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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“It simply requires the Government to publish every two years independently verified estimates of the number of people we should be training across health and care. The Government have recognised the pressures on the NHS by giving generous amounts of extra funding. I commend the Government for doing that, but extra money without extra workforce will not solve the problems that we want to solve. At the moment, the NHS just cannot find the staff.”
“I believe it will. I am grateful to the hon. Gentleman for raising that issue, because medical training is relevant to the whole United Kingdom, not just one part of it. I hope the amendment will be beneficial to Northern Ireland as well. If we put ourselves in the shoes of any frontline doctor, nurse or care worker, we would see that they are all completely realistic that this is not a problem that can be solved by next Monday. It takes a long time to train a doctor or nurse. All they have is one simple request: that they can be confident that we are training enough of them for the future, so that even if no immediate solution is in place, there is a long-term solution. That is the purpose of amendment 10.”
“He and I both know that there is some concern in the Government about the cost of training additional doctors and nurses. I want to take that concern head on. Yes, the amendment would lead to more doctors, nurses and professionals being trained. Yes, that would cost extra money. Yes, it would save the NHS even more money, because every additional doctor we train is an additional locum we do not need to employ. Locums are not only more expensive for the NHS, but less good for patients. Patients prefer to see the same doctor on every visit if they possibly can, which is much harder with a high number of temporary workers.”
“The hon. Lady gives a good example, because mental health is an area that we have all recently come to realise can be immensely beneficial to ourselves, our families and our constituents. However, while there has been explosive growth in demand, we have not had growth in the supply of people able to look after those with mental health issues. We can only do that with the kind of long-term planning that amendment 10 will make possible. The royal colleges say that, as of today, there are shortages of 500 obstetricians, 1,400 anaesthetists, 1,900 radiologists, 2,00 A&E consultants, 2,000 GPs, 39,000 nurses and thousands of other allied health professionals. That is why this problem has become so acute. The Minister has engaged thoughtfully with me on the issue on a number of occasions.”
“I absolutely agree with the hon. Lady, who knows about acute services. I also point to recent evidence from Norway that shows the same for general practice: patients who see the same GP over and over again go to A&E departments less than patients who see different GPs.”
“That is the nub of the problem: the number of doctors, nurses and other professionals we train depends on the priorities of the current Secretary of State and Chancellor. As a result, we have ended up with a very haphazard system that means that although we spend about the average in western Europe on health, as a proportion of GDP, we have one of the lowest numbers of doctors per head—lower than any European country except Sweden.”
“My right hon. Friend is right that there are problems with the GP contract. I do not want to get into too many discussions about doctors’ contracts in this very consensual debate, but Conservative Members have to take responsibility for not having remedied the pensions anomaly, which gives people an incentive to retire much earlier than we would want. We have to address that issue. Lots of people might reasonably ask whether I did enough to address the issues in the nearly six years that I was Health Secretary. The answer is that I set up five new medical schools and increased by 25% the number of doctors, nurses and midwives we train. However, that decision was taken five years ago and it takes seven years to train a doctor, so not a single extra doctor has yet joined the workforce as a result.”
“The hon. Lady is absolutely right. Medical school, the foundation years and, as my right hon. Friend the Member for South West Wiltshire (Dr Murrison) said, the retention of staff—all those things need to be built into long-term planning and baked into the system. That long-term planning strikes a contrast, if I may say so, with some of the short-termism that we have seen recently. Even in the recent Budget and spending review, the budget for Health Education England, which funds the training of doctors in this country, was not settled. Although I think that the proposed merger with NHS England is probably the right thing to do, I fear it will mean that the budget is not settled for many more months, at precisely the moment when the workforce crisis is the biggest concern for the majority of people in the NHS.”
“My right hon. Friend speaks about these issues with a great deal of knowledge, given his former ministerial and Select Committee roles, and he is absolutely right. I think that the big lesson from the pandemic, and indeed an issue that emerged in the report that our Committees jointly produced, is the way in which science can add value to clinical practice and clinical practice can add value to science.”
“It is supported by 50 NHS organisations, including every royal college and the British Medical Association—an organisation which, to be honest, is not famous for supporting initiatives from me—and by six Select Committee Chairs and all the main political parties in this place. I am sure that the Government will ultimately accept it, because it is the right thing to do, but if they are intending to vote it down today, I would say to them that every month in which we delay putting this structure in place is a month when we are failing to give hope to NHS staff on the front line. Let me end by quoting the Israeli politician Abba Eban, who said that “men and nations behave wisely when they have exhausted all other alternatives.” Let us prove him wrong today by supporting amendment 10.”
“I thank the hon. Lady, who before entering this place spent her time campaigning to support NHS and care staff. She speaks with great experience, and I think that the fundamental point she makes is very important. Unless there is long-term strategic planning, when we have a priority such as the one we have at the moment of tackling the backlog, we will often make progress on that priority by sucking in staff from other areas, which then suffer. That is an unintended consequence which happened when I was Health Secretary, and I fear that it will happen again without a long-term strategic framework. Amendment 10 has wide support.”
“On a point of order, Mr Deputy Speaker. I wonder if you could advise me on how I can put on record my dismay, and that of my right hon. Friend the Member for Tunbridge Wells (Greg Clark), at the leaking of private Select Committee discussions ahead of our recent joint report on coronavirus lessons learnt. The report was ultimately agreed unanimously by Members of three parties on two Committees. I want to put on record my view that the hon. Member for Luton North (Sarah Owen) does an outstanding job as a Select Committee member, and I know that my right hon. Friend the Member for Tunbridge Wells has the same view of the hon. Member for Brent Central (Dawn Butler).”
“The amendment will make sure that when care boards consider their priorities, the things that matter to patients—the safety and quality of care—are put at the very top of their list. We know the way the NHS works. It is the fifth-largest bureaucracy in the world, and there is a plethora of internal NHS—”
“Madam Deputy Speaker, I think on this occasion I can oblige you, because I will be very brief. I wish to speak to amendment 114, which may seem a rather technical amendment—as is evidenced by the fact that, out of 650 colleagues, only one has actually signed it, and that is me—but it makes up in quality for what it does not have in quantity. It is about making sure that the new integrated care boards focus their energy on the safety and quality of care of patients. That is very important, because the new integrated care boards will have enormous power. In effect, they will be the local governing bodies of our NHS. Although the statutory structures matter, what the people running those care boards focus their attention on is incredibly important to all our constituents.”
“I see the Minister wants me to give way. May I make my argument for one moment, and then give way? There is a plethora of internal NHS targets, there are operational targets and there are financial targets. They often have an excellent purpose, but, as in the case of Mid Staffs and other cases where things went badly wrong, being under a lot of pressure to meet those targets means corners can be cut, and the quality of care experienced by patients can be really damaged. The amendment would make sure that there was discipline in the system, so that whatever pressure NHS managers were under, they were always focused on safety and quality of care.”
“Before I come to the Minister, I want to say—and I am very grateful to my right hon. Friend the Member for Wokingham (John Redwood), who gave me consistent support on this agenda when I was Health Secretary—that, in the public sector, the one system that has seemed to make sure we focus public bodies on our constituents’ priorities is the Ofsted system in schools. We have rolled that out, I think reasonably successfully, to hospitals, GP surgeries and care homes, and this amendment makes that possible for the new integrated care boards. I want to give the Minister a chance to intervene to tell us his reflections on whether this system could work.”
“I conclude by thanking the Government for their support for amendment 114. I will move it formally later, but I am not expecting to divide the House on it.”
“I am happy to do that, because I know my hon. Friend has a great interest in social care issues. I feel conflicted by new clause 49. I think that what we will end up with after this measure will be a whole lot better for people on low incomes than what we had, because the means-test threshold will be raised from £23,000 to £100,000, and that is a very significant improvement. However, I have to be honest and say that it is nothing like as progressive as we had hoped, but it is a step forward. My concern when it comes to social care is that our entire debate is focusing on what does and does not contribute to the cap, when the fundamental problem in social care is the core funding to local authorities; that, though not a matter for this Bill, has a direct impact on the care received by our constituents.”
“No country can have a veto over a sovereign Britain deciding to pay its debt, not least the United States, because it did exactly the same thing under President Obama.”
“I salute the quiet dignity of Richard Ratcliffe, who is one of the bravest people I have ever met. I thank the hon. Member for Hampstead and Kilburn (Tulip Siddiq) for her campaigning. We are from different parties, but she makes me proud to be a Member of this House. How do we get Nazanin, Anoosheh, Morad and Mehran home? If it were ransom money, heartbreaking though it is, we should not pay it, because it would only lead to more hostages being taken. But it is not ransom money; it is a historical debt that we owe Iran. The debt should not be linked to this case, but it is, and that is why we should pay it. It is not easy to do because of sanctions, but with political will it can be done.”
“I believe that during the period when I was Foreign Secretary, the decision whether we owed that money was settled. There was an understanding, confirmed publicly by the Defence Secretary, that the money is owed and should be paid. It was going to take, and will take, a real effort to deal with the practicalities. But the Americans managed it and we can most certainly manage it, if necessary by getting an RAF plane to fly gold over to Tehran. There are lots of ways of doing it.”
“There must be two outcomes: first, the reuniting of all the families who have been separated by this vile detention in Iran, including Nazanin’s family; and secondly, the legacy of this tragedy must be the end of the vile practice of hostage diplomacy, which must be consigned back to the 19th century where it belongs. Britain needs to learn from this to lead a diplomatic initiative with other countries, so that if someone is taken hostage from one country, we treat it as if they had been taken hostage from any of us. We act accordingly; we deter it and it never happens again.”
“I will make some progress. One other thing needs to happen to ensure that Nazanin and the other dual nationals can come home: we must completely de-link their fates from the outcome of the Vienna talks on the joint comprehensive plan of action. Just as we tell Iran it should not make anyone a pawn in a diplomatic game, we too must live by those words and ensure they are not being used in any way by any country to put pressure on Iran to sign up to that deal. Their fates should be completely separate. This is a terrible tragedy. It is a shame not just on Iran but on Britain that it has taken us five and a half years to solve it.”
“If we are to have a vaccine-led rather than restrictions-led strategy, we need to be absolutely at the front of the pack with approvals. I fear that we are in the middle of the pack, so what will my right hon. Friend do to turbocharge our regulators and the decisions that they are giving him?”
“I welcome the statement; I absolutely agree with what the Health Secretary has announced. No one can fault the Government’s political commitment to the vaccine programme, which has had a pretty much unlimited budget and has been a huge priority, but my right hon. Friend will be aware that despite that commitment, we have now fallen behind Spain, Portugal, South Korea, Singapore and other countries in the proportion of adults who have been jabbed twice. I am just worried that our regulators have lost some of their fleetness of foot in decision making. It is great that we are giving boosters to the over-40s, but we must now have the data on the under-40s. It is great that we are giving a second jab to 16 to 17-year-olds, but what about 13 to 15-year-olds? America has already authorised the Pfizer jab as safe for the over-fives.”
“Exactly the same arguments for the covid vaccine apply to the flu vaccine. I note that, today, the Health Secretary has not made an announcement about the flu vaccine. Can I encourage him to do so? I wanted to vaccinate NHS staff for flu much more comprehensively than was happening. I think my successor wanted to do it as well. This needs to happen for exactly the same reasons. There is asymptomatic transmission of flu just as there is asymptomatic transmission of covid. I encourage my right hon. Friend to look at that and I would be interested to hear what his plans are on that front.”
“This is a difficult decision, but it is the right decision, and I congratulate the Health and Social Care Secretary on biting the bullet on this. I congratulate his predecessor, my right hon. Friend the Member for West Suffolk (Matt Hancock), on laying the foundations of the vaccination programme that has made it possible. When we have a disease that can be transmitted asymptomatically, all of us have a responsibility to protect the most vulnerable people, and no one more so than doctors and nurses. I do not know of a single doctor or nurse who does not want to be double or triple jabbed in order to make sure that they are protecting their own patients. Reducing the number of nosocomial infections is one of the big learning points from this pandemic going forward, so this is the right thing to do.”
“I met some of them after the Manchester Arena bombing and I know that he would not want this terrible, terrible series of acts to cast a cloud over their fantastic work.”
“I thank my right hon. Friend for the extremely sensitive tone with which he is approaching this incredibly difficult issue. He is absolutely right to put the concerns of families and staff first. He is also right to say that this issue will not be resolved by one evil man facing justice. The big question everyone is concerned about is this: could this happen elsewhere and why did this horrendous series of crimes happen over such a long period of time without being detected? I welcome the call for an independent inquiry and the Secretary of State’s decision to do that. May I ask him to praise the work of the vast majority of morticians throughout the country who do an incredibly difficult job extremely well?”
“Finally, may I ask her when she is planning to tell the House about the very important decision on mandatory jabbing for NHS workers? That is a difficult decision. It is one I would support if the Government brought it to the House. I have read in the press that they are thinking of doing that in the spring, which mi well be the right timing, but this is something that NHS staff want to know about.”
“I also commend her efforts on the vaccine programme, but, as the shadow spokesman said, one reason we are behind other European countries on vaccinating teenagers is that the Joint Committee on Vaccination and Immunisation did not give its decision until September, whereas France was able to start vaccinating before the summer holidays. Is she looking at how we could speed up the JCVI processes? I appreciate that her hands are tied. May I also ask the Minister to look at the booking system, because in parts of my constituency people are not able to book a booster jab until after they have passed the six-month mark? Would it not be better for anyone to be able to book their booster jab after they have passed the five-month mark?”
“My apologies, Mr Speaker, for missing the start of the Minister’s statement because you managed to expedite parliamentary business with commendable briskness this morning. I thank the Minister for her update. Let me say how welcome it is that we have approved the new antiviral, molnupiravir—a new word for us to memorise—which could be immensely significant. When does she think we will be able to distribute it to people who have caught covid who are at home? She says that there is going to be a national study, which is potentially an important step. However, in a pandemic we sometimes bypass these national studies and go straight to distributing medicines that we know are safe to members of the public. Might this not be one of those occasions where we decide to speed things up?”
“Q14. NHS staff performed magnificently during the pandemic, but there are now severe shortages in nearly every specialty. Will my right hon. Friend support an amendment to the Health and Care Bill that is backed by 50 NHS organisations and every royal college to require Health Education England to do regular independent forecasts of the numbers of doctors and nurses that we should be training, so that we can reassure people that, despite the pressure today, we are at least training enough doctors and nurses for the future?”
“I warmly welcome my successor’s successor to her place, although saying that makes me feel rather old. She will know that Richard Ratcliffe, Nazanin’s husband, has restarted his hunger strike this week. She will also know that Nazanin is not going to come home until we pay the debt that we owe Iran for the Challenger tanks, which the Defence Secretary has accepted that we owe Iran. When are we going to repay that debt, and what will the Minister do to ensure that hostage taking never pays?”
“When we came back from recess, I was hoping to ask the Minister one question this week, so to be able to ask her three questions in two days is an unexpected thrill. I am grateful to her for her statement, and I welcome what she says. No Government can stand by when there is a 10-year difference in life expectancy between the richest and poorest 10% in our society. These measures are important and will make a difference. But could I ask her about something even more worrying than adult obesity? On childhood obesity, we are still the second fattest country in Europe. Has she had any discussions with the Department for Education about one of the root causes of that, which is that for several decades we have not guaranteed daily sport and exercise to every child in every state school?”
“First, on the decision that people cannot have their booster jab until six months after their second job, how hard and fast should that rule be? Does it really matter, when it is only nine weeks until the Christmas holidays, if someone has their booster jab after only five months? Should we not look at having some flexibility on that decision, so that we can get more people in for their booster jabs more quickly? Secondly, at the risk of making the Minister blush, does she not need to be a Cabinet Minister? Is it not one of the issues that the previous vaccines Minister sat at the Cabinet table and that she does not? This is such an important thing for our national defence against the virus and our utter determination to avoid another lockdown. Do we not need a vaccines Minister sitting around the Cabinet table as we did before?”
“Last week, the Health and Social Care Committee and the Science and Technology Committee published a report saying that the vaccine roll-out was one of the biggest and most impressive achievements in British public administration in our lifetime, and I want to pay tribute to the Government and to the vaccines Minister for what has been achieved. But in truth, at its peak in the spring, we were jabbing 400,000 people a day; now it is fewer than 200,000 people a day. If we look at our higher hospitalisations, cases and death rates compared with countries such as France and Germany, we can see that the heart of it is not actually things like mask wearing and covid passports; it is their higher vaccine immunity. So I want to ask the Minister two questions.”
“I just want to understand this: given that about a third of the over-80s and 40% of the over-50s who are eligible for a booster jab have not taken it up, and that our vaccination rates are lower among teenagers than other European countries, what are we doing, other than encouraging, pleading and exhorting people to take the vaccines, to actually get these rates up? None of us wants to go to plan B, and I understand the Government’s reluctance to do that, but nor am I convinced that just exhorting people will be enough.”
“I, too, have had the great pleasure of asking a question of the Minister this morning, but there is no shortage of fascinating and important questions to ask on this topic. My second question of the day is really a follow-up to what we discussed earlier. The heart of the issue we face now is the fact that our vaccine immunity is beginning to wear down. That seems to be what people such as Professor Neil Ferguson believe is the reason we have higher case rates and death rates than countries such as France and Germany.”
“No one questions the hon. Lady’s commitment on these issues, but is it not a bit unfair to criticise the Government for a lack of concrete action when, for example, the proportion of electricity generated by coal has fallen, since 2013, from 40% to less than 2%? That is a real change. When it comes to looking forward, a number of new technologies are still necessary if we are going to avoid the climate tipping point. Does she agree that investment in science and technology is going to be a crucial part of the mix?”
“I would like to ask the Secretary of State about pressures in emergency care and comments that the new chief executive of NHS England made to the Health Committee this morning that we have shortages of 999 call handlers. Is he concerned about the time it is taking to answer some 999 calls? Do we have those shortages? What are his plans to address them if we do?”
“Friend said something that resonated particularly with me when she talked about the grief of fathers. I cannot claim to have experienced anything like the grief that she and her husband have experienced, but my father did, because my sister Sarah died when she was just six months old. I was there at the time. I was only two so I had no memory of it. During my father’s entire life—he died eight years ago—my mother used to tell us never to mention Sarah because he found it so hard. That reflects the comment of the hon. Member for Lanark and Hamilton East (Angela Crawley) that there is no timeline for grief.”
“It really is an honour to follow two such extremely powerful and persuasive speeches. I particularly thank my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory) for her courage in bringing Lily’s story to this House. It is actually a rather wonderful thing that she is giving such meaning to Lily’s life by talking about what happened so openly. The grief that she expressed so eloquently is shared by 1,700 families in our country every single year, so she is speaking for a lot of families up and down the country. Her words will resonate, so I thank her. It was not easy to do. But like many families who are bereaved, she has taken the decision to relive that grief over and over again to try to stop that tragedy being repeated, and I think we all salute her courage in doing so. My hon.”
“I commend Jacqueline Dunkley-Bent and Matthew Jolly in NHS England, who are leading the maternity safety transformation programme, and the many doctors, nurses and midwives who are supporting them. I also commend charities such as Sands and the Lullaby Trust as well as many others. Most of all, I commend the families who have campaigned through thick and thin, including James Titcombe, remembering his son Joshua; Derek Richford, remembering his grandson Harry; Carl Hendrickson, remembering his son Chester and his wife Nittaya; and Richard Stanton and Rhiannon Davies, remembering their daughter Kate. There are many others. Five babies die every single day. This is our moment to put it right.”
“It is led by the inspirational Judy Ledger, who was inspired to do what she does by her tragedies. The report also talks about more screening and health inequalities, both of which were mentioned by my hon. Friend the Member for Truro and Falmouth. I finish with two brief points. First, it would be wrong to say that this is an NHS problem. It is a tragedy that happens in all countries all over the world, and this year the World Health Organisation has made maternal and newborn loss the theme of World Patient Safety Day. The WHO says that, every day across the world, 7,000 babies die and the majority of those deaths are preventable. Finally, we should remember the tremendous progress that has been made. In the last decade, the number of neonatal deaths is down by 25% and the number of stillbirths is down 30%.”
“The cost of putting that right is between £200 million and £350 million a year. That is a significant amount. The Government deserve credit for already agreeing to put in £95 million a year, but that additional cost is as nothing compared to the £2.4 billion that we are paying in compensation every year. I hope that the Government will agree to put right that staffing shortfall. They have said this week that they are considering that. Training is another vital issue. It is so important for doctors, nurses and midwives to have the time to learn from things that go wrong and to improve systems, but they can do that only if there is protected time for training in their busy schedules. I commend Baby Lifeline for the fantastic, proven training that it does, which has saved many lives.”
“Just think of the heartache and the transformation in the lives of families up and down the country were we to do that. I turn briefly to the other recommendations in the Select Committee’s report, published in July. One of the most important recommendations relates to staffing. When it comes to medical error, if there are not enough staff on a ward, the likelihood of mistakes will self-evidently be higher. Eight out of 10 midwives say that there are not enough midwives on their shifts, and Health Education England—the Government’s own body—says that there is a shortage of just over 1,900 midwives across the system. NHS Providers thinks that there is a shortage of about 500 doctors in maternity units and the Royal College of Anaesthetists says that there is a shortage across the system of about 1,000 anaesthetists.”
“The country with the highest safety standards and the lowest number of baby deaths in Europe is Sweden, which has about half our level of baby deaths. In Sweden, compensation is given more quickly just on the basis of a mistake being made, with the result not that they pay more but that they pay massively less, because they have half the number of tragedies that we have. Surely those of us who are passionate about patient safety will support that, and those who are—as we all are—worried about baby deaths will support that. Even people in the Treasury should understand that the way to reduce the obscene compensation bill is to make it easier for families in those terrible situations to claim compensation. If we had the same maternity safety levels as Sweden, 1,000 more babies would survive every single year.”
“If, because of a mistake, a child is born disabled, the parents quite understandably want financial support to deal with the unexpected costs that the family will face for the whole of that child’s life. However, under the law, the only way to get that compensation is if a court agrees that there was clinical negligence. Quite understandably, parents will fight to get that compensation and, also understandably, the doctors, nurses and midwives become defensive if they are accused of clinical negligence. It does not have to be that way. We need a system where people are entitled to compensation as soon as it is accepted that a mistake was made without the necessity to prove clinical negligence.”
“When I was Health Secretary—I do not think this has changed even now—every week I signed off a multimillion-pound payment to a family whose child was disabled for life because of medical error that the NHS accepted. Most weeks it happened twice. Overall, the cost of that compensation for medical error in the NHS is £2.4 billion a year. Just under half of that relates to maternity. We have got to the obscene situation where we pay more in compensation to families when something has gone wrong than on the entire cost of every doctor and every nurse working in maternity units up and down the country. Why is that? It is because of a simple problem that the Health and Social Care Committee—I am delighted to see members of the Committee in their places on both sides of the House—is urgently asking the Government to address.”