10/01/2018 House of Commons

Some points of order. It wouldn't be

a full day without a point of order

from Angus Brendan McNeill.

I

congratulate you on your

pronunciation. By the opposition and

the panellists talked of the NHS

seemingly unaware there are four NHS

services in the UK. I am looking for

your guidance what can be done to

assist knowledge and accuracy in

senior parliamentarians in the

Chamber. Or is this just the English

Parliament?

If I didn't know the

honourable gentleman as well as I

do, I would think that he was being

mischievous. But I can't imagine

that he would behave in that way.

But I am on the one hand flattered

of the exhortation by the honourable

gentleman in his point of order. On

the other hand, at least a tad

intimidated for the idea that the

chair can be expected to insist

amongst any member, or any group of

members, upon knowledge and

accuracy. Is I think and unrealistic

ambition on the part of the

honourable gentleman. That is not a

matter for the chair, members take

responsibility for their statements

but insofar as the honourable

gentleman seeking to draw attention

to what she regards as the

sensuality of the Scottish health

service, adding he has accomplished

his objective, or even the plurality

of services which she witters from

his position, I think he has a

conflict is objective.

I seek advice

on how best to raise the issue of

Cancer treatment in Oxford with the

Minister responsible. This seriously

terminally ill patients face delays

and cuts to services at the asked

them. Cancer doesn't wait.

First of

all, the matter was at least raised

at Prime Minister's Questions today

with considerable force, albeit not

by the honourable lady on this

occasion. Secondly, I know the

honourable lady won't take offence,

I was looking mean a thing --

meaningfully at and keen to call her

on a question, admittedly not of the

cancer services minister, but of the

Prime Minister. But the honourable

lady in a uncharacteristic display

of reticence did not respond to my

exhortation is our to to her feet at

that time. Thirdly, what I would say

to the honourable lady is

notwithstanding health questions a

considerable distance away, business

questions are tomorrow and if the

honourable lady wishes to meet from

her seat with alacrity to put a

question on this matter to the

leader of the House, she can.

Finally, if she applies for an

adjournment debate, she might be

successful.

I hope you might be able

to advise me on how I can ascertain

Government policy and action on an

urgent matter which affects my

constituents in Norwich. Hundreds of

potential job losses could take

place with the closure of the

Commons mustard factory and Britvic

factories in my constituency. I have

asked ministers to come to meet

workers at the highly profitable

factory. I understand he is still in

his place at the Department but a

number of new ministers and junior

ministers whose responsibilities we

do not know. -- Colman's muster. --

mastered.

I thank him for his advance notice.

I say that's with great seriousness,

the importance to the honourable

gentleman and his constituents. On

the specific matter, which of the

new material team has responsibility

for that matter, it is constantly --

customary to publish from time to

time a list ministerial

responsibilities and it would be

helpful to both sides of the House

perhaps, is the responsibilities

within departments could be publicly

clarified as soon as possible.

Meanwhile, his concern is on the

record and I am sure it will be

noted on the Treasury bench.

Secondly, I say on the back of my

own experience as a member before I

became Speaker, my advice to him in

seeking a visit is, processed, man.

Processed. Make -- persist. Keep

going, keep asking, keep requesting,

put the matter in the mind of

ministers. By making a nuisance of

myself as a backbencher, more often

than not I got at least a

significant share of what I was

looking for for my constituents. A

point of order.

This point of order

is in pursuance to the point of

order and made last night which you

gave good, clear suggestions on. I

now understand the Secretary of

State has issued a statement but not

an official statement and wondering

whether or not given the words

spoken on the 6th of December you

have heard from the Secretary of

State as to whether or not he

intends to come back to rectify the

record?

The short answer is I have

received no indication of any

intention on the part of the

Minister to make a statement on this

matter. Reference to the matter was

I think made by the Chancellor of

the Duchy of Lancaster and Minister

for the Cabinet Office during his

Question Time session. I think there

is an indication to the honourable

gentleman as to how the Government

intends to proceed on this matter.

That may not satisfy him but that is

what we have got at present.

Moreover, it will not be beyond the

sagacity of the honourable gentleman

and some of his colleagues similarly

exercised about this matter to

highlight their concerns during the

report stage of the EU Withdrawal

Bill. I look forward with dated

breath, eager anticipation and beads

of sweat on my brow to hearing the

honourable gentleman expresses

concern for the simple reason that I

intend to chair the bulk of those

sessions on each of the two days,

the 16th and 17th of January. Much

excitement awaits me. There is a

further point of order.

In the

answer to my question on the half of

my homeless constituents who is also

a foster carer, the banister

appeared to suggest there was some

doubt she would be de-registered as

a foster carer because of her poor

homeless accommodation. Can confirm

she has been de-registered for that

reason and how would I put that on

the record?

The honourable lady has

achieved our objective, it will

appear in the official report and

the honourable lady wishes to send a

personalised and sang copied to the

premise, it is open to her to do so.

If there are no further points of

order, we come to the ten minute

rule motion, John...

I beg to move

that leave the given for me to bring

in the planning agent of change Bill

to require specified planning

control is in relation to

developments likely to be affected

by existing sources and connected

purposes. This Bill is the science

to protect existing music venues

from college from crippling cost

arising from residential property

developments in their area are

particularly nice. This has been

campaigned on for some time. Over

one third of music venues are closed

over the last decade estimated.

Members of Parliament have examples

of much loved venues in their area

closed are under threat. That is why

there has been cross-party

widespread support. Many turned out

at this morning 's photocall. This

was also raised on the 3rd of

November on the adjournment debate

by the Member for St Helens North.

Sir Paul McCartney and some of the

music greats have said without the

grassroots public cousins, clubs and

music venues my career would be very

different. If we do not support

music at this level,... Grassroots

public Houses. Redundant, commercial

or industrial premises are converted

to residential or indeed are knocked

down and rebuilt or as empty sites

are developed. Of course, much of

this is very welcome. It is part of

the regeneration of our inner

cities, restoring their historic

vibrancy and also creating

much-needed homes. However, it can

sometimes lead to the loss of what

makes parts of those areas

attractive in the first place.

Especially to younger residents.

Incidentally, that doesn't just

apply to music venues, but to the

wider fabric of inner-city life and

there are important questions as to

how we preserve the vibrancy and

diversity of city life more

generally across our main

conurbations. However, my short Bill

is more modest and focused as a

mission, adopting the principle of

agent of change into planning law.

What that basically means is that

when buildings are converted to

residential use or a new development

put up the onus is on the developer

is not the venue to ensure the new

talent are protected from factors,

particularly nice, which could be

held to affect their general and

energy and enjoyment.

Bristol is a city where I am

informed has more office to

residential convergence than

anywhere else outside London. Two

other sponsors the members for

Cardiff West and Central have been

supporting the save woman be street

campaign along with the members

Cardiff North and South and Cardiff

South and Penarth. That has led

directly to the adoption of the

agent of change principle across

Wales, welcome adoption by the Welsh

Labour government. Another sponsor

met the member for Somerton and

Frome is concerned to protect a

value -- a much valued venue in

Frome. The Mayor of London with

London grassroots music venue rescue

plan will be introducing an agent of

change rule into the next London

plan. As I mentioned the Welsh

Government announced a summer move

and it's already under consideration

by the Scottish Parliament. My bill

will provide the legislative

reinforcement. What my bill is

aiming to do is to give greater

clarity and powerful local councils

and the planning inspector to

incorporate this principle into

planning decisions. So why was I so

receptive to this idea and why is

there such strong public support?

Because it matters. It matters for

those who enjoy the entertainment

than to whom it opens up new

horizons. And obviously for the

staff and owners of the venues. But

it matters a lot more than that and

not just for the nearby late-night

kebab shops. For a start it's impact

on musicians. This is why the bill

is being supported by the musicians

union. Less venues means less work

and opportunity to develop talent.

But also to move from amateur to

part-time to full-time professional

to national or even international

stardom. Just talking to dated Billy

Graham mentioned to me that three

times he tried to move from other

ordinary job to being a full-time

musician and it was the existence of

the clubs and pubs and venues that

enabled him to actually finally make

it onto the national stage. We are

in danger of taking away the ladder

that has served individual musicians

and the music industry so well for

so long. And what an industry. Not

only domestic sales rising again, we

are second to the US in

international sales. It's a huge

boost to Britain's standing around

the world and our soft power not to

mission millions in other seal sales

last year. Let alone it being a

significant part of our tourism.

There is a real concern that the

industry is now depending on a great

past with the loss of grey hair

around. I am in favour of good

representation of good here but also

I support refreshing the industry

with new talent. There is a danger

of mining rather than farming our

musical heritage and it's also

narrowing a route of opportunity for

your working-class youngsters. As a

West Woodlands MP I am proud to

represent part of the area which

gave birth to heavy metal however, I

recognise how damaging the loss of

venues can be to smaller towns.

Retaining youngsters and slowing the

just to the city. All those factors

are important. Another factor makes

it imperative. Either from

Parliament or the government given

the wide level of cross-party

support from ex-ministers as well as

government members I hope the

government will adopt this measure

and helped to push it through. That

factor is Brexit. As Brexit is

happening and we face an uncertain

to check its vitally important that

Britain is made more efficient and

effective across-the-board and we

maximise every possible advantage

that Britain has. One of these is

clearly our cultural and

entertainment offer but only London

but in our other great centres

around the country. Many of which

are like Birmingham and Manchester

attracting increasing foreign

investment although Birmingham is

the best venue for Channel 4. The

quality of life is also significant.

It's partly about personal safety,

environmental quality, but it's also

about the answer to the basic

questions would I want to live

there? That is a question not only

the companies but also for the staff

they are seeking to attract.

Especially the highly mobile

technically skilled and talented

international and multinational

workforce not least in our huge

creative sector. But culture and

living environment is important to

them. That means art galleries,

theatres, football clubs, other

sporting environments but it also

mean music venues and the street

scene. It poses a question to those

who are being enticed to move abroad

after Brexit, would you and your

family and your employees prefer to

live in London, Birmingham

Manchester or in Frankfurt? This

measure I hope will provide some

small but useful assistance provided

industry and I commend this bill to

the House.

The question is that the

Right Honourable member had leave to

bring in the Bill. As many of that

opinion say I. To the contrary now.

The eyes have it. Who will prepare

and bring in the Bill?

Kevin

Brennan, said Greg Knight, Pete

Wishart, Joe Stephens, Esther Edward

Vaizey, Kerry McCarthy, David

Warburton, Conor McGinn. Mr Nigel

Evans, and myself.

Mr John speller.

Planning agent of change Bill.

Second reading. Friday the 19th of

January. A very good day, my

birthday.

We now come to the first

opposition day motion on the NHS

winter crisis. To move the motion I

called the Shadow Secretary of State

for Health, Jonathan Ashworth.

I beg

to move the motion in the name of my

right honourable friend the Leader

of the Opposition and myself. I

begin by paying tribute to the

extraordinary efforts of our NHS and

social care staff for all of their

work this Christmas and New Year.

They continue to do all of us in

this House proud. It's almost a year

since the House debated the National

Health Service following the

Christmas and New Year break. A year

ago we debated winter pressures with

a backdrop that had been

characterised by the Red Cross as a

humanitarian crisis. Here we are a

year later again. Debating a winter

crisis worse than last year. A

winter crisis described as even

worse than last year. He goes on, in

some cases I've heard of 50 patients

in an emergency Department waiting

for a bed. We have to try and manage

them as best we can. In cold dusty

corridors while dealing with new

emergency patients. His words. His

words backed up by the realities on

the ground revealed in the weekly

reports of what is happening. Since

the start of this winter over 75,000

patients waited for over 30 minutes

in the back of a numberless. Over --

almost 17,000 patients waited over

60 minutes and this is despite NHS

improvements directed last year that

emergency departments should accept

handover of patients within 15

minutes of a numberless arriving. I

will give way.

Does he recognise the

pressure across the system. In Arrow

Park on the Wirral they put 48 extra

beds available for the winter crisis

and in the event they had to make 40

extra beds available by cancelling

all elective surgeries. Does he

believe this is the way to plan for

the winter and does he believe that

the Department of Health made robust

and appropriate plans?

She speaks

eloquently about the pressures on

her local hospital but she will also

be aware of how foolhardy it would

have been to close the walk-in

centre on the Wirral which was

proposed closure because there

wasn't enough staff at Daryl Clark

hospital. Because of her campaign

that eastern walk-in centre has been

saved because of Labour MPs working

in the constituency.

King's College

Hospital in my constituency, one of

the largest in the country, has been

taken into financial special

measures. With my right honourable

friend agree with me that the

failure of Kings is a canary in the

for the NHS and must be a wake up

call for the government on the level

of resources the NHS staff need and

Willie join me and calling on behalf

of Secretary to ensure Kings emerges

from financial special measures with

the additional funding it needs to

deliver safe and effective care for

patients?

She has been a passionate

defender of Kings, speaking out in

this House on numerous occasions.

Before Christmas we saw the

resignation of the chair and he

spoke out about the real pressures

facing our NHS. I will give way.

It

was under a Labour government that

the walk-in centre closed but I

don't seek to blame the Labour

government because it was a local

decision that was made by local

practitioners. Would he at least not

agree in the spirit of trying to

build some sort of sensible debate

about our NHS instead of always wet

amazing it that this government has

put in an extra £437 million

specifically for the winter period.

Would he not at least give the

government credit for that planning

we have never seen before?

The

honourable lady was former Health

Minister and she will know that in

our local hospitals 771 patients

have waited longer than four hours

on trolleys not able to get a bed.

She talks about winter many but we

were calling for winter emergency

money back at the general election

and repeated those causing

September. That didn't many did not

come through until the November

budget and hospital trusts were not

told about the allocations before

Christmas. That is no way to prefer

if the winter. When she was Health

Minister she would have been saying

that that officials in her

department.

But the point is, for

the first time the government has

done everything it possibly could

because no government can predict

what the weather may be like or

indeed the uptake of flu

vaccinations and it is wrong to

suggest that this is the fault of

the government in England when this

has been a problem across the whole

of the UK including Scotland and

Labour run Wales.

We have had eight

years of sustained underfunding in

our NHS because of decisions by this

government that she was a member of

until very recently.

I refer to the

comments made to the health select

committee by Jim Mackie back at the

start of October three months ago.

He told the select committee it's

true we are running tighter than any

of us would want and we have not had

the impact from the social care

investment this year we would have

hoped for so it will be difficult

and very tight over winter. This

government knew what was coming and

yet they have let the whole country

down.

Pointing out the response of Tory

members saying this was not

predictable. This was not

preventable. This winter crisis was

predictable.

And patients were left in ambulances

for more than 30 minutes outside

Kingsmill hospital between the week

of the 25th and 31st of December,

one and 40% of those arriving by

ambulance that week. That's my

honourable friend agreed those

patients and families deserve any

apology and a promise that will

never happen again. I have absolute

praise for the staff at Kingsmill.

That is remote first daughter was

born, in fact but the way patients

have had to wait for ambulances is

entirely unacceptable. Let me make

progress. I will try to take as many

interventions as possible, a half

day debate and I know a lot of

people want to get in and speak. We

have the stories of ambulances, 150

times they have been diverted away

from gridlocked A & E departments.

Occupancy levels running at unsafe

levels. Over one third of England's

children's care units 100% fall on

Christmas Eve with not a single

spare bed. Reports of whole

children's wards being used for

adults. We do not know the full

scale of the crisis because this

year NHS England is not reporting

which hospital trusts have reported

the so-called bubble alerts. I hope

he will explain why the Opal data is

not published as it has been done in

recent years. Every one of these

statistics is a real human story.

Stories of elderly fragile patients

treated in the backs of ambulances

in freezing January. Patients

language and -- languishing in

hospitals on trolleys. Such is the

80-year-old epileptic man waiting to

be treated. His daughter, Jacki

Weaver, said it was absolutely

horrendous. You couldn't get past

all the trolleys.

67 people sitting

on trolleys. We ran out of corridor

space. 200 people medically fit for

discharge with nowhere to go. The

pressure on my constituents and

those of my honourable friend in

North Staffordshire was appalling

but also the pressure on the staff

who had to cope with looking after

these patients, my consecutive --

constituents deserve better, we need

money for social care and needed at

last year. -- Opel data.

That is a

moving contribution. The people

whose relatives are waiting so long

in corridors, when they hear the

Prime Minister Singh, nothing is

perfect, I think the truth is we do

not want perfection, just a bit of

dignity and humanity. -- when they

hear the Prime Minister saying.

I

went out on a shift with a ambulance

Crewe, they said they were awaiting

two hours or more other side of A &

E at Lincoln. One paramedic was

going in, in resuscitation, he was

clerking patients. What does the

honourable gentleman think of that?

What we will do?

A powerful and raw

contribution to our proceedings

because she was working over the

Christmas holiday at the front line

in Lincoln and I pay tribute to her

and her colleagues in Lincoln. I

hope the finest reflects upon the

contribution and response to it.

The

stories are indeed heartbreaking. No

one wants to see that for their

constituents are a relic --

relatives. Will the Minister

recognising welcome the investments

made into the elderly and frail

unit, I have seen that in my

hospital and it has made a massive

difference. Too early to tell it has

solved the problems and we want to

do more of course but that is making

a real difference on the ground. As

well as the additional Government

funding of nearly £4 million that

was put in in time. That is also a

hospital that was in special

measures, the readership are turning

it around. Does he welcome the

practice helping our constituents?

Welcome examples of good practice

but I also share her frustration

that she has put on her own website

about the money taking so long to

reach the fund line. The money has

been approved, the frustration has

been the time the trust taking to

gain access to the money. The money

should have been announced sooner

for our NHS. I will try to make

progress. What about the story of

the 87-year-old who suffers from

dementia? She was at Worcestershire

Royal. Forced to wait ten hours in

hospital to see a Dr, had to be tied

into a wheelchair with a scarf after

her bed was taken away. At Southmead

Hospital in Bristol, we learnt they

have capacity of 104%. A leaked memo

yesterday revealed acute medical

units physicians have been on their

knees with workload pressures. At

the biggest risk remains patients in

corridors in the emergency

department with no allocated Dr, no

allocated bed, no treatment.

In my

local hospital in Barnsley, despite

the incredible effort of the staff

there, general and acute bed

occupancy reach 100% on the 31st of

December. Does he agree that these

safety targets are simply not being

met and that is not good enough?

Bed

occupancy levels at this level are

unsafe. And the Secretary of State

is committed to patient safety. He

has made it a signature issue apace

and yet is presiding over a health

service were bed can see --

occupancy is over 85%. We have heard

about the pressures in South

Yorkshire. What about West

Yorkshire? In a hospital ward in

Pinderfields where people were left

lying on the floor. A witness said

the man who was lying on the floor

at the bottom of my husband's that

was being sick, asking for a trolley

to lie on but there was not want to

give him. Dismissed in the House on

Monday by the then Minister is

saying there was enough chairs for

him to sit on.

I'm sure he will join

me in thanking the staff for their

gargantuan effort this winter had

over the festive period. Just this

week I spoke to a nurse at that very

same hospital who advised me they

had had to clear out the cleaning

cover to put a bed in there for a

patient to actually be in their

receiving an infusion. Does he share

my horror on what on earth are NHS

is becoming under this Government?

Beds in a broom cupboard. The Tory

NHS. Isn't it a disgrace? We have

had a long wait studs let me make

progress.

I am grateful. In relation

to the incident at Pinderfields

Hospital, completely unacceptable

people should be lying in corridors.

The hospital in fungi before I made

the statement on Monday that

patients concerned photograph had

been asked whether they wanted to

sit down and had decided not to.

I

am grateful that he has clarified.

Perhaps he should have done that on

Monday and still might be in place

as the Health Minister had he said

that on Monday. We have had huge

pressures on North East Ambulance

Services. Because of pressures they

are asking some patients if they

have alternative transport such as

family members. East of England

Ambulance Service and set some

patients were being sent faxes with

paramedics stuck in ambulances

chewing up for more than 500 hours

at hospitals. University Hospital

North the defence -- Midlands said

they have run out of corridor space

and said they have failed to

apologise for in his words third

World conditions. What is the

response of the Prime Minister and

Secretary of State? A perfunctory

apology and the blanket

unprecedented cancellation of

elective operations.

He mentions the

east of England Ambulance Service.

He will be aware of the elderly Lady

who lost their life waiting four

hours waiting for an ambulance to

arrive. Often as a result of

ambulances stacked up out of

hospitals. Does he agree these

intolerable incidents have to be

ended and to have a mature national

conversation about how we increased

the funding for our NHS and care

system to ensure people get care

when they need it?

I am entirely

happy to have a conversation about

how we increase the funding in the

National Health Service. But they

have huge scepticism that this

Government, having overseen eight

years of desperately tight funding

allocations for the NHS, cuts to

community health service are

prepared to engage constructively in

that conversation. On the specific

case he mention, I think the

honourable member for Clacton though

I cannot see in his place, apologies

if he is, has called for an enquiry

into that particular incident. He

has actually warned that if it was a

result of underfunding we need to

put funding into Ambulance Services

and I would share his concerns. Let

me make progress because I have been

generous. I am conscious it is a

half day debate. The consequences of

this crisis are not only to those in

urgent need, they are also to those

who are using the NHS, everyone,

because this panic cancelling of

elective operations means patients

will suffer. Not only will patients

suffer longer for operations whilst

in pain and distress, they will wait

for appointments with the

uncertainty of not knowing not to

know what is wrong with them, the

knock-on effects on NHS services on

the wider society are huge. Already,

patients are facing a waiting times

crisis with 4 million on the waiting

list. But a last month will mean

thousands of patients across the

country are stuck with their lives

on hold. To call this routine care

misses the fact that these are big

issues for those individual patients

affected. A young man awaiting heart

valve surgery will have to have

arranged for a time off work and his

family to be a ranting, to care for

him, now has to cancel all and does

not know when his operation will

happen. It also runs the risk of a

deterioration in his heart function

which could lead to further

hospitalisation in an emergency,

adding to the pressures on our

emergency service. Would he at least

recognised that the NHS is doing

more operations than ever before? In

my area of mid-Essex, and incredible

72,000 operations were carried out

last year, over 9000 more operations

than back in 2010. And will he join

me in thanking the incredible NHS

staff for the many, many more

outcomes that they are delivering?

Thank you. Yes, I will and they do

thank the NHS staff. Of course, if

she wants to thank the NHS staff,

she could have supported motions for

a fair pay rise. I don't think she

did.

I always follow his remarks

with a great deal of interest. Any

cancellation is appallingly bad but

does he understand the worst

possible cancellation is a

cancellation on the day of surgery,

which is clinically unacceptable.

Will he at least give the system

credit for at least trying to

introduce some sort of planning this

year, for the first time I can

remember since 1984?

The honourable

gentleman will know that the system

is in the state because of years of

sustained underfunding. I know his

response, his answer, is a

cross-party Commission, a sort of

Royal Commission, and I have huge

respect for his contributions on

these debates. Let's be clear, the

NHS has not been getting for eight

years the level of funding it should

be getting by historical terms.

Down

in Sussex, patients transport was

privatised and given to a company

called Copaforma. It was then

stripped for underperforming of the

contract in every way shape or form.

It has now transpired that they have

been given more money in seven

months than they would have a full

year. -- Coperforma.

Even if the

debate is allowed to run on, which

is in the hands of the usual

channels beyond four o'clock,

probably half loan to do so. I say

that now, I am not publishing a

list, we will just have to do is sit

and hope.

I will try not to take any more

interventions. This privatisation

was an absolute disaster. It was a

disaster for patients, for the

ambulance drivers who went eight

weeks without pay. He has been

campaigning on this as have the GMB

union and forest out to learn that

having entered this contract money

is still going and I praise my

honourable friend for leading this

campaign. I've talked about the

impact of cancelled operations.

It adds to the pressures on the

service. Somebody needs of cataract

operation and are now at risk

because they can see and they could

end up in AMD needing hospital bed.

These are real people who rely on

the NHS and whom the government is

letting down. I did say I would try

and make some progress. It's very

clear we have a lot of members who

want to speak. Now we are beginning

to hear it is not just routine

nonurgent operations being

cancelled. The Times today reports

of a hospital in Oxford considering

delaying the start of chemotherapy

due to staff salvages and lack of

capacity. A four-week delay on all

new patients needing chemotherapy

and there are proposals for those of

the first cycle to have full chemo

but then discriminate against those

on cycles to three and four giving

those patients number of cycles. A

two tier chemotherapy system. In the

Guardian today we read the story of

Carly O'Neill who entered the

hospital for a cancer operation, was

waiting in her down with wristbands

in the hospital, only to be told her

operation would have to be cancelled

because there wasn't a bed

available. Or how about my

constituent Mr Jeff Brooker who was

diagnosed with cancer of the

bladder. He had his planned

operation cancelled twice this

winter and when he was asked about

the apology from the Secretary of

State he said he may have apologised

for postponements but it was as if

he was opposed -- apologising for

the cancellation of a jumble sale.

Ministers were uncaring and he

blamed poor planning. He said if

operations like mine are postponed

its likely it will cause deaths. The

decision could even be the death of

me. Cancer patients having

operations cancelled. Trusts looking

at the laying chemotherapy and these

ministers said there and they should

be ashamed. I will give way for the

last time.

It is important that we

do not make a crisis where there is

not one. I have been assured by the

University hospitals trust today

that the leaked memo does not

represent the current reality. I

like him have concerns about

recruitment and I am worried about

the future of recruitment in the NHS

but it's important that we don't

current cancer patients who will

continue to receive their treatment.

The memo was e-mailed to staff in

the last few days. If the trust is

backing down on that all of us

across the House will welcome that.

But the point stands, the trust was

looking at the laying chemotherapy

and they referred to a lack of staff

because as we know this trust has

cast -- kept any beds in recent

years including cancer beds. I am

going to make some progress. We

don't want to make more -- this

moral crisis but cancelling

operations impact on hospital

finances. It means a loss of review

-- revenue footrests who are

struggling to meet their deficit

targets. Rather than allowing

waiting times to escalate further

why won't he today committed giving

hospitals emergency funds so those

cancelled operations can be

rescheduled as soon as possible and

hospitals do not lose the revenue

and get further into problems with

their deficits. They will also know

that cancellations impacts the

training of next generation of

doctors. So can he tell us if these

cancelled operations continue what

is his plan to ensure Junior doctors

and surgeons are able to catch up on

the training they need? Our patients

deserve the best trained doctors in

the world. Cancelling these

operations impact on the training.

We all agree that every penny counts

in rising to the winter crisis

caused by Downing Street. I know he

will tell us about the winter

funding but we also know that the

winter funding came too late and NHS

providers have ordered came too late

in December. Many hospital trusts

will be telling him privately that

it came too late. It also means

hospital trusts have to turn to

expensive private staffing, agencies

to get through the winter. In many

places NHS trusts effectively held

to ransom by staffing agencies. Last

month NHS improvement refused in a

request to publish how much these

private agencies accosting

individual trusts. Does he agree

this is unacceptable and that we

should now how much extra money set

aside for winter is going to private

agencies? Will he undertake to

produce a league table naming and

shaming every single agency and how

much they have been getting from

each and every trust. He will also

tell us that the problems we have is

because of an ageing society. Of

course because of the demographics

we see pressures on the service not

just that winter but only around

with patients being treated at this

time of year putting huge pressure

on the service throughout the year.

But these demographic changes in

society did not drop out of the blue

sky in the last few weeks. We have

known about these trends for years.

Which makes it even more criminal

that the government has presided

over eight years of underfunding in

the NHS. £6 million worth of cuts in

social care. That is why we have

seen delayed transfers of care

increased. And when it comes to

social care he may have the title

but he has no plan to deal with the

severe cuts we had over recent

years. What makes this winter crisis

even more serious is not just the

cats to social care or the

underfunding of the NHS is because

the crisis takes place against the

back drop of some of the most

serious and far-reaching neglect of

the health of our publishing

perpetrated on the people of this

country by more than a century. We

have a recognised authority on

public have warning that this

country has since 2010 stalled in

the task of improving the life

expectancy of our publish and and

the differences in life expectancy

between the poorest areas of the

country and most better off as

narrowed in recent years. This is

what happens with austerity and

cats. This is what happens when you

fail to invest in housing when you

fail to invest in the installation

of our housing stock, when you allow

fuel poverty to increase, when you

oversee falling incomes. The

shocking consequences the number of

hospital beds in England taken up by

patients being treated for

malnutrition doubled since 2010.

Isn't that a disgrace.

He is right

about one thing which is the issue

of demographic shift and the ageing

population is directly behind some

of the malnutrition figures. Is it

not the case that the failure to

plan for the rising and Asian

publish and didn't happen in the

last five years it's a failure of

the last ten to 15 years so he

should not pretend this has appeared

overnight.

We travelled the

investment in the NHS. And the

Labour government we had trolley

waits but what are the trolley waits

under this government?

This is not just a winter crisis.

This is an all-round funding crisis.

A year around social care crisis. A

year on health inequality crisis.

Manufactured in Downing Street by

this government. Eight years of

underfunding. 14,000 beds lost.

District nursing cut by three and a

half thousand. Mental health nurses

cut. GP numbers down. 40,000 nurses

short. Social care staff

demoralised.

In my borough of

Lewisham I were adolescent mental

health services are facing a budget

cut of up to 200,000 leaving

children not getting the children

they need. Will he agree with me

that the government has failed to

provide mental health services to

some of the most vulnerable in

society.

50% of children's mental

health services not with the money.

Yet we have this Secretary of State

in place. Isn't the truth doctors

and nurses have lost confidence in

him. Haitians have lost confidence

in him. The Prime Minister it seems

has lost confidence in him. He

fights for his own job but he would

fight for the NHS. Our patients are

crying out for change and they were

like that the Health Secretary still

in post today and see that to coin a

phrase that has changed, nothing is

changed. I commend our motion to the

House.

The question is as on the

order paper.

Let me start by saying

on behalf of the whole House a

massive thank you to all staff

across the health and care system

who went beyond the call of duty,

gave up their Christmases and new

years to keep patients say. Their

dedication makes the NHS the best

health care system in the world.

They demonstrated quite visibly

through the values constantly

putting the needs of patients before

there. But I am afraid that attempts

to politicise pressures on the NHS

are a serious mistake. The last time

the NHS had a really difficult flu

winter was 20 -- 2009 and he was

working in Downing Street at the

time. At the time the Shadow Health

Secretary refused to attack the

government because it was an

operational issue. Andy Burnham the

Health Secretary thanked him for his

measured tone so that together we

can give a reassuring message to the

public. Sadly I cannot say that

today. He says in some of the

extraordinary language he has been

using the NHS is on its knees so

let's look at the facts.

14,000 more doctors since 2010.

12,000 more nurses on awards. 5000

more operations every day. In A&E

's, 1800 more people being seen and

treated within four hours every

single day than 2010. I give way.

In

the note of sounding conservatory I

thank him for giving way. The Royal

Bolton Hospital made provisions for

the Christmas period but despite

that they have now had to cancel all

of their routine operations as well

as elective operations in trauma and

orthopaedics. I am told the 1st of

February 2018. Can I therefore ask

what provision and financial

assistance is he going to provide

for my local hospital so that they

don't suffer as a result of this?

We did provide an extra £1.4 million

for the hospital before Christmas.

Let me deal with the cancelled

operation, I agree it is a big deal

for patients who are told that their

planned procedure is going to be

postponed and no one wants to

minimise the distress that it

causes. But what happened last year

and what's happened in previous

winters that is operations have been

cancelled at the last moment and

that is much more distressing and

much more challenging for hospitals

to plan around that. So the decision

was taken to do this in a much more

planned way. We hope that over all

we will see fewer operations

cancelled at the last moment. But we

need to do it in a planned way.

I

can't myself for intervening,

somebody close in my family was a

person who was about to go into the

operating theatre last year. I came

to the Secretary of state about it

and I can tell you it wasn't a good

experience, it is much better

experience to be planning and giving

people notice and the emergencies

will happen, but those that can plan

ahead and we can have a better

system, I think that is a good move

that this Government has put in

place.

My honourable friend is right

and I hope she won't mind me saying

in her case it was a cancer issue

and one of the things that this

allows us to do is make sure we

don't have to cancel cancer

operations at the last moment that.

Moment. That is what we are trying

to do. I heard there was someone,

yes I will give way.

I'm grateful,

but intervene, when I had cancer

treatment, if my operation had been

cancelled I could have come to this

House and ask the Secretary of State

to intervene, but I'm speaking on

behalf a person who went to press to

talk about her cancer operation,

what can she say to her?

What I will

say is the instructions from NHS

England couldn't be clearer that

cancer operations should not be

cancelled. From the perspective of

the government and the NHS senior

leadership and should raise that

with me, because we want to preserve

the capacity for the people who most

need it. I will give way.

The

Secretary of State complains of

politicisation of the NHS, many

colleagues are offering a different

approach and a mature conversation

to come up with a solution. Lord

Saatchi and others are arguing for

the same thing. Will he embrace that

approach - a civilised approach that

comes up with a consensus for the

country about how we secure our

health and care system?

I have said

publicly that I think as we come to

the end of five year forward view,

we need to look to find a consensus

for the next stage for the NHS, we

will see need more funding, we need

to build a national consensus to

feigned that funding and my view is

we should do that for a ten-year

period. I'm open to all discussion

about the best way to do that, but

we heard from the shadow Health

Secretary that the party opposite is

not interested in being part of the

discussions and that is why it

illustrates how difficult it is to

make a consensus. I will make

progress. I want to look at what he

said about winter, he said that the

Government, the word he used, again,

he said the Government was sleep

walking into winter. This has been

contradicted by the medical of NHS

England, who said it is the one

winter we are best prepared for and

we started preparing a year earlier,

we have a good plan, Chris Hobson of

NHS providers who is regularly

criticising the Government, he said

this time preparations have never

been more thorough. Let's look and I

will make some progress and then

give way. A billion pounds into the

social care system. Because the

biggest lesson from last year was

that pressure in the social care

system was making it difficult for

hospitals to discharge. What has

been the result of that invest?

Combined with an extra £337 million

in the budget we have 1,100 hospital

beds freed up by reducing the number

of delayed transfers of care and

2,700 additional acute beds

commissioned. The shadow Health

Secretary said it is unacceptable

Nat 85% bed occupancy has been

missed. I said I will give way in a

moment. Secondly, because many

patients can be better seen by GPs,

in the spring Budget last year, £100

million of capital was allocated to

help hospitals set up GP streaming

services. In the year he said the

government was sleep walking, the

number of type one trusts with GP

streaming has tripled. And we also

made it easier for people to access

GPs and nurses over the Christmas

period and for the first time people

were able to get urgent GP

appointments. The number of 111

calls dealt with by a clinician has

increased to nearly 40%. That has

massively reduced pressures on A&Es.

I give way.

Thank you. I'm grateful.

Just draw to the Secretary of

State's attention the fact that we

continue to have no Northern Ireland

Executive. We have no local health

minister in Northern Ireland. So

there is a specific problem in

Northern Ireland. The NHS staff in

Northern Ireland are superb, but

they have been under enormous

pressure and the ambulance crews, it

is demoralising and wearisome for

them. This government must take some

responsibility in the continued

absence of Northern Ireland

Executive. Could he assure me and

tell me what recent discussions he

has had and with whom in Northern

Ireland about dealing with the

crisis in the NHS and the ambulance

crews in Northern Ireland?

Well, she

will understand, because I'm the

Health Secretary for England, I

haven't been having a lot of is

discussion about the situation in

Northern Ireland. But I don't want

to agree with her that it is

unhelpful for the NHS in Northern

Ireland if there isn't an Executive.

The former Northern Irish Secretary

and the House wishes him well with

his medical challenges, but he was

very engaged in trying to address

this and I know the new Northern

Irish Secretary will make it her top

priority, because it matters so much

for public services. I will give

way.

Thank you for giving way. He

doesn't want to get drawn into

Northern Ireland, but the Prime

Minister seems to be willing at

every opportunity to attempt to

smear the Welsh NHS. Spending in

Wales is 8% higher per head than in

England. It went un-4.5% last year.

We are putting funding up, but the

Prime Minister seems to suggest

otherwise.

Well, he forgets the

Barnett formula is the reason why

spending is higher in Wales. But I

have things to say about the

situation in Wales. I will oblige

him later. I will give way.

Could I

bring the Secretary of State back to

the point about the benefit of

having gap-led services in hospitals

to take the pressure off A&E and

commend Solihull hospital or the

doing that and with a reduction in

those, the winter pressures, the

examples that have been given and

could that be replicated across the

NHS?

This is what is so

disappointing about some of the tone

we have been hearing. We seeing

reforms that are making a real

difference and I commend what is

happening in Solihull, but the key

to solving the long-term pressures

on our emergency departments is to

be better at treating people in the

community and the van guard areas of

the NHS are seen their growth in

emergency admissions about half the

national average and this is the

five-year view that we are rolling

out. And I think we need to

celebrate where that success is. I'm

going the make some progress before

I give way further. Because there is

something important that we haven't

been talking about very much, which

is extremely relevant to people on

the NHS front line and that is flu.

We have had a much bigger spike in

flu cases this year, a much bigger

spike than we have had at any time

since the winter of 2009. But we

have the most comprehensive flu

vaccination programme in Europe and

this year it was made available to

people who are eight years and under

and to care home staff and the

result is that we have a million

more people vaccinated for flu this

year than in the year before. And

uptake among NHS staff is at 59.3%,

the highest ever. So I just say

this, because the honourable

gentleman seems to be trying to make

the case that no preparations were

made when the reality is that the

NHS could not have been working

harder to prepare for this winter.

And I want to make this point, the

result of those preparations is that

A&E performance having been

declining for six years in a row,

last year for the first time

according to the latest data,

actually stabilised. In the week

after Christmas, compared to the

year before we had fewer A&E

diverts, more calls to NHS 11. The

trolley waits which people have been

talking about and it unacceptable

for people to be left on a trolley

for a long time, but the November

figures show they were down three

quarters compared to the previous

November. A huge amount has been

happening.

Does he think that

patients being treated in cleaning

cup boards, six patients in four bed

bays without lockerser curtains or

call bells is a sign of good

preparation for the winter crisis.

It is unacceptable. But what is

disappointing that is she stands up

and runs down the NHS when her own

trust which received £3.4 million of

funding before Christmas to help

with winter has managed to improve

performance last November's figures

91.8%, compared to 77.7% a year

earlier. That is a huge achievement.

Why won't she praise what is

happening, rather than rung it down?

Very grateful and I support the

leadership he has offered for this

winter crisis and support the tone

he has been atopting in this debate

-- adopting in this debate and now

he has widened responsibilities for

social care, can he help west

Berkshire who have had problems with

past formulas and don't have enough

money to take the pressure off the

hospital in the way he would like?

I

will revisit the issues in his local

authority, because I have looked at

them before and I know there are

particular precious there. But he

alights on again something which the

opposition have not wanted to talk

about, which is significant, which

is the Prime Minister's commitment

to the integration of health and

social care, something which eluded

the last Labour Government over 13

year, we are now starting to see

this happen and the decision made on

Monday means that the decision means

that policy leadership will come

back to the Department of Health

which will help it progress faster.

I will give way one more time.

I

would like to bring back the point

about caring for people before they

get to hospital and issues to do

with GPs in my local area there has

been a difficult recruiting GPs and

the investment in increasing medical

training for new doctors is vital. I

would like to take this opportunity

to plead with the Secretary of state

to look at the bid from Anglia

Ruskin university to become the

first medical school in Essex, where

is there is no path way for young

people to train as doctors within

the county.

I note her very

persuasive plea for her local

university and this is not a

decision that I'm going to be

taking, because my own university is

also keen to offer more medical

places. But she is right, to say

that training the next generation of

doctors and nurses is again the

long-term solution to the pressures.

I'm going to make some progress and

then I will give way, a final set of

interventions. Now, the heart of the

shadow Health Secretary's case that

is winter pressures are caused by

political decisions and not by

operational issues. So let's put

aside the difficult winters that

Labour had in 1999, 2008 and 2009,

but if he is going to drag politics

into this, he cannot say that it is

the fault of politicians in England

and then totally ly gloss over the

responsibility of politicians in

Wales, where the royal college of

emergency medicine say it is a

battlefield and patient safety is

compromise and it is unsafe and I

say to him this, if it is the

government's fault in England that

one in nine A&E patients are waiting

too long, whose fault is it in Wales

where one in six are waiting too

long and that the test results if

you're waiting in Wales, you're nine

times more likely to wait too long.

I give way.

I thank my Right Honourable friend

for giving way. As far as the Welsh

NHS is concerned he is right. If I

may have slight indulgence, may I

give a quote from an A&E nurse in

Wales who gave this quote last week:

"On every shift both corridors are

full of patients on trolleys. We are

housing ambulance crews for longer

than ever due to bed is not being

available in the hospital, patients

are being nursed in inappropriate

areas due to no space. I've seen

nurses in tears. I myself have been

in tears. This is the first time

I've ever been demoralised and

embarrassed to say I'm an A&E nurse

in Wales." That's in Wales under

Welsh Labour. With the Right

Honourable gentleman agree with me

that that is pure hypocrisy coming

from that side of the House and they

should take notice of the mistakes

that have been made in Wales?

I

totally agree with my honourable

friend. I totally agree with my

honourable friend, and I think this

is the central flaw in the case that

the party opposite are making. We

know winter is the most difficult

time, but they cannot say there is

political responsibility in one part

of the UK and say absolutely

nothing, I noticed the Shadow Health

Secretary looking at his notes when

we talk about Wales, but the reality

is it blows apart his case.

According to the BMA there is one

area where not a single doctor was

available overnight, and there is

one A&E where performance has fallen

to 40%, something unheard of in

England, or indeed in Scotland. But

there is a political decision that

has a big impact on NHS winter

performance, and it's something my

honourable friend from Chelmsford

talked about earlier, which is the

number of doctors that we train. Not

once in my time as Health Secretary

have I heard Labour called for an

increase in training places. But the

simple truth is... The simple truth

is that there is no point in

throwing money at a problem if you

don't have the doctors and nurses

available to spend that money on.

Whilst I have been Health Secretary

we have 40,000 more doctors, nurses

and other clinicians working in the

NHS. But we need more and that is

why under this Prime Minister we

have announced the biggest increase

in training places for doctors and

nurses in the history of the NHS. I

will give weight to the honourable

gentleman and then I will give way.

Can I take him back to the issue of

social care, and by the way,

congratulations on facing down the

primers on Monday, you emerged as

one man, two jobs and no governor!

But he must accept that the cuts of

£6 billion since 2010 in social care

has had a major impact, particularly

on winter crises. Does he regret the

Government's decision to take the

money out of social care?

What I would say to him is that in

2010 we were facing the worst

financial crisis the Second World

War. He will know which government

was in charge when that happened.

People were talking about a run on

the pound, and I noticed the party

opposite continues to talk about a

run on the pound, and that crisis

had to be addressed. We, like other

countries, had to make significant

reductions in public funding. But

when we got the economy back on its

feet, when we started creating jobs,

1000 jobs a day since 2010, what was

the first place with that extra

money into? The NHS and indeed the

social care system, £600 million

more in the social care system than

two years ago. I want to progress

because there are lots of people

that want to speak this afternoon

and I'm going to conclude my

remarks. I will give weight to my

honourable friend.

I thank him for

giving way, he knows of my interest

in the Ambulance Services and I was

on duty for Yorkshire Ambulance

Services responder for Christmas and

New Year and will be again tomorrow

night. When he talks about workforce

planning he talks about doctors and

nurses quite rightly. Will he say

something about how incredibly well

trained paramedics can be used to

better relieve some of the pressure

that we see at A&E and some of the

delays that occur there?

I thank him

for his work as a first responder

because it's a fantastic example in

his community. We have several

hundred more paramedics and we have

several years ago. He's absolutely

right, the role of paramedics has

been dramatically changed over

recent years. It used to be about

scooping people up and taking them

to hospitals. Now we are treating

many more people on the spot, and

they have an extraordinarily

important role. But it is a changed

role, and it is a changed emphasis,

as in other parts of the NHS, which

is moving towards doing as much as

we can to treat people safely

outside hospitals, to keep them at

home, because we know that is the

safest way. I'm going to give way

one last time. I can see that... I

will give way to a couple more.

I'm

grateful to the Health Secretary for

giving way. The simple fact is if we

want to see more care in community

to the government must start -- stop

slashing social care budgets, if we

want to stop people coming to

hospital with preventable diseases

we must put more money in full so

when you look at the money going in

the government is penny wise and

pound foolish.

3 million additional

jobs created so we have a strong

additional, economic record which is

why we have been increasing funding

on social care recently. We have

increased funding on the NHS

significantly, and as for slashing

funding, his local trust received

£9.7 million before Christmas. I

give way.

I'm grateful to my Right

Honourable friend. Can I ask him to

reflect on the issue of beds and

inform him that as a result of some

of the measures taken by him in

recent weeks, Shrewsbury and Telford

Hospital trust in my area managed to

release an extra 120 beds to help

cope with the significant winter

pressures they have received. Would

he agree with me that in areas which

have community hospitals, such as

Bridgnorth Community Hospital and

Ludlow Community Hospital in my area

where there are community beds, that

they have a role to play in

releasing pressure on the acute

hospitals for those patients that no

longer need acute care?

I do agree

with that. But as he has intervened

in this debate I want to take the

chance to thank him for being

absolutely superb Minister of stay

at the Department of Health, and the

fact that the NHS is better prepared

this year than it has been for very

many years is partly because of his

efforts. I want to commend him for

his fantastic contribution. I will

give weight one final time.

Does my

Right Honourable friend agree with

me that the calibre of local trust

leadership can play a huge role in

this? In Gloucestershire new trust

leadership has tackled head on

serious internal financial failings

and as a result A&E times have been

slashed and turned around. In

December the A&E waiting targets

were met. Does he not agree that

this shows what can be done with the

right leadership?

It absolutely does

and no one campaigns more vigorously

for local trusts than my Right

Honourable friend. I visited the

Gloucester sight of his trust and

met the management and staff just

before Christmas and it is

extraordinarily impressive and a

great inspiration to many parts of

the NHS. I just want to finish by

talking about the issue of funding,

because the Shadow Health Secretary

again has been using very strong

language, conveniently overlooking

the fact that in the last four years

real terms funding for the NHS has

increased by £9.3 billion. That is

£5.5 billion more than his party

were promising in 2015. But he is

right. I'm going to conclude my

comments now because a lot of

honourable member is to speak. He is

right that there are real pressures.

What are the facts? We spend 9.9% of

our GDP on health, that's 1% above

the EU average and about the same as

the EU 15, the Western European

countries. But we want to spend more

so this is what we've been doing. In

England from 2011 funding went up by

15.6%. In Wales Labour chose to only

increase it by 8%. This motion is

about money and I just want to

conclude by saying this. When it

comes to NHS funding Labour give the

speeches but Conservatives give the

cash. SPEAKER:

Dr Philippa Whitford.

Thank you, Mr Speaker. Like others

across the House I want to thank all

staff in all four UK systems who is

as Secretary of State said have gone

above the Call Of Duty to focus on

their patients. I don't think any

debate we have in here is intended

to upset, or insult any of them.

Before I start them before the

honourable member for Ludlow perhaps

leaves the chamber, if I could thank

him for his service as a Minister of

stay for help and I have often met

across the chamber. I'd like to

correct a comment he made in answer

to my question on Monday, which was

incorrect. He claimed at that time

that the number of patients waiting

longer than 12 hours in A&E in

England was half the level in

Scotland. Now, naturally I would

have expected a Minister to know all

the stats and what they mean. In

England data is only published for

the percentage of patients who meet

or do not meet the four-hour target.

There is no publication of data of

eight hours or 12 hours. What

happens is the clock restarts for

patients who require admissions, and

that is defined from the decision to

admit until they get a bed and are

known as trolley waits. So, 48,000

patients waited over four hours on a

trolley after their four-hour wait

in A&E to get a bed and the 109 he

was referring to had waited over 12

hours on a trolley for a bed after

the four or five hours they had

waited in A&E, and therefore this

was utterly incorrect to compare

that with the Scottish data where we

have a single clock from when the

patient starts right through until

they get where they are going. I

simply want to clarify that while

the member is in the chamber.

I

thank the honourable member for

giving way. That doesn't negate the

fact, and I know this is one of the

past time the SNP want to engage in,

comparing Scotland and England, it

is a fascination for them. But the

reality is that in my constituency

in Stirling served by an excellent

hospital, 57% of the patients only

were seen within four hours in the

last week of last year because we

have a flu epidemic in Scotland, as

they do in England, and I think that

should be acknowledged.

I thank the

honourable member for his

intervention and if he would give me

a bit longer I would intend to talk

about the flu epidemic. I think

before he gets too celebratory he

might want to wait until tomorrow

until we have come parable data,

because while in Scotland the data

is published every week, in England

it's only published every month. I

am glad, however, that we no longer

wait six weeks after the end of the

month, ten weeks after the start of

it, but get it a fortnight later so

that will be available tomorrow and

then he can compare hospital trusts

in England with hospitals in

Scotland to his heart's content. As

someone who celebrates the United

Kingdom, I think the fact that

Scotland has led the entire UK since

March 2015 on emergency admissions

and A&E would be something he might

actually want to praise. Having

corrected that, all of us recognise

this is a particularly tough winter

because there has been an outbreak

of flu on top of a bad freeze. Now,

I would point out for those of you

who think the worst is past, the flu

season goes until March, and at the

moment this is an outbreak, it isn't

an epidemic on its an outbreak. At

it comes on top of underlying

pressures. And obviously we see

right across the four nations that

this has involved staff having to

really come as I said, go above and

beyond the Call Of Duty. Now, I

think it's unfortunate, and whether

it was how Public Health England

said it, or how the media reacted to

it, but this business of describing

in public that the flu vaccination

doesn't work is irresponsible. The

flu vaccination recipe is planned

why the World Health Organisation at

the beginning of each year. They

will already be working on next

year's flew. They do not have a

crystal ball and people who have

what we call in the medical

profession a retrospective scope

should recognise that that tool was

not available at the time the

decisions were made. Flu. It is a

biological process to produce a

vaccine and it takes months, so the

position is made in March for the

northern hemisphere, and all of the

companies produce to that recipe.

Headlines in Scotland implying the

Scottish Government pop down to

Boots and took the wrong vaccine

off-the-shelf art facile, but it

actually encourages people not to

bother. We already have falling

vaccination rates in childhood

vaccination and in flu. We should be

pointing out that multiple flu

viruses are circulating, and while

all the talk in the media's is, of

Australian flu that is about a

quarter of the strains circulating

for someone of the issues around flu

is it happens in cold weather. We

get the coldest weather in the

United Kingdom, so we have double

the rate of flu that you have done

here in England. We also had a worse

freeze and are continuing to have a

worse freeze, so in actual fact,

when you are looking at the data I

think you will see that Scotland,

when the data comes out tomorrow,

will still lead the UK. We won't be

performing to the level that we want

to. We haven't met the 95% target

for emergency departments since

August. But England hasn't met them

since 2015 and sadly Wales has not

met them since 2008, so this is a

challenge right across, but Scotland

has been more resilient. I call on

all MPs to encourage staff and

people to get flu vaccination,

because this will continue until

March, and it is still absolutely

worth doing.

One of the issue is the Secretary of

State talks as if the problems in

A&E are due to people who shouldn't

be there. People who work there say

that isn't the case. With fractured

ankles and wrists on the ice, A&Es

will have been busy, having people

carted in and X rayed and what we

Saul in Scotland getting a stookie

put on before they go home that,

will take time. Anyone who works in

A&E will say the issue is frail,

sick people with often multiple

conditions. Whether they have

fractured their hip or have a

respirty problem secondary to flu

they need a bed and there is not

enough beds.

I thank the honourable

lady, I do work in A&E and I have

spent some shifts in recess working

in A&E on new year's eve. Many of

the people attending where I work

are there because they're frail,

they're also there because this

Government has ensured they can't

get an appointment with their GP and

we don't have mental health budgets.

I thank the honourable lady or the

the intervention. The shape of

medicine has changed, more is

delivered in primary care. More

surgery is delivered in a day. If

you're doing a straight forward

operation on an older patient, they

will still always require longer

rehabilitation, they're more likely

to stay self-days, if their fracture

their hip they will require full

rehabilitation before they go home

and the beds in England have been

halved since 1987 throughout

successive governments and if you

look at the NHS stats that were

released for the end of the second

quarter of 17/18 there has been

almost a thousand beds lost even

since the winter of last year, where

it was described as a humanitarian