree that it is vital to support joined-up initiatives such as Caring Together in north-east Cheshire, which involves the local clinical commissioning group, council and NHS trust? (165228)

My hon. Friend is absolutely right to highlight such initiatives. That was why the Government, as part of the Health and Social Care Act 2012, set up health and wellbeing boards, which bring together housing providers, the NHS, the third sector and social care locally so that they can look at how to improve and better integrate personalised care, especially for the frail elderly.

T2. In the 1960s and 1970s, the drug Primodos was given to pregnant women, resulting in serious birth defects in thousands of babies, who are now adults in their 40s. The then Committee on the Safety of Medicines failed to act in time, the scientist at Schering, the drug manufacturing company, accepted subsequently that he had made up his research, and the solicitor Peter Todd has described the events as the biggest medical and legal cover-up of the 20th century. Will the Secretary of State meet me and the victims of Primodos so that we can present our evidence on what has happened? (165224)

The hon. Lady is right to highlight the fact that when we have scientific and clinical data, they must be used responsibly, as the MMR scandal also indicated. Of course I would be delighted to meet her to talk through this matter further.

T8. In advance of the publication of the Keogh report later today, and following the revelations that Basildon hospital had one of the highest standard mortality rates following catastrophic failures, will my right hon. Friend assure the House and my constituents that he will support the new management regime in its attempts to improve the quality of care? Will he also tell the House if he found any evidence of a systematic attempt by the previous Prime Minister and the previous Government to cover up figures— (165231)

Order. The hon. Gentleman should not abuse topical questions to ask two questions, and he should be asking not about the policies of the previous Government, but about the policies of the present Government, on which I know the Secretary of State will briefly reply. We are grateful.

We will, of course, give every support to the management at Basildon to turn around their hospitals. The wonders of modern technology have informed us that the shadow Health Secretary was wrong to say that there has been a decline in nursing numbers in Basildon: they have actually gone up by nearly 100 since the last election.

T3. The Francis report recommended that the National Institute for Health and Care Excellence draw up minimum safe staffing levels that would be policed by the Care Quality Commission. It stated that NICE should develop“evidence-based tools for establishing”the staffing needs of each service in the NHS which is likely to be required“as a minimum in terms of staff numbers and skill mix.”Will the Minister tell us when the Government will act on this and all the recommendations in the report? (165226)

If the hon. Lady heard the exchange earlier, she will know that what Robert Francis was recommending was evidence-based tools, not a national minimum staffing level. The reason for that is that the number of nurses needed varies from hospital to hospital and ward to ward. We need to make sure that that happens. In the best hospitals it already does. The system that we have—this was supported by the shadow Health Secretary in his evidence to the Francis review—is not one where the Secretary of State sits behind his desk and dictates the number of nurses required in every hospital. If we did that, we would not be able to run the NHS properly, but we need to make sure that there are proper standards in place, which is why we have a chief inspector of hospitals to make sure that that happens.

T9. It is right that clinicians should speak out about safety in our hospitals, but does my right hon. Friend agree that now is probably not the right time for clinicians to be speculating in the national media about the safety at Leeds heart unit, given that the Department has yet to release the second phase of the review, as this endless speculation is causing great anxiety to already worried parents? (165232)

I agree with my hon. Friend. He has campaigned very honourably and sensibly for children’s heart services at Leeds. This is not a time for speculation. We will announce this month what the new process will be for resolving Safe and Sustainable. He and I both want this to happen as quickly as possible to remove that uncertainty. Also, we have to find a way of making sure that the data are solid and that we can trust them.

T4. Will the Secretary of State join me in congratulating Abbey primary school on becoming the first “silver star” school in Leicester for banning sugary drinks and for promoting healthy eating and exercise? Does he agree that this is the best way of preventing diabetes and obesity in later life? (165227)

Absolutely. I would be delighted to come along and visit the school. May I give full credit to the right hon. Gentleman for his campaign and to the Silver Star charity, which does great work? That is why it is so right that we put public health back in local authorities, where it should always have been and where it was, historically. This sort of local action is very much the way forward, so I congratulate the school and the right hon. Gentleman again.

Further to the question raised by the hon. Member for Walsall South (Valerie Vaz), I have met the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) regarding safe staffing levels and I provided a substantial file of evidence on behalf of the Florence Nightingale Foundation in support of its 1:8 registered nurse to patient ratio. What part of that evidence are Ministers unconvinced by?

I am sure the evidence to which the hon. Gentleman refers is very persuasive, but I am sure he would agree that a ratio such as 1:8 cannot be applied uniformly across his local hospital or across all local hospitals. It can vary from day to day, depending on the level of illness and the age of the people going into particular wards. The best hospitals have computer models that change the numbers of nurses operating in different wards on a daily basis. Other hospitals do not do that, except on a quarterly basis. That is the change that we need to make.

T6. Does the Secretary of State believe that making data on individual consultants public is pointless if hospitals are using informal mechanisms to frustrate patient choice, such as having a team of specialist nurses decide which consultant a patient is referred to? Will he reinforce patient choice and dissuade hospitals from doing that? (165229)

The hon. Lady is absolutely right to highlight the fact that we need more transparency in data and that patients have a right to know about the quality of surgical care, but it is also right that we need to look at that carefully across the different surgical specialties, and particularly at the different criteria that might also impact upon good care and good health care outcomes, particularly in oncology.

Two-year-old Oliver Rushton in my constituency has cerebral palsy and needs a selective dorsal rhizotomy if he is to be able to walk or stand on his own. Unfortunately, after considerable delay, Oliver’s request for NHS treatment has been turned down. He is now getting the treatment, but only after an incredible fundraising effort from his parents, who have personally raised £40,000 to pay for it. Will my hon. Friend meet me to discuss the case?

I would be very happy to meet my hon. Friend to discuss that case and the commissioning arrangements for the procedure, and indeed other treatment for patients with cerebral palsy.

T7. The guidance that the Government have produced on transferring funds from the NHS to local authority social care makes it clear that the money can be used to plug gaps in social care caused by cuts. Does that not just mean that the local authorities that are under most pressure because they have had the biggest cuts will not be in a position to develop the integrated health and care services that we would all like to see? (165230)

I hope that I can reassure the hon. Lady, because the conditions for accessing that £3.8 billion fund are absolutely clear. Local authorities will not be able to access it unless they can promise to maintain services at their current levels. They are allowed to make financial efficiencies, as is the NHS, and everyone needs to look at that, but not if it means a deterioration in services.

Being able to be visited frequently by one’s loved ones is a vital part of improving care for vulnerable older people in acute settings. How is closeness to home being taken into account in any service changes proposed by Monitor or the NHS Trust Development Authority?

First, I congratulate my hon. Friend on the admirable way he sticks up for his constituents in Stafford in incredibly difficult circumstances. I think that the whole House recognises what he has done. Secondly, in answer to his question, there is always a balance to be found, because we all recognise that, all things being equal, people would rather be treated nearer to where they live for exactly the reasons he gave. We also need to ensure that people get the best care when they arrive at hospital, which is why it is very important to go through these difficult processes to work out where that balance lies.

Is the Secretary of State aware of the increasing problems there are in A and E because of alcohol? If so, will he tell us what he is going to do about it?

There are problems, particularly in large cities and at weekends. In fact, in the case of the reorganisation of services at Trafford general hospital, one of the things that we can invest in as a result is mental health facilities in neighbouring A and Es so that people have better access to the services they need.

The Secretary of State will be aware of the case of Nadejah, the face of the Teenage Cancer Trust, who at the age of 23 has been refused the CyberKnife cancer treatment that could save her life. Her mother Michelle is here today. Will he intervene so that this young woman gets the treatment that her consultant, Professor Hochhauser, recommends, and will he meet Nadejah’s mother and me so that we can work together to unblock the funding so that she can get the treatment she so desperately needs?

I am more than happy to meet the hon. Lady and the family but, as she knows, this is a treatment that we have talked about endlessly, and we have had many meetings, which I am more than happy to continue to have with her.

Since 2010, thousands of NHS staff have left the NHS with big, fat redundancy cheques, only to go through the revolving door and get new jobs in the NHS, often months later. Will the Secretary of State tell us how much has been spent on redundancy payments and whether he regrets that waste of NHS money?

The hon. Lady asks that question as if that kind of thing never happened under Labour. The answer is that it is not acceptable, which is why we are changing the rules to ensure that people cannot get payoffs and then walk straight into another NHS job. The other answer is that the reorganisation that she criticises means that we have put more money on the front line, including for 6,000 more doctors, which I think was the right thing to do.

Does the Secretary of State agree it is a scandal that those, such as Gary Walker, Amanda Pollard and Kim Holt, who have exposed the horrors buried in our NHS have either been fired or do not have jobs, but those who are heavily implicated in such cases, such as Barbara Hakin—about whom I have written to the Secretary of State—David Nicholson, and others, still do?

My hon. Friend has campaigned long and hard on issues of accountability, and I agree with her basic case, even if I do not agree with her about all the individuals she mentioned. One issue that will arise during today’s statement is that of how people are held accountable. That has been missing in our NHS, and we must put it right.

There has been much talk about action plans and I am sorry that the Minister of State, Department of Health, the hon. Member for North Norfolk (Norman Lamb), is not in his place. Is the Health Secretary aware that Mencap has expressed concerns that the Government’s response to the “Six Lives” progress report by the Department of Health does not set goals or time scales for tackling the issues highlighted in that report?

I know that the care services Minister would have liked to be here but he is at his son’s graduation today. I will pass on the hon. Gentleman’s question and ensure that he receives a full response.

At the end of this month, the East of England Multi-Professional Deanery will remove junior doctors in paediatric services from Bedford hospital. That will reduce paediatric services, which will obviously cause major concerns for families with children in Bedford and Kempston and north Bedfordshire. Will my right hon. Friend join me and my hon. Friend the Member for North East Bedfordshire (Alistair Burt) in calling for an open and independent inquiry into why clinical supervisory failures continued at Bedford hospital and were not addressed, and into the terrible consequences that resulted from that?

I am sure my hon. Friend will be pleased that Health Education England, supported by the General Medical Council, took such rapid action to address concerns over patient safety and the supervision of junior doctors at his hospital. It is right that a rapid action plan has been brought in by local health care commissioners and Health Education England in order to support that, put in place the right supervision for medical staff, and ensure we put things right as quickly as possible.

Further to the question from the hon. Member for Bristol North West (Charlotte Leslie), Ministers often—quite rightly—mention the importance of whistleblowers, so why have the Government weakened protection for whistleblowers through the Enterprise and Regulatory Reform Act 2013?

We are strengthening protection for whistleblowers and are going much further by creating a culture of openness and transparency in the NHS, where people are not bullied if they speak out about poor care.

Torbay is often held up as a model for an integrated care service, but two important services are not fully integrated—mental health care and children’s services. Will the Government encourage the incorporation of all services into a fully integrated health care system?

My hon. Friend makes an important point and the heart of what he says is that integrated, joined-up care is most important for those who are regular users of the NHS. Children with complex needs or people with mental health conditions that can improve but not necessarily be cured can really benefit from an integrated approach. I salute what Torbay has done in blazing a trail. We are learning from that and hope that such a process will be rolled out in every part of the country as soon as possible.