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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“Let me reassure her that if there are any additional costs to the Scottish health system, it will of course be recompensed. We do not think that major pressures will be created in the Scottish screening programme, and we are confident that we will be able to contact everyone in the UK who is registered with a GP—whether in Scotland, Wales, Northern Ireland or England—by the end of May. We have had very productive discussions with Scottish officials about the IT exchange that will be necessary to ensure that women living in Scotland also receive their letters by the end of May.”
“The hon. Lady has asked some important questions. I am sorry if what I said was not clear, but I do not think I said that there was no need to diagnose early. It is obviously incredibly important for cancer to be diagnosed as early as possible. What I said was that I had been advised that in many cases, because of advances in breast cancer treatment, it would not make a difference to the particular women affected in this case. I fully accept that in some cases it will, and of course it is very important to diagnose all cancers as early as possible. I will find out from Oxford University the dates on which it expects to report the full outcome of the AgeX trial. Obviously we all want to hear the results as soon as possible. I will also inform the hon. Lady of the exact date on which Scottish Government officials were informed.”
“I thank my hon. Friend for the work that he did on cancer when he was working at the Department of Health, and for his broader work in supporting the hospital sector. He is absolutely right: additional people will come forward for treatment, so one of the other matters that we have been looking into is our treatment capacity. We certainly intend to ensure that people are treated within the normal short period if a cancer is detected, and the first step in that process is to ensure that everyone has a scan in the next six months. During that period, we will make certain that they are able to look forward to the same rapid treatment that all other people whose cancers are detected can be confident of receiving.”
“I do not know the answer to that question, but I will look into it. If we find that the uptake was lower than expected in that age group, it will be a very important clue about something that may have gone wrong, and I am sure that the review panel will want to examine it. The overall uptake rate is about 80%, but I agree with the hon. Gentleman that we should look into what the rates were in specific age cohorts.”
“I am afraid that my right hon. Friend is absolutely right. The truth is that we do have a quality assurance programme, and it failed to pick up this problem for far too long. We need to understand why that happened. We think that a single IT mistake was made at the very start of the programme, and we understand that sometimes such mistakes are devilishly difficult to identify. None the less, as was suggested by the hon. Member for Stockton South (Dr Williams), there must have been clues that could have been picked up—or so one would think—and we need to get to the bottom of that.”
“We are indeed talking to the charities operating in this sector about how we can best provide all kinds of support, including mental health support, as well as clinical guidance. We often talk in the House about the challenges facing the NHS, but it is important to note that breast cancer is an area in which survival rates have been improving, and have actually been catching up with those in other European countries. The NHS deserves great credit for that, despite today’s very serious failing.”
“Absolutely. As my hon. Friend will know from his own medical background, it is impossible to know that until there is a detailed case note review, but we will certainly undertake that review for anyone who thinks they may have been affected.”
“According to the advice that I have received so far, there is no read-across to other screening programmes, but obviously the independent review panel will look into that as it seeks to examine all aspects of the issue. We have made the commitment today that we will invite for scans all those who either should be scanned or should consider whether they wish to have a scan, and will offer them a date before the end of October, although we hope that in the vast majority of cases it will be much sooner than that.”
“To respond to the earlier question about what people should do now, anyone is free to call the helpline number, which will be made public today, but we are hoping to get the letters out as quickly as possible over the next four weeks, during the month of May, so that everyone can be pretty confident that they are okay if they have not received one of those letters.”
“We have not had conversations at ministerial level, but we have had conversations at official level. The Welsh Administration do not believe this problem has affected them, even though Wales was using the same IT system we were using in England. Our concern is about people living in England who are registered with a Welsh GP or people living in Wales registered with an English GP. That is why we are having constructive discussions to share IT information and make sure everyone in England or Wales registered with a GP will get that letter.”
“I thank my hon. Friend for her excellent advice, which gives me the opportunity to repeat that the advice for women about looking after their breasts and making sure they are alert to potential breast cancer remains unchanged. All women should take great care over this and should always come forward to see their GP or local cancer service if they have any concerns or doubts.”
“I thank the hon. Lady for her comments. We have many other occasions to have a broader discussion about resourcing of the NHS, but I recognise what she says: in the specific situation we are in now, with the people who will need additional scans and additional treatments over and above what the NHS would have otherwise done, we will need to find additional resources to make sure others are not disadvantaged.”
“My right hon. Friend is absolutely right, and I assure him that the review being done by Lynda Thomas, one of the most senior cancer campaigners in the country, and Professor Gore, one of the most senior oncologists in the country, will look at what lessons can be learned for the entire cancer programme, and not just at the specific issue of why this particular IT problem occurred.”
“That is a reasonable question, and I assure the hon. Lady that we are sending these letters out as quickly as we possibly can, but we felt that, even though we are not able to send them all out this afternoon—for example, because we have to reconcile with the clinical databases in Scotland, Wales and Northern Ireland for women who have moved to those areas and that is going to take place later this month—it was important to come to the House as soon as possible, without delay, to inform Members that this was happening. There will be a period of a few weeks during which people will have to wait to see if they get one of the letters, and we fully appreciate that that will cause a lot of worry to the women involved.”
“That is a good point, and we will get in touch with all the cancer charities that we think are going to be affected by what has happened and make sure they have the support they need.”
“I will have to get back to the hon. Gentleman with a detailed answer to that question. Ministers were informed of this issue in March, and we are responsible, as Ministers, for the effective functioning of that system—in the way all Ministers have responsibility for their various areas—so one of the questions we need to ask is whether the right escalation procedures and checks and balances were in place so that Ministers could be informed if there was likely to be a problem.”
“I thank my right hon. Friend for suggesting the Bishop of Norwich as a good person to help in the Paterson review, and the answer to her question is yes: if, because of a failing by the NHS, harm has happened, people will be eligible for compensation, and we will do all the necessary work to establish whether that is the case.”
“We will look at whether we are able to get in contact with people and will get in contact whenever we can, but there is of course a helpline through which anyone can contact us. It is also important to say that, according to the advice I have received, missing the final screening will in many cases not make a difference to a patient’s cancer or the treatment they receive, but we will do everything we can to support everyone who thinks they might have been affected.”
“That is a very good point. The original issue—or the original potential issue—was identified by people working on the AgeX trial for Oxford University, who then brought it to the attention of Public Health England in early January. One of the issues seems to have been the confusion about whether the scans stopped when someone turned 70 or whether they should carry on until their 71st birthday. That is why we think the original coding error happened, but obviously this is a matter for the review, and we need to learn everything from it.”
“I thank the hon. Lady for making that fair and important point. I will make a special effort in the case of Northern Ireland to understand what the situation is and to ensure that it is publicised to the people of Northern Ireland. Absent politicians are able to do that.”
“That is a very good question. I am not aware of any such instances, but that is exactly what we want to look at in the review. It does seem strange that people who were expecting to be invited did not come forward, and that their not receiving an invitation did not set any hares running. That is one of the things that we need to look at.”
“My right hon. Friend is testing my clinical knowledge here; there will be other people in the Chamber who are better able to answer that question. I am ready to be corrected by eminent experts on this, but my understanding is that, in relation to women in their 70s, for every 1,000 women there are around 12 cancers, and of those 12 cancers, around three are potentially life-threatening.”
“That is an important question. We have the Be Clear on Cancer campaign, which is a national advertising campaign but, as my hon. Friend the Member for Lewes (Maria Caulfield) said, it is important for people to recognise that, if we are going to protect them from cancer, they will have to take an active and proactive role in detecting any cancers they might have. Important though the screening service might be, they cannot rely on the screening service, because their own experience of how their own body is functioning is the most important detection method of all.”
“We are absolutely guaranteeing that all women affected who are still alive will be invited to have a screening if they want it. Only those under 72 will automatically be sent a date and time for their screening. Those over 72 will be invited to talk to the helpline so that they can form a judgment as to whether a screening is appropriate, but anyone who wants one will get one.”
“I believe that the IT work, which is a collaboration between the Scottish NHS and the English NHS, will be completed in the week of 15 May. That is why we are confident that we will be able to get the letters out to people registered with Scottish GPs who have moved from England by the end of May, which is the same timescale as for getting the letters out to people living in England. We will then know that number, and I will of course let the hon. Lady know.”
“Yes, we are briefing all GP surgeries and all GPs about what the appropriate response is, because we recognise that that might happen. Of course, GPs are there for people to talk to at any time if they have concerns, and some people may choose to do that. We have also set up a specialist helpline that will be open seven days a week from 8 am to 8 pm, where people will be able to get advice straightaway by picking up the phone. We think that that will be the most practical option for most people.”
“That is a slightly different topic, but we have no greater priority than to ensure that Brexit does not interrupt the cancer care of UK patients.”
“The whole House is thinking of my hon. Friend who, like many people in this country, is going through a huge amount of personal pressure as cancer strikes close to home. He is right that back-office systems are often poor when it comes to contacting patients, which is in contrast to the superb clinical care that we are usually able to offer, so we will absolutely consider that as part of the review.”
“PHE has given clear assurances that the problem has been fixed, but it is open to any suggestions that the review makes as to how things could have been handled better.”
“Anyone who has concerns as of today is welcome to call the helpline, but the women whom we know have been affected will be contacted by the end of the month. The first thing that many people will do is take action on receipt of a letter. If they are under 72, the letter will tell them that they will shortly be sent a date for a catch-up scan. If they are over 72, it will tell them how they can get advice as to whether that is appropriate for them.”
“That is a good point. I can assure my hon. Friend that the Department will be leading a big consultation exercise so that everyone is informed about how their individual organisations will be affected.”
“Absolutely. There are basically two parts to this process. One is what the problem was with the original procurement, and the other is the problem with the assurance of the project over the time period.”
“My hon. Friend is absolutely right. One of the most important ways of getting that change in mindset is by giving patients more control. Later this year, we will be offering all NHS patients an app through which they can access their medical record, and that should start to become a way in which people take control of their healthcare destiny, including such things as invitations to screenings for all cancers and many other public health measures.”
“We need to ensure that screening is accessible. I fully understand the concerns of my hon. Friend’s constituents, and I am happy to ask the Public Health Minister to look into that issue.”
“My right hon. Friend speaks extremely wisely. We have the Touch, Look, Check campaign, and it is important that we see screening as just one important part of the battle against breast cancer, but it is no substitute for many of the other things that really matter.”
“My hon. Friend may well be right that we need to do that, but what I would like to do first is to see the outcome of this review, what the lessons are and what precisely it says about the quality assurance that applied in this case, and then make a judgment about the implications for the rest of the NHS.”
“Yes, I am happy to give that assurance. The number of people affected is only an estimate at the moment, but there will obviously be great interest in the House and in the country in what the actual number ends up being.”
“That is an important question. One of our top priorities has been to construct a resolution to the problem that will not have an impact on the regular screening programme for women between the ages of 50 and 70, which is so important. All I can say is that a huge amount of trouble has been taken to try to ensure that we are putting additional capacity into the system to deal with the extra work.”
“Yes, absolutely. We are doing this review because we want to understand precisely why this happened and what the proper counter-measures are.”
“I am most grateful to my right hon. Friend. I wonder whether, on behalf of the Prime Minister and the Cabinet, I could follow the shadow Health Secretary in commending Tessa’s campaigning. Most people come to this place hoping to leave a legacy, but she has left not just one legacy, but two—her amazing achievements with London 2012 and her amazing campaigning on cancer. It is our privilege to take part in this debate and our duty to act on what she says.”
“This is only possible because of the balanced approach we are taking—investing in our public services and helping families with the cost of living, while getting our debt falling. Rarely has a pay rise been so well deserved for NHS staff, who have never worked harder.”
“As part of the deal, the lowest starting salary in the NHS will increase by more than £2,500, from £15,404 this year to £18,040 in 2020-21, and a newly qualified nurse will receive starting pay 12.6%—nearly £3,000—higher in 2020-21 than this year. But this deal is about retention as well as recruitment. It makes many other changes that NHS staff have been asking for—such as shared parental leave and the ability to buy extra or sell back annual leave—so they can better manage their work and family lives, work flexibly and balance caring commitments. The additional funding that Chancellor announced in the Budget to cover this deal—an estimated £4.2 billion over three years—cements the Government’s commitment to protecting services for NHS patients, while recognising the work of NHS staff up and down the country.”
“We know that NHS sickness rates are around a third higher than the public sector average, and reducing sickness absence by just 1% in the NHS will save around £280 million. The deal will put appraisal and personal development at the heart of pay progression, with often automatic incremental pay replaced by larger, less frequent pay increases based on the achievement of agreed professional milestones. It includes a significantly higher boost to lower-paid staff, to boost recruitment in a period when we know the NHS needs a significant increase in staffing to deal with the pressures of an ageing population. Pay rises range from 6.5% to 29% over three years, with much higher rises targeted on those on the lowest and starting rates of pay.”
“The whole House will want to pay tribute to the hard work of NHS staff up and down the country during one of the most difficult winters in living memory. Today’s agreement on a new pay deal reflects public appreciation for just how much they have done and continue to do, but it is much more than that. The agreement that NHS trade unions have recommended to their members today is a something for something deal that brings in profound changes in productivity in exchange for significant rises in pay. The deal will ensure better value for money from the £36 billion NHS pay bill, with some of the most important changes to working practices in a decade, including a commitment to work together to improve the health and wellbeing of NHS staff to bring sickness absence in line with the best in the public sector.”
“That is possible because we have taken very difficult decisions over the past eight years—they were opposed by the Labour party—that have meant 3 million more jobs and have transformed our economy out of recession into growth. None of that would have been possible if we did what his party is now advocating, which is to lose control of public finances by increasing borrowing by £350 billion. Let us just remind ourselves that countries that lose control of their finances do not put more money into their health services—they put less. In Portugal, the amount is down 17%, and in Greece, it is down 39%. The reason that we can announce today’s deal is very simple: this country is led by a Government who know that only a strong economy gives us a strong NHS.”
“A band 6 paramedic with four years’ experience will see a £4,000 rise. On top of that, we are putting in a huge number of things that NHS staff will welcome, including, for example, statutory child bereavement leave and shared parental leave. Yes, we are asking for important productivity changes in return, but this is about the modernisation of NHS staff terms and conditions, which is good for them and good for taxpayers. The hon. Gentleman asks where the money is coming from: it is additional funding from the Treasury for the NHS. It is not coming from extra borrowing. If he had been listening to the autumn statement, he would have heard that debt as a proportion of GDP is starting to fall this year for the first time.”
“If the hon. Gentleman wants a plan to give the NHS the funding it needs, can he explain why Labour in Wales has deprived the NHS of £1 billion of funding that it would have had if funding had increased at the same rate as in England? Far from Labour being vindicated, the House will remember that the pay restraint in the NHS for the past eight years was caused by the worst financial recession since the second world war, caused by a catastrophic loss of control of public finances. The hon. Gentleman asks for some details. Today’s pay deal means that someone starting work in the NHS as a healthcare assistant will see their rate of pay over the next three years go up by 26%, nearly £4,000. A nurse with three years’ experience will see a 25% increase, which is more than £6,000 over three years.”
“I thank my hon. Friend for her comments. Underneath this agreement, there is a very important new partnership between NHS employers and the unions to improve the health and wellbeing of staff through mental health provision and the implementation of the Stevenson-Farmer review, taking on board a number of points raised by the Health Committee, and through improved support for people with musculoskeletal conditions, because a lot of NHS work is very physical. However, she is absolutely right: professional development is also very important. By reforming the increments system that we have been using for many years, we will give staff the chance to see their pay go up in a way that is linked to their skills going up as well. That is something that many staff will welcome.”
“The majority of NHS staff will see that their pay is protected against the cost of living, but many NHS staff, including the lowest-paid, will see increases that are substantially higher than inflation rates, because, first, that is the kind of society that we believe in. Conservative Members want everyone to be given decent rates of pay, and there are many parts of the country where the cost of living is very high and this will make a very big difference. We also recognise that there will be 1 million more over-75s in 10 years’ time, so we need to expand the number of staff in the NHS and its capacity to deal with those pressures. We therefore need to attract more people into working for the NHS and social care systems.”
“I thank my right hon. Friend and commend him on his courage in putting through some incredibly challenging and important reforms to our welfare state, when many people said that it was nigh on impossible. He is right: the biggest and most misleading thing that we hear is the charge that in austerity Britain, the NHS budget has been cut. In fact, the countries that cut their health budgets were Portugal and Greece—countries that are following precisely the policies that are advocated by the Opposition. In this country—so-called austerity Britain—NHS spending has gone up by 9%.”