Sir Jeremy Hunt
MP for Godalming and Ash · Conservative · United Kingdom
“It is a pleasure to speak under your chairmanship, Mr Twigg. I speak today as chairman of the all-party parliamentary group for financial markets and services. I refer hon. Members to my entry in the Register of Members’ Financial Interests, which states that I accept speaking engagements from financial services companies.”
“Chief executives of banks made very ill-judged decisions to continue paying themselves large bonuses at a time when the rest of the country was suffering, and the country suffered a longer and deeper recession at that time as a result of our exposure to the financial services sector, which was much greater than that of our peers.”
“We are in a much, much better state than we were in 2008.” But I do think that it has gone slightly too far in the other direction. Sometimes we can over-correct.”
“What further action will the Government take to improve access to finance for small and medium-sized enterprises and scale-ups, which has been a particular issue in the period since the financial crisis?”
“I thank the hon. Lady for her role in helping to salvage Barings. I did not know that before. She is absolutely right to raise that issue. I do not say this in a party political way, because my party pretty much supported it at the time, but there is no doubt that, in the run-up to the financial crisis, regulation was not as tight as it n…”
“To their credit, this Government have built on those reforms with the Leeds reforms, the Pension Schemes Act 2026 and the forthcoming Financial Services and Markets Bill, all of which are extremely welcome. But, as the hon. Member for Buckingham and Bletchley said, our competitors are not standing still.”
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“I say to Ministers, who have listened to my arguments genuinely and in good faith, that NHS and care staff deserve better after two years of the pandemic, and the people waiting for their NHS operations deserve better, too.”
“In other words, more nurses does not mean enough nurses, and we can never know what enough is unless we are honest enough to ask ourselves the hard questions. The lesson of Mid Staffs, Morecambe Bay, Southern Health and Telford is that the first step in dealing with poor care is to be honest about the issue. We now have in the NHS a workforce issue of enormous proportions, which is why Lords amendment 29 is supported by every NHS leader, every royal college, every health think-tank, every union and more than 100 NHS organisations in total. I am afraid that, by voting down a simple request for independent estimates of the number of doctors and nurses we should be training, the Government are actively choosing to sweep the problem under the carpet.”
“I immensely respect the work done by the Minister for Health and the Secretary of State, and I am grateful for their engagement, but I say to them, from the bottom of my heart, that not training enough doctors and nurses is a false economy. It costs patients’ lives, it costs taxpayers’ money, it demoralises the workforce and it lets down the people who are waiting for their NHS operation. The Health Minister’s argument is that we will have 50,000 more nurses by the end of this Parliament and we are training more doctors than ever, but today’s report by the King’s Fund shows that that is a hollow claim, because even though we are on track for our 50,000 nurses, the number of vacancies is still not going down.”
“They will do so because they know that any such independent estimate would conclude that we need to be training more doctors and nurses. Why on earth would we not want to train more doctors and nurses, if we looked objectively at the challenges facing the NHS today? We last debated this on the day the Ockenden report was published in Parliament. That report talked about more than 200 babies’ lives that would probably have been saved with better care. The key recommendation in that report was for 2,000 more midwives and 500 more obstetricians, and that would not have been necessary had this amendment been in place. We can put this right.”
“Thank you, Madam Deputy Speaker. I rise to speak in support of Lords amendment 29B. Even though I believe the Government will reject it today and this may be the last time this House can debate it, I will try to make my comments with the customary courtesy that the Minister for Health attributed to me just now, with his customary courtesy. He said that this amendment was unnecessary, but I wish to ask the House: what precisely is unnecessary about an amendment that simply requires independent, regular estimates of the numbers of doctors and nurses we should be training? What could drive the Government to want to vote down such a harmless amendment, not once, not twice, but, including today, three times? I will tell the House why the Government are going to vote this amendment down.”
“The Secretary of State will have read the scandal exposed in The Sunday Times this weekend that six babies are born every month after being exposed to sodium valproate, which has been known for many years to cause disabilities. Last year the Government consulted on putting warning labels on valproate. Is it not time to go much further and ban the prescription of sodium valproate to epileptic pregnant mothers?”
“Can we build a culture in the NHS that is open and transparent and that accepts that things go wrong, but is hungry to learn from mistakes so that we never again repeat the tragedies?”
“May I gently say to the Secretary of State that while I warmly welcome more midwives and more doctors, that approach is not consistent with voting down today the Lords amendment to the Health and Care Bill that would make sure that we never have those shortages again? Finally, I pay tribute to Richard Stanton and Rhiannon Davies and to Kayleigh and Colin Griffiths. Richard and Rhiannon came to talk to me about their daughter Kate, who died in 2009; Colin and Kayleigh’s daughter Pippa died in 2016, when I was Health Secretary. Because of the blame culture and the culture of fear in the NHS, it was left to them and many other families to fight for justice. Can this be the last time that we put that burden on the shoulders of bereaved families?”
“Today’s report goes beyond my darkest fears. When I commissioned it as Health Secretary in 2016, I was approached by 23 families; we have heard today that more than 200 babies might have been alive today if better care had been provided. I thank Donna Ockenden and her team for an incredibly thorough investigation. I also thank the Health Secretary for his compassionate and comprehensive response to the House today. Donna Ockenden does not use the word “recommendation”; she talks about immediate and essential actions. What is the Secretary of State’s deadline for the implementation of those actions? That is something that every expectant mother in the country desperately wants to know.”
“Could the Minister possibly just tell me whether there is a single NHS organisation that is not supporting Lords amendment 29, which the Government are planning to reject?”
“What message does it send to young doctors, newly qualified midwives and newly qualified nurses, who are incredibly stressed and pressured by the situation on the frontline, if we are saying to them, “Look, it is really tough now, but we are not even prepared to train enough doctors, nurses and midwives for the future to relieve that stress and pressure later on in your career”?”
“The Government are publishing a 15-year framework, but he knows and we know that it will simply detail the number of doctors that the Government think they can afford, not the number of doctors we actually need. In the past—even last year—when the NHS has tried to publish the number of doctors it thinks it needs, it has been stopped by the Government. Why is there this reluctance to publish the number of doctors we are going to need in 15 years’ time, given that 97% of hospital bosses say that staff shortages are having an impact on the quality of care they are giving and there are 110,000 vacancies? The answer is simple: it is because the Government know we are not training enough right now.”
“Like the shadow Health Secretary, I rise to speak in support of amendment 29, which the Government plan to vote down. This wholly innocuous amendment simply asks them to publish, every two years, independent projections of the number of doctors and nurses we should be training. The Government are rejecting the amendment because they think it would compel them to train more doctors, which is true, but it ignores the fact that this is the best way to reduce the £6.2 billion locum bill that is currently devastating the NHS budget. The shadow Health Secretary was very generous to me, and I return the compliment by saying that I think he is doing an excellent job. I hope he remains shadow Health Secretary for many years. I ask the House, in the nicest possible way, to reject the compromises proposed by the excellent Minister.”
“This is why it is supported by more than 100 health organisations; every royal college and every health think tank; people in all parts of this House; many peers in the other place, including Lord Stevens, who used to run the NHS; and—this is the point I wish to conclude with—by thousands of thousands of doctors and nurses on the frontline.”
“I thank my hon. Friend for that comment. He was an excellent cancer Minister. In our time, the biggest pressure was funding, but now people say that the biggest pressure is workforce. It is devastating for morale to refuse to address this issue at a time such as this. Any Government who care about the long-term future of the NHS have an absolute responsibility to make sure that we are training enough doctors and nurses for the future. Any Government who care about value for money for taxpayers should welcome a measure that will help us control a locum and agency budget that has got massively out of control. That is why opposing Lords amendment 29 makes no sense either for the Department of Health and Social Care or for the Treasury.”
“No one is expecting a solution tomorrow, but we do at least have a responsibility to look each and every one of those people, who worked so hard for us in the pandemic, in the eye and say, “We do not have a solution right away but we really and truly are training enough for the future.””
“We talked about the agonies faced by families. We did not talk enough about the agonies faced by doctors, midwives and nurses who find themselves responsible for the death of a child—it is psychologically incredibly devastating for them. We need to be able to look them in the eye and say, “The No. 1 thing in the Ockenden review that came out was that staffing shortfalls can make a difference. We understand that.” They know and we know that there is no silver bullet; this cannot be solved overnight. It takes seven years to train a doctor, 10 years to train a GP and three or four years to train a nurse or a midwife.”
“It is absolutely the case. We need something like this because, as I know—I will do my self-reflection now—when a Health Secretary negotiates a spending settlement with the Chancellor, the number of doctors they are going to have in 10 or 15 years’ time is quite low down their list of priorities because they are thinking about immediate pressures. So we need something that deals with that market failure. I did set up five new medical schools and was proud to do so, but I do not know whether that was enough. That is why we need something to make sure that we never have to worry, whoever the Government and the Health Secretary are, that this fundamental thing that is vital for the future of the NHS for all of us is always properly looked after. Let me conclude by remembering what we were discussing this morning in the Ockenden review.”
“I salute the leadership of the Foreign Secretary on this issue. As I know from my own experience, this is a fearsomely difficult diplomatic challenge, and it would not have been solved without sustained, personal interest right from the top, and she deserves great credit for that. Most of all, I commend the efforts of Richard Ratcliffe, Nazanin’s husband. His quiet courage, his humility and his total determination never wavered throughout six years of hell, and he really was the bravest person I met during my time as Foreign Secretary. He is an inspiration to many people. Is the Foreign Secretary inspired by the united western response to the crisis in Ukraine, and is there something we can learn from that to unite as democratic countries to stamp out the vile practice of hostage taking?”
“I welcome today’s announcement and thank the Home Secretary for listening to the House. My constituent Larry Sullivan owns a technology business in Russia and has some very able young software engineers desperate to get here. They would make a big contribution to the UK economy. They are fanatically against Putin’s war of aggression. Is there a route for them to come here before Putin slams the door shut?”
“Yesterday, the Foreign Secretary said that one of the things that pained her the most was the sale of embassy buildings over many years and she hoped no more of it would happen on her watch. Will she cancel the proposed sale of 45% of our Tokyo embassy estate, which would deeply dishearten one of our closest allies at a time when we are seeking to strengthen the western alliance?”
“Today is the first day of Brain Tumour Awareness Month. The Secretary of State kindly wrote to me in January when my mother died from a brain tumour, and Baroness Tessa Jowell, who was much loved on all sides of the House, also died from a brain tumour. Given that it is the biggest cause of cancer death for the under-40s, and we still do not really know what causes them, does he agree that this should be a priority for research, so that we understand as much about brain tumours as about other cancers?”
“May I commend the resolute approach being taken by my right hon. Friend and ask whether she will consider secondary sanctions—sanctions not against Russian entities but against entities in other countries that seek to profit from the gap left in trade—as it is totally unacceptable for others to profiteer from this invasion. The move will also increase the pressure on Russia, as it did successfully on Iran.”
“Does the Prime Minister agree that the international order as envisaged in the Atlantic charter of 1941 has been the most successful in the history of freedom and democracy and that, as one of the architects of that order, we have a special responsibility to defend it? While today’s sanctions are extremely welcome, this cannot just be about economic measures. We need a fundamental review of our military capability, including revisiting the integrated review, whose assumptions may now be out of date.”
“I strongly support the robust approach that my right hon. Friend has taken, and that indeed he took as Foreign Secretary, but Putin will have predicted and discounted western sanctions long ago. Does my right hon. Friend agree that if we are not to be behind in the diplomatic chess game, we need to do some things that Putin is not expecting? First, we need a sustained increase in western defence capability and spend. Secondly, we need a sustained reduction in the ability of the Russian state to finance its own armed forces. We need economic and financial sanctions that last not just until the next Government decide to have a reset, but if necessary for as long as this dangerous man remains President of Russia.”
“I support today’s announcement, which is a tribute to British science and to the Government’s leadership in the vaccine programme. Does the Prime Minister agree that when it comes to future pandemics, the real danger zone is those early months when we do not have a vaccine against a new virus and that, in that context, it is about not just whether the NHS can cope, but whether the NHS can cope without switching off other vital, life-saving treatments? If he does agree, it is not enough just to say that we have more doctors and nurses than we had before; we must also ensure we have enough doctors for the future. If he has plans for that, will he please tell the House how he will make sure that we are training enough of them?”
“For most members of the public, the central person responsible for their care is their GP. Is it not time to go back to the days when everyone had their own family doctor, instead of a different doctor every time they call the surgery? They might not see the same person every time, but there should be someone at the GP surgery who is responsible for their overall care, whether that is in the health system or the social care system.”
“The Select Committee on Health and Social Care recommended an increase of £7 billion a year by the end of the Parliament, but it is actually going up by £2 billion a year. What will we do to overcome the resistance in the NHS to merging budgets with a social care system that is feeling very stretched? Secondly, it is a very big step forward that everyone will have a single electronic health and care record by 2024, but my simple question is whether the public will be able to access the data. Patients are the best guarantors and defenders of their own health, so they should be able to access everything that professionals can see about them. My third question is about having a single professional responsible for someone’s care. What is the role of GPs in that?”
“As one in the long line of former Health Secretaries with scars on their back—to quote Sir Tony, if we are allowed to—from when they tried to integrate the health and care systems, I warmly welcome this White Paper. I think it is more than aspirations. But there are three central elements of the plumbing that we have to get right, and I want to ask the Minister, who I know is very committed to this, for his response. First, previous attempts to have pooled budgets for vulnerable people have been bedevilled by the fact that the NHS has not wanted to pool its budgets with an underfunded social care system. The grant to local government is still not generous, to say the least.”
“What will happen the next time the Secretary of State wants to introduce an important vaccine, for example for flu, and make it mandatory? Is not the real reason that we have made this decision that we have a staffing crisis that the Government have still not brought forward their plans to address? When will those plans be brought forward?”
“My right hon. Friend knows that my instinct is to support him in the very difficult decisions he has to take in a pandemic, and I think he is doing an excellent job, but I have some concerns about today’s announcement. I think they may not be shared widely in the House, so I hope colleagues will indulge me if I explain why. Frontline workers have done an extraordinary job in this pandemic, but I have yet to meet a single one who believes that anyone in contact with patients has a right to put them at increased risk by not having a vaccine, unless there is a medical exemption. My concern is that having marched the NHS to the top of the hill and having won a very important patient safety argument, we are now doing a U-turn.”
“At the height of the first wave, the Government had the courage to pre-order 400 million doses of vaccines without even knowing whether they worked. That has laid the foundations for our having the best vaccine programme of any large country, so I welcome today’s announcement. It will not surprise the Prime Minister, though, if I draw his attention to the fact that NHS doctors and nurses are absolutely shattered. He will have seen this week that one in six doctors say that they have had near misses or harmed patients because of exhaustion. If he does not want to accept the Select Committee’s recommendations to address the workforce crisis, what will he do to give hope to our brilliant frontline staff?”
“This morning, the Health Secretary is reported in The Times as saying that the NHS can learn from the way in which academy chains are regulated, but he will know that the education system has no national targets, while the NHS uses more national targets than any healthcare system anywhere in the world. Will he look at the role of targets and the risk that they focus managers on bureaucratic numbers, sometimes at the expense of quality of care for patients?”
“I congratulate my hon. Friend on securing this debate and on the forthcoming addition to her family. On the point made by the hon. Member for Strangford (Jim Shannon) about staffing levels, does she agree that one of the most important reasons why we need to fill the staffing shortfalls—the 2,000 extra midwives needed immediately—is that we need to be better at identifying higher-risk pregnancies? Continuity of care, so that people are looked after by the same midwife throughout the pre-natal, birthing and post-natal periods, is an incredibly effective way to do that.”
“Will it deal with what the Health Foundation says is a shortage of 4,000 doctors and nearly 19,000 nurses who will be necessary for that elective recovery programme? Finally, when is he going to publish the workforce strategy? Will that have independently verified assurance that we are training enough doctors and nurses for the future?”
“I welcome today’s announcement. We have one of the best vaccine programmes in the world and as a result we can look forward to a time of living with covid with justified confidence. This is a very important step forward. As the Secretary of State knows, last week the Health and Social Care Committee published a report on what is going to happen now that the NHS is starting to think about tackling the covid backlog. We said that we were worried that that would be derailed by a workforce crisis, with shortages in nearly every speciality throughout the NHS. When is the covid backlog plan going to be published? Will it have details about what is going to happen in areas such as emergency care and general practice social care, all of which have a direct impact on the ability of the elective care programme to deliver?”
“When will the budget for Health Education England be agreed, because two and a half months before the next financial year we still do not know what it is? Will the workforce plan have independent forecasts so that we can make sure we are training enough doctors and nurses for the future?”
“This country has one of the best vaccination programmes in the world and the very best in Europe. We should remember that the foundations were put in place when, at the height of the first wave, the then Health Secretary bought 400 million doses of vaccine that we did not even know would work. That has meant that we are now emerging sooner and more broadly than nearly anywhere else. But that success was also because a lot of GPs in the NHS were diverted away from their normal work into the vaccination programme, and that has come with costs in terms of the other treatments they are not able to deliver. When will we see a workforce plan that takes account of the new responsibilities for vaccination that the NHS will have?”
“4. Hospitalisations in London have peaked, so the Prime Minister was absolutely right to hold his nerve on new restrictions in the last few weeks, but does he agree that the NHS faces not just omicron staffing absences, but permanent and dangerous staffing shortfalls in nearly every specialty? Will he end the cycle whereby those shortfalls continually threaten not just patient care, but sometimes even our freedoms, by overhauling workforce planning by backing Baroness Cumberlege’s amendment to the Health and Care Bill in the House of Lords, having a word with his neighbour in Downing Street and making 2022 the year we finally solve this problem?”
“One year and five days ago the UK administered the first properly approved covid vaccine in the world, and the Government are absolutely right to focus on immunisation, but Israel approved booster jabs for all adults in September, France approved jabs for teenagers in June, both long before us, and the United States has already approved jabs for five-year-olds, again long before us. Is the Secretary of State worried that our regulators, having been the nimblest in the world, are now taking too long? They are brilliant scientists and they are rightly totally independent, but what can he do to speed up this crucial decision making in a pandemic?”
“Will he provide funds to ensure that all those patients can be discharged, so that the NHS can be ready for any potential spike in new cases?”
“Disappointing though the statement will be for many people, the Secretary of State has my full and unqualified support. This is not a choice between more and fewer restrictions; it is a choice between taking action early to protect a future lockdown and making such a lockdown inevitable. We all hope that the omicron variant is milder than delta, but if it is not, a failure to act now could cost many lives. I want to ask the Secretary of State about the social care sector. I know that he will say more about it later this week, but he will have seen the estimate from NHS Providers that 10,000 beds—over 10% of all NHS hospital beds, and more beds than are currently occupied by covid patients—are occupied by people who are fit to be discharged but cannot obtain a care package.”
“I strongly support the balanced and sensible way in which the Secretary of State is buying time until we find out how dangerous this new variant really is. How is he preparing the NHS for the potential worst-case scenario that we might face, particularly in respect of the 10,000 NHS beds that NHS providers think are occupied by people waiting for a social care package? Given that in the first wave many people sadly died at home from stroke and heart attacks because they did not want to go into hospital, what are we doing for emergency care? Also, on cancer care, 45,000 fewer people started cancer treatment in the first wave, so how will the Secretary of State make sure that when we switch the NHS on for omicron we do not switch other services off?”
“It is also hard to see the NHS and social care systems being fully integrated, as they should be, and an end to the workforce crisis, which sees 40% turnover in many companies. This is a start. The Minister is a very capable new Minister and I personally have great confidence in her, but will she bring forward further measures to deal with those huge problems? Otherwise, we will see hospital wards continuing to be full of people who should be discharged, and older people not getting the care they need because the carers do not exist.”
“I thank the Minister for her work putting the White Paper together in a very short period. I know that she has put a lot of effort into it, but it is hard to see it as more than three steps forward and two steps back. The step forward, which we should acknowledge, is the introduction of a cap. Whatever the arguments about what counts towards the cap, having a cap will make a big difference to many people, and that is welcome. However, these measures do not really give confidence in two crucial areas. The first is the funding to local authorities for their core responsibilities. The White Paper barely gives them enough to deal with demographic change and national living wage increases, and it is a long way off the £7 billion-a-year increase the Health and Social Care Committee called for by the end of the Parliament.”
“May I congratulate the Minister on the excellent job that she is doing of standing in for the Foreign Secretary? A genocide is happening in Tigray. What work is the Minister doing with our partners in the United States, the EU and other western countries to send a message to Prime Minister Abiy that no international aid can be channelled through the Ethiopian Government until the genocide stops? Why does he still have that Nobel peace prize? Is it not high time that he was stripped of it?”
“The late Donald Rumsfeld coined the phrase, “known unknowns”, and that is what we face with the new omicron virus. The Secretary of State is therefore absolutely right to take sensible and proportionate measures to buy time while we wait to understand how dangerous this new variant can be, but does he not agree that the fact that we face this danger is a symptom of the failure of western countries to make sure that vaccines are distributed adequately around the world? I recognise the enormous contribution that the UK has made through COVAX, the development of the AstraZeneca vaccine and so on, but is it not a moral and practical failure that while richer countries have managed to vaccinate 60% of their populations, for poorer countries the figure is just 3%?”
“Thank you, Mr Speaker. The Secretary of State knows that some in Government are worried about the extra cost of training additional doctors, but does he agree that every additional doctor we train means one fewer locums that the NHS has to hire, which is cheaper for the NHS and better for patients?”
“He must have wrestled with those thoughts for a long time, and I am delighted that he has been able to unburden himself today. The hon. Gentleman was absolutely right to focus on burnout in the NHS workforce. All of us would agree that NHS and care staff have done a magnificent job looking after us and our families in the pandemic, but right now they are exhausted and daunted. They can see that A&E departments and GP surgeries are seeing record attendances. They can see nearly 6 million on waiting lists, which is more than one in 10 of the population. They also have the vaccine programme and covid patients.”
“I rise to speak in support of amendment 10 but, before I do, I also want to express strong support for amendments 40 to 43, tabled by the hon. Member for Central Ayrshire (Dr Whitford), which will make a big difference in making the new health services safety investigation body a success. I strongly encourage the Minister to listen to what she says later not just with the deference due to an experienced surgeon, but with the enthusiasm to follow a doctor’s advice, because what she says is extremely important. I also thank the hon. Member for Ellesmere Port and Neston (Justin Madders) for his generous comments about me. Having sat opposite him at the Dispatch Box on many an occasion, I realise how difficult they must have been for him to say.”