Hunt broke law by axing NHS 18-week treatment target, says Labour

Jeremy Hunt has broken the law by not forcing the NHS to ensure that patients receive hospital treatment within the stated maximum of 18 weeks, according to legal advice obtained by Labour.

The counsel’s opinion says the health secretary is acting illegally by not obliging NHS England to compel hospitals to treat the required 92% of patients within 18 weeks of being referred by their GP.

The advice, by James Goudie QC, is potentially embarrassing for Hunt as it draws attention to the NHS’s increasingly poor performance against key waiting time targets for A&E care, cancer treatment and ambulances’ responses to 999 calls, as well as the referral to treatment (RTT) requirement. It specifies that at least 92% of all those waiting for non-urgent hospital treatment, such as hip or knee replacement or cataract removals, should wait no more than 18 weeks.

Controversy erupted last month when Simon Stevens, NHS England’s chief executive, announced that he was relaxing the 18-week target so that under-pressure hospitals could focus on more important priorities, in a move critics said meant it was being scrapped. The Royal College of Surgeons accused the NHS of “waving the white flag” on the target and condemning patients already in pain to further suffering due to the extended delays they would now face to get surgery.

Labour peers commissioned the 12-page opinion from Goudie, a barrister specialising in public law and employment law at 11 King’s Bench Walk chambers in London. It says: “I am asked whether the SoS [secretary of state] acted unlawfully by failing to include the 92% RTT target in the mandate to NHS England for 2017-18. My answer is: ‘Yes’.”

It goes on to explain: “This is because the 2012 Regulations and the NHS constitution have the effect that this must be included. The annual mandate cannot lawfully be used to circumvent or undermine by omission the absolute statutory and sub-statutory requirements.”

The mandate is the detailed annual document in which the Department of Health spells out precisely what key priorities it wants NHS England to fulfil in the coming year.

Labour claimed Goudie’s advice showed the government’s NHS plans were “in total chaos”. The party planned to use a motion in the House of Lords on Thursday to try to force ministers to explain what it says is a fundamental breach of patients’ rights under the NHS constitution. Philip Hunt [no relation], Labour’s health spokesman in the Lords, will also challenge ministers to publish the legal advice they have taken surrounding the 18-week target.

“Tory plans for the NHS are in total chaos. Legal advice commissioned by Labour confirms that the government have acted unlawfully in failing to deliver the 18-week treatment target for patients,” said Jonathan Ashworth, the shadow health secretary.

“Almost 4 million people are now on waiting lists because of the neglect and underfunding of this Conservative government and now this year’s NHS mandate is at risk of legal challenge. The government are failing to deliver the standards of care to which NHS patients are legally entitled,” he added.

Labour is now considering what its next move should be in light of Goudie’s advice, including whether it should seek a judicial review to challenge the legality of Jeremy Hunt’s actions over the 18-week target. No decision has yet been made on possible legal avenues it may pursue.

But Hunt last night insisted that he had done nothing wrong and that he had ordered NHS England to start hitting the 92% target again, which hospitals have missed every month since March last year at a time when the total number of patients awaiting treatment has crept up to almost 4 million.

“We do not believe there is a case to answer,” a Conservative spokesman said.

“Indeed, we wholeheartedly reject any suggestion that the government is not committed to the 18-week target, and as the mandate itself clearly states, we are specifically requiring the NHS to return to delivering that standard,” he added. The NHS is now carrying out record numbers of operations and treating 5,000 more people a day than in 2010, the spokesman added.

Hospitals breached the 92% target for the first time in December 2015 since its introduction in 2010. After meeting it again in the next two months, performance slipped to 91.5% last March and has stayed below 92% since. It hit an all-time low of 89.7% last December. In February, a total of 367,094 patients waiting for treatment had already waited for more than 18 weeks, according to the most recent NHS data.

Tim Gardner, a senior policy fellow at the Health Foundation thinktank, said: “The failure of the NHS to treat patients within the 18-week target is a symptom of wider pressures on the system. NHS hospitals are running at or near capacity to cope with growing demand for emergency care, and this limits their ability to perform planned procedures. If funding pressures continue to increase, the NHS will increasingly be forced to make trade-offs to live within its means.

“The government must ensure there are adequate levels of investment to maintain good standards of care in every part of the health and care system.”

Hunt broke law by axing NHS 18-week treatment target, says Labour

Marjorie Wallace: "All hell broke loose - I took a lot of flak for what I did"

“All hell broke loose,” she admits, “I took a lot of flak for what I did. But I was travelling all over the nation, meeting households who have been at their wits’ finish, unable to care for severely mentally ill people who had merely been sent home and might be psychotic, violent or suicidal.”

Marjorie is a redoubtable character, but when we meet she is fragile, as well. 5 months ago, her beloved partner of more than 30 many years, Tom Margerison, the journalist who commenced New Scientist, died aged 90, soon after suffering Parkinson’s condition for 15 many years. A week after the funeral, a automobile crash left Marjorie with a broken arm.

Nevertheless, she has continued doing work at SANE virtually without a break. Her passion to understand and support other folks stems from her time at University College London in which she studied psychology. There, she met the Polish psychoanalyst Count Andrzej Skarbek, who was having to pay college students £3 a session to consider antipsychotic drugs for study.

“At the time, I was so poor, I was surviving on a bowl of chips each other day, so it sounded excellent,” says Marjorie.

Ahead of lengthy, she was currently being romanced by the Count. “The vodka came out, Polish tangos went on – he was far from the lonely émigré medical professional I had supposed, but a married aristocrat whose family had been patrons of Chopin. He referred to as me his Traviata.” Marjorie fell madly in really like.

At close to the very same time, in the Sixties, she fell just as heavily for journalism – working extended hours to meet the “exorbitant demands” of the pioneering Frost Programme, which went out dwell. Her day would begin at 7am and finish at 1am, and concerned persuading guests this kind of as Nikita Khrushchev and Sir John Betjeman to appear. Marjorie then worked with Sir David Frost on the moon landings just before moving to the BBC’s flagship evening news programme Nationwide. She was employed following one particular of the producers accredited her legs for “shapeliness”.

Her connection with the Count continued, and in 1972 she gave birth to their son, Sacha. At the time, Marjorie was sharing a flat with the writer Mary Kenny, and the youthful females threw wild and glamorous parties, exactly where Peter O’Toole would bounce the baby on his knee whilst novelist Edna O’Brien held court.

In 1974, right after the Count had divorced his wife, the couple married, moving to the heart of Hampstead. “Every fortnight, I’d serve the coffee and the sandwiches for the regional psychoanalysts,” she says.

The Count’s operate started to dominate their lives. “Even in the early days, our meetings took spot in some of the hospitals the place he worked. I’d devote hrs speaking to sufferers.”

But, after Sacha’s birth, Harold Evans, then editor of the Sunday Times, recruited Marjorie to join the paper, to work on its ground-breaking campaign to secure compensation for the victims of the drug thalidomide. She travelled about the nation, monitoring down young children born with foreshortened limbs, the consequence of their mothers taking the drug for the duration of early pregnancy. “It was incredible,” she says. “These families have been shunned and isolated.”

Marjorie began to develop what her personal youngsters would later laughingly get in touch with her “method acting” college of journalism. “I would reside with the families I interviewed, rest on the sofa, carry their kids into cafés and watch as the area emptied – everyone else as well shocked and embarrassed to be in the very same room.”

In 1976, Marjorie had her second son, Stefan, and wrote a book, On Giant’s Shoulders, about Terry Wiles, one of the thalidomide kids. It was later on produced into an award-winning film.

Marriage to a career was not fairly what her husband had had in mind, nonetheless. “He considered he was marrying his second countess – there to be gracious, not to be functioning. And then I had a miscarriage at five months, soon after operating in Italy to expose the Seveso tragedy.” This was the spillage of industrial chemical substances that resulted in thousands of Italians getting exposed to the carcinogen dioxin. Did it cause the miscarriage? Marjorie can only wonder.

The couple’s third son, Justin, born in 1978, was just nine months old when the Count left for Canada with out his family. “I think he imagined I would join him, but I did not want to abandon my career, or my elderly mom, so I was a single mum with 3 boys and no financial support.”

Marjorie had grow to be close to Tom Margerison, who had worked on the dioxin story, and later on collaborated with her on the book The Superpoison. Finally, in 1982, they set up home and in 1984, their daughter Sophia was born. “It was a joy to have Tom in my lifestyle,” she says.

The subsequent couple of many years had been “crowded”: Marjorie wrote the book The Silent Twins, about two women who communicated in their own language and had been sent to Broadmoor, and each the book and her screenplay for the BBC movie won acclaim. During her function, her 4 young children went all over the place with her. “They’d say: ‘Mum, what are we performing this weekend? Not Broadmoor yet again?’ ”

From this stage on, Marjorie started to focus on psychological illness. “The stories I located were breaking down this thought that care in the community would work this idea that if you get people out of hospitals, by some means they will not be mentally ill. The idea of liberating the sick from these previous-fashioned institutions was hugely seductive – but, without the promised money, individuals were becoming abandoned.”

Following a series of trailblazing articles or blog posts known as “The Forgotten Illness”, she was permitted by the Sunday Times to devote half her time as a journalist and half setting up SANE. And, by 1996, she had raised £6 million from the Greek shipping family members Xylas, the late king of Saudi Arabia and the sultan of Brunei for an global study centre, the Prince of Wales International Centre for SANE Research (POWIC) in Oxford. She is rightly proud that the creating is a busy hub with researchers investigating concerns from suicide prevention to mindfulness training.

For the duration of the early Nineties, Marjorie was diagnosed with breast cancer – and seven years later on Tom produced Parkinson’s. She nursed him devotedly, as well as visiting the Count, who had returned to Britain and lived nearby. He died in 2011.

It later on emerged that Marjorie had a connection with Lord Snowdon, in the many years when her domestic daily life had turned to caring. Of this, Marjorie says only: “We are and have constantly been the best of pals who enjoyed working collectively. He was my ‘partner in crime’, exposing injustice and trying to get assist for disabled individuals.”

Her campaigning goes on. “There is a lack of acute beds for the mentally ill, which is an absolute scandal,” she says. “I feel psychological well being services are in breakdown once more.”

Marjorie acknowledges that throwing herself into operate and the difficulties of other folks will not ease the ache of Tom’s death. Her children, though, are a wonderful support: Sacha is a songwriter with No 1 hits such as James Blunt’s You are Lovely below his belt Stefan writes music, as well Justin lives at property and operates in the neighborhood pub and Sophia is in the music business in Los Angeles.

“Somehow, I have to locate the time and the way to mourn,” says Marjorie. “People say Tom’s death should be a relief, and I’m glad he is not suffering. But there is no relief for me. He was my emotional lodestone, and with out him, I come to feel adrift. I have lost my secure harbour.”

Indeed she may have carried out, but Marjorie Wallace is practically nothing if not a survivor.

Marjorie Wallace: "All hell broke loose - I took a lot of flak for what I did"