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 hon. Lady is right that this is about the excess mortality rates of people admitted at the weekend—not of people who are already in hospital at the weekend. I am afraid that she is mistaken in her characterisation of the rest of the Government position. Clinical standards are clear: people admitted at the weekend, or at any time, should be seen by a consultant within 14 hours, but that is true in only one in eight hospitals across seven days of the week, which is why sorting out the consultant contract for urgent and emergency care matters. Although the opt-out in the consultant contract applies only to elective work, half as many consultants are available in A&E on Sunday as are available during the week, although Sunday is one of the busiest days of the week, so it is not just about junior doctors.”
“All we have said to them is that if there are areas where we are not able to make alternative arrangements for urgent and emergency care by, for example, using other front-line clinicians, we would like their support in those specific areas, not across the whole country, in asking junior doctors to step in on those cases in the interests of patient safety. We have not yet had those assurances, but we very much hope we will get them.”
“On the overall picture, we must be clear that this is not about asking junior doctors to work a lot of extra hours for free. We expect that as we have increased take-up of seven-day services and more people working antisocial hours, particularly on Sundays, that might lead to a higher pay bill, but we need to make sure that the proposals for the workforce that we have at present protect average pay and mean that as we move to seven-day services, they are affordable by hospitals. To answer my right hon. Friend’s question, we respect the right of doctors to strike, even though it is very disappointing when they choose to do so, but they have said on this occasion, in a way that is quite unprecedented, that they will withdraw urgent and emergency care on 8 and 16 December.”
“The hon. Lady is right to be concerned by the much higher than normal excess winter deaths that we had, but I would not characterise the reason for those excess deaths as she did. We think they were largely caused by the ineffectiveness of the flu vaccine that was recommended by the World Health Organisation last year but proved not to be as effective as it normally is. The early signs are that this year’s flu vaccine will be more effective. Those excess deaths are deaths at home and throughout the system, not just in hospitals, but of course we are doing everything this winter, as we did last winter, to make sure that we minimise the possibility of excess deaths.”
“I agree with my hon. Friend, who has great knowledge of NHS matters. I simply say to junior doctors that this is not just about contracts and pay; it is also about training. Having consultants more available at weekends will help improve training for junior doctors. We will also need to look at continuity of training, which I think has been undermined in recent decades. If junior doctors are looking for a visible reflection of this Government’s commitment to the NHS, they should look at last week’s spending review statement and the extra resources we are putting into the NHS in very tight circumstances. This Government are backing the NHS, and we are doing everything we can to back junior doctors as part of that.”
“I hope that the hon. Lady will understand that, because I very much hope that the BMA’s junior doctors executive committee will agree to go ahead with the agreement we have made with its negotiators, I do not want at this stage to go into further details about its contents. Obviously, the agreement will be published as soon as it is made, but I think that I would be pre-empting that decision by going into detail. It is a reasonable period of time for negotiations to take place.”
“Absolutely. We want to reduce the number of doctors working unsafe hours and make sure that we have binding ways of ensuring that hospitals cannot ignore the intention of any agreement we make and ask doctors to work extra hours that they do not want to work and that might be unsafe, or indeed to trade on the good will that means many doctors work extra hours unpaid. That is an important part of the discussions that I hope we will now be able to enter into.”
“I am afraid that I do not agree with the hon. Lady’s characterisation of the situation as a “fiasco”. We are making really important changes that will save patients’ lives by eliminating the weekend effect that we have seen in the NHS for some time, which I think any responsible Government need to deal with. The way to improve morale in the NHS is by making it easier for doctors to give their patients the care they want to give, and at the moment that is very difficult in many places at the weekend. We want to put that right.”
“That is the reason we have had this whole dispute with the BMA, and it is disappointing that, rather than it negotiating with us on something that I think every doctor understands we need to address, it has come to the eleventh hour like this. In the end, my hon. Friend is absolutely right that doing the right thing for patients is also doing the right thing for doctors, because doctors go into medicine because they want to look after patients.”
“We are keeping in regular contact with our counterparts in the devolved Assemblies and Parliaments. As this is a devolved matter, it is obviously up to them to decide what they do, but I hope they will be encouraged by the progress that I think we are beginning to make in the argument for seven-day services.”
“I would like to reassure categorically those doctors that that is not the intention of the changes we are making. We have made it clear that we will protect the pay of anyone working within the legal contracted hours, and in fact three quarters of junior doctors will see their pay rise as a result of these changes. We want to deliver safer care. If we are able to go ahead with the negotiations with the BMA that I hope we can in the coming weeks, I hope we will be able to put in place very strong safeguards that all sides agree will reassure my hon. Friend’s constituents.”
“My attitude is very straightforward: I need to do the things that will make patients in the NHS safer, and I want to negotiate reasonably with anyone where there is a contractual issue that needs to be resolved. I think that the Government’s position has been reasonable. The vast majority of doctors will see their pay go up, and the pay for everyone else working legal contracted hours will be protected. This is a very reasonable offer that does a better job for patients, but it has been difficult to get through to the BMA. I urge the hon. Gentleman to talk to his friends at the BMA and to urge them to be reasonable and talk to the Government, whereby we could have avoided some of the problems.”
“No one knows more about campaigning for patients than my hon. Friend, as he has done in his constituency, and I congratulate him on that. He is right. There does not need to be an argument on a matter such as this, because it unites the Government in what we want to do to make the NHS the provider of the safest care in the world with what doctors themselves want to do. The best way forward is to put aside suspicion and for both sides to recognise that we are trying to do the right thing for patients, for doctors, and for the NHS.”
“Let me tell the hon. Lady what the failure was: it was setting up a contract for junior doctors in 2003 that has made it impossible for hospitals to roster proper care at weekends. The duty of a Secretary of State is to put right those historical wrongs so that patients are safe.”
“I have always believed that a negotiated agreement will be better for doctors, patients and the NHS, because I am sure that the BMA has value that it can add in the negotiating process to make sure that we implement the spirit and not just the letter of what the Government want to do. I agree with my hon. Friend, and I hope that we can enter into constructive, serious negotiations.”
“I do think that that is the primary concern of the vast majority of junior doctors, which is why I think it was wrong for the BMA to refuse even to sit down and discuss with the Government how we were going to implement a manifesto commitment. I now hope we can get past that, so I will not say any more other than that I think it is now possible to get a better agreement for the NHS, and I hope we will now be able to do that.”
“My hon. Friend is absolutely right: we have had some very unfortunate megaphone diplomacy over recent months, but I hope we can now put that behind us and that lessons will be learned. As he rightly says, we have never wanted to do anything other than what I think is good for doctors, as well as what is good for patients, and that is what the proposals were about.”
“Anaesthetists have an absolutely vital role to play in providing proper seven-day services. In the highest-risk operations it is obviously very important for consultant anaesthetists also to be present, to give their very important judgments. I absolutely give the hon. Gentleman that assurance.”
“I hope we can do that. The Opposition have talked regularly about social care, and rightly so. The fact is that both Labour and Conservative-run councils are responsible for the social care system, and being able to discharge into the social care system is a very important part of seven-day services. We are now about to enter a period of important reform in NHS and social care integration, so I see no reason why that approach could not be bipartisan.”
“I am afraid the hon. Gentleman is, as ever, completely wrong. First of all, I have not denigrated junior doctors. I have spent a lot of time praising their absolutely vital contribution as the backbone of the NHS. Secondly, I have not conflated routine services with mortality rates. In fact, I have done specifically the opposite. In answer to the hon. Member for Central Ayrshire (Dr Whitford), I confirmed that we are talking about urgent and emergency care and making sure that services are consistently delivered for urgent and emergency care across the week. That is our priority and that does link to mortality rates.”
“My hon. Friend is absolutely right. What is the common ground between the Government and junior doctors? We want to make sure they are working safe hours; we do not want to cut their pay; we want safer services for patients; and we want to make sure that the many junior doctors who do work weekends get proper consultant support and training opportunities at weekends as well as during the week. I think that that is enough on which to come to a deal.”
“I can tell the hon. Lady that NHS Employers, which represents all NHS hospital trusts, has said: “Trusts are clear that the current contracts for both consultants and junior doctors must be reformed to provide modernised and safe 7 day services in our hospitals.””
“I cannot provide my hon. Friend with that information this afternoon, because we do not yet know whether the strike will go ahead tomorrow, and how many operations will end up being cancelled in advance of it because of the late notice, but I am happy to get that information for him when we have an estimate.”
“I hope that the hon. Lady will be reassured by the Government’s November offer, which has specific protection for junior doctors doing research that the NHS needs them to do to ensure that they are not disadvantaged by doing any such research. I am happy to write to her about the plans we have outlined.”
“I do agree. I think that improving seven-day services across the NHS should unite both sides of the House and, indeed, should unite the Government and the medical profession. It is extremely unfortunate that we have got into this position, but there is now an opportunity to put things right and I hope that that happens.”
“My hon. Friend is right to bring this back to patients, which we should always do in health debates. Sadly, I fear—even if the strike is called off, as I hope it is—that in the majority of cases it will be too late to rebook people for tomorrow. We in the NHS will do everything we can to rebook people as quickly as we can. He is right that this is one of the very sad things that happens if people do not sit around the table and talk.”
“By 2020, all patients admitted to hospital in an emergency will have access to the same level of consultant assessment and diagnostic tests, whichever day of the week they are admitted.”
“I thank my hon. Friend for raising that issue, which is incredibly important for his constituents and for Dorset as a whole. I know that the Under-Secretary of State for Health, my hon. Friend the Member for Ipswich (Ben Gummer), who has responsibility for hospitals, will be going there very soon. The clinical standard says that anyone admitted to hospital in an emergency should be assessed by a consultant within 14 hours. Across every day of the week and all specialties, that happens in only one in eight of our hospitals. That is why it is so important to get this right.”
“Obviously, I am very concerned to hear what the hon. Lady says. I know that my right hon. Friend the Minister of State has been looking at this issue and is very willing to talk to her about it. Alternative provision has been made, but she is right to make sure that her constituents have access to urgent and emergency care seven days a week.”
“My hon. Friend speaks very wisely on this issue. Yes, this is not about making sure that every hospital is providing every service seven days a week. It is about making sure that in an urgent or emergency situation, people can access the care they need and that, for example, high dependency patients are reviewed twice a day, even at the weekends, by consultants. That happens across all specialties in one in 20 of our hospitals, which is why it is so important to get this right.”
“I am not quite sure I understand what the hon. Lady is referring to. We are not reducing A and E hours; we are investing. We have nearly 2,000 more consultants in our A and E departments than five years ago and we need to support strong A and E departments as much as possible.”
“I can absolutely give my hon. Friend that assurance. This is essential for the constituents of all hon. Members, whichever side of the House they sit on, and this Government will always stand on the side of patients. The weekend mortality rates are not acceptable. That is why we are doing something about them.”
“I commend the extraordinary contribution made by NHS front-line workers of Indian origin. I have met the Indian doctors association, the British Association of Physicians of Indian Origin, and have had many discussions on that front. It is very important, however, that people speak good English if they are providing care in the NHS. There are real issues for clinical safety when the standard of English is not high enough. We have a lot of fantastic support from immigrants who do a great job on the NHS frontline, but good English is an absolute pre-requisite.”
“Junior doctors are the backbone of the NHS. It is highly regrettable that their union has let them down by refusing to negotiate a new contract that will be fairer for doctors and safer for patients, and deliver the truly seven-day services we all want.”
“NHS Employers has regular discussions with the Medical Schools Council, which represents the Peninsula medical school. Although the training of doctors is not the specific contractual dispute that is in the headlines, it is something on which we could make significant improvements. We want to use this opportunity to work with medical schools and the royal colleges to see whether we can bring back some of the continuity of training that used to be such an important feature of junior doctors’ training.”
“What exactly would the hon. Lady say to her constituents who are not receiving the standard of care that they need seven days a week, and will she stand side-by-side with them, or with a union that has misrepresented the Government’s position? We have been clear that there are no preconditions to any talks, except that if we fail to make progress on the crucial issue of seven-day reform, we of course reserve the right to implement a manifesto commitment. That must be the way forward, and I urge the British Medical Association to come and negotiate rather than grandstand, so that we get the right answer for everyone.”
“I absolutely give my hon. Friend that reassurance. There are no preconditions, and this morning I wrote again to the BMA to reiterate that point. Of course, if we fail to make progress we have to implement our manifesto commitments, but we are willing to talk about absolutely everything. I agree strongly with my hon. Friend that it will be difficult to avoid harm to patients during those three days of industrial action. Delaying a cancer clinic might mean that someone gets a later diagnosis than they should get, and a hip operation might be delayed when someone is in a great deal of pain. It will be hard to avoid such things impacting on patients, and I urge the BMA to listen to the royal colleges—and many others—and call off the strike.”
“I do not know what the hon. Lady thinks is antagonistic about holding reasonable discussions with doctors for three years to try to solve the problem of seven-day care. Those discussions ended with the BMA, after two and a half years, walking away from negotiations last October. We made a manifesto commitment to have a seven-day NHS and to do the right thing for patients, and we simply asked the BMA to sit round the table and talk to us about it. I am confident that we can find a solution.”
“I urge the hon. Lady to correct for the record her wholly untrue statement that I ever said that doctors do not work outside 9 to 5. That is exactly the kind of inflammatory comment that makes the current situation a whole lot worse than it needs to be. I have always recognised the work that doctors do at weekends, but I also recognise that we have three times less medical cover at weekends, which means that mortality rates are higher than they should be. On A&E performance, we are taking extensive measures to ensure that the NHS is prepared for winter. It will be a tough winter, but unnecessary and wholly avoidable industrial action by the BMA will make it worse.”
“My right hon. Friend championed the cause of patients when he was a Health Minister, and we must continue to do the right thing for patients, which is also the right thing for doctors. It is wholly inexplicable that the BMA should try to gag the GMC and stop it issuing guidance to doctors about their professional responsibilities. Whatever the disagreements over the contract, the most important thing is to keep patients safe.”
“I accept total responsibility for doing the right thing to save patients’ lives. I have to say that I think that any holder of this office would be doing wholly the wrong thing if they were to try to brush under the carpet six academic studies that we have had in the last five years that say we have higher mortality rates at weekends than we should expect. This Government are on the side of patients and we will do something about that.”
“On Friday, I announced an ambitious plan to halve the rates of maternal deaths, neonatal harm and injury and still births by 2030 by learning from best practice in this and other countries. Following the tragic events in Paris, I know the House would also like my reassurance that we regularly review and stress test the NHS’s preparedness for responding rapidly to terrorist attacks. I have written to Madame Marisol Touraine, my French counterpart, to offer our solidarity and support. Vive la France!”
“I gently say to the hon. Lady that we have to find efficiencies in every part of the NHS, and we are asking the public health world to find the same efficiencies as hospitals, GP surgeries and other parts of the NHS, but that should not be at the expense of services. I completely agree with her about childhood obesity, on which we will announce some important plans shortly.”
“They are right about the pressures on the NHS, which is why we are investing £5.5 billion more into it than Labour promised. Those pressures will be made a lot worse by the forthcoming strike, so will the hon. Lady clear something up once and for all: does she condemn the strike—yes or no?”
“That is the difference: the hon. Lady follows the unions; I lead the NHS. When Labour had a big choice whether to support vulnerable patients who desperately need better weekend care, they chose political expediency—and the whole country noticed.”
“I do think it is a serious problem. People find it hard to live near to the hospital at which they work, particularly where housing is very expensive. This is an issue that we are looking at closely.”
“I have already explained that, but I hope the hon. Lady will understand that we also need the Labour party to explain why it is committed to £5.5 billion less for the NHS over this Parliament than this Conservative Government, on the back of a strong economy that her party has never been able to deliver.”
“I am happy to confirm that we are willing to talk about absolutely anything with the BMA to avoid a dispute that would be very damaging to patients. We do, of course, reserve the right to implement our manifesto commitment to seven-day reforms if we fail to make progress in the negotiations, but at this time, in the interests of patients, the right thing to do is sit round the table and talk rather than refusing to negotiate and going ahead with the strikes.”
“I shall be happy to do that. We have made great progress in tackling dementia, and there are some very good examples all over the country, but we can still do a lot better. We now need to concentrate not just on dementia diagnosis, but on the quality of the care that we give people when they have been given such a diagnosis.”
“I congratulate the right hon. Gentleman on his timing, given that the Prime Minister is now present. I assure him that we are committed to putting extra resources into the NHS, and to ensuring that we increase the proportion of those resources that go into mental health. I also congratulate the right hon. Gentleman on the mental health award that he received last week, which was extremely well deserved.”