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 tell the hon. Lady what action is happening this year. The proportion of CCG budgets being assigned to mental health is increasing from 12.5% to 13.1%, which is an increase of £342 million. That is action happening today because this Government are funding our NHS.”
“We know that a strong primary care system is the bedrock of the NHS, which is why I am pleased to announce today that NHS England will publish the new GP contract, agreed by the Government, NHS England and the British Medical Association. It will see almost £240 million extra invested in GP services; require GPs to establish whether overseas visitors are eligible for free care, allowing the NHS to better recoup the costs of that care; and improve access for patients by removing extra funding if GPs regularly close for afternoons during the working week.”
“My hon. Friend is absolutely right. Actually, the policy is that all A&Es, where space is available, should do that. The hospitals that do it have by far the most successful results—not least Luton and Dunstable, which has pioneered that model.”
“The NHS is under a lot of pressure, but what we never get from the hon. Gentleman is any solutions. Our solution is 600 more A&E consultants since 2010, 1,500 more A&E doctors, 2,000 more paramedics, and 2,500 more people being seen within four hours every day. His solution at the last election was to cut the NHS budget by £1.3 billion.”
“Let us look at the reality, instead of the hon. Gentleman’s rhetoric. In his own local trust in Leicester, there are 246 more nurses than in 2010 and 313 more doctors. Some 185 more patients are being seen in A&E every day and next year a new £43 million emergency floor will open at the Leicester Royal Infirmary. That is because we are backing the NHS instead of wanting to cut its budget.”
“The hon. Gentleman is absolutely right; this issue is a very big concern. The only way, in the long run, to reduce those litigation costs is to have safer care. That is why the Government have prioritised safety in everything we do.”
“I recognise that it is not a sustainable position to have to do that. Pressures on the frontline meant that it had to happen, but we do need to invest for the future and I agree with the hon. Lady that capital budgets are very important.”
“I absolutely agree. About 3% of schoolchildren have severe anxiety, but if we get treatment to them quickly, often we cure the condition and it does not come back. My hon. Friend is absolutely right that we need to be as imaginative as possible.”
“I am always somewhat disappointed by the right hon. Gentleman’s rhetoric, given that we are spending about £1 billion more every year than when he was mental health Minister. This April, we will reintroduce maximum waiting times for eating disorders. As he knows, we have committed to publish pathways for all conditions during this Parliament. That will include his constituent who, I agree, is waiting much too long at the moment.”
“I have sympathy for people who are frustrated about that issue. As I have said before, my objection is not one of principle; it is whether it is practical to do it. Perhaps that is something that GPs could decide at a local level.”
“May I gently tell the hon. Lady that I do not think our debates on the NHS are helped by her taking my comments out of context? I was quoting Chris Hopson, from NHS Providers, talking about a specific week when he said there were, in that week, a small number of incidents. We recognise the pressures across the NHS, which is why this Government are backing the NHS with record funding.”
“I can absolutely reassure my hon. Friend that we take that into account in all the funding we give for NHS primary care, but it depends on having a strong economy. That is something this Government will always do for the NHS.”
“and learned Friend the Member for Rushcliffe (Mr Clarke) said, the NHS had difficult winters in 1999, 2008, and 2009. He remembers difficult winters from his time as Health Secretary, but there are things that are different today. One of them is that, compared with six years ago, we have 340,000 more over-80s, many of whom are highly vulnerable or have dementia. We know that when people of that age go to an A&E at this time of year, there is an 80% chance that they will be admitted to hospital.”
“A huge number of actions are now being taken, but we must say right up front that it is totally unacceptable for anyone to wait 35 hours on a trolley and that we expect the hospital to ensure that that does not happen again. There are plans in place to open additional bed capacity this week. We have already had capacity made available by Worcester Community Trust to support the flow. The trust has deployed its chief operating officer on the task of facilitating discharges. The trust is in special measures, so we have a big management change, and a new chief executive will be starting later on in the spring. What is wrong with what the shadow Health Secretary has just said is the suggestion that winter problems are entirely unusual. As my right hon.”
“Winter is always challenging period, and I want to repeat the thanks of the shadow Health Secretary and the thanks that I gave on Monday to NHS staff. According to NHS Improvement, on the Tuesday after Christmas the NHS had its busiest day ever. Earlier in December, it treated a record number of patients within four hours. Overall, as the Prime Minister said this morning, we are seeing 2,500 more patients within the four-hour standard every single day compared with what happened in 2010. As we discussed on Monday, the NHS made record numbers of preparations for this winter, because it is always a difficult time, including having 3,000 more nurses and 1,600 more doctors in full-time employment. Let me address what the shadow Health Secretary said with regard to Worcestershire. I met colleagues from Worcestershire on Monday.”
“He is right to draw attention to the pressures in the NHS, but, regrettably, I will have to spend much of my time correcting some totally inaccurate assertions that he has made, and that is a shame. This is an important debate for our constituents—for his and for mine—and for the NHS. The country deserves a proper debate, but that is difficult when we are given misinformation at a time when the NHS is under sustained pressure. I am also very pleased to see the Leader of the Opposition in his place. I think that he has become rather a fan of my parliamentary appearances— [Interruption.] It is a Jeremy thing, he says—if only. I wish to address one part of my speech to him, because it is an area of policy for which he is perhaps more personally responsible.”
“I beg to move an amendment, to leave out from “House” in line 1 to the end and add: “commends NHS staff for their hard work in ensuring record numbers of patients are being seen in A&E; supports and endorses the target for 95 per cent of patients using A&E to be seen and discharged or admitted within four hours; welcomes the Government's support for the Five Year Forward View, the NHS's own plan to reduce pressure on hospitals by expanding community provision; notes that improvements to 111 and ensuring evening and weekend access to GPs, already covering 17 million people, will further help to relieve that pressure; and believes that funding for the NHS and social care is underpinned by the maintenance of a strong economy, which under this administration is now the fastest growing in the G7.” I thank the shadow Health Secretary for bringing this afternoon’s debate to the House.”
“Last year, on average, it involved around 7,000 beds, which is far too many. That is why the Secretary of State for Communities and Local Government announced in December a new package of support worth around £400 million—”
“Let me answer the hon. Gentleman’s question. I said that I would write to him, and I will do so. He may have noticed that there are other issues that we are dealing with, which is why I may not have had time to sign the letter. The £400 million extra for local authorities over the next two years will make a significant difference and he should recognise that.”
“Robert Francis said that the failures at Mid Staffs were “in part the consequence of allowing a focus on reaching national access targets.” Therefore, although we retain targets, we will not allow them to be followed slavishly in a way that damages patient care.”
“I will give way, but first I want to make some progress. I want to talk about something else that is different in our A&E departments today compared with six years ago. Although we are sticking to the four-hour target, we also insist on much higher standards of safety and quality. On Monday, I congratulated Labour on the introduction of the four-hour target—I support it—but we should also remember that four years after that standard was introduced, we started to see some horrific problems at Mid Staffs, many of which were in the A&E department. Some were caused because people thought they would be fired if they missed the target.”
“I have already given way to the hon. Gentleman. There are many other Members who want to intervene. That is why we have a new inspection regime that makes it harder to cut corners in the way that used to happen when beds were not being washed, there was poor infection control and ambulances were being used as waiting rooms.”
“I agree that staff numbers are critical, but we have, since 2010, 1,500 more doctors in our A&E departments and 600 more consultants. Across the NHS, we have more than 11,000 additional doctors, so we do recognise the pressures that the NHS faces. Indeed, we have 1,600 more doctors than this time last year, so we are doing a great deal to solve the problem.”
“My hon. Friend is absolutely right. It is a mistake in this debate to try—as I understand Opposition parties want to do—to boil this all down to the issue of Government funding when there is actually a lot of variability in the country. At this time of year, which is always difficult, some hospitals are doing superbly well in extremely challenging circumstances. We have just heard about some of the hospitals that are doing well, and there are a number of them.”
“I will give way to as many people as I can, but I also want to address the substantive points made by the shadow Health Secretary. He talked about the four-hour target. In his motion and his speech, he made the totally spurious suggestion that we are not committed to that target. I remind him what my right hon. Friend the former Chief Whip quoted me as saying on Monday. I did not just commit the Government to the target; I said that it was one of the best things that the NHS does. However, I also said that we need to find different ways to offer treatment to people who do not need to be in A&E. It is hardly rocket science. When there is pressure in A&E, it is sensible—indeed, I would argue that it is the duty of the Health Secretary—to suggest that people who can relieve pressure on A&E by using other facilities do so.”
“That is absolutely right. To back up my hon. Friend’s point, yesterday’s OECD report said that in Australia, Belgium, Canada, France, Italy and Portugal, at least 20% of A&E visits are inappropriate. NHS England’s figure is up to 30%, which is why we need the public’s help to relieve pressure and that is what I meant when I talked about an honest discussion.”
“We did know that information and that is why we thought it was totally irresponsible to want to cut the NHS budget in 2010, and not to back the NHS’s own plan in 2015. As a result, we have 11,000 more doctors. In the hon. Lady’s local hospital, 243 more people are being treated within four hours every single day.”
“I will make some progress and then give way. I could have put what I said on Monday another way. I could have said: “We have to persuade those people not in medical emergencies to use other parts of the system to get the help they need”. I did not actually say that, but I will tell the House who did. It was the then Labour Health Minister in Wales, Mark Drakeford, in January 2015. Frankly, when the NHS is under such pressure, it is totally irresponsible for the Labour party to criticise the Health Secretary in England for saying exactly the same thing that a Labour Health Minister in Wales also says.”
“I did not say that because we are not going to do it. As we have had an intervention from a Welshman, let me tell the hon. Gentleman a rather inconvenient truth about what is happening in Wales. Last year, A&E performance in Wales was 10% lower than in England, and Wales has not hit the A&E target for eight years. We will not let that happen in England. I noticed that the shadow Health Secretary quoted a number of people, but one that he did not quote was the Royal College of Emergency Medicine. I wonder whether that was because of what it said about Wales this week. It said: “Emergency care in Wales is in a state of crisis…Performance is as bad, if not worse, as England, in some areas.” There we have it: in the areas in which Labour is in control, these problems are worse.”
“Let me make my point. I do not say that to make a political point, but to show that it is patently ridiculous to try to play politics when there are winter pressures in the NHS. This happens in the whole NHS—in Wales as well as in England.”
“That is exactly the problem we had with Mid Staffs. We had a culture in the NHS where people were hitting the target and missing the point. Although targets are important management tools in all organisations, it is important that they are followed in a sensible way that puts the interests of patients first.”
“That is an extra £2.4 billion and we expect that to mean an extra 5,000 doctors working in general practice.”
“I would just like to make another point about Wales while we have the privilege of having someone here who aspired to lead the Labour party, as the current leader of the Labour party is no longer in his place. Something that Wales and England have in common is the need to ensure that, if we want alternatives to A&E, people are able to see their GPs. I have said many times that people wait too long to see their GPs. In all honesty, I think that the GP contract changes in 2004 were a disaster. The result was that 90% of GPs opted out of out-of-hours care. But we have been putting that right. Now 17 million people in England—about 30% of the population—have access to weekend and evening GP appointments. More than that, we have committed to a 14% real-terms increase in the GP budget by the end of this Parliament.”
“All I would say is that I hope that people in the NHS do not listen too much to what the Labour party says about the state of the NHS and that they listen to what the Government are saying, which gives a much more accurate picture, as I will go on to explain.”
“I will make some progress before giving way again. The second part of the motion talks about funding. There is no doubt at all that we will need to look after 1 million more over-65s in five years’ time and we will need to continue to increase investment in the NHS and social care system. That is happening with an extra £3.8 billion going into the NHS this year. Can I just remind Labour Members that that is £1.3 billion more than they promised when they stood for election last year? I just say this: it is not enough to talk about extra funding—you have to actually deliver it. Labour Members have to answer to their constituents as to why, for two elections in a row, they have promised less money for the NHS than the Conservatives, and why, in the one area where they are responsible for the NHS, they have cut funding.”
“My hon. Friend is right. What we did not hear from the Labour party is that, in 2010, we inherited a £70 billion PFI overhang, which is making it incredibly difficult for hospitals to recruit enough staff, because they are having to pay so much money to financiers.”
“The reason we have been able to protect and increase funding in the NHS in the last six years, when the Labour party was not willing to do so, is precisely that we have created 2 million jobs and given this country the fastest growing economy in the G7, and that is even more important post-Brexit. To risk that growth, which is what the Labour party’s proposal would do, would not just risk funding for the NHS, but be dangerous for the economy and mortally dangerous for the NHS.”
“My hon. Friend is absolutely right, and I talked about these issues when I visited her in her constituency. The truth is that, to solve this problem, we are going to have to have a dramatic increase in the number of people working in general practice, which is why we are funding the second biggest increase in the number of GPs in the NHS’s history. It is a great shame that the Leader of the Opposition is not here, because this is the bit that I wanted to address to him—his proposal to put extra funding into the NHS by scrapping the corporation tax cuts. That reveals, I am afraid, a fundamental misunderstanding of how we fund the NHS. Corporation taxes are being cut so that we can boost jobs, strengthen the economy and fund the NHS.”
“I am committed to people using A&Es falling within the four-hour target, but I also think that we need to be much more effective at diverting people who do not need to go to A&E to other places, as is happening in Wales, as is happening in Scotland and which, frankly, is the only sensible thing to do. However, going back to the funding issue, I just want to make this point: for all the heat in this Chamber in debates on the NHS, probably the biggest difference between the two sides of the House is not on NHS policy but on the ability to deliver the strong economy that the NHS needs to give it the funding that it requires. I am afraid that the proposals in the motion today reveal that divide even more starkly.”
“My right hon. Friend is right. That is the worst kind of gesture politics, because it may get the Leader of the Opposition a few votes or a few more Momentum supporters, but it would damage the NHS.”
“My hon. Friend is absolutely right. I think people in the country will find it hugely ironic that the party that spent so much energy in the last Parliament campaigning against top-down reorganisations is now campaigning against locally driven changes.”
“First, I would like to use this moment to congratulate the hon. Gentleman’s local trust on coming out of special measures last year and on the progress it is making. In a way, that is the answer to his point. His local trust was in special measures, and North Cumbria is still in special measures. We had some profound worries about patient care in both trusts, and we still do in the North Cumbria trust. That is why the status quo is not an option, but we understand the concerns of his constituents and many others about some of the proposals being made.”
“There is a concern at the moment about a growth in respiratory infections, and that is causing capacity constraints. We are watching what is happening on flu very carefully, but we have a record 13 million people vaccinated against flu, and I hope that that will put the NHS in a good position.”
“That is absolutely the point, and the last point I want to make before concluding on funding is that we miss a trick—I think the shadow Health Secretary is in some ways more reasonable than his leader on these issues, which is probably terminal for his career—if we say that this is just about money. We forget the debate we went through on schools in this country 20 years ago, when there was, again, a debate about money, but we realised that the issue is actually also about standards and quality. That is what has happened in Sherwood Forest, and I congratulate the trust. It is important that we do not let debates about funding eclipse that very important progress that we need to make on standards.”
“This Government’s vision is simple: we want it to offer the safest, highest quality care anywhere in the world. When we have difficult winters and an ageing population, of course that makes things more challenging, but it also makes us more determined. It means that we are backing the NHS’s plan; it means more GPs and better mental health provision; and it means an NHS turning heads in the 21st century just as it did when it was founded in the 20th century.”
“It is not just the fact that there are 11,000 more nurses and 11,000 more doctors; not just the fact that, on cancer, we are starting treatment for 130 more people every single day, and have record cancer survival rates; not just the fact that we have 1,400 more people getting mental health treatment every day and some of the highest dementia diagnosis rates in the world; and not just the fact that we are doing 5,000 more operations every day and that, despite those 5,000 more operations every day, MRSA rates have halved. We have an NHS with more doctors and more nurses, and despite difficult winters, with patients saying they have never been treated more safely and with more dignity and more respect. Next year the NHS will be 70 years old.”
“I am going to conclude now because lots of people want to come in, I am afraid. The shadow Health Secretary’s central claim—these are his words—was that the culpability for what is happening in the NHS “lies at the door of Downing Street”. I owe it to the country and this House to set the record straight on this Government’s record on the NHS.”
“Taken together, what I have announced today are plans to support the NHS in a difficult period; and plans for a Government who are ambitious for our NHS, quite simply, to offer the safest, highest-quality care available anywhere, for both mental and physical health. But they will take time to come to fruition, and in the meantime all our thoughts are with NHS and social care staff who are working extremely hard over the winter, and throughout the year, both inside and outside our hospitals. I commend this statement to the House.”
“As Professor Keith Willett, NHS England’s medical director for acute care, has said, no country in the world has a standard for all health problems, however small, and if we are to protect services for the most vulnerable, nor can we. NHS England and NHS Improvement will continue to explore ways to ensure that at least some of the patients who do not need to be in our A&Es can be given good, alternative options, building on progress under way with a streaming policy in the NHS England A&E plan. In this way, we will be able to improve the patient experience for those with more minor conditions who are currently not seen within four hours, as well as protect the four-hour promise for those who actually need it.”
“Nowhere outside the UK commits to all patients to sort out any urgent health need within four hours. Only four other countries—New Zealand, Sweden, Australia and Canada—have similar national standards, which are generally less stringent than ours. This Government are committed to maintaining and delivering that vital four-hour commitment to patients, but since it was announced in 2000, there are nearly 9 million more visits to our A&Es, up to 30% of which NHS England estimates do not need to be made, and the tide is continuing to rise. If we are going to protect our four-hour standard, we need to be clear that it is a promise to sort out all urgent health problems within four hours, but not all health problems, however minor.”