Monday, 18 January 2016

Lilford Park Flooding - Residents Meeting

I am holding a public meeting on Thursday 28th January at 7pm in the Turnpike in Leigh and all residents affected by the flooding of the Lilford Park area are invited.

The primary focus of this meeting will be to discuss why - what was a very serious flooding incident happened and why the flood basin in Lilford Park, which was built to protect people from flooding, failed to do so.
This meeting will be for those residents to get answers to all their questions and get a full explanation.

Residents affected by the floods are entitled to council tax relief, a credit on their water bill and also a council grant of £500.

For more information go to

Tommy Sale - Simply The Best of Us

When you do my job, it's very rare to be able to stand up and speak and find everyone in complete agreement with what you say.
But I know that, for today at least, in paying this tribute, I speak for every man, woman and child in this town.
Tommy Sale was quite simply the best of us - the greatest Leyther of them all.
I first met him fifteen years ago.
Perhaps because of the teacher in him, Tommy liked to give me a bit of guidance in those early days.
He took a particular interest in the first live TV interview I did.
I was standing on the green in front of Big Ben, more than a little nervous, and, through my earpiece, I heard the Granada Reports presenter Lucy Meacock say: "We can now go over to Westminster and speak to the new MP for Wigan, Andy Burnham."
Well, to say that my life flashed before my eyes is an under-statement. But I recovered enough to correct her. I was in fact the new MP for Leigh, I said.
The weekend after, in the old boardroom at Hilton Park, Tommy beckoned me over.
"Andy, I was very glad you put that girl on the television straight. MP for Wigan. What a terrible thing to say."
When it came to local loyalties, there was never any doubt where Tommy's lay.
A couple of years later, we were sitting together in the same stand and I was proudly telling him about my dream of the Leigh Sports Village. I was a young man in a hurry.
In his typical under-stated way, Tommy told me that he has some knowledge of doing something similar. He then proceeded to look out on the pitch and paint the picture of he and his team of volunteers, straight after the war, working day and night, ferrying bricks, cement and coal slack, to build the very ground where we were both sitting.
It was a humbling moment. Talk about me needing to get some time in!
This was a man who built our club and our town with his own hands, his brain, his passion, his sheer ambition for Leigh and its people.
But he didn't stop at the ground; he then went on to build the team.
Arguably the single most important thing Tommy did to put Leigh on the map came in the late 1960s.
With Leigh second bottom, he went over to a golf club in St Helen's and talked a certain 27 year-old Saint into becoming Leigh's coach.
He succeeded - and I don't think Leigh has ever quite recovered!
We went on a journey that took us to Wembley and our moment of national glory.
Adopting the legendary Alex Murphy as a Leyther stands as one of - if not the - most inspired signing in the history of Rugby League.
Tommy achieved great things. Not for himself. But for Leigh.
A great man but, just like this town, no airs and graces, always on a level with people.
He was Leigh personified.
The army took Tommy away for a while. He achieved the rank of Second Lieutenant, a good wage of £20 per week and was playing Rugby Union - or the Game of the Establishment, as he called it.
But he swapped it all to come back home, earn £4 a week as a gardener, and do what he wanted to do - play Rugby League for Leigh.
And this is what sets Tommy apart.
Other great people have been born here, but made their name away from Leigh. Tommy was born near here and made his name here, by devoting himself to this place.
That's why he's the greatest Leyther of them all.
When I was first elected, I remember getting letters about all kinds of things that people wanted for the town.
But one came more than any other - could I help get an honour for Tommy Sale?
Together with Peter Smith and Trevor Barton, we tried. But it didn't happen straight away.
Yet the letters just kept on coming, year after year.
I know I am looking right now at many of the people who sent them.
You knew what was right, you never gave up and, thanks to you, the day finally came when Tommy got what was rightfully his.
That MBE was celebrated as much as a trophy for our beloved club. And that says so much about this town - one man's success celebrated as if it was everyone's.
I will never forget the day when I had the proud honour of welcoming Tommy and his family to Parliament on the proud occasion of his receiving the award at the Palace.
I gave him a tour of the corridors of power and, as I steered him around, he kept whispering to me: "Andy - all this fuss for me. Can you imagine that?"
I kept telling him how, yes, I could imagine it. It was because of everything he had done and the way he had done it.
A man of standards, dignity, discipline but with a care for people.
The complete gentleman at all times.
Someone who never wavered from his mother's advice: "in life, you must learn two things; to give a little and take a little; but give more than you take."
Leigh values through and through. Tommy embodied them. It's why he was the best of us, the best of Leigh.
It was the manner in which he accepted his MBE that speaks volumes about him.
I repeat Tommy's words today at the request of his family because they tell you more than I ever could about the man, his values, his outlook on life.
You can almost hear him saying them now, so typical they are of him.
"The town of Leigh owes me nothing; it is I that should be thanking them, as well as St Peter's Church, Leigh Rugby League Club and all of my family for the wonderful life they have given me."
Tommy loved Leigh. But Leigh loved him too.
Goodnight and God bless Tommy.
Forever the greatest Leyther of them all.

Wednesday, 18 November 2015

Letter to Home Secretary Theresa May on police funding

Dear Theresa

I understand that final decisions are being taken on the Government’s Comprehensive Spending Review and particularly the Police budget.

Yesterday in the House, I raised my concerns about the potential impact of the Government’s decisions on front-line policing. This is not the first time I have warned about this issue. You will recall that I called a full-day Opposition Day debate on this matter two weeks ago. However, it has now become more urgent in light of the terrible events in Paris.

The Chancellor has said that he is expecting to achieve non-protected departmental cuts of between 25-40%. As I am sure you would agree, cuts anywhere near this scale to the police service budget would have a devastating effect, with thousands more police officers lost and neighbourhood policing decimated.

I remain firmly of the view that efficiency savings up to 5% are achievable, but that anything above that is more difficult. This view has only been strengthened following the attacks in Paris.

I believe it is essential that we work to protect front-line officers and neighbourhood policing. We know that significant intelligence is gathered through community policing which aids the fight against extremism and terrorism. At a time when the threat of a terrorist attack in the UK is heightened, now is not the time to reduce the ability of the police to build important local relationships and gather that intelligence. 

As Peter Clarke, former Deputy Commissioner with the Specialist Operations Directorate, has said: “We risk breaking the ‘golden thread’ that runs through the police effort all the way from local communities to the farthest part of the world where, in an era of global terrorism, defence of the UK begins.”

But alongside strong neighbourhood policing, we also need to protect the ability of the police to respond to emergency situations as required and, as Sir Bernard Hogan-Howe has said, have sufficient firearms capability.

Protecting the public is not just about the counter-terrorism element of the police budget, but police funding as a whole.

In these changed circumstances, I believe that it would be unwise to ask the Police to deliver further difficult savings above 5% over the next five years.

As I said in the House yesterday, the Opposition wants to work constructively with the Government but will continue to challenge where we need to.

In that spirit, my colleague the Shadow Chancellor yesterday wrote to the Chancellor of the Exchequer offering our support for the enhanced expenditure needed to meet the increased threat to our security, including the police budget, be excluded from the parameters of the Charter for Budget Responsibility.

I welcome the funding that the Government has found for the security services but this cannot be seen in isolation from policing. If the Government proceeds with the proposed cuts, it would be a serious misjudgement and would put public safety at risk.

I hope you will give careful consideration to the issues I have raised and do all you can in the next few days to secure an acceptable settlement for the Police.

I am copying this letter to the Prime Minister and the Chancellor of the Exchequer.  

Yours sincerely

Rt Hon Andy Burnham MP
Shadow Home Secretary

Thursday, 22 October 2015

Calling Leigh's Veterans

I will be hosting my annual Veterans Lunch on Friday, 6th November 2015 at Leigh Miners’ Welfare Institute commencing at 12noon.

The annual event brings together veterans from across the Leigh Constituency as well as veteran organisations.

Following my campaign to raise awareness of the HM Armed Forces Lapel Badge all recipients of the badge will receive a personal invitation, but the event is open to all HM Armed Forces veterans in the Leigh Constituency and a nominated guest on a first come first served basis.

To confirm attendance please call Andy’s constituency office on 01942 682353 or email my office.

I know that veterans across the community look forward to attending, catching up with comrades and to remember the contribution and sacrifice of all those who have served their country across the globe. I hope that this small gesture will show Leigh’s appreciation for the valuable service our local veterans have given and continue to give to local life.

Monday, 6 July 2015

Andy4Leader campaign website

If you want to see the latest news from Andy's campaign to become Labour Leader, please visit

You can sign up to receive campaign updates, watch campaign videos, and get involved in Andy's campaign.

Monday, 25 May 2015

Statement on accomodation expenses

Like other MPs representing northern constituencies, and consistent with the rules set by the Independent Parliamentary Standards Authority, Andy Burnham has to have additional accomodation in London to fufill his parliamentary duties. Andy Burnham was forced into the current arrangement when the rules changed and this has been fully open and transparent since 2012. He did not seek the current arrangement and he wishes to stress that he does not make any money from it. A full explanation of how it arose follows.
1. 10 years ago, Andy Burnham decided to take out a second mortgage to buy a flat in London. Amongst other things, this saved a considerable amount of money for the taxpayer as it allowed him to reduce his accommodation claims.

2. The Commons only ever funded the 'interest' part of the mortgage. Andy Burnham funded the repayment part as well as another mortgage on his main home in Leigh.

3. Early in the last Parliament, the expenses rules changed to stop claims against mortgages. Andy Burnham did not want to leave his flat but had no choice. He moved to another flat in the same area.

4. At that time, MPs that had claimed against mortgages were asked to pay a lump sum to the Commons in respect of any "indirect subsidy" that may have accrued from being helped to take out a mortgage on a property that had increased in value. Andy Burnham did this in instalments over the last Parliament.

5. At the point when the lump sum was paid, it was determined that any direct or indirect public subsidy in the property had been fully redeemed. The requirement to clear any possibility of subsidy was introduced precisely to protect MPs from the kind of allegations that have been made.

6. When Andy Burnham left his flat, he continued to have a mortgage on it. He has therefore had to rent it out. The rental income received only covers the costs, which include: service charge; letting/management fee; and maintenance. No money is made from renting out the flat.

Thursday, 16 April 2015

Labour will guarantee neighbourhood policing in every way

Labour has set out plans to protect neighbourhood policing. We are identifying savings which will enable police forces to safeguard over 10,000 police officers over the next three years and legislating to introduce a new Local Policing Commitment, which makes sure police forces guarantee neighbourhood policing in every area.

To safeguard over 10,000 police officers, Labour will make £800 million worth of efficiency savings including scrapping expensive police and crime commissioners; ending the police subsidy of gun licenses; and mandating joint procurement and sharing support services. The Tories have ruled out all of these savings and only have a plan to cut more police.

Alongside the commitment to protect over 10,000 police officers from the cuts, Labour’s Crime and Justice Manifesto sets out plans to:

  • Put victims at the heart of the criminal justice system – by introducing the country’s first ever Victims’ Law.
  • Prevent crime before it occurs
  • Tackle child sexual exploitation and violence against women and girls
  • Build a justice system fit for the 21st Century 
  • Tackle extremism and the threat of terrorism

Because of the Conservatives’ decisions, neighbourhood policing – the foundation of good British policing – is at risk of disappearing, whilst increasing numbers of serious criminals are being let off the hook.

Labour has a better plan. We will make different choices, finding savings to safeguard 10,000 officers in the next three years. We will ensure victims are at the heart of the criminal justice system with the country’s first ever Victims’ Law. And we will ensure the police have the powers they need to keep us safe, including proper controls for dangerous terror suspects.

Sunday, 29 March 2015

Campaign Launch on Bradshawgate

There was a fantastic turnout for my campaign launch as I seek re-election in the General Election to be held on Thursday, 7th May and bid to keep Leigh a Labour seat in Parliament.

I was joined by Councillors and Labour Party members from across the Leigh area and it was great to meet local people to talk about Labour's better plan for Leigh and the country.

It has been a privilege to be the Member of Parliament for Leigh since 2001.

This election is one of the most important general elections there has been in modern times. Over the past five years we have seen living standards decline as wages have stagnated. Families will end up worse off at the end of this Parliament this year than they were at the start in 2010.

A Labour government elected in May will have the right priorities and will take the decisions necessary to improve the lives of people across Leigh and the country - we will reform the energy market, freeze gas and electricity bills until 2017, impose a Mansion tax on the most expensive homes, and use those funds to build an NHS with the time to care. This election is about which direction the UK will take, and who will form the next Government of the UK – and if people want a Labour Government, the only certain way to achieve that is by voting Labour on 7 May.

Are you registered to vote. It only takes a few minutes and can be done online at the link here. If you wish to vote by post you can download a form here.

Tuesday, 17 March 2015

Government waters down critical children’s mental health report

Today’s report on mental health services for children and young people, published by the Department of Health, fails to include key criticisms of the Government’s record made in the original copy.

The copy of the original report that emerged last month saw expert authors criticise the Government for its reductions in funding and the impact on services and waiting times.

“Since 2011 there has been a reduction in funding and consequent reduction in service provision, and an increase in waiting times; […]. Meanwhile, CAMHS providers report increased demand in terms of the number and complexity of referrals combined with cuts in CAMHS budgets."

However, the same paragraph today had become:

“Since 2011, our best evidence is that these difficulties are the result of financial constraints accompanied by rising demand."

Similarly, the original report references a “Lack of parity in funding decisions” – between mental health and physical health – but this criticism has been removed.

Only ten days ago it emerged that the Department of Health is also failing to publish a damning report on its management of the NHS by Lord Stuart Rose. Labour wrote to Health Secretary Jeremy Hunt to call for its immediate publication, but the Secretary of State has not responded.

This Government has become so desperate to run from its NHS record that they are now removing damaging criticisms from official reports. It is outrageous behaviour from a Government to seek to silence expert critics.

David Cameron and Nick Clegg cannot hide from the fact that the children’s mental health budget has been cut in real terms over this Parliament and the NHS has lost 3,300 specialist mental health nurses and 1,500 mental health beds.

They’ve left highly vulnerable children without the support they need and being shunted up and down the motorways in search of crisis beds. Many children have been left hundreds of miles from their home and families and that is a scandal that has got to end.

The NHS as we know it can’t survive another five years of the Tories’ failing plan. Labour has a better plan to put mental health at the heart of the NHS by integrating mental health, physical health and social care into one service. We will invest an extra £2.5 billion each year in the NHS, increase the proportion of the mental health budget spent on children and recruit 20,000 more nurses, including mental health specialists.

Wednesday, 11 March 2015

Getting the best NHS deal for Greater Manchester

There must be an election coming.  After five years of making savage cuts to council budgets, and five years of fragmenting and privatising, George Osborne has waited until five weeks before this Parliament ends to endorse Labour’s plan to integrate the NHS and social care.

We can all speculate about the reasons for his Road to Damascus-style conversion and have every right to be suspicious of the real reasons behind the rushed timetable unveiled this week. But the great thing about our political leaders in Greater Manchester is that they are always more interested in getting the best deal for our people than playing party politics. That’s what sets them apart from others and means they get so much done.

Unlike Mr Osborne, they are not sudden converts to NHS and care integration. So they have my full support in pushing for the best deal from whichever Government is in power.

Osborne’s plans could allow Greater Manchester to get on with the job of delivering Labour’s policy of Whole Person Care. But, before any final deal is signed, there are major questions that the Chancellor needs to answer.

Firstly, how much money is actually on offer and will it be enough?

On Tuesday, this paper revealed huge deficits in Greater Manchester’s hospitals after years of council budget cuts too. And we know that pressure is growing as our population gets older. We all need to be vigilant against the danger that this Government is only offering to devolve a funding crisis and then blame us when things get worse.

This raises my second question: what will happen if the funding is insufficient? Will our hospitals be left to sink or swim or will we continue to get backing from the rest of the NHS?

These questions are highly relevant. Last September in Manchester, Ed Miliband committed to the extra £2.5 billion year that the NHS needs. This is a promise Mr Osborne has failed to match.

My third worry is whether these proposals would mean yet another reorganisation for Greater Manchester’s NHS - only two years after the last one. It would be the very last thing that we need, wasting time and money.

Fourthly, will Greater Manchester still be stuck with the Tory competition agenda after devolution – or does this give us an escape route? This is important as mandatory tendering is the biggest obstacle to integration and we can only succeed if it is removed.

If George Osborne can provide proper answers in all of these areas, then I believe his package could help us deliver Labour’s health and care policy. But this is not the deal that I would be offering to Greater Manchester if I am Health Secretary in ten weeks’ time. I believe I can offer a much better one.

Firstly, Labour will be devolving more money to Greater Manchester’s NHS and councils – raised by our new Mansions Tax – allowing it to build an NHS that starts in people’s homes, looks after them there and gets the rid of the culture of 15-minute care visits. There will be money for the extra nurses, GPs, homecare workers and midwives that we need.

Secondly, rather than create new bureaucracies, I will move quickly to devolve more power to our councils and councillors. Integration needs to be led at a local level – as we are already seeing in Salford, Stockport and Wigan.

Thirdly, I will waste no time in repealing George Osborne’s Health & Social Care Act which has foisted a toxic culture of competition on the NHS. This has led to the privatisation of part of our ambulance service in Greater Manchester – without a single community or council be asked their view or giving their approval.

Under my deal, the people of Greater Manchester will have full power to protect the public NHS and prevent future privatisation.

So the good news is, at the end of a fast-moving week, we can be confident that devolution and integration are coming and that Greater Manchester could have the chance to deliver Labour’s NHS policy whichever government is in power after May.

After all the damage that Mr Osborne and his Tory and Lib Dem allies have inflicted on our NHS in Greater Manchester, this seems like the least he should be doing for us.

This article appeared in a recent edition of The Manchester Evening News.

Monday, 9 March 2015

Letter to Jeremy Hunt on the Rose report

Dear Jeremy,


Last month, you presented the report on whistleblowers by Sir Robert Francis to the House and claimed the Government's actions in the last twelve months had led to a "transparency revolution". You committed to further work to "hard-wire transparency into the health and care system".

As you will recall, I welcomed this commitment and offered our support in achieving it. But I hope you will also appreciate that, if your statements are to have any credibility, it is essential that you and your Department are seen by the rest of the NHS to lead by example.

I am concerned that the Department's handling of the report on NHS management and leadership by Lord Rose fails the very clear test that you have set for the NHS and therefore undermines it.

The official reason for the delay in publication given by your Department was the need to reconsider its remit in the light of the Five-year Forward View. I find this statement both puzzling and implausible. The Forward View was published on 23 October; the Rose Report was submitted to the Department on 23 December 2014. This means there was plenty of time for the conclusions of the former to influence the latter. I cannot see how you can credibly use this as a reason not to publish the Rose Report.

Concern about this matter is shared across the House. Today, the Chair of the Health Select Committee has said that it would not be acceptable for a report paid for with public funds to be withheld from publication before the General Election. It is crucial that voters have the fullest possible insight into Coalition Government health policy before Parliament is dissolved.

My purpose in writing is to call on you to make immediate arrangements for the publication of the Rose Report in the form submitted to your Department late last year. Failure to do so will leave your statements on transparency at risk of being undermined by your actions.

Yours sincerely,


Wednesday, 11 February 2015

Research by the Nursing Times showing a high turnover of nurses recruited from abroad

I warned David Cameron it would be a false economy to cut nurse training places and that is proved by expensive recruitment from overseas and the unprecedented use of agency nurses. Labour plans to bring through a new generation of home-grown nurses by training a further 10,000 above current levels in the next Parliament.

David Cameron has left the NHS seriously short of the nurses it needs – he should match our plans to invest an extra £2.5 billion to recruit 20,000 nurses and 8,000 GPs.

Tuesday, 27 January 2015

Andy Burnham speech on Labour’s 10-year plan for health and care

Good morning and thank you for being with us at such an important moment.

The Party which created the NHS in the 20th century today resets it for the 21st.

Ed Miliband has this morning launched Labour’s pledge to create a national health and care service, backed by new investment in investment in the nurses, doctors, midwives and homecare workers that will ensure the NHS has time to care.

I am setting out a 10-year plan explaining how we will build it.

It is based on the simple notion that, if we start in the home and make care personal to each family, it is more likely to work for them and cost less for everyone.

A service where families no longer have to battle for help, telling the same story to everyone who comes through the door, but have just one person to call.

Where people can find mental health support, such as counselling or therapy, as readily as medication.
Where care is no longer cut up into crude 15-minute slots but where staff have the time to care.

And where people with dementia and autism are supported as well as those with cancer.

This is the scale of our ambition: an NHS for the whole person; affordable and sustainable for the country.

The challenge is so great that it can’t be achieved with more of the same: another imposed re-organisation without consent.

Instead, the journey to a national health and care service must be one that everyone is invited to join and everyone has a part to play; where change is not dropped on people from a great height but worked at and built by people in every community.

But one thing is clear: change can’t wait.

At the start of 2015, the NHS finds itself in a dangerous place.

If A&E is the barometer of the whole health and care system, then we must look at what it is telling us.

Hospitals have not met this Government’s lowered A&E target for 79 weeks running – and things are getting worse.

The barometer is warning of severe storms ahead.

If we don’t change course, the crisis we are seeing now in A&E and the ambulance service will become entrenched in the NHS.

At the start of this Parliament, I warned of the impact that cuts to social care could have on the NHS.

That warning has been borne out by what is unfolding now: the collapse of social care is dragging down the NHS with it.

As 2015 began, there were record numbers of frail, elderly people in hospital beds – trapped there because the hospital is the last resort in a system where other services can’t meet their needs.

Last year, an elderly lady from Lincoln spent an entire calendar year in a hospital bed; a sad sign of a system that simply isn’t working for anyone.

Hospitals are operating at their limits and, with the wards full, pressure is backing up through A&E.

People are waiting longer for ambulances to arrive and to be seen in A&E.

But there is a knock-on effect felt by other patients, having operations cancelled at the last-minute or waiting longer for cancer treatment to start.

This situation is affecting patients in the community too. As hospitals treat record numbers, so they draw in more resources. This Parliament has seen cuts to GP services, community services and mental health.

People struggling to get GP appointments are turning to A&E, as are people with mental health problems who can’t access the crisis support they need.

Unsurprisingly, our hospitals are close to being overwhelmed.
This is the vicious circle in which the NHS is now trapped.

And it could get much worse.

On the current Government’s spending plans, social care will be further stripped out, pushing hospitals to breaking point.

And, with the Health & Social Care Act still in force, the next Parliament could see the NHS sunk by a toxic mix of cuts, crisis and privatisation.

The NHS desperately needs a change of course and the plan we are launching today provides it.

It will lift the NHS out of its downward spiral and provide a long-term solution to the A&E crisis.

But it is much more than that.

It offers a positive vision of what the NHS can aspire to be in a century when people’s needs have changed; that answers the question of how it can be afforded; and that, after the divisive change of the past, is something for people to believe in and unite around; that offers something in short supply in the NHS right now: hope. Hope that the NHS is not on a slow path out but that it can be rebuilt as a 21st century service.

It is two years since I came here to propose full integration – a single health and care service.
Since then, we have been round the country and consulted professionals, patients and public.

We have taken expert advice from Sir John Oldham and the Commission on Whole Person Care. Their work has been invaluable to Ed Miliband and I and the plan we are publishing today draws heavily on it, together with that by Stephen O’Brien on mental health in society and Denise Kingsmill on the social care workforce. We thank them all.

Other important reports have been published since my 2013 speech: the RCP Future Hospital report; the NHS Confederation’s 2015 Challenge Manifesto; reports by the Fabian Society and the IPPR on Whole Person Care; the Barker Commission and the Five-Year Forward View.

All have helped shape our thinking and I see them as entirely complementary to our plan.
It is also a substantive and considered response to the Francis Report and the failings at Mid-Staffs.

What the Francis Report laid bare was the danger of trying to rise to the challenge of the ageing society with a hospital-based, production-line model of care that is not sufficiently person-centred and where social and mental needs are frequently neglected.

Robert Francis invited us to rethink from first principles how we care for older people and this is what we have done.

But our solution is equally applicable to the care of anyone who needs on-going support: from the child with complex needs to the adult with learning or physical disabilities.

When we talk of the ageing society, we tend to think of people in their 80s and 90s in homes or hospital. But the truth is that ageing is changing society more profoundly than we might realise.

For instance, children with severe disabilities are now living into their 20s and 30s - beyond the point of transition from children’s to adult services – while more adults with learning disabilities are living long enough to develop dementia too.

This is the complexity of care in the 21stcentury and the truth is we don’t yet have services that can provide an adequate response.

Our aspiration should be to have services that can meet all of one person’s needs – physical, mental and social – wherever they may be; from home to hospital and everywhere in between.

That is what Whole Person Care should mean in practice; services that don’t just see the immediate problem but the whole person behind it.

That is the vision I put to you two years ago and, in the discussions we have had since, I have taken great encouragement from the endorsement you have given to it.

But you made a number of important calls - and I have listened.

First, you asked for clarity.

The Oldham Commission sets out succinctly what we are trying to achieve: one person, one team, one service; a service that aspires to achieve in all of us a state of complete physical, mental and social well-being, rather than just treat disease or infirmity.

Second, you asked for stability.

Our response is to set the path to full integration and a single service as a 10-year journey.

The plan reaffirms our intention to work through the bodies we inherit, with no new structural re-organisation, but adding ambition and impetus to existing plans for integration.

Third, you asked for flexibility.

We agree that integration can’t be mandated from on high. Instead it will need to be worked at, a journey driven at local level, where people work to build relationships and change culture.

So we won’t impose one way of doing things – one model of care - but let different places find their own way to solutions that are right for their area.

And, fourth, you asked for consensus.

I know that the NHS is in such a fragile position, and morale so low, that a new round of contested reform might finish it off.

But, that said, the Health & Social Care Act put a political agenda at the heart of the NHS that goes against its grain.

So I also know that things can’t stay as they are.

That has been the dilemma I have faced and this plan is designed to square that circle: putting the right values back at the heart of the NHS without a re-organisation; and moving beyond the polarising debates of the past about tariffs, targets and structures and towards a new goal – Whole Person Care – true to people’s professional vocation.

If people get behind it, this plan can provide the new national consensus that the NHS so badly needs.

A big claim, I know. And people will ask – how?

It means going back to the things that truly matter - values, power, money, organisations and people – and getting those fundamentals right.

So let me take you through what we propose on each.

Our journey towards a national health and care service starts with values.

Today Labour calls time on the Tory market experiment in the NHS.

I am clear: the market is not the answer to 21st century health and care.

If we allow market forces to continue to take hold, they will eventually break the NHS apart.

Our destination is integration. Markets deliver fragmentation. They bring more providers onto the pitch, increasing the cost and complexity of care.

But they also clash with the NHS values, undermining collaboration with competition and patient care with the profit motive.

I believe the reason why the public continue to trust the NHS in the way that they do is because it remains at heart a service that is based on people and not profits.

That is why so many NHS staff give more of themselves to it than their contracted hours.

If today’s politicians do not understand that, they will never understand the value of what our predecessors created.
That is why the Health & Social Care Act 2012 created such a rift.

It remains a contested piece of legislation, with no democratic legitimacy.

Securing a national consensus on the NHS will simply not be possible as long as it remains in place.

So, if elected, Labour will introduce a Bill to repeal the Health and Social Care Act 2012 in our first Queen’s Speech.

But we do this not because Labour is turning its back on reform. We do it to enable the radical reform of services that is now urgent.

The NHS needs the freedom to collaborate, to integrate, to merge, to break down organisational boundaries without having to run wasteful tenders that integration harder to achieve in practice or having the competition authorities blocking its plans.

Over the next decade, services will have to change more than they have in the history of the NHS. To embrace that, the NHS will need to be secure in its position.

So we will cement the public NHS as our preferred provider at the heart of every community. Our new Bill will legislate for that, claiming a full exemption for the NHS from EU procurement and competition law - as we are entitled to do under the Lisbon Treaty - and from international trade treaties such as TTIP.

This does not mean there is no longer any role for the voluntary and private sector. There is a role. But we will clarify what that role should be: a supporting – not replacement - role.

To help them become stronger partners, non-NHS organsiations need more stability too. So we will move away from an approach based on short-term contracts towards long-term alliance contracts as proposed by the Oldham Commission.

But a distinction will be drawn between not-for-profit and for-profit providers.

Given that voluntary organisations build volunteering capacity – which in turn builds the health of people and communities – we should give them the benefit of much longer and more stable arrangements, for instance for five or even ten years.

Private sector organisations, working as long-term partners, will have to accept NHS standards.  So we will extend the Freedom of Information provisions to any provider of NHS services and consult on a new training levy so that all providers contribute to the costs of training clinical staff.

This approach returns the right values to the heart of the NHS. But is also cements its financial strength as a national service, rather than a market-based system.

All the evidence from around the world says that national systems like ours cost less than market-based health systems.

The NHS delivers comprehensive cover of a good standard to every single citizen for less than 10 per cent of GDP. No other country in the world comes close to that.

In a century when rising demand and costs is the greatest challenge, we should build on that foundation not chip it away.

A national system allows us to set out in a fair way what people are entitled to and thereby to control those costs.

People don’t want postcode lotteries in health care. Nor do we want an NHS that sits in judgment on people’s lifestyle, with arbitrary restrictions on operations, or saying that people with two cataracts can only have clear sight in one eye.

So we will stop that growing practice and re-establish the authority of NICE. If a service or medication is judged clinically necessary, effective and affordable, everyone should get it.

And we will ask NICE to help us set out a new entitlement to Whole Person Care, given that it will make sense to provide more services on a universal basis in an integrated NHS.

For instance, we will ask for advice on establishing a universal re-ablement scheme to help the most vulnerable people return home from hospital.

And to make sure the focus is always on prevention, we will ask NICE to take an expanded view of all public spending when making their decisions.

It makes no sense to restrict treatments to save money for the NHS if that only adds costs to other government departments. For instance, restrictions on mental health care for young people may add huge costs to the criminal justice system.

But as we strengthen the N in NHS – and restore democratic responsibility to the Secretary of State - where does that leave the local role?

This brings me to stage two on our journey which is about putting power in the right hands.

I don’t think we have ever got the balance right between the national and local roles.

The current Government’s reforms have weakened the national function.

But the last Government was accused of being too prescriptive: deciding not just ‘what’ should be done but ‘how’ people should do it.

If our journey to Whole Person Care is to set off on the right foot, we need to get the national and local roles in better balance.

Here’s what I think that should be: if the national role is to spell out the ‘what’, then the local should be to decide the ‘how’.

How best can Whole Person Care be delivered in our community? How can we make the range of services, buildings and providers we have work better for everyone?

Integration can’t be imposed by top-down edict and timetables.

But this doesn’t mean the pressure is off.

The quicker that people embrace full integration – and everything it entails – the sooner they will place local services on a path towards clinical and financial sustainability.

By legislating for commissioning with this budget – as a partnership between the NHS and councils through the Health and Well-being Board - we will finally vest people at local level with real power.

Local authorities will have a bigger canvas on which to create much more imaginative solutions to improve population health and well-being.

They will be able to link health with housing, education, planning, transport and leisure – achieving Professor Michael Marmot’s ‘health in all policies’ goal – and develop new solutions that are simply not achievable from within the confines of the current public sector silos.

Local areas will have more ability to invest in prevention – for instance, expanding exercise on prescription to make maximum use of local leisure facilities – while having more ability to protect children from the proliferation of outlets selling fast-food and cheap alcohol.

This is how our new approach to public health is consistent with the plan published today.

We know that intervening in the first 1001 days of life makes all the difference to life chances for children with the biggest challenges.

So why doesn’t it happen and why do families still have to battle every day?

It is because of those silos in commissioning, where people argue about who should pay for the speech and language therapy while all the while the child slips behind.

And it is because those same silos create services that don’t relate to each other and can’t see the whole child.

I heard about a recent meeting attended by a paediatrician to discuss the care of one child with 36 people in the room.

Another family reports a child having over 150 appointments in a year but couldn’t get help with a simple problem out of hours.

This is no longer affordable nor morally justifiable.

Nor is a situation where child and adolescent mental health services are the poorest relation of all, getting just six per cent of the mental health budget.

Our plan for integrated local budgets for children will change this.

It finally creates an incentive to do the right thing at the earliest possible stage in a child’s life, because all the long-term savings will return to the same pot.

That is the way we will build a fairer society, get best value for taxpayers and make services sustainable.

But it isn’t the only financial reform we need to make and this brings me to stage three on our journey: money.

The pressures on public spending are now so great that the journey towards integration will need real momentum.

And that will not happen until we change the way the money flows.

The NHS is today trapped in a financial framework that rewards the treatment of illness and infirmity.

The financial tide drags to the most expensive end of the system – the acute hospital bed.

Community services have no incentive to invest in prevention and hospitals get paid by everyone who comes through the door.

This is bad for patients and bad for taxpayers.

For the want of spending a few pounds in people’s homes on decent care, we are spending tens of thousands keeping people for months, even up to a year, in hospital beds.

If we were to put new investment into the NHS without fundamental financial reform, the reality is that much of it would end up being sucked into hospitals.

So we must turn that financial tide around.

We need a new financial system that makes the home the default setting for care, not the hospital, and prioritises prevention as well as treatment.

Social care is prevention and the key to making that change. It is by integrating it with the NHS that we create the conditions for major efficiency and productivity savings.
For people at greatest risk of hospitalisation, we will implement a ‘Year of Care’ payment system covering all of their care needs to replace the activity tariff.

At a stroke, this will switch the incentive from treating in a hospital to preventative support at home.

It will mean giving people quality time rather than flying 15-minute visits.

And it will mean a big shift towards more personalisation.

If we take time to ask people what will work for them and their family, then it will be more likely to work and not exceed the ‘Year of Care’.

When the NHS is paid for in this way, it will finally bring the change that is urgently needed to the way services are provided.

NHS organisations will have an incentive to start in the home and evolve into integrated care organisations, moving on from the 20th hospital-dominated treatment model.

This takes me to stage 4: organisations.

Whole Person Care will only succeed if all NHS bodies rethink how they work and begin their own journey towards integration.

For ‘Year of Care’ to work, it will need an accountable organisation to hold the ring and co-ordinate the care.

All health economies will need to develop integrated care organisations, providing services directly or working through trusted partnerships.

And if we are to encourage this evolutionary change, we must now rethink the principles that have governed provider reform and create a new role for Monitor.

The Foundation Trust reform, and the focus it brought on financial grip, helped improve efficiency and productivity.

But it no longer makes sense to focus solely on the viability of individual institutions, particularly where efforts to securing the finances of one could end up destabilising all around it.

The public spending outlook for the next 10 years brings a new reality: the competing silos are a luxury we can no longer afford.

The stark truth is there are too many separate organisations with separate administrations. There are savings to be made from reducing administrations in every health economy in England.

We need to break down the silos and end those divides that hold us back: primary versus secondary care; physical versus mental health; NHS versus council.

As the Future Hospital report recommended, people must leave loyalties to parts of the system behind and embrace a new shared loyalty to the local population.

To help this process along, and unlock the savings it will bring, we will abolish Monitor’s duty to promote competition and ask it to focus on promoting integration.

Rather than assessing the viability of individual organisations, we will ask it to rate all local health economies annually on the overall financial viability of their provider arrangements.

CQC will need to undergo a similar change as organisations begin to work across traditional boundaries, assessing overall care quality by locality as well as individual organisations.

The fact is that care failures in one local organisation can be the root cause of problems in another.

For instance, there are too many care homes in England failing to give adequate training to their staff who often feel they have no option but to call 999 in a challenging situation.

While we have been clear for some time about what integration will mean for local NHS organisations, there has been a missing piece in the jigsaw: out-of-hours care and the ambulance service.

To take a major step towards integrated, seven-day working in the NHS, it is right that we look at a new future for the ambulance service.

I see that as an integrated provider of emergency and out-of-hours care, able to treat people where they find them rather than carry them to hospital.

This is a substantial answer to relieving the growing pressure on A&E.

It is the lack of integration in out-of-hours care that often results in carrying to hospital as the default option.

Just as we call for a single team approach in local care, so the same principle should apply in out-of-hours arrangements.

This is how we do it.

As NHS 111 contracts expire, we will look at ambulance services taking them on so that, in time, they could handle all 111 and 999 calls from the same call centres.

This will mean more experienced staff on the phones, and better classification of calls.

But just as with other parts of the NHS, we need to ask the ambulance service to work from a default presumption of treatment at home, not hospital – if clinically safe and appropriate.

To do this, paramedics will need to be able to call directly on a wider range of health professionals – GPs, OTs, physios, care assistants – who can settle and support people at home in out-of-hours times before handing over to local teams.

Building a sense of a single team with GP out-of-hours services is essential, all with a financial incentive to keep people out of A&E.

So we will consult on better ways in which GP out-of-hours can be integrated with the ambulance service.

These changes will allow us to build a high-quality, highly co-ordinated response behind the NHS 111 number that commands better public confidence than it has today.

This new vision for a 21st century ambulance service is a classic example of how we can build better integrated services without new money when we move away from the mentality that every small service must be put out to tender.

But organisations won’t deliver Whole Person Care.

If the new NHS is to be what we want it to be, it will be built by people.

That is why Stage 5 is the most important of all: empowering not just those who give care but those who receive it too.

With moves towards fewer, more integrated providers – and the notion of an accountable provider under the ‘year of care’ system – we will ensure that no-one will be stuck with poor or unresponsive services.

We won’t let that happen.

The great thing about uniting physical, mental and social in one service is that it creates the conditions for true personalisation of care in a way our silo-based services could never manage.

So, to give people the power to get what they need to live the best life they can, we will amend the NHS Constitution to give them a series of powerful new rights. For example:

·         the right to a single point of contact for the coordination of all care for those with on-going needs.

·         the right to a personal care plan – covering health and social care - agreed between the individual, their family and services, including new preventative checks for vulnerable or frail older people to help spot risks and act before problems occur.

·         the right to counselling and therapy as well as medication, as part of a new emphasis on social prescribing

·         the right to support for family carers, such as respite care

·         the right to care where you want it, to give birth at home or to be in your own home at the end of your life with homecare provided on the NHS

These rights, alongside financial reforms, will encourage services to change – to become less patient-centred and more person-centred.

We will also give people a right to a GP appointment within 48 hours, cancer tests and results within one week.

Of course, they will not be able to be delivered overnight. Services will need time to adapt.

But, to ensure momentum on the journey to Whole Person Care, I can say today that I will require them to be deliverable in all parts of the country by the end of the next Parliament.

This is how people and their families will no longer be passive recipients but active participants in building the NHS of the future.

But these new rights will empower people who give care too.

Rather than a system based on targets, which too often empower managers, a system based on person-centred rights will create a different culture for staff to work in and one which is more true to their clinical vocation.

It won’t just be NHS staff who benefit from the changes I am announcing today.

They also lift the social care workforce - neglected and exploited for far too long, as Denise Kingsmill so rightly and persuasively said.

We all have some soul-searching to do.

How much longer are we prepared to say that an older person is only worth 15 minutes of support?

And how much longer as a society will we send out the message that caring for someone else’s mum, dad, brother, sister is the lowest form of work, lower than the minimum wage because it doesn’t way the travel time between the fifteen minutes?

For as long as we fail to change this, we will continue to have a care system that fails older people and those who care for them.

A service provided on a below-minimum-wage, zero-hours basis will never be able to provide the quality we would want for our own parents or aspire to for everyone’s parents.

It will mean those appalling scenes of abuse that we see on our TV screens will recur year after year.

This is a national scandal and, today, Labour vows to end it.

We need tougher penalties against individuals and institutions in which this abuse takes place. But we also need to begin to value the care workforce.

As part of the move to Whole Person Care, we will begin the process of unifying standards across the health and care workforce.

We will be able to do this through the introduction of the Year of Care approach. It will give NHS organisations an incentive to provide better home-based care that does a real job of keeping people out of hospital.
So we will ask the NHS to require proper training and support for social care staff, either those it employs or those with which it contracts.

And, as good care is based on continuity, we will tackle exploitation in the care sector by banning zero-hours contracts that exploit workers; firms will no longer be able to operate business models that rely on zero-hours contracts.

This will begin to change the culture of social care in England and value those who work in it.

By turning the financial incentives of the system around to provide better care and support in the home we can drive the change in quality of social care that is needed.

Previous NHS plans have invested more energy in rethinking structures rather than developing people.

Well I am not going to make that mistake.

Whole Person Care will in the end by driven by people and their passion for what they do, who want to do it better and know they could if freed up to work differently.
One of my greatest criticisms of what has happened in this Parliament is that a major re-organisation was foisted on the NHS with no meaningful workforce plan.

And, now, morale is sinking fast as hospitals and GP surgeries are becoming overwhelmed and doctors and nurses retire or go overseas.

But, as people leave, the pipeline isn’t bringing new people through in the required numbers.

This Parliament has brought deep cuts to training places - a false economy on the grandest of scales.

It has left the NHS saddled with a bill for agency staff that is spiralling out of control and forced to recruit overseas.

The NHS needs to break out of this and bring through a new, home-grown generation of staff to build the new NHS.

The extra £2.5 billion we will put into the NHS – our Time to Care fund - will be focused on building the workforce of the future, trained to work differently.

People often ask me where the extra nurses and other staff will come from.

Today I want to answer that directly.

I don’t think there’s any shortage of young people who aspire to work in the NHS.

It’s just got harder to do it.

Courses are heavily over-subscribed and I meet many young people in my constituency who aspire to work for the NHS but struggle to see a route in.

The increase in tuition fees, combined with reductions in places, has left some feeling a nursing or midwifery course is too big a risk.

So they turn instead to care but find themselves stuck in dead-end, zero-hours jobs with little or no training or career prospects.

There are thousands of young people stuck doing these essential but difficult jobs left feeling forgotten and under-valued.

I want to make a very direct offer to them.

If you want to help build this new NHS and devote yourself to it, we will give you a ladder into it - not just to become a nurse or midwife but any of the disciplines that Whole Person Care will need in much greater supply: physios, OTs, speech and language therapists, mental health nurses, dieticians, therapists and counsellors.

So, for young people working as care assistants or healthcare assistants, we will create a specific new route, through an apprenticeship and technical degree to move into nursing or other clinical roles or into the 5,000 new NHS social care roles we will create to deliver our universal re-ablement service and improvements to end of life care.

Sometimes it might seem that the NHS - built by a generation long ago who came back from the war – doesn’t mean as much to today’s young people.

But I was struck by a recent poll which showed that young people today care just as passionately about the NHS as those who saw it come into being.

I think this might be because, in their world, so driven by markets and money, the NHS represents something different to them.

If the post-war generation was infused with the same defeatism about the future that defines our times, then one thing is clear: there would be no NHS.

So that’s our message to young people: come and help us build the NHS of the future. It is your NHS too and now your generation must rebuild it for your century.

So this is our plan to re-set the NHS and, through these five stage of reform, we hope to bring people behind it.

The contested reforms of recent times have frayed the fabric that has underpinned it.

The NHS urgently needs a new consensus if it is to have the public backing to reinvent itself as a 21st century service.

Ed Miliband and I believe the plan we are outlining today provides the basis for that.

Never again should the public’s most valued institution be changed without their consent, as happened after the last Election.

Going forward, people will need to be informed, consulted and involved at every stage.

That is why I have put forward our plans in such unprecedented detail before people vote.

And, if I am Health Secretary in May, I will write to everyone, just as Nye Bevan did, to explain what people can expect from the new NHS but also what will have to change.

But, as well setting out new rights, we need to be honest with people: the NHS won’t be able to do everything.

So we will ask people to accept new responsibilities to help the NHS survive in a more demanding century by, for instance: taking more responsibility for our own health and becoming more physically active; by doing more to look after our own families and neighbours; by not applying on-demand consumer expectations but taking out only what we need; and by accepting that hospitals will need to change if home-based care is to be a reality.

This will help re-set expectations and help NHS staff rise to the difficult challenge ahead.

We say this today to the other political parties: if you can’t sign up to our plan, produce your own in as much detail as ours. Give people a proper choice at this election.

That’s because the NHS is now at a crossroads and the country needs to have the debate about which path it should take.

Labour has made its choice: an NHS for the whole person, based on its enduring values: compassion over competition; collaboration over fragmentation; people before profits.

I am proud of the plan we are publishing today.

I have put everything I have got into it because nothing matters more to me and I know what it means to millions of others.

It is borne out of deep reflection, honest assessment of our mistakes but huge optimism for what the NHS can be in the future.

It can be what we want it to be, as good as we all want to make it.

I know you may not agree with everything I have said but, if you agree with the broad direction, get behind it.

The NHS can’t wait forever for a new consensus to emerge.

We must start building our national health and care service today.


Wednesday, 7 January 2015

New Year Message

This article first appeared in the Leigh Journal.

As we come to the end of 2014, we can reflect on a year of good progress for Leigh.

It began with the opening of the impressive new Hanover Centre at Leigh Infirmary.

That was followed by the long-awaited start of work on the redevelopment at the top of Plank Lane.

And, of course, we finally waved goodbye to ‘Kamikaze Island’.

But, when all's said and done, one thing will will define 2014: it will go down as the year that, for one night only, Elton was a Leyther!

When I was first elected in 2001, I had high ambitions for Leigh. But, in truth, even I might have struggled to foresee how Leigh could ever play host to a global superstar before a 17500 strong crowd.

But we did - and, more than that, Leigh pulled it off in style.

Shortly after the big night, someone told me how they had seen Elton perform in Las Vegas just a few weeks earlier. They laughed when the remaining dates of Elton’s tour flashed up on the big screen: LA ... New York ... Leigh ...!

That unforgettable June night was the moment when the Leigh Sports Village truly came into its own and placed Leigh firmly on the map.

But the truth is Elton was not the only performer to light up the LSV. Leigh Centurions blazed a trail through the 2014 season and graced the LSV stage with perhaps their most exciting team for 30 years.

A couple of years ago, I ran a campaign for the return of promotion and relegation and I am pleased that, once again, the door to Super League is open to us.

So, your MP asks you to make one simple New Year's Resolution - let’s all of us get down to the LSV in 2015 and cheer our exciting young team back to Super League.

One dark spot on the year was the surprise decision by Wigan & Leigh College to pull the plug on A Level provision. It left many young people in the lurch.

We are waiting for the College to publish the findings of a review. But, whatever it concludes, I am clear about this: Leigh students should not have to get up at the crack of dawn and travel miles to do A levels. We want good A Level provision in the heart of our town and that is what I will campaign for in 2015.

Another challenging issue this year was HS2.

Before the close of the consultation, I organised a series of public meetings in Lowton and Golborne. What came over clearly was the high level of opposition to the proposed depot off Slag Lane. People felt it would destroy our green space and shatter our peace.

I listened and concluded they were absolutely right. Ever since, I have thrown whatever political weight I could muster into the campaign against the depot. I am pleased to say it seems we have won the day: the latest statement from HS2 says they are now looking at alternative sites. I will keep up the pressure in 2015 until it is finally confirmed.

There is another reason why transport will be the big issue of next year - it will finally see the opening of the Leigh Guided Busway.

Now I know it's the under-statement of the year to say people remain to be convinced about the Busway. I know that the disruption has been horrendous - particularly in Tyldesley - and we will continue to work hard to minimise it.

But here's a confident, if somewhat dangerous prediction, for 2015 - I think the Busway will turn out to be better than people think.

I understand people's scepticism as the busway was never my preferred option. That would have been a rail station or, failing that, Metrolink. But the technical and financial obstacles to both are huge and the truth is this: Leigh can’t wait forever for better public transport. We need it now.

Now that it’s coming, I think we need to seize the opportunity it presents for Leigh.

One of the big plus points of the busway is that it will be much cheaper than rail. A weekly return pass to Manchester will be around £14 or £15. That compares well with the £28 cost of a rail pass from Atherton. That will open up opportunities for young people in Leigh who struggle to run a car. All concessionary passes will be valid and pensioners will be able to travel for free with their bus pass.

Given that, I have no doubt that the Busway will bring shoppers back into Leigh.

People think of it only taking people away from Leigh. But I think it will work the other way round: Leigh and Tyldesley town centres will end up being the big winners. That's because, for anyone living on the guided section of the route, they can be in Leigh or Tyldesley in a matter of minutes with no traffic or hassle.

So, to coincide with the opening of the Busway, I want to launch a big ‘Come Back to Leigh’ marketing campaign. As part of the scheme, new investment is going in to the Leigh Bus Station and into the town centre. This is big chance to turn around the fortunes of the town centre and I am determined to make the most of it.

I think it's time to see the potential of the Busway rather than the problems. Already, there are signs that it will continue the regeneration of the town. Plans to turn Mather Lane Mill into flats - on the back of the Busway - are an exciting example of the wider benefits it will bring.

So there are grounds to be optimistic for our town as we head in to 2015. I remain as passionate as ever about my mission to restore its fortunes and am always grateful for the brilliant support you continue to give me.

Here's to a successful and prosperous 2015.

Sunday, 21 December 2014

Letter to Jeremy Hunt over ambulance waiting times

Dear Jeremy


It is reported today that, last week, you took a decision that could have far-reaching implications for ambulance and A&E services this winter.

A leaked document obtained by the Mail on Sunday suggests that, on Monday 15 December, you approved a proposal to relax the Red 2 response time from 8 to 11 minutes for some calls and to 19 minute minutes for others.

I gather that you wanted the change to have immediate effect but that it has been delayed until the first week of January.

If this is correct, it represents a major change of policy for the ambulance service and a departure from long-established working practices. While there may well be a case for making such a change, it  could reasonably have been expected to be subject to careful consultation and Parliamentary scrutiny. Instead, it appears to have been rushed through, without due process, in response to the deteriorating situation in the NHS.

The leaked document makes specific reference to the unusual nature of this decision in terms of both timescale and process:

·         it notes the proposals have not had the "full breadth of exposure normally expected";
·         it makes clear that the discussion about the changes was limited to a narrow group of people and that the ambulance service as a whole was not consulted but instead presented with a fait accompli;
·         and it records the firm view of NHS England that any such changes should not be implemented until the next Parliament.

I believe these revelations raise major questions over: (a) the safety and continuity of services this winter; and (b) your own conduct and judgement.

You will recall that I wrote to you on Friday 12 December asking you to make a statement to Parliament before the break setting out your plans to deal with winter pressures. You failed to reply and so, on Thursday, you were required to come to the Commons to answer my Urgent Question. I remind you that it specifically asked you to outline to Parliament your plans for ambulance services this winter.

Given that this was three days after you had made your decision, I find it highly unsatisfactory that you made no mention of it in response to my question or to those of other MPs. This is all the more extraordinary when we discover from the document that ambulances services were given a deadline of noon on the same day to sign a letter to NHS England supporting the change. You have treated Parliament with contempt.

This decision has implications for the NHS in all parts of England. Members of Parliament should have been informed about it and given the opportunity to challenge it, particularly given the unusual nature of the way it has been made. Instead, you appear to have deliberately kept Parliament in the dark and given an incomplete answer to my question.

Given the seriousness of the situation now facing the NHS, and the need for people to have confidence in your public statements, it is imperative that you now correct this error of judgement and provide answers to these 10 questions:

1.   Is it correct that you approved this change on Monday 15th December?

2.   If it is, why did you make no mention of it when you answered my Urgent Question on Thursday 18th December and what justification do you have for withholding such important information from Parliament?

3.   Is NHS England in support of making this change now or does it still consider that a longer timetable is needed?

4.   What categories of patients will now be expected to wait longer for an ambulance as a result of this change and what evidence do you have that these longer waiting times are safe?

5.   Will you publish all evidence and advice, both clinical and operational, which you considered as part of your decision-making process?

6.   How many people were involved in the discussion of these changes, who were they and for how long was this matter under consideration?

7.   Did you receive any warnings on the risks of making these changes at short notice in the middle of a difficult winter and were any of the people you consulted opposed to your plans?

8.   Why were the 10 ambulance trust Chief Executives not fully consulted? 

9.   What plans do you have to communicate these changes to the public and the rest of the NHS?

10.                Are you confident that it is a safe and sensible course of action to continue to implement these changes in the first week of 2015 given that the vast majority of people working in the NHS have only found out about them today?

I expect nothing less than a full response today to each of these questions. If you do not have an acceptable reason for withholding information about your decision from Parliament, I suggest you should prepare to make a full apology to the House at the first opportunity after it returns from recess.

Yours sincerely

Rt Hon Andy Burnham MP