Andy Burnham
Prime Minister · MP for Makerfield · Labour (Co-op) · United Kingdom
“The right hon. Lady mentions leadership. Let me tell her and the whole House where Britain is showing leadership. There have been Conservative politicians at this Dispatch Box—Labour politicians, too—for decades who have talked about the importance of the two-state solution between Israel and Palestine.”
“I cannot comment today on quasi-judicial decisions, but we will take a pragmatic approach to oil and gas, as I have said before at the Dispatch Box. Let us get to the heart of this question, as the right hon. Lady invites me to do. What is the right way to fund defence and, yes, bring the welfare budget down?”
“I do not think the right hon. Lady is on strong ground when it comes to defence spending. It was 2.5% of GDP when the last Labour Government left office. It was 2.3% of GDP when the Government she was in left office. It is now set to be 2.7% in the next year.”
“This Chancellor, of all Chancellors, will be willing to provide that funding to our armed forces and back our defence investment plan. This Government’s commitment to the defence of this country is absolute. We have taken the strongest possible stance in supporting President Zelensky and Ukraine.”
“I think there are many people watching Prime Minister’s questions across the south of England who would now like Mr Speaker to be demoted in the way that my hon. Friend suggests. [Interruption.] This is very thin ice for a Leigh Leopards supporter to be on.”
“I remember well my visit to Stourbridge; it will not leave me, actually, because of the devastation, and the loss of everything in a moment for so many families. My hon. Friend’s support for them was really visible on the day, and the community is clearly very strong; that was evident.”
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Every one of 2,246 lines we hold for Andy Burnham, in date order, each linked to its source. Free to read, in full, without an account. Page 41 of 45.
“That is because the Secretary of State only discovered last week that his own reorganisation had stripped him of his powers to intervene, leaving him looking weak—in office, but not in power. Having done that, the Government’s answer is to try to scapegoat others for problems of their making. It will not work—we will remind people that it was a right-wing reorganisation that has left the NHS destabilised and demoralised. We will never tire of reminding the Prime Minister that the British people never gave him their permission to put the NHS up for sale, and we will restore the right values to the heart of our NHS—compassion before competition, integration over fragmentation, people before profits. The NHS and the country deserve better than a Government who are out of touch and out of ideas.”
“For a start, I would have introduced a Bill to repeal the disastrous Health and Social Care Act 2012, which has placed our NHS on a fast track to fragmentation and privatisation. That Bill would have restored the powers and responsibilities that the Secretary of State’s predecessor gave away, and which he found out last week he no longer has. I would legislate for the full integration of health and social care as the only realistic answer to the challenges brought by the century of the ageing society. People can see that increasingly it is the Opposition who have the courage and the answers to deal with the big challenges the country faces, not a failed coalition that is now playing out time. Its toxic medicine of cuts and reorganisation has laid the NHS low, and now it has no answers to the chaos it created.”
“I agree that we need to do something about that, and we did bring forward measures in government, but standardised packaging is not plain packaging: it is about having designs on the pack that could be used to ensure there is no counterfeit tobacco. Surely some things are more important—the young smokers in the hon. Lady’s constituency and mine who are targeted by the tobacco industry. Surely we in this House can unite on issues such as this and take steps to improve the long-term health of the country. It seems to us that the Government have given up on the health of the nation. I said I would set clearly out for the House what I would do had I been standing at the Government Dispatch Box today.”
“I know that the right hon. Gentleman is very knowledgeable on this subject, but does he believe that councils have sufficient resources to consider new rights, given that we hear that care is collapsing all over the country and the Local Government Association says that if nothing else happens councils will be overwhelmed by the costs of care in less than 10 years?”
“The hon. Gentleman’s association with the detail seemed to be loose there; Andrew Dilnot wrote to the Government to say that health spending was lower in real terms in 2010-11 than it was when Labour left government. It is important to point out that the promise the hon. Gentleman stood on was for real-terms increases in every year of this Parliament and that that has not been honoured.”
“Accident and emergency departments across England are being closed, even though all are under intense pressure. For 11 weeks running, the NHS has missed the Government’s national A and E target. Last week, in places, one in three patients waited more than four hours in scenes not seen since the bad old days of the mid-1990s. What clearer symbol of the growing crisis in A and E is there than a tent as a makeshift ward in the car park at Norwich? The Secretary of State’s failure to address that cannot continue. Nursing jobs have been lost, ambulances are queuing outside A and E and patients are being treated in car parks. When will he get a grip?”
“Here comes another request for a meeting with the very obliging Minister. Last month he promised the House that he would rewrite the section 75 regulations to rule out enforced competitive tendering in the NHS. However, before Easter the respected House of Lords Secondary Legislation Scrutiny Committee said this of his redraft: “The substitute Regulations are substantially the same as the original Regulations.” It is no surprise that it seems to many that the Government are intent on privatisation by the back door, putting large parts of the NHS up for sale. With a crunch vote in the Lords next week, it is turning into another shambles. I make this offer to the Minister: will he again agree to withdraw the regulations and to sit down with us and the professions this week and come up with wording that is acceptable to all?”
“Finally, I want to turn to Stafford hospital itself, which Monitor has recommended should be placed in administration. This doubt about the hospital’s future will be causing real concern to the people of Stafford. After all they have been through, I think we can all agree that they deserve a safe and sustainable hospital, and I hope the Secretary of State will soon set out a plan to achieve that. Learning the lessons of Stafford cannot be done overnight. We all have to play our part. The Government have made a start today, but much more needs to be done and we will hold them to that.”
“Just last week, work force figures showed that there had been a reduction of 843 nurses between November and December last year. Does that not sound the clearest of alarm bells that some parts of the NHS are already in danger of forgetting the lessons of its recent past by cutting the front line too far? Do not communities need a clear, objective benchmark so that they can challenge staffing levels on wards, and would it not be a great help to them for the Francis recommendation on staff-patient ratios to be accepted? We learned last week that the Department has handed £2.2 billion from last year’s budget back to the Treasury. Surely that money would have been better invested in the front line and in bringing all hospitals in England back up to safe staffing levels.”
“Will the Secretary of State assure the House that requiring a year on the ward will not increase the financial barriers to young people entering nursing and, if more trainees are to be on the wards, will he ensure that there are enough staff with the time to train the extra students? That takes me to my fourth point and the most glaring omission from the Secretary of State’s statement, namely safe staffing levels. We will never get the right culture on our wards if they are understaffed and over-stretched, but there is evidence that things are going in the wrong direction and the Secretary of State was silent on the issue today. The CQC has recently reported that one in 10 hospitals in England do not have adequate staffing levels.”
“Thirdly, on regulation and training, Robert Francis has made a very clear case for a new system of regulation of health care assistants to improve basic standards—a case that we made during the passage of the Health and Social Care Act 2012—yet it did not feature in the Secretary of State’s statement. Have the Government accepted in principle the regulation of health care assistants? We support moves to rebalance nurse training and to include more hands-on experience, but student nurses already spend 50% of their time in clinical practice and face significant financial barriers when completing their training.”
“Instead, we need a powerful patient voice in every community that is able to sound the alarm if things are going wrong. Rather than pulling down the shutters, as the NHS has a tendency to do, complaints should be embraced as opportunities to learn and improve. It is just a matter of days until the new NHS comes into being and the concern is that patient voice has not been embedded at the heart of the new system. A third of councils say that their local healthwatch will not be up and running by the 1 April deadline, and there are wide variations in both structure and membership. Will the Government accept Robert Francis’s recommendation of a consistent basic structure for healthwatch programmes throughout the country before it is too late and they go their separate ways?”
“Will the Secretary of State assure the House that the duty will apply equally to all providers of NHS services, including private providers? His statement was a little vague on that point. More generally, with more private providers coming into the NHS, is it not the case that we will not get the transparency we need unless the provisions of freedom of information apply fully to all holders of NHS contracts and information cannot be withheld under commercial confidentiality? Secondly, on patient voice, the Government have announced new chief inspectors of hospitals and social care. Those were not Francis recommendations and, while we give them a cautious welcome, I am sure that the Secretary of State will agree that regulation alone will not be enough to prevent another Mid Staffs.”
“Although the Opposition welcome much of what the Secretary of State has said today, his statement falls short of that promised full response and contains serious omissions on which I would like to press him, in particular, on four of Robert Francis’s flagship recommendations, which I shall take in turn. First, we welcome the move to place a duty of candour on health care providers and believe it could help bring about the culture change the NHS needs. The Francis report, however, goes further and recommends a duty of candour on individual members of staff. Will the Secretary of State say more about why he has only accepted this recommendation in part and not applied it to staff? Has he ruled that out or is he prepared to give it further consideration?”
“I thank the Secretary of State for his statement and for the measured way in which he introduced it. The NHS is 65 this year, and if it is to be ready for the challenges of this century, it must learn from the darkest hours of its past. The NHS was founded on compassion and, as the Secretary of State said, what happened at Stafford was a betrayal of that. Rightly, apologies have been given, but it is now time to act and make this a moment of change. Robert Francis delivered 290 careful recommendations after a three-year public inquiry and, like the Secretary of State, I pay tribute to him today. In response, the Prime Minister promised a detailed response to each recommendation by the end of this month.”
“Three of the defibrillators donated to schools by the Oliver King Foundation have already been used, which brings home just how important it is to support those campaigns. As my hon. Friends the Members for Bolton West and for Liverpool, Walton have said, we all saw the case of Fabrice Muamba—what an inspiring story that is —which shows just what can be achieved, but as my right hon. Friend the Member for Knowsley said, he was saved only because he fell at a premier league football ground. Obviously, he did almost die, but he survived because he was at the ground and because back-up was on hand. The poor kids who fall at grass-roots football locations are not so lucky, but simple support could be in place that might save many more lives.”
“Oliver’s dad, Mark, was in a similar position to my constituent: he was not warned about the potential risks and, obviously, I am sure he now thinks about that all the time. Close to my constituency, we have also recently lost a very young boy. Ciaran Geddes was seven years old, and he died in April 2012 playing football on his own. He was a member of the Winwick junior football club, who play in the same Warrington junior league in which my son used to play. That brings it very close to home, and it was such a young life. Ciaran’s mum, Marika, is now campaigning through the Ciaran’s Cause charity, which has given 27 defibrillators to schools across Warrington, with 10 more to be given soon. Marika says that, with every defibrillator the charity gives, she feels that Ciaran lives on.”
“He had all the latest gear, but she said, “If somebody had just told me to pay for a screening test, it would have been the best £30 I could ever have spent, but I didn’t know anything about it. I didn’t know he was at risk.” My journey began there, and I started to look into the issue. When I held office in the Department of Health, I asked the Department to look at the issue and to consider the case for screening, as proposed by my hon. Friend the Member for Liverpool, Walton. While that work has been taking place, we have sadly seen further tragedies. Of course, we have spoken today about the loss of Oliver in Liverpool. He was another outstanding young sportsman whose talent was taken away from us.”
“Friends the Members for West Lancashire (Rosie Cooper), for Bassetlaw (John Mann) and for Bolton West (Julie Hilling) have all made outstanding speeches. The reason why people talk with such conviction and passion is that we have all seen the devastating effect of the unexpected loss of a life, particularly of a young person, but not necessarily so because this affects young and old. People have seen the inexplicable grief that a family feel when someone is brought down in their prime, often at the peak of their powers, playing sport. That was certainly the case with Daniel Young in my constituency. He died in 2005 playing football for Leigh RMI football club. He was an outstanding young footballer, and at the time his mother, Dionne, told me that she bought everything for him to make his young football career a success.”
“It is now time for Parliament to show more leadership on the issue, which we have brought up the parliamentary agenda, and to make changes that will save lives. We have heard from many hon. Members today, and the attendance of so many Members, not all of whom have spoken, shows the level of interest within Parliament. My hon. Friend the Member for Liverpool, Walton (Steve Rotheram) introduced the debate with a customarily outstanding speech, and he set out the issues very clearly. The hon. Member for Brigg and Goole (Andrew Percy) spoke from personal experience, and given his commitment, we should all listen to what he has to say. My right hon. Friend the Member for Knowsley (Mr Howarth) and my hon.”
“If it does nothing else, today’s debate will have achieved something, because the official record will contain a permanent memorial to Oliver King, and to the other young people mentioned in the debate, whose lives have tragically been lost. I want the debate to achieve far more than that, however, which is why I am leading for the Opposition today. I want today to be the start of a parliamentary journey in which the issues we are debating here will soon move to the Floor of the House and then, finally, into legislation supported, I hope, by a cross-party campaign. The debate is changing in the country. Every Member of this House will have seen campaigns in their local paper when lives have been lost, and those campaigns are calling for something to be done.”
“We have heard some outstanding speeches this afternoon, and a good deal of consensus, which I am sure will be encouraging for the thousands, indeed millions, of people throughout the country who are campaigning on the issue that we are discussing. We must not forget that we are here for this debate because 110,000 people have signed a petition, in the belief that lives can be saved if Parliament will give the issue more attention and make changes. The debate would not be happening without the outstanding campaigning efforts of the OK Foundation and other heart organisations. I pay tribute in particular to Councillor Jake Morrison, one of the youngest councillors in the country and a shining example of the difference that councillors can make when they dedicate themselves to a campaign.”
“The courses that it delivers for young children are outstanding. It would be easy to add such courses to the national curriculum. My children tell me all the things that they are doing in school: the things that they are learning to make in home economics, and the kings and queens that they know about. It is odd that we do not ensure that every young person in this country leaves school at 16 knowing how to save a life. What more basic skill could we give them during their school years?”
“I think that, between us, we can develop a set of simple policy calls that could make a difference and save lives. I will identify three in particular. As hon. Members have said, there is a compelling case for putting emergency life skills on the national curriculum and for making time available, perhaps as part of the personal, social, health and economic education component, to provide training for all young people. No young person should leave school without knowing how to provide CPR and use a defibrillator, because it is not all about defibrillators or CPR—the two together are important. If we train young people in those skills, as my hon. Friend the Member for Bassetlaw said, they will go home and talk to others about them. I have seen what the British Heart Foundation does in schools.”
“However, I think that a mistake was made. As the programme was wound down, responsibility was passed to ambulance services. There are two ways of looking at that. On the one hand, ambulance services have been doing brilliant work ever since as they have taken on the responsibility to improve communities’ capacity to respond. It is fantastic to see representatives of the ambulance service here today. I have certainly been impressed by what I have seen in the north-west. The team there is working with communities across the region to build their capacity to respond. The ambulance service has done good work, but national focus on the issue was lost when responsibility was passed down to the ambulance services, and we must acknowledge that. That brings me to the crux of what I wanted to say, particularly to the Minister.”
“According to the British Heart Foundation, in this country between 2% and 12% of people who suffer a sudden cardiac arrest survive, which is way too low. Elsewhere, in Seattle, as has been said, 50% of people survive, and in Japan, a public access campaign for AEDs has resulted in an immediate increase in rates of survival with minimum neurological impairment for out-of-hospital cardiac arrests. The evidence is absolutely clear, so what about policy? What did we do while we were in Government? We must be honest. I am not here to say that we did everything right, but we did something. On the back of the focus on heart services, we introduced the national defibrillator programme in the middle of the last decade. It made a modest amount of funds available to purchase defibrillators to give to local organisations.”
“Friend the Member for Bolton West said, it is about that chain of survival; it is about equipping people with the knowledge and the kit at local level to start making a difference so that, when the professionals arrive, there is somebody there to save. That is what we have to do. If we look at the statistics, 12 young people, as my hon. Friend the Member for Liverpool, Walton said, die from sudden cardiac arrest in the UK every week. We underplay that problem. Until recently, the Department of Health NHS Choices website stated that the figure was 12 young people a year. The figure was corrected after it was pointed out to the Department, but it is important that the problem is not underestimated. The clinching fact for why we should do more is that across the world, survival rates are very variable.”
“My feeling is that provision is too random at the moment—it is happening in some places and not in others—and we need clarity on policy at a national level so that we can piggyback on all those local campaigns to make progress. I do not think there is a funding issue, because communities will find the money to put these things in the right places, but we must know where they need to go. It is crucial to understand that, with the best will in the world, the ambulance service is often unable to make a difference for the people who sadly fall in a busy shopping centre, railway station or sports ground. Why? Because they are unable to get there within the Government target time of eight minutes, which is too late. As my hon.”
“The right hon. Gentleman is absolutely spot on, because we see incredible activity across all four nations of the United Kingdom in the wake of those tragedies. Communities are pulling together, raising funds and donating defibrillators to schools and sports clubs, which brings me to my main point: leadership is now needed at national level to co-ordinate that activity and to bring clarity to the whole situation so that the public know where to find a defibrillator and how to use one. I hope I can persuade the Government to work with Opposition Front Benchers on that. There is no politics involved here; this is about saving lives where we can and doing things to make human progress in this country. Other countries are more focused than we have been, and because of that they are saving more lives.”
“Let me make it clear that I want children to learn about kings and queens. Yes, it must be possible. We are talking about a one-off course lasting a couple of hours. Surely it is possible to find the time to deliver it. Perhaps the hon. Gentleman’s suggestion is one way to do so. My point is that every child should leave with a certificate to say that they have done the course, they know how to use the skills and they are confident in using them.”
“My third and main point is to ask the Minister to give serious consideration to setting a minimum legal requirement for the number of defibrillators in public places. The time has come for that to be required by law. Hon. Members have referred to fire extinguishers and smoke alarms. There comes a point when technology allows something to be made much more widely available in public places and buildings, and I believe that we have reached that point with defibrillators.”
“I know that the UK National Screening Committee has considered the issue, partly because I asked it to, but still no firm recommendations have been made. Will the Minister consider it? It could be delivered for incredibly small amounts of resource in NHS terms; a screening test costs about £30 pounds. It should be available to any parent who wants to make use of it, particularly for young people who play sport every week. My son plays a lot of sport, and I watch him play every week. I have still not had him tested. It crosses my mind all the time that perhaps I should. It should be an easy thing to do; it should not be hard to find. The time has come to provide more screening.”
“My hon. Friend is right. Let schools decide, but let us make it a clear legal requirement that they teach those skills. That is how to make a difference: by having a population that is much more educated in emergency first aid and CPR. The difference that it can make is huge. The Department for Education appears to be highly resistant; I do not know why. Surely we could link it to science or biology. Surely there are ways to deliver that teaching that are not irrelevant to the rest of the curriculum. That is our first request. Can we have a clear requirement? Secondly, as my hon. Friend the Member for Liverpool, Walton asked, is there not a case for a screening programme, particularly for at-risk young people, such as those who play lots of sport?”
“They know and people outside know that it is right to make a change, and some communities are just getting on and doing so; they are not even waiting for Parliament to do something, and that alone should be enough to make us think and act. If we made a commitment now, I am certain that in a matter of years we would see those statistics improve and more lives being saved which, at the end of the day, is the best memorial we can give to Oliver King, Ciaron Geddes, Daniel Young and all the young people who have tragically lost their lives.”
“Those locations could be publicised, and the public could be educated about how to use them. Why are we not doing it? We should be. I am not making a political point; I am being as critical of our time in government as I am of the current Government. We should be doing it. The case for action is unanswerable. My hon. Friend the Member for Liverpool, Walton has done us all a huge service by requesting this debate, which is long overdue. Other countries are way ahead of us in putting a proper, thought-through policy in place at every level: education, screening, prevention, and response through public access to defibrillators. My three requests can be given fair consideration by the Minister; if she were to act, we would secure something momentous for the people who have campaigned so vigorously on the issue over recent years.”
“Earlier in the debate, someone asked where we would find a defibrillator in Parliament. I would not know. We need to start thinking about clarity and signage. If we did so, we might be able to have a national open register of defibrillators. It is not beyond the wit of man to ensure through an app on a phone that people in a situation where somebody had fallen could find out in real time, via modern technology, where the nearest defibrillator was. An effort could then be made to locate it as soon as possible. Such things could be done. Lives could be saved. There is no excuse for complacency. We are not talking about huge amounts of money. This House could apply its mind to the issue, bring a little more focus to it and make proportionate and sensible requirements for where defibrillators must be located.”
“I am sure they could. That is my appeal to the Government. I am not being prescriptive and saying that I want this, that or the other. A compelling case has been made for schools because of the loss of young lives. Shopping centres are also a possibility because of the footfall, as are train stations, airports and so on, and workplaces, particularly where people are under the extra pressure of carrying out intense physical activity. The Government can advise on what the minimum requirement might be, but it is important to have one. Then we would have national clarity on where the public can expect to find a defibrillator. They would know where to locate one, because defibrillators would be required by law. Communities are crying out for it, and we do not have clarity at the moment.”
“If she is worried about overly burdensome legislation, it could start with a simple requirement to have a defibrillator publicly available in towns of, for example, 30,000 or more; it could be a modest requirement to get the ball rolling, as other countries have done.”
“I realise the situation is slightly unusual: the Minister is defending the policy of the previous Government and I am asking her to reconsider and to go further. She said that ambulance services are best placed because they understand their communities. I partly agree, but the problem is that ambulance services do not have the power to insist on defibrillators going where they are most needed. The ambulance services are not the planning authority or the owners of the big buildings; they can only use persuasion and cannot ensure that defibrillators go where they really need to go, where lives can be saved. That is why legislation is necessary.”
“Can I add my own tribute to the organisations—most of them—that my hon. Friend has just listed? Obviously, we do not doubt the Minister’s good will, but I think that we will have been disappointed by the response, particularly on the issue of legislation. With that in mind, may I encourage my hon. Friend to return to the Backbench Business Committee and make a request to bring this issue to the Floor of House? It seems to me that Parliament might take a different view from the Government on the need for legislation. I think that we should try to test the mind of Parliament on this issue. I hope that my hon. Friend will not be put off and will pursue his campaign in that direction.”
“While we commend moves to prevent abuse of the system, could he not better achieve his aim if he was not planning to close so many A and Es in London? The Government have made a lot of assertions, but there is a real lack of policy clarity and evidence. Unless the Secretary of State can provide convincing answers to my questions, the House will be left with the distinct whiff of a cooked-up a story to suit the Government’s political purposes rather than a real drive to protect the NHS from abuse.”
“What assurances can the Secretary of State give to health professionals that they will not be used to plug the gaps that have been created by the Government’s severe cuts to the front line of the UK Border Force? Will they be given a simple way of checking eligibility and not be burdened by extra bureaucracy? Will these changes apply equally to planned and emergency care? If so, that could put health professionals in a difficult ethical position. Does the Secretary of State agree that care should always be provided in life-threatening situations, and will he take this opportunity to reassure health professionals on that important point? Finally, the Secretary of State told “World at One” that one of the main reasons he was doing this was to relieve pressure on accident and emergency departments, particularly in London.”
“Earlier today, the Prime Minister’s spokesperson put the cost to the NHS of health tourism at £10 million to £20 million. On “World at One” this lunchtime, the Secretary of State said that he thinks it is more like £200 million. So which is it? Will the Secretary of State publish the evidence he has to support his claim? Secondly, we need more detail on what the Government are proposing. Has the Secretary of State consulted those in Scotland, Wales and Northern Ireland on any proposed changes? There are practical questions on which health professionals will need reassurance. We have heard in the news today about the problems in the UK Border Agency.”
“The NHS must not be open to abuse. Where people do not have entitlement to free treatment, steps should always be taken to recover the costs from individuals and Governments. That clear principle is shared by Members across this House. For some time, hospitals have rightly had a legal duty to recover any charges owed from overseas patients. The previous Government proposed a number of further steps, including amending immigration rules so that anyone with substantial medical debts is not allowed back into the country. We welcome efforts to build on that, while always guarding against overblown rhetoric, which does not help the immigration debate. We therefore need more precision and clarity from the Secretary of State. First, on the scale of the problem, as ever with this Government’s announcements, there is already confusion to clear up.”
“The truth is, however, that well-meaning as those steps were, there were places where the underlying culture of the NHS did not change and that is an important lesson for us all. When we make statements in this place and pass policies, we assume that everything changes on the ground, but it does not. The previous Government made similar statements to that made by the Secretary of State today, yet the use of agreements persisted. Why was that? The answer is that there is a culture in the NHS—a tendency to pull down the shutters and push people and complaints away when things go wrong—that is more ingrained than we might think.”
“In 1997 Labour inherited the job of responding to the Bristol heart scandal and the Harold Shipman murders. A series of major policy developments followed on patient safety, inspection and regulation. We passed the Public Interest Disclosure Act 1998, protecting whistleblowers. We published data that had never before seen the light of day on survival rates from heart and stroke care, and 1999 saw the first ever independent regulation of hospitals and care standards. In 2001 we established the National Patient Safety Agency, which has sadly since been abolished and, in 2006, on the back of the public inquiry by Dame Janet Smith, the General Medical Council and the Nursing and Midwifery Council were reformed to end the professional closed shop.”
“What happened at Stafford hospital was a betrayal of everything the NHS should stand for. We will face up to what went wrong and I will say more about that today. I repeat the apology to the families of people who suffered appalling abuse and neglect. We must do more. People affected will be watching this debate and rightly wondering what it will achieve. They want to know what is going to change and when. The time has come for cross-party agreement on a way forward, and that is my hope for this debate. There must be more accountability and transparency, and that is why we support the motion. We also support the Secretary of State’s ban on gagging clauses. It builds on statements made by the previous Government, which in turn were a response to previous scandals. That provides a crucial context for today’s debate.”
“In some trusts a national top-down style was replaced with a local top-down, bullying style, which can be even worse. I can remember the shock I felt on reading the first Francis report’s finding that, on receiving FT status, one of the first things that the Mid Staffs board did was to resolve to hold more meetings in private. That was an audacious breach of the spirit of the legislation passed by this House.”
“No, I will not. I was copied into an e-mail by Professor Brian Jarman in mid-March 2010 and, having asked the CQC to investigate what he had said, I wrote back to him on 31 March 2010. That was literally my last duty as Secretary of State for Health after the general election was called. I was not able to respond further to inquiries. It is important to provide some balance to the hon. Gentleman’s comments. Changing the culture in the NHS requires vigilance and persistence. As Robert Francis says, we have all been too remote from the front line. The foundation trust reform was a serious attempt to end the top-down culture in the NHS, bringing more accountability and transparency. If we look back, however, we will see that, when the centre stood back, there were places where an unhealthy local culture became even more firmly established.”
“In focusing on only part of the patient experience, there was not sufficient focus on the overall patient experience and the whole person—a particular problem when it comes to caring for very elderly people whose needs are a blur of the physical, mental and social. Robert Francis is right to call for a fundamental rethink of the way in which we care for older people, and I have put his recommendations at the heart of Labour’s policy review. However, there are more immediate things that we can do and I will spend the rest of my time on five substantive points.”