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Something about the NHS surprised me on Saturday. I visited a part of my constituency called Great Doddington for a public meeting—it would probably be characterised as a town hall meeting—to complain about the rotten fact that the post office there had been closed and that that was wrong. More than
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100 people attended. However, the meeting was led by a local GP and the effect of the revised GP contract negotiations on staffing came up. Out-of-hours services are affected. I appreciate that that might be a problem in other parts of the country, but in my area we still have an out-of-hours service, which works well. It is called Keydoc and if one is desperate to see a GP in the middle of the night, as I was a little while ago— [Interruption.] I thank my hon. Friend the Member for West Suffolk (Mr. Spring) for passing me a note asking me to wind up as quickly as possible because people are getting bored. [hon. Members: “No!”] Keydoc is a very good system that provides out-of-hours cover; indeed, I used it only recently for my son. We therefore do not have a problem with out-of-hours cover in our area—it may be a problem in other parts of the country—but local GPs are up in arms about the money that will be taken away from them because they are not prepared to enter into the Government’s new GP contract. Some local GPs even feel that their practices will have to close if the contract comes into existence.

Finally, I appreciate that the Government are trying to do what they can to manage the NHS. The fact that we would manage it much better is neither here nor there at the moment because there will not be an election for a couple of years. However, there is one thing that I can say. There is not a single complaint about the number of NHS nurses or doctors in the hospital in my constituency or about the service that people receive. Instead, people are absolutely livid that we do not even have a hospital in my constituency. The Minister has graciously agreed to come to the area to discuss the issue—and the day that she has chosen is April fools’ day.

2.31 pm

Sir Nicholas Winterton (Macclesfield) (Con): I am pleased to follow the eloquent and passionate speech by my hon. Friend the Member for Wellingborough (Mr. Bone), who showed considerable knowledge of the health service’s advantages and shortcomings in his area.

I did not initially intend to contribute to this debate, but I came in at the beginning and my interest has increased as the debate has progressed. I am pleased that the Minister will be replying, and I intend to give her plenty of time to do so. She may know that what would have been an outstandingly successful parliamentary career for me floundered because of my support for the national health service and what it stood for. I chaired the Health Committee for a period. It was a wonderful Committee, with fantastic relations with all areas of the national health service, mainly through the commitment of its members, not least various Labour Members, such as the late Audrey Wise and Mrs. Mahon. They were tremendously supportive of me in undertaking critical inquiries, one of which was into maternity services.

Mr. Greg Knight (East Yorkshire) (Con): Will my hon. Friend give way?

Sir Nicholas Winterton: In just a moment.


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Will the Minister give a commitment that the money that the Government have promised to maternity services in the NHS will be brought forward? Without that money, the guarantees in the Maternity Matters strategy cannot be effective and new midwives and students midwives cannot start doing the job that maternity services urgently require. I obviously speak with a little knowledge—as the House knows, for some years I have been an honorary vice-president of the Royal College of Midwives, which is an office that I am very honoured to hold.

The Minister will be aware that the midwifery profession also has a problem, in that a fairly high percentage of midwives are what I would call mature and may retire in the years that lie immediately ahead. That is why the staffing of maternity services and the coming forward of new midwives and students midwives into the NHS is so critical. It is unfortunate that so much emphasis is placed on targets, which take a lot of staff time, when much more should be devoted to, I would hope, successful outcomes.

Perhaps my right hon. Friend the Member for East Yorkshire (Mr. Knight) would like to intervene now, although I hope he will be quick because I want to give the Minister plenty of time.

Mr. Greg Knight: I am grateful to my hon. Friend for giving way. The moment has almost passed, but I just wanted to say that he should not regard his career as a failure because he has never served as a Minister. He has been a distinguished Chairman of the Health Committee and the Procedure Committee.

Sir Nicholas Winterton: I am very grateful to my right hon. Friend, who is now the very distinguished Chairman of the Procedure Committee. He was also a very distinguished Minister.

The shortage of physiotherapists and speech therapists has been mentioned by at least two speakers in the debate. Those therapists are critical in the treatment of people who have suffered a stroke. If we are to give people a meaningful life after a stroke, physiotherapy and speech therapy are critical to their rehabilitation.

In an intervention on my hon. Friend the Member for West Suffolk (Mr. Spring), I touched on the subject of mental health. This, too, is a subject in which I take a considerable interest. During my time working on health and social security matters, we undertook an in-depth inquiry into adult mental health and mental handicap. There is a shortage of skilled professionals in mental health, which is critical because for too long this has been a Cinderella area of health care. I hope that the Minister will be able to give us an assurance that money will be available for the employment of the staff who are so essential to the success of this Cinderella area of the national health service.

2.36 pm

Ann Keen: I should like to thank hon. and right hon. colleagues for their contribution to this debate on NHS staffing. I cannot apologise for smiling so often throughout the debate; such is my way that I am known often to smile at many hon. Members.


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Since 1997, the NHS has made significant progress in improving the level of health care in this country. The unprecedented level of investment by this Government in staffing in the NHS has been instrumental in bringing this about. I will try to refer to some of the points raised by hon. Members in the short time that I have. The hon. Member for Wellingborough (Mr. Bone) has invited me to visit his constituency, and I have agreed—and will continue to agree—to do so. I had the pleasure of meeting his wife when we were away on a trip together, and she had my sympathy on the issue of health care. She might possibly have my sympathy for other reasons, now that I have got to know the hon. Gentleman and the particular style that he has developed in the House. I feel that she might possibly agree with me on that.

Work force planning has always been critical to the NHS. Having worked in the NHS for more than 25 years, I know how important it is to have the right staffing levels on wards. I remember not having such levels in the ’80s and ’90s. I also remember training schools being closed. We were told that we were training too many nurses and doctors, and places were cut. In fact, I spoke recently to Dr. Peter Carter, the general secretary of the Royal College of Nursing, and he was happy for me to convey his views. He said:

At that time, we did not always plan in the way we should have done, and I am aware that officials in the Department of Health take some criticism. Let us also give them praise, however, as they are now working hard on work force planning, as they perhaps wanted to do in the ’80s and ’90s as well.

It is exceptionally important to have the right levels not only of doctors and nurses—they always come to the forefront when we talk about the health service—but of physiotherapists and talking therapists, who play a hugely important role, as do staff right across the section, from the cleaners who keep a complex cleaning care programme in place right through to the top docs. The work force is being planned under Lord Ara Darzi’s review, under my chairmanship and, most importantly, with the membership of the clinicians themselves, in the sectors that look after our cancer care and our new stroke strategy, which has been welcomed by the all-party parliamentary stroke group as well as by the Stroke Association. Matters relating to cardiac rehabilitation need to be addressed in some areas, and I urge the managers involved to do that.

While we are discussing managers, let me say that there has been a fall in their number. The last NHS census showed the first fall in management members since the introduction of occupations codes in 1995. However, let me go on to say that managers are exceptionally
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important to the NHS. We know that without them it can break down, and we know the serious consequences of that. We understand the importance of learning from previous mistakes and of ensuring that all managers and health care professionals are totally committed to providing safe care.

The hon. Member for Macclesfield (Sir Nicholas Winterton) spoke about his being the vice-president of the Royal College of Midwives. I watched his career with interest when he served on the Health Select Committee, particularly in respect of his involvement with “Changing Childbirth”. He was such a progressive thinker that he was not allowed to continue to practise. The General Secretary of the Royal College of Midwives, Karlene Davis, would work closely with the hon. Gentleman. She also works diligently on work force planning and has said how difficult it is to recruit midwives at the moment. We all take that very seriously.

It is the duty of us all to praise midwifery and the safety of childbirth in this country, which is indeed one of the safest places for the delivery of babies. Our birth rate is currently increasing, and I believe it nearly always does under a Labour Government. When people are satisfied and feel confident that they will continue to be employed—either within or outside the NHS—they are always happy to increase their families. It is no coincidence when that happens.

I hope that some hon. Members will reflect further on some of the words they used, particularly regarding heart disease. Our success rate should only be praised, so I particularly ask the hon. Member for Guildford (Anne Milton) to reflect more on her comments.

Anne Milton rose—

Ann Keen: I have very little time left, so the hon. Lady might want to see me at some later time.

Our stroke strategy and our cancer plan have been welcomed throughout the voluntary sector—and most importantly of all, by patients themselves. Patients’ satisfaction with the NHS is second to none. The work force in our NHS is also second to none. We need to do more to improve it, so we need to work together in the House. I would like to see a consensus on the point that the NHS as it stands today provides the best health care in the world. That is true only because of NHS staff. Let us all work together not to praise them only today but always. That is different from the 1980s and ’90s, when I experienced marches and collection buckets for NHS equipment. No one is doing that today because we have a Labour Government looking after the NHS.

Question put and agreed to.

Resolved,


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European Scrutiny (Standing Orders)

Mr. Deputy Speaker (Sir Michael Lord): Before we start the debate, it may help the House if I set out how our proceedings on the European scrutiny motion will be handled. There will be a combined debate on the motion and on all selected amendments. The business of the House order governing proceedings allows any selected amendment to be moved at the conclusion of the debate. Amendments will be called in order, followed, finally, by the main question.

2.43 pm

The Deputy Leader of the House of Commons (Helen Goodman): I beg to move,

Proper scrutiny by the House of legislative proposals and other important documents from the European Union is extremely important. As we all know, decisions taken in Europe affect many aspects of our lives. Government and Parliament must play a full part in those decisions.

Today, I set out a new approach to scrutinising the way in which the Government do business in Europe. The motions will encourage a fuller debate on Government position on policy issues that are affected by European legislation.

In the past, the European dimension of policy issues has often mistakenly been considered to be separate from United Kingdom domestic policy. As a result of that disengagement, confidence in scrutiny of the Government’s position on European issues has suffered, which has led to long-standing criticism of the processes.


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In its report on European scrutiny, the Modernisation Committee made recommendations for reform of the existing scrutiny process to reinvigorate the House’s consideration of European Union business. The Bill to enable the United Kingdom to ratify the Lisbon treaty, which modernises EU structures, is currently in Committee. There have been a good many debates on the Floor of the House and there are several more to come, but we are here today to debate other issues.

On 25 October, during a debate on a range of procedural reforms, the Leader of the House accepted a proposal from the European Scrutiny Committee that, within three months, we present proposals to improve the EU scrutiny system. Four successive Leaders of the House have drafted proposals, and the Modernisation Committee reported in 2005. There is widespread agreement across the House that we need to improve the current systems.

Mr. Frank Field (Birkenhead) (Lab): The German Parliament has calculated that 60 per cent. of its legislation initiates in Brussels. The same must apply to this country. In those circumstances, should not our procedures go way beyond what my hon. Friend is proposing today? Clearly the time that we spend in the House of Commons ought to be devoted mainly to European as opposed to home matters.

Helen Goodman: I am not sure that what my right hon. Friend says is strictly accurate because of the role of the Länder in Germany, but I hope that as I set out my proposals—some of which are on the Order Paper, while others stray into administrative matters—he will accept that they will lead to real improvements.

Mr. James Clappison (Hertsmere) (Con): The hon. Lady is making a good start, but may I pursue the question put to her by the right hon. Member for Birkenhead (Mr. Field)? I asked the same question of one of her Cabinet colleagues during our debate on the single market. Will she tell us what proportion of our law comes from EU institutions?

Helen Goodman: I must confess that the figure is not at the front of my mind at this moment, but I hope that by the time we reach the end of the debate I shall be able to give the hon. Gentleman the answer.

Simon Hughes (North Southwark and Bermondsey) (LD): May I ask a procedural question? The hon. Lady was kind enough to consult colleagues throughout the House before presenting the motion tabled by the Leader of the House. Would she be willing to place in the Library, or make available in some other way, the responses given to her during that consultation, so that people can compare the formal views represented to her with the proposals on the Order Paper?

Helen Goodman: As the hon. Gentleman knows, the consultations—in which he took part—were largely informal. I hope to be able to provide some further information that will satisfy him.


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