MPs are to vote today on Clause 119 of the Care Bill, which could give the health secretary powers to close down hospitals within 40 days, plus the rest of today’s news and comment.
6.24pm The amendment has been voted down.
6.14pm MPs will now vote whether to remove Clause 119 from the Bill entirely.
6.12pm MPs have voted no to the amendment. The Government won by 47 votes.
6.05pm Paul Burstow did not call for a vote on his amendment. However, Labour MP Jamie Reed also signed the amendment and he has called for a vote on it. The MPs are now voting.
5.55pm Poulter says the government will not accept Burstow’s amendment to give local commissioners a veto on the TSA’s recommendations because it would be “cumbersome and impractical”. He says Clause 119 does recognise the need to give commissioners from other trusts an input.
Poulter says new guidance will be issued to make it clear that local commissioners from other trusts will have an input in the TSA process.
5.39pm Poulter says it is “absolutely wrong” to conflate hospitals somtimes running a deficit with the administration regime.
5.35pm Health minister Daniel Poulter says Clause 119 is not a power to reconfigure services.
5.05pm Conservative MP Nick de Bois, who is voting against Clause 119, says that arguments for reconfiguration will not be won by politicians or NHS managers. It has to be a clinically-led argument.
4.49pm Burnham says it is “astonishing” that Jeremy Hunt isn’t in the Commons chamber.
4.40pm In his latest column Michael White looks at the debate over clause 119 and makes a prediction about the outcome of the vote.
4.37pm Stephen Dorrell says that everyone agrees that reconfiguration with public consultation is the best way. He says Clause 119 has narrow powers as the TSA will only be involved if all other preferred options have failed.
He says that to say a trust is in deficit is very different from saying it’s in administration.
He says that he would vote against Clause 119 if it was a back door means of driving change without consulting people, but he doesn’t believe it is.
4.15pm Burstow says the commissioners of a neighbouring trust cannot block a decision taken by the trust special administrator under the legislation.
He says his amendment would give local commissioners a veto. Commissioners would see the TSA report and accept or reject the recommendations.
He says that the public should not have changes “foisted upon them” and should be properly consulted.
4.03pm Burstow says it’s “far from clear” how a decision will be made to put a hospital through the administrative process. He says decisions about local health services should be taken by clinical commissioning groups.
4.00pm Liberal Democrat Paul Burstow says there are still too few successful reconfigurations, partly because the NHS has not been very good historically at engaging with its population.
3.36pm Conversative Sir Tony Baldry asks for reassurance that the new powers will only be used in extreme circumstances. He asks what the trigger will be for using administrative powers.
3.21pm Burnham cites the stroke services change in London as a positive example of reconfiguration. He says this worked because it was a clinical case for change. He says the proposals today are led by financial considerations.
3.17pm Liberal Democrat Andrew George MP says that all MPs agree with reconfiguration in principle but that changes when it comes to their own hospital. He asks Burnham how to tackle that.
3.14pm Shadow health secretary Andy Burnham says that the previous Labour government “put the clinical case for change front and centre and that is now being subverted”.
3.12pm Green Party leader Caroline Lucas says that clause 119 is not only “profoundly undemocratic” but also “counter-productive” because it will spark public opposition. She says that change needs to be driven by clinical arguments not through top-down decisions.
3.06pm Jeremy Lefroy, Conservative MP for Stafford, has tabled an amendment that he says would give the health secretary more fleixiblity to change recommendations from Monitor about the future of an NHS trust, rather than simply approve or reject them.
3.03pm Cygnet Health Care, a private provider of acute and intensive care mental health services, has announced the appointment of David Cole as its new chief executive.
Mr Cole trained as a mental health nurse and has 30 years of experience in health and social care. He was previously CEO of Castlebeck and Chairman up until mid-2008 and formerly chairman of Choice Care Group for last five years.
2.55pm A paper published today in the Journal Tobacco Control concludes that cigarette companies are casting doubt about standardised packaging by planting misleading stories, misquoting government data and commissioning ‘dodgy’ surveys about levels of illicit tobacco.
The paper, ‘Tobacco industry manipulation of data on and press coverage of the illicit tobacco trade in the UK’, published today in the Journal Tobacco Control analysed potential tobacco industry manipulation of data about illicit cigarette and tobacco trade in the UK.
By analysing newspaper articles over five years, the paper concludes that shortly after the Government announced the possibility of standardised packaging, tobacco companies began placing stories in the media that exaggerated the extent of illicit tobacco in the UK – confusing non UK duty paid cigarettes with illicit.
Professor Anna Gilmore, from the Tobacco Control Research Group at the University of Bath and UK Centre for Tobacco & Alcohol Studies said: “Industry claims that the use of illicit cigarettes in the UK is sharply increasing is wholly inconsistent with historical trends and recent independent data.”
She added: “Tobacco companies are exaggerating the threat of illicit tobacco by commissioning surveys of dubious methodology, planting misleading press stories and misquoting Government data. Industry data on levels of illicit must be treated with extreme caution.”
The paper is produced as the Government awaits the findings from Sir Cyril Chantler, who is reviewing the public health benefits of standardised packaging. Chantler is due to report his findings at the end of March.
2.45pm In the Commons Care Bill debate MPs have just voted no to an amendment that would have made the misuse of data provided by the HSCIC a criminal offence.
2.20pm Our Comment Editor Andy Cowper takes a look at clause 119. He argues that while there is “clearevidence of quality improvements with certain volumes of clinical procedures…we lack convincing evidence of the secretary of state’s or the Department of Health’s capacity and capability to know what the right size for a provider is”.
1.42pm The NHS Confederation has given its take on the “hospital closure clause”.
Chief executive Rob Webster said: “These clauses deal with a situation where there has been a catastrophic failure. This will be something that affects the whole health economy. We understand that the Trust Special Administrator will need to take a whole system view and the context in which a failing organisation operates and take a whole-system approach to developing a way forward.
“In conjunction with the Foundation Trust Network and others, the NHS Confederation called for amendments to the Care Bill that will require the TSA to consult with and consider the views of the organisations affected by any broader change the TSA recommends in the wider economy.
“Clauses 118 and 119 now allow the TSA to take an ‘aerial view’ of the whole health economy, and to find the best way forward where communities are affected by change that extends beyond the provider in crisis. This is essential because no one NHS organisation is an island.
“The debate has centred on these powers driving change across the NHS, with little regard to public consultation. We believe that this will not happen if radical change is planned and not crisis driven. This planned approach allows for effective consultation and works within the existing rules. What is essential is that, across England, politicians and the public understand the urgent need for change in order that the health service continues to remain sustainable.
“This is why our 2015 Challenge calls on both politicians to create the space for the change needed and local NHS organisations to be ready to make the essential changes. It is vital the NHS is in a position to get on with purposeful, planned change that addresses the real challenges the health service faces.”
1.29pm In the Care Bill debate Sarah Wollaston MP says that the care.data programme could help improve early diagnosis of cancer by identifying GP practices where the disease is not picked up early enough.
1.26pm The BBC reports that prescription charges are set to rise from April and again next year.
NHS dental charges will also increase by up to £5 from 1 April.
In a statement, Health Minister Norman Lamb said the increases were justified given the increasing demands on the NHS, with spending on medicines alone almost doubling since 2000.
1.00pm Clinical commissioning groups have received guidance to “encourage and support” them to deliver parity of esteem for mental health services, Sir David Nicholson has said.
The NHS England chief executive made the comments in response to widespread criticism of the decision late last year to require a higher level of efficiency saving from mental health and community providers, than of hospital trusts.
HSJ has reported on the serious concerns of charities, providers and others about the decision to impose a 1.8 per cent price reduction for 2014-15 on mental health and community trusts, and only a 1.5 per cent reduction for hospital trusts. The move was also criticised by health minister Norman Lamb.
12.55pm National Voices, the health and care charity coalition has welcomed the findings of the Duty of Candour Review and urges the Health Secretary, Jeremy Hunt, to accept them.
National Voices, spearheaded by member, Action against Medical Accidents (AvMA), has been campaigning for a duty to be honest with patients and families for several years and National Voices’ chief executive, Jeremy Taylor, gave evidence to the review panel.
AvMA chief executive, Peter Walsh, said: “All patients welcome the outcome of the review. It is unthinkable that the government will ignore this recommendation. A full duty of candour would probably be the biggest advance in patients’ rights and patient safety since the creation of the NHS. For decades the NHS has frowned upon cover-ups but has been prepared to tolerate them. This will be an end to that.”
Don Redding, National Voices’ Director of Policy, said: “At National Voices we welcome the findings of the Duty of Candour Review which says that if a patient is caused ‘significant’ harm, the organisation responsible must tell the patient or their family. The key advance is that the definition of ‘significant’ should include what are currently classified as incidents of ‘moderate’ harm but which are significant to patients - the original plan was to limit to the duty to fatal cases or those causing the most severe permanent disability.
“We also welcome recommendations that staff should have training and support in taking this forward. We urge Health Minister, Jeremy Hunt to accept the recommendations and to work with Action against Medical Accidents, National Voices and other stakeholders on the regulations which will enact them.”
12.48pm The Care Bill third reading debate has started and Sarah Wollaston MP is talking about the six month delay to the care.data project. She says there has been a “patronising approach” that has failed to set out the risks to the public.
She says that people should go to prison if they commit a data breach.
Four clinical commissioning groups last week issued a pre-qualification questionnaire for a single provider for end of life care and cancer care services.
HSJ revealed six months ago the plans of the county’s CCGs to tender the contracts, in which achieving given health outcomes are expected to form a major part of specifications and conditions of payment.
Colm Donaghy will take over the helm at Sussex Partnership, replacing Lisa Rodrigues. He will join the trust on 1st July.
12.07pm ITV News reports that a conservative spokesman has said Andy Burnham’s opposition to clause 119 is “irresponsible scaremongering”.
The spokesman said: “These claims from Andy Burnham are irresponsible scaremongering of the worst kind - changes to the special administrator regime will simply ensure that patients get safe care, and these powers have only ever been used in extremis twice since 2009, when Labour introduced them in the first place.
“This Government is determined to turn round failing hospitals, unlike the Opposition, which didn’t confront the sort of under performance and failure we tragically saw at Mid Staffs.”
12.05pm The latest update on the Care Bill is that clause 119 is due to be debated at 3pm, with a vote at 6pm.
Labour whips tweeted: “For those asking when #clause119 will be debated - expect debate to start about 3pm with vote/s at 6pm - will provide usual full analysis.”
11.55am The government is failing to ensure that insurance companies will not be able to buy patient medical records through the controversial NHS data scheme, shadow health secretary Andy Burnham has said.
Mr Burnham said government amendments to the Care Bill which will be voted on Tuesday are too wide ranging to provide the protections necessary to assuage concerns that confidential information will be sold for commercial purposes.
His intervention came as health minister Dan Poulter outlined the government amendments to the Bill which say care information can only be disseminated “for the purposes of the provision of health care or adult social care” and “the promotion of health”.
The mother, who has not been identified, was able to leave Walsall Manor Hospital with her newborn child in August 2013.
A document sent to Walsall Healthcare Trust said she had obtained information from a social networking site about another woman who was booked to deliver her baby in a neighbouring trust’s hospital.
11.45am Campaigners have gathered outside Parliament to protest against the “hospital closure” clause.
The third reading of the Bill is due to start at 12.45pm in the Commons.
We’ll be providing you with live updates throughout the day.
11.38am In the New Statesman George Eaton writes that the Care Bill vote in the Commons today will go Jeremy Hunt’s way but not without “significant resistance”.
A strategic framework into commissioning primary care, which was expected in early 2014, will now be published in September, the report revealed. It will cover all £13bn of services directly commissioned by NHS England.
In June NHS England will publish a framework on joint commissioning and CCG investment into primary care services. It will also look at flexibilities for area teams and CCGs to design local alternatives to national contract arrangements.
11.25am The Guardian reports that around 20 coalition MPs may rebel against Jeremy Hunt’s clause to allow a trust special administrator appointed to sort out a failing trust to order changes at a neighbouring hospital as part of an overall solution.
Lib Dem Paul Burstow MP is seeking an amendment to the clause which would allow local doctors who commission services from a particular hospital not directly involved in the other’s problems the right to veto any plans for an administrator to intervene in its running.
Barts Health Trust was predicting a £50m year-end deficit in December, but one of its March board papers states this has been “reassessed” down to £39m.
The paper states: “The main reason for this reassessment is partly due to the trust successfully redeploying staff and therefore reducing the need for redundancy costs. In addition, the recent improvements in patient treatment income have meant that for the last four months we have been in run rate balance.”
11.03am The Telegraph reports that Labour say 32 trusts are at risk of cuts and closure because of major financial problems.
The shadow health secretary Andy Burnham is appealing to Tory and Lib Dem MPs to vote no in the Clause 119 vote today.
10.22am In The Guardian columnist Polly Toynbee writes that every MP should “consider carefully” how they vote today on the “hospital closure” clause as this may come back and bite them hard in their own backyard.
Sean Duffy said he wants to “call time on that bias”.
10.19am NHS Employers has responded to the RCN’s Frontline First report.
Dean Royles, chief executive of the NHS Employers organisation, said: “These simplified figures help to tell part of a very complex story. Cash is flat, demand is rising, the way we care for people is changing and other professions like physiotherapists, dieticians, scientists and occupational therapists play a huge and often under-appreciated part in delivering quality care. Local nurse managers and their employers are doing a remarkable job in challenging circumstances and developing new models of care.
“Developments like day case surgery, endoscopy suites, patient hotels and growth in the number of doctors inevitably lead to a different skill mix. Judging the quality of care by the numbers of one particular staff group may be attractive to a nursing trade union but we also need to have a look at what skill mix gets the best outcomes for the patients. That’s the sophisticated debate we need to be having.”
10.09am The Guardian reports that around 20 MPs from both coalition parties plan to vote against the government on plans that could leave well-run hospitals in danger of being closed if neighbouring ones get into trouble.
Opposition to the measure, which forms part of the Care Bill being debated today, is being led by Paul Burstow a Lib Dem MP and former health minister.
Clause 119 of the Care Bill, the paper writes, would give a “trust special administrator” appointed to sort out a failing hospital trust the power to order changes in another local hospital’s services as part of an overall solution.
10.05am The Times reports that women drinking within NHS guidelines at the early stage of their pregnancy still have double the risk of giving birth to a premature or underweight baby, according to a study.
10.01am The Telegraph reports that thousands of women recovering from breast cancer are being left at risk because doctors fail to provide information about signs that the disease has returned, a report has warned.
A study of 14,000 women treated for the disease found just one in five was given a care plan telling them which symptoms to look out for after their treatment ended.
The report by the Breast Cancer Campaign says that bodies that are meant to check on the quality of care have made no attempt to monitor the standards.
The Frontline First report finds that within wider nursing workforce cuts is “a significant loss and devaluation of skills and experience in the NHS” with 3,994 fewer full time equivalent nursing staff working in senior positions (bands 7 and 8). Staff working at these bands include ward sisters, community matrons, clinical nurse specialists and advanced nurse practitioners.
Today the RCN is warning that the health service has been treating staff with years of experience as “disposable” and a quick way to save money, which means specialist clinical knowledge and leadership is being lost just as it is needed more than ever. The RCN also flags up the practice of “downbanding”, or forcing senior staff into lower pay grades.
Dr Peter Carter, chief executive and general secretary of the RCN said: “Nurses have been telling us for some time that workforce reorganisations are disproportionately targeted at more senior staff with key specialist or leadership roles. This is something which has a knock-on effect on all staff, and most importantly on patient care.
“As the Francis report rightly pointed out, patient care is affected when there are not enough senior nurses to effectively manage wards. When these positions are targeted for cuts, ward managers have less time to develop and support staff.
“What we have also seen too often in struggling hospitals is a lack of communication between management and clinical staff, meaning problems can go unreported and unresolved until it is too late. Senior nurses are ideally placed to act as a bridge between frontline staff and management, enabling resources to be used where they are most needed. In the community, senior and specialist nurses often work with a great deal of autonomy and are often solely responsible for patients. It is these patients who are affected when these posts are removed.
“Just as worryingly is the loss of specialist clinical skills and experience which is inevitable when so many band 7 and 8 nursing posts are cut or left vacant. As more patients require complex care from specialist nurses, letting so many years of skills and experience vanish from the NHS is an utterly reckless policy.
“We are facing a Europe-wide shortage of nursing staff and the last thing the NHS should be doing at this time is treating its highly experienced staff as disposable. We need to be doing everything we can to retain the skills we have in the NHS rather than using them as a quick and easy way to make savings. These cuts are a short-term attempt by trusts to find efficiency savings, yet they will lead to a very serious and very long-term crisis in our health service.”
The threat relates to the national commissioning body’s plans to reorganise its primary care support services, which administrate primary care. It has also emerged that the NHS England board is concerned about the plans.
The support services’ functions include supporting screening programmes, maintaining population databases, and coordinating charges for prescriptions and optician and dentist services.
9.46am The number of under 18s spending time in adult mental health wards in 2012-13 fell by 39 per cent compared to 2011-12, according to new data from the Health and Social Care Information Centre.
However, despite a full year of data not yet available for 2013-14 the figures so far suggest that this trend has been reversed with the figures already higher than the annual figures for 2012-13 even though they only cover the first eight months of 2013-14.
This dataset contains more instances of under 18s spending more than 48 hours on adult mental health wards compared to the CQC’s figures, something which the HSCIC said requires “further investigation”.
9.38am MPs will vote today on Clause 119 of the Care Bill, which could give trust special administrators powers to close down hospitals with 40 days notice.
7.00am Welcome to HSJ Live. To start the day, everyday technology such as mobile phones and Skype can give patients more control of their care, helping them to fit their health needs around their daily lives, writes Helen Crisp, assistant director at the Health Foundation.