Browse content similar to 11/02/2016. Check below for episodes and series from the same categories and more!
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confident the ministers will do their best to ensure the regime in | :00:00. | :00:00. | |
place will deal with the challenges they face in the tragic situations | :00:00. | :00:09. | |
around family breakdown. On the 21st of January I asked for the Leader of | :00:10. | :00:15. | |
the House to get the meeting the prime Minister promised with my | :00:16. | :00:20. | |
constituents regarding the scandal of the baby Ashes. I have heard | :00:21. | :00:28. | |
nothing. I also asked the Minister for Justice and the 26th of January, | :00:29. | :00:34. | |
and I have not heard from her either. Politicians need to keep | :00:35. | :00:41. | |
their promises, and we would like this meeting. I have checked on this | :00:42. | :00:45. | |
and I think she has possibly misinterpreted the response. If the | :00:46. | :00:49. | |
ministerial meeting has not come through I will follow it today. The | :00:50. | :00:57. | |
flooding in your was devastating for so many because so many could not | :00:58. | :01:03. | |
afford insurance. The government still have not applied for the EU | :01:04. | :01:09. | |
Solidarity fund. Can we have an urgent statement as to why that has | :01:10. | :01:13. | |
not taken place and what progress is being made? The government's | :01:14. | :01:20. | |
approach is being trying to get finance on those who need it | :01:21. | :01:25. | |
quickly, rather than complicated bidding processes. If you look at | :01:26. | :01:28. | |
the amounts of money provided, I think we have done the right thing. | :01:29. | :01:37. | |
Last Saturday marked the 126th anniversary of the landmark colliery | :01:38. | :01:39. | |
disaster in my constituency in which a number of men and boys lost their | :01:40. | :01:48. | |
lives. Can we have a debate on the sacrifices made by miners and their | :01:49. | :01:53. | |
families and communities over generations? There is no doubt that | :01:54. | :01:59. | |
mining communities played a huge role in this country. They provided | :02:00. | :02:04. | |
the energy which kept this country going for decades. I am glad that | :02:05. | :02:09. | |
today we can provide energy sources from a variety of different areas so | :02:10. | :02:14. | |
we do not have too subject those workers to those conditions today. | :02:15. | :02:20. | |
Order. Statement, the Secretary of State for health, Secretary Jeremy | :02:21. | :02:34. | |
Hunt. Nearly three years ago today the government first sat down with | :02:35. | :02:37. | |
the British Medical Association to negotiate a contract for junior | :02:38. | :02:41. | |
doctors. Both sides agreed that the current arrangements drawn up in | :02:42. | :02:45. | |
1999 were not fit for purpose. And that the system of paying for a | :02:46. | :02:49. | |
unsociable hours was unfair. Under the existing contact, Dutch | :02:50. | :02:57. | |
contract, doctors can receive different pay for different | :02:58. | :02:59. | |
unsociable hours. Doctors paying nights can be paid the same as those | :03:00. | :03:09. | |
who do not, and pay rise can be triggered for all doctors on a road | :03:10. | :03:14. | |
if they stay past their shift length. Despite the unfairness of | :03:15. | :03:19. | |
this, processing it and reforming it has been slow, with the BMA walking | :03:20. | :03:23. | |
out without notice before the general election. Following the | :03:24. | :03:33. | |
election, which... The committee refused point blank to reforms. | :03:34. | :03:42. | |
Discussions started with ACAS in December, but we have since have two | :03:43. | :03:47. | |
damaging strikes with operation cancelled. In January I asked the | :03:48. | :03:55. | |
chief executive of Salford Royal to read the negotiating team for the | :03:56. | :03:59. | |
government. Under his outstanding leadership, for which the whole | :04:00. | :04:03. | |
House will be immensely grateful, progress has been made on almost 100 | :04:04. | :04:08. | |
different points of discussion, with agreement secured the BMA on | :04:09. | :04:13. | |
approximately 90% of them. Despite this progress and willingness from | :04:14. | :04:16. | |
the government to be flexible on the crucial issue of Saturday paid, Sir | :04:17. | :04:22. | |
David wrote to me yesterday advising that a negotiated solution is not | :04:23. | :04:27. | |
realistically possible. Along with other senior NHS leaders and | :04:28. | :04:32. | |
supported by NHS employers, the NHS can Confederation, he has asked me | :04:33. | :04:39. | |
to end the uncertainty for the service by preceding with the | :04:40. | :04:46. | |
introduction of a new contract that they consider safer for patients and | :04:47. | :04:51. | |
reasonable for junior doctors. I have decided to do that. Tired | :04:52. | :04:59. | |
doctors risk patient safety. In a new contract, the maximum number of | :05:00. | :05:02. | |
hours worked in one week will be reduced from 91, 272. The number of | :05:03. | :05:11. | |
consecutive -- the maximum number of consecutive nights will be reduced | :05:12. | :05:16. | |
from seven, two four. The maximum number of long days will be reduced | :05:17. | :05:23. | |
from seven, 25. No doctor will ever be working to consecutive weekends. | :05:24. | :05:27. | |
Banning substantial improvements to patient safety and Doctor | :05:28. | :05:30. | |
well-being. We will also introduce a new guardian role who will have the | :05:31. | :05:41. | |
authority to impose fines for breaches in work. A new contract | :05:42. | :05:47. | |
will give additional paid to those working Saturday evenings from 5pm, | :05:48. | :05:54. | |
nights from 9pm until 7am, and all day on Sunday. I said the government | :05:55. | :06:04. | |
was willing to be flexible on Saturday premium paid, and we have | :06:05. | :06:11. | |
been. Those working one in four or more or more Saturdays, will receive | :06:12. | :06:16. | |
a paid premium of 30%, which is higher than average of that | :06:17. | :06:21. | |
available to most other clinical staff. It is also a higher premium | :06:22. | :06:26. | |
of that available to fire officers, police officers and those in other | :06:27. | :06:30. | |
walks of life. Nonetheless it still represents a reduction compared to | :06:31. | :06:39. | |
current rates. At is necessary to ensure they can afford weekend | :06:40. | :06:43. | |
rostering. We do not want take on paid to go down for junior doctors, | :06:44. | :06:49. | |
so I can tell the House that they will receive an increase of basic | :06:50. | :07:04. | |
salary, of not 11%, but of 13.5%. No trainee working within contracted | :07:05. | :07:08. | |
hours will have their pay cut. Our strong preference was also for a | :07:09. | :07:12. | |
negotiated solution. Our door remained open for three years. We | :07:13. | :07:17. | |
demonstrated time and again our willingness to negotiate with the | :07:18. | :07:25. | |
BMA on their concerns. However the definition of negotiation is a | :07:26. | :07:28. | |
discussion where both sides demonstrate flexibility and | :07:29. | :07:37. | |
compromise, and the BMA proved unwilling to do this. In such a | :07:38. | :07:41. | |
situation, any government must do what is right for both patients and | :07:42. | :07:50. | |
doctors. We have now had eight independent studies in the last five | :07:51. | :07:55. | |
years identifying higher mortality rates at the weekend to be a key | :07:56. | :07:59. | |
challenge is to be addressed. Six of these say that staffing levels need | :08:00. | :08:04. | |
to be investigated. Professors describe the status quo as | :08:05. | :08:07. | |
unavoidable weekend affect. -- effect, which could save lives if | :08:08. | :08:13. | |
addressed. They have set out ten clinical standards necessary to | :08:14. | :08:16. | |
remedy this. Today we're taking one important step necessary. | :08:17. | :08:22. | |
And I understand that this process has generated dismay amongst junior | :08:23. | :08:29. | |
doctors, I believe that this new contract we are introducing shaped | :08:30. | :08:33. | |
by Sir David Dalton and with over 90% of the measures agreed by the | :08:34. | :08:37. | |
BMA through negotiation, it is one that in time can command the | :08:38. | :08:40. | |
confidence of both the workforce and their employers. I do believe, | :08:41. | :08:47. | |
however, that the process of negotiation has uncovered some wider | :08:48. | :08:51. | |
and more deep-seated issues relating to the morale of June doctors and | :08:52. | :08:55. | |
the quality of life, which must be addressed. -- junior doctors. This | :08:56. | :09:02. | |
includes inflexibility around these, lack of notice about placements that | :09:03. | :09:07. | |
can be a long way from home. Separation from spouses and families | :09:08. | :09:11. | |
and sometimes inadequate support from employers, professional bodies | :09:12. | :09:17. | |
and senior clinicians. I have asked Professor Dame Sue Bailey, president | :09:18. | :09:21. | |
of the Academy of Royal colleges, alongside other senior clinicians to | :09:22. | :09:26. | |
beat a review into measures outside of the contracts that can be taken | :09:27. | :09:31. | |
to improve the morale of the junior doctor workforce. Further details of | :09:32. | :09:37. | |
this review will be set out soon. Mr Speaker, no government or Health | :09:38. | :09:38. | |
Secretary could responsibly ignore the evidence that hospital mortality | :09:39. | :09:46. | |
rates are higher at the weekend or the overwhelming consensus that the | :09:47. | :09:51. | |
standard of weekend services is to bowl with insufficient senior | :09:52. | :09:55. | |
clinical physician 's -- decision-makers. The likes of | :09:56. | :10:01. | |
Morecambe Bay and Basildon show that patients suffer when governments | :10:02. | :10:04. | |
drag their feet over such high mortality rates and this covenant is | :10:05. | :10:09. | |
determined our NHS should offer the safest, highest quality care in the | :10:10. | :10:13. | |
world. We have committed an extra ?10 billion to the NHS this | :10:14. | :10:16. | |
Parliament. But with that extra funding must, reform to deliver | :10:17. | :10:22. | |
safer services across all seven days. This is not just about | :10:23. | :10:26. | |
changing the contracts of doctors, we need better we can support | :10:27. | :10:32. | |
services, such as physiotherapy, pharmacy and diagnostic scans as | :10:33. | :10:36. | |
well as social care services over seven days, better discharging and | :10:37. | :10:41. | |
primary care access to avoid problems and admissions at the | :10:42. | :10:45. | |
weekends. Today this is a decisive step forward to deliver our | :10:46. | :10:49. | |
manifesto commitment and I commend this statement to the House. | :10:50. | :10:55. | |
Thank you, Mr Speaker. I am grateful to the Secretary of State for | :10:56. | :11:01. | |
advanced sight of his statement. It would have been good to have plagued | :11:02. | :11:05. | |
this exchange on Monday during the urgent question but be no that the | :11:06. | :11:08. | |
secretary of state could not be bothered to turn up. Mr Speaker, you | :11:09. | :11:14. | |
might also think that the House Secretary would do me the courtesy | :11:15. | :11:17. | |
of responding to the two letters I have said to him in the last week, | :11:18. | :11:24. | |
but you would be wrong. So much for a health service over seven days, a | :11:25. | :11:28. | |
five-day elite Health Secretary would be nice! Mr Speaker, this | :11:29. | :11:35. | |
whole dispute could have been handled differently. They have | :11:36. | :11:38. | |
Secretary's failure to listen to junior doctors, has deeply dubious | :11:39. | :11:44. | |
misrepresentation about research and care at the weekends and his desire | :11:45. | :11:48. | |
to make these contract negotiations into a symbolic fight for delivery | :11:49. | :11:54. | |
of services over seven days has led to a situation that has been | :11:55. | :11:59. | |
unprecedented in my lifetime. Everyone, including the BMA, agrees | :12:00. | :12:05. | |
with the need to reform the current contract, but hardly anyone thinks | :12:06. | :12:09. | |
they need to do that is so urgent that it justifies imposition and all | :12:10. | :12:15. | |
the chaos that will bring. The Health Secretary, Mr Speaker, said | :12:16. | :12:18. | |
NHS leaders have asked him to end the uncertainty, but can you confirm | :12:19. | :12:25. | |
that means the support imposing a new contract? One of the hospital | :12:26. | :12:31. | |
chief executives, who the secretary of state claims are supporting, he | :12:32. | :12:36. | |
has treated this morning. I have supported the view that the offer | :12:37. | :12:40. | |
made is reasonable. I have not supported contract imposition. That | :12:41. | :12:45. | |
is what he has said. For clarity, can he categorically say that the | :12:46. | :12:49. | |
NHS leaders he mentioned all fully support his actions today? Can the | :12:50. | :12:55. | |
Health Secretary not see that imposing a new contract which does | :12:56. | :13:00. | |
not enjoy the confidence of junior doctors will destroy morale, which | :13:01. | :13:05. | |
is already at rock bottom? Does he not realise that this decision could | :13:06. | :13:10. | |
lead to a protracted period of industrial action, which will be | :13:11. | :13:15. | |
distressing for everyone. Patients, doctors, everyone who works in or | :13:16. | :13:21. | |
depends upon the NHS? Order! Far too much noise in the Chamber, let me | :13:22. | :13:25. | |
say to members on both sides of the House who are shouting out, do it | :13:26. | :13:31. | |
again and you will not be called. As simple as that. If members cannot | :13:32. | :13:35. | |
exercise the self restraint to be quiet whilst the front benches are | :13:36. | :13:39. | |
speaking, they have no business in taking part in the exchanges. | :13:40. | :13:44. | |
Heidi Alexander. Grateful, Mr Speaker, what is the House secretary | :13:45. | :13:47. | |
honestly think the impact of an imposed contract would be on | :13:48. | :13:52. | |
recruitment and retention? A poll earlier this week found that nearly | :13:53. | :13:56. | |
90% of junior doctors are prepared to be the NHS if a contract is | :13:57. | :14:01. | |
imposed. How does the Health Secretary propose to deliver | :14:02. | :14:07. | |
services over seven days but one tenth of the current junior doctor | :14:08. | :14:11. | |
workforce? How can it possibly be right for us to be training junior | :14:12. | :14:16. | |
doctors and the consultants of tomorrow only to be exporting them | :14:17. | :14:20. | |
on Mars to the southern hemisphere? The Health Secretary needs to stop | :14:21. | :14:27. | |
behaving like a recruiting agent for Australian hospitals and start | :14:28. | :14:31. | |
acting like the Secretary of State for our NHS. Mr Speaker, I would | :14:32. | :14:35. | |
also like to ask the Secretary of State what advice he has taken | :14:36. | :14:40. | |
before making this decision. He may not want to respond to my letters, | :14:41. | :14:46. | |
but what does he say to the volume -- Royal College of Surgeons, Royal | :14:47. | :14:49. | |
College of obstetricians and an ecologist? All of whom have or is | :14:50. | :14:55. | |
the Secretary of State not to impose a contract? What legal advice has | :14:56. | :15:01. | |
the secretary of state taken about how an imposed contract would work | :15:02. | :15:05. | |
in practice? What employment rights do junior doctors have in this | :15:06. | :15:11. | |
context and what happens if they simply refuse to sign? Mr Speaker, | :15:12. | :15:15. | |
the Health Secretary has been keen to present a new junior doctor | :15:16. | :15:20. | |
contract as the chief watch on mocks the delivery of services over seven | :15:21. | :15:25. | |
days. This is a massive oversimplification and he knows it! | :15:26. | :15:30. | |
Whilst research shows a high mortality rate among patients | :15:31. | :15:35. | |
admitted to hospital at the weekend, there is absolutely no evidence | :15:36. | :15:38. | |
which shows a lack of junior doctors specifically causes this. Will he | :15:39. | :15:44. | |
stayed for the record that he accepts that? One of the real | :15:45. | :15:48. | |
barriers to more consistent services over seven days is the consultant | :15:49. | :15:53. | |
contract and Tom now, at least, the BMA and the government were making | :15:54. | :15:57. | |
progress in those negotiations. Could a decision to impose a new | :15:58. | :16:04. | |
junior doctors' contract not put the consultant negotiations at risk and | :16:05. | :16:08. | |
make the delivery of services over seven days even harder? Could the | :16:09. | :16:13. | |
secular state be clear about how the definition of unsociable hours will | :16:14. | :16:16. | |
need to change and other contracts in order to deliver services over | :16:17. | :16:21. | |
seven days and which groups of staff will this apply to? What we have | :16:22. | :16:26. | |
heard from the Secretary of State to date could amount to the biggest | :16:27. | :16:31. | |
gamble in patient safety this House has ever seen. He has failed to win | :16:32. | :16:38. | |
the trust of the very people who keep our hospitals running and he | :16:39. | :16:42. | |
has failed to convince the public of his grounds for change. Imposing a | :16:43. | :16:48. | |
contract is a sign of failure, it is about time the Secretary of State | :16:49. | :16:56. | |
realise that. Secretary of State. Mr Speaker, she has made a number of | :16:57. | :16:59. | |
incorrect statements that I will come to, but what the country will | :17:00. | :17:04. | |
notice about her response is a straightforward. When we have an NHS | :17:05. | :17:08. | |
any viewers time that runs over seven days, people will see it is | :17:09. | :17:11. | |
obvious and the correct thing to do. They will remember how hard it was | :17:12. | :17:15. | |
to get there but they will sadly remember the big coal that she made | :17:16. | :17:19. | |
to date which was to put short-term political advantage over the | :17:20. | :17:24. | |
long-term interests of patients. -- the big political call. She has | :17:25. | :17:31. | |
vulnerable constituents, we all have vulnerable constituents who need a | :17:32. | :17:36. | |
true NHS that runs over seven days. Those people are precisely the | :17:37. | :17:39. | |
people that the NHS should be there for and sorting this out should not | :17:40. | :17:43. | |
be a party issue, it should be something that unites the entire | :17:44. | :17:50. | |
house. She will come to regret the line that she has taken today. Let | :17:51. | :17:53. | |
me address some of our particular points. She has said today and on | :17:54. | :17:55. | |
other occasions that this has been badly handled. Well, if she wants to | :17:56. | :18:02. | |
know who has handled contract negotiations badly, it was the party | :18:03. | :18:05. | |
that gave consultants the right to opt out from weekend work in 2003. | :18:06. | :18:11. | |
Who gave GPs the right to opt out of out of hours care in 2004. Is it | :18:12. | :18:15. | |
difficult to sort those problems out? Yes, will be the lecture tab | :18:16. | :18:21. | |
over by those who caused them? No. She also said that she questioned | :18:22. | :18:28. | |
whether there is support for imposition. Let me read to her | :18:29. | :18:31. | |
exactly what the letter that I got from Sir David Dalton says. It says | :18:32. | :18:38. | |
on the basis of this stalemate, I advise the government to do whatever | :18:39. | :18:41. | |
it deems necessary to end uncertainty for the service and make | :18:42. | :18:45. | |
sure that a new contract is in place which is as close as possible to the | :18:46. | :18:50. | |
final position put forward to the DNA yesterday. What does Simon | :18:51. | :18:55. | |
Stevens, the chief executive of NHS England tell us? Are the regrettable | :18:56. | :19:00. | |
and avoidable circumstances, hospitals are calling for the end of | :19:01. | :19:05. | |
uncertainty and the implication of the package that the Dalton team are | :19:06. | :19:09. | |
recommending. She talked about the impact upon her and. Perhaps you | :19:10. | :19:13. | |
would like to look at the hospitals that have commented here over seven | :19:14. | :19:18. | |
days, some of which have the highest morale in the NHS because morale for | :19:19. | :19:24. | |
doctors is higher when they are getting better care for patients. | :19:25. | :19:28. | |
She has said that we should not impose this contract, but what she | :19:29. | :19:33. | |
is telling us is that because the BNP point-blank refused to negotiate | :19:34. | :19:37. | |
on patient care, we should give up on looking after vulnerable | :19:38. | :19:40. | |
patients. What an extraordinary thing for a rape Shadow Secretary to | :19:41. | :19:47. | |
tellers. -- BNA. She said that we were conflating this contract. Let | :19:48. | :19:53. | |
us look at what the Academy of medical colleges said in 2012. They | :19:54. | :19:56. | |
said that the weekend is it is likely to be 22 problems linked to | :19:57. | :20:02. | |
the absence of skilled and empowered senior staff. -- BMA. Most medical | :20:03. | :20:06. | |
colleges have told us that junior doctors will call the fight as | :20:07. | :20:15. | |
senior staff. Mr Speaker, the NHS has made great strides in improving | :20:16. | :20:20. | |
the quality of care. Since I have been Health Secretary, avoidable | :20:21. | :20:24. | |
harm in hospitals has merely halfed, nearly 20% of acute hospitals have | :20:25. | :20:27. | |
been put into a new special measures regime and we are turning them | :20:28. | :20:31. | |
around. Record levels of the public has said that their care is safe and | :20:32. | :20:40. | |
that they are treated with dignity and respect. An NHS over 70s is not | :20:41. | :20:44. | |
just a manifesto commitment, it is because we are willing to fight to | :20:45. | :20:47. | |
make the NHS is the safest, the highest quality health care system | :20:48. | :20:49. | |
in the world. Today we have seen the party opposite is not going to have | :20:50. | :20:55. | |
that fight. So it would appear that the Conservative Party is the true | :20:56. | :21:01. | |
party of the NHS. Kenneth Clarke. May I congratulate my rate | :21:02. | :21:05. | |
honourable friend on taking the clear and correct decision. It is | :21:06. | :21:09. | |
obvious after three years that the BMA were prepared to let the whole | :21:10. | :21:13. | |
thing back on with talks and days of action until he either abandoned the | :21:14. | :21:18. | |
service over seven days or give them a substantial settlement to provide | :21:19. | :21:24. | |
them to do it. Can I ask him in future discussions to concentrate as | :21:25. | :21:28. | |
he has done, on essential public interest, which is to meet the | :21:29. | :21:32. | |
rising and Moss was the man on the servers from an ageing population | :21:33. | :21:40. | |
and to use the extra resources that the NHS is getting at the moment to | :21:41. | :21:47. | |
deliver that better service to the patients and not allow it to be | :21:48. | :21:52. | |
taken away as so often in the past, including ten years ago, orbital | :21:53. | :21:58. | |
more than 2003, and to very large pay claims by the various staff | :21:59. | :22:04. | |
unions which will lessen his ability to give us a modern NHS that he | :22:05. | :22:09. | |
talks about. My right honourable friend speaks | :22:10. | :22:13. | |
with great wisdom and also great experience because many people in | :22:14. | :22:16. | |
this House will remember when he was Health Secretary how BMA put up | :22:17. | :22:22. | |
posters of him over the country asking what you call a man who | :22:23. | :22:27. | |
ignores medical advice and there was my right honourable friend smoking | :22:28. | :22:31. | |
his cigar! Every Health Secretary on the website has had similar | :22:32. | :22:35. | |
treatment as well, I would suggest. He makes a very important point. | :22:36. | :22:41. | |
Under the new Labour administration of Tony Blair, a huge amount of | :22:42. | :22:45. | |
extra resources were put into the NHS, but unfortunately because of | :22:46. | :22:52. | |
the contract changes in 1999, 2003 and 2004, the impact was actually | :22:53. | :22:56. | |
that it made clear at the weekend less effective, not more effective. | :22:57. | :23:00. | |
We have now, thanks to the tough decisions we have taken on public | :23:01. | :23:04. | |
spending and pulling the economy around, being able to give the NHS a | :23:05. | :23:08. | |
funding settlement mixture which is the sixth biggest in its entire | :23:09. | :23:13. | |
nearly 70 year history and we are absolutely determined that we are | :23:14. | :23:16. | |
putting that extra money into the NHS, that it should come with reform | :23:17. | :23:20. | |
that leads to better care for patients, that is the conservative | :23:21. | :23:30. | |
week and we will not deflected from it. | :23:31. | :23:34. | |
If I could pick up the secretary of state on to statements he has made. | :23:35. | :23:40. | |
Can you step away from the trees increased mortality at the weekend. | :23:41. | :23:44. | |
The Fremantle paper does not show that, it shows 30 day mortality for | :23:45. | :23:50. | |
people admitted at the weekends. There is a lower mortality rate. The | :23:51. | :23:54. | |
junior minister said that the secretary of state is careful, but | :23:55. | :23:58. | |
that is twice in the statement and I think that is very misleading. I | :23:59. | :24:01. | |
have to tell them that what should have happened in terms of things | :24:02. | :24:05. | |
like the Fremantle papers and other papers, is trying to understand why. | :24:06. | :24:10. | |
The only study that guides us a clear answer and backs up the | :24:11. | :24:16. | |
Francis Report is the paper into 103 stroke units showing the single most | :24:17. | :24:20. | |
important thing, the ratio of registered nurses. We should know | :24:21. | :24:23. | |
what the problem is before we try to fix it and the one group of staff | :24:24. | :24:28. | |
along with nurses that are there are junior doctors, they are not the | :24:29. | :24:36. | |
barrier to achieving this step ten standards. I welcome the progress | :24:37. | :24:38. | |
that has been made since last November. In the debate in this | :24:39. | :24:41. | |
Chamber in October, the secretary of state was relatively unloving. The | :24:42. | :24:46. | |
process has been made since those negotiations started and | :24:47. | :24:52. | |
particularly since Sir David Dalton became involved in the last month. I | :24:53. | :24:56. | |
find it incredible that with 90% of agreement, having traded at four | :24:57. | :25:02. | |
minutes past eight o'clock, let's go get both sides back to the table, to | :25:03. | :25:06. | |
see the next thing on the BBC that the contract is going to be imposed. | :25:07. | :25:11. | |
My two concerns are that the problem around recognition of unsocial hours | :25:12. | :25:14. | |
may increase the difficulty we already have in recruiting people | :25:15. | :25:22. | |
for the acute specialties A, maternity and acute medicine. They | :25:23. | :25:25. | |
are already struggling. This could make that worse and I have concerns | :25:26. | :25:31. | |
about the problem of the junior doctor at the bottom of a hierarchy | :25:32. | :25:36. | |
will have to go and complain. Then a hierarchical system, we can simply | :25:37. | :25:42. | |
imagine how difficult that could be and how easily they could get | :25:43. | :25:46. | |
labelled as a troublemaker. So I think there are things to begin | :25:47. | :25:49. | |
with, I do welcome the progress that has been made in the last month, but | :25:50. | :25:54. | |
I do not feel that this is a time to pour petrol on the fire and throw in | :25:55. | :25:56. | |
the towel. First of all can I welcome the tone | :25:57. | :26:10. | |
of her comments, which are more constructive than the comments we | :26:11. | :26:14. | |
have had from other opposition spokesmen, and she is right that | :26:15. | :26:19. | |
what the studies talk about is mortality rates for people admitted | :26:20. | :26:26. | |
at weekends, if you include International studies, there have | :26:27. | :26:29. | |
been eight study since 2010, and if you look at by those factors | :26:30. | :26:35. | |
happened, she is right. You have to look at why we have these problems. | :26:36. | :26:41. | |
Clinical standards say that when someone is admitted they should be | :26:42. | :26:45. | |
seen by a senior decision within 14 hours of admission. They will be | :26:46. | :26:51. | |
seen by a doctor by someone before then, but they will be seen by | :26:52. | :26:59. | |
someone seen in badge senior within 14 hours. That is made in one and | :27:00. | :27:14. | |
eight hospitals. Consultants are also part of this, and contract | :27:15. | :27:19. | |
reform is therefore essential. It is also about the presence of nurses, | :27:20. | :27:25. | |
and the terms we are offering today for junior doctors are better on | :27:26. | :27:30. | |
average than the nurses working in the very same hospitals, better than | :27:31. | :27:34. | |
the midwives and paramedics, which is why Sir David Dalton and many | :27:35. | :27:38. | |
others say that this is up there and reasonable offer. With respect to | :27:39. | :27:45. | |
accident and emergency recruitment, the impact of this contract changes | :27:46. | :27:50. | |
that people who regularly work nights and weekends will actually | :27:51. | :27:54. | |
see their pay go up relatively compared to the current contract. | :27:55. | :28:00. | |
These are the people delivering a seven day NHS, and we must support | :28:01. | :28:08. | |
them. I know that colleagues across the House would want to thank junior | :28:09. | :28:17. | |
doctors for the work they do. I hope they will look carefully at the | :28:18. | :28:25. | |
improvements and the safeguard that will encourage premium rates if they | :28:26. | :28:34. | |
have to work more than one weekend. I would hope that the BMA would also | :28:35. | :28:41. | |
recognise and welcome the very important appointment to lead the | :28:42. | :28:50. | |
enquiry into all the other aspects that lead to discontent with junior | :28:51. | :28:54. | |
doctors. What we now need is to move forward in a positive spirit that | :28:55. | :28:58. | |
actually brings this dispute to an end, takes the temperature down and | :28:59. | :29:02. | |
recognises that we all want the same thing, which is safety for patients. | :29:03. | :29:10. | |
Can I thank her for her constructive comments. She is right, at 13.5% | :29:11. | :29:17. | |
increase in basic pay is very significant because, unlike overtime | :29:18. | :29:23. | |
and premium pay, it is pensionable, it helps applying for a mortgage, it | :29:24. | :29:26. | |
aims you get more money if you are on maternity, and it is something | :29:27. | :29:28. | |
that will be much better for junior doctors. The review that Dame Sue | :29:29. | :29:34. | |
Bailey is doing, which was much derided IV opposition when I | :29:35. | :29:40. | |
mentioned it, is very significant, because one of the things that has | :29:41. | :29:44. | |
gone wrong in training is that since the implementation of the working | :29:45. | :29:48. | |
Time directive, we have moved away from the old firm system, which | :29:49. | :29:52. | |
means junior doctors were assigned to a consultant who had they would | :29:53. | :29:56. | |
see on a regular basis, who would be able to coach them, on a continuous | :29:57. | :30:01. | |
basis over weeks, months, that has been lost, and many people think | :30:02. | :30:06. | |
that has led to lower morale, and we want to see what we can do to sort | :30:07. | :30:12. | |
it out. I want to echo what she said about going forward with a positive | :30:13. | :30:18. | |
and constructive spirit. When the government took the decision to | :30:19. | :30:21. | |
proceed with implementing new contracts, we had the choice to go | :30:22. | :30:26. | |
many different routes because essentially we can decide exact link | :30:27. | :30:31. | |
what it is. We have chosen to implement the contract recommended | :30:32. | :30:37. | |
by NHS Chief Executive is as being fair and reasonable. It was | :30:38. | :30:40. | |
different to our original position. We have moved on most of the major | :30:41. | :30:45. | |
issues a considerable distance, but it is what the NHS thinks is a fear | :30:46. | :30:51. | |
and decent contract, and we have to move forward. The Secretary of State | :30:52. | :30:57. | |
and sure has the grace to acknowledge that the application | :30:58. | :31:00. | |
rate for speciality training has fallen since the government put | :31:01. | :31:05. | |
forward the last year. But can he accept that if he gets less junior | :31:06. | :31:09. | |
doctors, then the problem here is strong to solve would only get | :31:10. | :31:16. | |
worse? What I would say is that we have 10,600 more doctors working in | :31:17. | :31:23. | |
the NHS now than we did five years ago, and we are investing record | :31:24. | :31:27. | |
amounts going forward, and I think there has been a lot of smoke and | :31:28. | :31:34. | |
mirrors about what is actually in the contract proposals. I hope that | :31:35. | :31:38. | |
all trainees and medical students will look at what these proposals | :31:39. | :31:42. | |
are, they will see that independent people have looked over them and | :31:43. | :31:46. | |
believe they are fear and reasonable, actually better for | :31:47. | :31:50. | |
junior doctors, and we will continue to recruit more doctors into the | :31:51. | :31:59. | |
NHS. As one gets a bit older like myself, you get to rely on the NHS | :32:00. | :32:04. | |
more and more, and I have just had an operation and might have one | :32:05. | :32:09. | |
coming up, so people like me get worried about strikes, and I would | :32:10. | :32:12. | |
hope the Secretary of State would try to build on the morale of junior | :32:13. | :32:19. | |
doctors, but can I say that the NHS is not for the Labour Party or the | :32:20. | :32:23. | |
Conservative Party, it is for the people. And why should people like | :32:24. | :32:27. | |
me who are admitted on Saturday have a greater chance of dying? He has to | :32:28. | :32:34. | |
take on the vested interests and take care of the people. He is | :32:35. | :32:46. | |
absolutely right. If you look at the change... If we want the NHS to be | :32:47. | :32:51. | |
the best in the world, we have to be confident that we are giving | :32:52. | :32:54. | |
patients the best care in the world. I completely agree, and there is no | :32:55. | :32:59. | |
reason why this could not be something that the whole House could | :33:00. | :33:03. | |
unite behind. But what we cannot do is look at eight study is in five | :33:04. | :33:09. | |
years and say that we will do that as soon as we get a consensus in the | :33:10. | :33:13. | |
medical profession. We have been trying to get that for over three | :33:14. | :33:17. | |
years, you have to say enough is enough and we have got to do the | :33:18. | :33:27. | |
right thing for patients. As someone who spent 40 years in trade | :33:28. | :33:36. | |
disputes, can we ask how he expects industry relations to improve when | :33:37. | :33:43. | |
he has posed a contract, accused people of lying, and now he has told | :33:44. | :33:52. | |
us he will build into a contract the differential between the anti-social | :33:53. | :33:58. | |
payments will be a difference between those working next to them. | :33:59. | :34:04. | |
Did he put in the library the full list of what he believes the BMA | :34:05. | :34:13. | |
lied? How can he get things back to an even keel? As someone who I can | :34:14. | :34:23. | |
see has more experience of industrial relations disputes than I | :34:24. | :34:28. | |
have, let me say this, I think it is very clear that where you are able | :34:29. | :34:34. | |
to make progress is when you have given take from both sides, the | :34:35. | :34:36. | |
sides are both prepared to negotiate and come to a deal in the interests | :34:37. | :34:41. | |
of the service and the people working in the service. With respect | :34:42. | :34:56. | |
to some of the things put out by the BMA, such as the pay calculator they | :34:57. | :35:09. | |
put on their website, which caused a great amount of anger and dismay, I | :35:10. | :35:18. | |
do not think it is... If I could say to him, the differential between | :35:19. | :35:22. | |
doctors and other workers in hospitals is what the BMA is seeking | :35:23. | :35:27. | |
to protect. It still exists, but we have reduced it because we think it | :35:28. | :35:33. | |
is fairer that way and better for junior doctors. May I add to what my | :35:34. | :35:46. | |
honourable friend said by delving into past history, in 1977I was | :35:47. | :35:51. | |
knocked off a motor cycle by a careless driver on a Sunday because | :35:52. | :35:57. | |
staff were not in the hospital -- because staff were not in the | :35:58. | :36:02. | |
hospital, the room could not be cleaned and I got an infection. It | :36:03. | :36:08. | |
is about the prolongation of small and routine episodes and injuries, | :36:09. | :36:19. | |
and can we say again to the House that when we look at back again to | :36:20. | :36:26. | |
this episode, but it took 40 years to bring about this long overdue | :36:27. | :36:33. | |
change. He is absolutely right. X-rays illustrate the point that it | :36:34. | :36:36. | |
is not just about Doctor presence, it is about people who are able to | :36:37. | :36:44. | |
do x-ray scans, CT scans, get results from laboratories, there is | :36:45. | :36:48. | |
a whole raft of things necessary for seven day care. He is also right | :36:49. | :36:53. | |
that there are huge savings if you get this right. If someone gets an | :36:54. | :37:00. | |
unavoidable pressure ulcer because they have not had the care that they | :37:01. | :37:04. | |
should, they are likely to stay in hospital for over ten days longer. | :37:05. | :37:09. | |
That will cost the NHS several thousand pounds more, which means | :37:10. | :37:13. | |
this is the right thing to do economically and ethically. There | :37:14. | :37:20. | |
are huge pressures everywhere in the NHS, for instance GP out-of-hours | :37:21. | :37:28. | |
services are under strain. What is the Secretary of State doing about | :37:29. | :37:30. | |
those pressures and the additional strain that could be triggered by an | :37:31. | :37:35. | |
exodus of doctors following the imposition of the doctors contract? | :37:36. | :37:40. | |
Will he entertain a commission, as my honourable friends on both sides | :37:41. | :37:48. | |
of the House have suggested, to find a long-term solution? The problem | :37:49. | :37:56. | |
with commissions as they take a long time to come up with solutions, and | :37:57. | :37:59. | |
we need to sort these problems out now, which is why the Chancellor has | :38:00. | :38:05. | |
committed to 3.8 billion next year. We want 5000 more GPs working in | :38:06. | :38:09. | |
general practice, which will help the issues of the out-of-hours | :38:10. | :38:16. | |
services. We have a five-year plan that the NHS is at the mentoring, | :38:17. | :38:22. | |
has the funding to implement, which will transform | :38:23. | :38:31. | |
Can I thank my right honourable friend for his patience in bringing | :38:32. | :38:37. | |
this matter to a conclusion. Go see also share the real sadness that so | :38:38. | :38:42. | |
many of us feel that these wonderful young people who come into the | :38:43. | :38:47. | |
health service to be doctors, with such high ideals, are caught up in | :38:48. | :38:51. | |
this terribly debilitating and damaging dispute? And can I ask him | :38:52. | :39:00. | |
to reinforces average to re-engage directly with junior doctors and the | :39:01. | :39:04. | |
medical profession as a whole to speak directly with and not allow | :39:05. | :39:09. | |
the destructive behaviour of the British Medical Association destroy | :39:10. | :39:13. | |
the relationship? He is absolutely right. There was | :39:14. | :39:19. | |
absolutely no reason to have this dispute. The things we're trying to | :39:20. | :39:25. | |
sort out, seven day safest care for patients, is something every doctor | :39:26. | :39:31. | |
wants to do. They choose the medical profession for the highest ethical | :39:32. | :39:37. | |
reasons. I share his sadness that it has come to this. Given that the | :39:38. | :39:41. | |
counterpart is not willing to budge, we have to take action to remove | :39:42. | :39:45. | |
uncertainty, do the right thing for patients and do the right thing for | :39:46. | :39:49. | |
doctors. I will certainly continue doing gauge. The new commission will | :39:50. | :39:57. | |
also look at wider issues of morality which will make a big | :39:58. | :40:00. | |
difference. I must advise the House that so far | :40:01. | :40:04. | |
we have got through eight questions in 14 minutes, which by the | :40:05. | :40:08. | |
standards of the House operating at its best, is poor. That means | :40:09. | :40:19. | |
shorter questions and pithy answers. I had an e-mail from a doctor in my | :40:20. | :40:23. | |
constituency this morning who thanked me for forwarding replies | :40:24. | :40:26. | |
from the department, although he did say he was disappointed with them. | :40:27. | :40:32. | |
He did say the BMA have proposed a contract which meets the cost skills | :40:33. | :40:37. | |
requirement of the government, although this seems to be rejected | :40:38. | :40:43. | |
by the government. Is it true? I am going to be pithy. It is not just | :40:44. | :40:47. | |
about cost neutrality, it is about dealing with weekend care, which is | :40:48. | :40:53. | |
why the proposal was not accepted. May I congratulate my right | :40:54. | :40:57. | |
honourable friend for always having at the forefront of patient care and | :40:58. | :41:06. | |
the well-being of junior doctors. Would my right honourable friend | :41:07. | :41:11. | |
remind the House how much extras are involved with the NHS in contrast to | :41:12. | :41:17. | |
the opposition? He is absolutely right. There are some regrettably | :41:18. | :41:21. | |
political elements within the BMA. The great irony is that without the | :41:22. | :41:25. | |
austerity measures those same people opposed in the last Parliament, we | :41:26. | :41:28. | |
would not have been able to give the NHS its sixth biggest funding | :41:29. | :41:35. | |
increase ever. I watched the Secretary of State on the TV on | :41:36. | :41:40. | |
Sunday. Two to -- two things struck me. One that he got more pale as the | :41:41. | :41:43. | |
letters were read out from junior doctors. And two that the Secretary | :41:44. | :41:49. | |
of State made clear that the point was the senior doctors not being | :41:50. | :41:55. | |
president -- that the senior doctors not being present was a barrier. Why | :41:56. | :42:01. | |
pick a fight with junior doctors? Senior decision-makers are the most | :42:02. | :42:04. | |
important people in terms of delivering care. But I junior doctor | :42:05. | :42:10. | |
with substantial training does qualify as a senior decision-makers, | :42:11. | :42:14. | |
and that is why we need them more. BMA has taken the oversubscribed | :42:15. | :42:20. | |
political speciality of spin doctoring to a whole new level. Can | :42:21. | :42:28. | |
I express my admiration of the Secretary of State's ability to keep | :42:29. | :42:30. | |
his cool under the sort of provocation he has had, and say how | :42:31. | :42:37. | |
it is that a 13.5% increase in the pensionable pay could possibly lead | :42:38. | :42:42. | |
to problems with recruitment and retention. My honourable friend | :42:43. | :42:48. | |
speaks with personal knowledge of this. This is one of the things that | :42:49. | :42:51. | |
has been wrong with the junior doctors contract for many years. | :42:52. | :42:55. | |
Basic pay is too low. Therefore they feel under huge pressure to boost | :42:56. | :43:01. | |
basic pay by some of the premium working. That has led to some | :43:02. | :43:05. | |
distortions. So yes, it is a significant increase in basic pay, | :43:06. | :43:10. | |
which is a big step forward. Mr Speaker, I spent 30 years in the | :43:11. | :43:14. | |
world of work representing employees, conducting negotiations | :43:15. | :43:19. | |
and solving disputes. I have seldom seen a sense of grievance so | :43:20. | :43:25. | |
grotesquely mishandled, insulting the intelligence of junior doctors | :43:26. | :43:28. | |
by telling them they do not understand what is on offer. Does | :43:29. | :43:33. | |
the Secretary of State not feel a sense of shame that his handling of | :43:34. | :43:40. | |
this dispute should have so poisoned relationships with junior doctors, | :43:41. | :43:46. | |
the backbone of the NHS? Mr Speaker, he can do a lot better than that. We | :43:47. | :43:51. | |
have been willing to negotiate since June. It was not me that refused to | :43:52. | :43:55. | |
sit around the table and talk until December, it was the BMA, who before | :43:56. | :44:00. | |
even talking to the government, balloted for industrial action. What | :44:01. | :44:04. | |
totally irresponsible behaviour. If Labour were responsible they would | :44:05. | :44:10. | |
be condemning it as well. I would like to thank the Minister | :44:11. | :44:14. | |
for his statement today and for the work he is doing to deliver the | :44:15. | :44:18. | |
truly seven-day week NHS we already want. But Willie confirmed that the | :44:19. | :44:24. | |
BMA, the Royal colleges, government and the wider NHS, are agreed on the | :44:25. | :44:30. | |
need to improve weekend care, which, as Professor Bruce Kehoe has said, | :44:31. | :44:37. | |
is a clinical and moral course? She is absolutely right. There is a huge | :44:38. | :44:40. | |
amount of support are doing the right thing for patients, and that | :44:41. | :44:45. | |
is why it is so extraordinary that the BMA have decided to defend the | :44:46. | :44:48. | |
indefensible, not to sit around and talk about how we can do this, and | :44:49. | :44:53. | |
indeed to go back to the earlier question, to put out Commons that | :44:54. | :45:00. | |
are deeply misleading to their own members that have inflamed the | :45:01. | :45:02. | |
situation admitted for worse than it needed to be. The Royal College of | :45:03. | :45:06. | |
GPs have reacted to the decision by saying they are shocked and | :45:07. | :45:10. | |
dismayed. The Royal Oak of psychiatrists have also said it will | :45:11. | :45:14. | |
exacerbate the recruitment and retention issues that the NHS is | :45:15. | :45:19. | |
facing currently. Why does the Health Secretary ignore the concerns | :45:20. | :45:23. | |
of these two Royal colleges? When they have had a chance to look | :45:24. | :45:29. | |
carefully at what we are proposing, I think they will find a lot in it | :45:30. | :45:35. | |
they can commence. Both are psychiatrists and GPs we are putting | :45:36. | :45:39. | |
in a premium to attract more people into those specialties, which are | :45:40. | :45:41. | |
immensely important to them and the NHS. | :45:42. | :45:46. | |
Willie Secretary of State wrote to the attention of the Shadow | :45:47. | :45:50. | |
secretary of state the research in the Netherlands that has shown that | :45:51. | :45:55. | |
improved weekend working, in fact, seven day working, as cut stillbirth | :45:56. | :45:59. | |
rates in the Netherlands dramatically and was up by 6.8%? And | :46:00. | :46:05. | |
that seven-day working has the potential to have a real impact on | :46:06. | :46:09. | |
survival rates for young babies. I would like to commend her for her | :46:10. | :46:13. | |
campaigning on that. She could not be more right. We had a report by a | :46:14. | :46:19. | |
professor before Christmas, which said the mortality rates for | :46:20. | :46:24. | |
neonatal children were 7% higher at weekends. That just underlines why | :46:25. | :46:33. | |
it is so important. On the 5th of December 2011 the government tried | :46:34. | :46:39. | |
to bring in a cut to unsocial hours. Can the Secretary of State, at a | :46:40. | :46:42. | |
time when morale is so low across the NHS, guarantee he will not bring | :46:43. | :46:47. | |
forward cuts? The reason for that was to introduce seven-day working. | :46:48. | :46:53. | |
We have no plans to do that but I cannot be drawn any further except | :46:54. | :46:57. | |
to say we do have to deliver our manifesto commitments. The specific | :46:58. | :47:01. | |
issues we have identified with respect to seven-day working, do | :47:02. | :47:04. | |
relate to consultant and junior doctor presences. | :47:05. | :47:11. | |
Can I thank my honourable friend for the clear way in which he has kept | :47:12. | :47:15. | |
the House up-to-date on his progress. It is very important, | :47:16. | :47:20. | |
surely, that not only do we actually free up beds in hospitals at | :47:21. | :47:23. | |
weekends, but also we should be making greater use of our pharmacies | :47:24. | :47:29. | |
to deliver better health care within the committee. Can my right | :47:30. | :47:33. | |
honourable friend explain how that might happen? I believe my right | :47:34. | :47:38. | |
honourable friend, the Minister of State, is actually with the | :47:39. | :47:41. | |
pharmacists discussing that precise issue. He raises this issue | :47:42. | :47:46. | |
regularly and rightly and they do have a very important part in the | :47:47. | :47:51. | |
future of the NHS. On Sunday I witnessed seven-day working in a | :47:52. | :47:55. | |
Welsh hospital where a clinic was held in Neville Hall for the | :47:56. | :47:59. | |
convenience of patients and to get maximum use of an expensive gamma | :48:00. | :48:05. | |
camera. Wally constantly denigrates the work of the Welsh health | :48:06. | :48:10. | |
service, will he paused to congratulate the Welsh and Scottish | :48:11. | :48:13. | |
governments, who avoided the misery of a strike and will also avoid the | :48:14. | :48:17. | |
poisonous legacy of resentment that he will face from junior doctors? | :48:18. | :48:25. | |
They may have avoided the difficult decision we are taking in the NHS in | :48:26. | :48:29. | |
England, but I would simply say that the longer they go on avoiding that | :48:30. | :48:33. | |
issue, the longer they will have higher mortality rates at weekends. | :48:34. | :48:37. | |
We are determined to do something about it. I would like to thank the | :48:38. | :48:43. | |
Secretary of State for his statement. If we do not have enough | :48:44. | :48:46. | |
junior doctors, patient safety cannot be guaranteed. You referred | :48:47. | :48:53. | |
to reducing the hours, the Knights, the days. Does the health minister | :48:54. | :48:57. | |
believe this will ensure there will be no more strikes? What safeguards | :48:58. | :49:02. | |
are in place for the medical profession if an agreement cannot be | :49:03. | :49:07. | |
reached? It is because an agreement cannot be reached that we are taking | :49:08. | :49:13. | |
the measures we have today. The bits of the new contract he has drawn | :49:14. | :49:17. | |
attention to add the bits that will have the biggest impact on the | :49:18. | :49:20. | |
morale of junior doctors, because we are saying we do not think it is | :49:21. | :49:23. | |
right for hospitals to ask you to work five nights in a row, or to | :49:24. | :49:29. | |
work six or seven long days in a row, and we're putting that right in | :49:30. | :49:32. | |
the new contract. That will lead to better care for patients and less | :49:33. | :49:37. | |
tired doctors. I met a large group of junior | :49:38. | :49:40. | |
doctors in my constituency to discuss the new contract. They were | :49:41. | :49:44. | |
highly professional. There were totally committed to the NHS. But | :49:45. | :49:49. | |
for the first time some of them were considering working abroad. One said | :49:50. | :49:53. | |
that although she loved her job, she would never let her daughter train | :49:54. | :49:57. | |
as a junior doctor. Isn't that a demonstration that the low morale, | :49:58. | :50:02. | |
the despair and the likely flight of junior doctors in the light of | :50:03. | :50:05. | |
imposition, is a huge threat to the future of the NHS? | :50:06. | :50:09. | |
I think the biggest threat to morale for doctors is if they are not able | :50:10. | :50:14. | |
to deliver the care that they came into the profession to deliver. And | :50:15. | :50:20. | |
that is why, that is why sorting out the proper seven-day NHS, | :50:21. | :50:24. | |
particularly for junior doctors who work in A departments at the | :50:25. | :50:27. | |
weekend and often do not have the support they have of the week -- in | :50:28. | :50:31. | |
the week, that is what we are trying to put right. I appreciate it is | :50:32. | :50:34. | |
difficult when your counterpart in the dispute does not want to | :50:35. | :50:37. | |
negotiate. But in the end governments have to decide what is | :50:38. | :50:41. | |
right for patients, what is right for the service and what is right | :50:42. | :50:47. | |
for doctors. Lie Hull has traditionally struggled to recruit | :50:48. | :50:53. | |
doctors in specialities. I'm concerned that the imposition of | :50:54. | :50:56. | |
this contract will have a detrimental effect on staff morale | :50:57. | :51:01. | |
and staff retention in the NHS. Isn't this going to make things even | :51:02. | :51:05. | |
more difficult for areas like Hull that struggle to recruit in the | :51:06. | :51:11. | |
first place? We want more doctors and more nurses in the NHS. In the | :51:12. | :51:16. | |
end if we are putting extra money into recruit these extra doctors and | :51:17. | :51:21. | |
nurses, it is fair to the public paying for their salaries, to have | :51:22. | :51:24. | |
reforms that means they care gets better. That will apply to her | :51:25. | :51:29. | |
constituents in Hull just as my constituents in Surrey. | :51:30. | :51:38. | |
The health secretary has repeatedly and continues to mislead junior | :51:39. | :51:44. | |
doctors. Yet 98% of them voted for industrial action. Without | :51:45. | :51:47. | |
said the last thing they wanted to said the last thing they wanted to | :51:48. | :51:51. | |
be doing was to be out on strike. The doctors are some of the | :51:52. | :51:54. | |
brightest and most intelligent people we have in our country. Does | :51:55. | :51:59. | |
the Secretary of State believe they cannot make their minds up for | :52:00. | :52:03. | |
themselves? It is interesting because when they did that vote, the | :52:04. | :52:08. | |
BMA had actually not sat down and talked to the government, despite | :52:09. | :52:12. | |
repeated invitations. I personally met the leader of the junior doctors | :52:13. | :52:16. | |
committee and invited him to talks. And despite the repeated invitation, | :52:17. | :52:21. | |
they refused to talk. They decided to ballot for industrial action. How | :52:22. | :52:26. | |
serious are people about reaching a negotiated settlement if that is | :52:27. | :52:30. | |
what they do? I wonder if the Secretary of State | :52:31. | :52:34. | |
could clarify something? He says those work doing one in four or more | :52:35. | :52:41. | |
Saturdays will receive a pay premium of 30%, higher on average than that | :52:42. | :52:45. | |
available to most other clinical staff. Those Clough that he sites | :52:46. | :52:54. | |
will be employed... Those staff, if they work Saturdays, they receive | :52:55. | :53:01. | |
30%. Can he tell me how he has calculated an average? I do not | :53:02. | :53:03. | |
understand his mathematics. The contract gives Junior doctors | :53:04. | :53:15. | |
who work more than one in four Saturdays, one in three Saturdays, a | :53:16. | :53:19. | |
higher premium of 50%. On average it is a higher premium. As been pointed | :53:20. | :53:26. | |
out by May honourable friend, the word on strikes in Wales yesterday | :53:27. | :53:31. | |
-- were no. In response to the point, there was an increase in 10% | :53:32. | :53:37. | |
in the budget equivalent of 135 paces pernicious training. So | :53:38. | :53:41. | |
critical to this cover. It may have been what led to be education I had | :53:42. | :53:46. | |
from England junior doctor to say could we have your minister for | :53:47. | :53:51. | |
Wales please? What does this say about morale in the NHS and England | :53:52. | :53:59. | |
went in football and rugby, the Minister has now lost the confidence | :54:00. | :54:03. | |
of the changing and Kazakh I think that is the first time -- of the | :54:04. | :54:07. | |
changing room. I think that is the first time a Welsh MP has got up and | :54:08. | :54:11. | |
said they think things are better in the Welsh NHS. Look at the waiting | :54:12. | :54:15. | |
times that people have when they want to wait for basic operations on | :54:16. | :54:20. | |
the NHS in Wales, far far longer than England. I don't think we will | :54:21. | :54:23. | |
take any lectures about how to run the NHS from Labour in Wales. I | :54:24. | :54:31. | |
represent three fine hospitals, one great medical school and has spent a | :54:32. | :54:35. | |
lot of time listening to junior doctors and medical students. The | :54:36. | :54:38. | |
Secretary of State talks about the crisis of morale within the NHS, and | :54:39. | :54:45. | |
junior doctors, does he not recognise his handling of the | :54:46. | :54:48. | |
dispute has done so much to enhance that crisis and today's announcement | :54:49. | :54:53. | |
will make it so much worse? Bottle at all. The choice I had was to do | :54:54. | :54:59. | |
something -- not at all. To do something about mortality rates at | :55:00. | :55:03. | |
weekends or duck the issue. On the Conservatives we don't duck the | :55:04. | :55:06. | |
issue is about mortality rates, we do the right thing for patients. | :55:07. | :55:10. | |
After Labour's record I would have thought he would be more | :55:11. | :55:15. | |
circumspect. Point of order. Thank you. In an earlier exchange in deck | :55:16. | :55:22. | |
questions, the Secretary of State said in response to a question that | :55:23. | :55:27. | |
I posted her, large-scale solar is already subsidy free. I think she | :55:28. | :55:34. | |
may have inadvertently misled the House as I understand that under the | :55:35. | :55:38. | |
Government's imbibing review, the Government are proposing a subsidy | :55:39. | :55:43. | |
of ?34 per megawatt hour in terms of subsidy. How can get the Secretary | :55:44. | :55:49. | |
of State to correct statement? I thank him for this point of order. I | :55:50. | :55:54. | |
was not here during deck questions but as he knows, ministers take | :55:55. | :55:57. | |
responsibility for their own statements but has put the matter on | :55:58. | :56:04. | |
the record. Point of order. Earlier in business questions I raised the | :56:05. | :56:07. | |
case of my constituents Mike and Tina Trouville. I raised them in | :56:08. | :56:12. | |
Prime Minister questions on November four and the Prime Minister promised | :56:13. | :56:16. | |
a meeting with my constituents. I raised it with Leader of the House | :56:17. | :56:19. | |
because it is now the user of February and it is very difficult to | :56:20. | :56:23. | |
get that meeting. The Leader of the House said I misinterpreted the | :56:24. | :56:26. | |
response from the Prime Minister. I went back and checked Hansard on the | :56:27. | :56:35. | |
4th of November. I specifically say, will be Prime Minister agreed to | :56:36. | :56:38. | |
meet Mike and Tina to discuss why we need a national and local enquiry | :56:39. | :56:43. | |
into what happened to baby as is in such cases? His responses, I quote, | :56:44. | :56:49. | |
I am happy to arrange that meeting. I don't quite understand how I | :56:50. | :56:53. | |
misinterpreted that and more to be point my constituents who have now | :56:54. | :56:55. | |
been meeting three months for a meeting with the Prime Minister of | :56:56. | :57:00. | |
misinterpreted how could I assist -- take this forward Kazakh I think she | :57:01. | :57:10. | |
has already taken this forward. I am sure it they will take this further | :57:11. | :57:14. | |
and perhaps she will be risen to at least. We come now to two Select | :57:15. | :57:20. | |
Committee statements. Mr Clive Betts will speak to his subject up to ten | :57:21. | :57:26. | |
minutes. No interventions may be taken. After his statement I will | :57:27. | :57:30. | |
call members to put questions on the subject of the statement and called | :57:31. | :57:34. | |
Mr Clive Betts to respond to these in turn. This is very long. Members | :57:35. | :57:39. | |
can expect to be called only once, and a vengeance should be questions | :57:40. | :57:42. | |
and be brief. The front bench may take part in questioning, the same | :57:43. | :57:46. | |
procedure will be followed for the second Select Committee statement, I | :57:47. | :57:50. | |
called Beach Arabic Communities and Local Government Committee, Clive | :57:51. | :57:56. | |
Betts. -- the chairman. I would like to thank the chance to prevent a | :57:57. | :58:03. | |
report on houses and right to buy. -- present. I thank them for their | :58:04. | :58:11. | |
help in producing a report. There is clearly a housing crisis in the | :58:12. | :58:14. | |
country. They wanted to look at one of the key policies in greater | :58:15. | :58:18. | |
detail. Extending the right to buy pretence of us housing association. | :58:19. | :58:20. | |
This was a Conservative manifesto commitment. The Committee did not | :58:21. | :58:25. | |
question whether this Committee should be appointed, but as is | :58:26. | :58:28. | |
appropriate for select committees, scrutinised how it was being | :58:29. | :58:32. | |
invited. We also looked at other government policies such as the 1% | :58:33. | :58:36. | |
reduction in social rents, paid to stay and started homes which will | :58:37. | :58:39. | |
have an impact on the provision of social housing on housing | :58:40. | :58:43. | |
associations. We had a very large response to for evidence will stop | :58:44. | :58:48. | |
over 175 written submissions. We heard from a range of witnesses | :58:49. | :58:52. | |
including housing association chiefs across England, Scotland, Wales, | :58:53. | :58:57. | |
council leaders, representatives of tenants and model that lack of | :58:58. | :58:59. | |
mortgage lenders. Three of investigations we found a great deal | :59:00. | :59:02. | |
of uncertainty in relation to the key point, a lack of detail. The | :59:03. | :59:07. | |
funding model of the right by is extremely question. We call on the | :59:08. | :59:13. | |
Government to look at the programme is a matter of urgency. There was a | :59:14. | :59:18. | |
deal to extend the right to write on a voluntary basis restricting the | :59:19. | :59:21. | |
Government and the National Housing Federation. Recognise a voluntary | :59:22. | :59:24. | |
deal is a way of delivering a key policy from the Government's | :59:25. | :59:28. | |
manifesto while maintaining the independence of housing | :59:29. | :59:30. | |
associations. In the circumstances, is the best way forward for both. | :59:31. | :59:34. | |
However there remains much uncertainty in the wording of the | :59:35. | :59:38. | |
agreement. A minority associations but are against it and so much then. | :59:39. | :59:42. | |
We don't know yet how the race to buy will be imposed upon them. And | :59:43. | :59:46. | |
how binding the terms of the voluntary agreement will be. Another | :59:47. | :59:50. | |
issue is how much discretion each association will have to decline the | :59:51. | :59:53. | |
sales, can they for example choose not to sell any of their homes in a | :59:54. | :59:58. | |
certain area or will it be the case of a case-by-case basis? What is the | :59:59. | :00:02. | |
appeal process for tenants who are refused to break the bank was buy? | :00:03. | :00:05. | |
Extended right to buy is designed to increase home ownership and increase | :00:06. | :00:09. | |
housing supply. We support his aspirations and the principal giving | :00:10. | :00:13. | |
people the opportunity to own their own home. Providing a home sold on | :00:14. | :00:16. | |
the motorbike replaced on a one-to-one basis, housing continues | :00:17. | :00:21. | |
to be delivered across all tenders to meet the country's housing needs. | :00:22. | :00:25. | |
The field there are unresolved issues and remain concerned the | :00:26. | :00:27. | |
policies could have a detrimental affect on the prison of accessible | :00:28. | :00:34. | |
and affordable housing across all places including rented homes. We | :00:35. | :00:37. | |
looked in particular at houses in rural areas weather often is a | :00:38. | :00:41. | |
demand. The did supply of land availability means it can be | :00:42. | :00:45. | |
challenging to build new homes. In order of our rural committees to | :00:46. | :00:49. | |
thrive it is important that young people and those on low incomes can | :00:50. | :00:53. | |
afford to live on them. The terms include ability of housing | :00:54. | :00:56. | |
associations to offer a portable discount in place of selling a home. | :00:57. | :01:00. | |
Given that national parks can be large, it remains to be seen how | :01:01. | :01:05. | |
this work in practice. We are also concerned that extending right to | :01:06. | :01:08. | |
buy could hinder the provision of specialist and supporting housing | :01:09. | :01:10. | |
schemes. They are expensive to build and can be harder to replace but | :01:11. | :01:13. | |
provide essential services to those living in them. We believe to avoid | :01:14. | :01:19. | |
confusion or possible legal challenges, restrictive covenants on | :01:20. | :01:22. | |
the stricken sites and properties built using charitable funds should | :01:23. | :01:26. | |
be explicitly exempt from the extended right to buy. We found that | :01:27. | :01:30. | |
large numbers of homes sold through the statutory right to ride to | :01:31. | :01:34. | |
council tenants had in its short space of time become rental | :01:35. | :01:37. | |
properties in the private sector. This is a concern to us because of | :01:38. | :01:41. | |
private rented sector is often more expensive than | :01:42. | 0:54:45 |