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 is great credit to him that his mother is a pharmacist and his father is an NHS doctor. It is marginally less credit to him that he became a lawyer, but only marginally. He spoke with great passion and fluency about the importance of education. It was an excellent and moving first contribution to this House. I thank my hon. Friend the Member for Gordon (Colin Clark), a notable Conservative gain in the election. He spoke with great eloquence about the attractions of his constituency, including castles, beaches, restaurants and a golf course owned by the President of the United States. As for his campaign to get the Scottish Government to do more to deal with NHS staff shortages in his area, it is unusual for me to be on this side of the argument, but I can wholeheartedly support his campaign. I thank my hon.”
“They arrived minutes after the incident. Gunfire was still happening and they thought they were being fired at, but they walked straight into that gunfire. When I met them, they said they were just doing their job, but I think that shows that there is no such thing as “just a job” in the NHS; it is a vocation. On behalf of the whole country as well as this House, I want to thank them for showing us the NHS at its best. I want to record the fact that it is not just in times of tragedy that our NHS is there for us; it is there seven days a week, 24 hours a day. We have had a good and wide-ranging debate this afternoon. I congratulate, as the shadow Health Secretary did, the Members who made their maiden speeches; we heard some fantastic ones. I start with my hon. Friend the Member for Hitchin and Harpenden (Bim Afolami).”
“I thank the Opposition for choosing to have this debate on security, health and social care. Like the Home Secretary, the shadow Home Secretary and the shadow Health Secretary, I want to start by paying tribute to the amazing work of our emergency services in the recent terrorist atrocities. There are many stories, but two in particular sum up for me just how brilliant they were. The first was of an anaesthetist who picked up his daughter from the Manchester Arena when the bomb went off. He checked his daughter was safe, dropped her off at home and then went straight to work at Stepping Hill hospital. He worked through the night, and it was only in the morning that his colleagues realised he had actually been there when the bomb went off. I also want to mention the paramedics who arrived on the scene at London Bridge.”
“What she never mentioned is why we got into austerity in the first place: a global financial crash, made infinitely worse by profligate spending and a failure to regulate the City of London by the last Labour Government. The shadow Health Secretary, the hon. Member for Leicester South (Jonathan Ashworth), spoke eloquently about the NHS.”
“We will look carefully at what he said about a national sepsis registry. I also thoroughly agree with what my right hon. Friend the Member for Mid Sussex (Sir Nicholas Soames) said about leadership in the public sector and the NHS. I look forward to more discussions with him about that. On security, the shadow Home Secretary basically tried to turn an argument about public safety into an argument about austerity. However, I would gently say that for a shadow Home Secretary to protest about austerity in policing when she herself wanted to cut MI5 and the Met’s special branch, and when her leader wanted to cut the armed forces, is patently absurd.”
“People will recognise that in the very difficult period that we have just had, it would not have been possible to increase the number of doctors by nearly 12,000 and the number of nurses in our wards by nearly 13,000 if we had not taken difficult decisions on pay. What I can say is that we will not make our decision on public sector pay until the pay review body has reported. We will listen to what it says, and to what people in this House have said, before making a final decision. I want to mention what my hon. Friend the Member for Dudley South (Mike Wood) said about his battle against sepsis. Everyone in this House, on all sides, is totally delighted that he won that battle, but how typically selfless of him to use his speech to talk about the 44,000 people every year who do not win their battle against sepsis.”
“It is particularly important to have better links between the schools sector and the NHS if we are to crack this problem. We have a Green Paper coming up later in the year that will seek to address that. We also had a number of important speeches on the workforce and morale, including from my hon. Friends the Members for South West Wiltshire (Dr Murrison) and for Lewes (Maria Caulfield), a doctor and a nurse respectively, who spoke with great authority. We also heard from Opposition Members, including the hon. Members for Barrow and Furness (John Woodcock), for Halifax (Holly Lynch), for Sedgefield (Phil Wilson) and for Halton (Derek Twigg), who touched on issues around GP recruitment. On pay, all Members will recognise that whichever party is in power, we have to do the right thing for the economy.”
“I agree that all women, in all parts of the United Kingdom, should have the same rights to access healthcare. I note that a consultation on this matter is about to happen. The most important thing is that the voices of the women of Northern Ireland are listened to in that consultation. We had powerful speeches on mental health, in particular from my hon. Friend the Member for St Albans (Mrs Main) and the hon. Members for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) and for Makerfield (Yvonne Fovargue), but also from many others. Mental health is a very big priority for the Government, particularly children and young people’s mental health, because half of all mental health conditions become established before the age of 14.”
“I am going to make some progress. The shadow Health Secretary talked about underfunding of the NHS. He did not, of course, mention the new £43 million emergency floor at Leicester Royal Infirmary, which opened in April and is benefiting his constituents. There are indeed funding pressures in the NHS as we deal, like all countries, with the pressures of an ageing population, but they would be a whole lot worse if we had followed the advice of the Labour party in 2010 and cut the NHS budget; or followed the advice of the Labour party in Wales, which did cut the NHS budget; or followed the advice of the Labour party in 2015, when it promised £5.5 billion less than the Conservatives. The difference between this side of the House—”
“I will just make my point. The difference between this side of the House and the other side is not the desire to fund the NHS, but the ability to fund it through a strong economy, and that is exactly what we did. By 2014, we had created 2 million more jobs and the fastest growth in the G7, and what was our first priority? The NHS. Its budget has gone up by £6 billion in real terms since 2014. That is a 7% rise, and it is £2.6 billion more than the Labour party promised in 2015.”
“Wrexham Park, George Eliot, Hinchingbrooke, Cambridge, Morecambe Bay, Tameside and East Lancashire went from special measures to good standards. The proportion of NHS patients who say that their care is safe has never been greater.”
“Let me tell the hon. Gentleman that our manifesto was very clear: it referred to an extra £8 billion for the NHS, funded by the strong economy that Labour can never deliver. When the hon. Gentleman talked about problems in the NHS, and problems in care in the NHS, it sounded as if all those problems had started with the Conservatives. He did not mention the most challenging and difficult problem that his party left behind: the legacy of atrocious care at Mid Staffs, Morecambe Bay and many other trusts. Unlike the last Labour Government, we did not sweep those problems under the carpet. We did the opposite: we introduced the toughest inspection regime in the world. Thirty-five trusts went into special measures, and 20 exited from those special measures.”
“It is the Conservative party, not the Labour party, that is the party of the NHS. Question put , That the amendment be made.”
“This is the difference between the two parties. The Labour party wants to use the NHS as a political football. We want to make it better for patients, and that means difficult decisions to grow the economy so that we can fund the NHS, and difficult decisions to raise standards. The party of the NHS, however, is not the party that uses it to milk votes; it is the party that fights to make it better for patients. That is why it is the Conservative party that is making those difficult decisions. It is the Conservative party that is on the side of patients. It is the Conservative party that is seeing the highest standards of care for cancer, mental health conditions, strokes, heart attacks and nearly every major disease category that we have ever seen in the history of the NHS.”
“The Information Commissioner was updated in August. In July 2016, I committed to keeping the House updated once the investigations were complete and more was known, and I will continue to do so.”
“I accepted that advice for the very simple reason that publicising the issue would have meant GP surgeries being inundated with inquiries from worried patients, which would have prevented them from doing the most important work, namely investigating the named patients who were potentially at risk. A proactive statement about what had happened was again not recommended by my Department in July for the same reasons and because the process was not complete. However, as I explained to the House in February, on balance I decided that it was important for the House to know what had happened before we broke for recess, so I overruled that advice and placed a written statement on 21 July. Since then, the Public Accounts Committee has been kept regularly informed, most recently being updated by my permanent secretary in February.”
“Some 200,000 pieces were temporary residence forms and a further 535,000 pieces were assessed as low risk. A first triage identified 2,508 items with a higher risk of harm, of which the vast majority have now been assessed by a GP. Of those 84% were confirmed to be of no harm to patients and 9% as needing a further clinical review. To date, no harm has been confirmed to any patients as a result of this incident. Today’s National Audit Office report confirms that patient safety was the Department and NHS England’s primary concern, but as well as patient safety, transparency with both the public and the House has been my priority. I was advised by my officials not to make the issue public last March until an assessment of the risks to patient safety had been completed and all relevant GP surgeries informed.”
“As the House knows, on 24 March 2016 I was informed of a serious incident involving a large backlog of unprocessed NHS patient correspondence by the company contracted to deliver it to GP surgeries—NHS Shared Business Services. The backlog arose from the primary care services’ GP mail redirection service that SBS was contracted to run. No documents were lost, and all were kept in secure storage, but my immediate concern was that patient safety had been compromised by the delay in forwarding correspondence. A rapid process was started to identify whether anyone had been put at risk. The Department of Health and NHS England immediately established an incident team. All the documentation has now been sent on to the relevant GP surgery where it was possible to do so, following an initial clinical assessment of where any patient risk may lie.”
“However, what we can do is ensure that we react quickly when there is such a breach, which happened on this occasion, and that we have better assurance than we had on this occasion. I assure the House that the appropriate lessons will be learned.”
“Member for Leicester South (Jonathan Ashworth) that if he were in my shoes, and faced with advice that said that it was wrong to go public straight away as that would compromise the very important work GPs had to do to keep patients safe, he would have followed exactly the same advice. That is why, while I completely recognise that there is a potential conflict of interest with the Government arrangements, I do not accept that there was an actual conflict of interest, because patient safety concerns always overrode any interests we had as a shareholder in SBS. The NHS is a large organisation. It has a huge number of contracts with both the public and private sectors, and no Government of any party can ever guarantee that there will be absolutely no breach of contract.”
“] It is interesting that Opposition Members are laughing, as Labour was the party responsible for sitting on what happened at Mid Staffs for more than four years, when nothing was done. Transparency is incredibly important but it is not an absolute virtue, and in this case there was a specific reason for that. If we had informed the public and the House immediately, GP surgeries would have been overwhelmed—we are talking about 709,000 pieces of patient data—and they would not have been able to get on as quickly as we needed them to with identifying risk. That was the priority and that is what today’s report confirms: patient safety was the priority of the Department and NHS England. I put it to the hon.”
“Let me respond to those points. First, what happened at SBS was totally unacceptable. It was incompetent and it should never have allowed that backlog to develop, but before the hon. Gentleman gets on his high horse, may I remind him that SBS and the governance arrangements surrounding it were set up in 2008, at a time when a Labour Government were rather keen on contracting with the private sector? I know that things have changed, but the fact of the matter is that throughout this process our priority has been to keep patients safe. Transparency is nearly always the right thing; I am the Secretary of State who introduced transparency over standards of care in hospitals— [ Laughter.”
“Absolutely. There is a short-term and long-term lesson. The short-term point is that it is unlikely this would happen again because it was paper correspondence, and we are increasingly moving all the transfer of correspondence to electronic systems. The longer-term point is exactly that— [Interruption.] An Opposition Member mentions cyber-attacks; they are absolutely right to do so, because of course we have different risks. This clearly indicates that we need better checks in place, so that when we trust an independent contractor with very important work, we know that the job is actually being done, and that did not happen in this case.”
“I gently say to the hon. Gentleman that it is totally inappropriate to try to make political capital from this incident. The facts of the case are that the NAO today published a report saying that patient safety was the primary concern of both the Department of Health and NHS England throughout. There were some problems with the assurance of that contract, but the contract and the relationship with SBS in particular dates back to 2008. Both sides of the House need to learn the lessons of properly assuring NHS contracts, and I dare say the same is true in Scotland.”
“The company has been stripped of that contract; it was relieved of the contract back in 2015. We are very clear that it will have to fulfil all its contractual requirements, including paying its fair share of the costs that have been incurred as a result of this wholly regrettable incident.”
“I did not come to that conclusion. The hon. Lady is right, as a doctor, to say that patients’ trust in the way we hold their records is very important. In this case, the correspondence concerning patients was not forwarded, but it was not lost either. It was held securely, so no patient data were put at risk, but it should have been forwarded to another part of the NHS, and it was not; it was effectively stockpiled. That is what caused the concerns. We have been going through the high-priority cases. So far, the vast majority of cases have had two clinical reviews, and the ones we are still concerned about are having a third clinical review. We are taking this extremely seriously.”
“I am happy to confirm that. I am also happy to say that the problems in the old Mid Staffs, which I am afraid we had in many parts of the NHS, are being addressed much more quickly because of an independent oversight regime—the new Care Quality Commission inspection regime—and the appointment of a chief inspector of hospitals, who is independent in law and gives his judgment independently in law. That is something the Labour party regrettably tried to vote down.”
“The costs are in excess of £6 million, and we are seeking to recover as much of that as we can from the company involved. I know that the regime in the Labour party has changed, but to try to turn this into an issue of privatisation when under the right hon. Gentleman’s own party’s Government—and indeed, during his own time as Health Secretary—we had problems at Mid Staffs that were squarely in the public sector is wholly inappropriate. This is about proper assurance of what is going on in the NHS, and both sides of the House need to learn the lessons.”
“My hon. Friend is exactly right. Of course we welcome the fact that no patient harm has been identified to date. We have to wait until the process of the third clinical review is completed on at-risk patients’ records, which will happen by the end of December. She is absolutely right to say that SBS is no longer performing this contract; it has been taken in-house. Other parts of the SBS contract not related to what we are discussing today were given to another supplier.”
“I acknowledged in my statement that there is, or was, a potential conflict of interest when the contract with SBS was in operation, and the National Audit Office talks about that today. In reality, as the National Audit Office confirms, patient safety was always our overriding priority in all the decisions we took. I suggest to the hon. Gentleman, as I do to the shadow Health Secretary, that he would have taken exactly the same decisions had he been in my shoes.”
“There are two big lessons that we need to learn. First, why did the company have no internal systems in place to deal with the fact that from 2011 the mail was building up into a backlog? According to the NAO report, the situation was not escalated to the chief executive’s level until the end of 2015. That is wholly unacceptable. Secondly, it is also unacceptable that we did not have the assurance systems in place that would have allowed us to know that a backlog was building up. That is why it is so important that lessons are learned.”
“The original contracts with SBS went back to 2008, which is when it started providing mail redirection services, but they were renewed in 2011, which is why I think Members on both sides of the House need to reflect on this.”
“There has been a huge operation to deal with this. As the hon. Gentleman will know, there were 709,000 pieces of correspondence. We did an initial clinical triage to identify which ones were low risk, such as notifications of change of address, and which ones were higher risk, such as test results. We identified 2,500 that had a high priority, and 84% of those have so far been identified as being of no clinical risk, but we are continuing to do more thorough clinical risk assessment.”
“I am happy to confirm that. I think that in such situations it is important to allay public concerns about what might have happened. What happened was unacceptable, but no patient data were lost.”
“Just to be clear, what I said was that to date there is no evidence of any patients being harmed, but the process of proper clinical review, with multidisciplinary teams, will take until the end of the year. We have to do this properly to get to the answer. We hope that it remains the case that no patients were harmed, but we will not know that until the end of the year. However, throughout this whole process we have prioritised the highest risk cases and made sure that they get the most urgent attention.”
“The NHS is extremely good at responding to crises and emergencies, as tragically we have found out in recent months. This is an example of the NHS doing a very good job when it realises the scale of the problem. For me, the lessons that really need to be learned are about not the response to the issue but the assurance processes that allowed the problem to happen in the first place.”
“All those cases have already been looked at by two sets of clinicians, and so far, on the basis of those two reviews, no patient harm has been identified. However, because we want to be absolutely sure, we are having a third clinical review that will be even more thorough, potentially with more than one set of clinicians, so that we can get to the bottom of this and find out.”
“The hon. Lady is right. That is one of the most critical questions when it comes to trying to understand whether there was any actual patient harm. Ordinarily, if a patient was waiting for a test result that did not arrive at their GP’s surgery, the GP would chase it up and get a copy, so there would be no delay in treatment. However, only by looking at the patient’s notes can we understand whether any harm is likely to have happened. So far we have not identified any patient harm, but we will continue to look.”
“As the hon. Lady knows, I was informed at the end of March 2016. The issue with the correspondence that was destroyed relates to procedures around what it is legitimate to do when patients have been dead for 10 years. At the moment we are not aware of any specific risk to patients as a result of those sacks of mail being destroyed, but we will continue to look at the issue very closely.”
“I have been Health Secretary for a long time, but not since as far back as 2011. However, the hon. Gentleman asks an important question. It is true that the Department was entitled to three seats on the SBS board but took up only one, but I do not believe that would have made a difference in this case, because the board directors were intended to represent the Department as SBS shareholders. What we needed was better assurance of the implementation of the contract. That needed to happen with the NHS as a contractor. That is the lesson that needs to be learned.”
“We do need to be robust when companies fail in their contracts with the public sector. I do not think that this affects only private sector companies, because we contract with people in the public sector and are let down. Equally, we need to be robust when the right things do not happen. Most importantly, the lesson from what happened with SBS is that we need to understand much more quickly when things are going wrong, so that we can nip problems in the bud. That did not happen in this case.”
“Quite the opposite. Those examples show that we take the contracts off the private sector when it lets us down. That is what happened in the case raised by the hon. Gentleman and with SBS.”
“I gently remind the hon. Gentleman that the last Government who had an active policy of increasing private sector market share in the NHS were the last Labour Government. This Government legislated to stop the Government nationally prioritising the private sector and made that a decision for individual doctors at a local level.”
“Absolutely. My hon. Friend is right to point out that we are in a different world from the world of 2011. The future is to transport patient records securely over electronic systems. It is much quicker and there is much less room for error, but we do need the back-up systems that she mentioned.”
“I will relook at the situation in that surgery to ensure that we are learning any lessons that need to be learned. However, this is a complex process. There have already been two clinical reviews in the vast majority of the high risk cases, and we want to have a third review to really establish whether there was any actual patient harm. That takes clinician time, which is one of the reasons why we have not been able to complete the process by today. It will take until Christmas to do that because we have to balance the other responsibilities that clinicians have in their daily work.”
“I note the hon. Gentleman’s comments, but he will understand that I am not in a position to pass judgment at the Dispatch Box on the behaviour of individuals. The Department for Business, Energy and Industrial Strategy has respected and well-established systems in place to ensure that people who are not fit and proper to be company directors are not able to continue with their duties.”
“Just to be clear, this is a different contract, as I know the hon. Lady understands. We have been working hard, and I know that the hon. Lady worked hard with my Department in the previous Parliament to try to get to the bottom of the problems with the Capita contract. My understanding is that the situation is improving, but I will happily look into the individual situation she mentioned.”
“We are paying GP surgeries for the extra admin time that this is taking. That is designed to ensure that, where necessary, they can buy in extra resources to deal with the extra admin. The hon. Lady is absolutely right that we have to ensure that GPs’ core work is not compromised by the issue.”
“No one listening objectively could possibly say that I am, or that anyone on this side of the House is, downplaying this very serious situation. Since the issue came to light, we have instituted a review of 709,000 pieces of patient correspondence. We have identified the high-priority ones, of which there are 2,508. Two, and sometimes three, clinical tests have been done on all of them. No patient harm has been identified to date, but we are not complacent. We will continue the process until we have been through every single patient record with that thoroughness.”
“As I confirmed to the hon. Member for Stretford and Urmston (Kate Green), I will look into the outstanding issues with the Capita contract for GPs that are not related to the delivery of patient records. My understanding is that things have got better, but we were very unhappy with the initial performance from Capita.”