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| NHS debate shows political scrap over health is going to be ugly | NHS debate shows political scrap over health is going to be ugly |
| (about 20 hours later) | |
| It was not just the heat that was sweltering at Westminster – tensions in the chamber boiled over as Labour and Conservatives slugged it out over who was responsible for the failings in the health service. | It was not just the heat that was sweltering at Westminster – tensions in the chamber boiled over as Labour and Conservatives slugged it out over who was responsible for the failings in the health service. |
| If this is the precursor to the general election, it is going to be ugly. At one point a Labour MP shouted across the chamber at another politician to "fuck off", while the mild-mannered Jeremy Hunt claimed this was Labour's "darkest day", accusing Andy Burnham of allowing thousands to die on his watch as health secretary. | If this is the precursor to the general election, it is going to be ugly. At one point a Labour MP shouted across the chamber at another politician to "fuck off", while the mild-mannered Jeremy Hunt claimed this was Labour's "darkest day", accusing Andy Burnham of allowing thousands to die on his watch as health secretary. |
| Labour is not ahead on many issues, but still enjoys a 13% lead on health, and Cameron knows he totally messed up the NHS reforms in 2011. Since the arrival of Hunt, the coalition agenda has changed from restructuring to compassion, and increasingly, as examples of failure in care have mounted up, Downing Street has become ever more confident in criticising the NHS, convinced that the public can be persuaded that Labour systematically covered up the failure in the institution it created. | Labour is not ahead on many issues, but still enjoys a 13% lead on health, and Cameron knows he totally messed up the NHS reforms in 2011. Since the arrival of Hunt, the coalition agenda has changed from restructuring to compassion, and increasingly, as examples of failure in care have mounted up, Downing Street has become ever more confident in criticising the NHS, convinced that the public can be persuaded that Labour systematically covered up the failure in the institution it created. |
| In advance of the report by Professor Sir Bruce Keogh, the NHS medical director, the more Conservative weekend newspapers ran lurid stories suggesting the Keogh report would show 13,000 excess deaths in the 14 hospitals investigated. Tory MPs took to Twitter on Sunday to say Burnham could not survive as shadow health secretary. The totally unsubliminal and deliberate No 10 message was that the NHS was no longer safe in Labour's hands. | In advance of the report by Professor Sir Bruce Keogh, the NHS medical director, the more Conservative weekend newspapers ran lurid stories suggesting the Keogh report would show 13,000 excess deaths in the 14 hospitals investigated. Tory MPs took to Twitter on Sunday to say Burnham could not survive as shadow health secretary. The totally unsubliminal and deliberate No 10 message was that the NHS was no longer safe in Labour's hands. |
| Indeed, 10 Tory MPs wrote to the Telegraph on Monday to suggest: "It is clear now that the last Labour government oversaw thousands of unnecessary deaths in our NHS hospitals and failed to expose or confront these care scandals. The patients we represent were betrayed. It would be an outrage if Andy Burnham were ever to return to the role of secretary of state for health." | Indeed, 10 Tory MPs wrote to the Telegraph on Monday to suggest: "It is clear now that the last Labour government oversaw thousands of unnecessary deaths in our NHS hospitals and failed to expose or confront these care scandals. The patients we represent were betrayed. It would be an outrage if Andy Burnham were ever to return to the role of secretary of state for health." |
| On the right, Spectator editor Fraser Nelson suggested the report might reopen a debate on the liberalisation of the NHS. | On the right, Spectator editor Fraser Nelson suggested the report might reopen a debate on the liberalisation of the NHS. |
| Everyone will have their own view about how the two parties fared in Tuesday's gruesome clashes. Hunt can legitimately claim he is forcing the NHS to be more honest about error. He gains a hearing when he says varying standards of care cannot all be attributed to resources. His proposals to introduce Ofsted-style specialist inspections are widely accepted. | Everyone will have their own view about how the two parties fared in Tuesday's gruesome clashes. Hunt can legitimately claim he is forcing the NHS to be more honest about error. He gains a hearing when he says varying standards of care cannot all be attributed to resources. His proposals to introduce Ofsted-style specialist inspections are widely accepted. |
| But Tuesday did not feel like the day Labour lost the NHS, partly due to the hyped pre-briefing. Keogh sent an email disowning the weekend accounts of his report: "Not my calculations, not my views. Don't believe everything you read, particularly in some newspapers." | But Tuesday did not feel like the day Labour lost the NHS, partly due to the hyped pre-briefing. Keogh sent an email disowning the weekend accounts of his report: "Not my calculations, not my views. Don't believe everything you read, particularly in some newspapers." |
| As the report started to appear on Tuesday, it was revealed there was no death toll. Indeed, Keogh also dismissed such figures as "clinically meaningless and academically reckless", saying excess deaths were not a measure of avoidable deaths. He instead said that a key problem was low levels of staffing, including a lack of nurses. A 12-hour shift for nurses was frequent in many of these hospitals. | As the report started to appear on Tuesday, it was revealed there was no death toll. Indeed, Keogh also dismissed such figures as "clinically meaningless and academically reckless", saying excess deaths were not a measure of avoidable deaths. He instead said that a key problem was low levels of staffing, including a lack of nurses. A 12-hour shift for nurses was frequent in many of these hospitals. |
| The health department denied it had briefed the 13,000 number. It was pointed out that the figure was instead a calculation by Professor Sir Brian Jarman of Imperial College. | The health department denied it had briefed the 13,000 number. It was pointed out that the figure was instead a calculation by Professor Sir Brian Jarman of Imperial College. |
| Jarman calculates that had the hospitals had average death rates, 13,000 deaths could have been avoided in that period. But his conclusions are not generally accepted. | Jarman calculates that had the hospitals had average death rates, 13,000 deaths could have been avoided in that period. But his conclusions are not generally accepted. |
| The Liberal Democrats also hastily distanced themselves from Hunt's tone. Andrew George, the St Ives MP, accused Hunt of "an ill-judged attempt to drag this important issue into the gutter of partisan politics and petty point-scoring". | The Liberal Democrats also hastily distanced themselves from Hunt's tone. Andrew George, the St Ives MP, accused Hunt of "an ill-judged attempt to drag this important issue into the gutter of partisan politics and petty point-scoring". |
| The former chair of the Care Quality Commission Lady Young also intervened to send a letter to the prime minister insisting the CQC had not been put under pressure by the previous government to tone down its regulatory judgments or to hide quality failures. | The former chair of the Care Quality Commission Lady Young also intervened to send a letter to the prime minister insisting the CQC had not been put under pressure by the previous government to tone down its regulatory judgments or to hide quality failures. |
| Burnham, nevertheless, was on the defensive, lashing out at smears, while Hunt was unconstrained in his assault in the Commons, saying: "If founding the NHS is considered Labour's proudest achievement, today is its darkest moment as a Labour government are exposed as caring more about their own reputation than about our most vulnerable citizens in the NHS." | Burnham, nevertheless, was on the defensive, lashing out at smears, while Hunt was unconstrained in his assault in the Commons, saying: "If founding the NHS is considered Labour's proudest achievement, today is its darkest moment as a Labour government are exposed as caring more about their own reputation than about our most vulnerable citizens in the NHS." |
| But Burnham, as health secretary, acted over Basildon and Tameside. He also put five of the 14 hospitals contained in Tuesday's report in special measures. No smoking gun has been revealed showing Burnham rejected official advice to stage an inquiry. | But Burnham, as health secretary, acted over Basildon and Tameside. He also put five of the 14 hospitals contained in Tuesday's report in special measures. No smoking gun has been revealed showing Burnham rejected official advice to stage an inquiry. |
| He can also legitimately point out that the Francis report, which was handed to the government in February, had not yet been implemented – particularly in its points on minimum safe staffing levels, the regulation of healthcare assistants and the duty of candour to individuals. | He can also legitimately point out that the Francis report, which was handed to the government in February, had not yet been implemented – particularly in its points on minimum safe staffing levels, the regulation of healthcare assistants and the duty of candour to individuals. |
| The best one can hope is that once the smoke has lifted from the political battlefield, Keogh can reconstruct a consensus on reform, including the Francis reforms. | The best one can hope is that once the smoke has lifted from the political battlefield, Keogh can reconstruct a consensus on reform, including the Francis reforms. |
| • This article was amended on 16 July 2013. An earlier version incorrectly identified the shadow health minister, Jamie Reed, as the MP who shouted across the chamber. |