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Order. Urgent question, Caroline Lucas. To ask the Secretary of State | :00:07. | :00:19. | |
for business energy and industrial strategy if you will make a | :00:20. | :00:22. | |
statement on the sale of the Green Investment Bank. Government has set | :00:23. | :00:31. | |
up its plans for the sale of the green investment back laid before | :00:32. | :00:34. | |
Parliament on the 3rd of March 20 16. Government intends to move the | :00:35. | :00:38. | |
GIB into the private sector that it can increase its access to private | :00:39. | :00:47. | |
capital. Potential bidders are interested in GIB because of its | :00:48. | :00:51. | |
green specialism and we are asking potential investors to confirm their | :00:52. | :00:56. | |
commitment to GIB values and how they propose to protect them as part | :00:57. | :01:04. | |
of the bid for the company. The government has created a special | :01:05. | :01:08. | |
share held by independent trustees to protect GIB's green purposes in | :01:09. | :01:15. | |
future. As I'm sure that the house will appreciate the sale is | :01:16. | :01:19. | |
commercially sensitive so I cannot comment on the identity of any | :01:20. | :01:23. | |
bidders discussions taking place between the government and potential | :01:24. | :01:27. | |
bidders. All parties have been required to sign confidentiality | :01:28. | :01:34. | |
agreements. The restrictions applied to the government and the bidders. | :01:35. | :01:42. | |
Thank you. I thank the Minister for his reply, but it gives little | :01:43. | :01:46. | |
reassurance as everyone knows who the preferred bidder is. McQuarrie | :01:47. | :01:51. | |
has a worrying track record. I'm putting the question would support | :01:52. | :01:55. | |
from across the house. This week we heard that the Green Investment Bank | :01:56. | :01:58. | |
stands on the brink of not only being flopped off but being broken | :01:59. | :02:05. | |
up. Founded in 2012 the GIB has been widely recognised as a true success | :02:06. | :02:09. | |
story, kick-starting innovative low carbon projects across the UK. Yet | :02:10. | :02:14. | |
this preferred bidder, McQuarrie, not only has a dismal and terrible | :02:15. | :02:19. | |
environmental record, it has an appalling track record of asset | :02:20. | :02:24. | |
stripping. So why has the government given preferred bidder status to | :02:25. | :02:28. | |
this company? What assessment has it made of McQuarrie's called given | :02:29. | :02:33. | |
that in 2005 the board of the London stock exchange said McQuarrie were | :02:34. | :02:48. | |
unfit to undertake takeovers. Changes suggest that McQuarrie is | :02:49. | :02:55. | |
planning to hollow out the GIB. Why have ten new companies been set up? | :02:56. | :03:00. | |
Can he confirm that the changes made at the last year were made at the | :03:01. | :03:07. | |
behest of McQuarrie? Why is the government infighting and asset | :03:08. | :03:15. | |
stripper to take over the Green Investment Bank? Isn't this exactly | :03:16. | :03:25. | |
the wrong time to be selling off the Green Investment Bank given that the | :03:26. | :03:27. | |
government has decided to embark upon a new industrial strategy which | :03:28. | :03:33. | |
must to be in accord with our own climate change commitments have low | :03:34. | :03:37. | |
carbon projects at its core. And finally will the Minister admit that | :03:38. | :03:41. | |
this selling of could lead to the bank being fatally undermined as an | :03:42. | :03:46. | |
inn during institution. Will he stop the killing off of the Green | :03:47. | :03:50. | |
Investment Bank? Will you hold the sale process with immediate effect. | :03:51. | :03:56. | |
I think the honourable lady knows that is a string of questions that I | :03:57. | :04:02. | |
am not able to answer. She will also know that I cannot make any public | :04:03. | :04:07. | |
comment on the identity of bidders for the process under way for | :04:08. | :04:11. | |
reasons I elaborated at the top. She is drawing a lot of imprecations | :04:12. | :04:18. | |
from media speculation. It would be irresponsible for me to comment on | :04:19. | :04:22. | |
that. I will try to give her reassurance which flows back to the | :04:23. | :04:27. | |
objectives behind the sale, which I set out in the statement. It is | :04:28. | :04:31. | |
precisely been those we want the Green Investment Bank to be more | :04:32. | :04:38. | |
unfettered from because rates of state that we are putting it into | :04:39. | :04:43. | |
the private sector. The objectives had been discussed in this House, we | :04:44. | :04:47. | |
are looking at very clear objectives around securing value for money for | :04:48. | :04:52. | |
the taxpayer which must be out primary responsibility. We want to | :04:53. | :04:56. | |
ensure that it can be reclassified to the private sector. We have also | :04:57. | :04:58. | |
been clear that the reason we want to move it into the private sector | :04:59. | :05:11. | |
is two enable it to grow and become a going concern. Investors will be | :05:12. | :05:16. | |
buying into the green business plan. These are the criteria we have set. | :05:17. | :05:21. | |
These are the criteria against which we are evaluating the proposals | :05:22. | :05:30. | |
before us. The Green Investment Bank is a horrendous Conservative success | :05:31. | :05:36. | |
story, devised by the Conservatives before 2010 and introduced by a | :05:37. | :05:39. | |
Conservative led government. It has been a great catalyst for investment | :05:40. | :05:45. | |
in the green economy, in particular the wind farm of the East Anglia | :05:46. | :05:49. | |
Coast. There is a concern that if the press stories are to be believed | :05:50. | :05:52. | |
regarding asset stripping and loss of jobs, it won't be able to perform | :05:53. | :05:56. | |
that role in future. Will my honourable friend consider in that | :05:57. | :06:01. | |
light a pause to the process so that we can ensured the Green Investment | :06:02. | :06:09. | |
Bank will continue to perform its great role that it has done since | :06:10. | :06:14. | |
2012? I will join my honourable friend in saluting what was a great | :06:15. | :06:20. | |
success story of the coalition government, let's maintain the | :06:21. | :06:25. | |
season of goodwill, but under a Conservative led coalition. It was | :06:26. | :06:30. | |
the right thing to set up. It was asked that did it it was a great | :06:31. | :06:33. | |
success. Mobilising on the last figures about ?8 billion of private | :06:34. | :06:39. | |
investment into the critical area of infrastructure. So a great success | :06:40. | :06:45. | |
story. Can I assure him, and I know he is to experienced to be | :06:46. | :06:50. | |
influenced by such speculation in the media, that we are not being | :06:51. | :06:56. | |
naive in this process. We have set some clear criteria, we have one a | :06:57. | :07:03. | |
genuinely competitive process, and we are now evaluating the proposals | :07:04. | :07:06. | |
before us. But through the lens of the criteria that we have set, which | :07:07. | :07:12. | |
include value for money, deep is a vocation -- reclassification and the | :07:13. | :07:19. | |
Ford plans for a dynamic, ongoing concern seeking to mobilise for | :07:20. | :07:22. | |
private capital into the green industries. We need to mobilise a | :07:23. | :07:28. | |
lot of private sector capital to get the mean energy we need. I will | :07:29. | :07:37. | |
admit it has been a great success story. It is also a Labour success | :07:38. | :07:43. | |
story. It first appeared in our 2010 manifesto and I'm glad that the | :07:44. | :07:48. | |
coalition government took it up. If it is a success story, why are you | :07:49. | :07:59. | |
selling it off? Is it to be the case of public, good, private bad? I'm | :08:00. | :08:08. | |
telling you quite simply that given the assessment of Macquarie and what | :08:09. | :08:12. | |
we have seen of them, it has a history of asset stripping. How | :08:13. | :08:15. | |
exactly will the Minister protect his valuable public institution from | :08:16. | :08:20. | |
having its assets sold off? That is a fair question. We know the garment | :08:21. | :08:30. | |
plan to hold a share of the company which will maintain the green | :08:31. | :08:38. | |
approach. What oversight for the Government have of those companies | :08:39. | :08:43. | |
once the sale goes through? The Prime Minister told us that | :08:44. | :08:46. | |
industrial strategy would be at the heart of her government. Yet now the | :08:47. | :08:49. | |
Government is selling off an institution that has exceeded from | :08:50. | :08:53. | |
scratch and against the odds in attracting investment to our Green | :08:54. | :08:58. | |
info structure. The ministers have been outmanoeuvred by Macquarie and | :08:59. | :09:03. | |
we have no confidence that it will not happen again. Will the | :09:04. | :09:06. | |
Government agreed to stop the sale of the green investment bank today | :09:07. | :09:12. | |
until such time as its green purpose and core assets can be genuinely | :09:13. | :09:17. | |
protected? If the Minister will not, does he accept that the Green | :09:18. | :09:20. | |
Investment Bank's fate rests on his shoulders? | :09:21. | :09:27. | |
I will pass over the bizarre claim that the green investment bank is a | :09:28. | :09:32. | |
Labour success story by virtue of it being mentioned in a 2010 manifesto | :09:33. | :09:38. | |
with nothing done for 13 years of government before that. We started | :09:39. | :09:50. | |
with low levels of green investment, which we have done. I will warn them | :09:51. | :10:01. | |
against speculation. He reflects on the head of its and values of the | :10:02. | :10:07. | |
private sector. He should be aware, holding the position he does, that | :10:08. | :10:14. | |
we need to mobilise a huge amount of private capital. It is private | :10:15. | :10:17. | |
capital, not public capital that will make the difference in terms of | :10:18. | :10:21. | |
the big shift in infrastructure. What he misses is the critical role | :10:22. | :10:27. | |
that the state has played in correcting a market failure. The | :10:28. | :10:31. | |
fact we have 18 competitive process and private investors want to buy | :10:32. | :10:35. | |
this as a going concern because of its green specialism actually | :10:36. | :10:40. | |
indicates that the market failure has been corrected. The fact these | :10:41. | :10:47. | |
institutions have mobilised capital into this infrastructure is a key | :10:48. | :10:53. | |
sign. It will do more and be an even more successful institution as a | :10:54. | :11:01. | |
going concern. The Government has a whiz been clear that the green | :11:02. | :11:09. | |
investment bank was always created as possibly going to the private | :11:10. | :11:13. | |
sector. Will it remain as green investment. I know he is dedicated | :11:14. | :11:19. | |
to environmental issues, so will he give us assurances that we will | :11:20. | :11:23. | |
stick to our laudable manifesto pledge of leaving the are met in a | :11:24. | :11:28. | |
better situation than we found it? -- leading the environment? I will | :11:29. | :11:38. | |
pay to be to do her record and authenticity in regard to the | :11:39. | :11:42. | |
protection of environment and climate change? I will give her this | :11:43. | :11:49. | |
assurance. We have taken before Parliament the whole procedure for | :11:50. | :11:53. | |
protecting the green purpose of the Green Investment Bank through the | :11:54. | :11:57. | |
special share arrangement, that will be held by an independent company | :11:58. | :12:01. | |
and will have the power to approve or reject any proposed changes to | :12:02. | :12:05. | |
the two Lord Pannick's green purposes. -- to the Green Investment | :12:06. | :12:17. | |
Bank's green purposes. It was selected through a genuinely | :12:18. | :12:19. | |
independent process. She will see that the names are independent and | :12:20. | :12:25. | |
extremely credible. That is a mechanism we have set up. I will | :12:26. | :12:29. | |
return to this point around the objectives of the sale. We want this | :12:30. | :12:32. | |
to go into the private sector to do more of what it is doing, unfettered | :12:33. | :12:37. | |
by the inevitable restrictions that the state has to put on it at this | :12:38. | :12:44. | |
stage. Thank you for granting this urgent question and I thank the | :12:45. | :12:47. | |
honourable men before putting it forward, and we support it. The | :12:48. | :12:54. | |
Prime -- the Minister said that he wants to see this continued and it | :12:55. | :12:58. | |
will not be happening if it is asset stripped. The wrong reports will see | :12:59. | :13:03. | |
a 90% fall in renewable investment. That must be addressed and the Green | :13:04. | :13:09. | |
Investment Bank should be the vehicle for that. What assurances | :13:10. | :13:16. | |
other that assets will be re-invested in green infrastructure? | :13:17. | :13:24. | |
What reassurances can he give us that the HQ in Edinburgh will | :13:25. | :13:29. | |
continue? How will the Government ensure that the shortfall in | :13:30. | :13:33. | |
investment in renewables will be met? Finally, in light of the | :13:34. | :13:39. | |
forthcoming industrial strategy and emissions reduction plan, will he | :13:40. | :13:43. | |
pours the sale so Parliament can properly look at these and see what | :13:44. | :13:47. | |
role the won can play in that process? -- the Green Investment | :13:48. | :13:56. | |
Bank can play in that process? It would be nice if you paid more | :13:57. | :14:00. | |
recognition of the extraordinary progress this country has made | :14:01. | :14:06. | |
towards clean energy and we now generate more electors are deep from | :14:07. | :14:08. | |
renewables than from coal, which is a pivotal moment in this country. | :14:09. | :14:14. | |
Green Investment Bank will pay an abortive role in being a catalyst | :14:15. | :14:20. | |
for that investment. In terms of the assurances he seeks, which I | :14:21. | :14:23. | |
understand and share, it is part of our process of evaluating proposals | :14:24. | :14:27. | |
before us against the criteria that we have set out, being very | :14:28. | :14:32. | |
transparent about, agreed through the House, it is true that lends | :14:33. | :14:36. | |
that we are now evaluating the proposals before us. That obviously | :14:37. | :14:39. | |
includes attitudes to the workforce and sensitivities around jobs in | :14:40. | :14:48. | |
Scotland. These are part of the criteria that we're looking at the | :14:49. | :14:54. | |
proposals with regard to. I cannot say much because of the concert and | :14:55. | :14:59. | |
jealousy -- confidentiality situation we are in. | :15:00. | :15:10. | |
For the member and the opposite bench to make a sweeping statement | :15:11. | :15:18. | |
that private investment is bad... When he looks at the golden share, | :15:19. | :15:22. | |
will he consider if it could be possible for the golden share not to | :15:23. | :15:25. | |
just provide guarantees for future implement but on the existing | :15:26. | :15:30. | |
portfolio? Perhaps for the first couple of years, during the transfer | :15:31. | :15:38. | |
to any bidder. I thank my honourable friend for that observation. The is | :15:39. | :15:42. | |
right about his first point. It couldn't have been clear from the | :15:43. | :15:47. | |
opposition front bench, R Blick good, try that bad. That will have | :15:48. | :15:51. | |
been noted in the business community, reinforcing the question | :15:52. | :15:58. | |
asked about the attitude of the party opposite about it. With regard | :15:59. | :16:05. | |
to the maintenance of assets, I have set out the mechanisms for it. They | :16:06. | :16:08. | |
are bust. Parliament agreed they were robust. What I would say about | :16:09. | :16:12. | |
so-called asset stripping and freedom to sell assets, let's not | :16:13. | :16:18. | |
get ourselves into a position where we are just hoping assets for ever, | :16:19. | :16:23. | |
and that is a good thing. We would not want that for Green Investment | :16:24. | :16:32. | |
Bank under its current situation. We have to be practical in terms of the | :16:33. | :16:38. | |
limitations that we would place on a private sector bid. I come back to | :16:39. | :16:41. | |
the point, we are clear about the criteria we are setting for the sale | :16:42. | :16:47. | |
and we are looking at proposals to a holistically view of the criteria we | :16:48. | :16:50. | |
have set, which include the need for reassurance about the forward plans | :16:51. | :16:56. | |
for the organisation, the level and ambition in terms of mobilising | :16:57. | :16:58. | |
private sector capital into this critical area of clean | :16:59. | :17:05. | |
infrastructure. I think if the interest of consensus, there was | :17:06. | :17:09. | |
spotty support for the Green Investment Bank from the get go, | :17:10. | :17:14. | |
there is cross-party concern, I say to the Minister, about this. Lord | :17:15. | :17:17. | |
Barker, a minister in the last Parliament, Vince cable and people | :17:18. | :17:22. | |
on this side of the House. Is the key question this, they promised a | :17:23. | :17:27. | |
new approach to industrial strategy with a new Department in contrast to | :17:28. | :17:33. | |
their predecessor, who did not use the term industrial strategy. What | :17:34. | :17:40. | |
has changed? If there is a moment to prove their commitment to this new | :17:41. | :17:44. | |
strategy, it is this, their plans around the tent won. -- it is their | :17:45. | :17:50. | |
plans around the Green Investment Bank. There was a need to do it, we | :17:51. | :17:58. | |
did it, they didn't. His party had plenty of opportunity to do it. He | :17:59. | :18:05. | |
talks about the need for continued commitment in investment in | :18:06. | :18:09. | |
renewables. I think we have shown that. One of the most decisive steps | :18:10. | :18:12. | |
this Department has taken in the short time we have been in power is | :18:13. | :18:17. | |
the announcement of the new contract for difference auction which will be | :18:18. | :18:22. | |
the next age of support for the more mature renewable sources. The whole | :18:23. | :18:37. | |
point, where think there is a diversion to view about this, is | :18:38. | :18:39. | |
that the party opposite things that state ownership is a good in itself | :18:40. | :18:44. | |
whereas, in this situation, we have moved on. This important | :18:45. | :18:49. | |
organisation has done a great job, not to liberate it. So that it can | :18:50. | :18:55. | |
do more. -- we want to liberate it. It is true that led we're looking at | :18:56. | :18:57. | |
the proposals before us. Thank you Mr Speaker. Would my | :18:58. | :19:08. | |
honourable friend agreed that it's not about the assets that are owned | :19:09. | :19:16. | |
that already exist that bother in the future is there a greater or | :19:17. | :19:21. | |
lesser amount in renewable green projects. This will be a success if | :19:22. | :19:28. | |
the level of investment in new projects increases as a result of | :19:29. | :19:33. | |
privatisation. I'm delighted to detect that question from my right | :19:34. | :19:37. | |
honourable friend who was in many ways the Guardian angel of the | :19:38. | :19:41. | |
coalition government in terms of the deliberations that led to the | :19:42. | :19:45. | |
establishment of this. He is right and makes a fundamental point. We | :19:46. | :19:49. | |
should not be judging this organisation for what it is at the | :19:50. | :19:53. | |
moment, it's about what it can be about the levels of future | :19:54. | :19:56. | |
investment and the commitment to the Green purpose of this organisation. | :19:57. | :19:59. | |
I don't think this government could have clearer about that. It's about | :20:00. | :20:05. | |
the future. Can I give the Minister the opportunity to answer the | :20:06. | :20:09. | |
question I posed to him at select committee yesterday. How can he | :20:10. | :20:13. | |
reconcile insisting on preserving the green purposes of the bank and | :20:14. | :20:19. | |
preventing asset stripping from a new buyer with satisfying the ONS | :20:20. | :20:22. | |
classification is about public sector control and on balance Street | :20:23. | :20:32. | |
requirements post disposal? He is making a game presumptions about | :20:33. | :20:38. | |
asset stripping. He knows the structure we set up because he was | :20:39. | :20:43. | |
involved in the Parliamentary debate around it. There is a lot of concern | :20:44. | :20:48. | |
in this house about protecting the integrity of the green purpose of | :20:49. | :20:51. | |
the GIB which is why we have gone through this process which is | :20:52. | :20:56. | |
robust. It's about setting up the green chair and the government's | :20:57. | :21:02. | |
mechanism around it. That has had the agreement of Parliament and is | :21:03. | :21:05. | |
the system we have put in place. Also I come back to the human | :21:06. | :21:09. | |
motives of people wanting to buy this organisation to grow it and to | :21:10. | :21:16. | |
do more with it. The authenticity and integrity of those proposals are | :21:17. | :21:21. | |
what we are evaluating. I'm sure the Minister will share my slight | :21:22. | :21:24. | |
amusement that the opposition this afternoon are arguing about | :21:25. | :21:34. | |
everything you read about the Green Investment Bank you should believe, | :21:35. | :21:36. | |
but yesterday they said the opposite. Private investors are keen | :21:37. | :21:41. | |
to come in and it shows the purpose it served and without the | :21:42. | :21:44. | |
restriction it could deliver more investment, not less. My honourable | :21:45. | :21:56. | |
friend has made the from the parental -- the fundamental point I | :21:57. | :22:00. | |
was trying to make. As a market failure been corrected? There is | :22:01. | :22:08. | |
evidence of the large amount of Private investment flowing into the | :22:09. | :22:14. | |
green infrastructure. We want to make sure the GIB is free and | :22:15. | :22:19. | |
unfettered from the state to do more. The environmental audit | :22:20. | :22:25. | |
committee's report into the cell found ministers had rushed to | :22:26. | :22:30. | |
privatise it without consultation and stated that the bank should | :22:31. | :22:35. | |
continue to exist as a low investor, or its sale should not proceed. We | :22:36. | :22:41. | |
don't want a repeat of the Royal Mail debacle where the public as it | :22:42. | :22:44. | |
was sold off at ?1.4 billion before it's true -- below its true value. | :22:45. | :22:52. | |
Is it not extraordinary that the bank's assets were restructured last | :22:53. | :23:00. | |
November or it done at the request of the shareholder Executive to | :23:01. | :23:07. | |
present itself to the preferred bidder? I do believe that is the | :23:08. | :23:13. | |
case at all. We have a responsibility to deliver value for | :23:14. | :23:20. | |
money to taxpayers. We are conscious of the deal if it materialises to | :23:21. | :23:24. | |
present it well to the public we serve and represent. That's why | :23:25. | :23:28. | |
value for money is the top of our list in terms of the criteria. We | :23:29. | :23:32. | |
are setting high standards in terms of the presentation of this deal and | :23:33. | :23:39. | |
the delivery of materials. Can I remind the Minister that during the | :23:40. | :23:43. | |
cause of the enterprise built the government rejected our amendment | :23:44. | :23:46. | |
which would have guaranteed the green purpose of the bank. Can he | :23:47. | :23:51. | |
give this assurance to the bank today that after privatisation would | :23:52. | :23:54. | |
the Green Investment Bank be free to invest in fracking projects? To the | :23:55. | :24:00. | |
substantive point about the protection of the green procedure | :24:01. | :24:06. | |
and if the honourable gentleman disagrees that fine, but Parliament | :24:07. | :24:13. | |
recognise that we have set up a robust mechanism whereby the green | :24:14. | :24:17. | |
purpose of the organisation is set in the articles of association and | :24:18. | :24:24. | |
any change to that needs to be done through a resolution to the | :24:25. | :24:28. | |
trustees. It's worth recognising the integrity of these people. James | :24:29. | :24:42. | |
Curran, Lord take this on, Peter Young, a good group of people set up | :24:43. | :24:46. | |
by rigorously independent processes to safeguard the integrity of the | :24:47. | :24:55. | |
green purpose of the bag. We were told that we will be the greenest | :24:56. | :25:01. | |
government ever and yet the failed Greendale Project collapse. | :25:02. | :25:05. | |
Investment in renewable resources have slashed and we have slipped in | :25:06. | :25:09. | |
the world ranking for low carbon economies. Will he look urgently at | :25:10. | :25:17. | |
the financial and economic reasons why it it is crucial that we invest | :25:18. | :25:22. | |
in these areas and reverse the decision he is making today on the | :25:23. | :25:27. | |
Green Investment Bank. You're struggling a bit of an old horse. -- | :25:28. | :25:36. | |
flogging. They've is real investment going into clean energy in this | :25:37. | :25:40. | |
country. The Hinckley deal made one of the biggest commitments in the | :25:41. | :25:45. | |
world to low carbon energy. There is no question about this government's | :25:46. | :25:48. | |
commitment to the transition to a low carbon economy. We inherited a | :25:49. | :25:56. | |
situation where we were operating on a far to lower base and it was a | :25:57. | :26:00. | |
coalition government led by conservatives that change that. The | :26:01. | :26:08. | |
minister refused to name the bidders for the Green Investment Bank but | :26:09. | :26:11. | |
then he went on to say that private companies were saying they wanted to | :26:12. | :26:15. | |
buy the Green Investment Bank because of its success. Which | :26:16. | :26:18. | |
private companies were saying that what did the Minister make the | :26:19. | :26:29. | |
quotation up? I'm not sure what part of the confidante Richard -- part of | :26:30. | :26:36. | |
the confidentiality he does not understand. We are selling a going | :26:37. | :26:44. | |
concern and we are not entering proposals that don't respect that. | :26:45. | :26:50. | |
When is this government going to learn the lessons of the past on | :26:51. | :26:57. | |
selling off public assets? I was here when Mrs Thatcher decided to | :26:58. | :27:02. | |
sell off not only electricity, but gas and then finally water. She said | :27:03. | :27:11. | |
we were going to be a British share owning democracy. That was the | :27:12. | :27:16. | |
phrase. Now if you look at the list, you'll find that some of them are | :27:17. | :27:22. | |
owned in Germany, some are owned in France, some like McQuarrie is in | :27:23. | :27:27. | |
Australia, who brought up the Birmingham toll road in a flash | :27:28. | :27:32. | |
under the Tory government. -- Macquarie. And now we are having | :27:33. | :27:37. | |
another lecture on how he is going to preserve the identity of the | :27:38. | :27:42. | |
Green Investment Bank. History tells us it is not possible. It will go to | :27:43. | :27:47. | |
those who are reading for it and it will not be just Britain. We are | :27:48. | :27:54. | |
just being the process of leaving the EU and now the chances are it | :27:55. | :27:59. | |
will be somebody in the EU that will be buying up British assets. Maybe | :28:00. | :28:06. | |
not this. Why don't you learn the lessons? One of the lessons of | :28:07. | :28:13. | |
privatisation is record levels of investment that have flowed into | :28:14. | :28:16. | |
organisation since they have been privatise. I respect the experience | :28:17. | :28:23. | |
and sincerity and integrity, but I think he is totally wrong and I have | :28:24. | :28:28. | |
a strong instinct that the honourable gentleman would still | :28:29. | :28:34. | |
like British Telecom to be a government owned company. In the | :28:35. | :28:42. | |
Financial Times Vince Cable raise concerns about asset stripping and | :28:43. | :28:47. | |
he thought that was Macquarie's objective. Ed Davey said he thinks | :28:48. | :28:51. | |
it is unlikely that the golden share would give ministers enough clout to | :28:52. | :28:57. | |
influence the bank's investment strategy. Those two people who were | :28:58. | :29:01. | |
very much involved in setting up the bank should be taken seriously and | :29:02. | :29:06. | |
we should act upon those concerns? I'd take seriously all the concerns | :29:07. | :29:10. | |
expressed by politicians, past and present, because it is important | :29:11. | :29:16. | |
through this urgent question that the message comes out of the house | :29:17. | :29:20. | |
to potential bidders about the concerns that people have. I | :29:21. | :29:25. | |
absolutely respect that and the individuals that she mentioned, but | :29:26. | :29:29. | |
she says I'm dismissing media speculation. I'm not, I'm just not | :29:30. | :29:33. | |
commenting on it because Minister shouldn't. Thank you for the | :29:34. | :29:45. | |
reminder of the involvement of the Liberal Democrats in the initiation | :29:46. | :29:49. | |
of the Green Investment Bank breg. Vince Cable said that he is | :29:50. | :29:53. | |
unconvinced that the golden share will prevent the asset stripping of | :29:54. | :29:56. | |
the company and therefore will threaten the original intentions of | :29:57. | :30:00. | |
the Green Investment Bank at its inception. They are hol arrangements | :30:01. | :30:10. | |
under which the special share solution was reached and discussed. | :30:11. | :30:14. | |
It was debated through Parliament and settled through that process. My | :30:15. | :30:19. | |
personal view is that it's a robust mechanism in itself, given its legal | :30:20. | :30:26. | |
underpinning, given the integrity and independence of the people that | :30:27. | :30:29. | |
have been selected to be the trustees and guardians of this | :30:30. | :30:33. | |
process, but I also come back to the fundamental point about the | :30:34. | :30:38. | |
motivation behind people who might want to make, by this organisation | :30:39. | :30:46. | |
and the criteria and the discipline we will have been evaluating those | :30:47. | :30:50. | |
proposals and deciding whether we go ahead or not. I along with many | :30:51. | :30:55. | |
colleagues fought for the headquarters of the Green Investment | :30:56. | :30:59. | |
Bank to come to Edinburgh which it now has over 50 staff. How many of | :31:00. | :31:04. | |
those 50 staff will remain in Edinburgh after privatisation? Can I | :31:05. | :31:08. | |
just say, many people have mentioned Vince Cable but the legacy of Vince | :31:09. | :31:14. | |
Cable is the botched privatisation of Royal Mail and that's why people | :31:15. | :31:21. | |
have concerns. By its nature, it invests in projects the markets | :31:22. | :31:24. | |
won't touch when the projects come on stream they are much more | :31:25. | :31:28. | |
profitable than normal projects. If a preferred bidder sells it off, | :31:29. | :31:31. | |
they will sell it at great profit the taxpayers expense. I've agreed | :31:32. | :31:44. | |
to meet with a member of Parliament in that area because I recognise the | :31:45. | :31:48. | |
importance of the process and jobs. It was the right decision to locate | :31:49. | :31:55. | |
part of the organisation then and jobs are part of what we want to | :31:56. | :32:00. | |
hear a commitment to staff are ongoing organisation is part of what | :32:01. | :32:06. | |
we to hear from bidders. But because he has mentioned stuff, let me place | :32:07. | :32:09. | |
on record and I hope this is shared by members across the house the | :32:10. | :32:12. | |
admiration and respect the government has for the senior | :32:13. | :32:16. | |
management team and all start at GIB, led by Sean Smith and -- Lord | :32:17. | :32:22. | |
Smith and Sean 's Kingsbury, not just for what they have achieved, | :32:23. | :32:29. | |
but the professionalism with which they have conducted themselves. The | :32:30. | :32:32. | |
Green Investment Bank has made substantial investment in Wales in | :32:33. | :32:40. | |
partnership with five local authorities. It's a model that works | :32:41. | :32:44. | |
well. What guarantees can diminish the give that the new owners will | :32:45. | :32:48. | |
invest in this sort of way and in the regions and nations of the | :32:49. | :32:52. | |
United Kingdom rather than abroad or possibly in the golden Southeast? | :32:53. | :32:57. | |
Again, I'll come back to the main points regarding the questions we | :32:58. | :33:01. | |
ask of bidders in the criteria we set. We want to achieve value for | :33:02. | :33:07. | |
money and we are selling an ongoing concern. We are determined to | :33:08. | :33:12. | |
protect the green purpose of the organisation and we want to hear | :33:13. | :33:15. | |
plans for the mobilisation of future investment. If models are working | :33:16. | :33:25. | |
and professional organisations for whom will be bidders, they will pay | :33:26. | :33:29. | |
regard to it. That's what we want to hear from bidders and we are at the | :33:30. | :33:33. | |
point in the process where we are evaluating it. I can't say any more. | :33:34. | :33:39. | |
For the sake of transparency can you let the house know whether or not | :33:40. | :33:41. | |
the Green Investment Bank will be able to invest in fracking in the | :33:42. | :33:47. | |
future? The Green Investment Bank will be required under this process | :33:48. | :33:55. | |
to continue to respect the green purpose of the organisation as set | :33:56. | :33:58. | |
out in the articles of the Association and therefore the degree | :33:59. | :34:03. | |
to which the proposals fit the criteria are a judgment to be made | :34:04. | :34:07. | |
by management and the trustees we have set up to be independent | :34:08. | :34:09. | |
guardians of this process. When Vince Cable was legislating for | :34:10. | :34:20. | |
the bank, we were guaranteed it would operate throughout the UK and | :34:21. | :34:27. | |
operating in Northern Ireland and not protruding cross-border | :34:28. | :34:31. | |
projects. One of the first investments was in Northern Ireland, | :34:32. | :34:34. | |
in my own constituency. Many of us are concerned that the quality of | :34:35. | :34:37. | |
that investment and that reach will be lost in this sell-off. When the | :34:38. | :34:44. | |
Minister talks about integrity in relation to this, it is not | :34:45. | :34:48. | |
something that people associate readily with the preferred bidder. | :34:49. | :34:55. | |
I'm not going to comment on the identity or character or values of | :34:56. | :35:00. | |
any bidder at this stage but I will join him in recognising the good | :35:01. | :35:07. | |
work done and the approach taken by the Green Investment Bank in | :35:08. | :35:09. | |
ensuring that the investors they make are spread across the country. | :35:10. | :35:15. | |
I come back to the point I was saying, our motivation for this | :35:16. | :35:19. | |
being in the private sector is for this to grow in the private sector | :35:20. | :35:31. | |
across the UK. Having listened to the Minister rewrite history from | :35:32. | :35:38. | |
2010 on the Government's appalling approach in this area. The Green | :35:39. | :35:46. | |
Investment Bank was an success story that had cross-party support. What | :35:47. | :35:50. | |
guarantees without breaking any confidential at the around the | :35:51. | :35:58. | |
negotiations that are going on, can he give to this House that moving | :35:59. | :36:04. | |
forward that those risky investments that bank is so good at supporting | :36:05. | :36:08. | |
will continue and that the green investment moving forward will | :36:09. | :36:12. | |
continue in as good a state as it is now in five years' time or even | :36:13. | :36:22. | |
better? I'm forced to repeat a large amount of what I have said before. | :36:23. | :36:26. | |
We have set up through a process agreed to the Parliamentary process | :36:27. | :36:32. | |
a mechanism for protecting the green purposes of the organisation going | :36:33. | :36:36. | |
forward. Beyond that, as I have said, we are very serious about | :36:37. | :36:39. | |
selling this as a going concern, serious about wanting to see | :36:40. | :36:44. | |
positive proposals for growth and future investment, we're at that | :36:45. | :36:47. | |
point where we are evaluating proposals from bidders against that | :36:48. | :36:53. | |
lens. I will say that we are and will be in the process by the | :36:54. | :36:59. | |
attitudes of the senior management team. Last year, Macquarie, to quote | :37:00. | :37:07. | |
a company at random, made its largest ever profit, and it did so, | :37:08. | :37:13. | |
as the markets will tell the Minister, by selling off Moto, | :37:14. | :37:24. | |
Britain's largest motorway service company and selling the profits to | :37:25. | :37:31. | |
shareholders. What is there in the current safeguards that. The future | :37:32. | :37:35. | |
buyer, whoever they may be, from doing the same kind of thing as Tim | :37:36. | :37:39. | |
two has always done, selling assets, taking the money out of the company | :37:40. | :37:47. | |
and using it to pay shareholders? -- the same kind of thing as Macquarie. | :37:48. | :37:53. | |
He has chosen a company at random, I will not talk about any companies at | :37:54. | :38:03. | |
all. The safeguards we have set up a protected by law. An important part | :38:04. | :38:12. | |
of that is the forward intention and the intention to mobilise private | :38:13. | :38:22. | |
capital in the future. With Brexit and the uncertainty around that, is | :38:23. | :38:28. | |
this not a risky idea, to sell the Green Investment Bank at this time? | :38:29. | :38:34. | |
Can the Minister tell me how he envisages government ensuring there | :38:35. | :38:37. | |
will be money available for those new, innovative technologies that | :38:38. | :38:41. | |
will be important to areas like mine in Hull and the Humber? With respect | :38:42. | :38:46. | |
to the honourable lady, I'm not sure why exit is related to this process | :38:47. | :38:51. | |
and the decisions underpinning it. Her fundamental point about the need | :38:52. | :38:56. | |
to invest in energy innovation, I agree with her 110%. That is why our | :38:57. | :39:04. | |
Department has a ?500 million spending review portfolio dedicated | :39:05. | :39:13. | |
to a wider system of budgetary support for energy-efficient | :39:14. | :39:21. | |
systems. If we are to give the carbon reduction, we have to | :39:22. | :39:30. | |
continue to innovate. We have to support that. The Green Investment | :39:31. | :39:37. | |
Bank employs 55 employees out of the head office in my constituency. When | :39:38. | :39:43. | |
it was setup in 2012, the Business Secretary Vince Cable, said that | :39:44. | :39:48. | |
Edinburgh has a lot going for it in terms of asset management and | :39:49. | :39:53. | |
finance sectors and also its proximity to green energy activity. | :39:54. | :39:56. | |
We also said that choosing Edinburgh supported the wider narrative of | :39:57. | :40:02. | |
binding Scotland into the UK in the run-up to the independence | :40:03. | :40:04. | |
referendum. Will the Minister meet with me to discuss how such promises | :40:05. | :40:12. | |
can be delivered to those 55 employees in my constituency? I | :40:13. | :40:21. | |
extend the same invitation, I will meet any colleagues who are affected | :40:22. | :40:27. | |
by this proposal. My question is in regard to the bidding process. I | :40:28. | :40:30. | |
wonder what the minister's view is on the potential bidder, Macquarie, | :40:31. | :40:38. | |
the cuff link buccaneers, and whether he believes in the most | :40:39. | :40:43. | |
recent experience as Thames Water owners, where they saw off hundreds | :40:44. | :40:46. | |
of millions of dividend payments shipped off to investors, minimal | :40:47. | :40:52. | |
tax paid, and disappointing investment in the network. The | :40:53. | :40:57. | |
honourable lady has made her point and she will know what point I can | :40:58. | :41:02. | |
make. I cannot comment on the identity of any bidder at this | :41:03. | :41:12. | |
point. If green investments are profitable, attractive and sound as | :41:13. | :41:17. | |
has been claimed, there should be no concern about the introduction of | :41:18. | :41:20. | |
private finance for such projects. Is not surprised that given the | :41:21. | :41:24. | |
pressure on the public purse at the moment, this House is not welcoming | :41:25. | :41:31. | |
another source of funds? He makes an aborted point about the increased | :41:32. | :41:34. | |
attractiveness investment in renewable energy and low carbon | :41:35. | :41:43. | |
infrastructure. What I say in terms of not just what has happened in the | :41:44. | :41:45. | |
UK but around the world, governments has -- governments have seen | :41:46. | :41:55. | |
dramatic falls and the cost of capital attached to them makes them | :41:56. | :42:00. | |
a more investor bowl proposition. It helps reinforce our argument that, | :42:01. | :42:04. | |
in many ways, this makes it the right time to liberate the Green | :42:05. | :42:08. | |
Investment Bank from state control, to be able to play a bigger part in | :42:09. | :42:18. | |
the market. The gold escape group has supported | :42:19. | :42:24. | |
innovative projects throughout the UK that not only help us drive down | :42:25. | :42:35. | |
costs, can he keep them warning that the bank is heading for break-up and | :42:36. | :42:39. | |
halt the sale so it remains a single public institution that is one step | :42:40. | :42:45. | |
ahead of the market? Lord Barker is a good friend of mine, I hold him in | :42:46. | :42:53. | |
great respect, I reassure him and the House that the Government is not | :42:54. | :42:56. | |
being naive in this process. We are clear about the pride teary -- | :42:57. | :43:06. | |
criteria we set. The Minister has been clear that the | :43:07. | :43:09. | |
creation of the special share and the Government arrangements around | :43:10. | :43:12. | |
that will protect the integrity of the green purpose in future | :43:13. | :43:16. | |
investments. Can I press on more detail at about how the special | :43:17. | :43:21. | |
share will protect successful bidders from off-loading current | :43:22. | :43:29. | |
projects? I make two points on that. Firstly, the special share is set up | :43:30. | :43:33. | |
to protect the integrity of the green purpose, which is set out in | :43:34. | :43:36. | |
the articles of association, they are there to read now. Any proposed | :43:37. | :43:41. | |
changes to that need to be improved by the trustees that had been | :43:42. | :43:44. | |
selected independently. That is the mechanism. To the point, I will go | :43:45. | :43:52. | |
back to what we were talking about before, it is not a sensible view | :43:53. | :43:58. | |
that investment company should hold onto assets for ever. If they get | :43:59. | :44:04. | |
attractive offers to buy the rest -- to divest assets, they would look | :44:05. | :44:15. | |
seriously at that. We will look at future investment, what this could | :44:16. | :44:21. | |
become under private ownership. He is right when he says that there was | :44:22. | :44:26. | |
cross-party support for the green investment bank. There was not | :44:27. | :44:29. | |
cross-party support for support in Scotland for removing support for | :44:30. | :44:34. | |
carbon capture or indeed wind energy. Given how disastrous his | :44:35. | :44:38. | |
party's policies have been in Scotland, it might explain why they | :44:39. | :44:41. | |
don't do so well with the electorate in Scotland. Will he commit to all | :44:42. | :44:46. | |
of the projects that have been invested in that total hundreds of | :44:47. | :44:51. | |
millions of pounds in Scotland, regardless of whether the buyer is, | :44:52. | :44:56. | |
they will continue and see them in? I dispute her analysis. This country | :44:57. | :45:04. | |
has made enormous progress in the shift to green energy and Scotland | :45:05. | :45:06. | |
has been a big part of that. Again, I point her to the recent admit to | :45:07. | :45:15. | |
the next round of contract auctions. Last year, we generated 25% of our | :45:16. | :45:19. | |
electricity from renewable sources. Issue looks at the starting point in | :45:20. | :45:23. | |
2010, how argument falls away. To her point about continued | :45:24. | :45:29. | |
investment, I point to my earlier comments. When taken alongside the | :45:30. | :45:36. | |
cuts to renewable energy and the abolition of the Department of | :45:37. | :45:39. | |
energy and climate change last year, does the sell-off of the green | :45:40. | :45:44. | |
investment bank now show that the Government is no longer committed to | :45:45. | :45:49. | |
being a world leader on climate change and sustainability? I'm | :45:50. | :45:54. | |
afraid that is total nonsense. If she wants proof points about, one of | :45:55. | :45:59. | |
the first actions of this Department within days of the new government | :46:00. | :46:04. | |
warming it was to lower the fifth carbon Budget. She knows how | :46:05. | :46:09. | |
ambitious that is. That was not the actions of a government that is | :46:10. | :46:13. | |
shirking its responsibilities in elation to Britain's role in | :46:14. | :46:22. | |
mitigating climate change. Is the managed to -- is are seeking any | :46:23. | :46:28. | |
assurances that the sales of assets must be 100% free invested in green | :46:29. | :46:32. | |
energy and the UK? I have laboured the point to exhaustion that one | :46:33. | :46:37. | |
about priorities is to protect the integrity of the green purpose of | :46:38. | :46:41. | |
the organisation. What we want to hear from bidders is their plans for | :46:42. | :46:46. | |
future investment. Order. Point of order. The Attorney General is | :46:47. | :46:55. | |
making a speech today, indeed may have already made the speech which | :46:56. | :46:59. | |
is paving the way for more military drone strikes against jihadi 's. | :47:00. | :47:05. | |
This looks like, smells like, walks like a policy announcement, Mr | :47:06. | :47:09. | |
Speaker. Mr Speaker, you will be aware of concerns in this House | :47:10. | :47:14. | |
about the use of drones, the lack of parliamentary scrutiny of their use, | :47:15. | :47:17. | |
and their terms of engagement, and the risk acknowledged by the | :47:18. | :47:22. | |
Attorney General of civilian casualties associated with their | :47:23. | :47:24. | |
deployment. Given the controversial nature of drones, do you, Mr | :47:25. | :47:28. | |
Speaker, I agree that any step change in the use, a policy shift, | :47:29. | :47:33. | |
is a matter that should be raised and debated in this House, not | :47:34. | :47:40. | |
trailed in a speech? I am grateful to the Right Honourable Jedward for | :47:41. | :47:43. | |
his point of order and for his courtesy in giving the advance | :47:44. | :47:48. | |
notice of his intention to raise it. I share his concerns that policy | :47:49. | :47:57. | |
announcements should be made in this House, rather than outside of it. I | :47:58. | :48:01. | |
am not familiar with the contents of the speech and I am not in a | :48:02. | :48:05. | |
position to pronounce as to whether the Attorney General's speech and | :48:06. | :48:14. | |
outs to an absence of policy change. That said, he has made his concern | :48:15. | :48:18. | |
clear and no doubt it will have been heard on the Treasury bench. He can | :48:19. | :48:22. | |
be sure it will be conveyed to the relevant ministers. I think the | :48:23. | :48:28. | |
fairest thing I can say is, let us await events and perhaps I might add | :48:29. | :48:33. | |
that, as the right honourable gentleman, is a former deputy Leader | :48:34. | :48:38. | |
of the House, he will be well aware of and personally closely familiar | :48:39. | :48:44. | |
with the instruments available for backbench scrutiny of the executive | :48:45. | :48:51. | |
in this place. If there are no further points of order, we come now | :48:52. | :48:52. | |
to the ten minute rule motion. I beg to move that lead be given to | :48:53. | :49:04. | |
bring in a Bill to make provision for the affairs, property and | :49:05. | :49:09. | |
affairs of missing persons and for connected purposes. | :49:10. | :49:16. | |
Sooner or later all parents come to the realisation that our children | :49:17. | :49:24. | |
are slipping away. Those calling, then toggling them running. The | :49:25. | :49:28. | |
gentle guiding hand no longer needed as with great delight as they | :49:29. | :49:33. | |
discover the trick of balancing on two wheels and there they go, | :49:34. | :49:37. | |
pedalling off down the lane. That first day at school, then a few days | :49:38. | :49:43. | |
later, a few years later, the hand starts to slip from yours when you | :49:44. | :49:48. | |
get anywhere near the school gates. Those teenage bedroom years spent in | :49:49. | :49:52. | |
self-imposed solitary confinement. The date when they cram all the | :49:53. | :49:57. | |
stuff into the boot of the car and it is off to university. First job | :49:58. | :50:02. | |
are moving into their first home. All bittersweet moments for most | :50:03. | :50:07. | |
parents because for most of us, we know they will return. Not so for Mr | :50:08. | :50:15. | |
and Mrs Laurence, parents of Claudia, a missing person since the | :50:16. | :50:19. | |
18th of March 2009, nearly eight years ago. We could never imagine | :50:20. | :50:27. | |
the rising panic of those first few minutes, hours and days when they | :50:28. | :50:31. | |
realised something was wrong. Increasingly frantic calls and | :50:32. | :50:35. | |
players going unanswered. Voicemails never retrieved. Those turned into | :50:36. | :50:46. | |
weeks, weeks to months, months two years. The fate of Claudia is still | :50:47. | :50:52. | |
unknown, still be subject of a police investigation. Many faults | :50:53. | :50:57. | |
hopes raised over the years, a lead, a prosecution, nothing. Hopes | :50:58. | :51:02. | |
raised, hopes dashed. When a person disappears with no explanation the | :51:03. | :51:06. | |
friends and family are left with an unbelievable amount to cope with. | :51:07. | :51:10. | |
With all those unanswered questions and difficult emotions. These | :51:11. | :51:16. | |
desperate situations are worsened by the need to pick up the pieces of | :51:17. | :51:21. | |
their lives, pay the mortgage, the rent, the car loan, the insurances. | :51:22. | :51:26. | |
Data protection of financial services law prevents even the | :51:27. | :51:29. | |
closest relative from dealing with the finances. As Mr Laurence told | :51:30. | :51:36. | |
me, banks, insurance companies, mortgage lenders all say we can't | :51:37. | :51:40. | |
accept your instructions, you are not our customer. He went on to say, | :51:41. | :51:45. | |
you are at your lowest ebb and you have to fight all these problems. | :51:46. | :51:51. | |
It's terribly distressing. I firmly believe that the vast majority of | :51:52. | :51:56. | |
members join this house because they want a better world for all our | :51:57. | :52:00. | |
children but there are some problems we will never be able to solve. The | :52:01. | :52:05. | |
floors of mankind will always be there. Our police forces cannot | :52:06. | :52:09. | |
prevent and solve all crimes, but we can help. We can ease the burden in | :52:10. | :52:16. | |
a small but very important way. Under the current law of England and | :52:17. | :52:22. | |
Wales won a person disappears the property is effectively left | :52:23. | :52:25. | |
homeless. No one has legal authority to protect it on their behalf. This | :52:26. | :52:29. | |
can lead to assets depreciating and property falling into despair and | :52:30. | :52:36. | |
leaving those behind without the access to finances that the missing | :52:37. | :52:44. | |
person would have provided. A guardian of the affairs of the | :52:45. | :52:47. | |
missing person will fill this void and will provide a practical | :52:48. | :52:55. | |
financial solution to those left behind. The court will have the | :52:56. | :53:00. | |
power were to appoint a guardian of the application of a person with a | :53:01. | :53:03. | |
sufficient interest in the property and affairs of someone who is | :53:04. | :53:07. | |
missing. In essence the provisions of the bill will mean that generally | :53:08. | :53:12. | |
the person will have to be missing for at least 90 days. The Guardian | :53:13. | :53:17. | |
will take control of the property and financial affairs of the missing | :53:18. | :53:20. | |
person and will have authority to act on behalf of the missing person. | :53:21. | :53:23. | |
They will be able to use the property of the missing person to | :53:24. | :53:30. | |
help those left the hound -- left behind they will be accountable and | :53:31. | :53:35. | |
will be supervise. The terms of the appointment will be for a period of | :53:36. | :53:39. | |
up to four years but will be renewable by application to the | :53:40. | :53:43. | |
court. The small fee involved will be payable by the missing person's | :53:44. | :53:47. | |
estate so there will be little or no cost to the taxpayer. Crucially the | :53:48. | :53:53. | |
Guardian will act in the best interest of the missing person. The | :53:54. | :54:07. | |
proposals draw and a Presidents used in Australia and under the mental | :54:08. | :54:12. | |
capacity act 2005. Many of us have benefited from similar powers in | :54:13. | :54:25. | |
different situations. Quite simply, this legislation fills a gap in the | :54:26. | :54:31. | |
Lord that few people even realise exists. There are around 4000 | :54:32. | :54:35. | |
missing people occurrences every year and I would like to thank | :54:36. | :54:41. | |
everyone connected to support and campaign organisation missing | :54:42. | :54:44. | |
people, many of whom are involved because they have also lost a loved | :54:45. | :54:50. | |
one. I would like to offer particular axe to Mr and Mrs | :54:51. | :54:53. | |
Laurence who have a deep connection with my constituency. They | :54:54. | :54:57. | |
championed the cause of guardianship, even though it can no | :54:58. | :55:02. | |
longer help the situation. I am also grateful to members from across the | :55:03. | :55:06. | |
house and from the other players who have pledged their support for this | :55:07. | :55:09. | |
motion, particularly to my honourable friend from York and | :55:10. | :55:15. | |
Selby and the honourable member for York Central who have done so much | :55:16. | :55:19. | |
work on this already. Missing people have many tragic stories of loved | :55:20. | :55:27. | |
ones lost and hearts broken of those left behind. Husbands, wives, | :55:28. | :55:34. | |
fathers, mothers, brothers, sisters and children. This is possibly one | :55:35. | :55:39. | |
of those all too rare occasions where members can certainly make a | :55:40. | :55:45. | |
difference, simply by supporting this straightforward bill. I'm | :55:46. | :55:50. | |
grateful to the Justice select committee, the work of the all-party | :55:51. | :55:54. | |
group for runaway and missing children and crucially government | :55:55. | :55:56. | |
ministers who have pledged their full support for this bill. All I | :55:57. | :56:02. | |
ask, Madam Deputy Speaker, respectfully, is for the support of | :56:03. | :56:06. | |
all honourable members to guarantee its passage through the house and | :56:07. | :56:13. | |
into legislation. Here, here. The question is that the honourable | :56:14. | :56:16. | |
member have leave to bring in the bill. I think the ayes habit. Who | :56:17. | :56:33. | |
will bring in the bill. Christina Rhys, Nigel Adams, David Warburton, | :56:34. | :56:40. | |
lin supple Roberts, Rebecca Powell, Doctor Philippa Whitford and myself. | :56:41. | :57:00. | |
Guardianship missing Persons Bill. Second reading what day? 3rd of | :57:01. | :57:24. | |
February. We now come to the opposition Day motion on NHS and | :57:25. | :57:29. | |
social care funding in the name of the Leader of the Opposition. I | :57:30. | :57:32. | |
informed the house that the speaker has selected amendment eight in the | :57:33. | :57:36. | |
name of the Prime Minister. I called John Ashworth to move the motion. | :57:37. | :57:40. | |
I'm grateful Madam Deputy Speaker and I want to move the motion that | :57:41. | :57:45. | |
stands in my name and the name of my right honourable friend. Can I begin | :57:46. | :57:48. | |
by paying tribute to the staff working in the NHS. To the nurses, | :57:49. | :57:57. | |
doctors, paramedics, all the staff. We say thank you for all the hard | :57:58. | :58:01. | |
work, commitment goodwill and commitment to this winter crisis. I | :58:02. | :58:08. | |
have a pleasure of meeting some of those staff at St George 's Hospital | :58:09. | :58:12. | |
in tooting it on the the pressures they have been facing last night I | :58:13. | :58:18. | |
convened a summit of various royal colleges and trade unions working in | :58:19. | :58:26. | |
the health service. Many will colleges have spoken out today, | :58:27. | :58:30. | |
warning of the underfunding and understaffing. In the last few days | :58:31. | :58:34. | |
I have received messages from doctors and clinicians from across | :58:35. | :58:37. | |
the country who all tale of the immense pressure, strain and crisis | :58:38. | :58:43. | |
we are basing this winter. Let me share with the house some of the | :58:44. | :58:49. | |
stories I have been told and I have excluded the names of hospitals and | :58:50. | :58:54. | |
trusts so as not to cause undue stress and alarm, but let me offer a | :58:55. | :58:58. | |
flavour of what I have heard. One doctor told me there was a point | :58:59. | :59:03. | |
when A was full and we had no space for a major trauma call that | :59:04. | :59:07. | |
was coming in. The trauma case was going to have to be put into a | :59:08. | :59:11. | |
corridor because the resuscitation area was full. Another story. In my | :59:12. | :59:17. | |
A corridor care is not unusual, it is now the norm. We are trying to | :59:18. | :59:29. | |
keep patients save, but there are not enough of us and we are on our | :59:30. | :59:33. | |
knees. Doctors and nurses are in tears. Let me just finish and I will | :59:34. | :59:40. | |
gladly give way. Another story. Over the weekend my bosses repeatedly | :59:41. | :59:43. | |
asked for ambulances to be diverted away from our hospital because we | :59:44. | :59:48. | |
have no beds, but we have multiple requests denied. The A is | :59:49. | :59:55. | |
perpetually round with trolleys. I have many more examples, but I'm | :59:56. | :59:58. | |
sure the house understands the broader point I'm trying to make. I | :59:59. | :00:07. | |
will give way. I thank my honourable friend for giving way. There is | :00:08. | :00:10. | |
unprecedented pressure in Wirral as well. As recently as last week there | :00:11. | :00:19. | |
has been A attendances and GP referral was massively up in and | :00:20. | :00:26. | |
unprecedented way. Extra beds have been laid on and they are full. Last | :00:27. | :00:31. | |
week all elected in patient appointments were cancelled and the | :00:32. | :00:35. | |
ambulance turnarounds have reached up to five others. The Prime | :00:36. | :00:38. | |
Minister did not seem to think there was a crisis in the NHS at Prime | :00:39. | :00:43. | |
Minister's Questions. If this isn't a crisis, but my honourable friend | :00:44. | :00:49. | |
tell us what is? She makes a point eloquently and powerfully represents | :00:50. | :00:52. | |
her constituents as she always does in this place. I hope the secretary | :00:53. | :00:57. | |
of state can respond to some of the points that have been made. I did | :00:58. | :01:00. | |
promise my honourable friend from Stoke, I will give way later. I'm | :01:01. | :01:09. | |
grateful for my honourable friend giving way. The Royal Stoke in my | :01:10. | :01:14. | |
city is under intense pressure. No doubt we will hear from the | :01:15. | :01:17. | |
Secretary of State that this is part of the winter pressure. Winter | :01:18. | :01:21. | |
hasn't really started, we haven't really had a winter and yet this is | :01:22. | :01:24. | |
the pressure we have been under not for a few weeks, but for months. The | :01:25. | :01:33. | |
whole NHS system is broken. An eloquent point about the situation | :01:34. | :01:37. | |
facing Stoke and many of us are aware of the situation facing state | :01:38. | :01:41. | |
for some time. I hope the Secretary of State can touch on the situation | :01:42. | :01:45. | |
in Stoke because it is sadly something we have had to refer to | :01:46. | :01:50. | |
over again. I promise I will try to give way to as many honourable | :01:51. | :01:55. | |
members as possible. Let me assure the Secretary of State I will pass | :01:56. | :02:00. | |
on the names of these trusts and hospitals so he could look into the | :02:01. | :02:05. | |
matters that have been raised. Let's be clear. These desperate stories | :02:06. | :02:08. | |
are not the words of politicians trying to score political points, | :02:09. | :02:13. | |
but the honest heartfelt considered testimonies of doctors and | :02:14. | :02:18. | |
clinicians on the front line in our hospitals. They just simply want to | :02:19. | :02:22. | |
do the very best for their patients and many clinicians want to speak | :02:23. | :02:26. | |
out but of course they feel they can't speak out and this is why | :02:27. | :02:30. | |
these remarks have been made anonymously because according to | :02:31. | :02:41. | |
reports on the BBC, hospital trusts have received instructions from the | :02:42. | :02:48. | |
Prime Minister not to speak out. But the Secretary of State verified | :02:49. | :02:50. | |
those reports in his remarks in a few moments. I give way. What he is | :02:51. | :02:57. | |
describing, and I've worked in the NHS over this Christmas period, it | :02:58. | :03:02. | |
has been a very tough winter so fair, but this is nothing new. I've | :03:03. | :03:07. | |
worked in the NHS over 20 years and under previous governments we had | :03:08. | :03:11. | |
ambulances queueing around the block to get into A and major incidents | :03:12. | :03:15. | |
declared because there were four. This is not a new problem. We accept | :03:16. | :03:23. | |
that? Said to the honourable lady and I entirely respect her work as I | :03:24. | :03:29. | |
believe a nurse before she came into this place... I begged the | :03:30. | :03:36. | |
honourable lady Pozner pardon. She is still a nurse. If we are not | :03:37. | :03:41. | |
raising these matters on behalf of our constituents we are failing in | :03:42. | :03:45. | |
our responsibility as members of Parliament because we must never | :03:46. | :03:49. | |
forget that this is just not about the staff in our NHS, it is about | :03:50. | :03:53. | |
patients and their safety which has always got to be our absolute | :03:54. | :03:59. | |
priority. I will give way. Thank you for giving way. I echo the point he | :04:00. | :04:04. | |
made about this being about patients across the country. My constituent | :04:05. | :04:09. | |
was my mother Angela has been waiting for an acute mental health | :04:10. | :04:13. | |
but for over a week. She was taken to A where they couldn't treat | :04:14. | :04:17. | |
locally in Liverpool because it was full. She was treated for the | :04:18. | :04:21. | |
physical help the facts in an ambulance and sent home and her | :04:22. | :04:24. | |
family are devastated and are very concerned about her condition. These | :04:25. | :04:27. | |
stories we need to focus on today. More broadly on the issues of mental | :04:28. | :04:41. | |
health provision... On the specifics of that case, I have the Secretary | :04:42. | :04:44. | |
of State will respond to my honourable friend when he responds | :04:45. | :04:50. | |
to the debate. My honourable friend talked about patient care. She is | :04:51. | :04:56. | |
right. All of us across this out, all many of us, will have been | :04:57. | :04:59. | |
getting stories from constituents, telling of their recent experiences | :05:00. | :05:05. | |
in hospital. I have been given some examples. I will share them with the | :05:06. | :05:11. | |
House. Again, I will not reveal the names of trusts and hospitals, I | :05:12. | :05:15. | |
will pass them on after the debate. A mother of four children, under ten | :05:16. | :05:20. | |
years old, as a secondary tumour in her leather. She was due to go into | :05:21. | :05:23. | |
hospital this Thursday to have it removed. Her surgery has been | :05:24. | :05:28. | |
delayed for at least two macro weeks due to the hospital coping with a | :05:29. | :05:32. | |
winter crisis and there being no beds available. She has not yet been | :05:33. | :05:36. | |
given a new date. Someone else got in touch this morning whose wife has | :05:37. | :05:41. | |
been on the waiting list for a knee replacement since April last year. | :05:42. | :05:44. | |
An appointment for early December was cancelled owing to the hospital | :05:45. | :05:50. | |
being and black colour. Weeks later, the hospital phoned with another | :05:51. | :05:54. | |
appointment for today, which was cancelled yesterday. Again, these | :05:55. | :06:01. | |
are not agents trying to score political points or politicise | :06:02. | :06:11. | |
matters, they are wanting possibly to be done. I will give way. I thank | :06:12. | :06:19. | |
him. We on this side care deeply about patients. Personally, as | :06:20. | :06:24. | |
another parliament, I not on individual stories and challenges | :06:25. | :06:26. | |
experienced by my constituents. He has surely seen the guidance from | :06:27. | :06:31. | |
the NHS providers organisation representing NHS providers who are | :06:32. | :06:34. | |
not always friends of the Government am about who said this week that we | :06:35. | :06:39. | |
also need to be careful in extrapolating from individual | :06:40. | :06:45. | |
incidents in hospitals under particular pressure. Yes, times are | :06:46. | :06:51. | |
tough in the NHS, there are winter pressures, but he should not make | :06:52. | :06:53. | |
inappropriate use of individual stories. The lady ought to be | :06:54. | :06:59. | |
careful. I will be charitable but you would not one to give the | :07:00. | :07:04. | |
impression that she is dismissing these examples that I am reading | :07:05. | :07:10. | |
out. With respect to NHS providers, they have continually warned of the | :07:11. | :07:16. | |
chronic underfunding of the NHS under this government. NHS providers | :07:17. | :07:19. | |
have continually warned that head forehead spending in this country | :07:20. | :07:27. | |
will be falling. She should quit all of the facts from the NHS providers. | :07:28. | :07:33. | |
I thank you for giving way he is telling some shocking stories. Was | :07:34. | :07:40. | |
he shocked to hear people heckling in Prime Minister's Questions, what | :07:41. | :07:45. | |
about Wales? There is more funding in Wales than in England. We have | :07:46. | :07:50. | |
brand-new hospitals including my own constituency and we have had a new | :07:51. | :07:54. | |
treatment fund announced to allow better access to treatment. My | :07:55. | :07:58. | |
honourable friend makes a powerful point about Wales. As a member for | :07:59. | :08:03. | |
Cardiff, he will understand what is happening in the Welsh NHS. I will | :08:04. | :08:11. | |
give way. Then I will make some progress if I may. Would he accept | :08:12. | :08:17. | |
that every winter for as long as I can remember, we have had a winter | :08:18. | :08:22. | |
crisis in the NHS? It usually happens after Christmas because, in | :08:23. | :08:29. | |
winter, the demands on the service become unpredictable. Infections | :08:30. | :08:32. | |
spread and you lose staff and there are bound to be parts of the system | :08:33. | :08:35. | |
that come under real strain and no one is trying to minimise the fact | :08:36. | :08:40. | |
that they do. Apart from producing this year's crop of stories of very | :08:41. | :08:44. | |
unfortunate incident in various places, does he have any policy | :08:45. | :08:51. | |
proposal to make at all apart from simply spending more money wherever | :08:52. | :08:56. | |
the reports are coming from? He is very experienced, but he will know | :08:57. | :09:03. | |
that this is one of the worst winters for probably 20 years. | :09:04. | :09:08. | |
Actually, he casually suggests that this happens every year. I remove | :09:09. | :09:12. | |
the years of a Labour government when it didn't happen. Ireland and | :09:13. | :09:19. | |
the years of a Labour government when it went further than the | :09:20. | :09:23. | |
financial settlements that he was delivering as the Chancellor of the | :09:24. | :09:25. | |
Exchequer and more than doubling the money going into the NHS. If I may, | :09:26. | :09:30. | |
I really would like to make a little bit of progress. I promised my or | :09:31. | :09:36. | |
for friends and mothers of the other side that I will give way as much as | :09:37. | :09:40. | |
possible but I am aware there are many members waiting to speak. I | :09:41. | :09:42. | |
will make some progress and then give an opportunity for people to | :09:43. | :09:47. | |
make an intervention. We are all becoming far too familiar with the | :09:48. | :09:53. | |
grim statistics. In September, 50 of the 152 trusts call for urgent | :09:54. | :09:58. | |
action to cope with demand. The number of patients being turned away | :09:59. | :10:06. | |
from A at a record high. 15 hospitals ran out of beds in one day | :10:07. | :10:11. | |
in December. Last night, the BBC revealed leaked documents from NHS | :10:12. | :10:16. | |
improvements that showed that there were more than 18,000 trolley waits | :10:17. | :10:22. | |
of four hours or more. Almost a quarter of patients waited longer | :10:23. | :10:28. | |
than four hours in A last week. Just one hospital met its target. | :10:29. | :10:33. | |
Since the start of December, hospitals of only seen 82 percent of | :10:34. | :10:42. | |
patients within the target. Ministers can try and deny what is | :10:43. | :10:46. | |
going on and I cannot deny these facts about what is happening this | :10:47. | :10:53. | |
winter in the NHS and their watch. We know that what happens in the NHS | :10:54. | :10:57. | |
in winter is a signifier of a wider crisis. Across the piece, bed | :10:58. | :11:03. | |
occupancy levels now routinely exceed the recommended maximum | :11:04. | :11:11. | |
levels, often to levels higher than 95%. We have an NHS going through | :11:12. | :11:14. | |
the largest financial squeeze in its history. Indeed, the former | :11:15. | :11:21. | |
Secretary of State said they plan for five years of NHS austerity, | :11:22. | :11:25. | |
they were never expecting ten years of NHS austerity. We have seen 4.6 | :11:26. | :11:33. | |
billion cut from the social care Budget and as the Kings fund said, | :11:34. | :11:36. | |
is there a problem? Because there is a | :11:37. | :11:47. | |
simply a series of cuts affecting our hospitals. It has been a | :11:48. | :11:55. | |
position of utter complacency. Things had only been falling over in | :11:56. | :11:59. | |
a couple of places, he said. When he came to the House on Monday to make | :12:00. | :12:03. | |
his statement, he did not commit to extra emergency funding for social | :12:04. | :12:08. | |
care, he didn't promise that the financial settlements would be | :12:09. | :12:12. | |
reassessed in the March Budget. In fact, it is worse than that. When he | :12:13. | :12:15. | |
was making his statement, his own spin doctors were telling the Health | :12:16. | :12:21. | |
Service Journal, this is on the day when the winter crisis is leading | :12:22. | :12:24. | |
the news and he's making a statement in his house, come his spin doctors | :12:25. | :12:32. | |
were saying that, there is no prospect of additional funding to | :12:33. | :12:34. | |
support emergency care any time before the next election. So nothing | :12:35. | :12:39. | |
for social care, nothing for emergency care, nothing to tackle | :12:40. | :12:42. | |
understaffing, nothing to tackle underfunding. Thank you very much(!) | :12:43. | :12:49. | |
What did we get in response? A downgrade of the four our A | :12:50. | :12:55. | |
target. He shakes his head, he says nonsense. I will remind him of what | :12:56. | :13:02. | |
he said. We need to have an honest discussion with the public about the | :13:03. | :13:07. | |
purpose of A departments. He said he wanted to provoke a discussion, | :13:08. | :13:12. | |
he wanted to provoke a discussion. He has certainly provoked a | :13:13. | :13:16. | |
backlash, not these by blaming the public for turning up at A | :13:17. | :13:22. | |
departments. He said, the four our target is a promise to sort out all | :13:23. | :13:27. | |
urgent health problems within four hours. He was his clarification, but | :13:28. | :13:38. | |
not all health problems, however minor. We have now seen a letter to | :13:39. | :13:43. | |
trust a few weeks ago which talks of the need to broaden Harrah oversight | :13:44. | :13:50. | |
of A They said, we believe there is merit in broadening out oversight | :13:51. | :14:00. | |
response further than a single metric. Can he answer our questions. | :14:01. | :14:06. | |
I know he avoided the questions yesterday and Sky News. Does he | :14:07. | :14:11. | |
recall that in 2015, he Arthur Abraham you on these matters are | :14:12. | :14:16. | |
waiting times. Bruce Keogh said that A standards have been important in | :14:17. | :14:24. | |
making sure that people get access to emergency care. I do not consider | :14:25. | :14:28. | |
there is a chase for changing the standard this time. The Secretary of | :14:29. | :14:33. | |
State still agree with Bruce Keogh? If he does agree, can he tell us, | :14:34. | :14:38. | |
why did he make his remarks on Monday when he said we need have a | :14:39. | :14:41. | |
discussion about future of the A standard. If he wants to lead a | :14:42. | :14:47. | |
discussion about the future of the standard, what discussions has he | :14:48. | :14:53. | |
had with the Royal College of Nursing medicines? They argue that | :14:54. | :14:58. | |
the standard is a vital measure of performance and safety. It should | :14:59. | :15:01. | |
apply to at least 95% of all patients attending emergency | :15:02. | :15:05. | |
departments. If he is still committed to that standard, is he | :15:06. | :15:09. | |
still committed to maintaining it at 95%? My honourable friend has had | :15:10. | :15:22. | |
one bite at the cherry. If he doesn't mind, I will make some | :15:23. | :15:27. | |
progress for now. I will do my best to get as many people in if I may. | :15:28. | :15:34. | |
Does the Secretary of State agree that the four hour standard is a | :15:35. | :15:39. | |
reasonable proxy for patient safety? Does he agree that every reach of | :15:40. | :15:43. | |
the standard can be regarded as a potentially elevated...? I will give | :15:44. | :15:52. | |
way, she has been persistent. If the honourable gentleman were to read | :15:53. | :15:56. | |
the Government amendment, he said he endorses and supports the 95% target | :15:57. | :16:08. | |
for A waiting times. I will pay tribute to the bunch is doing and | :16:09. | :16:15. | |
loneliness -- is doing and loneliness. The Secretary of State | :16:16. | :16:22. | |
did the English between urgent and minor... He heckles so much, the | :16:23. | :16:32. | |
web, it is sometimes difficult to hear what he is saying. Can he tell | :16:33. | :16:37. | |
us how he would define the difference between urgent at minor | :16:38. | :16:43. | |
care for this for our standard? Can he tell is the minimum severity of | :16:44. | :16:47. | |
physical injury or other medical problem switch will be needed for a | :16:48. | :16:50. | |
patient to qualify for access to A? How will we determine these new | :16:51. | :16:55. | |
standards? How quickly will they be available? Which injuries will | :16:56. | :17:04. | |
qualify? If the Secretary of State is not moving away from this | :17:05. | :17:07. | |
standard, I'm afraid he needs to clarify matters urgently because the | :17:08. | :17:10. | |
oppression has been given that he is moving away from that standard. Not | :17:11. | :17:16. | |
by me, but by his own remarks on Monday. If he is not moving away | :17:17. | :17:22. | |
from the standard, can he give a guarantee that he will not shift | :17:23. | :17:25. | |
away at all throughout the Parliament from the standard and it | :17:26. | :17:29. | |
will remain at the current rate it is now? I will give way. I was in | :17:30. | :17:38. | |
the chamber on Monday and listened carefully. He was challenged on the | :17:39. | :17:41. | |
target and asked if he was watering it down, he said explicitly that far | :17:42. | :17:46. | |
from watering it down, he was recommitting the Government to it | :17:47. | :17:50. | |
and he actually said, and he was generous to the Labour Party, it is | :17:51. | :17:53. | |
one of the best things the NHS did. I think that was clear. | :17:54. | :18:01. | |
I will say to the right honourable gentleman, the former chief Whip, | :18:02. | :18:06. | |
the Secretary of State said we need to be clear it is a promise to sort | :18:07. | :18:09. | |
out all urgent health problems within four hours, not all health | :18:10. | :18:15. | |
problems. The Secretary of State enemy to cover the House and make | :18:16. | :18:19. | |
these remarks and said these hares running. You should make his | :18:20. | :18:25. | |
objections not to meet but to the Secretary of State. I will move on a | :18:26. | :18:31. | |
little bit. If the Secretary of State is not abandoning the | :18:32. | :18:40. | |
standard, we look forward to him making that clear. He has also said | :18:41. | :18:43. | |
and implied that we need to educate the public that so they do not turn | :18:44. | :18:49. | |
up at A departments. That was the implication of his remarks on | :18:50. | :18:52. | |
Monday. Can he tell us how he's going to do that? What will be the | :18:53. | :18:57. | |
cost of locations of expanding to the public not turning up at Axa | :18:58. | :19:02. | |
macro departments? Will we see a large advertising campaign? The | :19:03. | :19:09. | |
heat: local authorities whose budgets have been cut question Mike | :19:10. | :19:13. | |
would he give the new resources for this education campaign? | :19:14. | :19:19. | |
He makes an important point. The key thing is in the 90s when Labour took | :19:20. | :19:27. | |
over in 97, the health service was in crisis and is today, but the | :19:28. | :19:32. | |
point I want to make is isn't part of the problem people go to A | :19:33. | :19:37. | |
because they cannot see their GP? It is difficult to get to the GP which | :19:38. | :19:42. | |
is why we have the pressures on A and it will get worse with community | :19:43. | :19:49. | |
pharmacy cuts this year, losing them from our towns and streets because | :19:50. | :19:56. | |
of the cuts pursued. The figure of 3000 community pharmacy is being | :19:57. | :20:00. | |
lost, was what the previous minister said to MPs. I will give way one | :20:01. | :20:04. | |
last time and then I must make progress. I had a debate in | :20:05. | :20:10. | |
Westminster Hall on pharmacies and integration in the NHS and not one | :20:11. | :20:15. | |
single Labour MP from the backbench bother to take part. Not one. Labour | :20:16. | :20:26. | |
MPs have raised these matters for weeks, including urgent questions | :20:27. | :20:30. | |
and an Opposition Day debate. On that point, I presume what the | :20:31. | :20:37. | |
honourable lady meant was there were two backbench Labour members who | :20:38. | :20:44. | |
took part in the debate. Would he agreed the point about community | :20:45. | :20:49. | |
pharmacies and GPs and investment in social care is it says the | :20:50. | :20:52. | |
government money if it does it, that is why they should make the | :20:53. | :20:55. | |
investment now to take pressure off A I'm grateful for him correcting | :20:56. | :21:02. | |
the record on the debate in Westminster Hall. The Secretary of | :21:03. | :21:10. | |
State denies he will water down the A target, we welcome that but will | :21:11. | :21:14. | |
watch carefully to ensure he does not sneakily water it down for the | :21:15. | :21:19. | |
remaining years of Parliament. Can he tell us what he expects to happen | :21:20. | :21:23. | |
as we go through winter, because we know whether warnings have been | :21:24. | :21:28. | |
issued and we could be heading for a cold snap. Could he update us on | :21:29. | :21:33. | |
urgent preparations put in place to ensure the NHS can cope? Is the NHS | :21:34. | :21:40. | |
prepared for a flu outbreak. What is his assessment if overstretched | :21:41. | :21:45. | |
hospitals could cope if there is a flu outbreak? So far it appears | :21:46. | :21:48. | |
ministers have buried their heads in the sand and that will not do. I | :21:49. | :21:58. | |
will give way. I'm grateful. Honourable members both made the | :21:59. | :22:03. | |
point of the issues in the NHS are historic. On Radio 4 today, the | :22:04. | :22:11. | |
right honourable member for 's Leigh accepted he had not spent the right | :22:12. | :22:18. | |
money on social care. Will he accept these are historic and not new? The | :22:19. | :22:25. | |
honourable lady refers to the history. Under this government the | :22:26. | :22:30. | |
NHS is going through its largest financial squeeze in its history and | :22:31. | :22:33. | |
when we had a Labour government we more than doubled the investment | :22:34. | :22:37. | |
going into the NHS. Because he is a member from the East Midlands I will | :22:38. | :22:40. | |
give way to the honourable member from Corby. I am grateful. I agree | :22:41. | :22:46. | |
we need to have an honest debate. Would he accept he stood on a | :22:47. | :22:50. | |
general election manifesto that would have spent billions less on | :22:51. | :23:00. | |
the NHS? Willy set out exactly what services he would spend less on in | :23:01. | :23:03. | |
the NHS now. We stood on a manifesto that would have delivered more | :23:04. | :23:07. | |
doctors and nurses and he stood on a manifesto that said they would cut | :23:08. | :23:12. | |
the deficit and not the NHS. They are cutting the NHS and failing on | :23:13. | :23:21. | |
the deficit. Can I ask the Secretary of State direct questions about | :23:22. | :23:25. | |
Worcestershire. I was grateful for his remarks on Monday. Can I press | :23:26. | :23:30. | |
him further, because it has been reported NHS England was warned of | :23:31. | :23:35. | |
the bed crisis on 22nd of December and I would be grateful if he could | :23:36. | :23:39. | |
update the house on urgent meetings he is having on Royal Worcestershire | :23:40. | :23:43. | |
and where we will be closer to knowing the outcome of an enquiry | :23:44. | :23:49. | |
and in the context of that, we know the STB for the Worcestershire area | :23:50. | :23:53. | |
is proposing a number of acute beds productions. I wonder in the context | :23:54. | :24:02. | |
of the issues that appear to be fair, witty remark upon that whether | :24:03. | :24:06. | |
he thinks that is the right to follow. The NHS is going through | :24:07. | :24:14. | |
this winter crisis and then it is about to go on another top-down | :24:15. | :24:21. | |
reorganisation, if you like, aimed at... He says bottom-up, they are | :24:22. | :24:26. | |
not. They are being told they have to fill a financial gap. Of 21.76 4 | :24:27. | :24:43. | |
billion. That is the reality that STPs have to face. We have seen | :24:44. | :24:48. | |
community hospitals closed. It will mean a number of a deeply Mac | :24:49. | :24:52. | |
downgraded and it will mean acute beds lost in places like Devon for | :24:53. | :24:58. | |
example, where the STP talks of an overreliance on bed. They talk about | :24:59. | :25:11. | |
vulnerable services such as maternity and paediatrics. In | :25:12. | :25:15. | |
London, a city with the worst health inequalities they are expected to | :25:16. | :25:21. | |
deliver better health outcomes for its growing 10 million residents | :25:22. | :25:27. | |
with 4.3 billion less to spend. I ask the Secretary of State, can he | :25:28. | :25:33. | |
explain to the house how he expects the NHS to perform in future winters | :25:34. | :25:39. | |
when we have a growing elderly population and STPs are pursuing | :25:40. | :25:44. | |
cuts to beds and A and wider services? I was recently briefed by | :25:45. | :25:52. | |
an excellent and respected GP and clinical psychiatrist who had been | :25:53. | :25:57. | |
authors of our county's STP. Can he explain how on earth they are | :25:58. | :26:01. | |
responsible for a top-down reorganisation? I have been told by | :26:02. | :26:08. | |
NHS England who would told by the Secretary of State, that is how. The | :26:09. | :26:20. | |
right honourable member mentioned spending, but does he share my | :26:21. | :26:31. | |
concern infection spreading of arrogance, complacency, from being | :26:32. | :26:36. | |
out of touch from family suffering and witnessing in action on an epic | :26:37. | :26:43. | |
scale? I think he makes his point extremely well. I would not want to | :26:44. | :26:50. | |
be so mean about the Secretary of State. I'm grateful. We have heard | :26:51. | :27:00. | |
ludicrously the suggestion that Labour did not perform on spending | :27:01. | :27:05. | |
or performance at our track record was excellent and it is not just my | :27:06. | :27:08. | |
words but the words of the former Prime Minister who said in 2011, I | :27:09. | :27:13. | |
refuse to go back to the days when people had to wait hours to be seen | :27:14. | :27:19. | |
in A or months to have surgery. Let me be clear we went. He knew | :27:20. | :27:23. | |
that Labour had a good record and the NHS used to be good, why do the | :27:24. | :27:30. | |
Tories not admit it? I remember Shadow Health Secretary is when we | :27:31. | :27:33. | |
were in government opposing every penny piece of money Labour was | :27:34. | :27:41. | |
putting into the NHS and I remember Shadow Health Secretary who now sits | :27:42. | :27:46. | |
in the cabinet, talking about the A target as being, quote, | :27:47. | :27:52. | |
indecent. It is no wonder we are sceptical about government | :27:53. | :27:55. | |
intentions on this A target when we look at their history. I will | :27:56. | :28:04. | |
give way. I'm grateful. He is talking about the Labour years and | :28:05. | :28:08. | |
record of the NHS, does he recall Labour closing not only maternity at | :28:09. | :28:15. | |
one hospital but accident and emergency in 2005, as well? I do not | :28:16. | :28:22. | |
have the details of the Sussex STP to hand but presumably if it is | :28:23. | :28:29. | |
suggesting closures, the honourable gentleman will campaign against | :28:30. | :28:33. | |
closures and knock on the door of the Secretary of State if those | :28:34. | :28:35. | |
remarks are an indication of his view on these matters. He is saying | :28:36. | :28:42. | |
everything was rosy under Labour but it was ten years ago the Mid | :28:43. | :28:45. | |
Staffordshire scandal broke in which hundreds of elderly patients more | :28:46. | :28:52. | |
had died and expected to, it was a terrible scandal and he should | :28:53. | :28:55. | |
remember that because our shadow spokesman were holding a Labour | :28:56. | :29:04. | |
government to account at the time. I take all deaths in hospitals | :29:05. | :29:09. | |
seriously. My commitment to patient safety is unswerving and I will | :29:10. | :29:13. | |
raise matters, whether it is Royal Worcestershire or elsewhere, not in | :29:14. | :29:17. | |
a partisan way with the Secretary of State. I was not being partisan when | :29:18. | :29:22. | |
I ask questions about while Worcestershire. I will raise matters | :29:23. | :29:26. | |
because that is the responsible thing to do. It is not becoming of | :29:27. | :29:30. | |
the honourable gentleman to play politics in that way. Madam Deputy | :29:31. | :29:37. | |
Speaker, the culpability for the state the NHS is in today lies at | :29:38. | :29:42. | |
the door of Downing Street. A government that promise to protect | :29:43. | :29:48. | |
the NHS and cut the deficit and it didn't. The government gives away ?1 | :29:49. | :29:56. | |
billion tax cuts to corporations. The government wastes billions | :29:57. | :30:01. | |
pushing the NHS in the direction of fragmentation and greater | :30:02. | :30:03. | |
outsourcing while ignoring lengthening queues of the sick and | :30:04. | :30:09. | |
elderly in our constituencies. Yesterday we saw the Secretary of | :30:10. | :30:13. | |
State on Sky losing his ministerial car and being chased down the | :30:14. | :30:17. | |
street, his approach laid bare, not a clue where he is going. Nothing to | :30:18. | :30:25. | |
say, not facing up to the problems. Last year he blamed junior doctors. | :30:26. | :30:31. | |
On Monday he blamed the patients and today he blames Simon Stephens. | :30:32. | :30:35. | |
Tomorrow he will blame the weather. It is time he started pointing the | :30:36. | :30:40. | |
finger at himself and not everybody else, the NHS is in crisis, | :30:41. | :30:45. | |
ministers are in denial. I say to the government on behalf of | :30:46. | :30:50. | |
patients, their families, our behalf of NHS staff, please get a grip. I | :30:51. | :30:57. | |
commend our motion to the house. The question is as on the order paper. I | :30:58. | :31:01. | |
call Jeremy Hunt to move the amendment. I beg to move the | :31:02. | :31:08. | |
amendment standing in the name of my right honourable friend the Prime | :31:09. | :31:12. | |
Minister. I want to thank the Shadow Health Secretary for bringing the | :31:13. | :31:15. | |
debate, he is right to draw attention to pressures in the neck | :31:16. | :31:20. | |
chess but I am regrettably going to have to spend much time correcting | :31:21. | :31:24. | |
totally inaccurate assertions -- in the NHS. That is a shame because it | :31:25. | :31:31. | |
is an important debate for constituents and the NHS and the | :31:32. | :31:34. | |
country deserves a proper debate but that is difficult when we have | :31:35. | :31:39. | |
misinformation at a time when the NHS faces sustained pressure. I am | :31:40. | :31:43. | |
pleased to see the Leader of the Opposition in his place. I think he | :31:44. | :31:47. | |
is rather a fan of my Parliamentary appearances recently. It is a Jeremy | :31:48. | :31:55. | |
think, he says. If only. I wish to address one part of my speech to him | :31:56. | :32:02. | |
because it is an area of policy for which he is perhaps more personally | :32:03. | :32:06. | |
responsible. Winter is a challenging period and I want to repeat thanks | :32:07. | :32:11. | |
the Shadow Health Secretary said and the banks I gave on Monday to NHS | :32:12. | :32:18. | |
staff. -- my thanks. On Tuesday, the NHS had its bid -- busiest day, | :32:19. | :32:27. | |
treating a record number of patients in four hours. And 2500 more | :32:28. | :32:33. | |
patients within the four-hour standard everyday compare to 2010. | :32:34. | :32:38. | |
As we discussed on Monday, the NHS made record numbers of preparations | :32:39. | :32:44. | |
for the winter because it is difficult, including 3000 more | :32:45. | :32:47. | |
nurses and 1600 more doctors on full-time employment. I will address | :32:48. | :32:54. | |
so that it does get dealt with early what the Shadow Health Secretary | :32:55. | :32:57. | |
talked about with respect to Worcestershire. I met colleagues | :32:58. | :33:03. | |
there on Monday. A huge amount of action is being taken but we should | :33:04. | :33:07. | |
say it is totally not acceptable for anyone to wait 35 hours on a trolley | :33:08. | :33:12. | |
and we expect the hospital to ensure it does not happen again. There are | :33:13. | :33:19. | |
plans to open additional capacity. We have had capacity made available | :33:20. | :33:23. | |
by Worcester community trust. It supplied its chief operating officer | :33:24. | :33:29. | |
to be based at the trust to facilitate discharges, and we have a | :33:30. | :33:35. | |
new chief executive, the trust is in special measures and the new chief | :33:36. | :33:38. | |
executive will start later this spring. What is wrong about what the | :33:39. | :33:45. | |
Shadow Health Secretary has said is the suggestion that winter problems | :33:46. | :33:53. | |
are unusual. The NHS had difficult winters in 99, 2008 and 2009, as The | :33:54. | :33:59. | |
Right Honourable member said. I will give way in a moment. He remembers | :34:00. | :34:04. | |
difficult winters from his time as Health Secretary. There are things | :34:05. | :34:08. | |
that are different today and one of them is compared to six years ago, | :34:09. | :34:16. | |
we have 340,000 more over 80s, many honourable, many with dementia, and | :34:17. | :34:21. | |
we know when people of that age go to A at this time of year there is | :34:22. | :34:27. | |
an 80% chance they will be admitted. I will give way. I thank him. He | :34:28. | :34:34. | |
talks about correcting points and it is important the house has | :34:35. | :34:40. | |
information. Can I repeat the question, the latest figures, can he | :34:41. | :34:44. | |
tell us the number of people remaining in hospital, that could be | :34:45. | :34:49. | |
discharged, because there is no community support they have stayed | :34:50. | :34:52. | |
in hospital. Could he give us that figure? | :34:53. | :35:01. | |
It was around 7000 beds last year, which is far too many. Which is why | :35:02. | :35:07. | |
it was announced that a new package of support worth around ?400 | :35:08. | :35:11. | |
million, I will just answer his question, I said I would write to | :35:12. | :35:14. | |
him and I will. He may have noticed there are other issues we are | :35:15. | :35:18. | |
dealing with which is why I may not have had time to sign the letter. | :35:19. | :35:22. | |
What the Communities Secretary announced, ?400 million extra over | :35:23. | :35:27. | |
the next two years will make a significant difference and he should | :35:28. | :35:33. | |
recognise that. I am grateful for him giving way, there will be | :35:34. | :35:35. | |
constituents who are concerned about the headlines they have read. I am | :35:36. | :35:40. | |
pleased the secretary of state will correct some of the points that were | :35:41. | :35:44. | |
made. They also want to know what is being done and what should be done. | :35:45. | :35:49. | |
I listened for 33 minutes to the Shadow Secretary of State, the | :35:50. | :35:52. | |
Labour spokesman of the NHS, not a single new idea other than spending | :35:53. | :35:58. | |
money. Could my right honourable friend provide practical answers to | :35:59. | :36:03. | |
allay concerns in the papers. That is why I will be talking later about | :36:04. | :36:07. | |
what our solutions are to these problems. I will give way but I also | :36:08. | :36:11. | |
want to make some progress, which I will do now. I want to talk about | :36:12. | :36:17. | |
something else that is different today in our AMD departments | :36:18. | :36:21. | |
compared to six years ago. Which -- a and E departments. We also insist | :36:22. | :36:28. | |
on much higher standards of safety and quality. On Monday, I | :36:29. | :36:32. | |
congratulated labour for the introduction of the four our target. | :36:33. | :36:38. | |
I support it. We should all member that four years after that standard | :36:39. | :36:42. | |
was introduced, we started to see some horrific problems among staff | :36:43. | :36:48. | |
in the a and E departments, many thought they would be fired if they | :36:49. | :36:52. | |
missed the target. What Robert Francis said about this that the | :36:53. | :36:57. | |
failure of its staffs were "Imparts the consequence of allowing a focus | :36:58. | :37:01. | |
on reaching national access targets." While we retain targets, | :37:02. | :37:06. | |
we will not allow them to be followed slavishly in a way that | :37:07. | :37:17. | |
damages patient care. My point is that that is why we have a new | :37:18. | :37:21. | |
inspection regime which makes it harder to cut corners in a way that | :37:22. | :37:25. | |
frankly used to happen which meant beds were not being washed. There | :37:26. | :37:29. | |
was poor infection control and ambulances were being used as | :37:30. | :37:34. | |
waiting rooms and so on. I will give way. I am grateful for him outlining | :37:35. | :37:40. | |
the steps he is taking in this emergency but does he also recognise | :37:41. | :37:44. | |
that the major cause of the problems in A are the lack of staff we | :37:45. | :37:48. | |
have? As a result of that, does he regret the huge cuts there were two | :37:49. | :37:55. | |
training projects in 2010, 2011, 2012, which is having an impact now | :37:56. | :37:59. | |
on the number of doctors and nurses in our NHS? I agree Stockman was | :38:00. | :38:07. | |
critical in this but we have more doctors in A departments, more | :38:08. | :38:12. | |
consultants, more than 11,000 additional doctors. We are | :38:13. | :38:17. | |
recognising the pressures being faced in the NHS. 1600 more doctors | :38:18. | :38:21. | |
since this time last year, this is something we are doing a lot about. | :38:22. | :38:25. | |
I will give way once more on this side. Does my right honourable | :38:26. | :38:30. | |
friend agree that learning Best practice within the NHS, the | :38:31. | :38:36. | |
hospitals that manage to integrate and help with social care, such as | :38:37. | :38:40. | |
Wigan and Salford hospitals who reduced and created those beds, that | :38:41. | :38:44. | |
is an example of best practice is that the whole NHS can learn from? | :38:45. | :38:51. | |
My honourable friend is absolutely right, it is a mistake in this | :38:52. | :38:55. | |
debate, which I understand that opposition parties want to do, to | :38:56. | :38:59. | |
put it down to government funding but in the country, we see a lot of | :39:00. | :39:04. | |
variability. This period of the year is always difficult but some | :39:05. | :39:07. | |
hospitals are doing superbly well in challenging circumstances. We have | :39:08. | :39:12. | |
just heard some of the hospital is doing well and there are a number. I | :39:13. | :39:19. | |
will give way to as many people as I can but I also want to address the | :39:20. | :39:23. | |
substantive point is that the Shadow Health Secretary said. He talked | :39:24. | :39:28. | |
about the four our target and in his motion and hit in his speech, he | :39:29. | :39:32. | |
made the totally spurious suggestion that we are not committed to that | :39:33. | :39:36. | |
target. I remind him of what might right honourable friend said, quoted | :39:37. | :39:43. | |
me as saying on Monday, what I said was not just committing the | :39:44. | :39:46. | |
government to the target but that it was one of the best things the NHS | :39:47. | :39:53. | |
does. I also said that we need to find different ways to offer | :39:54. | :39:57. | |
treatment to people who do not need to be in A This is hardly rocket | :39:58. | :40:04. | |
science. When you have pressure in A, it is sensible and indeed, I | :40:05. | :40:08. | |
would argue the duty of the Health Secretary to suggest that people who | :40:09. | :40:16. | |
can relieve pressure on A do so. I am grateful to the Health Secretary | :40:17. | :40:21. | |
for giving way, yesterday at Crawley Hospital, and acute care unit was | :40:22. | :40:26. | |
opened which precisely to ensure that those people who don't need to | :40:27. | :40:31. | |
attend A are properly directed to the most appropriate care. Which is | :40:32. | :40:35. | |
good for them as individual patients and good for the whole system as | :40:36. | :40:42. | |
well. He is absolutely right. To back up his point, we had a report | :40:43. | :40:47. | |
from the OECD yesterday that said that in Australia, Belgium, Canada, | :40:48. | :40:53. | |
France, Portugal, at least 20% of A visits are inappropriate. NHS | :40:54. | :40:58. | |
England's figure is that this is up to 30%. That is why we need the | :40:59. | :41:02. | |
public's help to relieve pressure. That is what I meant when I talked | :41:03. | :41:07. | |
about an honest discussion. I give way. The Secretary of State told us | :41:08. | :41:15. | |
a moment ago that there are 300,000 more people over the age of 80, | :41:16. | :41:18. | |
surely he would know this information when his government took | :41:19. | :41:20. | |
over seven years ago from the sensors data. Why is it that we are | :41:21. | :41:27. | |
now seeing on the front pages of newspapers that one in four of A | :41:28. | :41:33. | |
awards are unsafe and that we have similar challenges across the | :41:34. | :41:38. | |
country West Chamakh we did know that information and that is why we | :41:39. | :41:42. | |
thought it was totally responsible to cut the NHS budget in 2010. As a | :41:43. | :41:49. | |
result of that, we have 11,000 more doctors and in her own local | :41:50. | :41:54. | |
hospital, every single day, we are treating within four hours, 243 more | :41:55. | :42:02. | |
people. What I said, I will make some progress and then give way. I | :42:03. | :42:07. | |
could have put what I said on Monday a different way. I could have said | :42:08. | :42:10. | |
that we have to persuade those people not in medical emergencies to | :42:11. | :42:14. | |
use other parts of the system to get the help they need. I didn't | :42:15. | :42:17. | |
actually say that but I will tell you who did say that, the Labour | :42:18. | :42:22. | |
health minister in Wales, Mark Drake that, in January last year. And | :42:23. | :42:27. | |
frankly, when the NHS is under the pressure it is under, it is | :42:28. | :42:30. | |
responsible for the party of the city criticised the Health Secretary | :42:31. | :42:35. | |
in England for Sanogo same thing that the Health Secretary in Wales | :42:36. | :42:43. | |
is also saying. -- for saying the same thing. I am grateful, I think | :42:44. | :42:50. | |
the Secretary of State is so in confusion in the House and the | :42:51. | :42:54. | |
country on this question and again today. If what he is saying is the | :42:55. | :42:58. | |
same as my honourable friend the Health Secretary of Wales that we | :42:59. | :43:01. | |
want to divert people who don't need to go to A from doing so, then I'm | :43:02. | :43:07. | |
sure everybody in this House would support that. But what we suspect he | :43:08. | :43:12. | |
is saying is that the four our waiting target is going to be | :43:13. | :43:18. | |
disappointed to some people turning up to ten par and that is the | :43:19. | :43:21. | |
downgrading he is talking on if that is the case, he should come clear | :43:22. | :43:26. | |
and he should be clear whose job it is going to be to do supply the | :43:27. | :43:30. | |
target to some people with minor ailments. I did not say that and I | :43:31. | :43:37. | |
didn't say it because we are not going to do it. Let me tell him, we | :43:38. | :43:43. | |
did have an intervention from a Welshman, rather inconvenient truth | :43:44. | :43:45. | |
about what is happening in Wales. Last you, and par performance with | :43:46. | :43:50. | |
10% lower than in England and in Wales, they have not hit the A | :43:51. | :43:55. | |
target for eight years. We are not going to let that happen in England. | :43:56. | :44:00. | |
I noticed the Shadow Health Secretary quoted a number of people | :44:01. | :44:03. | |
but one organisation he didn't quote was the Royal College of emergency | :44:04. | :44:08. | |
medicine, I wonder if the reason is because of what they said about | :44:09. | :44:12. | |
Wales this week. They said emergency care in Wales is in a state of | :44:13. | :44:17. | |
crisis. "Performance Is as bad, if not worse than England in some | :44:18. | :44:24. | |
areas. " In areas Labour is in contrast -- labour is in control, | :44:25. | :44:33. | |
these issues are worse. I say that, not to make the political point but | :44:34. | :44:38. | |
to say that it is blatantly ridiculous to start trying to play | :44:39. | :44:41. | |
politics when you have winter pressures in the NHS because this | :44:42. | :44:45. | |
happens in the whole NHS, in Wales as well as in England. I'm going to | :44:46. | :44:49. | |
make progress but I will give way to my honourable friend. I thank him, | :44:50. | :44:57. | |
can I reiterate the point he made about the four our target. During | :44:58. | :45:00. | |
the Labour government I was working in the NHS and significant pressure | :45:01. | :45:05. | |
was put on us by managers to meet the four our target and negate | :45:06. | :45:08. | |
clinical need and often patients were prioritised according to | :45:09. | :45:12. | |
meeting the target rather than the clinical need and that was a | :45:13. | :45:16. | |
disgrace. That is exactly the problem we had with mid staffs. What | :45:17. | :45:21. | |
we had was a culture in the NHS where people were hitting targets | :45:22. | :45:26. | |
but missing the point. While targets are important, management tools, it | :45:27. | :45:32. | |
is important they followed in a sensible way that puts the welfare | :45:33. | :45:37. | |
of patients first. I would like to make another point about Wales why | :45:38. | :45:42. | |
we have the privilege of someone who aspired to lead the Labour Party | :45:43. | :45:47. | |
here, as the current leader of the Labour Party is no longer in this | :45:48. | :45:51. | |
place. I want to make this point, something England and Wales have in | :45:52. | :45:55. | |
common is the need to make sure that if we want all senators to A that | :45:56. | :45:59. | |
people are able to get to see their GP. I have said many times that | :46:00. | :46:04. | |
people wait too long to see their GPs. I have to say in all honesty, | :46:05. | :46:09. | |
the GP contract changes in 2004 were a disaster. Because the result of | :46:10. | :46:16. | |
those changes were that 90% of GPs opted out of out-of-hours care. But | :46:17. | :46:21. | |
we have been putting that right. Now, 17 million people in England, | :46:22. | :46:27. | |
30% of the publishing, have access to weekend and evening GP | :46:28. | :46:31. | |
appointments. More than that, in this Parliament, we have committed | :46:32. | :46:36. | |
to a 14% real terms increase in the GP budget, that is an extra ?2.4 | :46:37. | :46:42. | |
billion. And we sped that to see an extra 5000 doctors working in | :46:43. | :46:46. | |
general practice. I give way to the honourable lady. I received a very | :46:47. | :46:54. | |
distressed e-mail this morning from a senior NHS manager who has written | :46:55. | :47:00. | |
to me saying" I truly despair there will not be an NHS this time next | :47:01. | :47:04. | |
year. " You need to listen on the opposition benches, you need to | :47:05. | :47:10. | |
listen and understand what your secretary of state is doing to the | :47:11. | :47:14. | |
health service. I will give you a pr cis of what they are talking | :47:15. | :47:22. | |
about it. The honourable lady will return to has it, there are 33 | :47:23. | :47:25. | |
members wishing to speak in this debate, it is an important debate, | :47:26. | :47:29. | |
if she can keep intervention in brief, I will let her but very | :47:30. | :47:40. | |
brief. Thank you madam touch to Speaker, I shouldn't have used the | :47:41. | :47:47. | |
word "You." The government knows the NHS is in crisis, foundation trust | :47:48. | :47:50. | |
are failing, GPs are on their knees, so they are, the government are | :47:51. | :47:56. | |
handling it back to local areas and saying you fix it and by the way, | :47:57. | :48:04. | |
there is no money. All I would say is that I hope that people in the | :48:05. | :48:09. | |
NHS don't listen to much to what the Labour Party says about the state of | :48:10. | :48:13. | |
the NHS and listen to what the government is saying which is giving | :48:14. | :48:17. | |
a more accurate picture. As I will go on to explain. I will make some | :48:18. | :48:21. | |
progress and I will then give way further. The second part of the | :48:22. | :48:25. | |
motion talks about funding. And there is never questioned at all | :48:26. | :48:29. | |
that we will be needing to look after 1 million more people over 65 | :48:30. | :48:35. | |
in five years' time, we will need to continue increasing investment in | :48:36. | :48:38. | |
the NHS and the social care system. That is happening this year with an | :48:39. | :48:44. | |
extra ?3.8 billion going into the NHS, going in this year. They are | :48:45. | :48:48. | |
remind honourable members, it is ?1.3 billion more than they | :48:49. | :48:51. | |
themselves promised when they stood for election last year. I will just | :48:52. | :48:56. | |
say this, it is not enough to talk about extra funding, you act -- you | :48:57. | :49:01. | |
have to actually deliver it. They have to answer to their own | :49:02. | :49:05. | |
constituents why Fort two elections in a row they have missed less money | :49:06. | :49:09. | |
to the NHS than the Conservatives and the one area they are | :49:10. | :49:12. | |
responsible for the NHS, they have cut funding. | :49:13. | :49:16. | |
I think he is taking the right measured tone that was absent | :49:17. | :49:25. | |
earlier. We recognise the NHS is under financial pressure but some of | :49:26. | :49:30. | |
these are historic, reflecting in my area poor PFI contracts forced upon | :49:31. | :49:34. | |
them in the Gordon Brown sleight of hand. He is right. What we did not | :49:35. | :49:43. | |
hear from the party opposite was in 2010 we inherited a ?70 billion PFI | :49:44. | :49:48. | |
overhang that is making it difficult for hospitals to recruit staff | :49:49. | :49:52. | |
because they are having to pay so much money to pay for it. An example | :49:53. | :50:00. | |
of how we are spending money practically on the ground to make | :50:01. | :50:06. | |
sure patientss get a better deal is in Lincolnshire where, with a | :50:07. | :50:10. | |
shortage of GPs, the local health authority is offering ?20,000 as a | :50:11. | :50:15. | |
golden hello to do GPs. Isn't that the way of managing resources and | :50:16. | :50:20. | |
attracting the best talent to our areas and helping ensure patients | :50:21. | :50:24. | |
get the best care? She is right. I have talked about these issues when | :50:25. | :50:29. | |
I've visited her. The trick is to solve the problem we will have to | :50:30. | :50:33. | |
have a dramatic increase in people working in general practice, which | :50:34. | :50:37. | |
is why we are funding the second biggest increase in NHS history for | :50:38. | :50:44. | |
GPs. It is a shame the Leader of the Opposition is not here because this | :50:45. | :50:48. | |
is the bit I wanted to address to him, his proposal to put extra | :50:49. | :50:55. | |
funding into the NHS by scrapping corporation tax cuts. This reveals a | :50:56. | :50:58. | |
fundamental misunderstanding about how you fund the NHS. Corporation | :50:59. | :51:06. | |
taxes or cut so we can boost jobs and strengthen the economy, so we | :51:07. | :51:12. | |
can fund the NHS. The reason we have been able to protect and increase | :51:13. | :51:16. | |
funding in the NHS in the last six years when the party opposite was | :51:17. | :51:21. | |
not willing, is because we have created 2 million jobs and given | :51:22. | :51:25. | |
this country the fastest-growing economy in the G7. That is more | :51:26. | :51:30. | |
important posts Brexit. To risk that growth, which is what their proposal | :51:31. | :51:35. | |
would do, would not just risk funding for the NHS, it would be | :51:36. | :51:39. | |
dangerous for the economy and mortally dangerous for the NHS. I | :51:40. | :51:45. | |
want to understand what he will say about the four-hour target. Is it | :51:46. | :51:58. | |
conceivable that some of the people who are currently within the A | :51:59. | :52:02. | |
target will at some stage fall outside the target in the future? I | :52:03. | :52:09. | |
am committed to people using A falling within the four-hour target. | :52:10. | :52:15. | |
I also think we need to be more effective out diverted people who do | :52:16. | :52:19. | |
not need to go to A to other places as happens in Wales and | :52:20. | :52:25. | |
Scotland and is the only sensible thing. Going back to funding, for | :52:26. | :52:30. | |
all the heat in this chamber on debates on the NHS, probably the | :52:31. | :52:34. | |
biggest difference between the two sides is not on policy, but on the | :52:35. | :52:39. | |
ability to deliver the strong economy the NHS needs to give it the | :52:40. | :52:45. | |
funding required. I am afraid the proposal today in the motion | :52:46. | :52:49. | |
revealed that divide more starkly. I am grateful. We have this debate at | :52:50. | :52:55. | |
the election about the need for the stronger economy to pay for the NHS | :52:56. | :52:59. | |
and the public decided we won that argument. Can I give another example | :53:00. | :53:05. | |
from his friend Jeremy, from yesterday, he made a proposal to cap | :53:06. | :53:12. | |
high pay. The top 1% of taxpayers pay 27% of income tax revenues and | :53:13. | :53:17. | |
that proposal would cut funding available to the NHS and damaged the | :53:18. | :53:22. | |
services staff have produced. It is the worst kind of gesture politics | :53:23. | :53:28. | |
because it may get him more votes or Momentum supporters, but it would | :53:29. | :53:35. | |
damage the NHS. Would he agree with me that rather than making | :53:36. | :53:40. | |
meaningless and totally underfunded promises on more money for the NHS | :53:41. | :53:47. | |
contrary to their manifesto back in 2015, members opposite would do | :53:48. | :53:52. | |
better to recognise the demographic changes, ageing population need for | :53:53. | :53:57. | |
the NHS to change, and to support the locally developed plans for | :53:58. | :54:04. | |
change in the NHS, the STPs? She is absolutely right. People in the | :54:05. | :54:10. | |
country will find it hugely ironic that the party that spent so much | :54:11. | :54:16. | |
energy in the last Parliament campaigning against top-down | :54:17. | :54:18. | |
reorganisation is now campaigning against locally driven changes. I | :54:19. | :54:25. | |
will give way and then I will conclude. As the government points | :54:26. | :54:35. | |
out often, they want to hand decisions to local groups, but could | :54:36. | :54:41. | |
he give an explanation too worried patients in the south and west of | :54:42. | :54:47. | |
Cumbria as to why the local health services are suggesting the changes | :54:48. | :54:51. | |
to A in the west and potentially in the South? I know he spent time | :54:52. | :54:59. | |
looking at this area. I would like to use this moment to congratulate | :55:00. | :55:03. | |
his local trust for coming out of special measures and the progress | :55:04. | :55:09. | |
they are making. In a way, that is the answer, because his local trust | :55:10. | :55:13. | |
was in special measures and north Cumbria is still in special measures | :55:14. | :55:17. | |
and we have profound worries about patient care in both trusts but we | :55:18. | :55:22. | |
still do in North Cumbria. That is why the status quo is not an option | :55:23. | :55:27. | |
that we understand the concerns of constituents about proposals being | :55:28. | :55:35. | |
made. What does he make of this talk among professionals in relation to | :55:36. | :55:39. | |
the potential for a flu outbreak and what does he make of the doctor who | :55:40. | :55:41. | |
wrote to me on Sunday saying she is wrote to me on Sunday saying she is | :55:42. | :55:49. | |
concerned they are too busy to isolate patients coming in who need | :55:50. | :55:53. | |
oxygen and they are too busy to cover that, to isolate patients so | :55:54. | :55:57. | |
others do not capture potential flu epidemic? There is a concern about a | :55:58. | :56:07. | |
growth in respiratory infections and that is causing capacity | :56:08. | :56:10. | |
constraints. We are watching what is happening on this carefully but we | :56:11. | :56:17. | |
have 13 million people vaccinated this year against flu which is a | :56:18. | :56:25. | |
record. Money is important, but can I support the Health Secretary in | :56:26. | :56:28. | |
not viewing these issues so the three that lends? My local trust, | :56:29. | :56:32. | |
Sherwood forest cover has some of the worst finances of any trust, | :56:33. | :56:38. | |
almost all due to a PFI deal signed by Gordon Brown. My trust is | :56:39. | :56:43. | |
improving. It is under pressure this winter but management says it is not | :56:44. | :56:47. | |
in crisis, and that is a trust improving because of quality | :56:48. | :56:53. | |
management, reform and good quality processes. That is absolutely the | :56:54. | :57:00. | |
point. We miss a trick and I think the Shadow Health Secretary is in | :57:01. | :57:04. | |
some ways more reasonable than his leader on these issues, if we say it | :57:05. | :57:09. | |
is simply an issue... That is probably terminal for his career! If | :57:10. | :57:17. | |
we say it is just about money, we forget the debate we went through on | :57:18. | :57:21. | |
schools 20 years ago when there was a debate about money and we realised | :57:22. | :57:26. | |
it is about standards and quality or so and that has happened in Sherwood | :57:27. | :57:30. | |
forest and I congratulate the hospital. It is important we don't | :57:31. | :57:34. | |
let debates about funding eclipse the progress we need to make | :57:35. | :57:44. | |
standards. I am going to conclude, because lots of people want to come | :57:45. | :57:52. | |
in. He made as his central claim, his words, the culpability for what | :57:53. | :57:57. | |
is happening in the NHS lies at the door of Downing Street. I think I | :57:58. | :58:01. | |
owe it to the country and this House to set the record straight on this | :58:02. | :58:07. | |
government's record on the NHS, not just 11,000 more nurses and 11,000 | :58:08. | :58:11. | |
more doctors and on cancer we are starting treatment for 130 more | :58:12. | :58:16. | |
people every day and have record survival rates, not just the fact we | :58:17. | :58:21. | |
have 1400 more people getting mental health treatment every day and some | :58:22. | :58:25. | |
of the highest dementia diagnosis rates in the world, not just the | :58:26. | :58:30. | |
fact we are doing 5000 more operations every day and despite | :58:31. | :58:35. | |
that, MRSA rates have hard. We have the NHS with more doctors, nurses, | :58:36. | :58:41. | |
and despite difficult winters, patients saying they have never been | :58:42. | :58:45. | |
treated more safely and with more dignity and respect. Next year, the | :58:46. | :58:52. | |
NHS will be 70 years old and this government's vision is simple, we | :58:53. | :58:57. | |
want it to offer the safest, highest quality care anywhere in the world, | :58:58. | :59:02. | |
and when you have difficult winters and an ageing population, that makes | :59:03. | :59:06. | |
things more challenging, but it makes us more determined and means | :59:07. | :59:11. | |
we are backing the NHS plan, more GPs, it means better mental health | :59:12. | :59:16. | |
provision and a NHS turning heads in the 21st century just as it did when | :59:17. | :59:25. | |
it was founded in the 20th. Here we are again debating the NHS. We had | :59:26. | :59:33. | |
the statement... All on my own because this is predominantly a | :59:34. | :59:39. | |
crisis, this is NHS England, not a crisis that is NHS Scotland, as I | :59:40. | :59:47. | |
will talk about. The problem is we are talking about patients who are | :59:48. | :59:52. | |
suffering, patients who may suffer from more infections. We are talking | :59:53. | :59:58. | |
about staffing tears, who are desperate, who feel they cannot | :59:59. | :00:01. | |
deliver the care they would expect to deliver. This is not just a | :00:02. | :00:10. | |
matter of isolated stories. We hear from NHS improvement that only one | :00:11. | :00:15. | |
trust met the target in December. Only nine out of 152 made it over | :00:16. | :00:23. | |
90%. This is not something that is just a matter of Joe from Wiltshire | :00:24. | :00:29. | |
and Mike from Leeds, this is something happening on a major | :00:30. | :00:34. | |
scale. 50 out of 152 trusts have declared a black or red situation | :00:35. | :00:41. | |
over December, and 158 diverts of ambulances. It is not just normal | :00:42. | :00:48. | |
winter pressures, it is not what the honourable lady opposite who is an | :00:49. | :00:52. | |
A nurse and people like myself and other medics in the chamber have | :00:53. | :00:57. | |
seen in our careers. This is a really bad winter, and yet we have | :00:58. | :01:02. | |
not had a really bad winter, we have not had bitter weather, we have not | :01:03. | :01:08. | |
had a flu epidemic. What we have seen when we look at the four-hour | :01:09. | :01:13. | |
data is the last one published was October, when the NHS in England | :01:14. | :01:19. | |
managed to achieve the four-hour target 83.7% of the time, 5% down | :01:20. | :01:25. | |
from the same time the previous year and compares with 93.9% in Scotland. | :01:26. | :01:31. | |
Scotland managed 93.5% in Christmas week. I'm sorry, the crisis in | :01:32. | :01:38. | |
Scotland, we have our challenges, but it is not the same as discussed | :01:39. | :01:45. | |
here. I will happily give way. I am grateful. Will she confirmed, | :01:46. | :01:51. | |
though, that throughout the whole of 2016, which includes winter, summer, | :01:52. | :01:58. | |
autumn and spring, the Scottish Government's A target was only met | :01:59. | :02:05. | |
in seven out of the 52 weeks? I'd be delighted to agree but I would like | :02:06. | :02:10. | |
to point out that NHS England did not make it over 90% anywhere in | :02:11. | :02:16. | |
2016, so I think perhaps the honourable gentleman might want to | :02:17. | :02:20. | |
check the NHS England figures before having a punt at me. NHS England is | :02:21. | :02:27. | |
performing 8-10% lower than NHS Scotland, which has been the top | :02:28. | :02:32. | |
performing of the nation 's for the last 19 months. We have not done | :02:33. | :02:38. | |
that from magic, we face the same ageing population, exactly the same | :02:39. | :02:43. | |
increased demand and complexity and exactly the same indeed often worse, | :02:44. | :02:48. | |
shortage of doctors than NHS England, because of our rural areas. | :02:49. | :02:54. | |
It is not something that is a different measure, we use the same | :02:55. | :02:58. | |
measure, but if you look at the data, there is a difference and it | :02:59. | :03:03. | |
has been maintained. The Secretary of State is right, winter is | :03:04. | :03:08. | |
challenging. Summer is when A is often busier for attendances because | :03:09. | :03:11. | |
the children are on companies and people go out and do silly things. | :03:12. | :03:20. | |
-- are wrong trampolines. But the people who come to A are sicker, | :03:21. | :03:25. | |
older, more complicated, and that is the problem that we have at the | :03:26. | :03:32. | |
moment. What we have not seen is any summer respite in NHS England. The | :03:33. | :03:39. | |
worst performance in the summer was 80.8%. The best performance was | :03:40. | :03:46. | |
86.4%. NHS England is under pressure in the summer and when you add the | :03:47. | :03:51. | |
winter on top, it is no wonder we are talking about the situation is | :03:52. | :03:56. | |
doctors, nurses, patients and relatives are describing. I remember | :03:57. | :04:01. | |
my first health debate after my maiden speech was an Opposition Day | :04:02. | :04:07. | |
debate on the four-hour target. I commented at the time and still | :04:08. | :04:13. | |
maintain that this target is not a stick for each party to hit each | :04:14. | :04:17. | |
other over the head with. But it is a thermometer to take the | :04:18. | :04:22. | |
temperature of the acute service. It does that really well. Because what | :04:23. | :04:27. | |
it measures is not just people coming in through the front door, | :04:28. | :04:31. | |
but how they are moving through the hospital, and how they are moving | :04:32. | :04:33. | |
out. We are seeing a system that is | :04:34. | :04:44. | |
completely overheated. The comments about it not being anything unusual | :04:45. | :04:49. | |
and just a normal winter and everyone is whingeing means the | :04:50. | :04:53. | |
government isn't recognising the problem. And the first step to | :04:54. | :04:57. | |
dealing with any problem is to recognise it. Then you can look at | :04:58. | :05:02. | |
how you want to tackle it. I thank her for giving way. I would remind | :05:03. | :05:05. | |
her the point that Prime Minister made in prime ministers questions on | :05:06. | :05:10. | |
the Tuesday after Christmas that the NHS received the highest number of | :05:11. | :05:16. | |
visitors it has ever received, A receiving the highest number of | :05:17. | :05:19. | |
visitors it has ever received in its history. Doesn't that show the | :05:20. | :05:24. | |
challenges facing the NHS nationally and locally? Those are extraordinary | :05:25. | :05:29. | |
figures and the Secretary of State is very much doing his best to help | :05:30. | :05:34. | |
the professionals deal with those numbers. I would totally accept that | :05:35. | :05:39. | |
the NHS has been under inordinate pressure am absolutely is busiest | :05:40. | :05:44. | |
day in its history. But with an ageing population that has been | :05:45. | :05:48. | |
discussed for years, we should have been able to see this coming. If in | :05:49. | :05:53. | |
the next few months we get a massive flu epidemic, we are really going to | :05:54. | :05:57. | |
see things keel over. What we can't have is the debates we have already | :05:58. | :06:03. | |
had in this chamber about STPs, taking more beds away. I totally | :06:04. | :06:07. | |
agree with the Secretary of State that some of it is that patients | :06:08. | :06:12. | |
could be seen somewhere else. But it is not a matter of changing the four | :06:13. | :06:18. | |
our target and saying someone won't count is that we provide better | :06:19. | :06:23. | |
automotives. If we provide better alternatives, people will go to | :06:24. | :06:27. | |
them. We have discussed community pharmacies in this chamber and it | :06:28. | :06:31. | |
has been recognised that the minor ailments service we have in Scotland | :06:32. | :06:35. | |
can deal with five or 10% of those patients. We have located out of | :06:36. | :06:43. | |
hours GP 's units beside our A, someone sent along the corridor into | :06:44. | :06:50. | |
the next building if it is a GP and not A that they need to see. We do | :06:51. | :06:56. | |
need to educate the public but the public will use an alternative | :06:57. | :07:00. | |
service if it is there. If it isn't, then if they turn up at A and they | :07:01. | :07:05. | |
keep sitting there, someone will see them. We shouldn't blame them for | :07:06. | :07:12. | |
that. I thank her for giving way. She is right to say we have an | :07:13. | :07:15. | |
ageing population but it is predictable. The significant thing | :07:16. | :07:20. | |
is that in 2008, the UK was spending around the same as all the major EU | :07:21. | :07:27. | |
nations, we are now spending considerably less than major | :07:28. | :07:32. | |
nations, isn't that what is causing the problem? I don't think money is | :07:33. | :07:36. | |
the only problem, I do accept part of it is how things are done. The | :07:37. | :07:41. | |
Secretary of State talks about the variation and hospitals performing | :07:42. | :07:44. | |
well but only one of them is meeting the target. Only nine of them are | :07:45. | :07:49. | |
over 90%. It is not that the majority are doing well and few are | :07:50. | :07:55. | |
failing, we will come onto STPs in a minute, in how we deliver the NHS is | :07:56. | :08:00. | |
crucial but change costs money. Therefore you have two invest in | :08:01. | :08:07. | |
alternatives in your community services, primary care, step up and | :08:08. | :08:11. | |
step down to take that pressure. At the moment, one of the concerns | :08:12. | :08:16. | |
about the STPs is because they don't have the money. What we see are a | :08:17. | :08:19. | |
lot of them are starting that way and thinking they will shut A and | :08:20. | :08:25. | |
a couple of wards and community beds which we need more of. To fund | :08:26. | :08:30. | |
change in primary and social care. And in actual fact, the system will | :08:31. | :08:36. | |
fall over, you need to have double running and develop alternatives and | :08:37. | :08:39. | |
then you are able to gradually send patients into that. I was enjoyed | :08:40. | :08:48. | |
listening to her well-informed remarks, I agree also that most | :08:49. | :08:52. | |
people don't want to go to A if they can avoid it. Would she agree | :08:53. | :08:56. | |
that part of the problem is when people phone general practices, they | :08:57. | :09:00. | |
tend to either not be offered an appointment in a reasonable time | :09:01. | :09:05. | |
frame or they can't get to see the doctor that they closely associate | :09:06. | :09:09. | |
with and that particular applies to people with chronic and long-term | :09:10. | :09:14. | |
conditions. A report makes there today that we need to address that | :09:15. | :09:18. | |
as a matter of urgency and possibly seven days a week general practice | :09:19. | :09:24. | |
may paradoxically be mitigating against the possibility of providing | :09:25. | :09:28. | |
people with that continuity of care during core hours. I think having | :09:29. | :09:34. | |
access to a GP and I think many doctors in general practice would | :09:35. | :09:38. | |
accept the argument for something like a Saturday morning, that people | :09:39. | :09:44. | |
who are work, but someone who can't see their favourite doctor is | :09:45. | :09:49. | |
actually very unlikely to go to A and wait eight hours to see a doctor | :09:50. | :09:53. | |
they have never seen in their life. I don't think it is that, I think | :09:54. | :09:57. | |
people feel they can't find an alternative. If it is taking three | :09:58. | :10:02. | |
or four weeks to get any appointment with their GP if they don't yet have | :10:03. | :10:06. | |
a community pharmacy that will offer a service, and eventually they end | :10:07. | :10:11. | |
up at A Therefore it is the service of last resort for people. | :10:12. | :10:15. | |
They go there and just stay there. We have do develop those other | :10:16. | :10:20. | |
alternatives first and as the honourable gentleman says, no point | :10:21. | :10:23. | |
in their right mind will choose to go and wait four hours in A if | :10:24. | :10:28. | |
they could be seen in half an hour at a community pharmacy. I have do | :10:29. | :10:32. | |
disagree with her because winter pressures that we are seeing at the | :10:33. | :10:38. | |
moment, tend not to be people with short-term conditions, they tend to | :10:39. | :10:41. | |
be the chronically sick. And those people want to have a relationship | :10:42. | :10:45. | |
with a particular practitioner who understands their needs and | :10:46. | :10:50. | |
understands the family contest, surely that is the essence of | :10:51. | :10:54. | |
general practice. I totally agree with that. But the chances of them | :10:55. | :11:00. | |
having their doctor on a Saturday morning or Sunday afternoon is | :11:01. | :11:03. | |
reduced. One of the things they have done in Scotland is to identify that | :11:04. | :11:10. | |
40% of admissions from 5% of patients. Because those patients are | :11:11. | :11:14. | |
automatically flagged. No matter what they ring up with, they will | :11:15. | :11:18. | |
get a double appointment because it is not just the chest infection or | :11:19. | :11:23. | |
the year in infection, you have to look at how it interferes with | :11:24. | :11:28. | |
everything else. It is not a catastrophe of people living longer, | :11:29. | :11:33. | |
those of us who are medical in-house do remember that was definitely the | :11:34. | :11:36. | |
point of why we went into medicine and that is the point of the NHS. | :11:37. | :11:41. | |
But we are not ageing very well. From about 40 or 50 onwards, people | :11:42. | :11:46. | |
are starting to accumulate conditions that maybe they wouldn't | :11:47. | :11:49. | |
have survived in the past. By the time they are 70, they have four or | :11:50. | :11:57. | |
five things that make treating them a challenge. I have friends still | :11:58. | :12:01. | |
working on the front line and they say it is not even just numbers but | :12:02. | :12:06. | |
complex T. Someone comes with what sounds like an easy issue but in | :12:07. | :12:11. | |
actual fact, with their diabetes and their renal failure and their | :12:12. | :12:15. | |
previous heart attack, it is a complex issue. And this is part of | :12:16. | :12:18. | |
the problem we face. We need to be looking forward to preparing for | :12:19. | :12:26. | |
that. STPs need to be thinking about being designed around old people. | :12:27. | :12:30. | |
Not being designed around young people who can come in and have an | :12:31. | :12:34. | |
operation as a day case and go away. That is not what we are facing. | :12:35. | :12:39. | |
Older people need longer in hospital. Even medically before they | :12:40. | :12:44. | |
reach the point of being able to go home, it will take them a couple of | :12:45. | :12:54. | |
days longer to be strong enough, they probably live alone. They | :12:55. | :12:57. | |
probably do not have family near them. They will need a degree of | :12:58. | :13:03. | |
convalescent support, they will need social care. This is really where | :13:04. | :13:08. | |
the nub of the problem lies, that social care funding has gone down. | :13:09. | :13:12. | |
And therefore more people are stuck in hospital or more people end up in | :13:13. | :13:17. | |
hospital who actually wouldn't have needed to be there in the first | :13:18. | :13:21. | |
place. I'm grateful to her for giving way. In terms of the | :13:22. | :13:25. | |
frailties of older people, just as Scotland led the way with a primary | :13:26. | :13:31. | |
school introducing the daily mile, is there something we can learn from | :13:32. | :13:35. | |
countries like Andorra that have a focus on exercise for older people. | :13:36. | :13:40. | |
So they are not as frail in their 70s and 80s? I think the prevention | :13:41. | :13:46. | |
and public health message is crucial. I think that is one of the | :13:47. | :13:51. | |
other challenges we have. I am grateful the Secretary of State no | :13:52. | :13:56. | |
longer talks about 10 billion because actually, the increase in | :13:57. | :14:00. | |
the Department of Health budget is 4.5 billion, part of that has been a | :14:01. | :14:04. | |
reduction in public health funding. Just at a time where we need to move | :14:05. | :14:08. | |
it to a totally different scale, whether it is children doing the | :14:09. | :14:12. | |
daily mile, adults doing the daily mile, maybe we should run up to | :14:13. | :14:16. | |
Trafalgar Square there and back every lunchtime. I am sure that | :14:17. | :14:20. | |
would do all of us the power of good. We need to invest in these | :14:21. | :14:25. | |
things that prevent. One of the points I would make is that when we | :14:26. | :14:30. | |
end up desperate, and whether it is patching up how the NHS runs or | :14:31. | :14:34. | |
dealing with illnesses we didn't bother to prevent, we always end up | :14:35. | :14:39. | |
spending more money. I am grateful to her for giving way. She knows how | :14:40. | :14:45. | |
much I respect what she is saying and she is the chairman of the | :14:46. | :14:49. | |
all-party running group and I endorse the daily mile and encourage | :14:50. | :14:53. | |
all adults, Park runs are a good example of that. They happen across | :14:54. | :14:59. | |
the nation. My question to her, her huge expertise in Scotland, | :15:00. | :15:04. | |
including NHS England learned from Scotland, what is best practice? | :15:05. | :15:08. | |
Could she give us some example is a best practice in Scotland, hospitals | :15:09. | :15:13. | |
and trusts that we can take away and learn from? I think the whole issue | :15:14. | :15:17. | |
is down to sustainability. That is the idea of the sustainability and | :15:18. | :15:22. | |
transformation plans, those who have heard me speak know that I support | :15:23. | :15:26. | |
the idea in principle. The idea is to go back to place -based planning | :15:27. | :15:32. | |
on an integrated basis for a community. That is what the | :15:33. | :15:37. | |
difference is with Scotland, what we have focused on is integration. We | :15:38. | :15:42. | |
got rid of hospital trusts in 2004, PCTs in the late 2000s, and since | :15:43. | :15:52. | |
April 2014, we set up integrated joint boards. That is a bag of money | :15:53. | :15:57. | |
from the NHS, a bag of money from the local authorities goes on the | :15:58. | :16:01. | |
table and a group sit around and work out what is the best way to | :16:02. | :16:05. | |
deal with that interface and to support social care. Because anyone | :16:06. | :16:09. | |
in this chamber or anyone with family members who have been stuck | :16:10. | :16:14. | |
in hospital, they know that you get into a bickering situation. Mrs | :16:15. | :16:17. | |
Bloggs is in a bed so the local authority are not interested because | :16:18. | :16:22. | |
she is sick, they are busy with Mrs Smith who has just fallen off a | :16:23. | :16:26. | |
ladder trying to put her curtains up and is not considered safe because | :16:27. | :16:30. | |
she is leaving the gas on. You have all this perverse obstruction and | :16:31. | :16:39. | |
that is what gets rid of that. I thank her for giving way, I welcome | :16:40. | :16:43. | |
the tone she brings to this debate, unlike what we saw earlier. One of | :16:44. | :16:48. | |
the points she makes is the importance of integrated care, | :16:49. | :16:50. | |
social and health. Does she believe that with further evolution in | :16:51. | :16:55. | |
England in the major cities, there is a huge opportunity to move that | :16:56. | :17:01. | |
agenda forward south of the border? You I think the whole idea of STPs | :17:02. | :17:07. | |
going to areas, we simply have geographical health wards, that is | :17:08. | :17:11. | |
the only layer we have. We are not wasting huge amounts of money on | :17:12. | :17:16. | |
layers and layers. You can integrate. For an STP to work, it | :17:17. | :17:20. | |
has to make sense geographically and that might be a county, maybe | :17:21. | :17:23. | |
something bigger or smaller. Personally I think they should have | :17:24. | :17:31. | |
a statutory position. We have 211 CCGs, an average of six CCGs for | :17:32. | :17:37. | |
every STP. That is a waste of layers, that is going to be very | :17:38. | :17:42. | |
difficult to integrate. One of the biggest difference is, is we got rid | :17:43. | :17:48. | |
of in 2004, the purchaser provider split. There is no evidence in | :17:49. | :17:55. | |
25-year is of any clinical benefit from the purchaser provider split. | :17:56. | :17:59. | |
The internal market now the external market. It is estimated the cost of | :18:00. | :18:05. | |
running that market are between five and ?10 billion a year. That is | :18:06. | :18:08. | |
money that is not actually going to health care but either going to | :18:09. | :18:12. | |
bidding, tendering, administration or profit. I think, we can't do an | :18:13. | :18:19. | |
overnight change but if we made a principled decision to work our way | :18:20. | :18:24. | |
back to the NHS as the main provider of public health treatment and | :18:25. | :18:30. | |
integration of care through the STP or a macro, I think we could reach a | :18:31. | :18:36. | |
point of sustainability. As I said earlier, you have two actually both | :18:37. | :18:41. | |
protect things like into hospitals and community services. Invest in | :18:42. | :18:46. | |
them. We have rebuilt three cottage hospitals as modern hospitals in our | :18:47. | :18:50. | |
health wards. That is where you want to put an older person on their own | :18:51. | :18:54. | |
with a chest infection who actually needs a few days of antibiotics and | :18:55. | :18:59. | |
TLC and decent feeding. You don't want them in the big hospital, you | :19:00. | :19:05. | |
want them close to home. What we are seeing with the ST people macro is | :19:06. | :19:08. | |
that people seek community hospitals as easy to get rid of. It is only an | :19:09. | :19:14. | |
efficiency saving if what you are getting rid of is inefficiency. If | :19:15. | :19:18. | |
you are slashing and burning, what you are ending up doing is spending | :19:19. | :19:19. | |
more money in the end. Much of what she says is music to my | :19:20. | :19:32. | |
ears, as someone who is campaigning to save the local General Hospital, | :19:33. | :19:36. | |
but I wonder if we could have the benefit of her views on the role of | :19:37. | :19:43. | |
patients and consultation in all of this when considering and | :19:44. | :19:48. | |
transformation plans. Not just consultation in the way it has often | :19:49. | :19:52. | |
been done in the past - here we are, we have made a decision, we are | :19:53. | :19:57. | |
telling you about it. Unfortunately, that is very much what we have heard | :19:58. | :20:02. | |
around the STP process, partly because it has been so short, and | :20:03. | :20:06. | |
partly, another, because it is budget- centred and not patient- | :20:07. | :20:10. | |
centred care. They have all been given a number, and if you are not | :20:11. | :20:14. | |
meeting it, do not bother submitting your plan. That will not give an | :20:15. | :20:20. | |
integrated service. The public also have to be involved, but I think the | :20:21. | :20:23. | |
front line clinicians, they are the people who work in the service. They | :20:24. | :20:28. | |
know where the bottlenecks are, they know where -- they know what is the | :20:29. | :20:36. | |
horseshoe nail that the service is missing that is holding it back, and | :20:37. | :20:42. | |
if you have clinician- led redesign, as I was involved in in my health | :20:43. | :20:46. | |
board 17 years ago the breast cancer, you can end up where you | :20:47. | :20:50. | |
track the part of the patient. You very quickly imagine yourself that a | :20:51. | :20:55. | |
patient, UCD bottlenecks, and that is where you focus investment. I | :20:56. | :21:02. | |
read an article yesterday, -- you see the bottlenecks. I read an | :21:03. | :21:09. | |
article about management consultants coming in advising to shut a board, | :21:10. | :21:17. | |
increase parking spaces, and that was not good value for money for ?2 | :21:18. | :21:24. | |
million. I thank her for eloquently pushing issues that face all of us, | :21:25. | :21:27. | |
no matter where we are from. Would she agree with me that the use of | :21:28. | :21:30. | |
good health care data for those clinicians, enabling patients to be | :21:31. | :21:34. | |
seamlessly put through the system are important. Many people don't | :21:35. | :21:40. | |
realise that their information from the GP does not go into the acute | :21:41. | :21:49. | |
service and at the social care. I believe that would help patients. I | :21:50. | :21:55. | |
would not say we are super IT wizards in Scotland, but we did not | :21:56. | :22:02. | |
get involved in the care. Data issue, which is now a shadow over | :22:03. | :22:09. | |
the NHS in England. Nothing goes in the post. All of our letters back | :22:10. | :22:18. | |
are electronic. I block my dictation machine during a clinic and when I | :22:19. | :22:23. | |
finish, they all go away. They are on their way by 2pm. We have already | :22:24. | :22:28. | |
done that. AGP can e-mail my colleagues and say, I do not know | :22:29. | :22:32. | |
whether you need to see this person or not. And what I have heard from | :22:33. | :22:36. | |
clinicians is, we cannot e-mail about a patient. Because of the | :22:37. | :22:44. | |
wrong move around the data service, that is holding things back. Our GPs | :22:45. | :22:49. | |
use a care summary, so if they have a palliative patient, that will be | :22:50. | :22:53. | |
put on the out of our system so that if there is a call about that person | :22:54. | :22:58. | |
who has been accepted as being in terminal care, the doctor already | :22:59. | :23:04. | |
knows. We not throwing them in an ambulance. We're keeping them | :23:05. | :23:06. | |
comfortable. We have had a discussion on the aim is for them to | :23:07. | :23:14. | |
be at home. It is about sharing information, which is the first | :23:15. | :23:18. | |
step, and that is something that England has to get. In finishing | :23:19. | :23:24. | |
off, I think, really, integration... I'm sorry if I was taking too long | :23:25. | :23:32. | |
for the lady at the back. I think, really, integration is the key, and | :23:33. | :23:38. | |
it is possible, through the STPs, but only if they are designed around | :23:39. | :23:43. | |
patients, safety and services, and not just starting with a bottom line | :23:44. | :23:51. | |
and working backwards. Order. Before I call the next speaker, it will be | :23:52. | :23:55. | |
obvious to colleagues that there are a great many people who wish to | :23:56. | :23:59. | |
speak this afternoon, and that the debate although it has advanced a | :24:00. | :24:03. | |
long way in time, has not advanced very far as far as the number of | :24:04. | :24:08. | |
people called is concerned, so we now have to have a time limit of ten | :24:09. | :24:18. | |
minutes. Surely less. I can see there was some surprise at that. Ten | :24:19. | :24:27. | |
minutes for the moment. Anyone who can do arithmetic will be aware that | :24:28. | :24:31. | |
it will need to be reduced later, so I suggest starting working on your | :24:32. | :24:35. | |
speeches now. Doctor Sarah Wollaston. Thank you, Madam Deputy | :24:36. | :24:41. | |
Speaker, and I will be mindful of those comments. Thank you for the | :24:42. | :24:47. | |
member's thoughtful and thought-provoking comments. I would | :24:48. | :24:53. | |
like to endorse what she said and expand on some of those points. We | :24:54. | :25:00. | |
have heard that NHS staff are facing unprecedented demand over the | :25:01. | :25:03. | |
winter, but the point is, it is not just winter pressures, they are | :25:04. | :25:06. | |
extending into the summer. As we heard, it is not just about numbers | :25:07. | :25:10. | |
but about the complexity and the frailty of those who are presenting | :25:11. | :25:18. | |
in our A departments. The 4-mac- our target -- the four-hour target, | :25:19. | :25:26. | |
the trusts that were most successful in getting close to that target are | :25:27. | :25:33. | |
those that see this as a systemic issue where both health and care | :25:34. | :25:37. | |
staff are all contributing to this, not just some box ticking exercise, | :25:38. | :25:40. | |
but because they recognise that fundamentally this is an issue about | :25:41. | :25:46. | |
patient safety and about the quality of patient experience. That is why | :25:47. | :25:50. | |
the target matters and the Secretary of State is right to endorse that. I | :25:51. | :25:54. | |
think he is also right to raise the fact that sometimes we need to be | :25:55. | :25:59. | |
more nuanced about our targets and to be able to be open to listening | :26:00. | :26:03. | |
to what clinicians are telling him about how we can improve the way | :26:04. | :26:07. | |
targets are applied. I think it would be a great shame if in this | :26:08. | :26:16. | |
House, because of political for raw Ballance political upheaval, we fail | :26:17. | :26:23. | |
to have those discussions. I would urge the Secretary of State to | :26:24. | :26:26. | |
listen to clinicians in terms of where we can improve targets. He has | :26:27. | :26:31. | |
made it clear that we are right to keep the four-hour target. I would | :26:32. | :26:35. | |
also like to say, in talking about this as a whole system issue, of | :26:36. | :26:40. | |
course, with accident and emergency, it is a barometer, as my honourable | :26:41. | :26:44. | |
friend has pointed out, for wider system pressures. I would like to | :26:45. | :26:49. | |
focus my remarks on integration of health and social care, and also, | :26:50. | :26:53. | |
with those colleagues across this House who have called for a | :26:54. | :26:57. | |
convention in how we review the funding of this as a whole system | :26:58. | :27:01. | |
issue, we have heard it is the 70th birthday of the NHS next year, and | :27:02. | :27:05. | |
what could be a better president than politicians changing the debate | :27:06. | :27:09. | |
and the way we talk about funding of health and social care, and to do so | :27:10. | :27:16. | |
in a collaborative manner that works out the right solution for our | :27:17. | :27:20. | |
patients? The consequences of us not doing that are really profound for | :27:21. | :27:25. | |
our constituents, and they won't thank us for not being prepared to | :27:26. | :27:30. | |
put aside party differences and work towards the right solution, because | :27:31. | :27:34. | |
ultimately, this is about a demographic change that we are | :27:35. | :27:38. | |
simply not prepared for. We did this for pension age, recognising that | :27:39. | :27:44. | |
had to be a different debate, given the change in longevity. Over the | :27:45. | :27:52. | |
decade to 2015, we have seen a 31% increase in the number of those | :27:53. | :27:56. | |
living to 85 and older, and of course, that is a cause for | :27:57. | :28:00. | |
celebration, but what we are not seeing is a commensurate increase, a | :28:01. | :28:08. | |
matching increase, in the disease- free life expectancy. Unfortunately, | :28:09. | :28:12. | |
we are also not making sufficient progress on tackling inequality. And | :28:13. | :28:17. | |
I welcome the Prime Minister's focus on that. In her very first speech, | :28:18. | :28:21. | |
she talked about the burning injustice of health inequality and | :28:22. | :28:25. | |
tackling that, but I believe we have a role in this House in doing that | :28:26. | :28:30. | |
together in a consensual manner. I give weight to my right honourable | :28:31. | :28:38. | |
friend. I thank the honourable lady for allowing me to intervene. Does | :28:39. | :28:44. | |
she share my welcomer the Prime Minister's response today that she | :28:45. | :28:48. | |
is prepared to meet with us and other members of Parliament from | :28:49. | :28:52. | |
across this house with the hope that this might start a more constructive | :28:53. | :28:57. | |
approach? I thank the right honourable gentleman. Absolutely, I | :28:58. | :29:00. | |
thought it was extraordinarily encouraging to hear the Prime | :29:01. | :29:04. | |
Minister prepared to consider the centimetre with us across the House. | :29:05. | :29:09. | |
I would urge colleagues who feel this is a better way forward to sign | :29:10. | :29:14. | |
up to this and two, themselves, speak to their party whips and make | :29:15. | :29:18. | |
it clear that there is widespread support for considering this. I give | :29:19. | :29:25. | |
way. I wonder if on this vital issue the honourable lady wants to say | :29:26. | :29:28. | |
something about what her own party did admit to my previous times when | :29:29. | :29:33. | |
we have tried to get important cross-party working on health and | :29:34. | :29:36. | |
social care, in that once they made it an election issue and produced | :29:37. | :29:43. | |
posters on a death tax, and the second time just walked away from | :29:44. | :29:47. | |
talks. This is exactly not the kind of debate we want to be having. | :29:48. | :29:54. | |
Let's look to the future and say that where we are now, if the | :29:55. | :29:59. | |
honourable lady would let me finish, what I would say now is that we are | :30:00. | :30:04. | |
in a different part of the electoral cycle, and whilst I accept her | :30:05. | :30:08. | |
comments, I was still a clinician in the NHS at the time that that | :30:09. | :30:13. | |
happened, and I, like many of those who work in health and social care, | :30:14. | :30:20. | |
look at this place and think... I watch the debate we have here and | :30:21. | :30:23. | |
think, surely there has to be a better way. I would ask the | :30:24. | :30:26. | |
honourable lady perhaps to put that aside and look to the future rather | :30:27. | :30:30. | |
than be looking backwards, because I don't think we're going to get | :30:31. | :30:34. | |
anywhere, so I think what our constituents want us to do as | :30:35. | :30:38. | |
politicians is to recognise the scale of the challenge and get to | :30:39. | :30:42. | |
grips with it. I am going to take one more intervention, then I am | :30:43. | :30:46. | |
conscious of time. I thank the honourable lady for giving way. | :30:47. | :30:50. | |
Looking to the future, would you not agree with me that there should be a | :30:51. | :30:55. | |
new funding settlement, certainly in terms of the budget for the NHS and | :30:56. | :30:58. | |
social care, and bring both together? At the moment, we have had | :30:59. | :31:04. | |
cuts of 4.6 billion. That is exactly what I hope. We must end the silos | :31:05. | :31:10. | |
of health and social care, thinking of this money being a health pound | :31:11. | :31:14. | |
or a social care pound, and think of it as a patient pound and a taxpayer | :31:15. | :31:19. | |
pound, and how we get the best from that, which brings me onto a point I | :31:20. | :31:22. | |
would like to raise directly with the Secretary of State. There is an | :31:23. | :31:27. | |
example that has happened in my constituency. There is the Torbay | :31:28. | :31:31. | |
and South Devon NHS Foundation Trust, which has formed an | :31:32. | :31:36. | |
integrated care organisation. Across health and social care, there are | :31:37. | :31:41. | |
people, passionate people, about this, who sweated blood to get this | :31:42. | :31:45. | |
organisation off the ground. They recognise the benefits. It is talk | :31:46. | :31:52. | |
about not just nationally but internationally, a recognised way of | :31:53. | :31:54. | |
doing this better bust I regret to say that because of the scale of the | :31:55. | :31:59. | |
financial pressure on the ICO, what we are now hearing is that the NHS | :32:00. | :32:03. | |
is pulling out of the risk sharing agreement next year. I'm afraid this | :32:04. | :32:07. | |
is totally unacceptable. I hope the Secretary of State meet with me to | :32:08. | :32:13. | |
discuss the pressures facing the ICO, because it has achieved the | :32:14. | :32:16. | |
kind of things we're talking about in this debate. They can have their | :32:17. | :32:25. | |
pooled risk sharing and working together to genuinely get people out | :32:26. | :32:28. | |
of hospital more rapidly who do not need to be there ban is happening in | :32:29. | :32:32. | |
other various, to put people from social care into hospitals to see | :32:33. | :32:38. | |
how we can speed that process up, and unfortunately, if that risk | :32:39. | :32:41. | |
share falls apart, we will see one of the key pillars of how we want to | :32:42. | :32:45. | |
improve the flow through hospitals and at the other end breaking down. | :32:46. | :32:50. | |
Part of the reason, as I understand it, is, unless the control totals | :32:51. | :32:55. | |
are met, what is put at risk if the funding that they are hoping to use | :32:56. | :33:00. | |
to improve the facilities in the accident and emergency department, | :33:01. | :33:03. | |
because the challenge for Torbay isn't the way they work together to | :33:04. | :33:07. | |
get people out of hospital, it's the facilities at the front door, and | :33:08. | :33:11. | |
they could do so much there. We have this odd paradox that we could end | :33:12. | :33:15. | |
up improving the facilities at the front door but worsening the ability | :33:16. | :33:20. | |
of the facility to respond at the point where we are trying to get | :33:21. | :33:24. | |
people cared for in the community. I would say a certain degree of | :33:25. | :33:26. | |
financial challenge would have the effect of bringing health and social | :33:27. | :33:30. | |
care organisations to work more closely together because they know | :33:31. | :33:34. | |
it makes sense, but when there are unrealistic targets being set, and | :33:35. | :33:39. | |
what we can find is that we can go the other way and it starts to mean | :33:40. | :33:42. | |
that people have to retreat to protect their budget silos. I have | :33:43. | :33:46. | |
the Secretary of State will look closely at what is happening there | :33:47. | :33:49. | |
and meet with me to discuss whether or not we can't just get this back | :33:50. | :33:53. | |
on track again for next year. Although I am confident that the | :33:54. | :33:57. | |
local authority and the NHS staff -- the NHS staff and those in the trust | :33:58. | :34:03. | |
will continue to work together. They have an extraordinary tradition of | :34:04. | :34:06. | |
doing so. I think there are threats, and as I say, I hope they can be | :34:07. | :34:10. | |
addressed, because this is about the entire flow from the front door | :34:11. | :34:13. | |
right the way through to getting people cared for back at home, but | :34:14. | :34:17. | |
more widely, there is an issue here that we now have more than 1 million | :34:18. | :34:22. | |
people who are not able to receive the care that they need in | :34:23. | :34:27. | |
communities. In my area, we have a prime provider in special measures, | :34:28. | :34:32. | |
and these are financial issues. Yes, there is much the NHS can do that | :34:33. | :34:36. | |
isn't about money. We know there is a lot of variation that can't be | :34:37. | :34:40. | |
explained just by financial challenge and demographics alone, | :34:41. | :34:43. | |
but finance is inevitably part of this. Finance and workforce - these | :34:44. | :34:48. | |
are the key challenges we face, and we have to work together across all | :34:49. | :34:51. | |
parties, in my opinion, to achieve that. | :34:52. | :34:55. | |
In closing, on a slightly separate point, let me raise the front page | :34:56. | :35:04. | |
of the Times newspaper today which I think his extraordinary | :35:05. | :35:07. | |
disappointing. This is the second time we've seen a major national | :35:08. | :35:13. | |
newspaper reporting events the Chief Executive of the NHS, Simon | :35:14. | :35:17. | |
Stephens. I would like to invite the Secretary of State or the minister | :35:18. | :35:21. | |
closing the debate to unequivocally support the Chief Executive of the | :35:22. | :35:25. | |
NHS. What he is doing, when it comes to a select committee, as chair I | :35:26. | :35:30. | |
ask him to respond to a question, I expect him to be truthful and | :35:31. | :35:34. | |
transparent in his answers and I think that he should be commended | :35:35. | :35:39. | |
for doing so, and not find himself the subject of briefings. I would | :35:40. | :35:43. | |
invite someone to unequivocally support him and ask for best to | :35:44. | :35:51. | |
stop. Dame Rosie Winterton. Thank you. Thank you Madam Deputy Speaker. | :35:52. | :35:57. | |
I think that the debate so far has shown the huge level of concern from | :35:58. | :36:04. | |
the public and from NHS staff, about the crisis in the NHS and social | :36:05. | :36:09. | |
care. And, I would say that I think the honourable member reflected some | :36:10. | :36:15. | |
of the views of the select committee, but I would ask all | :36:16. | :36:19. | |
members opposite to really take seriously these concerns, and not | :36:20. | :36:26. | |
dismiss them. All honourable member 's must surely be getting | :36:27. | :36:31. | |
representations from staff, and from patients. About what is happening | :36:32. | :36:37. | |
locally. I would like to pay tribute to all health and social care staff | :36:38. | :36:41. | |
in Doncaster, particularly at Doncaster Royal Infirmary whose work | :36:42. | :36:47. | |
I've seen first-hand and I know how dedicated and committed they are to | :36:48. | :36:54. | |
caring for patients in the most difficult of circumstances. At the | :36:55. | :36:59. | |
end of December, they've managed to achieve 90% against the 95% I get | :37:00. | :37:04. | |
and had good ambulance hand the times, as well are as good support | :37:05. | :37:10. | |
from the council and partners. But they are facing real pressures and | :37:11. | :37:15. | |
are fearful about pressure is still to come, especially if there is a | :37:16. | :37:20. | |
cold spell, as predicted. That is why the mixed messages from the | :37:21. | :37:23. | |
secretary of state have been extremely damaging. Madam Deputy | :37:24. | :37:30. | |
Speaker, I was the health minister for four years and had | :37:31. | :37:34. | |
responsibility for emergency care. I know how important it is to work | :37:35. | :37:40. | |
with NHS staff to help to implement targets, and not give the impression | :37:41. | :37:47. | |
that the NHS is somehow giving up on those targets. The lead from the top | :37:48. | :37:54. | |
is incredibly important. There has was been controversy about targets. | :37:55. | :37:59. | |
But, as health minister, I have visited many A departments. There | :38:00. | :38:04. | |
is absolutely no doubt in my mind that the A target has led to | :38:05. | :38:12. | |
improved care for patients and dramatically reduced the waiting | :38:13. | :38:16. | |
times, which the evidence has shown and has been clear. That is what | :38:17. | :38:22. | |
happened. One of the striking things about those visits was seeing how | :38:23. | :38:28. | |
consultants, nurses, ambulance teams, all members of the health | :38:29. | :38:32. | |
care team while working together. They would work out protocol so | :38:33. | :38:37. | |
that, for example, nurses could take over some of the work that had | :38:38. | :38:42. | |
previously been done by consultants. Nurse practitioners and emergency | :38:43. | :38:49. | |
care consultants. So, they could ease the burden and share between | :38:50. | :38:56. | |
the team the work that was needed. Triage became the norm. Seeing who | :38:57. | :39:01. | |
needed treatment urgently from a consultant, and who could be seen by | :39:02. | :39:07. | |
a nurse practitioner. I would always ask staff, is the target getting in | :39:08. | :39:12. | |
the way? Or, is it helping? Invariably, the answer would come | :39:13. | :39:16. | |
back that it is helpful in making us work together more effectively. I | :39:17. | :39:20. | |
vividly remember a nurse practitioner saying, please do not | :39:21. | :39:24. | |
abandon the target because it is making the consultants sit down with | :39:25. | :39:28. | |
us and look at the whole team. And for patients, the difference is | :39:29. | :39:32. | |
crucial. For their working life as well, they were not seeing patients | :39:33. | :39:39. | |
who had been sitting around for hours and hours and were feeling | :39:40. | :39:41. | |
very depressed and tomorrow lowest. That made the difference to the | :39:42. | :39:48. | |
health care team as well. -- and demoralised. As well as improving | :39:49. | :39:52. | |
care for the patients. I will give way... With the right honourable | :39:53. | :39:57. | |
lady agree that it is not so much meeting the target which is | :39:58. | :40:02. | |
important but getting patients seen quickly, expeditiously and well. | :40:03. | :40:06. | |
And, there is not an A Department in this country who does not want to | :40:07. | :40:13. | |
improve its position in a league table of response times. They all | :40:14. | :40:16. | |
want to do that and the difference which now applies did not apply | :40:17. | :40:24. | |
quite so much when she was Minister, but that level of comparison is much | :40:25. | :40:29. | |
better. I ever so gently suggest that whilst a four-hour target was | :40:30. | :40:33. | |
important when she was Minister, that importance has degraded over | :40:34. | :40:36. | |
time because everyone is trying to see patients more quickly? I do not | :40:37. | :40:41. | |
agree with the honourable gentleman on that. I think that the experience | :40:42. | :40:50. | |
of implementing the four our target led to much better diagnosis of the | :40:51. | :40:55. | |
type of treatment that people needed -- four hour. Also better | :40:56. | :41:01. | |
interaction with the community. Let me come onto that, I also think the | :41:02. | :41:05. | |
secretary of state and maybe the honourable gentleman is guilty of | :41:06. | :41:08. | |
that as well, was trying to separate the target within the accident and | :41:09. | :41:16. | |
emergency department from what went on outside that. I see the | :41:17. | :41:20. | |
importance and putting the two together and I would like to say | :41:21. | :41:23. | |
something about that because providing the alternative treatment, | :41:24. | :41:27. | |
which is maybe what he is getting out, means proper support from the | :41:28. | :41:31. | |
community and it is bringing those two together which makes it possible | :41:32. | :41:36. | |
to achieve the target but it was a driver. I give way to the honourable | :41:37. | :41:41. | |
lady who I know has some experience. In my experience in working to try | :41:42. | :41:45. | |
to meet the four-hour target, there's often an emphasis... In the | :41:46. | :41:49. | |
past there was one, and emphasis which took priority over everything | :41:50. | :41:53. | |
else including patient care and clinical need, sometimes it was | :41:54. | :41:58. | |
abused. Huge pressure was put onto staff to meet that four-hour target | :41:59. | :42:02. | |
and patient care suffered, I have seen it myself, it has suffered as a | :42:03. | :42:07. | |
result of to meet targets. What I would say is that I think it is a | :42:08. | :42:12. | |
way... It is always important, I did this as the health Minister, to look | :42:13. | :42:16. | |
out for the feedback from clinicians was. I can see, because it was | :42:17. | :42:22. | |
starting during my time as health minister, that we constantly had to | :42:23. | :42:27. | |
look at whether what was the 95% target, whether there was clinical | :42:28. | :42:30. | |
reason as to why there should be a reduction on that. It became clear | :42:31. | :42:33. | |
that there were some patients who needed longer to be assessed, | :42:34. | :42:37. | |
because of their particular condition. I can see that is why it | :42:38. | :42:43. | |
would be reduced to 95% but the point that I am making is that it | :42:44. | :42:47. | |
was based on the clinical need and I think what happened last week was | :42:48. | :42:51. | |
the impression was given that it was, my goodness, we had to cope | :42:52. | :42:56. | |
with winter pressures, let's reduce the target in order to meet it, | :42:57. | :43:03. | |
rather than make an assessment about clinical need, I think it is | :43:04. | :43:08. | |
completely the wrong message for the NHS and I think that was the wrong | :43:09. | :43:14. | |
thing to do. I want to briefly set out some areas where I think we can | :43:15. | :43:22. | |
bring the community input together with what is happening in emergency | :43:23. | :43:30. | |
departments themselves, in order to produce some of the pressures. I | :43:31. | :43:39. | |
think the first point was made by my honourable friend from the front | :43:40. | :43:42. | |
bench, social care is absolutely vital in ensuring that people do not | :43:43. | :43:51. | |
end up in A, good social care. I have previously raised problems that | :43:52. | :43:55. | |
I think the current proposition by the government to, in a sense, move | :43:56. | :44:01. | |
responsibility to local councils to raise the money, is particularly | :44:02. | :44:03. | |
unfair in areas like mine because they simply cannot raise through a | :44:04. | :44:08. | |
council preset the same amount of money as can be made in other less | :44:09. | :44:15. | |
deprived... Better off areas. It simply does not work. We needed | :44:16. | :44:19. | |
probably more than any other area but our ability to raise money will | :44:20. | :44:28. | |
be less. I've been speaking to NHS staff in Doncaster, senior staff, | :44:29. | :44:32. | |
and there are some real problems in terms of the emergency care | :44:33. | :44:38. | |
staffing. What they are telling me is that it will take years, and | :44:39. | :44:42. | |
there are more doctors being trained, I accept that, but it will | :44:43. | :44:46. | |
take years for those to come through and the single most effective thing, | :44:47. | :44:54. | |
the most effective step, to ease the pressure at the moment and A | :44:55. | :45:00. | |
departments would be to immediately increase funding into social care. | :45:01. | :45:06. | |
Because, that would keep people away from accident and emergency | :45:07. | :45:09. | |
departments, and that could be done straightaway. There are the personal | :45:10. | :45:15. | |
out there but it just needs the government to make the decision, as | :45:16. | :45:20. | |
my honourable friend from the front bench said, to increase funding. | :45:21. | :45:25. | |
Secondly, we had to look seriously at the problem with GP shortages, | :45:26. | :45:29. | |
because again, as others have said, if a patient is waiting three weeks | :45:30. | :45:33. | |
for an appointment with a GP, they are bound to end up in A This is | :45:34. | :45:37. | |
something which needs to be addressed quickly with proper, | :45:38. | :45:41. | |
forward looks at exactly where the gaps are occurring in GP services. I | :45:42. | :45:51. | |
have said before that I think PCTs, or the care commissioning groups | :45:52. | :45:56. | |
now, or NHS England, should take over practices and employ salaried | :45:57. | :46:00. | |
GPs which would make a huge difference. Community pharmacists, | :46:01. | :46:06. | |
again, if people had confidence that going to the pharmacy would save | :46:07. | :46:10. | |
them a visit to A, that would relieve pressure on the system. I | :46:11. | :46:14. | |
hope that the minister can assure us that he is looking seriously at the | :46:15. | :46:18. | |
community pharmacy forward view which sets out how pharmacists can | :46:19. | :46:22. | |
be integrated into the NHS and social care. Whilst I have him here, | :46:23. | :46:29. | |
I do want to touch briefly on mental health, because the Prime Minister | :46:30. | :46:32. | |
answered a question today about mental health and the crisis people | :46:33. | :46:37. | |
can get into where they end up in A She particularly talked about | :46:38. | :46:40. | |
young people and I would urge the Minister to look at the role and | :46:41. | :46:45. | |
educational psychologists can play in mental health for children and | :46:46. | :46:52. | |
not then ending up in A Finally, I do also want to say that one of | :46:53. | :46:59. | |
the things in my experience of a health minister was that you needed | :47:00. | :47:05. | |
people on the ground locally, to help the organisations across the | :47:06. | :47:10. | |
whole spectrum. Local government through social care, pharmacists, | :47:11. | :47:15. | |
GPs, ambulances, working with A departments. That reorganisation, | :47:16. | :47:23. | |
the ?2 billion reorganisation which took away PCTs and SHAs, that has | :47:24. | :47:29. | |
made it much more difficult, the changes that are needed. I hope that | :47:30. | :47:34. | |
the Minister will look seriously at how it is happening because local | :47:35. | :47:38. | |
knowledge can be vital in these circumstances. So, I believe that | :47:39. | :47:43. | |
from the contribution to the secretary of state, it seems as | :47:44. | :47:47. | |
though he was trying to use every excuse not to face up to the reality | :47:48. | :47:52. | |
of what is happening, and I think it sends a terrible message to NHS | :47:53. | :47:58. | |
staff, and I hope that as a result of the debate today, the concerns | :47:59. | :48:02. | |
which have been raised will be taken on board by ministers and the | :48:03. | :48:06. | |
Secretary of State, and they will come back to the house with a proper | :48:07. | :48:09. | |
plan which recognises the problems and offers real solutions. | :48:10. | :48:16. | |
The house was right to assume that ten minutes per person is | :48:17. | :48:25. | |
unsustainable, after the next speaker I will reduce the time limit | :48:26. | :48:30. | |
to seven minutes. But the time limit remains, the house will be very glad | :48:31. | :48:34. | |
to know, at ten minutes first Sir Simon Burns. Thank you, Madam Deputy | :48:35. | :48:44. | |
Speaker. I welcome the debate today, to have the opportunity to discuss | :48:45. | :48:48. | |
an issue which is extremely important to all honourable members | :48:49. | :48:52. | |
on all sides of the house, because there is a significant problem | :48:53. | :49:00. | |
during the recent weeks because of the extra increasing number of | :49:01. | :49:05. | |
people needing services at A and from the health services locally. I | :49:06. | :49:11. | |
would like to pay tribute to the magnificent work often in very | :49:12. | :49:15. | |
difficult circumstances that doctors, nurses, consultants and | :49:16. | :49:21. | |
other staff, and people in general practice, carry out on a day-to-day | :49:22. | :49:26. | |
basis, not simply during a winter crisis period, but throughout the | :49:27. | :49:30. | |
year, looking after people to the best of their abilities. I think | :49:31. | :49:36. | |
that my own hospital, Broomfield Hospital in Chelmsford, is in | :49:37. | :49:40. | |
difficult circumstances and doing a fantastic job to provide the best | :49:41. | :49:47. | |
possible care in good times and more difficult times, and I am certainly | :49:48. | :49:51. | |
aware as a constituency MP that there are been some problems for | :49:52. | :49:56. | |
some of my constituents in the last week or so because of the demands | :49:57. | :50:02. | |
and pressures but we have to look at what we can do to move forward in a | :50:03. | :50:07. | |
positive, not partisan, politicised way. To make sure that our | :50:08. | :50:14. | |
constituents get the best treatment is possible. | :50:15. | :50:18. | |
There is no point in just shouting, as my honourable friend, the cherub | :50:19. | :50:26. | |
a health select committee said, and engaging in -- the chair of the | :50:27. | :50:33. | |
health select committee said, in engaging in yah boo politics. I have | :50:34. | :50:38. | |
to say, I am extremely proud of the record of this Government in the way | :50:39. | :50:43. | |
it has been committed to funding the NHS over the last seven years, and | :50:44. | :50:49. | |
its commitments for the next three or four years. We made sure when we | :50:50. | :50:55. | |
came into office at a time of austerity, where Government | :50:56. | :50:57. | |
department budgets were cut, that the health Department budget was one | :50:58. | :51:03. | |
of the few departments whose budgets were protected so that they got a | :51:04. | :51:09. | |
real terms increase in funding every year since we came into power, | :51:10. | :51:17. | |
albeit, I will accept, it was a modest real terms increase, but it | :51:18. | :51:22. | |
showed our commitment and our intent to invest in improving the National | :51:23. | :51:27. | |
Health Service. I am also proud of the fact that I and all my | :51:28. | :51:30. | |
honourable and right Honourable friends on this side of the House | :51:31. | :51:35. | |
fought the last general election on a commitment that we were going to | :51:36. | :51:39. | |
substantially, over the five-year period of this Parliament, increase | :51:40. | :51:43. | |
funding on the NHS to what has turned out to be bit chewed up ?10 | :51:44. | :51:50. | |
billion, which is more, I say in a very gentle way, than was on offer | :51:51. | :51:56. | |
to the country from certain other parties. I am also pleased that my | :51:57. | :52:02. | |
right honourable friend, the Secretary of State, and the Minister | :52:03. | :52:05. | |
of State for health, have been planning for any potential strains | :52:06. | :52:13. | |
on demand during this winter period with the provision of ?400 million | :52:14. | :52:20. | |
to local health economies, and other measures like the vaccination | :52:21. | :52:28. | |
programme, a preventative measure to get a record number, 30 million | :52:29. | :52:32. | |
people, vaccinated to try to offset some of the potential health | :52:33. | :52:38. | |
problems that can flow during a winter period. That is using | :52:39. | :52:42. | |
foresight, that is using planning to try and minimise problems, and at | :52:43. | :52:50. | |
the same time, providing funding to back up their actions, and that is | :52:51. | :52:53. | |
what a responsible Department of Health should do and has done. Now, | :52:54. | :53:04. | |
you can demand as much money as you like for the health service, but my | :53:05. | :53:10. | |
argument is that, yes, the health service does have to have extra | :53:11. | :53:16. | |
money, year in, year out but it shouldn't just be thrown at an | :53:17. | :53:22. | |
issue. There is a far bigger part of the equation, and that is building | :53:23. | :53:28. | |
upon the performance and the standards and the quality of care | :53:29. | :53:32. | |
that that health service is going to provide to our constituents. Very | :53:33. | :53:40. | |
briefly... I thank the honourable member, and I absolutely agree with | :53:41. | :53:44. | |
what he is saying about increased resources, but would he agree that | :53:45. | :53:49. | |
we need more resources now for integrated health and social care, | :53:50. | :53:53. | |
and this is the time to remove the NHS as a political football and have | :53:54. | :53:57. | |
a cross-party review? I certainly agree that under the leadership of | :53:58. | :54:02. | |
the Department of Health, we should work with anyone and everyone to | :54:03. | :54:06. | |
come up with a solution. I was the Minister for social care in the late | :54:07. | :54:16. | |
1990s, before we left office, where integrating health and social care | :54:17. | :54:19. | |
was in its very early, formative stage. And the ambitions were | :54:20. | :54:25. | |
immense and tremendous. I'm afraid, the reality has not matched the | :54:26. | :54:33. | |
ambitions of what was being said in the 1990s, and that is why I was | :54:34. | :54:40. | |
particularly interested in hearing the comments of my honourable | :54:41. | :54:43. | |
friend, the chair of the select committee. Because yes, we have to | :54:44. | :54:49. | |
look at that, but we also have to look, pushing the funding side to | :54:50. | :54:53. | |
one side for the moment, is building on the work that my right honourable | :54:54. | :54:58. | |
friend, the current Secretary of State for Health, has particularly | :54:59. | :55:02. | |
invested in, which is patient safety and raising standards and dignity | :55:03. | :55:07. | |
for patients in our hospitals and throughout the health system. And | :55:08. | :55:14. | |
also making sure that we cut out waste and inefficiency is. Now, | :55:15. | :55:17. | |
there was the Nicholson challenge when I was at the Department of help | :55:18. | :55:23. | |
the second time round, in 2010. The challenge was, over three or four | :55:24. | :55:29. | |
years, to save ?20 billion by cutting out waste, by sharing best | :55:30. | :55:35. | |
practice to improve the quality of care, and I know from the bait just | :55:36. | :55:47. | |
before Christmas that the NHS achieved ?19.4 billion worth of | :55:48. | :55:52. | |
those savings. The beauty of that was, not only was it creating | :55:53. | :55:58. | |
greater effectiveness and efficiency in the delivery of health care and | :55:59. | :56:03. | |
sharing best practice, but it also didn't mean that the Treasury got | :56:04. | :56:10. | |
?19.4 billion that they could spend or do with as they wished. It was | :56:11. | :56:16. | |
?19.4 billion that was reinvested in patient care. Yes. Was it not the | :56:17. | :56:23. | |
case that a significant proportion of that was due to wage freezes for | :56:24. | :56:29. | |
NHS medical and nursing staff, and therefore that is not something that | :56:30. | :56:33. | |
can easily be repeated? The honourable lady is absolutely right | :56:34. | :56:39. | |
that if you are earning under ?20,000... Sorry, if you are earning | :56:40. | :56:44. | |
over ?20,000 a year, there was a wage freeze, but that was in keeping | :56:45. | :56:49. | |
with the policy throughout the public sector, including members of | :56:50. | :56:53. | |
Parliament and ministers. The important thing was that they were | :56:54. | :56:58. | |
able, by a variety of means, one of them was a pay freeze, but others | :56:59. | :57:03. | |
were by improving the delivery of service, cutting out inefficiencies, | :57:04. | :57:12. | |
in effective ways of operating and getting rid of almost 20,000 surplus | :57:13. | :57:18. | |
managers so that you can then concentrate on having clinicians, | :57:19. | :57:23. | |
nurses, ancillary workers and everyone else to work towards | :57:24. | :57:29. | |
patient care, that achieved that. And that is the right way forward. | :57:30. | :57:39. | |
We cannot give up on that in also continuing to see if we can... I am | :57:40. | :57:42. | |
about to finish, I'm afraid. Finally, a lot has been said about | :57:43. | :57:50. | |
the STP programme. We had one in mid and South Essex. I have to say that | :57:51. | :57:57. | |
I strongly support it, because it is completely focused on improving and | :57:58. | :58:00. | |
enhancing the quality of accident and emergency care. What annoys me | :58:01. | :58:08. | |
is those who wish to politicise it for grubby political reasons. It | :58:09. | :58:13. | |
involves, and funnily enough, I am not talking about honourable members | :58:14. | :58:19. | |
opposite. It involves three hospitals, with three A | :58:20. | :58:24. | |
departments. The proposals, not one of those A departments will be | :58:25. | :58:30. | |
close, yet, as soon as the proposals were put out, and on the assumption, | :58:31. | :58:34. | |
correctly I suspect, that most people have not read the proposals, | :58:35. | :58:41. | |
the word went out that my local A department was going to be closed | :58:42. | :58:44. | |
down by the Department of Health because of this nasty Government's | :58:45. | :58:51. | |
proposals to save money. The exact opposite was the case. If one read | :58:52. | :58:58. | |
the documents, all three A are remaining open. What is happening, | :58:59. | :59:02. | |
and it is building on what happens now, is that if you have a heart | :59:03. | :59:07. | |
attack, you are taken immediately to Basildon Hospital, because that is | :59:08. | :59:12. | |
the specialist for cardiothoracic treatment. If you need treatment for | :59:13. | :59:17. | |
burns up plastic surgery, you come to Broomfield Hospital in | :59:18. | :59:20. | |
Chelmsford, because that has one of the finest units in the of Europe. | :59:21. | :59:25. | |
If you have head injuries, you will go down to the east of London, to | :59:26. | :59:31. | |
Romford, because that is a specialist area for people with head | :59:32. | :59:35. | |
injuries. Now, if I had any of those conditions, I would want, for me or | :59:36. | :59:40. | |
my constituents, the best possible treatment from the best experts | :59:41. | :59:44. | |
available, and that is what is happening. And that will be built | :59:45. | :59:48. | |
upon, enhanced and improved. That is an improvement, that is not a cut. | :59:49. | :59:55. | |
That is not taking away services from local communities. But for | :59:56. | :00:00. | |
those people who have an agenda where they want to play politics, | :00:01. | :00:08. | |
they will tell people anything, in the hope it will frighten them, to | :00:09. | :00:13. | |
try to discredit the work of the NHS. So, I am pleased we've had the | :00:14. | :00:18. | |
opportunity to discuss this matter also it is very tricky, there was no | :00:19. | :00:27. | |
simple answer. It is not unique. We frequently have winter crises, | :00:28. | :00:30. | |
particularly because of the ageing population and the increasing demand | :00:31. | :00:32. | |
that the health service has had to deal with in recent years. But we | :00:33. | :00:38. | |
must not lose sight of the fact that we have an NHS and a Government that | :00:39. | :00:44. | |
is determined to further improve and enhance the quality of care, the | :00:45. | :00:51. | |
safety and the standards of care, for all our constituents, aided and | :00:52. | :00:56. | |
abetted by a first-class service that is working under very difficult | :00:57. | :01:03. | |
circumstances often. Thank you, Madam Deputy Speaker. It is very | :01:04. | :01:08. | |
important to talk more widely about the NHS, about its importance, its | :01:09. | :01:13. | |
funding, and perhaps about its organisation too, but today's debate | :01:14. | :01:19. | |
is to bring focus to the current crisis in many parts of our National | :01:20. | :01:23. | |
Health Service, and to ask the Government to do something about it. | :01:24. | :01:27. | |
Undoubtedly, our National Health Service is highly valued. It has a | :01:28. | :01:32. | |
dedicated staff, and it provides excellent services, but in many | :01:33. | :01:37. | |
parts of the country, it is under pressure, and today's debate does | :01:38. | :01:41. | |
call for specific actions to address the crisis. It calls for more | :01:42. | :01:46. | |
funding for social care now, and it calls for an improved settlement for | :01:47. | :01:51. | |
both the National Health Service and social care in the next budget. So, | :01:52. | :01:55. | |
in our general discussion about how things might be reorganised and | :01:56. | :01:59. | |
changed in the future, it's very important not to lose focus on the | :02:00. | :02:03. | |
current problems, and those are the reasons for today's debate. That has | :02:04. | :02:09. | |
been -- there has been a lot of discussion about what is happening | :02:10. | :02:12. | |
in hospitals, and inevitably that will be so, because that is where | :02:13. | :02:18. | |
there is, in many areas, a crisis in A, and great pressure on hospital | :02:19. | :02:23. | |
services. But there has also been reference to services provided by | :02:24. | :02:29. | |
our health service outside of hospitals - community services - and | :02:30. | :02:33. | |
it is important to focus on them as well, not just because they are | :02:34. | :02:36. | |
important in their own right, that because if they are working | :02:37. | :02:40. | |
effectively, they can prevent hospital admissions and indeed | :02:41. | :02:44. | |
improve people's health. Those services include community health | :02:45. | :02:48. | |
services. That involves the GP services, the absolute bedrock of | :02:49. | :02:56. | |
our national health service, nurses, physios and pharmacies. The National | :02:57. | :03:03. | |
Health Service does have some responsibility, but local | :03:04. | :03:10. | |
authorities, currently under ever increasing pressure, Opera narrowly | :03:11. | :03:14. | |
responsible for social care. I am concerned about the cats that the | :03:15. | :03:17. | |
Government has imposed on community pharmacists. Pharmacists are | :03:18. | :03:22. | |
absolutely essential to our National Health Service. They are part of the | :03:23. | :03:26. | |
NHS, they are privately run, in the name. They offer advice as well as | :03:27. | :03:32. | |
specific services, and they can often prevent people having to go, | :03:33. | :03:36. | |
not just a hospital, but to their local GP, where the pharmacist is | :03:37. | :03:41. | |
able to give proper advice and services. It is of great concern | :03:42. | :03:46. | |
that the Government's plan for cuts to community pharmacists will put | :03:47. | :03:50. | |
pharmacies in areas like mine, in Liverpool, at risk. I also deplore | :03:51. | :03:56. | |
the reduction in independent pharmacists who provide such an | :03:57. | :04:01. | |
excellent service. So, I do ask the Government to think again about its | :04:02. | :04:05. | |
cuts to community pharmacies, a vitally important part of our health | :04:06. | :04:09. | |
service. When they are closed, it will be far too late. The Government | :04:10. | :04:13. | |
should act now and should not go ahead with those cuts, which will | :04:14. | :04:19. | |
have a dramatic effect on places such as Liverpool and other places | :04:20. | :04:22. | |
in the country. I also asked honourable members to think more | :04:23. | :04:27. | |
about social care and what is happening. In Liverpool, we're | :04:28. | :04:31. | |
facing a major crisis in social care. As local authority funding has | :04:32. | :04:38. | |
been cut severely, and is to be cut again. 58% of Liverpool City | :04:39. | :04:45. | |
Council's budget has already been cut, and ?90 million more of savings | :04:46. | :04:51. | |
is demanded of the next three years, half of that to be achieved in the | :04:52. | :04:53. | |
next year. There has been a reduction in social | :04:54. | :05:04. | |
care provision. Social care packages reduced from 40,000 to 9000, many | :05:05. | :05:10. | |
more cuts in the pipeline. Providing social care is essential, not just | :05:11. | :05:15. | |
to enable people to leave hospital when they are healthy and ready to | :05:16. | :05:20. | |
leave, that is a very important issue. But also, to enable people to | :05:21. | :05:27. | |
live a constructive life. There are many people who are currently | :05:28. | :05:30. | |
fearful of impending and possible cuts to their social care packages. | :05:31. | :05:35. | |
Who believe that they will not be able to live reasonable lives within | :05:36. | :05:39. | |
their own home if essential services are cut. I asked the government to | :05:40. | :05:44. | |
again think about what they are doing and telling us that the better | :05:45. | :05:51. | |
care fund is an answer is not the case, in Liverpool, ?35 million is | :05:52. | :05:57. | |
promised for the fund in the coming years but that will only scratch the | :05:58. | :06:01. | |
surface of the problem. In areas like Liverpool and areas where it is | :06:02. | :06:05. | |
difficult to raise money, a 1% increase in the council tax fund | :06:06. | :06:10. | |
will raise ?1.4 million. Neither of these things address looming and | :06:11. | :06:17. | |
very real crisis in social care, and I urge the government to look again | :06:18. | :06:24. | |
at this and not talk about platitudes. It is not fair, not plan | :06:25. | :06:28. | |
to be there, there needs to be an urgent approach for something to be | :06:29. | :06:33. | |
done. Mental health has been raised by a number of honourable members | :06:34. | :06:44. | |
and in my constituency, I mentioned two instances. Assistance has been | :06:45. | :06:53. | |
withdrawn, like opening letters for normal queries, that has gone. | :06:54. | :06:58. | |
Another example is from a man who faces very serious until health | :06:59. | :07:03. | |
conditions and he has a condition which means he cannot work. He was | :07:04. | :07:11. | |
promised specialist help in York but the offer was withdrawn as it was | :07:12. | :07:17. | |
made in error. That is unforgivable. I have followed this through, and he | :07:18. | :07:23. | |
was promised local treatment, although it was very unclear as to | :07:24. | :07:26. | |
whether it would be appropriate. That has not been offered in the way | :07:27. | :07:32. | |
it was suggested. I have followed it up but I know that 14 months on from | :07:33. | :07:36. | |
the time that he was offered help for a very incapacitating and | :07:37. | :07:42. | |
extremely Sirius mental health condition, nothing has happened. | :07:43. | :07:47. | |
That is simply not good enough and I will pursue it further -- serious. | :07:48. | :07:52. | |
That is one illustration of cruel cuts on mental health services and | :07:53. | :07:57. | |
how they are affecting individuals. I agree that we should look more | :07:58. | :08:00. | |
generally at funding for our national health service but the | :08:01. | :08:07. | |
crisis to date, the government has to act now. I am very pleased to | :08:08. | :08:14. | |
follow the honourable lady, and before I start off on my remarks, I | :08:15. | :08:19. | |
am sorry the honourable member for Central Ayrshire is no longer in her | :08:20. | :08:24. | |
place, I particularly enjoyed her remarks because in her contribution, | :08:25. | :08:31. | |
she actually set out a number of constructive policy amendments | :08:32. | :08:36. | |
trawling on the Scottish example where we could reflect on them -- | :08:37. | :08:42. | |
drawing. And improve the situation. In his 33 minute contribution, I did | :08:43. | :08:47. | |
not hear a single contribution from the shadow secretary of state which | :08:48. | :08:50. | |
is disappointing and something he may reflect on otherwise the debate | :08:51. | :08:55. | |
will not move far forward. I may also say that I suspect it was | :08:56. | :08:59. | |
because she was under the Central for Ayrshire in clinical experience, | :09:00. | :09:03. | |
I enjoyed the contribution from the right honourable member for | :09:04. | :09:06. | |
Doncaster Central who, after a period of unforced violence as | :09:07. | :09:10. | |
opposition Chief Whip, was clawing on her ministerial experience | :09:11. | :09:19. | |
demonstrating I think it is valuable when they draw on their own | :09:20. | :09:23. | |
experience and bring it to the debate -- drawing on her experience. | :09:24. | :09:29. | |
With the motions before us today, the Labour motion we are debating | :09:30. | :09:34. | |
talked about the four-hour target, and the funding issues. I want to | :09:35. | :09:38. | |
touch on those in my inevitably brief speech. I raised this in the | :09:39. | :09:44. | |
intervention I made earlier, I was in the house on Monday and the | :09:45. | :09:48. | |
secretary of state was very clear. I do not understand why Labour members | :09:49. | :09:53. | |
fail to see this. He did not, in any way, water down the target and as I | :09:54. | :09:57. | |
said, the right honourable member for Exeter challenged him on it. The | :09:58. | :10:02. | |
secretary of state specifically said he recommitted the government to | :10:03. | :10:05. | |
that target and was generous in paying tribute to the Labour | :10:06. | :10:08. | |
government for having introduced it, saying it was one of the best things | :10:09. | :10:15. | |
about the NHS. I think the shadow secretary of state said in his | :10:16. | :10:19. | |
remarks that somehow the secretary of state had talked about making | :10:20. | :10:22. | |
sure that target applied to those with urgent health problems, and had | :10:23. | :10:29. | |
somehow set is secretly outside of the House of Commons. I looked | :10:30. | :10:33. | |
carefully at the secretary of state 's oral statement which she gave in | :10:34. | :10:37. | |
the House of Commons two days ago and they were explicit in making | :10:38. | :10:41. | |
sure that the four-hour standard related to urgent health problems | :10:42. | :10:44. | |
and specifically talked about the NHS England's medical director for | :10:45. | :10:50. | |
acute care said, that no country in what has it four-hour standard for | :10:51. | :10:55. | |
all health problems, it is for urgent health problems and if we are | :10:56. | :10:58. | |
too protected for vulnerable patients, that is what we need to | :10:59. | :11:03. | |
do. -- protected. That is incredibly valuable. I would like to say, | :11:04. | :11:09. | |
because it is related to the motion, about social care funding and the | :11:10. | :11:14. | |
charge that keeps being thrown by the opposition about local authority | :11:15. | :11:17. | |
decisions. It is entirely true that in the last parliament the coalition | :11:18. | :11:22. | |
government had to make savings to local government budgets, because of | :11:23. | :11:27. | |
the impact of the financial crisis, and how unprepared the country had | :11:28. | :11:33. | |
been left due to the previous Labour government. In the dramatic | :11:34. | :11:37. | |
financial crisis that we inherited with a budget deficit of 11%, we had | :11:38. | :11:43. | |
to make savings. But local councils had choices about the decisions that | :11:44. | :11:48. | |
they made and where the cuts fell. In Gloucestershire, the county | :11:49. | :11:50. | |
council prioritised spending on adult social care, and said it was | :11:51. | :11:55. | |
the single most important service it delivered, not just for older people | :11:56. | :11:59. | |
but a said the budget goes on provisions for with disabilities, | :12:00. | :12:05. | |
including learning disabilities, and it protected the budget in cash | :12:06. | :12:08. | |
terms which is one of the reasons why we are the best performers in | :12:09. | :12:14. | |
the region for no delayed patient discharge timings in the acute | :12:15. | :12:19. | |
sector. Of course, there problems and challenges but the hard-working | :12:20. | :12:23. | |
health and social care staff do an excellent job... His comments about | :12:24. | :12:29. | |
the local governor and are just ludicrous. The level of cuts that | :12:30. | :12:34. | |
were placed were far greater than any other government department. You | :12:35. | :12:37. | |
cannot introduce that kind of level of cuts and say to local Gottman, | :12:38. | :12:41. | |
you had to decide. Of course it would lead to social care problems | :12:42. | :12:46. | |
-- government. The point was made that Mike authority had cuts as well | :12:47. | :12:52. | |
and had to make choices. It had to make difficult cuts. But it chose to | :12:53. | :12:59. | |
prioritise the single most important service it delivered, adult social | :13:00. | :13:02. | |
care, which meant it had to make difficult cuts in other areas which | :13:03. | :13:07. | |
were not easy but difficult. That choice to put adult social care at | :13:08. | :13:11. | |
the top of the list of priorities was the right choice six years ago | :13:12. | :13:15. | |
and remains the right choice today. Or I simply say is if councils | :13:16. | :13:19. | |
choose to put adult social care at the bottom of their list of | :13:20. | :13:24. | |
priorities, I do not think it was the right decision to have made. I | :13:25. | :13:30. | |
would also like to say that I have been to visit the A department, I | :13:31. | :13:38. | |
do not have an acute A department in my constituency but my | :13:39. | :13:41. | |
constituency is served by an A department in Gloucester and | :13:42. | :13:46. | |
Cheltenham. I went to visit the new Chief Executive at Gloucestershire | :13:47. | :13:49. | |
hospitals NHS Foundation Trust to visit with some of the staff in the | :13:50. | :13:55. | |
A department. That hospital has had its challenges, she is a new | :13:56. | :13:58. | |
Chief Executive and is working hard with her management team on turning | :13:59. | :14:03. | |
around a performance in A which has not been up to scratch. I spoke | :14:04. | :14:07. | |
to her about the processes that are being put in place and I'm confident | :14:08. | :14:12. | |
with the hard-working staff they have at that hospital, with that | :14:13. | :14:15. | |
improve leadership, that they will be able to hit the targets the | :14:16. | :14:20. | |
government has asked them to do. I've joined the police on a night | :14:21. | :14:28. | |
shift, and I saw compassionate staff offering care in pressured | :14:29. | :14:36. | |
circumstances. Would you agree that the STB process is to enhance | :14:37. | :14:42. | |
capacity elsewhere in the county, including bolstering and enhancing | :14:43. | :14:45. | |
provisions at Cheltenham General Hospital? The whole point about this | :14:46. | :14:54. | |
process is making sure that we have capacity across the health sector. | :14:55. | :14:57. | |
One of the things I thought was important from what the secretary of | :14:58. | :15:03. | |
state said, and is in the Prime Minister's amendment to the debate | :15:04. | :15:07. | |
today, which is why will be supporting that amendment, it talks | :15:08. | :15:10. | |
about other changes to the health and social care system. I agree | :15:11. | :15:14. | |
completely with what the chair of the select committee has said, in | :15:15. | :15:22. | |
Gloucester we are fortunate, unlike the member for Central Ayrshire. We | :15:23. | :15:27. | |
are lucky that for our county we have a single CCG and county | :15:28. | :15:30. | |
council. They work very well together with a lot of joint working | :15:31. | :15:34. | |
and increasingly over time they want to bring health and social care | :15:35. | :15:38. | |
together which is exactly what the chair of the select committee said, | :15:39. | :15:41. | |
it is the right thing to do and what the member for Central Ayrshire said | :15:42. | :15:44. | |
they have done in Scotland which helps deliver a better service. The | :15:45. | :15:50. | |
more we can improve capacity in the system, we can make sure people | :15:51. | :15:54. | |
access primary care where they need to and access social care where they | :15:55. | :15:57. | |
need to, and take pressure off the accident and emergency system. When | :15:58. | :16:03. | |
I visited the A department, they have a very good triage department | :16:04. | :16:06. | |
in place, if you gone there for conditions which can be treated in | :16:07. | :16:11. | |
general practice, we have general practitioners based in the A | :16:12. | :16:16. | |
department, ready to ensure that you are signposted and treated in an | :16:17. | :16:20. | |
appropriate setting, and not damaging the ability of the service | :16:21. | :16:23. | |
to properly deliver that acute care to those who really needed, and I | :16:24. | :16:27. | |
think those kinds of steps are the things we had to look at going | :16:28. | :16:32. | |
forward. Of course, give way. With those people fall within the | :16:33. | :16:36. | |
four-hour target? That's the heart of the debate we're having at the | :16:37. | :16:41. | |
moment as whether four hours should cover more urgent and more elective | :16:42. | :16:46. | |
problems in A departments? I don't know the detail of the statistics | :16:47. | :16:50. | |
and how they measured but you want to Mitchell that those -- you want | :16:51. | :16:55. | |
to make sure that those people who walk through and do not need urgent | :16:56. | :17:03. | |
care, they still need appropriate care. Whether it is to a community | :17:04. | :17:08. | |
pharmacy or general practice, or using information services which the | :17:09. | :17:13. | |
NHS provides online or on the telephone, it is making sure people | :17:14. | :17:17. | |
go to the right settings which is not right at the moment. That is why | :17:18. | :17:22. | |
it is being acknowledged and worked on in future. Finally, I would also | :17:23. | :17:26. | |
like to say that I think the government's moods in terms of | :17:27. | :17:33. | |
devolving spending power and decision-making to local areas -- | :17:34. | :17:37. | |
moves. In what will take place in greater Manchester, enabling the | :17:38. | :17:44. | |
ability of bringing social care together, I have encouraged my | :17:45. | :17:49. | |
authority as it leads the devolution proposals as it is an ambitious ask | :17:50. | :17:55. | |
and I hope the government will look seriously at it in the months ahead. | :17:56. | :18:05. | |
Catherine West... Thank you. I do not know what the coral is of Chief | :18:06. | :18:12. | |
Whip... I believe it is a crop of whips! I wonder if I can begin on a | :18:13. | :18:24. | |
slightly less happy note -- the plural is. Quoting from an education | :18:25. | :18:28. | |
psychologist who has written to me this week saying that "I and my | :18:29. | :18:33. | |
colleagues are often in disbelief about the amount of work we need to | :18:34. | :18:37. | |
manage, the difficulties in working across services because of cuts and | :18:38. | :18:42. | |
changes to policy. Everyone is perpetually exhausted and burnt out. | :18:43. | :18:46. | |
When we are not ill at work because of training, illness or leave, we | :18:47. | :18:52. | |
feel guilty and relieved simultaneously". Her e-mail | :18:53. | :18:56. | |
describes how she is the only clinical psychologist on duty in the | :18:57. | :18:59. | |
whole of a very busy in London constituency. Mr Speaker, I wanted | :19:00. | :19:11. | |
to comment briefly on the juncture between primary and secondary care. | :19:12. | :19:18. | |
And, indeed, acute care as well. I think many of us have experience in | :19:19. | :19:23. | |
the last 18 months of fighting for a generally pack -- general | :19:24. | :19:26. | |
practitioners service. And the Westbury clinic which is just | :19:27. | :19:30. | |
between the constituency of Hornsey and Wood Green and Tottenham, it has | :19:31. | :19:35. | |
been quite a battle ground in the last 12 months and we've really had | :19:36. | :19:39. | |
to fight for the services of basic general practitioners for our | :19:40. | :19:45. | |
constituents, both myself and the honourable member for Tottenham. | :19:46. | :19:50. | |
I think this is replicated across the country and is what is leading | :19:51. | :19:57. | |
to the build-up in individuals, as the Secretary of State said | :19:58. | :20:02. | |
previously, we have so many people coming who probably could be seen by | :20:03. | :20:05. | |
a GP but cannot get an appointment so they turn up to accident and | :20:06. | :20:11. | |
emergency. I am grateful. Thank you, Mr Speaker. In Stoke-on-Trent, | :20:12. | :20:14. | |
certainly, one of the problems we face is that we are something like | :20:15. | :20:21. | |
six GPs away from the whole system collapsing, because as they retire | :20:22. | :20:24. | |
or leave for other reasons, those patients are going onto the ever | :20:25. | :20:29. | |
smaller number of GPs that there are. And that means that if another | :20:30. | :20:38. | |
couple of GPs retire, and two our Brit -- are due to retire, the whole | :20:39. | :20:42. | |
system is likely to collapse in Stoke-on-Trent. What will that do to | :20:43. | :20:47. | |
A? I think it is that sort of situation which does lead to an | :20:48. | :20:52. | |
individual patient waiting 35 hours on a trolley to be seen, as we saw | :20:53. | :20:57. | |
this weekend. I know a number of members have made this point, but it | :20:58. | :21:03. | |
bears repetition, that it seems quite disgraceful that one blames | :21:04. | :21:07. | |
one's staff when this is going wrong, when clearly the | :21:08. | :21:10. | |
responsibility lies with politicians and the Government. I was quite | :21:11. | :21:16. | |
upset to see that the front page of today's Times blames the senior | :21:17. | :21:22. | |
civil servant at the heart of the NHS, when really it is about poor | :21:23. | :21:27. | |
planning from the Government. On the subject of poor planning, I am sure | :21:28. | :21:34. | |
the honourable lady, like the rest of the House, heard James O'Brien | :21:35. | :21:41. | |
speaking on LBC yesterday, describing his experience of having | :21:42. | :21:44. | |
conjunctivitis over the holidays and having to go to a community pharmacy | :21:45. | :21:47. | |
because he could not get a GP appointment. Is this the time when | :21:48. | :21:55. | |
we should be supporting, not closing, community pharmacies? | :21:56. | :21:59. | |
Whether it was a Brexit fever madness that took over or not, I | :22:00. | :22:06. | |
don't know, but there was a moment when cutting community pharmacists | :22:07. | :22:10. | |
seemed the right thing to do, especially when it was the wrong | :22:11. | :22:15. | |
thing, particularly with the impact of the illnesses we all fall prey to | :22:16. | :22:21. | |
over the winter months. In my earlier intervention, I ask the | :22:22. | :22:23. | |
Secretary of State for Health about the influenza epidemic, and he | :22:24. | :22:28. | |
assured me on the number of vaccinations, and that more people | :22:29. | :22:31. | |
had been vaccinated against seasonal flu. But the point I was making was | :22:32. | :22:36. | |
that went tragically people do get the flu, and I understand there is | :22:37. | :22:39. | |
quite an increase in the number of young people getting it, not | :22:40. | :22:45. | |
necessarily in the group where they would be advised to be inoculated, | :22:46. | :22:51. | |
they are suffering, and the doctors don't have time to isolate those | :22:52. | :22:54. | |
individual cases, which means there is a real risk, given how busy the | :22:55. | :23:02. | |
staff are, that that flu could become an epidemic, and I hope that | :23:03. | :23:06. | |
the Secretary of State, having given us assurances today, will take the | :23:07. | :23:08. | |
point up farther with chief executives of acute trusts. Briefly, | :23:09. | :23:13. | |
on the question of social care, just to give colleagues an indication, in | :23:14. | :23:19. | |
2010, when I was a council leader, we had a social care budget for | :23:20. | :23:23. | |
children. It is nothing to do with schools, just children will stop | :23:24. | :23:29. | |
?102 million. The same local authority now, in a busy London | :23:30. | :23:36. | |
area, now has 420 17-18, a budget of 26 million. If you're telling me | :23:37. | :23:40. | |
that the needs are half as much as they were, or that families need | :23:41. | :23:51. | |
half as much support, I would be very surprised. That cut is deeply | :23:52. | :23:57. | |
worrying for the children who are in desperate need of social care. On | :23:58. | :24:02. | |
the adult social care side, of course, that is equally worrying, | :24:03. | :24:06. | |
where on Monday, the Secretary of State told us that we shouldn't | :24:07. | :24:11. | |
worry because ?600 million is going into social care. Well, I wouldn't | :24:12. | :24:16. | |
worry, except that I happen to know that between 2010 and 2015, four 8p | :24:17. | :24:23. | |
was taken out. Anyone who has even Key stage two maths will know that | :24:24. | :24:35. | |
that does not add up. If you take... Not only that, but I feel very sorry | :24:36. | :24:43. | |
for cancelled because they in -- if they increase council tax it is not | :24:44. | :24:48. | |
popular. And if they don't do it, they are blamed for not sorting out | :24:49. | :24:51. | |
the social care crisis. We know that the amounts raised even in an area | :24:52. | :24:55. | |
where the preset does bring back a lot of money as a local authority, | :24:56. | :24:59. | |
that doesn't help in the longer term, because it is a short-term fix | :25:00. | :25:03. | |
and it is not fixing the problem we need to be looking at, which is | :25:04. | :25:06. | |
basically having more homes where older people can live comfortably, | :25:07. | :25:11. | |
have fewer faults and accidents, be warmer so they are not suffering | :25:12. | :25:15. | |
from fuel poverty, and therefore stay out of accident and emergency, | :25:16. | :25:18. | |
which is about long-term planning. As we know, we have hardly build any | :25:19. | :25:23. | |
new homes, even new homes for older folk where we could be using that as | :25:24. | :25:27. | |
a change to help families come into those homes, thereby sobbing another | :25:28. | :25:28. | |
problem, and we end up with this crisis of older people being in | :25:29. | :25:46. | |
accident and emergency, and on occasion, even being on a trolley | :25:47. | :25:49. | |
for 35 hours, which I still feel I can't quite believe. I am sure the | :25:50. | :25:52. | |
newspapers are telling the truth, but it does seem that 35 hours is an | :25:53. | :25:55. | |
awfully long time not to be seen on a trolley. In relation to melt | :25:56. | :25:57. | |
ill-health, the member for Tottenham and I had a debate earlier in the | :25:58. | :26:02. | |
year, followed by a meeting with the local sub region of members of | :26:03. | :26:07. | |
Parliament. We were very worried about people suffering mental health | :26:08. | :26:13. | |
problems. We have a perfect storm at the moment for people suffering from | :26:14. | :26:17. | |
mental health. Number one, the cuts in benefits. We are in the seventh | :26:18. | :26:21. | |
year of austerity, and there was no doubt that people with mental health | :26:22. | :26:25. | |
problems are right at the bottom of the pile where those cuts are | :26:26. | :26:30. | |
concerned. Two, housing and those programmes that help people with | :26:31. | :26:36. | |
mental health problems stay in their tenancies. That has been cut back, | :26:37. | :26:39. | |
there is no one to support them, and it is part of the reason why they | :26:40. | :26:43. | |
fall ill. Number three, the cutbacks to the number of nurses. We have | :26:44. | :26:47. | |
fewer mental health nurses than two years ago in the system. And of | :26:48. | :26:53. | |
course, begs. A constituent came to see me at my surgery in November, | :26:54. | :27:01. | |
saying he had fallen ill with a mental health problem. He was amazed | :27:02. | :27:07. | |
at the poor level of care he received, including because there | :27:08. | :27:11. | |
was no one really to diagnosing properly. He was given no indication | :27:12. | :27:22. | |
about what sort of service. He was sent about 20 miles away to another | :27:23. | :27:26. | |
hospital to be cared for, causing great stress and worry for his | :27:27. | :27:30. | |
family. Mr Speaker, in conclusion, the whole of the health system is in | :27:31. | :27:36. | |
crisis and needs our urgent attention, and I do hope that | :27:37. | :27:40. | |
despite all the demands, the political demands, that the Brexit | :27:41. | :27:43. | |
process will create, that we will not forget not just the most | :27:44. | :27:48. | |
vulnerable but our basic, universal NHS for all. Andrea Jenkins. Thank | :27:49. | :27:57. | |
you, Mr Speaker. I would like to begin by objecting to the | :27:58. | :28:00. | |
exaggerated language used by Mike Adamson, the chief executive of the | :28:01. | :28:04. | |
British Red Cross, over the weekend. What was said by him does a huge | :28:05. | :28:09. | |
disservice to our hard-working health care professionals in the | :28:10. | :28:15. | |
NHS. It was sloppy and irresponsible language. The Red Cross does some | :28:16. | :28:19. | |
fantastic work, which I'm sure we agree on both sides of the Hours, | :28:20. | :28:25. | |
but as a registered charity, the organisation is legally obliged not | :28:26. | :28:29. | |
to be political, and if Mike Adamson cannot remain neutral, I suggest he | :28:30. | :28:33. | |
examine his position carefully. As a member of the health committee and | :28:34. | :28:38. | |
chair and co-founder of the patient safety all party Parliamentary | :28:39. | :28:41. | |
group, health care is extremely important to me, and I am proud to | :28:42. | :28:45. | |
be a Conservative member of Parliament under this Government. It | :28:46. | :28:49. | |
is thanks to this Government and this Health Secretary that the NHS | :28:50. | :28:55. | |
funding is at record levels. Mr Speaker, the Government's commitment | :28:56. | :29:01. | |
to delivering a seven-day NHS, expanding access to GP surgeries and | :29:02. | :29:06. | |
hospital-based consultants at evenings and weekends, and the NHS | :29:07. | :29:12. | |
has made more extensive winter preparations than ever before. In | :29:13. | :29:16. | |
the run-up to the winter period, as the Secretary of State stated | :29:17. | :29:20. | |
earlier, there were over 1600 more doctors and 3000 more nurses than | :29:21. | :29:24. | |
just a year ago. This is a record to be proud of and something that would | :29:25. | :29:30. | |
not have been achieved if we had had the opposition party running our | :29:31. | :29:34. | |
National Health Service. Mr Speaker, as chair of the patient safety APG | :29:35. | :29:41. | |
Gee, I am pleased to say that the Government has introduced a new | :29:42. | :29:48. | |
OFSTED- style safety regime to improve patient safety. Hospital | :29:49. | :29:51. | |
infections have been virtually halved since 2010. The level of MRSA | :29:52. | :29:57. | |
is virtually half, and CDP sealed cases are down by 20%. It is this | :29:58. | :30:02. | |
Health Secretary that has taken the lead on this issue and putting | :30:03. | :30:06. | |
patients at the heart of the NHS. Record numbers of people are being | :30:07. | :30:09. | |
treated in our health service, and there are pressures on the service, | :30:10. | :30:13. | |
but it is not this Conservative Government that is a threat to the | :30:14. | :30:18. | |
NHS. If we look at the appalling situation of the NHS in | :30:19. | :30:20. | |
Labour-controlled Wales, where they are cutting funding, and as our | :30:21. | :30:26. | |
latest statistic shows, they are failing to meet the four-hour A | :30:27. | :30:32. | |
tigers by a wide margin, it is easy to see who is the defender of the | :30:33. | :30:37. | |
NHS and who would cut investment. To conclude, Mr Speaker, it is this | :30:38. | :30:42. | |
Government that is increasing spending on our NHS, focusing on | :30:43. | :30:46. | |
improving patient safety, and is dedicated to providing the best | :30:47. | :30:53. | |
possible service. I am grateful for the opportunity to raise some | :30:54. | :30:58. | |
serious concerns about this Government's refusal to fully fund | :30:59. | :31:02. | |
our NHS. We are seeing this Government running out of places to | :31:03. | :31:07. | |
cut corners to save money. We see a lack of respect and compassion given | :31:08. | :31:14. | |
to people who need health care. We see those needing care at home | :31:15. | :31:18. | |
having to make do with 15 minute flying visits. We have seen the | :31:19. | :31:23. | |
pressure in A department building over the last six years, and yet, | :31:24. | :31:28. | |
every year, we have reached a winter crisis. Somehow, this is a surprise | :31:29. | :31:32. | |
that the Government. We have seen A waiting times increasing to the | :31:33. | :31:37. | |
point where now over 1.8 million people are more than four hours, an | :31:38. | :31:46. | |
increase of 400% since 2010. Bed blocking is increasing as our | :31:47. | :31:49. | |
underfunded social care services struggle to deal with the demand. We | :31:50. | :31:53. | |
have seen an increase in the number of patients waiting on trolleys to | :31:54. | :31:57. | |
be treated or admitted and the number of hospitals running out of | :31:58. | :32:02. | |
beds increasing. We are also about to see a 12% cut to community | :32:03. | :32:06. | |
pharmacies, which will lead to the closure or reduction in services on | :32:07. | :32:13. | |
our local pharmacies, and the time it takes to get a GP and appointment | :32:14. | :32:22. | |
-- a GP appointment in policing -- increasing. If we want a care system | :32:23. | :32:26. | |
that works with compassion and treats those in the professionally | :32:27. | :32:30. | |
and efficiently, this Government has to fund it. In 2015, the head of the | :32:31. | :32:41. | |
NHS, Sir Simon Stephens, said that the NHS needed ?8 billion. It was | :32:42. | :32:46. | |
this party which committed to fund it the Labour Party didn't. If she | :32:47. | :32:50. | |
is so keen on funding the NHS, why didn't the Labour Party pledged to | :32:51. | :32:56. | |
do so back in 2015? Pharmacies, this Government failed to grasp that cuts | :32:57. | :33:01. | |
to one service directly impact upon another. Let me be clear, only two | :33:02. | :33:05. | |
months ago I stood in this chamber to condemn the Government proposing | :33:06. | :33:12. | |
to cut community pharmacies by 12%. That would potentially see 25% of my | :33:13. | :33:18. | |
42 pharmacies facing closure in Bradford West. This highlights the | :33:19. | :33:22. | |
short-sighted approach taken by this Government. They are attacking all | :33:23. | :33:27. | |
forms of primary health care and front line services that people rely | :33:28. | :33:31. | |
upon. If the figures are correct, nearly 30% of people that attended | :33:32. | :33:37. | |
A services in Bradford Royal Infirmary, within my constituency, | :33:38. | :33:40. | |
over the last month, they could have been treated elsewhere for minor | :33:41. | :33:47. | |
ailments. Many would go to the local pharmacy board to see their GP, but | :33:48. | :33:53. | |
what is this Government's long-term approach to the systematic issues if | :33:54. | :33:57. | |
they continue to water down primary care services? All we will see is | :33:58. | :34:02. | |
the number of visitors unnecessarily attending A increase and the | :34:03. | :34:06. | |
problems faced by those needing access to services increase. Let's | :34:07. | :34:11. | |
talk about GP services. We are seeing the same impact from a | :34:12. | :34:15. | |
reduction in GP services. Only a few months ago, I campaign with the | :34:16. | :34:19. | |
local community to save manning health practice. That was | :34:20. | :34:26. | |
temporarily put on hold. However, we have managed to stop this centre in | :34:27. | :34:30. | |
the short-term, but I know that others are right risk in my | :34:31. | :34:36. | |
constituency, and many GPs face uncertain future is due to funding | :34:37. | :34:40. | |
restraints. It paints not only a picture of under picked -- | :34:41. | :34:43. | |
underfunding of primary care services, but also a picture of a | :34:44. | :34:47. | |
strategy that simply does not work together. Even a simple | :34:48. | :34:50. | |
understanding of health care provision would allow us to see that | :34:51. | :34:55. | |
if we decrease NHS services in one sector, it impacts upon the rest of | :34:56. | :34:56. | |
it. This will increase pressures on | :34:57. | :35:04. | |
service providers but this government continues to underfund, | :35:05. | :35:08. | |
and cut funding to all aspects of front line services, and expect the | :35:09. | :35:13. | |
quality of care to remain the same. Where is the long-term planning that | :35:14. | :35:17. | |
would ensure people are getting access to the care that they deserve | :35:18. | :35:22. | |
and are entitled to? Local government social care funding, | :35:23. | :35:26. | |
again, we see the same strategy from this government with social care | :35:27. | :35:32. | |
funding. With cuts to care funding has been dramatic, as members have | :35:33. | :35:36. | |
highlighted. Nearly ?4.6 billion has been taken out of the sector since | :35:37. | :35:41. | |
2010. Mainly from local governor and funding cuts. My district of | :35:42. | :35:44. | |
Bradford has had to announce that they will need to find another ?8 | :35:45. | :35:50. | |
million in savings in their budgets going forward. They are trying to be | :35:51. | :35:54. | |
innovative and find ways to make sure that this does not affect from | :35:55. | :35:59. | |
front line care by putting resources into prevention. As far as I am | :36:00. | :36:03. | |
concerned, this government still fails to recognise the impact of | :36:04. | :36:11. | |
deprivation on our care needs. One of the most deprived constitutions, | :36:12. | :36:15. | |
mental health issues go hand-in-hand with deprivation. The cuts to local | :36:16. | :36:18. | |
government funding make this even more evident. It is not the work of | :36:19. | :36:22. | |
our exceptional health care staff which causes this crisis. It is the | :36:23. | :36:28. | |
reduction in funding, and the short-term strategy of this | :36:29. | :36:31. | |
government to which is responsible, and it is time that they wake up and | :36:32. | :36:35. | |
provide the health care provision that people deserve. Thank your very | :36:36. | :36:41. | |
much Mr Speaker, many of my constituents are extremely fortunate | :36:42. | :36:46. | |
to be served by the Luton and Dunstable Hospital, which was named | :36:47. | :36:49. | |
checked twice by the secretary of state in his statement on Monday. | :36:50. | :36:55. | |
One of the things they do extremely well is that they have an excellent | :36:56. | :36:59. | |
streaming process in A with good alternatives where | :37:00. | :37:07. | |
A services are not suitable. It gives them high standards. Social | :37:08. | :37:15. | |
care is provided by Central Bedfordshire Council which has been | :37:16. | :37:19. | |
extremely innovative in building extra care provisions for older | :37:20. | :37:25. | |
people. I visited these provisions which are hugely popular and are in | :37:26. | :37:29. | |
central locations. They are much cheaper than residential care. And, | :37:30. | :37:33. | |
they provide a much better living environment for older people. This | :37:34. | :37:38. | |
is exactly the sort of thing that we need to see a lot more of across the | :37:39. | :37:44. | |
country. I think these are two examples of really good individual | :37:45. | :37:48. | |
practice, within the NHS and social care. And, what we need to be much | :37:49. | :37:52. | |
better at is spreading good practice across the country as a whole. It is | :37:53. | :37:58. | |
just worth putting on the record in this debate that since this time | :37:59. | :38:05. | |
last year, we do have over 1600 more doctors, 3100 more hospital nurses | :38:06. | :38:11. | |
since 2010, over 11,000 more doctors and nurses. The proportion of | :38:12. | :38:16. | |
patients harmed by the NHS fell by over one third between 2012 and | :38:17. | :38:27. | |
2015. Infraction is 50% lower than a year ago. A tremendous achievement. | :38:28. | :38:32. | |
Health spending in England is actually 1% higher than the OECD | :38:33. | :38:37. | |
average. And, the UK is spending more on long-term care as a | :38:38. | :38:42. | |
percentage of GDP than Germany, Canada and USA. The King 's fund has | :38:43. | :38:48. | |
also that STBs are the best hope for the future of the NHS in England -- | :38:49. | :38:56. | |
S T P. The head of NHS providers has said that the system as a whole is | :38:57. | :38:59. | |
doing slightly better than this time last year. This is dependent on | :39:00. | :39:03. | |
having a strong economy and I would argue that this party has | :39:04. | :39:08. | |
demonstrated confidence in running the economy. I'm not complacent, I | :39:09. | :39:14. | |
recognise there is an arms race between the extra provisions the | :39:15. | :39:16. | |
government has put in and increasing demands on the NHS. One issue which | :39:17. | :39:22. | |
disappoints me is that we do not have enough focus on holiday in | :39:23. | :39:26. | |
these debates, it is always about funding. I draw attention again to | :39:27. | :39:31. | |
the initiative brought in by the government just before Christmas, | :39:32. | :39:39. | |
which is projected to save ?1.5 billion, and could be redirected to | :39:40. | :39:46. | |
patient care across 18 specialties. Low infections, less provision | :39:47. | :39:51. | |
operations, and we are using data to shine the spotlight on variability. | :39:52. | :39:57. | |
That is absolutely key for our constituents and, in relation to | :39:58. | :40:01. | |
mental health and the welcome statement by the Prime Minister on | :40:02. | :40:05. | |
Monday, I was delighted to hear emphasis on first aid for mental | :40:06. | :40:09. | |
health, something that will take place within our schools. Equally as | :40:10. | :40:14. | |
important, if not more so, I would say, is the issue of keep fit for | :40:15. | :40:18. | |
mental health, what do we need to do, all of us, to maintain good | :40:19. | :40:23. | |
mental health? The mental health foundation says we have to talk | :40:24. | :40:26. | |
about our feelings, eat well, keep in touch with family and friends, | :40:27. | :40:31. | |
take a break, accept who we are, keep active, drink sensibly, ask for | :40:32. | :40:38. | |
help and look after others. Those ten pointers are not as well-known | :40:39. | :40:41. | |
as they should be, I am pleased to put them on the record just now but | :40:42. | :40:46. | |
it is crucial that we all look after our mental health which will help to | :40:47. | :40:51. | |
reduce the stigma within this area. Another area that I am passionate | :40:52. | :40:55. | |
about is doing something about obesity, we have a National Health | :40:56. | :41:02. | |
Service and we do not do enough to keep our fellow citizens healthy. I | :41:03. | :41:10. | |
would like to see more emphasis done following an academic of the | :41:11. | :41:13. | |
University of Oxford, she published an article in the Lancet just before | :41:14. | :41:19. | |
Christmas showing that where GPs offer a referral to 12 one-hour | :41:20. | :41:24. | |
weekly sessions to obese patients, there was a significant reduction in | :41:25. | :41:29. | |
their obesity. In 2015, a quarter of adults were obese... Honourable | :41:30. | :41:38. | |
member like me is a regular reader of the Daily Mail, their proposal | :41:39. | :41:43. | |
that are obese or heavy smokers or both, they are denied medical | :41:44. | :41:49. | |
treatment until they lose weight or stop smoking. Would he recommend to | :41:50. | :41:56. | |
the front bench that policy? I'm fixing on how we can keep ourselves | :41:57. | :42:00. | |
healthy to reduce demands on the NHS by behaving responsibly. 40% of | :42:01. | :42:14. | |
children aged 2-15, 80% in lower households. Those figures showed | :42:15. | :42:19. | |
shame as all. That is why I mentioned the Daily Mail, and the | :42:20. | :42:26. | |
scheme brought in by that school in Stirling, we need to see more of | :42:27. | :42:30. | |
that and the strength and obesity policy. My daily newspaper at the | :42:31. | :42:35. | |
moment is the China daily which is delivered free to my office at the | :42:36. | :42:40. | |
moment. I was intrigued to see, Mr Speaker, that universities in China, | :42:41. | :42:44. | |
students had to take a physical fitness test lasting 50 minutes. I'm | :42:45. | :42:56. | |
not suggesting that we introduce it here, but we should look around the | :42:57. | :42:59. | |
world to see what other countries are doing to promote keeping | :43:00. | :43:05. | |
populations fit and healthy and reduce pressure on health services. | :43:06. | :43:09. | |
At the other end of the age spectrum, we need to do a lot more | :43:10. | :43:12. | |
to keep older people fit and healthy, as many issues of social | :43:13. | :43:19. | |
care would be greatly lessened if older people were to stay healthy in | :43:20. | :43:24. | |
later life. I am very proud to be associated with the Buzzard's 50 | :43:25. | :43:30. | |
plus organisation in my constituency, which helps older | :43:31. | :43:36. | |
people take regular exercise at local leisure centres. In Andorra, | :43:37. | :43:41. | |
where I mentioned earlier, this is normal for the whole population. | :43:42. | :43:46. | |
Older people in the 70s and 80s regularly take place in water | :43:47. | :43:50. | |
aerobics classes and go to the gym. When a BBC correspondence went there | :43:51. | :43:53. | |
a few years ago, some of the women he spoke to were in their 70s and | :43:54. | :43:59. | |
taking part -- correspondent. They said what is more important than | :44:00. | :44:04. | |
keeping yourself it? If you don't keep your body moving, you won't | :44:05. | :44:08. | |
keep your mind in shape. We need more of that kind of activity within | :44:09. | :44:16. | |
our own country -- keeping yourself fit. We have heard from the opposite | :44:17. | :44:24. | |
benches today about the so-called annual winter crisis, as if the | :44:25. | :44:27. | |
situation at the moment that we are in has always been there. There have | :44:28. | :44:32. | |
been crises but nothing like on the scale that we have recently seen. We | :44:33. | :44:38. | |
are hearing about corridors being used as wards, and I have seen it in | :44:39. | :44:42. | |
my own local hospital when I took my young son to hospital. When we went | :44:43. | :44:48. | |
through into the water and salt use of trolleys with patients on there, | :44:49. | :44:55. | |
before my little son was seen to -- and saw the use of trolleys. In | :44:56. | :45:01. | |
December of last year, the minister in his place at the moment, the | :45:02. | :45:06. | |
honourable member for nut low, answered that question. -- Ludlow. | :45:07. | :45:14. | |
Could the government give figures for patients left queueing in | :45:15. | :45:18. | |
corridors? I was told there were no such figures. The government and | :45:19. | :45:21. | |
minister is well aware this is going on in hospitals up and down the | :45:22. | :45:24. | |
country and if the government does not collect these figures centrally, | :45:25. | :45:32. | |
if hospitals collect those figures, the government should ask for them. | :45:33. | :45:37. | |
If the hospitals do not, they aren't really carrying out the duty of care | :45:38. | :45:41. | |
to our constituents because I think that it is important that we know | :45:42. | :45:48. | |
how many are being held in corridors. We hear stories of | :45:49. | :45:52. | |
ambulances being redirected and bed occupancy is over 85% | :45:53. | :45:58. | |
recommendations and in some cases over 95% that we are seeing. We have | :45:59. | :46:04. | |
heard about the ?4.6 billion in cuts in the social care funding. And | :46:05. | :46:09. | |
already, whilst it has not been explicit, we are seeing talk about a | :46:10. | :46:17. | |
discussion on the downgrade in the four-hour A weight. I know myself, | :46:18. | :46:25. | |
in Preston, there is difficulty in getting GP appointments -- wait. If | :46:26. | :46:28. | |
I bring to see the doctor, I'm often told that we had to wait 2-3 weeks | :46:29. | :46:34. | |
to see that Doctor. It's probably 2-3 hours at the very least if I go | :46:35. | :46:39. | |
to the hospital and it is a serious case that we are looking at. No | :46:40. | :46:46. | |
wonder A is in crisis. There is a whole cohort of doctors in their mid | :46:47. | :46:50. | |
to late 50s looking forward to retirement. I know the number of | :46:51. | :46:54. | |
doctors has increased, we heard that today from the Health Secretary, but | :46:55. | :46:58. | |
I do not think it is anywhere near meeting the number leaving the | :46:59. | :47:01. | |
service or going to work elsewhere as well. On the social care sector, | :47:02. | :47:08. | |
we are seeing in Lancashire tens of millions of pounds of cuts in | :47:09. | :47:15. | |
Lancashire County Council which is leaving the elderly vulnerable and | :47:16. | :47:19. | |
more likely to have accidents at home which is putting her Sian A | :47:20. | :47:25. | |
as well. The Cinderella service has always been there, -- putting | :47:26. | :47:33. | |
pressure on A as well. They do not get the support that they deserve | :47:34. | :47:36. | |
and I've seen in my own constituency since the closure of the acute | :47:37. | :47:45. | |
mental health ward hospitals, the agent Dale unit, how mental health | :47:46. | :47:50. | |
patients have been decanted across Lancashire because they do not have | :47:51. | :47:55. | |
the support they need in Preston itself. Over a five-month period | :47:56. | :48:04. | |
last year, we saw a 16% increase in attendance at A in Preston | :48:05. | :48:09. | |
Hospital and over the same period, average attendances increased from | :48:10. | :48:16. | |
217 to 225 per day. A small percentage of the increase was due | :48:17. | :48:20. | |
to the version of Chorley hospitals A and I'm sure if the member for | :48:21. | :48:25. | |
Chorley was here today, he would echo what I have just said. But that | :48:26. | :48:31. | |
is not all down to the closure of Chorley's A Many of the patients | :48:32. | :48:35. | |
who would have gone there are now going to weaken and going elsewhere. | :48:36. | :48:42. | |
The problem in Preston, as well as Chorley and elsewhere, the | :48:43. | :48:44. | |
government should not be allowing wards to close when they demand -- | :48:45. | :48:49. | |
when the demand is so high. Ambulance arrivals have increased | :48:50. | :48:55. | |
from 68 to 91, according to the north-west Ambulance Services. In | :48:56. | :49:01. | |
the meantime, a return to a 24-hour A service that Chorley Hospital | :49:02. | :49:05. | |
has been ruled out. At best, there would be a 12 hour A service | :49:06. | :49:10. | |
sometime later this month. At Preston, we have 134, Alta 138, of | :49:11. | :49:20. | |
the A departments up and down the country when 95% of patients are not | :49:21. | :49:24. | |
seen within the four ours. Which means that only four hospitals, A | :49:25. | :49:33. | |
in the country, our meeting the four-hour standard. Mr Speaker, I | :49:34. | :49:37. | |
believe this is a disgrace. And, it is testimony to the cuts and | :49:38. | :49:43. | |
austerity being forced on the NHS and local government social services | :49:44. | :49:45. | |
departments up and down the country. I call upon the government to | :49:46. | :49:50. | |
increase spending on social care, and further fund the NHS at this | :49:51. | :49:52. | |
years budget as a of urgency. It's a pleasure to follow the member | :49:53. | :50:06. | |
for Preston in today's debate. I am also conscious that I am following | :50:07. | :50:13. | |
many more learning members -- learned members, from both sides of | :50:14. | :50:19. | |
the chamber, who bring very valuable experience from the front line | :50:20. | :50:25. | |
within the NHS. Like probably all members across the chamber, I | :50:26. | :50:31. | |
receive letters, visits from constituents, with concerns and | :50:32. | :50:35. | |
issues about the NHS, about their own health issues, and some of them, | :50:36. | :50:39. | |
as we all know, Mr Speaker, can be very sad and the motive, and we all | :50:40. | :50:45. | |
do our utmost to help them and what can be very difficult situations. | :50:46. | :50:50. | |
But let's not forget the many positive stories and experiences we | :50:51. | :50:56. | |
hear also. Many of us in the chamber, again, will have had our | :50:57. | :51:00. | |
own very positive experiences about the NHS as well, and away it has | :51:01. | :51:04. | |
helped us and our families and continues to do so, and I think it | :51:05. | :51:08. | |
would be wrong and unfair of us not to recognise those today. So, I | :51:09. | :51:12. | |
would like to start by thanking those NHS staff and those who work | :51:13. | :51:22. | |
in the health and social care services, not just for the work they | :51:23. | :51:27. | |
do at this time of year but for the work that they do throughout the | :51:28. | :51:31. | |
year, day in, day out. My mother was a home-care rather many years, and | :51:32. | :51:36. | |
my sister is a practice nurse, so I often hear from them what it is like | :51:37. | :51:42. | |
to work on the front line. I also include the Manor Hospital, our | :51:43. | :51:51. | |
local hospital in Walsall, and they, like many hospitals, have their own | :51:52. | :51:55. | |
precious to face. We heard today, on the Tuesday after Christmas, A saw | :51:56. | :52:00. | |
the highest number of patients, and I believe all those involved in | :52:01. | :52:03. | |
health care are working extremely hard to this. I include the | :52:04. | :52:09. | |
Secretary of State and his ministers in this, in the work that they do to | :52:10. | :52:13. | |
tackle this immediate problem, and what are doing in moving us towards, | :52:14. | :52:21. | |
I'm sure, a better and more sustainable future. Hospitals across | :52:22. | :52:24. | |
the country are facing huge pressures, and as I said, as we | :52:25. | :52:31. | |
enter the winter period. We have an increasingly ageing population but | :52:32. | :52:34. | |
also one that is increasing in terms of numbers as well. There are many | :52:35. | :52:38. | |
more treatment options available than ever before. Some of them come, | :52:39. | :52:45. | |
we all know, at a high cost, but a cost we would like to be able to | :52:46. | :52:50. | |
meet to help those patients. All of these factors place challenges and | :52:51. | :52:55. | |
pressures on the NHS, its staff and its resources. The impact of an | :52:56. | :52:58. | |
ageing population is something that has been raised with me by some of | :52:59. | :53:05. | |
my local GPs, and the need to recognise and tackle this. I know | :53:06. | :53:08. | |
that local GPs in my surgery would be very welcoming the Minister if he | :53:09. | :53:14. | |
would like to drop by Oldridge on his way back to Shropshire one | :53:15. | :53:21. | |
Friday for a very useful and positive roundtable discussion, so | :53:22. | :53:24. | |
there is an invitation for you there, Minister. Also, the | :53:25. | :53:32. | |
importance of having an integrated and effective social care system is | :53:33. | :53:35. | |
part of this too. I don't believe that whilst money is an important | :53:36. | :53:42. | |
factor, it is not just about that. The Secretary of State said earlier | :53:43. | :53:45. | |
that we miss a trick if we say that it is. We forget it is also about | :53:46. | :53:50. | |
safety, standards and quality, and making progress on these areas too. | :53:51. | :53:55. | |
I can recall, a number of years ago, the headlines were always about MRSA | :53:56. | :54:03. | |
and some of those really nasty hospital bugs and infections, and we | :54:04. | :54:07. | |
have gone a long way in terms of the work we are doing to combat those. I | :54:08. | :54:10. | |
am proud this Government is committed to the NHS, and that as we | :54:11. | :54:17. | |
enter the inter--- the winter period, we have nearly 1800 more | :54:18. | :54:21. | |
doctors, nearly 3000 more hospital nurses than we had a year ago. We | :54:22. | :54:27. | |
launched the largest ever flu vaccine programme. We allocated ?400 | :54:28. | :54:33. | |
million to local health Systems for winter preparing this. There are | :54:34. | :54:40. | |
12,000 additional GP sessions over the festive period. Of course, there | :54:41. | :54:47. | |
is more to do, and there always will be, but I believe that we are | :54:48. | :54:50. | |
writing to the challenge and that we will continue to do so and I am sure | :54:51. | :54:55. | |
the Secretary of State and his team will continue to rise to that | :54:56. | :55:03. | |
challenge as well. I don't intend to take too long, because I am mindful | :55:04. | :55:07. | |
of the fact that the motion before us largely talks about NHS England, | :55:08. | :55:12. | |
but I am goaded to speak by the repeated references by the current | :55:13. | :55:17. | |
Secretary of State, and indeed the previous Prime Minister, and the | :55:18. | :55:22. | |
current Prime Minister, to the NHS in Wales, and the relative | :55:23. | :55:26. | |
performance of eight. I want to use a few minutes to try and set the | :55:27. | :55:29. | |
record straight and give a clearer illustration of the relative | :55:30. | :55:34. | |
performance of the two NHSs. Before I do, I wanted to reflect on the | :55:35. | :55:37. | |
speech the Prime Minister gave, and interesting, thoughtful speech | :55:38. | :55:42. | |
earlier this week about her desire to create a shared society, as she | :55:43. | :55:47. | |
put it, in Britain. As many members did, I read it and thought it was | :55:48. | :55:51. | |
precisely what all governments ought to be doing in this country at all | :55:52. | :55:55. | |
times. I thought I would briefly read one passage. She said: That is | :55:56. | :55:59. | |
why I believe that the central challenge of our times is to | :56:00. | :56:03. | |
overcome division and to bring our country together to create a society | :56:04. | :56:07. | |
that respects the bonds we share as a union of people and of nations. | :56:08. | :56:11. | |
And I completely agree with the current Prime Minister about that, | :56:12. | :56:14. | |
but I find it impossible to reconcile that stated objective and | :56:15. | :56:21. | |
the rhetoric that we hear from a current Prime Minister with the | :56:22. | :56:26. | |
reality of the way in which she, and in particular her predecessor, have | :56:27. | :56:30. | |
sought to divide this country, in particular, on the issue of the NHS, | :56:31. | :56:35. | |
illegitimately, in my view, demeaning the performance of the NHS | :56:36. | :56:42. | |
in Wales, demoralising staff and destroying confidence and faith in | :56:43. | :56:46. | |
the NHS in Wales in Welsh citizens. All of those things I think, have | :56:47. | :56:51. | |
been completely illegitimate, and I hope with a few short statistics to | :56:52. | :56:54. | |
illustrate how misleading some of the representation has been in | :56:55. | :57:01. | |
recent years. I would say that it was in fact 37 times, the first | :57:02. | :57:06. | |
autistic, that the previous Prime Minister referred in a disparaging | :57:07. | :57:11. | |
fashion to the NHS in Wales, using it on every occasion as a political | :57:12. | :57:15. | |
attempt to mitigate against criticism of the NHS in England, and | :57:16. | :57:21. | |
in my view, breaking the bonds, those important bonds, between | :57:22. | :57:24. | |
different parts of the UK. I will set out a few facts. The truth is, | :57:25. | :57:29. | |
the budget for Wales, the entire budget, is about ?15 billion per | :57:30. | :57:36. | |
annum. Of that, ?7.1 billion is spent on the NHS, that's 48% of all | :57:37. | :57:41. | |
spending by the Government in Wales. The difference between that and | :57:42. | :57:45. | |
England is enormous, because in England, of course, the entire | :57:46. | :57:50. | |
budget of the NHS is ?120 billion and the entire budget of the | :57:51. | :57:56. | |
country, if you like, is around ?750 billion, so around 16% of the budget | :57:57. | :58:04. | |
in England is spent on the NHS, Violet is about 40% in Wales. -- | :58:05. | :58:15. | |
while it is about. The Government has manipulated statistics on this | :58:16. | :58:18. | |
issue. The second thing the Government has done repeatedly in | :58:19. | :58:21. | |
the last six years, and we heard it three times already today, is | :58:22. | :58:26. | |
referred to the lesser rate of spending per head in Wales compared | :58:27. | :58:31. | |
to England. In 2010, the Welsh Government chose to reduce spending | :58:32. | :58:40. | |
in the NHS by 1%. A 1% reduction in order to increase spending and | :58:41. | :58:45. | |
prioritise education in Wales. Since then, we have seen successive rounds | :58:46. | :58:51. | |
of investment by the Welsh Government, ?80 million announced | :58:52. | :58:54. | |
this week for a new treatment fun, ?40 million last week for capital | :58:55. | :58:59. | |
spending. It's now broadly comparable in percentage terms. If | :59:00. | :59:03. | |
you look at per capita spending last year, we spent in wells around ?2026 | :59:04. | :59:10. | |
on the NHS, violin England it is ?228. -- 2000 ?228. It is | :59:11. | :59:20. | |
negligible. Wales spent 6% more per head than England overall. Those are | :59:21. | :59:23. | |
the realities of comparative spending. Their rise some things | :59:24. | :59:30. | |
where the Welsh NHS does worse. You do wait longer for some diagnostic | :59:31. | :59:35. | |
treatment in Wales, and there is a need to spend more on MRI scanners | :59:36. | :59:39. | |
and CT scans, but part of the issue there is to do with an older, more | :59:40. | :59:46. | |
sick, post-industrial population, rural sparsity, lesser ability to | :59:47. | :59:51. | |
attract people to more far-flung hospitals, all perfectly explicable, | :59:52. | :59:54. | |
reasonable solutions. In England over the last nine months, we have | :59:55. | :00:00. | |
seen rising waiting lists, the biggest we have seen in the last | :00:01. | :00:05. | |
nine years. In other areas, Wales does well. Ambulance response times, | :00:06. | :00:11. | |
getting therein eight minutes and 77% of those calls are met in Wales | :00:12. | :00:17. | |
will stop cancer treatment times - most people would agree to is vital | :00:18. | :00:24. | |
to get people treated. The target is consistently missed in England, | :00:25. | :00:31. | |
averaging 81%. In Wales, it is 86%. Let's look at A, given that is the | :00:32. | :00:35. | |
crucial area we're looking at today. The four-hour target, in Wales 83% | :00:36. | :00:42. | |
of people are seen within that target. In England, it is presently | :00:43. | :00:50. | |
88%. In England, whether our 150 A departments, versus the six or seven | :00:51. | :00:55. | |
we have in wells, another completely ludicrous and meaningless | :00:56. | :01:00. | |
statistical comparison, of those 150 A trust departments in England are | :01:01. | :01:07. | |
below the Welsh average. In several of the Welsh trusts, out of the sex, | :01:08. | :01:16. | |
they are up at the 96-98% mark. It is another illustration have how | :01:17. | :01:20. | |
misleading and abuse of it has been the Tories to use the Welsh NHS as a | :01:21. | :01:24. | |
stick to political points in this place. In conclusion, I want to say | :01:25. | :01:30. | |
two things. The truth about the Welsh NHS is that it performs | :01:31. | :01:33. | |
excellently in some areas and could be improved in others. As the OECD | :01:34. | :01:39. | |
said in a 10-year of all the help care systems across this country, no | :01:40. | :01:43. | |
part of Britain performs their miserably better than any other. | :01:44. | :01:50. | |
That is the truth of the differences between our NHS in this country. The | :01:51. | :01:56. | |
minister, the Prime Minister and others need to remember that they | :01:57. | :02:00. | |
are ministers for the whole of the UK, not just for England, and their | :02:01. | :02:05. | |
duty is to increase the bonds of solidarity, not destroy them. Thank | :02:06. | :02:11. | |
you very much, Mr Speaker. I think this has been an absolutely | :02:12. | :02:14. | |
first-rate debate this afternoon, with a number of extremely fine | :02:15. | :02:19. | |
contributions. I was particularly taken, as ever, by the remarks of my | :02:20. | :02:23. | |
honourable friend, the chair of the select committee, who pointed out | :02:24. | :02:25. | |
rightly that we are all living longer, which is great, but | :02:26. | :02:30. | |
unfortunately our healthy lives are not expanding, which causes problems | :02:31. | :02:34. | |
for A, who have to deal with that. Although we talk about large numbers | :02:35. | :02:39. | |
of people passing through A, and they deal with Bobby below the time, | :02:40. | :02:42. | |
the truth of the matter is that it is those with chronic and long-term | :02:43. | :02:50. | |
complicated conditions who tend to use the lion's share of resources in | :02:51. | :02:56. | |
A and the secondary care system. As we get older, there will be more | :02:57. | :03:00. | |
and more of those cases, and we need to prepare for that. We also need to | :03:01. | :03:05. | |
mitigate against them, and one thing that has not been discussed terribly | :03:06. | :03:08. | |
much this afternoon is prevention and public health and our need to | :03:09. | :03:12. | |
ensure that we deal with things that are avoidable. The Prime Minister | :03:13. | :03:17. | |
rightly in her excellent speech on Monday on the shared society said | :03:18. | :03:23. | |
that we live in a country where, if you're poor, you will die on average | :03:24. | :03:28. | |
nine years earlier than others. That is an absolutely appalling thing. We | :03:29. | :03:32. | |
should all be ashamed of that in this country. Now, half of that | :03:33. | :03:36. | |
health inequality is because of tobacco consumption and the fact | :03:37. | :03:42. | |
that if you are in a manual occupation, you are far more likely | :03:43. | :03:45. | |
to be a smoker and smoke more than if you are a professional or | :03:46. | :03:52. | |
managerial person. We have to be serious about controlling the | :03:53. | :03:57. | |
scourge of tobacco, and I would really encourage ministers to | :03:58. | :04:01. | |
produce the Tobacco control plan as quickly as possible. It is overdue | :04:02. | :04:05. | |
now, and we do need to deal with this. I would hope very much that it | :04:06. | :04:11. | |
will contain some helpful remarks on the tobacco duty escalator. I hope | :04:12. | :04:17. | |
it might contain some remarks on the licensing of retailers, and serious | :04:18. | :04:20. | |
conversations with supermarkets, the aim being to reduce availability of | :04:21. | :04:24. | |
tobacco, re-juice consumption and therefore reduce the burden of | :04:25. | :04:28. | |
disease affecting our National Health Service and having appalling | :04:29. | :04:33. | |
consequences for citizens. I very much support the amendment on the | :04:34. | :04:35. | |
order paper today. I am sorry that I was not present | :04:36. | :04:46. | |
when the honourable lady who speaks for the SNP was present when she was | :04:47. | :04:50. | |
making her remarks about community hospitals, I'm sorry about that | :04:51. | :04:54. | |
because community hospitals are particularly important to me and I | :04:55. | :04:56. | |
would like to have contributed in response to some of her remarks. I | :04:57. | :05:01. | |
have community hospitals in my area, and I had one particular that serves | :05:02. | :05:08. | |
Shaftesbury and is threatened with closure is because of STP plans, we | :05:09. | :05:12. | |
need to be very careful about short-term funding cuts which may | :05:13. | :05:15. | |
appear to be expedient, if we have not properly costed out a service | :05:16. | :05:21. | |
like that because it is certainly the case that Community Hospital | :05:22. | :05:25. | |
beds, providing the case mix is right and traditionally they've been | :05:26. | :05:30. | |
pretty appalling, in providing that right, providing a cost-effective | :05:31. | :05:34. | |
means of treating people, particularly the elderly, in a | :05:35. | :05:38. | |
setting close to their homes and not in acute hospitals which is the | :05:39. | :05:42. | |
wrong place for elderly and sick people, and steals quite effectively | :05:43. | :05:46. | |
with the delayed discharge problems that afflict our system at the | :05:47. | :05:54. | |
moment. We are often faced with the political choice of whether to pose | :05:55. | :06:01. | |
for expediency, our own expediency, the closure or reorganisation of | :06:02. | :06:05. | |
services. I face it in my own constituency and was pleased to hear | :06:06. | :06:08. | |
from my right honourable friend, the MP for Chelmsford. That we need to | :06:09. | :06:15. | |
be brave, sometimes, in approaching that. It is certainly the case that | :06:16. | :06:19. | |
if you want to drive up standards and outcomes in the NHS we had to | :06:20. | :06:23. | |
increasingly look at specialist centres which inevitably means | :06:24. | :06:26. | |
service reconfiguration and probably mean some closures, which will be | :06:27. | :06:30. | |
disagreeable to many colleagues, but it is certainly the case that | :06:31. | :06:35. | |
standards, and outcomes, I improved in things like cancers, strokes and | :06:36. | :06:38. | |
heart attacks if we have specialist centres which have regional and | :06:39. | :06:47. | |
subregional services. I would not be one to oppose closure or | :06:48. | :06:51. | |
reconfiguration for its own sake and we have two always understand that | :06:52. | :06:54. | |
resources are finite and we need to get the most and the best outcomes | :06:55. | :07:01. | |
available. I say gently that we need to look at funding and be aware of | :07:02. | :07:12. | |
the campaign supported by me and the right honourable member for North | :07:13. | :07:15. | |
Norfolk in relation to a commission or convention, which seems to me a | :07:16. | :07:18. | |
nonpartisan way of reaching a problem in how we will | :07:19. | :07:27. | |
fund the NHS going forward. I commend it to him and I look forward | :07:28. | :07:31. | |
to hearing that the prime ministers prepare to meet colleagues and see | :07:32. | :07:37. | |
if this can be a productive way forward. We do not spend as much on | :07:38. | :07:42. | |
the NHS as we need to spend, that's the bottom line. It is no good that | :07:43. | :07:53. | |
people say we spend 1% of the OECD average. Most people in this country | :07:54. | :07:57. | |
would not wish to be compared to it, we need to close that gap and as the | :07:58. | :08:02. | |
government of the day made clear, several years ago now, we need to | :08:03. | :08:08. | |
close the gap with the EU 15, particularly countries like France, | :08:09. | :08:12. | |
Germany and the Netherlands whose outcomes are much better than this | :08:13. | :08:15. | |
country and it is no coincidence that they spend much, much more on | :08:16. | :08:19. | |
health care. Today, the chief executive of the NHS is being | :08:20. | :08:23. | |
examined in a committee, I hope one of the things he will be examined on | :08:24. | :08:27. | |
is the ?22 billion efficiency measures that he felt might be | :08:28. | :08:32. | |
achievable in the five-year forward view, clearly two years into that | :08:33. | :08:38. | |
five-year forward view, those efficiency savings will not be met, | :08:39. | :08:42. | |
they never were going to be met. They need to determine how they are | :08:43. | :08:46. | |
going to make up that difference between the efficiency measures that | :08:47. | :08:54. | |
the NHS can reasonably achieve and those projected two years ago. May I | :08:55. | :08:59. | |
finish by congratulating the Minister, the government, for | :09:00. | :09:03. | |
achieving what they have. We've heard how things have improved in | :09:04. | :09:07. | |
relation to things like activity, hospital infections, there is much | :09:08. | :09:11. | |
more to do and I hope particularly that he will look at this funding | :09:12. | :09:16. | |
issue. This is a very important issue and I congratulate my | :09:17. | :09:19. | |
honourable friend on bringing it to the house. The pressures on our | :09:20. | :09:21. | |
National Health Service have a multitude of consequences. | :09:22. | :09:31. | |
Limited financial resources, ageing populations and global competition | :09:32. | :09:35. | |
for skills, but there are many aspects which do have a political | :09:36. | :09:38. | |
origin and the covenant cannot continue to avert their eyes from | :09:39. | :09:42. | |
that. Today, I want to talk about my own | :09:43. | :09:47. | |
experience of pressures on staff in the NHS and those in A are facing. | :09:48. | :09:51. | |
And walking a mile in the shoes of those on the front line making | :09:52. | :09:56. | |
life-and-death decisions daily. My exposure to these pressures are | :09:57. | :09:59. | |
professional and personal. Professionally, like many other MPs, | :10:00. | :10:04. | |
I spent time in the A departments of Chester Royal Hospital recently | :10:05. | :10:09. | |
-- Chesterfield. Shadowing staff on the watch. But exposure to those | :10:10. | :10:13. | |
issues are also personal. Last year on Friday, July the 15th, | :10:14. | :10:17. | |
my father died from an aneurysm and four days earlier he had spent -- he | :10:18. | :10:27. | |
had been sent home with what a vascular surgeon described at the | :10:28. | :10:33. | |
inquest as classic aneurysm symptoms. | :10:34. | :10:37. | |
He presented at the A Department with severe pain in his right groin, | :10:38. | :10:42. | |
and was described as being confused and not communicating. After five | :10:43. | :10:46. | |
hours in A, he was sent home in a taxi and four days later he died in | :10:47. | :10:56. | |
my arms. It was particularly haunting, and | :10:57. | :10:58. | |
what was wanted was his response to the question of why my father was | :10:59. | :11:05. | |
sent home, there were pressures in the department that day, you said it | :11:06. | :11:09. | |
was nonstop on the Friday afternoon, particularly busy and from one case | :11:10. | :11:12. | |
to the next comic he constantly had to decide as he did most days, which | :11:13. | :11:19. | |
should be in a hospital bed and which to send him this time. Every | :11:20. | :11:24. | |
day, we had to make these choices, he said. I probably sent home five | :11:25. | :11:27. | |
people that they who should have been in a bed. Those are the choices | :11:28. | :11:31. | |
we are left with when there simply are not enough. He asked if my | :11:32. | :11:36. | |
father minded going home and when he did not object, he put him in a | :11:37. | :11:43. | |
taxi. Doctor Steven Hitchens, an out of hours Doctor at Chesterfield | :11:44. | :11:50. | |
Royal, said that the hospital would confirm today that they are | :11:51. | :11:55. | |
experiencing severe pressures in A, the clinical decision unit, | :11:56. | :12:03. | |
this all comes from a toxic combination of underinvestment, | :12:04. | :12:08. | |
staff cuts, poor planning and GP surgery shortages. He says this is a | :12:09. | :12:11. | |
failure from the Scotland plain and simple. They are to blame and they | :12:12. | :12:17. | |
have to take responsibility -- failure from this government. To | :12:18. | :12:24. | |
keep the wheels vaguely on, it's a grim determination of | :12:25. | :12:28. | |
professionalism. In the government have thought emergency departments | :12:29. | :12:31. | |
can soak up exploitation and abuse but we cannot. We have exceeded | :12:32. | :12:38. | |
acceptable tolerances long ago. This is what the experience of people | :12:39. | :12:42. | |
working in the system is, how can we be surprised when it leads to | :12:43. | :12:46. | |
personal catastrophes? How can we also be surprised when doctors who | :12:47. | :12:54. | |
have had tens of thousands of pounds spent on their training move to | :12:55. | :12:58. | |
other countries where they feel they are more appreciated? Those concerns | :12:59. | :13:06. | |
were echoed when I shadowed the Department at Chesterfield Royal. | :13:07. | :13:11. | |
There were those who were not urgent cases and should have been at a GP | :13:12. | :13:13. | |
surgery. When I asked one man and he had come | :13:14. | :13:18. | |
to A, you try for three days to get a doctor 's appointment. | :13:19. | :13:26. | |
-- he had tried. Problems could have been sorted out and identified if | :13:27. | :13:29. | |
they were seen early enough, but the escalate without access to primary | :13:30. | :13:35. | |
care. The budgets in 2011 and 2012 were | :13:36. | :13:39. | |
catastrophic for the provision of the next generation of staff and we | :13:40. | :13:42. | |
are reaping the full costs of those decisions. Aside from the ethics of | :13:43. | :13:47. | |
relying on overseas staff to keep our NHS sustainable and the impact | :13:48. | :13:51. | |
on health services on developing countries, it's crazy that at a time | :13:52. | :13:54. | |
and there is a global shortage of trained medical staff, the | :13:55. | :13:59. | |
government cuts off the flow of new recruits. | :14:00. | :14:05. | |
It is similar in nursing. In 2011, 20 5525 students enrolled in nursing | :14:06. | :14:08. | |
to recourses but cuts to budgets meant that within two years of the | :14:09. | :14:15. | |
Tory covenant, we are more than 10% down. Staff shortages -- Tory | :14:16. | :14:22. | |
government. And it should ?2 billion has been spent on agency staff in | :14:23. | :14:26. | |
recent years, this money could have been spent on additional staff and | :14:27. | :14:29. | |
is not being spent as it should be on patient care. What we need to | :14:30. | :14:34. | |
remind ourselves, if things were different under a Labour government, | :14:35. | :14:39. | |
they led to record NHS satisfaction levels, achievement of 98% weighting | :14:40. | :14:44. | |
targets, a sustainable GP system and in the words of the King's Fund, the | :14:45. | :14:49. | |
most efficient health system in the world. It led to higher patient | :14:50. | :14:53. | |
expectations yet, under the government, this process has been | :14:54. | :14:56. | |
eradicated. In 2008, after 11 years of Labour | :14:57. | :15:00. | |
investment, health spending caught up with leading EU nations. The OECD | :15:01. | :15:06. | |
has shown that once again, spending is significantly below leading | :15:07. | :15:10. | |
nations again. I am ashamed to say that I am grateful that my father | :15:11. | :15:14. | |
had his first life-threatening aneurysm on holiday in Germany, the | :15:15. | :15:18. | |
quality of emergency care he received their saved his life and | :15:19. | :15:21. | |
gave his family three more years with him. I regret that last year | :15:22. | :15:24. | |
the same could not be said of our NHS. We have it within our hands to | :15:25. | :15:29. | |
make our NHS the service admired around the world. Whilst the | :15:30. | :15:35. | |
challenges that face it are substantial they are predictable. If | :15:36. | :15:39. | |
the government listened to those who questioned cuts to training, the | :15:40. | :15:45. | |
impact of GP shortages in A, the impact of care cuts in the poorest | :15:46. | :15:49. | |
areas in our health service, we would not be facing the crisis that | :15:50. | :15:54. | |
we do today. So, the call for further action on A waiting times | :15:55. | :15:58. | |
and investment in our care system cannot be ignored. The government | :15:59. | :16:06. | |
seems to provide -- the scale of this crisis will engulf them if they | :16:07. | :16:10. | |
do not take action now. The elderly struggle to cope and disabled are | :16:11. | :16:13. | |
stuck in their homes not taking advantage of what we take for | :16:14. | :16:18. | |
granted. People are sent home from A to die. We must do better. Thank | :16:19. | :16:30. | |
you very much. There is no NHS A waiting crisis in my constituency | :16:31. | :16:35. | |
because there is no A unit in my constituency because it was closed a | :16:36. | :16:41. | |
dozen years ago by the Labour government and people had to access | :16:42. | :16:45. | |
emergency services by travelling almost ten miles on single | :16:46. | :16:51. | |
carriageway roads up to East Surrey Hospital, which is the legacy of the | :16:52. | :16:55. | |
party opposite in my constituency. I am pleased to say, Mr Speaker, that | :16:56. | :17:02. | |
since 2010, services have been returning to Crawley Hospital, as a | :17:03. | :17:08. | |
direct consequence of the enhancements of the health budget is | :17:09. | :17:13. | |
which this government has committed to and still commits to. I know that | :17:14. | :17:20. | |
it is often dismissed by the Labour opposition, and others. But, it is | :17:21. | :17:25. | |
quite significant that the NHS asked for an additional ?8 billion in the | :17:26. | :17:31. | |
coming period. And, the Conservative Party in government are delivering | :17:32. | :17:38. | |
10 billion of extra investment. It has a very real effect, that is not | :17:39. | :17:44. | |
tonight -- not to deny that there are huge pressures on the health | :17:45. | :17:50. | |
service, as many members have said in this debate. We have an ageing | :17:51. | :17:56. | |
population and a growing population. Fortunately, people are living | :17:57. | :17:59. | |
longer and we have new drugs available to treat conditions where | :18:00. | :18:02. | |
previously they were not able to be treated. That puts additional | :18:03. | :18:08. | |
pressure on our health service and the way -- and they can be nice | :18:09. | :18:14. | |
problems to have with a population living longer. The way to address it | :18:15. | :18:22. | |
is not using this as some sort of political tit-for-tat, but the | :18:23. | :18:27. | |
health service and well-being is something that we all share, both us | :18:28. | :18:34. | |
as individuals, Mr Speaker, and for our families and loved ones as well. | :18:35. | :18:40. | |
I would prefer that we focus on constructive arguments as to how we | :18:41. | :18:48. | |
address increasing health care needs as a nation, rather than political | :18:49. | :18:53. | |
point scoring which we have had a lot of today. I would have to say | :18:54. | :18:58. | |
that in the 33 minutes of the shadow health spokesman speaking as other | :18:59. | :19:03. | |
right honourable member 's have mentioned, we have not seen one | :19:04. | :19:09. | |
policy suggestion as to how, under Labour administrations, we would see | :19:10. | :19:17. | |
a different approach to the National health service. Mr Speaker, this | :19:18. | :19:22. | |
week, I'm delighted to say that Crawley, my constituency, celebrates | :19:23. | :19:29. | |
the 70th anniversary of being designated a new town. I think one | :19:30. | :19:33. | |
of the most disastrous decisions in that 70 years has been in 2005, as I | :19:34. | :19:43. | |
mentioned, the loss of A, but I mentioned previously that some | :19:44. | :19:47. | |
services are returning and only yesterday, I am pleased to report to | :19:48. | :19:53. | |
the house that a new clinical assessment unit was opened, which | :19:54. | :20:01. | |
precisely seeks to do what we have been discussing, which is to take | :20:02. | :20:05. | |
pressure off A whereby those people who should not be being | :20:06. | :20:12. | |
treated in an emergency situation are triage and signposted to better | :20:13. | :20:14. | |
support services. The clinical assessment unit that | :20:15. | :20:28. | |
opened yesterday seeks to do that and will be successful. Also opened | :20:29. | :20:30. | |
in recent years in Crawley Hospital a new 24-hour a week urgent care | :20:31. | :20:38. | |
centre and an out of hours GP surgery as well. All of these things | :20:39. | :20:43. | |
are ways, as we strive to get to that 24/7 NHS, all of these things | :20:44. | :20:53. | |
are ways that we can better serve patients and as a whole on the | :20:54. | :20:58. | |
health system relieve pressure on emergency care, which, of course, | :20:59. | :21:01. | |
particularly at this time of year and almost every winter comes under | :21:02. | :21:08. | |
additional strain. So, this evening, Mr Deputy Speaker, I will be | :21:09. | :21:15. | |
supporting the Government's amendment to the opposition motion | :21:16. | :21:20. | |
that was initially submitted. Because, I do think we need to | :21:21. | :21:25. | |
recognise the hard work that our staff in the NHS put in. I think we | :21:26. | :21:30. | |
do need to recognise the initial investment. I think we need to | :21:31. | :21:33. | |
recognise that it isn't just about the funding, but it is also, Mr | :21:34. | :21:38. | |
Deputy Speaker, about the way we deliver health care in an acute | :21:39. | :21:44. | |
setting when people present. And also, finally, in my closing | :21:45. | :21:49. | |
remarks, I would like to briefly touch on social care as well. Health | :21:50. | :21:55. | |
care and social care are, of course, inextricably linked. We have an | :21:56. | :21:59. | |
ageing population, as many Right Honourable member is have mentioned. | :22:00. | :22:03. | |
And they have, of course, increasing health needs. -- members one of | :22:04. | :22:09. | |
those areas is an increased health need in terms of dementia. I'm | :22:10. | :22:13. | |
pleased to say Crawley was one of the first designated dementia free | :22:14. | :22:18. | |
towns and that isn't just a label, multi-agency working between health | :22:19. | :22:21. | |
and local authorities and indeed voluntary and private sectors to | :22:22. | :22:26. | |
ensure that those with dementia are better supported. Again, I am | :22:27. | :22:32. | |
delighted to announce that recently a new award, the piper Ward opened | :22:33. | :22:39. | |
in Crawley Hospital, a dementia ward specifically to better treat the | :22:40. | :22:44. | |
health and social care needs of our elderly population. Mr Deputy | :22:45. | :22:49. | |
Speaker, there is much more that I would want to contribute to this | :22:50. | :22:54. | |
vitally important debate today, and indeed throughout this Parliament, | :22:55. | :23:03. | |
but with limited time I will let other honourable and Right | :23:04. | :23:06. | |
Honourable member is have their contribution. Thank you. | :23:07. | :23:12. | |
Thank you, Mr Deputy Speaker command may I start this afternoon by paying | :23:13. | :23:17. | |
tribute to my friend for his incredibly moving speech this | :23:18. | :23:20. | |
afternoon. Mr Deputy Speaker, people are dying, literally. We are no | :23:21. | :23:27. | |
longer sane people will die unnecessarily, we are in the present | :23:28. | :23:30. | |
tense and we are hearing horror stories from around the country of | :23:31. | :23:34. | |
people dying on hospital trolleys and at home waiting for ambulances | :23:35. | :23:38. | |
to arrive. These are lies that potentially could have been saved | :23:39. | :23:41. | |
had it not been for this crisis. People are dying in hospitals | :23:42. | :23:49. | |
undetected, and overworked nurses. A constituent went to visit her rant | :23:50. | :23:54. | |
that in hospital and found him dead on the ward in his bed because the | :23:55. | :24:00. | |
nurses were overworked. He died alone while his relatives were at | :24:01. | :24:04. | |
home completely unaware of quite how seriously ill he was. I am somewhat | :24:05. | :24:10. | |
bemused to hear member after member stand up and defend the government | :24:11. | :24:13. | |
when the facts are absolutely clear about what is going on. There seems | :24:14. | :24:18. | |
to be a sense of severe denial going on. How can this be ignored? How can | :24:19. | :24:23. | |
the government sit back and save the solution is to discard the waiting | :24:24. | :24:27. | |
time targets? It is not the people who turn up with sore throats | :24:28. | :24:31. | |
clogging up the system, it is genuinely sick people, people who | :24:32. | :24:35. | |
desperately need adequate attention. Another constituent who arrived at | :24:36. | :24:38. | |
A last week was told she would have to wait at least ten hours to | :24:39. | :24:42. | |
see a doctor. This is not good enough. We are one of the richest | :24:43. | :24:48. | |
nations in the world. It transpired she had sepsis, a potentially fatal | :24:49. | :24:52. | |
illness, and it was only down to an overworked and stressed triage nurse | :24:53. | :24:56. | |
who recognised her symptoms and immediately instigated treatment | :24:57. | :24:59. | |
that she is alive today and able to come to me and talk about her | :25:00. | :25:03. | |
horrendous story. Her treatment was started in the hospital corridor | :25:04. | :25:06. | |
where she sat on a chair on an intravenous drip because there were | :25:07. | :25:12. | |
no beds available. Not just in the hospital but in any of the | :25:13. | :25:16. | |
neighbouring hospitals within the trust. The theme is always the same | :25:17. | :25:20. | |
from all of my constituents who come to me with their horrendous | :25:21. | :25:23. | |
experiences. The doctors and nurses and other health care staff are | :25:24. | :25:27. | |
doing absolutely everything they can. They are literally on their | :25:28. | :25:30. | |
knees. Nobody wants to blame them, they can see what is being asked of | :25:31. | :25:34. | |
them is far beyond what anybody would be asked of in any other | :25:35. | :25:38. | |
profession but they can all see the system is literally at breaking | :25:39. | :25:44. | |
point. And instead of berating the Red Cross for suggesting that our | :25:45. | :25:48. | |
NHS is in the midst of a humanitarian crisis, let's stop for | :25:49. | :25:50. | |
a moment and think about why they have had to use that term and let's | :25:51. | :25:55. | |
talk about what we can do. A friend of mine recently attended an | :25:56. | :25:58. | |
outpatient appointment at our local hospital and mentioned to the | :25:59. | :26:02. | |
overworked junior doctor, to whom we owe so much, how incredible junior | :26:03. | :26:05. | |
doctors who were treated so appallingly recently. He pleaded | :26:06. | :26:10. | |
with her, with my friend, to tell me just how bad things were, however | :26:11. | :26:16. | |
overworked they were, how the NHS was crumbling around us and by his | :26:17. | :26:19. | |
colleagues couldn't perform to the best of their abilities because of | :26:20. | :26:21. | |
the horrendous pressure they were under. He talked about working 12, | :26:22. | :26:27. | |
14 hour shifts with a ten minute break. He told her that he loved his | :26:28. | :26:32. | |
job, it was a vocation, never a job. He was proud of his country and of | :26:33. | :26:35. | |
the National Health Service. The only thing that kept him from | :26:36. | :26:39. | |
working here instead of fleeing abroad like many of his friends had | :26:40. | :26:43. | |
was the fact that he cared for his NHS so much. When is the Secretary | :26:44. | :26:49. | |
of State going to stand up and take some responsibility for what is | :26:50. | :26:54. | |
going on? People waiting hours for ambulances, people waiting hours in | :26:55. | :26:58. | |
A, people lying on trolleys being treated, in seminar rooms, in | :26:59. | :27:03. | |
corridors. Where does it end? We are already seen creeping privatisation | :27:04. | :27:06. | |
of the NHS with companies like virgin care putting profits before | :27:07. | :27:11. | |
patients. Is the end goal to move to an American-style system where | :27:12. | :27:14. | |
people are literally dying on the streets? Where you turn up at A | :27:15. | :27:18. | |
and the first question they have you got insurance and can you prove it? | :27:19. | :27:23. | |
My constituency is served by two hospitals, Dewsbury district and | :27:24. | :27:27. | |
Huddersfield Royal Infirmary. Both of which are due to be downgraded, | :27:28. | :27:31. | |
losing vital services and beds as the respective trusts struggle to | :27:32. | :27:34. | |
meet the financial pressures placed upon them. One of the hospitals that | :27:35. | :27:38. | |
are supposed to pick up the resulting demand from these | :27:39. | :27:41. | |
downgrades is Pinderfields Hospital in Wakefield which last week warned | :27:42. | :27:45. | |
people against attending A before the downgrades have even taken | :27:46. | :27:50. | |
place. These downgrades go ahead, I am in absolutely no doubt that lives | :27:51. | :27:54. | |
will be lost. I plead with the ministers and Secretary of State, | :27:55. | :27:58. | |
now, to stop these downgrades and bring forward the much-needed funds | :27:59. | :28:01. | |
that could potentially save the lives of my constituents. It was | :28:02. | :28:06. | |
very interesting to hear the Prime Minister refer to these hospitals | :28:07. | :28:08. | |
today during Prime Minister's Questions and she talked about the | :28:09. | :28:12. | |
fact there were two hospitals in the trust, if somebody can pass on that | :28:13. | :28:16. | |
there are three hospitals within the trust. I quoted this before but | :28:17. | :28:19. | |
again I feel today is more relevant than ever. The founder of our great | :28:20. | :28:24. | |
National Health Service said the NHS will last as long as there are folk | :28:25. | :28:28. | |
left with the faith to fight for it. Since the benches opposite appeared | :28:29. | :28:31. | |
to have lost faith and stopped fighting, it is our duty on these | :28:32. | :28:37. | |
benches now more than ever to step up that fight. I wouldn't like to | :28:38. | :28:42. | |
speculate where members -- when members of the opposite bench last | :28:43. | :28:48. | |
visited an NHS hospital outside of an official visit. In between | :28:49. | :28:56. | |
Christmas and New Year. I thank the honourable member for his | :28:57. | :29:00. | |
intervention. Perhaps then he should show some more empathy towards the | :29:01. | :29:04. | |
patients that are waiting on trolleys for ten hours just to be | :29:05. | :29:08. | |
seen. One thing I have known for sure is many thousands of my | :29:09. | :29:12. | |
constituents rely on the services every day. The message from them is | :29:13. | :29:16. | |
unequivocal, the NHS needs the funds and needs them now. I was admonished | :29:17. | :29:22. | |
today by the Speaker for berating the Prime Minister during Prime | :29:23. | :29:24. | |
Minister's Questions and I will continue to do that, let's be | :29:25. | :29:28. | |
absolutely clear, while this mismanagement of our National Health | :29:29. | :29:31. | |
Service is ongoing and I will never, ever stop fighting for our NHS. I | :29:32. | :29:40. | |
appreciate the opportunity to speak in this debate, and for the record, | :29:41. | :29:44. | |
the last time I was in an NHS hospital was when I was working on a | :29:45. | :29:50. | |
night shift on Saturday night. I declare an interest as a nurse who | :29:51. | :29:55. | |
has worked during this winter crisis this year. But I have also worked | :29:56. | :29:59. | |
during winters for the last 20 years as a nurse who has been qualified | :30:00. | :30:04. | |
for over 20 years. Thank you for giving way. I apologise for doing so | :30:05. | :30:10. | |
so early in her speech but the previous speaker is too busy | :30:11. | :30:13. | |
congratulating herself on her own speech that the honourable member | :30:14. | :30:24. | |
for Lewes was working in an NHS hospital on Saturday. That is not of | :30:25. | :30:29. | |
interest to the Labour benches but I have been a nurse for over 20 years | :30:30. | :30:33. | |
and have seen winter crises and this is not an unusual thing to happen. | :30:34. | :30:37. | |
There is no doubt this year there is more pressure than ever before and | :30:38. | :30:41. | |
we have heard there are record numbers of people attending A But | :30:42. | :30:46. | |
there have been winter crises year-on-year under many previous | :30:47. | :30:49. | |
governments. It wasn't unusual when I worked in A for patients to be | :30:50. | :30:55. | |
treated in corridors, on chairs, where ever there was a space. It | :30:56. | :30:59. | |
wasn't unusual for ambulances being queued up around the block waiting | :31:00. | :31:03. | |
for hours to unload patients. I dispute it, I'm still working in the | :31:04. | :31:07. | |
NHS and I dispute the Lady's chuntering from the other side. It | :31:08. | :31:12. | |
was not unusual... I want to make progress and there are others who | :31:13. | :31:16. | |
want to speak. It was not unusual for major incidences to be declared | :31:17. | :31:21. | |
because we could not take any more patients. It was not unusual for | :31:22. | :31:25. | |
neighbouring hospitals to declare major incidences and we would have | :31:26. | :31:29. | |
to take up the slack. I'm sure the truth hurts but that is actually | :31:30. | :31:33. | |
what happened over my 20 years experience of working in the NHS and | :31:34. | :31:37. | |
in this winter crisis over the last few days. It is absolutely | :31:38. | :31:42. | |
outrageous for members opposite to suggest this is something new. They | :31:43. | :31:45. | |
are in denial if they believe this hasn't been happening for many years | :31:46. | :31:49. | |
and I will tell you a story. The party opposite is so fixated on the | :31:50. | :31:54. | |
four hour rule that managers used to bully us and tell us which patients | :31:55. | :31:57. | |
would get a bed, not on clinical need but on the need of the target | :31:58. | :32:02. | |
that was about to expire. For example, one night I was working in | :32:03. | :32:06. | |
a busy A when an elderly gentleman was admitted and have fallen at home | :32:07. | :32:10. | |
and broken his hip and had to be nursed on a trolley in the middle of | :32:11. | :32:14. | |
a busy corridor. Before our target was looming. At three and a half | :32:15. | :32:17. | |
hours he called out to me and said nurse, nurse, I need to go to the | :32:18. | :32:22. | |
toilet. I had no cubicle to put that man in. He couldn't get off his | :32:23. | :32:25. | |
trolley because he had broken his hip. The best I could do under a | :32:26. | :32:29. | |
Labour government was to wheel a curtain around him and in the middle | :32:30. | :32:33. | |
of a busy hospital corridor with his war medals on his chest he went to | :32:34. | :32:38. | |
the toilet. He got to the ward in four hours, his target was met but | :32:39. | :32:42. | |
that was not good care and its members opposite think that was I | :32:43. | :32:45. | |
think this is a new problem they have been burying their heads in the | :32:46. | :32:52. | |
sand. I will not give way. SPEAKER: Border. If the Honourable Lady wants | :32:53. | :32:58. | |
to give way she will not, you cannot shout two at once. It is recognised | :32:59. | :33:02. | |
if you are going to give weight you will give way but if not it is the | :33:03. | :33:07. | |
choice of the Speaker. Thank you, Mr Speaker. These problems are not new. | :33:08. | :33:11. | |
I have worked in outpatient settings as well wear A Tigers have had an | :33:12. | :33:15. | |
impact on patients waiting for elective surgery -- targets. There | :33:16. | :33:21. | |
were such pressure from a Labour government it saw me seeing elective | :33:22. | :33:25. | |
patients with breast cancer having their operations cancelled time | :33:26. | :33:28. | |
after time after time because of emergency admissions. I had to tell | :33:29. | :33:33. | |
a young man who had had her operation cancelled three times | :33:34. | :33:35. | |
while she had a young family waiting for Christmas. She was waiting to | :33:36. | :33:40. | |
have a mastectomy and have her breasts removed from breast cancer | :33:41. | :33:44. | |
but the only bed we had left was in a postnatal ward where she had | :33:45. | :33:48. | |
recovered from her operation, waking up next young mums learning to | :33:49. | :33:52. | |
breast-feed. That was in the attempt to meet for our targets. Don't tell | :33:53. | :33:59. | |
that services have reduced. -- four our targets. Staff were put under | :34:00. | :34:02. | |
severe pressure, not with quality of care in mind but targets and I will | :34:03. | :34:06. | |
make no apologies in making that clear. I am a supporter of four our | :34:07. | :34:11. | |
targets, I was enthusiastic when they were introduced, a way of | :34:12. | :34:15. | |
monitoring performance and improving service but they came the absolute | :34:16. | :34:19. | |
king above everything else. I congratulate the Secretary of State | :34:20. | :34:21. | |
because one of the things he has introduced is looking at the | :34:22. | :34:25. | |
outcomes, what happens to a patient when admitted and if they have to | :34:26. | :34:29. | |
stay there for about half hours to avoid an admission or to get full | :34:30. | :34:32. | |
care what is the problem with that? If they have to go within two hours | :34:33. | :34:36. | |
because they have been adequately treated, fantastic. But we should | :34:37. | :34:40. | |
not be held to account by and are Britt Reid four hour rule which has | :34:41. | :34:45. | |
no clinical significance -- butchery for our rural. -- arbitrary. I just | :34:46. | :34:58. | |
want to touch on the issue of money. Money is of importance and as the | :34:59. | :35:02. | |
publishing grows and as our ageing population grows, as our ability to | :35:03. | :35:05. | |
treat more patients grows we will need more funding for health care | :35:06. | :35:09. | |
and social care. It is worth noting that in my area, there are trusts | :35:10. | :35:17. | |
either side of my constituency with the same funding looking after the | :35:18. | :35:21. | |
same numbers of population, one is in special measures, unable to deal | :35:22. | :35:25. | |
with its discharges, and so has queues and unable to meet its for | :35:26. | :35:29. | |
our targets. Another one along the coast five miles away is rated as | :35:30. | :35:35. | |
outstanding -- four our targets. It does not have the same pressure of | :35:36. | :35:41. | |
four our weights. They can discharge patients speedily. There is | :35:42. | :35:47. | |
something about the money and what it amounts to. Labour put a huge | :35:48. | :35:50. | |
amount of money into the NHS but much was squandered. ?10 million on | :35:51. | :35:55. | |
a failed IT project that never saw the light of day, PFI deals still | :35:56. | :35:59. | |
today costing the NHS ?2 billion a year. How much could be done with | :36:00. | :36:03. | |
that ?2 billion? One brief intervention. | :36:04. | :36:08. | |
I commend her for making what is a very balanced speech, making the | :36:09. | :36:16. | |
point that meeting targets does not equate to delivering good health | :36:17. | :36:19. | |
care, although they do have their place. Would she agree with me that | :36:20. | :36:23. | |
one of the biggest challenges in A is a consistent lack of ability to | :36:24. | :36:29. | |
recruit middle grade doctors in a number of A up and down the | :36:30. | :36:32. | |
country and that is one of the biggest problem is that has not been | :36:33. | :36:37. | |
addressed, to date? I absolutely agree. There's a problem recruiting | :36:38. | :36:42. | |
in the south-east, my constituency, although health care professionals | :36:43. | :36:46. | |
because it is an expensive place to live. I agree with you on that. If | :36:47. | :36:51. | |
we are to move forward, we need to work in a more cross-party way, and | :36:52. | :36:56. | |
to continue to use four our targets as a stick to beat the government | :36:57. | :37:00. | |
with does nothing for cross-party working, so we need to stop the | :37:01. | :37:04. | |
political cheap shots that are being used, we need to recognise that | :37:05. | :37:08. | |
money isn't always the solution, it's about how it is spent and what | :37:09. | :37:12. | |
difference it can make. It also has to be clinically led and, as | :37:13. | :37:16. | |
politicians we can work together but we don't work with health care | :37:17. | :37:20. | |
professionals are both in primary and secondary care, then I fear | :37:21. | :37:24. | |
that, in future, we'll be sitting here again and talking about another | :37:25. | :37:31. | |
winter crisis in years to come. Thank you very much, Mr Deputy | :37:32. | :37:35. | |
Speaker. I would like to join many others in commending those people | :37:36. | :37:40. | |
who work in the NHS and in the care system including the honourable | :37:41. | :37:47. | |
member for Lewes. I just commended the honourable member for Lewes as | :37:48. | :37:52. | |
somebody who works in the NHS as well as the member for central | :37:53. | :37:58. | |
supper, who also works in the NHS, I think without payment -- central | :37:59. | :38:04. | |
Suffolk. It is important to acknowledge that there are many | :38:05. | :38:07. | |
people in the NHS working under incredible strain and we owe them a | :38:08. | :38:14. | |
debt of gratitude. I want to be very clear that I support the Labour | :38:15. | :38:22. | |
motion, and I recognise the importance of access standards in | :38:23. | :38:26. | |
our NHS. I remember when I first arrived here in 2001, my first | :38:27. | :38:33. | |
debate in Westminster Hall was waiting times standards for people | :38:34. | :38:37. | |
with orthopaedic cases, and people then were waiting three years the | :38:38. | :38:41. | |
treatment, sometimes, so the waiting time standards that were introduced | :38:42. | :38:46. | |
dramatically changed people's experience of health care, and we | :38:47. | :38:51. | |
should celebrate that, but sometimes it distorts behaviour and those | :38:52. | :38:54. | |
distortions ought to be addressed as the honourable member for Lewes was | :38:55. | :38:59. | |
making clear. With the ambulance standards there was a very serious | :39:00. | :39:03. | |
distortion of behaviour, which often causes enormous frustration for | :39:04. | :39:07. | |
paramedics who also working on the ludicrous amounts of pressure. The | :39:08. | :39:14. | |
other points I would make on access standards is that, whilst I totally | :39:15. | :39:17. | |
applaud the Labour government introducing access standards, they | :39:18. | :39:22. | |
didn't introduce them for mental health. That is why we now have to | :39:23. | :39:27. | |
complete the picture. Now, the government has confirmed that it | :39:28. | :39:33. | |
accepts in full the task force report on mental health, but that | :39:34. | :39:39. | |
report includes the proposal to work -- to roll out comprehensive maximum | :39:40. | :39:42. | |
waiting time standards in mental health so that someone with mental | :39:43. | :39:46. | |
health has exactly the same right as anyone else to get access to good | :39:47. | :39:51. | |
quality evidence -based treatment on a timely basis, and I would urge the | :39:52. | :39:55. | |
government, and it was in an amendment to be tabled for this | :39:56. | :39:59. | |
debate which has not been called, I urge the government, they have | :40:00. | :40:02. | |
accepted that report, let's now make sure that it is implemented, because | :40:03. | :40:07. | |
it amounts to discrimination in the health service. How can he possibly | :40:08. | :40:11. | |
justify the fact that someone with mental ill-health does not have the | :40:12. | :40:14. | |
right to timely treatment which other people enjoy? We have the end | :40:15. | :40:19. | |
that discrimination, it seems to me. The final thing I wanted to address | :40:20. | :40:23. | |
relates to the question I asked the Prime Minister today. Asking her to | :40:24. | :40:29. | |
meet with a group of cross-party MPs, putting forward the proposal | :40:30. | :40:32. | |
that the government should establish what we are calling an NHS and care | :40:33. | :40:39. | |
convention, and it's an opportunity, we feel, to engage with the public | :40:40. | :40:43. | |
in a mature debate about the scale of the challenge we all face, we can | :40:44. | :40:47. | |
trade insults across this Chamber, we all know in our heart of hearts | :40:48. | :40:52. | |
that the system is under unsustainable pressure. That is the | :40:53. | :40:56. | |
truth, we know that. At some point the member for Lewes conceded the | :40:57. | :41:00. | |
point, that we will need extra resources in the future. Let's plan | :41:01. | :41:05. | |
now, and that we get everybody on board, get cross-party support, and | :41:06. | :41:11. | |
just as under the Labour government in the last decade, sometimes you | :41:12. | :41:15. | |
need a process to unlock a problem that ordinarily, partisan politics | :41:16. | :41:20. | |
has not been able to resolve. And I am pleased, I welcome the fact that | :41:21. | :41:24. | |
the Prime Minister agreed today to meet with a group of us who are | :41:25. | :41:28. | |
making this call. We have set up a petition on the Parliament website | :41:29. | :41:33. | |
so that any member of the public can join this call, and I would urge | :41:34. | :41:36. | |
honourable members across this House, if you support, if the member | :41:37. | :41:41. | |
support this call, then join in it. I actually think that it is in the | :41:42. | :41:46. | |
government's political interest to do it, but fundamentally it is in | :41:47. | :41:49. | |
the interest of the citizens of this country that we, together in this | :41:50. | :41:58. | |
House, collectively address an enormous existential challenge the | :41:59. | :42:02. | |
NHS and the care system. We surely cannot tolerate over 1 million older | :42:03. | :42:07. | |
people not getting access to the care and support that they need. And | :42:08. | :42:11. | |
I don't want to live in a country where your access to care and | :42:12. | :42:14. | |
support in old age depends on whether you can pay for it, but we | :42:15. | :42:18. | |
are in genuine risk of slipping towards that situation, and if we | :42:19. | :42:23. | |
all believe that that is not tolerable, then we have a duty to | :42:24. | :42:28. | |
Act, and we must be prepared to Act together, not just trade insults at | :42:29. | :42:34. | |
each other. I think there is a real opportunity now to do what the | :42:35. | :42:38. | |
public is desperately pleading for, to bury our differences, to work | :42:39. | :42:43. | |
together, to achieve a long-term, sustainable settlement for the NHS | :42:44. | :42:49. | |
and the care system. I thank you. Thank you, Mr Deputy Speaker. Mini | :42:50. | :42:54. | |
for integration of health and social care is the most important issue | :42:55. | :42:57. | |
facing the NHS today. The most productive way to address this issue | :42:58. | :43:02. | |
or bed blocking is to integrate services, pool resources and | :43:03. | :43:06. | |
dramatically raise the profile and support of community health | :43:07. | :43:09. | |
professionals in care and support providers. We often hear of the | :43:10. | :43:13. | |
problems facing the health services. I'm going to concentrate on the | :43:14. | :43:18. | |
solutions. In November last year I set up a local health inquiry and | :43:19. | :43:21. | |
identified a number of people across the constituency and we, together, | :43:22. | :43:29. | |
are investigating what health and social care should and could look | :43:30. | :43:33. | |
like in West Cornwall. This is all part of the process in kernel and | :43:34. | :43:37. | |
the hours of silly. We're asking this question of representatives of | :43:38. | :43:42. | |
health and social care providers, we are talking to NHS providers and | :43:43. | :43:45. | |
managers, health campaigners, daycare managers, pharmacists, | :43:46. | :43:49. | |
mental health clinicians, hospitals and matrons, age UK, etc, and I am | :43:50. | :43:57. | |
including my predecessor in this discussion. All the clinicians we | :43:58. | :44:00. | |
have met have identified savings that can be made through integration | :44:01. | :44:03. | |
that they believe would improve patient care. The results of this | :44:04. | :44:09. | |
inquiry were set up with clear recommendations that have concluded | :44:10. | :44:16. | |
and art at the considered as part of the sustainability planning process" | :44:17. | :44:19. | |
and the Isles of Scilly. It is clear from the evidence we have heard that | :44:20. | :44:23. | |
extra funding will be needed to implement the transformation that | :44:24. | :44:28. | |
has been planned. Already health services in Cornwall and on the | :44:29. | :44:31. | |
Isles of Scilly have a deficit that runs into tens of millions of | :44:32. | :44:36. | |
pounds. Delivering rural health services is an expensive and | :44:37. | :44:39. | |
underfunded exercise in Cornwall and the hours of Scilly, and in that | :44:40. | :44:45. | |
part of the country, we need a fair funding arrangement for health and | :44:46. | :44:50. | |
social care. People in my constituency agree that we must | :44:51. | :44:53. | |
integrate health and social care. They also agree that extra funds are | :44:54. | :44:58. | |
urgently needed to fund the integration of these services. Any | :44:59. | :45:03. | |
Autumn Statement the Chancellor confirmed government plans to | :45:04. | :45:05. | |
continue to increase the tax allowance threshold for workers. I | :45:06. | :45:11. | |
completely agree with efforts to lower the tax burden. Constituents | :45:12. | :45:18. | |
have asked me to look at ways where we can raise taxes in order to help | :45:19. | :45:23. | |
the integration of health and social care. On that basis, would the | :45:24. | :45:26. | |
government consider opposing the increase that was announced in the | :45:27. | :45:32. | |
Autumn Statement and use the revenue generated to fund the transformation | :45:33. | :45:36. | |
of integrated services? This could provide ?6 billion towards the rest | :45:37. | :45:42. | |
of this Parliament that would assist health and social care providers to | :45:43. | :45:45. | |
make the improvements they need, to reduce costs in the long run whilst | :45:46. | :45:52. | |
improving patient care? One example where extra funding would have | :45:53. | :45:55. | |
dramatic results is increasing the pay and support of care and support | :45:56. | :46:00. | |
workers. In West Cornwall, some of those community care workers are | :46:01. | :46:04. | |
paid as little as ?7 20 per hour, but they do incredibly important | :46:05. | :46:07. | |
work in keeping people at home and keeping them in safe conditions. As | :46:08. | :46:14. | |
a result of this low pay and the pressure on them, we struggle to | :46:15. | :46:19. | |
recruit and retain these valuable employees. If we were to look at | :46:20. | :46:23. | |
increasing the taxable threshold just for a short time, this money | :46:24. | :46:27. | |
would help to integrate the services that we all are committed to, and | :46:28. | :46:32. | |
help to make the savings and improvements in patient care that we | :46:33. | :46:38. | |
all long to see. Thank you, Mr Deputy Speaker. In Cumbria, the | :46:39. | :46:44. | |
government says that its regime for the NHS is about transforming health | :46:45. | :46:50. | |
and social care to create a Centre of Excellence for integrated health | :46:51. | :46:55. | |
and social care provision in rural, remote and dispersed communities. | :46:56. | :46:58. | |
This sounds fantastic. It sounds exactly what we need. So, if this is | :46:59. | :47:05. | |
the case, while local people so concerned with the actual proposals | :47:06. | :47:11. | |
that there was a petition for a vote of no-confidence in this regime and | :47:12. | :47:16. | |
why did the Secretary of State himself say in this morning's debate | :47:17. | :47:20. | |
that he has profound concerns about the quality of care in Cumbria? West | :47:21. | :47:27. | |
Cumbria has seen rapid population growth due to the proposed nuclear | :47:28. | :47:35. | |
new-build along with proposed tidal energy projects. There are concerns | :47:36. | :47:38. | |
that none of this is being taken into account. Today I want to focus | :47:39. | :47:47. | |
my particular concerns about the proposals for maternity services and | :47:48. | :47:50. | |
community hospitals. Firstly, maternity. The highly skilled and | :47:51. | :47:57. | |
experienced midwives in West Cumbria have told me that the success | :47:58. | :48:02. | |
regime's preferred maternity option is not their preferred option. The | :48:03. | :48:10. | |
idea behind the Success resume is to bring care closer to home with a | :48:11. | :48:15. | |
model that would ensure provision of safe, high-quality care providing a | :48:16. | :48:19. | |
first class experience. But the midwives ask, how can this be | :48:20. | :48:23. | |
achieved by the proposals looking to change maternity care at West | :48:24. | :48:30. | |
Cumberland Hospital, where the Success regime's preferred option | :48:31. | :48:33. | |
sees the choice of birthplace removed from hundreds of women and | :48:34. | :48:37. | |
would potentially see severe delays in women and babies receiving | :48:38. | :48:44. | |
life-saving assistance. The clinical outcomes and satisfaction rates | :48:45. | :48:47. | |
currently at West Cumberland Hospital under the maternity care | :48:48. | :48:51. | |
system they have now are excellent, and provide safe, high-quality care. | :48:52. | :48:57. | |
And these proposed changes would bring in inequality, in terms of | :48:58. | :49:02. | |
fair access to maternity services across the county, and discriminate | :49:03. | :49:06. | |
against West Cumbrian women having a choice about their maternity care. | :49:07. | :49:12. | |
This will affect those particularly who are vulnerable to deprivation | :49:13. | :49:13. | |
and social isolation. The proposals would see around 700 | :49:14. | :49:21. | |
additional women deliver their babies at Carlisle every year. But | :49:22. | :49:28. | |
where are they going to be cared for? The Cumberland infirmary in | :49:29. | :49:31. | |
Carlisle already struggles with its current workload. West Cumbria and | :49:32. | :49:39. | |
mothers need proper answers. And, in addition to this, there is a | :49:40. | :49:44. | |
proposed new Garden Village is to be built south of Carlisle with up to | :49:45. | :49:50. | |
12,000 new homes. So how on earth is the West Cumberland infirmary in | :49:51. | :49:57. | |
expected to cope? And now turning to community hospitals. I am | :49:58. | :49:59. | |
particularly disappointed in the consultation document that there are | :50:00. | :50:05. | |
no options for the current situation we have regarding beds at Maryport | :50:06. | :50:11. | |
and Wigton community hospitals. All of the proposals remove all of the | :50:12. | :50:16. | |
beds. This will be particularly difficult for families with patients | :50:17. | :50:22. | |
having end of life care because their relatives are often elderly | :50:23. | :50:25. | |
and have their own medical conditions and with no transport of | :50:26. | :50:30. | |
their own travelling to visit family members can be particularly arduous. | :50:31. | :50:34. | |
And both hospitals serve areas with large amounts of deprivation and | :50:35. | :50:39. | |
very poor transport links. For patients and their families in | :50:40. | :50:43. | |
Maryport they may have to travel to community hospitals or acute | :50:44. | :50:47. | |
hospitals, journey times would be long with poor bus links, which is | :50:48. | :50:52. | |
obviously difficult for elderly and disabled people. The people of | :50:53. | :50:56. | |
Maryport feel so strongly about it they have run a passionate campaign | :50:57. | :51:01. | |
to show the Success Regime just how much Maryport hospital means to | :51:02. | :51:05. | |
them, how much it is an integral part of the local community, and | :51:06. | :51:08. | |
they are deeply upset at the removal of the beds. It is imperative that | :51:09. | :51:15. | |
all services are delivered as close to people's homes as possible. This | :51:16. | :51:19. | |
must include the retention of beds at all of our community hospitals | :51:20. | :51:26. | |
and keep consultant level maternity services at West Cumberland | :51:27. | :51:32. | |
Hospital. I would like to finish about a very personal experience, if | :51:33. | :51:37. | |
I may, and this is in particular reference to beds in community | :51:38. | :51:41. | |
hospitals. Not long before Christmas my father was taken seriously ill. | :51:42. | :51:47. | |
He was transferred. We managed to get him transferred from the Acute | :51:48. | :51:51. | |
Hospital to his local Community Hospital. This was within walking | :51:52. | :51:56. | |
distance of his home. It was a hospital where he knew the staff, | :51:57. | :51:59. | |
the district nurse was able to call in to see him. When it became clear | :52:00. | :52:06. | |
that he was at the end of his life we tried very hard to get him to | :52:07. | :52:13. | |
move home. We got to the stage of having a hospital bed in the living | :52:14. | :52:16. | |
room. Unfortunately this was not possible. However, unlike my | :52:17. | :52:22. | |
honourable friend, the member for Chesterfield, my father had a good | :52:23. | :52:31. | |
death in his Community Hospital. I believe that all my constituents | :52:32. | :52:33. | |
should be able to have the opportunity that me and my family | :52:34. | :52:40. | |
had when we were able to be with my father at the local Community | :52:41. | :52:44. | |
Hospital where he knew the staff, where he knew the district nurse who | :52:45. | :52:49. | |
came to see him. I think if we remove palliative care from our | :52:50. | :52:52. | |
community hospitals we are making a terrible mistake. Thank you, Mr | :52:53. | :53:00. | |
Deputy Speaker. There was constituency faces real challenges | :53:01. | :53:04. | |
in health care, ageing ovulation and demand for local NHS is growing | :53:05. | :53:08. | |
rapidly. There is no doubt that our primary health care system is under | :53:09. | :53:11. | |
considerable strain and so is the adult social care system and the | :53:12. | :53:17. | |
record demands in hospitals. Calling this a crisis is a disservice to | :53:18. | :53:21. | |
those in the Clinical Commissioning Group and our local hospital trust | :53:22. | :53:24. | |
who have worked so hard to prepare for the incredible challenges they | :53:25. | :53:29. | |
are facing this winter. Demanding the four Amys that serve our | :53:30. | :53:33. | |
constituency was higher in the week between Christmas and new event -- | :53:34. | :53:38. | |
new year than in the previous year. Inter Amys demand has doubled. The | :53:39. | :53:42. | |
A staff had to work incredibly hard to meet the demand -- in two | :53:43. | :53:49. | |
A I was contacted to say that some people were not seen in the | :53:50. | :53:52. | |
time they would expect, however I have heard from others who arrived | :53:53. | :53:56. | |
at A expecting bedlam only to be seen within well under four hours. | :53:57. | :54:01. | |
During last season's Christmas recess I spent the early hours of | :54:02. | :54:05. | |
Christmas Eve in Western Hospital A with my then three-year-old. | :54:06. | :54:10. | |
Like this year the Labour front inch frame Don McLean crisis and yet I | :54:11. | :54:13. | |
saw incredible clinicians doing an incredible job within the required | :54:14. | :54:17. | |
timelines. Moreover, an outpatient appointment is needed in the week | :54:18. | :54:20. | |
between Christmas and New Year was easily arranged and kept. My | :54:21. | :54:25. | |
personal experiences just one of millions experiences in the NHS each | :54:26. | :54:29. | |
year but I highlight it because if we are to have an honest, factual | :54:30. | :54:33. | |
debate about our health system we should caution against the emotion | :54:34. | :54:38. | |
of individual experiences, for there will always be a least one that | :54:39. | :54:40. | |
illustrates whatever point are seeking to make. Further into the | :54:41. | :54:46. | |
hospital system, three of the four hospitals that serve the Wales | :54:47. | :54:49. | |
constituency, have more beds available this year in the last week | :54:50. | :54:56. | |
of 2016 and first week of 2017 than they did in the corresponding period | :54:57. | :55:01. | |
the previous year. While occupancy last week in Taunton and Yeovil was | :55:02. | :55:07. | |
81% and 82% respectively, it is true that occupancy in Bath was 93% and | :55:08. | :55:12. | |
in Weston-Super-Mare last week it was 100%. Make no mistake, occupancy | :55:13. | :55:17. | |
levels such as those are a cause for real concern. It is also important | :55:18. | :55:24. | |
to note that whilst things are tight so far the trusts are managing. | :55:25. | :55:29. | |
However, I know that for all four of those hospitals and particularly | :55:30. | :55:33. | |
Western there are too many beds blocked by those who would be | :55:34. | :55:37. | |
discharged if care at home could be arranged. The Government has made | :55:38. | :55:40. | |
more money available for adult social care and given councils | :55:41. | :55:43. | |
greater flexibility to increase council tax in the interim. Somerset | :55:44. | :55:48. | |
County Council and our local NHS organisations are justifiably still | :55:49. | :55:53. | |
very concerned. So I encourage that the government looks again at the | :55:54. | :55:57. | |
local government funding settled meant for next year and adjust it | :55:58. | :56:00. | |
and ensure the funding gap between urban and rural areas does not widen | :56:01. | :56:06. | |
-- settlement. And secondly, funding for adult social care clearly and | :56:07. | :56:09. | |
fully reflects the places in the country where the demographic is | :56:10. | :56:13. | |
most top-heavy and where variety increases the cost of delivering | :56:14. | :56:19. | |
that support. Finally, Mr Deputy Speaker, the challenge faced in | :56:20. | :56:25. | |
local primary care. Local practices assured me that anyone requiring an | :56:26. | :56:28. | |
emergency appointment is seen that day, however it is true that my | :56:29. | :56:31. | |
constituents are too often expected to wait for a week or more if they | :56:32. | :56:38. | |
require to see their regular GP. Quite understandably, for those with | :56:39. | :56:41. | |
long-standing and complex health issues they expect to see the doctor | :56:42. | :56:45. | |
they know so these weights are unacceptable. But it is wrong to | :56:46. | :56:50. | |
connect these weights solely with funding. The greater challenge in | :56:51. | :56:53. | |
Somerset is not the primary health care budget which has risen for each | :56:54. | :56:57. | |
of the last three years, but our ability to recruit new GPs. The | :56:58. | :57:03. | |
Secretary of State worked hard to bring more GPs into the system as a | :57:04. | :57:07. | |
whole but now rural CCG is like Somerset will have to look at what | :57:08. | :57:11. | |
initiatives could be developed to encourage new GPs to ply their trade | :57:12. | :57:16. | |
in rural general practice. Furthermore we must listen to and | :57:17. | :57:21. | |
support those responsible for our STPs. We have called again and again | :57:22. | :57:26. | |
for politicians to keep our noses out of NHS planning. Now that we | :57:27. | :57:32. | |
have and clinicians are at the helm the opposition dismiss that because | :57:33. | :57:39. | |
it is expedient to do so. It has been written by people who know | :57:40. | :57:43. | |
their craft and when I asked them if they would have written the plan as | :57:44. | :57:47. | |
it is even if there were no resource constraints, they told me that they | :57:48. | :57:51. | |
would. They say that the demand has changed. They tell me that the | :57:52. | :57:55. | |
thinking over public health as changed and they tell me the | :57:56. | :57:58. | |
clinical view of how and where people should recover after they | :57:59. | :58:02. | |
have been in hospital has changed too. Things will change further yet | :58:03. | :58:06. | |
over the years ahead. Some of the things the STP proposes are very | :58:07. | :58:10. | |
challenging to me, Mr Deputy Speaker. Some will be unpopular with | :58:11. | :58:14. | |
the community I serve but their analysis is based on an expertise | :58:15. | :58:22. | |
which far outstrips mine, so unless I'm implored to reassert the | :58:23. | :58:25. | |
supremacy of politicians in these matters, we have had enough of | :58:26. | :58:28. | |
experts after all, we owe it to be clinicians empowered to design and | :58:29. | :58:32. | |
run our local health care systems, to scrutinise of course, but also to | :58:33. | :58:36. | |
support them. Moreover, they deserve to do that without the partisan | :58:37. | :58:40. | |
hullabaloo being stirred up by those opposite today. Our inboxes give us | :58:41. | :58:45. | |
a great feel for how things are, Mr Deputy Speaker. Our conversations | :58:46. | :58:50. | |
with constituents, clinicians and patient participation groups like | :58:51. | :58:54. | |
the one in Cheddar I will see tomorrow night shaped that the too. | :58:55. | :58:58. | |
To claim that all is perfect right now is not true. But to claim a | :58:59. | :59:04. | |
crisis is not true either. Our population and the practice of | :59:05. | :59:07. | |
medicine are changing. This debate needs to happen. But not in a | :59:08. | :59:12. | |
partisan funerary but in an honest, constructive, and supportive way | :59:13. | :59:13. | |
instead. -- funeral stomach for I was going to talk about the cuts | :59:14. | :59:27. | |
to health and social care funding to hospitals and health care in the | :59:28. | :59:30. | |
south-west but all of the things I wanted to say have been made by | :59:31. | :59:34. | |
owner stomach other honourable member is already. In keeping with | :59:35. | :59:37. | |
previous speeches I have made recently I have decided not to | :59:38. | :59:40. | |
repeat what has already been said but to scrub all of that and say | :59:41. | :59:45. | |
something completely different. It is about the health consequences of | :59:46. | :59:48. | |
loneliness in older people and the impact of funding cuts in NHS and | :59:49. | :59:53. | |
social care systems on loneliness, and in turn the impact of old | :59:54. | :59:56. | |
people's loneliness on the health care system. In the run-up to | :59:57. | :00:03. | |
Christmas I was regularly blinking back tears on the Underground | :00:04. | :00:06. | |
whenever I saw the advert is I'm sure many honourable member is will | :00:07. | :00:11. | |
have seen from Age UK saying no one should have no one at Christmas and | :00:12. | :00:14. | |
if you do not remember it it looked like this, which is the report I | :00:15. | :00:18. | |
re-read again yesterday, no one should have no one by Age UK | :00:19. | :00:22. | |
published in December last year about loneliness in old age. I found | :00:23. | :00:29. | |
reading that report brought home to me just really how much loneliness | :00:30. | :00:35. | |
affects people and how funding cuts which may appear small and | :00:36. | :00:39. | |
insignificant can have a cumulative effect on older people. A | :00:40. | :00:44. | |
constituent illustrated this to me recently when she came to talk to me | :00:45. | :00:47. | |
about her worries for the older people she cares for. As a lowly | :00:48. | :00:51. | |
paid care assistant she was not complaining about her pay, I am just | :00:52. | :00:56. | |
observing that. She told me she regularly stays well beyond her low | :00:57. | :01:00. | |
hours because she feels that the people she's working for need her. | :01:01. | :01:03. | |
Partly because they have greater care needs than the time allows, but | :01:04. | :01:08. | |
also because they are lonely. As I said, she wasn't complaining, but in | :01:09. | :01:12. | |
my opinion starving social care of adequate funding means that people | :01:13. | :01:19. | |
like my constituents are subsidising the health and social care system | :01:20. | :01:22. | |
voluntarily, which she is willing to do, but it should not be left to | :01:23. | :01:26. | |
chance like this. The Age UK report mentioned a survey they carried out | :01:27. | :01:31. | |
of 1000 GP practices by their Campaign to End Loneliness in 2013, | :01:32. | :01:37. | |
which found nearly 90% of GP practices than patients were coming | :01:38. | :01:41. | |
in because they will only. The report also points out that funding | :01:42. | :01:44. | |
has been cut and funding cuts mean that deals on -- meals on wheels, | :01:45. | :01:50. | |
daycare centres, public toilets and community centres have been cut, | :01:51. | :01:55. | |
closed or reduced in recent years. They point out that all of this | :01:56. | :02:00. | |
decreases opportunities for older people to get out, to socialise, to | :02:01. | :02:04. | |
take care of their health, to eat well, to exercise. One of which | :02:05. | :02:11. | |
increases loneliness and isolation and damages their health. And what | :02:12. | :02:16. | |
does that have to do with chronic serious illnesses? Age UK carried | :02:17. | :02:20. | |
out an evidence -based review for their loneliness report and found | :02:21. | :02:23. | |
out that chronic loneliness increases the risk of serious | :02:24. | :02:27. | |
illnesses such as diabetes, stroke, depression and dementia, as well as | :02:28. | :02:31. | |
I have already said, making it much harder for them to get out there to | :02:32. | :02:34. | |
receive help, or do things that might prevent those conditions | :02:35. | :02:37. | |
getting worse such as exercise and good diet. I pay tribute today to | :02:38. | :02:42. | |
all the people across the country who give their time as volunteers, | :02:43. | :02:48. | |
as staff, and as those who raise money for charities such as Age UK, | :02:49. | :02:54. | |
nationally and locally, and in Bristol, Bristol ageing better, to | :02:55. | :02:58. | |
do so much to combat loneliness in older people. If I may read one | :02:59. | :03:02. | |
example from the Age UK report, I will read an example if I have time, | :03:03. | :03:09. | |
Arthur's son was worried his health was deteriorating because of the | :03:10. | :03:12. | |
many hours he spent alone in his flat in sheltered accommodation. He | :03:13. | :03:16. | |
was unwilling to participate in group activities because of | :03:17. | :03:19. | |
difficulties he had hearing. He had had a busy social life but most of | :03:20. | :03:24. | |
the friends he had had died. Age UK introduced him to Paul who also had | :03:25. | :03:27. | |
to retire early after an accident and was also feeling increasingly | :03:28. | :03:32. | |
isolated and together they played dominoes, cribbage command would | :03:33. | :03:34. | |
dissect the latest football match and reminisce about their time in | :03:35. | :03:43. | |
the building trade, swapping funny stories of mishaps and adventures. | :03:44. | :03:45. | |
Paul provided after with good company and a link back to the job | :03:46. | :03:48. | |
he loved. Arthur has helped to restore Paul's sense of purpose and | :03:49. | :03:50. | |
self worth. This example and many others in the report showed just how | :03:51. | :03:55. | |
much work on loneliness can help to increase older people's health and | :03:56. | :03:59. | |
reduce the costs on our health and social care system. So, what the | :04:00. | :04:08. | |
CEOs, staff in my area have told me about cuts have on health care and I | :04:09. | :04:20. | |
also want the Minister to tell me how he and the Secretary of State | :04:21. | :04:23. | |
will lead the way to provide us with a fully integrated and fully funded | :04:24. | :04:26. | |
health, social care and mental health care service. But I want all | :04:27. | :04:33. | |
of us to read Age UK's report and follow the recommendations they make | :04:34. | :04:37. | |
at the end for MPs amongst others. I will end on one. As a member of | :04:38. | :04:42. | |
Parliament they have asked us, as well as to find out about loneliness | :04:43. | :04:46. | |
among old people in our constituency, raise awareness, | :04:47. | :04:49. | |
become an aged champion, encourage political parties to do more and | :04:50. | :04:52. | |
take steps to put loneliness in later life on the government's | :04:53. | :04:56. | |
agenda, so I hereby do this, and hold them to account for progress | :04:57. | :04:59. | |
which I will continue to do, they have asked us to make the case for | :05:00. | :05:04. | |
investment in local community resources to support sustainable | :05:05. | :05:07. | |
long-term action to help lonely old people whatever they may be, I urge | :05:08. | :05:11. | |
the government to take notice of that. I want to finish by saying | :05:12. | :05:15. | |
they have asked as to support the work of the Jo Cox commission on | :05:16. | :05:19. | |
loneliness. It is launching shortly. I would like one of us to take those | :05:20. | :05:23. | |
words to heart. Thank you, Mr Deputy Speaker. | :05:24. | :05:40. | |
The honourable member for Bristol West has spoken about loneliness | :05:41. | :05:48. | |
which is a problem across the country and some great work is being | :05:49. | :05:52. | |
done on that. Some colleagues have spoken about their personal and | :05:53. | :05:59. | |
family experiences, like the member for Wells and the member for | :06:00. | :06:02. | |
Chesterfield who have spoken about experiences both good and bad of the | :06:03. | :06:07. | |
National Health Service. I have personal experiences both good and | :06:08. | :06:10. | |
bad. Three years ago I spent Christmas Day night in A with my | :06:11. | :06:16. | |
son he was five years old at the time and he had his appendix taken | :06:17. | :06:19. | |
out first thing in the morning on Boxing Day, and had absolutely | :06:20. | :06:25. | |
exemplary care and was home within two days, easily making up the | :06:26. | :06:31. | |
quantity of sausages that he omitted to eat on Christmas Day with his | :06:32. | :06:38. | |
tummy a closer last Christmas my grandmother, aged 100, was in | :06:39. | :06:44. | |
hospital for several months and she had a much, much worse experience, | :06:45. | :06:51. | |
and it was not the NHS at its best. We all, I think, have good and bad | :06:52. | :06:58. | |
experiences to drawn and we hear from constituents as well about | :06:59. | :07:03. | |
those good and bad experiences. It's important to recognise what the NHS | :07:04. | :07:07. | |
does well and is doing well, and also where the system is failing, to | :07:08. | :07:14. | |
focus on supporting the good and checking the bad. I can very much | :07:15. | :07:18. | |
understand why this debate has been called the day, because there was no | :07:19. | :07:23. | |
question that the NHS is under extraordinary pressure this winter. | :07:24. | :07:27. | |
We've heard that it had the busiest week ever, last week. I will say I'm | :07:28. | :07:33. | |
quite disappointed by both the tone of some of the contributions today | :07:34. | :07:40. | |
and also, because it happens in the Chamber, the lack of proposals, | :07:41. | :07:45. | |
rather than suggesting more money, but with no proposals for where that | :07:46. | :07:52. | |
money comes from, which is fundamentally unhelpful, to suggest | :07:53. | :07:55. | |
there should be more money but with simply no proposals about where it | :07:56. | :07:59. | |
will come from. I am happy to give way. It's clear where the money | :08:00. | :08:05. | |
comes from, we are asking for ?700 million to be brought forward from | :08:06. | :08:10. | |
the better care for from 2019. It is already allocated. It is still quite | :08:11. | :08:17. | |
a lot of money to be down. This is against the backdrop of less than | :08:18. | :08:20. | |
two years ago, when the Labour Party was not committed to funding the NHS | :08:21. | :08:25. | |
with money that it was asking for, which this Conservative Party chose | :08:26. | :08:29. | |
to, so that is a rather shocking position that they are lying. I | :08:30. | :08:35. | |
would like to seize this opportunity to say a very heartfelt thank you to | :08:36. | :08:41. | |
all members of the NHS staff, nurses, doctors, allied health | :08:42. | :08:45. | |
professionals, porters, Gera Systems and social services and particularly | :08:46. | :08:52. | |
in Kent, -- care assistants, who are working extremely hard and dealing | :08:53. | :08:55. | |
with this pressure at the front line. And also to the patients and | :08:56. | :09:01. | |
their families who I know are being thoughtful and are making sure that | :09:02. | :09:07. | |
they make best use of the NHS, so I thank them as well. We know that | :09:08. | :09:13. | |
there is great variation in how the NHS is coping. As I speak I was told | :09:14. | :09:21. | |
that the waiting time in Maidstone A is just 37 minutes, so Maidstone | :09:22. | :09:27. | |
is coping well, but nearby, there is a weight of over four hours, so | :09:28. | :09:34. | |
there is a variation and maybe people listening will divert where | :09:35. | :09:37. | |
they are going. There may be a case for that and for greater | :09:38. | :09:40. | |
transparency but that is for another day. The point we were talking about | :09:41. | :09:48. | |
earlier, about money, there is no question that part of this is a need | :09:49. | :09:52. | |
for more funding and for more staff, but the government is doing exactly | :09:53. | :09:56. | |
that, giving the NHS more money, and also investing in significant | :09:57. | :10:03. | |
increases in the workforce. Quite apart from that, money is not the | :10:04. | :10:10. | |
whole answer. In part because, if the NHS continues doing all that it | :10:11. | :10:14. | |
does in the way that it is, and without they level of change, we | :10:15. | :10:18. | |
will find ourselves with a system that is unaffordable and which will | :10:19. | :10:24. | |
be look -- using a level of GDP that would not have public support. | :10:25. | :10:28. | |
Because we know that we have the situation of an ageing population, | :10:29. | :10:33. | |
people living longer with complex, multiple conditions and costly | :10:34. | :10:36. | |
treatment, high-cost treatments becoming available that people want, | :10:37. | :10:40. | |
so the NHS itself recognises that it's not just about more money but | :10:41. | :10:45. | |
about changing the way services are delivered, and that is actually | :10:46. | :10:48. | |
happening and are being worked on at the moment. Earlier today I spoke to | :10:49. | :10:54. | |
the chief executive of the hospital trust who is also the lead for Kent | :10:55. | :10:58. | |
and Medway sustainability and transformation fund, the STP, which | :10:59. | :11:07. | |
has come up several times today. What I saw from him and those around | :11:08. | :11:14. | |
him is the coming together of NHS organisations intended to work | :11:15. | :11:17. | |
closely together across central Medway, and the coming together with | :11:18. | :11:21. | |
social services in a way that is so important, necessary and right, to | :11:22. | :11:26. | |
work out how we can provide a better health service in a more sustainable | :11:27. | :11:29. | |
way. Breaking down the barriers between organisations were it | :11:30. | :11:34. | |
doesn't make sense that there's a shift between the NHS and social | :11:35. | :11:37. | |
care in who is providing what, and looking at how we can moved care out | :11:38. | :11:43. | |
of acute hospitals and closer to home, which we know is good for | :11:44. | :11:48. | |
patients, it is exactly what the honourable member was hoping for for | :11:49. | :11:54. | |
her father and what I hope of my grandmother as she knew the end of a | :11:55. | :11:57. | |
light enable people to be looked after closer to home, increasing | :11:58. | :12:03. | |
prevention and one that I feel strongly about, improving mental | :12:04. | :12:06. | |
health care, which the Prime Minister has personally shown the | :12:07. | :12:11. | |
lead she has taken on that since Monday, and I particularly value, in | :12:12. | :12:17. | |
the light of the pressure on A, the commitment to psychiatric | :12:18. | :12:22. | |
liaison in A which we know has helped people who go to A with | :12:23. | :12:27. | |
mental health problems and looks after the people who need to be seen | :12:28. | :12:31. | |
for physical health problems, and I welcome that in my area of Kent they | :12:32. | :12:35. | |
are looking at having psychiatric liaison in rural A departments by | :12:36. | :12:42. | |
2018, so bringing that world. There was important work going on at a | :12:43. | :12:46. | |
local level. -- bringing that forward. I would encourage members | :12:47. | :12:52. | |
opposite to, rather than perhaps knee jerk or even tear-jerker | :12:53. | :12:55. | |
contributions that we have had from some members today, to take a longer | :12:56. | :13:06. | |
view at the situation, to help have a more mature conversation about | :13:07. | :13:11. | |
what the NHS needs, to talk about policies and concrete proposals | :13:12. | :13:16. | |
rather than just more money for solving the problems, and, actually, | :13:17. | :13:23. | |
to define what the NHS is doing at the local level, NHS and local | :13:24. | :13:26. | |
authorities coming together for plans across their areas to have | :13:27. | :13:30. | |
better care for patients in an affordable, sustainable way. Thank | :13:31. | :13:39. | |
you, Mr Deputy Speaker. After four years of having responsibility for | :13:40. | :13:42. | |
the National Health Service, the Secretary of State for Health has | :13:43. | :13:45. | |
declared that we need to have an honest discussion of the public | :13:46. | :13:50. | |
about the purpose of A departments, and we, who have seen | :13:51. | :13:54. | |
his work from this House and have dealt his work on the front line | :13:55. | :13:57. | |
know exactly what he means. He means, let me tell you why everyone | :13:58. | :14:04. | |
else is to blame except for me. Earlier this week the Secretary of | :14:05. | :14:08. | |
State told the UK that nearly one in three visits to A do not need to | :14:09. | :14:14. | |
be made. This was his reasoning for weakening the target that every | :14:15. | :14:18. | |
patient should be seen within four hours. That target only applies to | :14:19. | :14:22. | |
you if your condition of your condition is serious and urgent | :14:23. | :14:27. | |
enough. I find it staggering, the sheer hubris of those statements. He | :14:28. | :14:31. | |
avoids accountability in this position. The danger that is | :14:32. | :14:37. | |
inherent in both, first as an A specialist Doctor I have treated | :14:38. | :14:41. | |
patients who have arrived in A with what seemed like minor | :14:42. | :14:44. | |
complaints that develop into more serious and life-threatening issues. | :14:45. | :14:49. | |
The Secretary of State, both in his words and his decision are saying | :14:50. | :14:52. | |
that the people of the UK should self diagnose before heading to A, | :14:53. | :14:57. | |
and that could have disastrous consequences, of which he would be | :14:58. | :15:04. | |
responsible. What if, because of it, patients decide just to stay at home | :15:05. | :15:08. | |
after that serious bang on the head that turns out to be a | :15:09. | :15:12. | |
life-threatening bleak to the brain? What about that potentially | :15:13. | :15:17. | |
deteriorating case of pneumonia that is not serious enough to warrant | :15:18. | :15:22. | |
going to A, that results in somebody being severely septic and | :15:23. | :15:27. | |
dying? As a citizen of this country and a patient of the NHS I find the | :15:28. | :15:32. | |
Secretary of State's refusal to accept responsibility for the state | :15:33. | :15:36. | |
of the A departments in this country deplorable. Instead, he | :15:37. | :15:41. | |
blames patients for visits that do not need to be made. They do not go | :15:42. | :15:48. | |
for fun. Patients go to A because they are ill and cannot get a | :15:49. | :15:51. | |
doctors appointment is for two beach. We've heard from members on | :15:52. | :15:54. | |
both sides of the House who have taken around young children to A, | :15:55. | :15:59. | |
did they do so for fun because they felt there was a need for their | :16:00. | :16:04. | |
child to treated? They go to the A because their GP does not have | :16:05. | :16:07. | |
resources at their practice for something as simple as handing out | :16:08. | :16:11. | |
crutches, in some cases. They go because there is something wrong and | :16:12. | :16:15. | |
they are worried sick and simply desperate to speak to somebody about | :16:16. | :16:21. | |
their health. No, I won't. Many now that they shouldn't be in A, but | :16:22. | :16:25. | |
what other option is this government leaving them? Just calm it down. | :16:26. | :16:32. | |
Let's not get into the habit of shouting at each other. Let's have a | :16:33. | :16:41. | |
nice, sensible debate. They go to the A because their GP does not | :16:42. | :16:45. | |
have resources. They go to A because there is something wrong and | :16:46. | :16:48. | |
they are worried sick and simply desperate to speak to somebody who | :16:49. | :16:51. | |
is a professional about their health. Many know they should not be | :16:52. | :16:58. | |
in A I've had patients Sane, the elderly, saying, I am so sorry, | :16:59. | :17:02. | |
Doctor, for wasting your time. But what other option is this government | :17:03. | :17:08. | |
leaving them? This is what we are debating today. The Secretary of | :17:09. | :17:11. | |
State wants an honest conversation. Well, let's have it. Let's talk | :17:12. | :17:15. | |
about the impact of the current state of the NHS that he has been in | :17:16. | :17:22. | |
charge of 44 years, and its impact on A departments and hospitals in | :17:23. | :17:26. | |
this country. Let's talk about rock bottom staff morale. Let's talk | :17:27. | :17:32. | |
about breakdown of staff managers. Let's talk about a rise in | :17:33. | :17:36. | |
depression amongst staff, let's talk about the fact that waiting times | :17:37. | :17:39. | |
are not the responsibility of patients. They are not to blame. | :17:40. | :17:49. | |
They are those responsibility of the right honourable member, the | :17:50. | :17:52. | |
Secretary of State for Health, and yet he blames the rise in waiting | :17:53. | :17:56. | |
times on the number of people going to A since the target was set. I | :17:57. | :18:01. | |
would say that it is the right and remember's responsibility to lead an | :18:02. | :18:05. | |
NHS that can meet the needs of its people, and again, the Secretary of | :18:06. | :18:09. | |
State pleads innocence. He says no other countries have such stringent | :18:10. | :18:14. | |
targets, suggesting it is unfair that we have. I would say that the | :18:15. | :18:19. | |
meeting of this target in particular, not water down but then | :18:20. | :18:23. | |
fall, is what establishes the NHS as their best health service in the | :18:24. | :18:29. | |
world, one that we can, should and would be proud of, under a Labour | :18:30. | :18:34. | |
government. After all, the ability of emergency departments to meet the | :18:35. | :18:37. | |
four our target is directly related to the health of the NHS itself. | :18:38. | :18:43. | |
It's simple, more people go to A when they have no other options are | :18:44. | :18:49. | |
available. I thank My Honourable Friend Paul giving way. The issue of | :18:50. | :18:55. | |
those options in A in my area of Cumbria is entirely down to the lack | :18:56. | :18:58. | |
of GPs, and it was only going to become more acute with so many GPs | :18:59. | :19:03. | |
reaching retirement age. But My Honourable Friend agree that this is | :19:04. | :19:06. | |
something the government needs to tackle urgently? Without a doubt, | :19:07. | :19:12. | |
yes. I wholeheartedly agree with my Right Honourable Friend and the | :19:13. | :19:17. | |
point she has made about the lack of GPs and the problems that we shall | :19:18. | :19:22. | |
see when three more retire. Three contacted me and my tooting | :19:23. | :19:25. | |
constituency saying that they have been offered jobs that were | :19:26. | :19:30. | |
subsequently retracted due to, and the reasons cited, financial | :19:31. | :19:34. | |
pressures. The Secretary of State pleads innocence. He says that no | :19:35. | :19:36. | |
other countries have such stringent targets. We should not be comparing | :19:37. | :19:41. | |
ourselves to the worst, we should be leading as the best. The explosion | :19:42. | :19:46. | |
of waiting times in this country are his failure and a sign of the | :19:47. | :19:51. | |
dangerous erosion of one of the country's greatest institutions. As | :19:52. | :19:54. | |
we saw last week when the British Red Cross at the be drafted into | :19:55. | :20:01. | |
hospitals, our NHS is in crisis, yet instead of listening to doctors and | :20:02. | :20:04. | |
fixing the systemic problems they have created, the government is | :20:05. | :20:09. | |
repackaging the A four our target to take attention away from real | :20:10. | :20:14. | |
challenges. The challenge of social care provision not being in place, | :20:15. | :20:20. | |
prohibiting floats through A departments. Editing access to GPs | :20:21. | :20:26. | |
across the country meaning that A is the only resort, and the chronic | :20:27. | :20:30. | |
cuts in funding at local authority level. Doctors and nurses forced to | :20:31. | :20:35. | |
miss breaks, as we have heard, working 14 hours, some of them | :20:36. | :20:39. | |
without a break. Sleep deprived, unsafe to practice clinical work. | :20:40. | :20:46. | |
And NHS staff do not feel supported, encouraged or motivated by this | :20:47. | :20:49. | |
government. None of these things would be addressed by a watered-down | :20:50. | :20:50. | |
four our target. Having spoken to the College of | :20:51. | :20:58. | |
Emergency Medicine those working on the front line at all levels and | :20:59. | :21:01. | |
those training junior doctors I would like to put forward questions | :21:02. | :21:04. | |
for the Secretary of State. Why has the four-hour target been | :21:05. | :21:09. | |
downgraded, who was consulted? Which body said it would be beneficial to | :21:10. | :21:14. | |
patients, A staff across the trusts, how he defined the major and | :21:15. | :21:17. | |
minor health problems? How will doctors and nurses magically know | :21:18. | :21:22. | |
whether it is major or a minor health problem at first sight | :21:23. | :21:25. | |
without proper assessment? Who is responsible if a seemingly minor | :21:26. | :21:30. | |
condition is actually life-threatening? Shall it be he was | :21:31. | :21:36. | |
Mac who will be responsible? How will this government explain that we | :21:37. | :21:39. | |
will be going back to the days where patients could wait over 12 hours if | :21:40. | :21:45. | |
they were not considered ill enough. The Secretary of State must | :21:46. | :21:48. | |
recognise the impact of this systemic crisis on accident and | :21:49. | :21:51. | |
emergency rooms across the country. In his words and decision to | :21:52. | :21:56. | |
downgrade the target the Secretary of State does neither, instead | :21:57. | :21:58. | |
placing blame on patients and putting patients at risk. Let me be | :21:59. | :22:03. | |
straight, I've been an A specialist Doctor under a Labour | :22:04. | :22:04. | |
government and Conservative government and there has been a | :22:05. | :22:08. | |
change under this government and for sure it's not been for the better. | :22:09. | :22:15. | |
Lucy Allan. Madam Deputy Speaker. There have been very many excellent | :22:16. | :22:19. | |
and constructive contributions to this debate and I particularly | :22:20. | :22:23. | |
welcome the valuable input from those who have real life experience | :22:24. | :22:27. | |
in the NHS. I would particularly like to congratulate my honourable | :22:28. | :22:35. | |
friend the member for Lewes and her excellent speech, and it was | :22:36. | :22:38. | |
disappointing to see a member opposite behaving with such | :22:39. | :22:42. | |
disrespect for a fellow member during that speech. Will owe a debt | :22:43. | :22:47. | |
of gratitude to those on the front line and none of them would thank us | :22:48. | :22:52. | |
for reducing this debate to an ill tempered party political act of | :22:53. | :22:59. | |
posturing. I know there are many sensible members opposite who fully | :23:00. | :23:03. | |
understand that no complex problem is ever solved just by increasing | :23:04. | :23:07. | |
funding in response to ever-increasing demand. There are | :23:08. | :23:13. | |
very strong members opposite who want to work in a constructive | :23:14. | :23:19. | |
fashion with all members across the House to tackle the challenges that | :23:20. | :23:24. | |
our NHS faces and I welcome that. The Right Honourable member for Don | :23:25. | :23:28. | |
Valley is one such sensible member and she made a point earlier this | :23:29. | :23:34. | |
week on BBC's radio for Westminster hour saying it is not even | :23:35. | :23:38. | |
electrically advantageous to the Labour Party to treat the NHS in the | :23:39. | :23:44. | |
way that the Labour Party so often does. We have just seen an example | :23:45. | :23:49. | |
of that. I believe it is for the benefit of all our constituents that | :23:50. | :23:54. | |
we all encourage a more constructive approach. I want to speak very | :23:55. | :24:00. | |
briefly about the four-hour target. Four-hour targets were introduced | :24:01. | :24:03. | |
for those with urgent health problems and I am sure that all | :24:04. | :24:06. | |
members of this House agreed that it is those indeed who should get | :24:07. | :24:11. | |
access to care as soon as possible, and not find that their needs are | :24:12. | :24:15. | |
eclipsed by someone with a minor ailment just because targets must be | :24:16. | :24:21. | |
met. The Secretary of State has spoken this week about his | :24:22. | :24:25. | |
commitment to protect the four-hour promise for those who actually need | :24:26. | :24:30. | |
it and he's absolutely right to say this. Because, today if we talk to | :24:31. | :24:37. | |
those who work in our local Amys and I know lots of members do this | :24:38. | :24:41. | |
regularly, they often say there are people going to A when they do not | :24:42. | :24:47. | |
need to do so. -- A Clinicians expressed the desire to prioritise | :24:48. | :24:51. | |
need rather than simply meet targets. As a constituency MP I | :24:52. | :24:56. | |
fully understand that it can being friendly difficult to see a GP when | :24:57. | :25:01. | |
you want to and it can be equally difficult to navigate a system of | :25:02. | :25:05. | |
ringing at the right moment to get an appointment on the right day. | :25:06. | :25:09. | |
However, it is not the answer to simply circumnavigate the system and | :25:10. | :25:15. | |
turn up at A to get fast tracked irrespective of need. We should not | :25:16. | :25:19. | |
be encouraging the expectation that whatever your element, no matter | :25:20. | :25:23. | |
what the demands on A staff, if you go to A you will get seen | :25:24. | :25:28. | |
within four hours. If people are going to A who do not need to be | :25:29. | :25:33. | |
there why are we offering them a four-hour service when they do get | :25:34. | :25:36. | |
there? When the minister sums up I should be grateful to hear more | :25:37. | :25:40. | |
about what can be done to tackle this particular issue. Maybe he | :25:41. | :25:44. | |
could mention what proposals there are four GPs in A, or what | :25:45. | :25:48. | |
proposals there are around different mechanisms of triaging or managing | :25:49. | :25:52. | |
expectations of our constituents. What matters most is that those in | :25:53. | :25:55. | |
need get access to the appropriate treatment as soon as possible and | :25:56. | :26:00. | |
that's what a target is for. It must be about safety and safety for those | :26:01. | :26:07. | |
with critical and urgent health conditions. I would just like to add | :26:08. | :26:14. | |
that we must never lose sight that our health and well-being is so | :26:15. | :26:18. | |
often dependent on our lifestyle and with the right help and support we | :26:19. | :26:21. | |
can all make the right choices to help us live healthy and help us | :26:22. | :26:26. | |
live happy. Diet, stress management, sleep hygiene, exercise, alcohol use | :26:27. | :26:30. | |
and smoking are key determinants in our physical and mental health and | :26:31. | :26:36. | |
well-being. I would like to see much more emphasis on self-care and | :26:37. | :26:39. | |
self-help, because we can all play our part. There is no amount of | :26:40. | :26:45. | |
funding that will ever compensate for a lack of self-care. Yes, we do | :26:46. | :26:52. | |
need a grown-up and honest approach to this incredibly important issue | :26:53. | :26:57. | |
that matters to all of us here and to all of us who have spoken so | :26:58. | :27:01. | |
passionately. I respect the passions of all members on both sides. What | :27:02. | :27:07. | |
we have to avoid is falling into the trap that we have seen today where | :27:08. | :27:12. | |
we let ourselves down, we let the House down and we actually do not | :27:13. | :27:17. | |
benefit those we most wish to assist in the way we approach this debate. | :27:18. | :27:24. | |
So, yes, let's keep on exploring a sensible and collaborative approach, | :27:25. | :27:28. | |
as articulated so eloquently by the member for North Norfolk and | :27:29. | :27:30. | |
particularly from our honourable friend from Totnes who echoed the | :27:31. | :27:34. | |
sentiments of others, and she is also doing excellent work in this | :27:35. | :27:40. | |
area of working together across the House. None of us, none of us should | :27:41. | :27:44. | |
ever play politics with the NHS because the NHS matters far too much | :27:45. | :27:53. | |
for simple games. Julia Chapman. Madam Deputy Speaker, it is a | :27:54. | :27:57. | |
pleasure to follow the Honourable Lady for Telford, I have not heard | :27:58. | :28:00. | |
has been before and I look forward to hearing many of her speeches in | :28:01. | :28:04. | |
the future. I have to say that to imply somehow we are letting each | :28:05. | :28:09. | |
other down, or the House, or our constituents by standing up and | :28:10. | :28:12. | |
championing health services in our constituencies, I completely | :28:13. | :28:18. | |
disagree with that. That is an essential part of our work. That is | :28:19. | :28:23. | |
why many of us wanted to be elected to this place in the first place, | :28:24. | :28:27. | |
particularly those of us like my honourable friend from Tooting who | :28:28. | :28:31. | |
has such relevant experience in today's debate and I thought made a | :28:32. | :28:35. | |
tremendous speech, and I listened with great interest to what she had | :28:36. | :28:39. | |
to say. I think the front bench opposite ought to be doing the same. | :28:40. | :28:43. | |
We have had a lot of debate about whether or not the NHS is in a | :28:44. | :28:49. | |
crisis, or whether it is a humanitarian crisis, an ordinary | :28:50. | :28:54. | |
crisis, the winter crisis. I looked up crisis and a crisis is a period | :28:55. | :29:00. | |
of intense difficulty or danger. I would say that is a good description | :29:01. | :29:04. | |
of where the NHS is today, a period of intense difficulty. That's what | :29:05. | :29:11. | |
I'm seeing in my local hospital and that is what my constituents are | :29:12. | :29:16. | |
coming telling me about. I've been an MP for nearly seven years and I | :29:17. | :29:21. | |
track the things people come and talk to me about in my surgeries, I | :29:22. | :29:25. | |
am sure many of us do and it is not hard to do. I have now every week | :29:26. | :29:32. | |
somebody coming to see me, I'd about an experience at the hospital, or | :29:33. | :29:36. | |
more and more often because of an experience in adult social care. -- | :29:37. | :29:43. | |
either an experience. That's not something that has occurred in the | :29:44. | :29:46. | |
last few weeks, it has been growing over time. I would say the crisis we | :29:47. | :29:51. | |
witness today is something that has been long predicted and that we have | :29:52. | :29:56. | |
all felt happening over time. And that the Government has chosen, they | :29:57. | :30:01. | |
made a decision, not to act to prevent the worsening of. That is | :30:02. | :30:06. | |
why there is such anger on this side of the House. When a quarter of | :30:07. | :30:12. | |
patients wait longer than four hours in A that is a crisis. I don't | :30:13. | :30:18. | |
really care whether they are there with a minor ailment or a more | :30:19. | :30:22. | |
serious problem, because four hours is too long. It's too long to wait. | :30:23. | :30:28. | |
The fact people are there with minor ailments just tells you, it is a | :30:29. | :30:33. | |
very clear demonstration of the problems that exist elsewhere in the | :30:34. | :30:38. | |
system. When you can't get a G8 Dummett GP appointment or phone 101, | :30:39. | :30:45. | |
you are more often than not directed to A when you phone 101. We need a | :30:46. | :30:51. | |
selection of services available at a central point where if you need a GP | :30:52. | :30:56. | |
you can see a GP, if you need to see a practice nurse you can do that. If | :30:57. | :31:00. | |
you do need to be admitted you can be admitted. I will give way. In an | :31:01. | :31:08. | |
effort to reassure her colleagues, it is a genuine question. What | :31:09. | :31:15. | |
impact does she believe, this is the question I would have asked the | :31:16. | :31:18. | |
honourable member for Tooting, what impact does she believe the 2004 GP | :31:19. | :31:23. | |
contract has had on out-of-hours care, which seems to be the nub of | :31:24. | :31:27. | |
many of the issues that have been discussed this afternoon. Well, do | :31:28. | :31:32. | |
you know what I think about that? The GP contract was changed in 2004 | :31:33. | :31:37. | |
and I did not notice the kind of issues that we face today until far | :31:38. | :31:45. | |
more recently. I'm not a scientist or a doctor, but I do understand | :31:46. | :31:52. | |
cause and effect. I think it doesn't ring true to me to say that | :31:53. | :31:56. | |
something that happened six years prior to the change in government | :31:57. | :31:59. | |
can be blamed for something that's happening six years after the change | :32:00. | :32:05. | |
in government. I'm not saying it has no consequence whatsoever, but I do | :32:06. | :32:08. | |
think there has been ample opportunity to put measures in place | :32:09. | :32:11. | |
that would have prevented us being where we are now. Her intervention | :32:12. | :32:17. | |
leads quite nicely into the point I want to make about the Secretary of | :32:18. | :32:22. | |
State. I hadn't intended to speak today but I was so frustrated | :32:23. | :32:29. | |
listening to him on the Today Programme trying to blame anybody | :32:30. | :32:33. | |
but himself. He has a pattern. The first thing he does is he will blame | :32:34. | :32:39. | |
the Labour government, in government until 2010, and then his party since | :32:40. | :32:44. | |
then. He blames Labour, he will blame Labour for anything he | :32:45. | :32:47. | |
possibly can. He will find something that happened at some trust and say | :32:48. | :32:51. | |
that's why this has gone wrong today. But if that doesn't work, if | :32:52. | :32:55. | |
he can't evidence that, he will say that particular trust is a basket | :32:56. | :33:00. | |
case, it is the trust's fault, it's the local managers, local commission | :33:01. | :33:03. | |
not organising themselves right, it is their fault. If that doesn't work | :33:04. | :33:08. | |
he blames the public and he says you're going to the wrong place, you | :33:09. | :33:11. | |
are accessing your care in a way I don't think you ought to, or call | :33:12. | :33:15. | |
them frequent flyers, or there will be a problem that is the public's | :33:16. | :33:19. | |
fault. They don't look after themselves properly, but clearly | :33:20. | :33:24. | |
their fault. If that doesn't work he blames the local council. That, I | :33:25. | :33:31. | |
think, is probably the worse thing that I've heard him do, blamed the | :33:32. | :33:35. | |
local authority. My local authority,... In a minute... They | :33:36. | :33:41. | |
have prioritise local Amaq social care but the pressures are not going | :33:42. | :33:48. | |
away. -- prioritised social care. They are running out of things to | :33:49. | :33:54. | |
cut. We are just closing our Central library in Darlington. We are making | :33:55. | :33:58. | |
hideous cuts and I don't know where the next round is going to come | :33:59. | :34:04. | |
from. I give way to the honourable gentleman if he still wishes to | :34:05. | :34:08. | |
intervene. I thank the Honourable Lady for giving way. It is incumbent | :34:09. | :34:12. | |
upon us all, I am sure she would agree, to discuss the future of our | :34:13. | :34:16. | |
NHS and health services responsibly. Can she not surely accept that when | :34:17. | :34:20. | |
the Secretary of State is talking about where people go for their | :34:21. | :34:23. | |
services, it is not a matter of blaming people's we ought to move | :34:24. | :34:27. | |
away from this blame culture. There is a benefit in trying to educate | :34:28. | :34:33. | |
people that if perhaps their illness is not best served at A and is | :34:34. | :34:37. | |
best served elsewhere that they ought to realise they should go | :34:38. | :34:40. | |
elsewhere and that helps all of us, both the people who are seeking the | :34:41. | :34:44. | |
services and the people who are giving them. | :34:45. | :34:49. | |
Why doesn't he tell his honourable friend, the Secretary of State, | :34:50. | :34:55. | |
this? He is the one blaming people, not me. I would welcome a programme | :34:56. | :34:59. | |
of explaining to people and making it easier for the public, including | :35:00. | :35:03. | |
myself, in helping us decide where it is we ought to go when we need | :35:04. | :35:08. | |
assistance. The solution, though, that the | :35:09. | :35:11. | |
government seems to have come up with around watering down the | :35:12. | :35:16. | |
target, even members on the government side don't seem to be | :35:17. | :35:21. | |
able to agree or explain exactly what change, or even if there is a | :35:22. | :35:25. | |
change, to the four hour target, they don't seem to be able to | :35:26. | :35:29. | |
explain exactly what that is. The other solution they have come up | :35:30. | :35:30. | |
with is to close a A It is something the local | :35:31. | :35:48. | |
community will not accept. Part of the reason we do our jobs is to give | :35:49. | :35:52. | |
a voice to that local community. So far, in that STP process, they have | :35:53. | :35:58. | |
been completely shut out. We would not have even known what was | :35:59. | :36:03. | |
contained in that plan, had it not been leaked by Hartlepool Borough | :36:04. | :36:07. | |
Council on their website. That is quite a shocking way to conduct a | :36:08. | :36:16. | |
local dialogue. Having started about three years ago, we had the better | :36:17. | :36:21. | |
health programme across the region where my constituency is. I was | :36:22. | :36:25. | |
shocked to find out in response to Parliamentary questions that local | :36:26. | :36:30. | |
health managers have spent ?4.6 million on this process. ?4.6 | :36:31. | :36:36. | |
million that could have been spent, and should have been spent, on | :36:37. | :36:40. | |
providing front-line health services to my constituents, and has been | :36:41. | :36:45. | |
spent on a consultation on whether or not to downgrade A I could | :36:46. | :36:49. | |
have spent that money a lot, lot better. I could have given the | :36:50. | :36:54. | |
answer to what the local population thinks about this proposal, because | :36:55. | :36:59. | |
they are very, very angry and upset about it. It is right that we | :37:00. | :37:04. | |
express that anger and disappointment, outrage and fears | :37:05. | :37:09. | |
for safety, in this House. Many people today have spoken about their | :37:10. | :37:14. | |
families and their relatives. The Member for Chesterfield, the Member | :37:15. | :37:18. | |
for Workington, spoke about their fathers. My dad I'd in 1994, and he | :37:19. | :37:26. | |
had a heart condition -- died. He was 48 and I was 20. One of the | :37:27. | :37:31. | |
things I have done since then is take a very keen interest in cardio | :37:32. | :37:37. | |
health and services for people with heart disease. I was shocked to find | :37:38. | :37:43. | |
that before 1997, it was not uncommon for people to die waiting | :37:44. | :37:47. | |
for heart treatment, often people would be waiting to 18 months for | :37:48. | :37:50. | |
heart treatment. This party in government changed | :37:51. | :37:57. | |
that. We changed that. We made it a matter of weeks. We have saved | :37:58. | :38:02. | |
countless lives as a consequence. And so, when people say that the | :38:03. | :38:08. | |
Labour Party did not do a good job with the NHS, or members opposite | :38:09. | :38:11. | |
try to imply that we somehow have this fake do we eyed sentimental | :38:12. | :38:18. | |
attachment to the NHS but they are completely wrong to do so. We will | :38:19. | :38:24. | |
fight for the NHS. We did create it, but we also did a good job running | :38:25. | :38:29. | |
it in government. We saved lives, cut waiting times, put in targets, | :38:30. | :38:33. | |
it made a difference, it was better for patients, and it will never be | :38:34. | :38:41. | |
any other case stated in here or outside. | :38:42. | :38:43. | |
I am afraid that it is rather unfair on those that have waited all day | :38:44. | :38:47. | |
and have not yet spoken. But some people have taken way over seven | :38:48. | :38:52. | |
minutes, and I'm afraid that I now have two reduced the time limit to | :38:53. | :38:58. | |
five minutes. I would like to pay tribute to all | :38:59. | :39:04. | |
those that work in our National Health Service. And welcome this | :39:05. | :39:09. | |
important debate. I hear the Secretary of State not blaming but | :39:10. | :39:14. | |
looking for solutions. And actually, I think that's more what we should | :39:15. | :39:18. | |
be about. I have called for an honest debate about the National | :39:19. | :39:21. | |
Health Service since I came to this place, because it is 70 years old | :39:22. | :39:28. | |
next year. Actually, if it is going to get to 100, we need to look after | :39:29. | :39:32. | |
it. But I want to start with the positives. My own hospital, West | :39:33. | :39:38. | |
Suffolk Hospital, has seen a 20% increase between Christmas and New | :39:39. | :39:42. | |
Year in the number of patients admitted. Those patients have been | :39:43. | :39:46. | |
poorly, very poorly, which was a point made earlier in the House. | :39:47. | :39:54. | |
They made a resilience plan for 5% uplift in patient numbers, and | :39:55. | :39:57. | |
actually, they have coped spectacularly. | :39:58. | :40:04. | |
People coming into A, and I point to the honourable member for tooting | :40:05. | :40:07. | |
who is no longer there, they have people coming in with ingrowing | :40:08. | :40:13. | |
toenails, and with dry skin. And it is important that we do something | :40:14. | :40:18. | |
about making sure we see the poorly as people in the most appropriate | :40:19. | :40:21. | |
way, and use was also is most effectively. | :40:22. | :40:28. | |
My constituency is the second oldest constituency, by age, in the | :40:29. | :40:37. | |
country. An ageing population:, comb morbidity | :40:38. | :40:42. | |
The allocation of resources as we go forward is important. But my | :40:43. | :40:52. | |
hospital has been one of the most resilient in the east, at 85%, and | :40:53. | :40:57. | |
its resilience is in most part due to its fantastic staff. West Suffolk | :40:58. | :41:10. | |
Hospital has been innovative. In January, it will be doing a bridging | :41:11. | :41:14. | |
care service with the councils, improvement will come through | :41:15. | :41:17. | |
prevention and integration, and not always by shouting for more money. | :41:18. | :41:22. | |
The honourable member for Faversham, mid Kent, stated that it is good | :41:23. | :41:27. | |
integration that we need, good working in Suffolk needs to be | :41:28. | :41:32. | |
copied. STPs, as the honourable member for Wales and Central | :41:33. | :41:35. | |
Ayrshire said, they need to be looked at as a force for good, and I | :41:36. | :41:39. | |
would urge the party opposite, don't knock it, work with it. A clinician | :41:40. | :41:44. | |
led. That is what everybody was asking for. We can't have | :41:45. | :41:53. | |
everything, we never can. We need an honest conversation. With rising | :41:54. | :41:57. | |
expectations, an ageing publishing, the private sector has been in use | :41:58. | :42:01. | |
in the NHS since 1948. If we are going to get more bang for our buck, | :42:02. | :42:06. | |
we may be should look at parts of the private sector, in order to | :42:07. | :42:11. | |
enhance what we get through these critical periods. Yes, certainly. | :42:12. | :42:20. | |
She is absolutely right on the need for a grown-up debate about | :42:21. | :42:23. | |
integrating, and about learning from best practice. But she share my | :42:24. | :42:31. | |
concern that as the party opposite fans the flames of indignation, all | :42:32. | :42:35. | |
they are doing is proving yet again that they are either unwilling, ill | :42:36. | :42:42. | |
equipped... ? I would agree in that since we last | :42:43. | :42:46. | |
debated this on November 23 with the opposition, apart from asking for | :42:47. | :42:52. | |
700 million to be brought forward, actually, there is very little | :42:53. | :42:55. | |
tangible other plans that are being put forward. And it is important, | :42:56. | :43:00. | |
and this is everybody we are talking about, so slinging bows and arrows | :43:01. | :43:04. | |
across this chamber is not going to get us to the solution that we need. | :43:05. | :43:09. | |
If it's about money, how come some areas do better than others? It is | :43:10. | :43:12. | |
about the allocation of resources and good leadership. There are three | :43:13. | :43:19. | |
letters about good health care I've had, a resident in my constituency, | :43:20. | :43:24. | |
the GP on the 28th October, the consultant on the 8th of November, | :43:25. | :43:30. | |
operated on on the 29th, that was actually at my District General | :43:31. | :43:33. | |
Hospital that use the private facility locally in order to enhance | :43:34. | :43:36. | |
that patient experience. We need a long-term solution, I am | :43:37. | :43:42. | |
pleased that the Prime Minister has spoken about tackling the | :43:43. | :43:44. | |
difficulties of mental health, something that the honourable member | :43:45. | :43:48. | |
for North Norfolk has championed, and with me shares a mental health | :43:49. | :43:53. | |
trust. I am pleased to see another 49,000 people being treated for | :43:54. | :43:57. | |
cancer, something that I came to this place to champion. Another | :43:58. | :44:04. | |
822,000 people being treated, seeing specialist cancer patients. We have | :44:05. | :44:09. | |
seen huge increases in demand, and we need to actually admit that we | :44:10. | :44:13. | |
can't just carry on. Advances in drugs, co-morbiditys and an ageing | :44:14. | :44:19. | |
population, we need to understand what is wrong, and we will do that | :44:20. | :44:24. | |
by better data throughout the system. The Richmond group wrote in | :44:25. | :44:29. | |
support of my Private members Bill that information held in health care | :44:30. | :44:32. | |
records has a huge potential to provide better care, improve health | :44:33. | :44:39. | |
service delivery. Paramedics have asked me for better access to data | :44:40. | :44:42. | |
to understand that when they find someone on the floor what measures | :44:43. | :44:45. | |
they are on and what beneficial treatment they can give them. GPs | :44:46. | :44:50. | |
want their information to flow through the system, to help social | :44:51. | :44:52. | |
care and to help the hospital sector. Pharmacies need to be able | :44:53. | :44:57. | |
to read and write, and social care need to look at somebody's pathway. | :44:58. | :45:02. | |
Patient outcomes should be the thing that we are all talking about, but | :45:03. | :45:08. | |
we have to make decisions. At the centre of all this, we need to | :45:09. | :45:11. | |
support those colleagues who are working above and beyond at this | :45:12. | :45:16. | |
current time, and we need to behave in a grown-up, responsible way as | :45:17. | :45:28. | |
they are, caring for our NHS. That an organisation is highly rated | :45:29. | :45:35. | |
as the Red Cross would say what they have is shocking. It points to be | :45:36. | :45:39. | |
hot of the government's did provide a reliable, properly resourced, | :45:40. | :45:41. | |
national Health Service free at the point of need. It should be a source | :45:42. | :45:45. | |
of shame for this government. The reports last week that patients died | :45:46. | :45:48. | |
on trolleys and corridors, one having waited 35 hours is shocking. | :45:49. | :45:56. | |
Could this be the face of the NHS in 2017 under the Tories? It seems it | :45:57. | :45:59. | |
is will stop Health Secretary responded by suggesting that the | :46:00. | :46:02. | |
four hour target should only apply to the most urgent cases, and that | :46:03. | :46:08. | |
it was estimated that 30% of agents in ten won shouldn't be there. He | :46:09. | :46:14. | |
should hang his head in shame. -- in A In Cheshire and Merseyside, the | :46:15. | :46:21. | |
NHS has defined savings of ?1 billion. Nearly a third higher than | :46:22. | :46:33. | |
the original 9 million forecast. I would be interested to hear why this | :46:34. | :46:38. | |
curious request has been made. Patients in Wirral West are | :46:39. | :46:40. | |
concerned about the impact of these savings or cuts will have in general | :46:41. | :46:46. | |
practice will stop by our rights to be concerned. The biggest financial | :46:47. | :46:49. | |
squeeze in the history of the NHS 's puddings services at risk. -- | :46:50. | :46:52. | |
putting. And NHS manager from my constituency | :46:53. | :47:09. | |
has written to me saying that STPs are pushing for a redesign of | :47:10. | :47:14. | |
services. Primary care and scale, the real punch line is there is no | :47:15. | :47:18. | |
funding to make these changes. They go on, locally there is talk about | :47:19. | :47:21. | |
and accountable care organisation for West Wirral, meetings being held | :47:22. | :47:27. | |
on almost a weekly basis to create a road map to do this with no money to | :47:28. | :47:34. | |
do it with. Having fragmented services, they are now making | :47:35. | :47:40. | |
services use what pitiful resources they have to try to put it all back | :47:41. | :47:43. | |
together again. I truly despair there will not be an NHS this time | :47:44. | :47:48. | |
next year. What a stark warning, a damning indictment on the | :47:49. | :47:51. | |
government's you. The Secretary of State should address the crisis by | :47:52. | :47:54. | |
giving the NHS funding they need to make up for the crisis of the | :47:55. | :47:59. | |
government's making about access to GP appointments, failure to train | :48:00. | :48:05. | |
enough nurses, I have long been aware of the Tory's gender for the | :48:06. | :48:09. | |
privatisation of the National Health Service, seen in the 2012 act, which | :48:10. | :48:17. | |
opened it up to the private sector, and allowing NHS hospitals to give | :48:18. | :48:21. | |
half their beds to private patients. I believe that this and previous | :48:22. | :48:25. | |
Tory government seek to move us to a two tier system, where those that | :48:26. | :48:29. | |
can afford it, paid private health insurance, and the rest are left | :48:30. | :48:36. | |
with a bargain basement NHS. Since the Thatcher period, this has been | :48:37. | :48:39. | |
shown. We appear to be reaching the end game. The government is cutting | :48:40. | :48:42. | |
the supply of health care in the Babic sector to create demand in the | :48:43. | :48:48. | |
private sector. -- in the public sector. It is an entirely different | :48:49. | :49:02. | |
concept, and in the process of trying to transfer us to that two | :49:03. | :49:06. | |
tier insurance -based model, did you not pause to think about the human | :49:07. | :49:10. | |
suffering he would unleash in the process with patients waiting for | :49:11. | :49:13. | |
hours on trolleys, anxious relatives waiting helplessly as they watch | :49:14. | :49:20. | |
what's happening, and stressed out day in, day out. Now is the time for | :49:21. | :49:24. | |
a decision. The government can review and it is not too late. It | :49:25. | :49:27. | |
can face the facts and admit to itself that actually engage people | :49:28. | :49:31. | |
would a state managed, state funded, National Health Service free at the | :49:32. | :49:37. | |
point of use, paid for, created by the Labour government after the | :49:38. | :49:41. | |
Second World War, the envy of the word, the government should swallow | :49:42. | :49:44. | |
its ideological pride and say, OK, we get it, we will fund the NHS, | :49:45. | :49:49. | |
anything else is a betrayal of all the NHS stands for. | :49:50. | :49:53. | |
Madam Deputy Speaker, thank you for calling me to speak. I believe we | :49:54. | :49:59. | |
need to look afresh at the entire health and social care pathway which | :50:00. | :50:02. | |
is why I'm delighted to contribute today. From visiting the pharmacist | :50:03. | :50:07. | |
to attending a GP appointment, to spending time in hospital, be it at | :50:08. | :50:12. | |
A or preplanned, and being able to reside beforehand and afterwards at | :50:13. | :50:16. | |
home or in a care home, we need to find the most efficient and | :50:17. | :50:20. | |
dignified way to treat and look after people. We must avoid using | :50:21. | :50:25. | |
one treatment centre as a default option, despite it not being the | :50:26. | :50:29. | |
best for the individual or for the financial purse, because it is the | :50:30. | :50:32. | |
only one which is available due to difficulties with individual | :50:33. | :50:37. | |
funding, opening hours or lack of accessibility to a better form of | :50:38. | :50:42. | |
provision. We must also, Madam Deputy Speaker, be encouraged to | :50:43. | :50:45. | |
speak freely about the pressures in the system and to provide ideas. For | :50:46. | :50:50. | |
years it frustrated me that anyone who thinks aloud with ideas which | :50:51. | :50:54. | |
can change health and social care for the better is denigrated as | :50:55. | :50:58. | |
seeking to harm it when the opposite is true. To this end I listened with | :50:59. | :51:04. | |
interest to be interviewed the Secretary of State gave to Radio 4 | :51:05. | :51:08. | |
on Monday morning. It struck me as measured and thoughtful as to new | :51:09. | :51:12. | |
ideas. I was particularly interested by the ideas as to how we could | :51:13. | :51:16. | |
deliver more capacity in the GP system because an increasing number | :51:17. | :51:21. | |
of people attending A are either accident victims or needing | :51:22. | :51:26. | |
emergency treatment. They did, however, need some form of medical | :51:27. | :51:30. | |
intervention as the Secretary of State mentioned. It was thoroughly | :51:31. | :51:33. | |
depressing to read the Secretary of State's words taken out of context. | :51:34. | :51:38. | |
I hope he will continue to think outside the box and that all inside, | :51:39. | :51:43. | |
insiders has will recognise the benefits of him doing so. Talking | :51:44. | :51:46. | |
about ideas, I suggest the following for each of the treatment centres in | :51:47. | :51:50. | |
the health pathway. Pharmacists, in the event we have too many clusters | :51:51. | :51:54. | |
of pharmacies, I agree with the need to ensure they are spread out across | :51:55. | :51:57. | |
the country with the money saved being recycled. At the same time, | :51:58. | :52:03. | |
can we find ways to help pharmacies deliver more interventions in order | :52:04. | :52:08. | |
to free up capacity at GP surgeries. We must do more to signpost patients | :52:09. | :52:13. | |
to pharmacist before going to their GP. A recent report costed common | :52:14. | :52:18. | |
ailment treatment in community pharmacies at ?29 per patient. Four | :52:19. | :52:23. | |
GP practices that treatment cost rises to ?82 and four A ?147. | :52:24. | :52:28. | |
Treatment results across all three were equally good regardless of | :52:29. | :52:31. | |
where they were treated. The research estimated 5% of GP | :52:32. | :52:42. | |
consultations for common ailments could be managed by community | :52:43. | :52:44. | |
pharmacies equating to more than 18 million GP consultations which could | :52:45. | :52:46. | |
be diverted. Turning to GPs, I was buoyed by the suggestion by the | :52:47. | :52:49. | |
Secretary of State that more GPs must be placed in A departments | :52:50. | :52:55. | |
and care homes. The new NHS requirement of GPs undertaking | :52:56. | :52:58. | |
weekly ward rounds in care homes is the right at the thinking to prevent | :52:59. | :53:01. | |
emergency treatment in our hospitals. I welcome GPs operating | :53:02. | :53:05. | |
on Sundays but practically we surely just need one surgery per area being | :53:06. | :53:10. | |
opened. I don't believe all GPs operating over seven days is a good | :53:11. | :53:14. | |
use of scarce resources, in the same way government funding of two | :53:15. | :53:17. | |
pharmacies across the road from each other is also not a good use of | :53:18. | :53:21. | |
scarce resources. I have long taken the view that we need to find ways | :53:22. | :53:31. | |
to free of our GPs so they might focus on patients who need them the | :53:32. | :53:34. | |
most. Because it is free there are too many wasted or cancelled GP | :53:35. | :53:36. | |
appointments. If there was a cost for unjustifiably keeping to an | :53:37. | :53:38. | |
appointment it might demonstrate how precious this resource is in the | :53:39. | :53:42. | |
same manner that an NHS dentist would charge for a missed | :53:43. | :53:46. | |
appointment when I was younger. Turning their forger A, some of | :53:47. | :53:50. | |
these reforms are about pharmacies and GPs but I designed to ensure | :53:51. | :53:54. | |
patients are only attending A if they have had an accident or it is | :53:55. | :53:58. | |
an emergency. Clearly this is not the case for some who are now | :53:59. | :54:02. | |
attending. We are also facing a demand on hospital places due to the | :54:03. | :54:07. | |
need to reform the way we look after an ageing population. Time does not | :54:08. | :54:11. | |
allow me to talk about social care, so important in my constituency, but | :54:12. | :54:15. | |
the delivery by the government of more social care funding before | :54:16. | :54:18. | |
Christmas was welcomed however it is crucial to question the operating | :54:19. | :54:22. | |
model in social care. The NHS benefits from a national funding | :54:23. | :54:25. | |
programme, social care is largely the responsibility of local | :54:26. | :54:28. | |
authorities and local rate players like payers in areas where | :54:29. | :54:32. | |
retirement may be high but employment and council tax receipts | :54:33. | :54:36. | |
are not. We have to think radically to ensure we get the best out of our | :54:37. | :54:41. | |
health and social care system. To do so will not only make resources | :54:42. | :54:44. | |
stretch further but deliver the innovation which will improve the | :54:45. | :54:47. | |
lives of the sick and infirm who are most in need of our care. Two days | :54:48. | :54:58. | |
ago the Health Secretary read out a statement in this chamber on the | :54:59. | :55:02. | |
crisis in our NHS and his answer to his Government's failure to meet A | :55:03. | :55:06. | |
waiting time targets is to downgrade those targets rather than seeking to | :55:07. | :55:11. | |
take any action to treat the Mall is at the heart of our NHS. The Health | :55:12. | :55:17. | |
Secretary heaped fulsome praise on our hard-working and dedicated NHS | :55:18. | :55:22. | |
staff, praise they richly deserved but it will ring hollow with many of | :55:23. | :55:27. | |
them. I speak from years of experience working in the NHS as a | :55:28. | :55:31. | |
clinical scientist. Having worked with staff of all grades, skills and | :55:32. | :55:37. | |
experience. The simple truth is that NHS staff are demoralised. As I said | :55:38. | :55:42. | |
two days ago, the reason they continue to work with care and | :55:43. | :55:46. | |
compassion is in spite of, not because of, any action taken by this | :55:47. | :55:50. | |
Health Secretary. Since that statement I have been inundated with | :55:51. | :55:55. | |
health service staff wanting to tell me their stories of how the service | :55:56. | :56:00. | |
they were once proud to work in is now in perpetual crisis, of the | :56:01. | :56:05. | |
strain of wanting to do their best for their patients but being | :56:06. | :56:09. | |
prevented from doing so because of short staffing, because of | :56:10. | :56:13. | |
overcrowding, because of delayed discharge, and because of | :56:14. | :56:17. | |
underfunding. Of the e-mails they get from ministers demanding to know | :56:18. | :56:21. | |
what they're going to do about failing to meet targets, and then | :56:22. | :56:25. | |
listening to the very same ministers telling the public that the NHS | :56:26. | :56:30. | |
doesn't have a problem. Health managers are saying that we have a | :56:31. | :56:35. | |
perfect storm of ageing patients needing more care just at the time | :56:36. | :56:39. | |
when social care has been cut to the bone leading hospitals to pick up | :56:40. | :56:45. | |
the pieces. An Aimi doctor at Manchester Royal Infirmary said to | :56:46. | :56:48. | |
me crisis is the new normal and it has become usual to have ten | :56:49. | :56:53. | |
patients waiting in the corridor -- A Doctor. In my own constituency | :56:54. | :56:58. | |
of Heywood Andy Little. Michael Middleton the hospital that serves | :56:59. | :57:01. | |
my constituency has been the subject of a damning report revealing | :57:02. | :57:05. | |
appalling neglect in maternity care and leading to the avoidable deaths | :57:06. | :57:09. | |
of mothers and babies. Pennine acute trusts have the highest number of 12 | :57:10. | :57:15. | |
hour A waits in October and the second-highest number of cancelled | :57:16. | :57:18. | |
urgent operations in November. In December it was forced to divert | :57:19. | :57:23. | |
ambulances 14 times in total, one of the highest figures in the country. | :57:24. | :57:28. | |
Social care across Greater Manchester races collapse and this | :57:29. | :57:31. | |
is borne out by the delayed discharge figures for Greater | :57:32. | :57:36. | |
Manchester, which doubled in the year to October. Greater Manchester | :57:37. | :57:40. | |
asked for ?200 million for social care in the Autumn Statement, but | :57:41. | :57:45. | |
this issue was not even referred to. Some C Greater Manchester's devolved | :57:46. | :57:48. | |
health care system as a solution, but even the chief officer John | :57:49. | :57:53. | |
Rouse, says while devolution can help close working, it is not magic | :57:54. | :57:58. | |
dust. I want to remind the Health Secretary about the NHS Constitution | :57:59. | :58:04. | |
for England, which was updated in October 2015, which establishes the | :58:05. | :58:08. | |
principles and values of the NHS in England. It sets out rights to which | :58:09. | :58:13. | |
patients, public and staff are entitled and pledges, which the NHS | :58:14. | :58:18. | |
is committed to achieve. And enshrined in the Constitution is the | :58:19. | :58:23. | |
patient's right to be cared for in a clean, safe, secure and suitable | :58:24. | :58:27. | |
environment and the right to be protected from abuse and neglect, | :58:28. | :58:32. | |
not an A corridor. Patients and the public have a right to be | :58:33. | :58:36. | |
involved in the planning of health care services and in changes in the | :58:37. | :58:39. | |
way health care services are provided and in decisions to be made | :58:40. | :58:44. | |
affecting the operation of the services. And for NHS staff, one of | :58:45. | :58:48. | |
the pledges is to engage staff in decisions that affect them and the | :58:49. | :58:53. | |
services they provide. And yet I seek precious little evidence of | :58:54. | :58:57. | |
staff or patients or the public having any input at all into the 44 | :58:58. | :59:01. | |
sustainability and transformation plans covering the regions England, | :59:02. | :59:11. | |
which appear to have been drawn up behind closed doors and are shrouded | :59:12. | :59:14. | |
in secrecy. Yet their impact on health care could be huge. But where | :59:15. | :59:17. | |
is the public involvement? Patients are being failed under this | :59:18. | :59:19. | |
Government's watch and their rights to save care are being neglected. | :59:20. | :59:29. | |
All that is asked is the occasional flurry of warm words yet the junior | :59:30. | :59:33. | |
doctors dispute showed his real attitude towards NHS staff. Aneurin | :59:34. | :59:39. | |
Bevan said no government that this, hopes to destroy the NHS can expect | :59:40. | :59:45. | |
the support of the people. That is from his essays. Sadly I think the | :59:46. | :59:48. | |
current secretary has managed to achieve replacing the fear. Thank | :59:49. | :59:57. | |
you, Madam Deputy Speaker. I want to start by paying tribute to our | :59:58. | :00:00. | |
hard-working staff in the NHS and those in the care sector. The best | :00:01. | :00:05. | |
way to help Dummett thank those health and care staff would be to | :00:06. | :00:07. | |
give them the resources they need to do the job we want them to do. I | :00:08. | :00:12. | |
welcome the contributions made by honourable member is today, | :00:13. | :00:15. | |
particularly the moving contribution by my honourable friend for | :00:16. | :00:18. | |
Chesterfield who told us about the personal catastrophe for him and his | :00:19. | :00:22. | |
family when his father was sent home from a pressured A sadly to die | :00:23. | :00:26. | |
from an aneurysm. My honourable friend from Workington was also able | :00:27. | :00:30. | |
to tell us about the happy death her father had with the end of life care | :00:31. | :00:34. | |
at the local Community Hospital. I want to mention the Honourable Lady | :00:35. | :00:37. | |
for Central Ayrshire, the Honourable Lady for Totnes, who emphasised the | :00:38. | :00:40. | |
complexity and verity of patients needing care in the winter months. | :00:41. | :00:45. | |
We should remember that in terms of the scale of pressures facing the HS | :00:46. | :00:50. | |
-- frailty of patients. Both honourable members supported the | :00:51. | :00:53. | |
four-hour target of the A as a barometer of the wider pressures in | :00:54. | :00:58. | |
the NHS guy a measure of managing the frail and convex patients. My | :00:59. | :01:05. | |
Right Honourable friend urged the government not to give the NHS of | :01:06. | :01:10. | |
Donaghy oppression of giving up on the four-hour target. It sends the | :01:11. | :01:18. | |
wrong message. There was a concern that parents might be discouraged | :01:19. | :01:22. | |
from taking their children to A Honourable member is opposite have | :01:23. | :01:25. | |
quoted Simon Stevens and Chris Hopson in support of claims on NHS | :01:26. | :01:28. | |
funding and I would like to update them because in the House this | :01:29. | :01:32. | |
afternoon Simon Stevens said on NHS funding: we got less than we asked | :01:33. | :01:36. | |
for. The Government are stretching it to claim the NHS got more. Simon | :01:37. | :01:41. | |
Stevens said it doesn't help anybody to pretend there are not financial | :01:42. | :01:46. | |
gambles. Chris Hopson of NHS Providers said: we do not believe | :01:47. | :01:53. | |
the NHS has all the money it needs and the NHS is not sustainable on | :01:54. | :01:56. | |
the current funding. I want to turn to the pressures caused by social | :01:57. | :01:59. | |
care. The crisis in our hospitals has been made much worse by the | :02:00. | :02:02. | |
government's continued failure to fund social care properly. The care | :02:03. | :02:08. | |
crisis is caused by insufficient funding in the face of growing | :02:09. | :02:12. | |
demand. Government ministers have ignored warnings from a wide group | :02:13. | :02:17. | |
of doctors and from leaders and professionals in the health and care | :02:18. | :02:21. | |
sectors. They fail to produce a Singleton any other extra funding | :02:22. | :02:23. | |
for social care in the autumn settlement. Then they told us extra | :02:24. | :02:28. | |
funding was made available for social care in the local government | :02:29. | :02:31. | |
funding settlement but this was not the extra funding needed from | :02:32. | :02:36. | |
central government. What ministers did was shift the burden onto | :02:37. | :02:41. | |
council taxpayers. This was made worse by the fact the ?240 million | :02:42. | :02:46. | |
adult and social care grant was actually money recycled within local | :02:47. | :02:48. | |
government budgets from the New Homes Bonus, and one third of | :02:49. | :02:55. | |
councils will be worse off as a result of this settlement. My own | :02:56. | :02:59. | |
local authority Salford will have ?2.3 million less in its budgets. | :03:00. | :03:05. | |
This is not a boost to social care. What health and social care leaders | :03:06. | :03:08. | |
have pleaded for was for ministers to bring forward funding to address | :03:09. | :03:13. | |
the current crisis in social care and that is what we have in our | :03:14. | :03:17. | |
motion today. This would provide some breathing space, and breathing | :03:18. | :03:21. | |
space is needed because the lack of social care means that thousands of | :03:22. | :03:25. | |
older people are stuck in hospital waiting for a care package in their | :03:26. | :03:29. | |
own home. That was the most common cause of delayed discharges due to | :03:30. | :03:33. | |
social care. More than a third of the record 200,000 delayed Dummett | :03:34. | :03:39. | |
delays reported were due to a lack of social care. Being stuck in | :03:40. | :03:43. | |
hospital can affect patient morale and patient mobility but also | :03:44. | :03:47. | |
increased the patient's risk of hospital acquired infections. We | :03:48. | :03:49. | |
know the major impact is the knock-on effect on people in A | :03:50. | :03:55. | |
waiting for a bed for an emergency admission. Health ministers like to | :03:56. | :03:57. | |
blame local authorities for the lack of social care but there are | :03:58. | :04:01. | |
problems with that. When NHS Chief Executive Simon Stevens was asked by | :04:02. | :04:05. | |
the DCLG committee chair in a recent Caerau on social care what extra | :04:06. | :04:09. | |
resources would be needed if every local authority performed as well as | :04:10. | :04:13. | |
the best local authority on delayed discharge, he said: even happen | :04:14. | :04:19. | |
Dummett having sorted that out if we have a the gap between the | :04:20. | :04:23. | |
availability of social care and the number of frail older people it will | :04:24. | :04:26. | |
show up as extra pressure on them, their families, carers and of course | :04:27. | :04:32. | |
the NHS. Of course we want to get to the position with a best practice in | :04:33. | :04:35. | |
tackling delays is spread across the country but ministers have to start | :04:36. | :04:38. | |
to reflect on what their government has done through the cuts they have | :04:39. | :04:43. | |
inflicted on local authority budgets. Figures from the Local | :04:44. | :04:46. | |
Government Association show the hardest hit local authority has had | :04:47. | :04:51. | |
cuts of 53% to its budget in the last five years. The average cut is | :04:52. | :04:56. | |
39%. Now the budget cuts for Surrey were at the lower end of the budget | :04:57. | :05:01. | |
cuts at 29%. Even so, the Cabinet member for social care in Surrey, | :05:02. | :05:05. | |
has talked in a letter to the Guardian about the issues the local | :05:06. | :05:10. | |
authority faces. He said: the Care Quality Commission is not the only | :05:11. | :05:12. | |
organisation with worries about inadequate adult social care funding | :05:13. | :05:18. | |
and the impact on already clocked up hospitals. He said while the social | :05:19. | :05:22. | |
care precept was a welcome move it falls many millions of pounds short | :05:23. | :05:26. | |
of what is needed now, let alone in the next two decades. I suggest the | :05:27. | :05:31. | |
Health Secretary and Chancellor talked to social care leaders to | :05:32. | :05:37. | |
understand the needs they see in local communities and the impact of | :05:38. | :05:41. | |
local social care on NHS hospitals. Ministers have been warned about the | :05:42. | :05:47. | |
impact of cuts on social care but ignored those warnings. The Royal | :05:48. | :05:50. | |
College of Emergency Medicine has said emergency care is on its knees, | :05:51. | :05:54. | |
mainly due to a lack of investment in both social and acute health care | :05:55. | :06:00. | |
beds. The BBC has reported that last week there were 18,000 trolley waits | :06:01. | :06:05. | |
over four hours. That is people waiting on a trolley in a hospital | :06:06. | :06:11. | |
corridor and there were 485 cases where patients waited over 12 hours. | :06:12. | :06:16. | |
My honourable friend raised the issue we don't know the figures | :06:17. | :06:20. | |
waiting stomach for patients waiting on corridors, all been treated and | :06:21. | :06:23. | |
waiting on a chair due to lack of trolleys. The figures don't tell us | :06:24. | :06:27. | |
all about the misery for patients and for their family members waiting | :06:28. | :06:32. | |
with them. Last night a senior A consultant said on ITV that patients | :06:33. | :06:36. | |
can be left with absolutely no dignity during these weights. He | :06:37. | :06:41. | |
said: we have got patients with severe illnesses on chairs receiving | :06:42. | :06:45. | |
drips, antibiotics, medications and patients with cardiac problems on | :06:46. | :06:48. | |
chairs because there are no trolleys for them to go on to. The senior | :06:49. | :06:54. | |
doctor talked about patients who are left unable to move off their | :06:55. | :06:58. | |
trolleys or stuck on chairs. And he talked about a lack of shutters and | :06:59. | :07:02. | |
blinds, which means that patients can be left in full view of others | :07:03. | :07:06. | |
while they are being treated. He also reported patients who were | :07:07. | :07:11. | |
incontinent in front of relatives and strangers because hospital staff | :07:12. | :07:14. | |
could not reach them in time. He said: patients have no dignity left. | :07:15. | :07:20. | |
That is what it can lead to. What would we feel if that was our | :07:21. | :07:27. | |
relative? This situation may get worse with the expected cold weather | :07:28. | :07:32. | |
with more major incidents being declared and many hospitals on black | :07:33. | :07:39. | |
alert. Downgrading the four hour waiting | :07:40. | :07:45. | |
time targets for A misses the point. As we have discussed in this | :07:46. | :07:51. | |
debate, that for our target is a proxy for patient safety. It is | :07:52. | :07:55. | |
miserable for a sick patient to lose their dignity through being | :07:56. | :07:59. | |
incontinent during a trolley weight in a hospital corridor. But it is | :08:00. | :08:03. | |
also miserable and frightening for a vulnerable patient to be discharged | :08:04. | :08:06. | |
in the middle of the night to a cold home without a care package. That is | :08:07. | :08:10. | |
why in our motion today we repeat the call for the government to bring | :08:11. | :08:14. | |
forward ?700 million of funding promised to social care in 2019 to | :08:15. | :08:18. | |
how the NHS and social care systems cope with extra pressures this | :08:19. | :08:22. | |
winter. We also call for a new improved settlement for the NHS and | :08:23. | :08:27. | |
social care in the budget in March, so that we avoid this crisis in the | :08:28. | :08:31. | |
future. Staffing emergency departments are at the shop end of | :08:32. | :08:38. | |
saving lives. A staff are so directly in the front line of that. | :08:39. | :08:44. | |
Care staff with a working in caring homes, make a huge difference to the | :08:45. | :08:47. | |
lives of millions of older and vulnerable people. People with | :08:48. | :08:53. | |
disabilities, and people with mental health conditions. Though should be | :08:54. | :08:57. | |
the best jobs in the UK. But without the right investment in the funding | :08:58. | :09:00. | |
they need, those people doing those jobs feel undervalued and | :09:01. | :09:04. | |
overstretched. I urge members to vote for this motion tonight. | :09:05. | :09:13. | |
Matt Lund deputies beaker, I am pleased to follow the honourable | :09:14. | :09:20. | |
lady, and be able to close this debate. I would like to thank all 34 | :09:21. | :09:24. | |
honourable members for their contributions, some of which mostly | :09:25. | :09:29. | |
on this side of the House have managed to rise above party politics | :09:30. | :09:33. | |
and make some constructive comments. I would like to start by joining my | :09:34. | :09:39. | |
right honourable friend the Secretary of State by thinking the | :09:40. | :09:44. | |
2.7 million staff working in our NHS and social care system. As the prime | :09:45. | :09:50. | |
Minster said earlier, we recognise they have never worked harder to | :09:51. | :09:57. | |
keep patients safe with a A working hard to see patients. | :09:58. | :10:03. | |
Regrettably through 5.5 hours of debate and criticism from the | :10:04. | :10:08. | |
benches opposite, we have heard little if anyway of providing | :10:09. | :10:15. | |
solutions to the challenges which we acknowledge our A face. The | :10:16. | :10:19. | |
opposition have again touted more funding as their only answer to | :10:20. | :10:24. | |
solve public sector challenges. In fact, the party opposite has | :10:25. | :10:29. | |
repeatedly pledged raising corporation tax eight times, | :10:30. | :10:32. | |
promising an unspecified amount from an unspecified source, this will not | :10:33. | :10:36. | |
help our NHS, and it will not fool the public. | :10:37. | :10:41. | |
There is a lot to do to protect the system and ensure a sustainable | :10:42. | :10:45. | |
future. What it is this government which has plans in place to get | :10:46. | :10:48. | |
through this extremely challenging period, and sustain the NHS for the | :10:49. | :10:55. | |
future. The shadow Secretary of State, the Member for Leicester | :10:56. | :11:00. | |
South, spoke for close to around three quarters of an hour without | :11:01. | :11:03. | |
making a single suggestion of what could be done to solve the problem | :11:04. | :11:09. | |
that are facing the NHS. Not one. He should have stayed to listen, he may | :11:10. | :11:12. | |
have done, and I apologise if I didn't pay enough attention to his | :11:13. | :11:19. | |
presence, but the Member for Doncaster Central that asked | :11:20. | :11:23. | |
specifically for community pharmacists to be paid for providing | :11:24. | :11:27. | |
minor ailment services, and I'm pleased to be able to tell the right | :11:28. | :11:30. | |
honourable lady that that is exactly what we are doing, and my honourable | :11:31. | :11:34. | |
friend the Minister for community health was discussing this only this | :11:35. | :11:38. | |
morning in Westminster Hall, and I regret to say not a single Labour | :11:39. | :11:42. | |
member was present to hear what he had to say. | :11:43. | :11:48. | |
Surely the House wants to hear the Minister after this long debate. | :11:49. | :11:57. | |
With courtesy, Minister. Thank you Madam Deputy Speaker. We | :11:58. | :12:01. | |
have heard a number of comments from opposition members, and I am pleased | :12:02. | :12:04. | |
to say they were outnumbered in this debate by members of the government | :12:05. | :12:11. | |
backbenchers. Rehearsing tired phrases to mislead the public over | :12:12. | :12:13. | |
alleged increasing independent provision within the health service. | :12:14. | :12:20. | |
And also, misrepresenting what my right honourable friend the | :12:21. | :12:22. | |
Secretary of State was saying in his remarks about A targets, but I | :12:23. | :12:29. | |
would, having said that, like to pay tribute as the honourable lady did | :12:30. | :12:35. | |
to the honourable gentleman from Chesterfield, who I can't see in his | :12:36. | :12:39. | |
place, but he is, and the honourable lady for Workington, who both showed | :12:40. | :12:45. | |
considerable personal courage in explaining the circumstances around | :12:46. | :12:49. | |
the deaths of each of their fathers, and I think they did so in an | :12:50. | :12:53. | |
entirely honourable and sensible way. I am grateful to them for | :12:54. | :12:57. | |
sharing that. I would also like to congratulate my honourable friend, | :12:58. | :13:02. | |
the Member for Faversham and Mid Kent, for managing to get her son | :13:03. | :13:06. | |
into hospital to have his appendix treated on Boxing Day. Clearly, as | :13:07. | :13:10. | |
she said, that service was working well. | :13:11. | :13:15. | |
The opposition sought to adopt a posture of moral high ground in this | :13:16. | :13:19. | |
debate, and I have to say that the honourable lady for Dewsbury, who | :13:20. | :13:24. | |
challenged members on this side as to whether they had visited | :13:25. | :13:27. | |
hospitals over the Christmas period other than on official visits, and | :13:28. | :13:32. | |
it was completely punctured by the honourable Member for Lewes, who | :13:33. | :13:34. | |
pointed out she was doing a night shift between business and New Year | :13:35. | :13:39. | |
in her role as a nurse, not on an official visit. | :13:40. | :13:42. | |
We have had some impressive contributions, and I would like to | :13:43. | :13:48. | |
thank the chairman of the select committee, who was supportive of a | :13:49. | :13:55. | |
new nuanced target for A, and for her calm and generally constructive | :13:56. | :14:00. | |
comments. And my right honourable friend, the Member for Chelmsford, | :14:01. | :14:03. | |
for his support for the success of regime in Essex, and pointing out | :14:04. | :14:09. | |
that it is not closing any of the three A departments in the | :14:10. | :14:14. | |
hospitals there. Also, my honourable friend, the Member for Crawley, who | :14:15. | :14:17. | |
made a thoughtful speech welcoming the opening of an assessment unit in | :14:18. | :14:21. | |
Crawley to believe pressure on the unis nearby. -- A | :14:22. | :14:35. | |
Of course, we do recognise on this side, and in government, that our | :14:36. | :14:40. | |
NHS faces pressures, both the immediate pressures of the colder | :14:41. | :14:43. | |
weather and the wider pressures of an ageing and growing population. | :14:44. | :14:47. | |
There were nearly 9 million more visits last year to our A when | :14:48. | :14:56. | |
compared to the year before the four hour commitment was made. More than | :14:57. | :15:10. | |
2 million a A compared, I won't give way, the | :15:11. | :15:13. | |
honourable lady didn't give way, I have a short time. When compared to | :15:14. | :15:18. | |
when the party came into office in May, 2010, in 2015-16, there were | :15:19. | :15:26. | |
2.4 million more A attendances, and this is in the context of a much | :15:27. | :15:34. | |
busier NHS overall. The NHS is delivering 5.9 million more | :15:35. | :15:39. | |
diagnostic tests, 822,000 more people seen by a specialist for | :15:40. | :15:43. | |
suspected cancer, and 49,000 more patients starting treatment for | :15:44. | :15:48. | |
cancer every year, compared to the year before we came into office also | :15:49. | :15:51. | |
it is therefore the case that a government of any colour would be | :15:52. | :15:54. | |
faced by the same problems, but it is this government that is committed | :15:55. | :15:58. | |
to funding the NHS's plan for a sustainable future. Had we followed | :15:59. | :16:08. | |
Labour's and, the NHS would have 1.3 billion a year less, equivalent of | :16:09. | :16:12. | |
13,000 fewer doctors or 30,000 fewer nurses. We remain committed to the | :16:13. | :16:19. | |
vital for our accident and emergency promise for those patients who need | :16:20. | :16:23. | |
to be there. We're proud to be the only country in the world to commit | :16:24. | :16:28. | |
to all patients that we will sort out any urgent health need within | :16:29. | :16:34. | |
four hours, only three other countries, New Zealand, Australia, | :16:35. | :16:37. | |
and Canada, have similar national standards, but none of these are as | :16:38. | :16:44. | |
stringent as ours. Today, it is the Conservative Party | :16:45. | :16:50. | |
that is the party of the NHS. This is why we pledged more than | :16:51. | :16:57. | |
Labour did, and why we are delivering more funding with a | :16:58. | :16:59. | |
higher proportion of total government spending going into | :17:00. | :17:05. | |
health in each year since 2010. Funding for the NHS will rise in | :17:06. | :17:11. | |
real terms by ?10 billion by 2020-21, compared to 2014-15, front | :17:12. | :17:16. | |
loaded with ?6 billion delivered by the end of this year as the NHS | :17:17. | :17:21. | |
asked for. It was this government that | :17:22. | :17:25. | |
established an independent NHS with an independent chief executive. It | :17:26. | :17:29. | |
was this NHS which came up with its own plan, and we were the only party | :17:30. | :17:35. | |
to back it. Madam Deputy 's Beagle, we agree | :17:36. | :17:39. | |
that the NHS and social care are facing huge pressures, and there is | :17:40. | :17:44. | |
more for us as a government to do, but I can say to the House -- Madam | :17:45. | :17:49. | |
Deputy Speaker, we enter winter with a more comment of planned than ever | :17:50. | :17:52. | |
before. We have confidence the plans are in place to cope with both the | :17:53. | :17:59. | |
current pressures we face, winter, A, and delayed discharges, and | :18:00. | :18:01. | |
also to sustain the future of the system. I would like to conclude by | :18:02. | :18:08. | |
saying a huge thank you to the 1.3 million staff in the NHS, and the | :18:09. | :18:13. | |
1.4 million people who provide social care. They are the ones who | :18:14. | :18:17. | |
continue to make this possible. We are aware of the pressures they are | :18:18. | :18:21. | |
under, especially during winter. We have increased the number of doctors | :18:22. | :18:25. | |
and nurses as my right honourable friend the Secretary of State said | :18:26. | :18:30. | |
earlier, especially in A We have launched plans to recruit more, both | :18:31. | :18:33. | |
doctors and nurses. Without them we would not have a national health | :18:34. | :18:37. | |
service that provides such a high level of care. | :18:38. | :18:46. | |
Opinions say iMac. On the contrary, no. | :18:47. | :18:55. | |
The ayes have it. The question is that the original words stand part | :18:56. | :19:06. | |
of the question, as many of that opinions say aye. On the contrary, | :19:07. | :19:08. | |
no. Clear the lobby! Order. The question is that the | :19:09. | :20:29. | |
original word standard part of the question. | :20:30. | :20:32. | |
Tellers for the noes, Christopher Pincher at. | :20:33. | :31:45. | |
The ayes to the right, 209. The noes to the left, 295. Their eyes to the | :31:46. | :32:16. | |
date, 209. The noes to the left, 295. Then nose have it. Then nose | :32:17. | :32:29. | |
habits. The question is that the proposed words be added. Those of | :32:30. | :32:36. | |
that opinion they ayes. On the contrary, no. I think their eyes | :32:37. | :32:43. | |
have it. The question as amended to be agreed. | :32:44. | :32:52. | |
We now come to point of order, Margaret Greenwood. If people wish | :32:53. | :33:03. | |
to have a conversation, they should go somewhere else. The honourable | :33:04. | :33:09. | |
lady is making a point of order. Thank you. The Minister told a House | :33:10. | :33:16. | |
there were no Labour backbenchers, in actual fact he has inadvertently | :33:17. | :33:20. | |
misled the House because I spoke in the debate and was a member that | :33:21. | :33:27. | |
lack and the Member for Google spoke in the debate. I just wanted to set | :33:28. | :33:32. | |
the record straight. I understand her point of order. I understand why | :33:33. | :33:39. | |
she wishes to make the point. It looks as if the Minister would like | :33:40. | :33:42. | |
to say something to that point of order. I am very grateful for | :33:43. | :33:50. | |
complete clarity with their eyes. There were two members present in | :33:51. | :33:55. | |
interventions but made no speeches interventions but made no speeches | :33:56. | :33:59. | |
or substantial contributions from Labour members present. I am sure | :34:00. | :34:05. | |
the House are thankful to the Minister or clarifying what he said | :34:06. | :34:09. | |
in his speech and to the honourable lady for clarifying higher position. | :34:10. | :34:17. | |
The matter is now closed. -- her position. We come to motion number | :34:18. | :34:20. | |
three on local government. The division is deferred until | :34:21. | :34:39. | |
Wednesday next. We come to motion number four on local government | :34:40. | :34:44. | |
Minister to move. The question is as the order paper, many of that | :34:45. | :34:50. | |
opinion say aye. The contrary, no. The ayes have it. The ayes have it. | :34:51. | :35:02. | |
Petition, Mary Craig. Thank you very much. Rise to make a petition 2000 | :35:03. | :35:07. | |
residents of Wakefield on the future of the health centre in my | :35:08. | :35:14. | |
constituency, whose GP service is at threat of being withdrawn, a very | :35:15. | :35:20. | |
important issue for my constituents. I urge the government and Wakefield | :35:21. | :35:24. | |
clinical commissioning group to take all necessary steps to ensure King | :35:25. | :35:30. | |
Street health centre remains open and has current contracts for GP led | :35:31. | :35:34. | |
services extended to allow Wakefield residents continued access to health | :35:35. | :35:35. | |
care. Petition, the future of King Street | :35:36. | :36:01. | |
Health Centre, Wakefield. Petition. My petition comes from | :36:02. | :36:12. | |
dozens of residents in Salford. The humble petition of the residents | :36:13. | :36:18. | |
of Salford showing that they would prefer the inhabitants of some boats | :36:19. | :36:22. | |
moored on the River Avon to refrain from staying for long periods of | :36:23. | :36:26. | |
time. Your petitioners pray that your honourable house ask Her | :36:27. | :36:30. | |
Majesty 's government to consider the opinions of local residents and | :36:31. | :36:34. | |
boat owners in this. Petition, boat moorings on the River | :36:35. | :37:01. | |
Avon. I beg to move this House to an | :37:02. | :37:05. | |
allergen. The question is that this House do now adjourned. | :37:06. | :37:10. | |
Thank you, Madam Deputy Speaker. In the previous parliament, we took | :37:11. | :37:19. | |
action to empower local doctors, surgeons and clinicians to look at | :37:20. | :37:24. | |
how hospital services were going to be provided, to think about the | :37:25. | :37:34. | |
optimum weight to provide these services and ever-changing | :37:35. | :37:35. | |
circumstances, namely demographics, and other changes that are taking | :37:36. | :37:42. | |
place in our society. That was the right step to take, rather than | :37:43. | :37:46. | |
promote civil servants in Whitehall making these decisions, we wanted to | :37:47. | :37:51. | |
make sure that the people at the coal face of providing these | :37:52. | :37:56. | |
services, people who were providing services to our constituents, people | :37:57. | :38:00. | |
with medical expertise, people who have dedicated their lives to | :38:01. | :38:02. | |
improving the care and safety of others that they were empowered to | :38:03. | :38:09. | |
make these decisions. I stand by that decision that we took, and I | :38:10. | :38:13. | |
want to tell the Minister this evening some of the practical | :38:14. | :38:17. | |
problems that have ensued in Shropshire as a result of that | :38:18. | :38:23. | |
devolution of power. I want to raise it with the | :38:24. | :38:27. | |
Minister, because I believe in this process, and I want to ensure that | :38:28. | :38:32. | |
it is retained and protected for future programmes in the future. In | :38:33. | :38:36. | |
Shropshire, we have two orbitals, one in Shrewsbury, one in Telford. | :38:37. | :38:43. | |
-- two hospitals. They look after all the people throughout the whole | :38:44. | :38:47. | |
of Shropshire and mid Wales. I'm not going to go into all of the | :38:48. | :38:52. | |
specifics with the Minister here this evening, because as he will | :38:53. | :38:59. | |
know, I and the other Shropshire MPs have briefed him repeatedly over the | :39:00. | :39:02. | |
last few days, weeks and months about this process. I would like, | :39:03. | :39:08. | |
however, Madam Deputy Speaker, to thank, with genuine heart-throb way, | :39:09. | :39:20. | |
the health workers in Shropshire... Have been able to dedicate | :39:21. | :39:36. | |
themselves and to persevere despite many problems and obstacles in their | :39:37. | :39:40. | |
way in coming up with these proposals for a reconfiguration of | :39:41. | :39:48. | |
A services in Shropshire and mid Wales. A decision has been achieved | :39:49. | :39:54. | |
after three years, and ?3 million of taxpayers money being spent on this | :39:55. | :39:59. | |
process, a decision was achieved. And that decision was going to go to | :40:00. | :40:04. | |
public consultation. Unfortunately, it has been blocked by Telford CCG | :40:05. | :40:13. | |
and Telford Council. Telford CCG have been part of this process from | :40:14. | :40:18. | |
its inception, and they were consulted throughout, but at the | :40:19. | :40:23. | |
11th hour when the decision did not go the way they thought it would, | :40:24. | :40:27. | |
all the way that they wanted it to do, they decided to a man to vote | :40:28. | :40:34. | |
against the proposals. Although they were party to the whole methodology | :40:35. | :40:41. | |
and process. In addition to Telford CCG voting against these changes, | :40:42. | :40:46. | |
Telford Council, an esteemed body no doubt, but a body with I would argue | :40:47. | :40:52. | |
limited medical experience, has decided to threaten the programme | :40:53. | :41:01. | |
with a judicial review, if they dare allow the public to have this final | :41:02. | :41:06. | |
public consultation. Of course, in a democracy, Telford | :41:07. | :41:11. | |
Council has the right to challenge things. Of course, in a democracy, | :41:12. | :41:15. | |
Telford Council may even have the right to use taxpayer money to | :41:16. | :41:20. | |
instigate a judicial review come about what the Minister must | :41:21. | :41:27. | |
remember and retain from our own experience is these two parties were | :41:28. | :41:32. | |
part and parcel of the whole process from its inception. And I have a | :41:33. | :41:37. | |
real and genuine concern going forward about the integrity of this | :41:38. | :41:43. | |
process if we do not back the local clinicians and doctors. I give way | :41:44. | :41:49. | |
to my hard-working neighbour from Telford. | :41:50. | :41:51. | |
I think the honourable gentleman for bringing forward this debate, and I | :41:52. | :41:54. | |
have to say that I have tried also to get a similar it entitled debate. | :41:55. | :42:00. | |
Will he agree with me that the Telford clinicians have an absolute | :42:01. | :42:03. | |
right to express their views just the same way as the Shropshire | :42:04. | :42:06. | |
clinicians do, and the fact they did not come up with the same view is no | :42:07. | :42:11. | |
indication that the Shropshire clinicians came to the wrong view? | :42:12. | :42:16. | |
As I alluded in my earlier speech, of course they have the right to do | :42:17. | :42:20. | |
so, and may I take this opportunity of acknowledging the work that my | :42:21. | :42:24. | |
honourable friend has done since she became a member of Parliament to | :42:25. | :42:31. | |
campaign for Telford, and also to campaign very strongly and | :42:32. | :42:35. | |
effectively on this issue, but without being overtly political, and | :42:36. | :42:39. | |
without adversely personalising this like some other people have done so. | :42:40. | :42:44. | |
And I will come onto talking about the CCG a little bit later. My | :42:45. | :42:50. | |
concern, I have to say, is, and I will reiterate this, we all put our | :42:51. | :42:53. | |
cards on the table. We all went along with this process. This | :42:54. | :42:59. | |
decision could have gone against Shrewsbury. Ultimately, they have | :43:00. | :43:02. | |
decided that they want to have an urgent care centre in Telford, and | :43:03. | :43:08. | |
they want the main A service to be provided by Shrewsbury. It could | :43:09. | :43:12. | |
have gone the other way. That could have been for Telford. We would have | :43:13. | :43:17. | |
lost out. But at the end of the day, it shouldn't be about winning or | :43:18. | :43:20. | |
losing, and this is the biggest problem. My honourable friend from | :43:21. | :43:24. | |
North Shropshire has talked about the pillow fight that has existed | :43:25. | :43:27. | |
between Shrewsbury and Telford ever since he became an MP. Certainly, | :43:28. | :43:33. | |
over the last 11 years, I have lost more sleepless nights over it than | :43:34. | :43:37. | |
anything else, the constant fighting between Shrewsbury and Telford over | :43:38. | :43:41. | |
hospital services. At the end of the day, we are one county, we are one | :43:42. | :43:45. | |
county, and we must fight collectively as one county for all | :43:46. | :43:51. | |
of the people of Shropshire. And of course, our friends from across the | :43:52. | :43:54. | |
board in Wales, I give way to my honourable friend. | :43:55. | :44:00. | |
I congratulate you for this debate. He is absolutely right. The | :44:01. | :44:04. | |
bickering between trees breathe and Telford has opened my nearly 20 | :44:05. | :44:13. | |
years in Parliament. I thoroughly back FutureFit. We will get a ?300 | :44:14. | :44:22. | |
million emergency care centre for my rule areas, but we will also gain | :44:23. | :44:30. | |
with care centres Imrul areas. What is utterly is spreading is the | :44:31. | :44:39. | |
indecision we have had. -- rural. I very much hope the end of this | :44:40. | :44:45. | |
debate will give us a clear recommendation for a decisive | :44:46. | :44:47. | |
mechanism to deliver the will of the local commissions. | :44:48. | :44:52. | |
I couldn't agree with my right honourable friend more. I would like | :44:53. | :44:54. | |
to pay tribute to him in the work that he has done on this over the | :44:55. | :45:01. | |
last few years. In order to continue, I would like the Minister | :45:02. | :45:06. | |
to intervene to ensure that the process allows for a decision. In | :45:07. | :45:13. | |
our case, what happened is that all the members of the Shropshire CCG, | :45:14. | :45:19. | |
six numbers of the Shropshire CCG, voted for the proposals. All the | :45:20. | :45:23. | |
members in Telford voted against. It was | :45:24. | :45:35. | |
The local two CCGs cannot come to an agreement, so I would like to hear | :45:36. | :45:56. | |
from him on that. I would like to appeal to constituents from the | :45:57. | :46:00. | |
whole of Shropshire and mid Wales to lobby Telford Council and others. | :46:01. | :46:06. | |
Let's start to get behind, as my right honourable friend said, let's | :46:07. | :46:09. | |
start to get behind the concept of all of us working together to lobby | :46:10. | :46:15. | |
the government more effectively for more resources, rather than fighting | :46:16. | :46:21. | |
one another in a rather parochial way as to where these services are | :46:22. | :46:26. | |
going to be. Let's not forget how close these hospitals are to one | :46:27. | :46:30. | |
another. We're not talking about 50 miles, we're not talking about 30 | :46:31. | :46:36. | |
miles or 20 miles, somebody may correct me if I'm wrong, but I think | :46:37. | :46:42. | |
they are only 13 miles apart. 13 miles apart, these two hospitals. We | :46:43. | :46:47. | |
ought to think about how to improve and modernise the provision of | :46:48. | :46:51. | |
health care for all of the people of Shropshire and mid Wales going | :46:52. | :46:55. | |
forward. And listening to the proposals of these medical experts | :46:56. | :47:00. | |
who have done so much work to put these proposals forward. I give way | :47:01. | :47:06. | |
very quickly. A quick point, and I thank our | :47:07. | :47:09. | |
honourable friend for bringing this debate forward. I represent | :47:10. | :47:22. | |
constituents in Powys in Wales, who are without a General Hospital, | :47:23. | :47:24. | |
relying heavily on Telford and Shropshire. Shropshire is at the top | :47:25. | :47:42. | |
end of my constituency. I urge consideration for my constituents. | :47:43. | :47:45. | |
I thank my honourable friend for that intervention. He is absolutely | :47:46. | :47:48. | |
right. My honourable friend from just a cross the border, we almost | :47:49. | :47:59. | |
think of him as a solo paean, almost. Not quite. He does so much | :48:00. | :48:05. | |
to represent his constituents in Wales, and by the way, have two | :48:06. | :48:09. | |
already travel rather long distances to get to the Royal Shrewsbury | :48:10. | :48:12. | |
Hospital. My honourable friend may correct me if I'm wrong, but I think | :48:13. | :48:16. | |
some of his constituents from the extreme west of his constituency | :48:17. | :48:26. | |
already take over an hour to get to A services in Shrewsbury. Some are | :48:27. | :48:32. | |
even further away from Shrewsbury would be an acceptable for his | :48:33. | :48:36. | |
constituents. I give way very briefly for the last time. | :48:37. | :48:41. | |
I come from a peripheral position, but to congratulate the member onto | :48:42. | :48:46. | |
Cubist Dabiq. The importance of getting this right has an impact | :48:47. | :48:50. | |
further west. If the issue is resolved, it would impact on my | :48:51. | :48:57. | |
District Hospital in Aberystwyth. It is important this issue is | :48:58. | :48:59. | |
addressed. I completely concur with the | :49:00. | :49:01. | |
honourable gentleman. I am grateful for his intervention. I would like | :49:02. | :49:06. | |
to end because I want to give as much time as possible for the | :49:07. | :49:09. | |
Minister to answer these questions by saying, let's not forget that if | :49:10. | :49:17. | |
we get this right this could potentially result in an investment | :49:18. | :49:23. | |
of ?300 million into the NHS and Shropshire. I don't know about my | :49:24. | :49:28. | |
colleagues, I know my honourable friend from North Shropshire has | :49:29. | :49:32. | |
been an above Parliament longer than I, but I certainly don't remember a | :49:33. | :49:36. | |
time in my 11 years as a member of Parliament where we have had such an | :49:37. | :49:42. | |
investment in the local NHS. If we get this right, we could see an | :49:43. | :49:47. | |
investment of ?300 million in Shropshire in order to implement | :49:48. | :49:54. | |
these changes. There is more work to be done in terms of securing this | :49:55. | :49:57. | |
money. More work will have to be done in innovative ways, both | :49:58. | :50:01. | |
locally and nationally to secure all of the funding, but if we don't sort | :50:02. | :50:07. | |
ourselves out, we are going to be further hind. Other areas in the | :50:08. | :50:16. | |
United Kingdom, who are going through this process -- behind, in a | :50:17. | :50:22. | |
more cordial and mutually effective way of going to jump the queue. | :50:23. | :50:27. | |
Shropshire will be left right at the end. That's something I am not heard | :50:28. | :50:33. | |
to see happen. Finally, Madam Deputy Speaker. Telford Council would have | :50:34. | :50:39. | |
you believe, obviously, that as part of this programme, clearly, women | :50:40. | :50:43. | |
and children services have to be moved from Telford to Shrewsbury, | :50:44. | :50:52. | |
because the main A will have to have women and children services | :50:53. | :50:57. | |
next to the main A provider at the Royal Shrewsbury Hospital. They say, | :50:58. | :51:03. | |
and this is an important point, because the services were moved from | :51:04. | :51:06. | |
Shrewsbury to Telford a few years ago, such a move would lead to the | :51:07. | :51:12. | |
waist of ?28 million, and they repeatedly talk about that through | :51:13. | :51:16. | |
the local media. No, no, no. It is not a waste. The building will be | :51:17. | :51:23. | |
used for other purposes, and all of the equipment already in that | :51:24. | :51:28. | |
building, which is easily moved will be moved to the Royal Shrewsbury | :51:29. | :51:33. | |
Hospital. So I refused any proposals that there has been a waste of the | :51:34. | :51:38. | |
?28 million because of the changes that will take place. I give way, | :51:39. | :51:42. | |
finally, to my honourable friend. Subtitles will resume on | :51:43. | :54:17. | |
'Wednesday In Parliament' at 2300. | :54:18. | :55:37. |