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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“The record overall—this is where we see the most obnoxious untruth spread by the story on austerity—shows that over the past seven years we have seen 600,000 fewer people in absolute poverty and 200,000 fewer children in absolute poverty. Income inequality has reduced to its lowest level for 30 years. Why is it that this apparently evil Tory Government have reduced inequality? It is because we have done what Labour never does, which is grow the economy, with 1 million new businesses, 3 million new jobs and unemployment at its lowest since 1975. Today, youth unemployment is below 5% for the first time and there has been a 40% drop since 2010.”
“I will make some progress now, because I know that lots of people want to speak in this debate. The other completely bogus claim we have heard this afternoon is that somehow the financial discipline of pay restraint that we have had to have has been deliberately targeted at ordinary people. Again, that is absolute nonsense, as we see when we look at what has happened. Despite the recession and the pressures on public finance, this Government have taken 4 million of the lowest-paid people out of income tax altogether. At the same time, the top 1% are paying more and the top 20% are paying more, and we have gone further, introducing the national living wage, which since its introduction in April has increased the pay of people at that level of pay by £1,400 per annum.”
“I am going to make some progress, because I want to deal with the issue of morale, and then I will give way for a final round of interventions. A lot of comments have been made about the NHS being at breaking point, at a tipping point and so on. There is huge pressure on the NHS, but, as has been said by my right hon. Friend the Member for Broxtowe (Anna Soubry), who is no longer present, that is not the whole picture. What the shadow Health Secretary did not say is that 7,000 people are alive today who would not have been had we stayed at the cancer survival rates of just four years ago. We are having probably the biggest expansion of mental health treatment in Europe, and an independent NHS England report says that for most major conditions outcomes have dramatically improved over the past three, five or 10 years.”
“It means we should look at making sure that we are training enough staff, so that when hospitals have the budgets to employ staff, they are there for them to employ; it means we should look at flexible working—on which, frankly, the NHS can do a lot better—if we are to tackle the agency bill that the shadow Health Secretary spoke about; it means we should put in place measures to encourage nurses to return to practice, which is why Health Education England is increasing the number of return-to-practice training places to 1,250 from 2019-20; it means we should look at new support roles for nurses, such as the 2,000 nurse associates who are starting training this year; and it means we should look at new routes into nursing, such as the nurse apprentice route that we are opening this year.”
“We will also honour the commitment we made prior to yesterday’s announcement, which was that before we take any decisions we will listen to the independent advice of the pay-review bodies. To value staff also means to look at non-pay issues as well.”
“I agree with the right hon. Gentleman that when deciding policy on pay we absolutely have to look at the impact on recruitment and retention, and that if we are going to deal with the pressures of an ageing population in the way that he and I would both want, we are going to need to recruit many more doctors and nurses for the NHS over the years ahead. The progress that we have made in the NHS in improving outcomes for patients, despite the huge pressure on the frontline, is possible because of the brilliant staff we have in the NHS. I want to recognise that pay restraint has been extremely challenging, which is why yesterday my right hon. Friend the Chief Secretary to the Treasury announced a new policy, allowing Departments flexibility where there are recruitment and retention issues, and where productivity savings can be found.”
“I am going to wind up my comments now, because lots of people wish to speak. [Hon. Members: “Oh!”] Okay, the House has persuaded me. I shall give way first to the hon. Member for Hornsey and Wood Green (Catherine West) and then to my hon. Friend the Member for Redditch (Rachel Maclean).”
“I assure the hon. Lady that we are making reforms because we want to train more nurses and to fund more nurse training places. There has been a dip in the number of people taking up nurse training places this year, as there was when the higher education reforms were introduced in 2012, but it recovered soon after that and we now see in other parts of higher education record numbers of students from poorer backgrounds going to university.”
“My hon. Friend is absolutely right. From some of the debates we have in this House, a person would never know that in July, for the second time running, an independent American think-tank looked at health systems in all the world’s major countries, compared us with the United States, Germany, France, Australia and others, and said that the NHS was top—the best healthcare system of any major country. We have a huge amount to be proud of.”
“I am going to conclude my comments by asking three questions. First, who is the real friend of public sector workers—the party that wrecked the economy, leading to massive cuts, or the party that turned the economy around with 3 million new jobs? Who is the real champion of public services—the party that did not only wreck the public finances but wants to do so all over again, or the party that is restoring discipline to the public finances so that we can start to invest more in our public services? Who is the real friend of the NHS—the party that has delivered more doctors, nurses and funding than ever before in its history, or the party that plays politics with the NHS in election after election, despite doing it so much harm?”
“The 150,000 EU nationals working in our health and care services do a brilliant job and we want them to continue doing it. I am in regular talks with Cabinet colleagues to inform both domestic workforce plans and the Government’s negotiations with the EU.”
“We absolutely will be taking a UK-wide approach. The numbers for England are actually slightly higher than those the right hon. Gentleman talks about—about 9% of doctors and about 19% of nurses are EU nationals. However, we are still seeing doctors and nurses coming to the UK, and we need to do everything in all parts of this House to reassure them that we see them as having a bright and vital future in the NHS.”
“My right hon. Friend makes a very important point. That is precisely why last year we increased the number of medical school places with, I think, the second biggest hike in the history of the NHS—a 25% increase. We absolutely do believe that this country should be training all the doctors and nurses that we need.”
“The hon. Lady may have noticed a little thing called Brexit that happened last year, which is the cause of understandable concern. If she looks at the facts about how many doctors came from the EU to the NHS in the year ending this March, in other words, post-Brexit, she will see that 2,200— [ Interruption . ] Someone asked about nurses. I happen to have that information here: 4,000 nurses joined the NHS from the EU in the year ending in March.”
“My hon. Friend makes an important point. We want to attract the brightest and best into the NHS from all over the world, wherever they come from, if there is a need. The only caveat I would make is that we have imported a number of doctors from very, very poor countries that actually need those skills back home. We have to recognise that we have international responsibilities to make sure that we train the number of doctors and nurses we need ourselves.”
“Let me reassure the hon. Gentleman that there is no intention to restrict access to vital professions such as the clinical professions in the NHS post-Brexit. We have said many times that we will have a pragmatic immigration policy. The long-term solution is not to depend on being able to import doctors and nurses from anywhere, because the World Health Organisation says that there is a worldwide shortage of about 2 million clinical professionals; we are not the only people facing the challenge of an ageing population.”
“My right hon. Friend is absolutely right to make that point. Nurses are, in fact, on the Home Office’s tier 2 shortage occupation list, and they will remain so for as long as we need them to do so. The bigger issue is that for a long time we have relied on being able to import as many doctors and nurses from the EU as we need to, and that has meant that we have not trained enough people ourselves. That is bad for EU countries and for our own young people.”
“Last year this Government announced one of the biggest expansions of medical training places in the history of the NHS, involving funding 1,500 additional medical school places every year—of which 500 start this September—and reforms that will enable universities to offer up to 10,000 additional nurse training places every year.”
“My hon. Friend makes a really important point. In parts of the country, GP shortages have been successfully addressed as the CCG has done in Swindon. An important part of this is persuading people who go into medicine that general practice is one of the most exciting and rapidly changing parts of medicine today. We have seen a 9% increase in the number of medical students choosing to go into general practice since 2015.”
“I heard a lot about Stepping Hill when I went to visit my hon. Friend; I think it was last year. I had the privilege of visiting the hospital more recently after the horrific terrorist attacks, and I commend the hospital for the brilliant work that it did in the wake of the bomb. The hospital has done a good job of recruiting; I think it has recruited 93 more doctors and nearly 300 more nurses since 2010. A national programme to help all trusts to retain their nursing staff has been launched by NHS Improvement in the last week.”
“The hon. Lady happens to work in an NHS hospital in which there has been a big increase in the number of nurses. Across the country, there are actually 13,000 more nurses working on our wards than there were in 2010, but she is right: we need more nurses and nursing staff, and that is why we are expanding the number of nurse associates. This year we are, for the first time, opening up an apprenticeship route into nursing, which means that people from non-traditional backgrounds—particularly band 3 healthcare assistants—will find it much easier to get into nursing. That is how we will expand the workforce.”
“We have had a big increase in the number of medical students choosing to go into general practice, but we have also had an increase in the number of GPs retiring early. That is a problem that we are urgently addressing.”
“Over those three Parliaments, I have learned to expect questions from my hon. Friend in a similar vein, and I commend him for his persistence in championing that cause. As he knows, I think the most important thing, with all such issues, is to follow the scientific advice.”
“I always welcome the hon. Lady’s forensic interest in matters south of the border, but given that Scotland has just seen its first fall in life expectancy for over 100 years, she might want to think about her own constituents. With respect to the number of nurses, we now have more than 50,000 nurses in training, and we are confident that we will deliver a big increase in the supply of nurses to the NHS.”
“At the heart of this is the need to open up avenues for more flexible working for both doctors and nurses. If the hon. Lady followed what we have done in England—by successfully pioneering such working, we have reduced agency spend by 19% in a year, whereas it is still going up in Scotland—she might find the NHS in Scotland has more money to spend on her own constituents.”
“I welcome my hon. Friend’s first question to me. I am very aware of the issues faced by the Worcestershire Acute Hospitals NHS Trust, which I visited during the difficult winter period that it has just come through. It now has a new chief executive and leadership team, who have made a very promising start. From the experience of many other hospitals that have been through difficult patches, we have found that it is usually never about the commitment of staff, but about getting the right leadership in place. I can assure her that I saw outstanding commitment from the staff of the trust.”
“I did not vote for the hon. Gentleman’s amendment, because—as usual—Labour Members have told us a lot about how they want to spend the money, without having the faintest idea of where it will come from. He is ignoring an elephant in the room: if we had followed the spending plans he campaigned for in 2015, the NHS would have £2.6 billion less this year, which is the equivalent of 85,000 fewer nurses.”
“Let me tell the hon. Gentleman what extra money is going into the NHS: three years ago, £1.8 billion, which was not asked for by Labour; two years ago, £3.8 billion, which is nearly £1 billion more than Labour was promising; and this year, £1.3 billion. That is a lot of extra money. Why is it going in? Because, under this Government, we have created nearly 3 million jobs, and that strong economy is funding an improving NHS.”
“Last year our A&Es saw 1,800 more people every day within the four-hour target than they did in 2010. We also have nearly 1,500 more emergency care doctors and over 600 more emergency care consultants.”
“I absolutely agree with my hon. Friend that an emergency care network that works well for his constituents is essential. As he fully understands, that will mean relying on a network of hospitals. I recognise the concern at his own local hospital, for which he campaigns extremely vigorously, and I assure him that I shall be watching very carefully what happens there.”
“The hon. Gentleman is right to say that it is time we had more medical schools, given that health and social care will be one of the fastest-expanding areas of the economy in the coming years. I think the Prime Minister was absolutely right to say that there should be no scaremongering about important local plans that will improve services for patients.”
“I was concerned about the general laughter following that comment, Mr Speaker. I am delighted that my hon. Friend’s father was treated so well, and I very much enjoyed my visit to the hospital recently. She is right: where there are changes in the patterns of training, we need to be very careful to ensure that they do not interrupt the delivery of local services in a disadvantageous way.”
“Westmorland general hospital has a very important future in the NHS and I am happy to give the hon. Gentleman that assurance. I do not think he should be concerned about STP footprints covering both rural and urban areas. However, where there is an issue in his constituency, and many others, it is the response times for ambulances in the most remote areas, and we are looking at that.”
“The capped expenditure process is an NHS England initiative to meet its statutory duty to live within its budget, and I support the principle that in a period where real expenditure on the NHS is going up by £5 billion, those benefits should be spread fairly among patients in all parts of the country.”
“Yesterday I updated the House on the action that we are taking to address delayed discharges from hospitals in advance of the winter. Since February, there has been a record decrease in delayed discharges, but faster progress is still needed to free up beds for the sickest patients and to reduce pressure on A&Es. Yesterday we therefore set out further measures to support the NHS and local government to reduce delays, including specific reductions required in all local areas, a prospective review of next year’s social care funding for poorly performing local authorities, and immediate CQC reviews in the worst-performing areas.”
“I completely agree with the hon. Lady that that is a very important issue. It is particularly important because people with mental health conditions need regular visits from their friends and family to help them to get over a crisis. Indeed, their chances of getting discharged and being able to go home are much higher when they are nearer home. She will be aware that we have a commitment to eliminate all out-of-area placements for children by 2020, and we are making big efforts with adults as well.”
“I have great respect for the hon. Lady, because she campaigns consistently on this issue, but I do not think that what she says is a fair reflection of what has happened. In the last year of the previous Labour Government, 45,000 people had to sell their home to pay for their care costs, whereas this Government have made it the law that no one has to sell their home. There is more work to do, but we have made important progress and will continue to do so.”
“There is a lot of merit in the opt-out system that has been developed in Wales for some time and is now happening in Scotland. We are looking closely at the evidence, but we have a lot of sympathy with this. If the system does lead to an increase in organ donations, it is certainly something we would want to pursue here.”
“I think the answer is that this varies from area to area. The CCGs grew up organically following the Health and Social Care Act 2012. Some parts of the country are discovering that the groups can be more effective if they combine forces, but these things have to be decided locally.”
“As ever, my hon. Friend makes an important point. I think that every child should leave school as knowledgeable about how to remain mentally resilient as about how to be physically healthy.”
“Like all clinical commissioning groups, Coventry and Rugby CCG is under a great deal of pressure, but our view is that, given the recent funding increases, it should be entirely possible for it to be sustainable.”
“I am more than happy to meet my hon. Friend, but he should be confident that we have put in place a substantial support package, including a buddy relationship with another trust and special teams from NHS Improvement, to turn the situation around.”
“We will look carefully at the Samaritans’ report, as we always do with what the Samaritans say. I think the signs are that our policies are having an impact and reducing suicide rates significantly, but suicide remains the biggest cause of death among men under 50.”
“If I may say so, that was a brilliant recovery. The hon. Lady is absolutely right to focus her attention on the performance of ambulance services. They are under pressure. They are hitting around 71% for their category A calls, and the target is to hit 75%. However, there are some bigger issues with the way those targets work, which we are looking at. Her ambulance service has just had a Care Quality Commission inspection.”
“I am more than happy to meet my hon. Friend. The principle behind the capped expenditure process is that we should have fairness between patients in different parts of the country. We should not see patients in one part of the country disadvantaged because the NHS has overspent in their neighbouring area, but the way in which we implement the process must be sensitive and fair. We must ensure that we get it right.”
“I suggest that the hon. Lady gets in touch with the details. What I would say is that when care is not satisfactory—whether it is delivered by the public sector or the independent sector—we have an independent inspection regime to root out the problems.”
“However, it takes two to tango, and we have had two elections in a row that the Labour Opposition have tried to turn into referendums on the NHS. If those on the Opposition Front Bench are willing to engage, then we on this side of the House are most certainly willing to do likewise.”
“I hope the Prime Minister’s comments this week will give them reassurance that we are seeking a deal that gives them the same rights to live and work here as UK citizens. I apologise for not being able to mention all of the many other contributions, but there were some important themes that I want to touch on. A number of Members talked about the possibility of developing a more cross-party consensus on difficult issues around health and social care. The right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper) spoke powerfully on that point, as did my right hon. Friend the Member for East Devon (Sir Hugo Swire) and my hon. Friend the Member for Totnes (Dr Wollaston). I would make this point. Governments of all colours always seek to get consensus on difficult policy issues, and this Government are no different.”
“He is, I think, the first ever Member to invite all hon. Members to join him at his 6 o’clock boot camp. As the shadow Health Secretary said, I feel as Health Secretary that I should set an example and join him, but unfortunately I have an unavoidable diary clash; that is a phrase he will learn to use as a new MP, I am sure. His passion for dealing with health inequalities came through loud and clear, and did him great credit. I also want to thank the hon. Member for Edinburgh West (Christine Jardine). She talked about the majesty of the three bridges across the Forth. For a couple of my teenage years, I grew up under one of them. She was absolutely right to want to reassure EU citizens working in the NHS of the vital importance of their role.”
“Friend the Member for Brentwood and Ongar (Alex Burghart) for his excellent speech. A teacher of medieval history, he taught us about the 9th century church in his constituency and the need to learn the lessons of the peasants’ revolt against excessive taxation. I can assure him that on the Conservative Benches we do not need to learn those lessons; we have reached enlightenment. I thank the hon. Member for South Antrim (Paul Girvan) for his beautiful panegyric to his stunning constituency. He spoke very powerfully against witch hunting in the military and very powerfully in favour of the Union; both positions will have strong support on the Government Benches. I welcome to the Labour Benches the hon. Member for Stockton South (Dr Williams). It is excellent to have another doctor in the House.”