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Rob Marris: Does my right hon. Friend share my astonishment that the hon. Member for South Cambridgeshire (Mr. Lansley) suggested today, in response to an intervention from me, that the absence of winter bed crises during this century was due to
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luck? Surely it is due to the resurrection of the NHS by this Government, with preventive programmes such as bowel cancer screening, osteoporosis screening and flu jabs for pensioners. That is not due to luck. It is due to sound policies, backed by staff, resources and vision—policies opposed by the Conservatives, whose own policies would decimate the NHS in deprived cities such as Wolverhampton.

Ms Hewitt: My hon. Friend is absolutely right. Just a couple of weeks ago, I was shown around the brilliant accident and emergency department at St Helens and Knowsley Trust by Graeme Inkster, one of the emergency consultants, who explained to me exactly why we do not have winter bed crises now. He showed me what he called the corridor of shame, which 10 years ago was full of patients lying on trolleys waiting for hours on end. He said that he used to come into work first thing on a Monday morning and find patients queuing in the corridor; they had been left over from the weekend because there had not been anybody to treat them. Some of them had been there for six, 12 or 18 hours. The hospitals did not have the money or the staff, and they had not reorganised the care around the patients. The investment we put in and the reforms we made—and the four-hour accident and emergency target, which the Opposition opposed—drove the changes that led to us ensuring that we do not have winter beds crises.

Mr. Burns: I am grateful to the Secretary of State for giving way. As she will not take any lessons from the Conservative party, will she take lessons from the Royal College of Nursing, the junior doctors and the consultants, who all think that her stewardship has been a disaster?

Ms Hewitt: Of course I listen to staff. I listened this morning to the midwives at the Royal College of Midwives, who gave me several examples of why we need to do more in terms of maternity services. That is why we worked with the RCM to produce the action plan, “Maternity Matters: choice, access and continuity of care in a safe service”, which was published recently. However, what I do that the hon. Gentleman does not do is also listen to the staff and the patients throughout the country, who show me the superb care that is taking place—and which never gets into the headlines and which we never hear about from the Opposition.

Andrew Gwynne (Denton and Reddish) (Lab): This point is not only to do with patient satisfaction—nine out of 10 of them are satisfied with the NHS. Does my right hon. Friend agree that the picture painted by the Opposition does not fit with the findings of the Commonwealth Fund’s international survey, which shows that our NHS is one of the best health services in the world?

Ms Hewitt: My hon. Friend is right. That latest survey by the independent Commonwealth Fund confirms what patients are saying. It looked at the health service in Australia, Canada, Germany, New Zealand, the United States of America and the UK. Four years ago, it rated the NHS as number three, and two years ago it was still number three, but according to the latest survey the NHS is now number one—it is the fairest, the most efficient and the best overall.

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Kali Mountford: Is it not also the case that although specialists tell us one thing, sometimes the community wants something different? Sometimes specialists say to us that they want all services in one place. In my community, they wanted one specialist care maternity service and a midwife-led unit. We now have £30 million investment in community service hospitals. As a result, Holme valley hospital—which had been threatened with closure in 1997 and has been built up under this Government—will now provide even more hospital services to our community, so we now have both services.

Ms Hewitt: My hon. Friend is right. I pay tribute to her for the leadership role that she played in ensuring that the voice of her constituents was heard. I also pay tribute to the clinicians. They said, “If we reorganise the services it will be safer and better for patients.” They were also listened to.

Mr. John Redwood (Wokingham) (Con): Can the Secretary of State explain why so many patients have been dying of killer bugs on her watch?

Ms Hewitt: Hospital-acquired infection is a serious issue. We take it very seriously and we were the first Government to require every hospital to record cases of methicillin-resistant Staphylococcus aureus and C. difficile and to report that publicly. Therefore, we know the exact nature of the problem and we can hold hospitals and their boards to account for getting those rates down. I am glad to be able to say that MRSA rates are falling, but there is a new strain of C. difficile. It is not only a problem in Britain; it is causing problems in many health services and we must do more to protect patients from it.

It is unsurprising that hospital patients are more satisfied as the waiting lists are lower than they have ever been—almost nobody is waiting more than six months for the sort of operation for which people used to wait two years. That happened because we put in more money—opposed by the Conservatives. But we did not put more money into the old ways of doing things, we put more money into new and better ways of caring for patients. At Walsall Hospitals NHS Trust, which I visited a few weeks ago, I met the staff who had reorganised the service, and found that with no further funding increase they could care for six orthopaedic patients in the time that previously they had been able to care for only one. They slashed the waiting time for MRI scans from two years to just a few weeks. That is investment and reform in action.

Mr. Graham Stuart: Can the Secretary of State explain why children in my constituency with major jaw problems are waiting more than 60 weeks from first going to see their GP until receiving treatment? That figure is not collected centrally, but from local information they have to wait more than a year.

Ms Hewitt: For the first time ever in the history of the NHS we are now collecting information on how long it takes for a patient to go from GP referral to actual treatment. We have got the waiting times for the first out-patient appointment down, and we have got the waiting times down at the other end for the in-patient treatment. Now what we are going to do—and I hope that the hon. Gentleman will support
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it—is ensure that for almost all patients and almost all conditions there will be no more than 18 weeks maximum from referral to treatment. For many people, the wait will be even shorter.

Let us take the example of Shepton Mallet treatment centre. I went there and talked to patients, including the chair of one of the local primary care trusts—a Labour chair, as it happens. At that treatment centre, patients see the consultant, have the scans and tests, get the diagnosis, decide on the operation and book the date for the operation—all in one visit. That never used to happen. Yeovil District Hospital NHS Foundation Trust has also changed its way of working and will now be one of the first hospitals in the country to deliver a maximum of 18 weeks for almost all of its patients. That is investment and reform in practice.

Meg Hillier: The Conservatives seem to be confused about the role of the Secretary of State. The Government should make the hard decisions about future funding and stability for the NHS and set tough targets, but they should leave the practitioners to run things. The Conservatives keep raising individual examples of particular treatments. Is it really the Secretary of State’s role to determine what happens in every hospital ward?

Ms Hewitt: My hon. Friend is absolutely right. It is one of the many contradictions in the Conservatives’ so-called health policy that they want independence for the NHS, but they oppose every proposal from local NHS staff for a reorganisation of services. Whenever something goes wrong or they want more money for their own local hospital—as so many Tory Members do—they come straight to me and demand that I intervene. It is completely bizarre.

Over and over again, we see that the best care for patients, organised around them, is also the best value for patients’ money. That is why I was so determined that we dealt with the overspending in a minority of hospitals, restored the NHS as a whole to financial balance and ended the unfair system of well managed hospitals in some of the most disadvantaged parts of the country having to bail out the minority of overspenders. It went on for years, it was not fair or efficient, and we stopped it. Of course, that was difficult—especially for NHS staff—but we now have the fairest, strongest and most transparent financial system that the NHS has ever had. That is not my verdict, but that of the Health Service Journal, which said that

Grant Shapps (Welwyn Hatfield) (Con): Does the Secretary of State provide the same advice to the right hon. Member for Salford (Hazel Blears), chair of the Labour party, when she complains about closures in her constituency?

Ms Hewitt: That was not worth giving way for, I am afraid.

As I said a moment ago, we needed that four-hour A and E target to change what was happening in A and E. Now, the 18-week target is mobilising NHS staff in hospitals all around the country to end the waiting that
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has been part of the NHS for nearly 60 years. What an achievement that will be—what a birthday present for the NHS, as it ends waiting, as NHS patients have always known it, on its 60th anniversary.

The hon. Member for South Cambridgeshire is against the 18-week target. That is hardly surprising; he thought that 18 months and more was acceptable.

John Mann (Bassetlaw) (Lab): After visiting a GP, one member of my family had to wait only three weeks for cancer surgery; another member of my family went into hospital with terminal cancer and spent 10 hours on a hospital trolley in a corridor. Can the Secretary of State guess which experience took place under the John Major Tory Government and which took place under this Labour Government?

Ms Hewitt: My hon. Friend makes his point very graphically. That is another real tribute not only to NHS staff and the new cancer networks, but to the target—the promise that we made—that patients diagnosed with cancer would wait a maximum of 62 days between an urgent GP referral and the start of cancer treatment. Just two years ago, fewer than two thirds of patients were getting from diagnosis to treatment so quickly; now more than 95 per cent. are. There have been real improvements in the past two years.

Most important of all, the NHS is saving more people’s lives. The lives of nearly 150,000 people with coronary heart disease have been saved. The hon. Member for South Cambridgeshire had something to say on that subject. It is perfectly true that under the Conservative Government, death rates from coronary heart disease were falling, but they were falling a great deal more slowly than in most other parts of Europe, and have been falling faster since. I looked at the numbers. During the 1980s, those death rates fell by about 20 per cent.; during the 1990s, they fell by 26 per cent. During the years of this Labour Government, they fell by 36 per cent., and we will meet early our target for a 40 per cent. reduction in those death rates. Furthermore, 50,000 more lives have been saved as a result of our changes to cancer care, and suicide rates are at their lowest level ever because of our changes to mental health services.

The hon. Gentleman mentioned the Mental Health Bill, which is going through Parliament. Since 1959, we have had a law under which a seriously suicidal mentally ill patient can, if the clinician judges it necessary to protect them from self-harm or suicide, be detained in hospital for treatment. We have discussed that recently. I find it extraordinary that the Conservative party should now want to end that provision and deny seriously suicidal patients the possibility of treatment from which they have benefited for decades.

Mr. David Kidney (Stafford) (Lab): Will my right hon. Friend accept the credit for giving greater responsibility to more NHS staff, such as nurse consultants and nurse prescribers? Will she reaffirm our party’s commitment to extend the same approach to mental health services? We want more members of
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mental health teams to have responsibility. We do not want to look back and defend vested interests, as the other place did with the support of the Conservative party.

Ms Hewitt: My hon. Friend makes an extremely important point and I hope that it is one on which the Opposition will think again.

Dr. Evan Harris: Would the right hon. Lady care to comment on the extent to which changes in coronary heart disease death rates are affected by changes in smoking habits made 10 or 15 years earlier? The improvements in the Tory years could have been due to changes in smoking habits 10 or 15 years previously, and some of the changes we are experiencing now could also be due to earlier lifestyle changes. Does the right hon. Lady accept that the long time lag means that the situation on death rates is not as simple as some people make out?

Ms Hewitt: The hon. Gentleman makes an important point, although Sir Liam Donaldson, the chief medical officer, stresses the point that the impact of smoking, including second-hand smoke, can show up extremely quickly—within a year or two—in coronary heart disease. Part of the improvements we have been making in the NHS is the much bigger investment in “stop smoking” services, which have helped more than 1.5 million people to give up smoking. The smoke-free legislation, supported on both sides of the House, will be the biggest step forward for public health for decades.

Of course change is difficult—we are changing from the old public sector monopoly to a patient-led NHS. It is not easy, but we have to do it to meet the huge challenges of an ageing population, people’s rising expectations, new drugs, changes in medical technology and an epidemic of lifestyle diseases. We have to change the way the NHS works to safeguard what is most precious and enduring about it: the values of a health service that is paid for by all of us, available to each of us on the basis of clinical need and free at the point of use—the values we believe in on the Labour Benches.

Mr. Crispin Blunt (Reigate) (Con): I think that the Secretary of State betrayed herself earlier in her speech when she talked about a Labour chair of a PCT. I thought such people were meant to leave their politics behind when they discharged their duties to the NHS. However, our experience is reflected in a gerrymandered decision about the sites of hospitals in the south of my constituency, which drove the Surrey and Sussex Healthcare Trust into the largest deficit in the country under her predecessor. That was followed by her gerrymandered decision for a hospital at the St. Helier site in the face of recommendations. She was driven off only because the decision was so unreasonable that it would not stand up to judicial review. It is because the Secretary of State has put the political interests of the Labour party first that she should resign.

Ms Hewitt: The hon. Gentleman is talking absolute nonsense. Appointments to primary care trusts are made by a completely independent statutory appointments commission. I cannot remember whether the Conservatives supported its establishment, but it is completely independent.
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Far from people being ashamed of their politics, if people in his party, my party or any other party are active, they declare it, but it makes no difference whatever to the appointments system.

Several hon. Members rose

Ms Hewitt: No, I shall not give way—

John Bercow (Buckingham) (Con) rose—

Ms Hewitt: But I shall give way to the hon. Gentleman because I have considerable respect for him.

John Bercow: I am extremely grateful to the right hon. Lady for giving way.

In September 2006, in response to protests, the Secretary of State rightly instructed that the consultation process on the future of the Nuffield speech and language unit should be undertaken again. Given that eight months later—on 16 May, to be precise—the representatives on the new steering group from the Royal College of Speech and Language Therapists and the Association for All Speech Impaired Children resigned their membership of that group on the ground that they did not wish to be associated “with substandard work”, will the right hon. Lady agree to meet me and a number of concerned parents and professionals, recognising, as she will, that the interests of highly vulnerable children are at stake?

Ms Hewitt: Of course I will.

We have believed in the values of the NHS ever since we created it. The Conservative party now claims to believe in those same values, but we are entitled to look at the Conservatives’ actions, as well as their words. For 18 years, they starved the NHS of funds and took money out of the NHS to subsidise private health care for a few.

Mr. Peter Lilley (Hitchin and Harpenden) (Con): Will the Secretary of State give way?

Ms Hewitt: No, I will not give way again.

That is exactly the policy that the right hon. Member for Witney (Mr. Cameron) put into his party’s manifesto just two years ago. The Conservatives voted against the extra money that we are putting into the national health service—more than £8 billion more in this year alone—and they opposed the changes in local services that will benefit patients.

Mr. Neil Turner (Wigan) (Lab): The Conservative party has prayed in aid the Royal College of Nursing, the Royal College of Midwives and the British Medical Association in its criticism of the Secretary of State. In the conversations that she has had with those bodies, have they asked to return to the staffing and funding levels of 1997?

Ms Hewitt: My hon. Friend makes an extremely important point. Frankly, the message to NHS staff that we are hearing from Conservative Members is, “You don’t need more money because you would have made the improvements anyway, so you don’t need the
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extra staff or the higher pay and we won’t give you a decent public service pension either.”

Two days ago, the right hon. Member for Witney set out his seven-point policy for the NHS. His first point was

Well, of course that is what he is saying. He wants the headlines. He loves the demonstrations and the marches. But let us look— [ Interruption. ] Conservative Members should take note of the small print of what their party leader said. He said that the changes should be suspended

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