Mental Health and NHS Performance

Anna Soubry Excerpts

Monday 9th January 2017 Commons Chamber

[Mr Hunt]

I agree with the hon. Lady that there are serious funding pressures in social care. We need a long-term solution to this, and we are doing important work on that. The precept is part of the solution. The local government settlement has been adjusted to take account of the different spending powers, or revenue-raising powers, of wealthier counties and wealthier local authority areas compared with other areas. We have to take into account the equality issue, and she is absolutely right to do that. However, if she is saying, “Have we solved the whole problem?”, the answer is no—there is more work to do.

[Anna Soubry (Broxtowe) (Con)]

I welcome the statement by my right hon. Friend. May I pay huge tribute to everybody working at Nottingham University Hospitals NHS Trust, especially in A&E, and especially over the nine days between Christmas and 2 January? Admissions almost doubled. At one point in the Queen’s medical centre A&E department there were 180 people seeking treatment—that is a record. There were 395 more admissions than discharges in that nine-day period. I pay huge tribute to everybody who is working in our NHS. Can my right hon. Friend give me an assurance that he will continue to work with our hospital trusts, like NUHT, as they bring forward plans to change schemes —it is not just simply about money—and do everything that he can to support them in these unprecedented times?

[Mr Hunt]

I am happy to do that. I echo my right hon. Friend’s praise for the staff at NUHT, which was particularly pressured over Christmas. They have made particular efforts to improve patient safety and quality of care over recent years. She is absolutely right, and of course I will continue to work closely with her trust and others.

National Health Service Funding

Anna Soubry Excerpts

Tuesday 22nd November 2016 Commons Chamber

[Jonathan Ashworth]

What world is the Secretary of State living in? Half a million patients have waited for four hours or more in A&E in the past three months—the worst performance for this time of year for more than a decade—and he says it is nonsense. Some 350,000 of our constituents are waiting longer than the promised time for elective treatment—some have been waiting more than a year—and he says it is nonsense. Delayed discharges from hospitals are at record levels, and he says it is nonsense. The number of people waiting for 12 hours or more on trolleys has increased by over 700% since 2011-12.

[Anna Soubry (Broxtowe) (Con)]

Will the hon. Gentleman tell the House why it is that, after 12 minutes, he has yet to praise all our hard-working doctors, nurses and other health professionals? Why is he constantly talking down our great NHS, including the hospitals in Leicester?

[Jonathan Ashworth]

I praise the hard-working staff in the NHS every day of the week, but I rather suspect that staff in the NHS will have more sympathy with the position I am outlining than with the right hon. Lady’s position, not least when, according to surveys, 88% of NHS staff think that the NHS is under the most pressure they can remember, and 77% think that there is less access to resources, putting the quality of patient care and clinical standards at risk. That, I say to her, is what NHS staff are saying.

Leaving the EU: NHS Funding

Anna Soubry Excerpts

Tuesday 15th November 2016 Commons Chamber

[Mr Umunna]

It is outrageous that Ministers were unable to give my hon. Friend those figures. Ministers themselves exacerbated the knock-on impact on the economy of the depreciation of the pound. It depreciated in value by 6% before October, and then by a further 15% because of uncertainty around our trading arrangements that was triggered by comments made by the International Trade Secretary that differed from those of the Chancellor to the Treasury Committee and in other forums. The knock-on effect is not, however, just on household budgets. As the cost of things increases, of course the NHS will take a big hit. Public services in general will be affected if growth reduces and Exchequer receipts fall.

Ministers’ claimed increases in NHS funding, which the Under-Secretary of State for Health, the hon. Member for Warrington South (David Mowat), might mention, are actually being funded by reductions in other areas of health spending that fall outside NHS England’s budget. Reductions in spending on social care are having a serious impact on the NHS, and that is translating into increased accident and emergency attendances, emergency admissions and delays to people leaving hospital. I have talked about what Select Committees, Ministers and Members of Parliament are saying, but we have also heard from third parties. The King’s Fund, the Nuffield Trust and the Health Foundation are clear that current Government spending plans through to 2019-20 will not be enough to maintain standards of care, to meet rising demand from patients and to deliver the transformation in services outlined in the NHS five year forward view.

I and more than 40 Members from different parties, including all my hon. Friends in the Chamber for the debate, have written to the Chancellor asking that when he presents his first autumn statement on 23 November, he sets out how he will put the Government on a path to increasing national NHS spending by that promised £350 million extra a week once we have left the EU. To be clear, that additional funding must be over and above the amount currently planned to be spent on the NHS. The British Medical Association has made the same demand.

[Anna Soubry (Broxtowe) (Con)]

Is the hon. Gentleman saying that the Government have to honour a promise made by others to the tune of £350 million a week extra for the NHS? My hon. Friend the Member for North East Somerset (Mr Rees-Mogg) and other notable leavers have now conceded that the actual figure was £120 million. Would it not be unfair to say that the Government have to deliver that pledge, given that they never made any such promise to the British people?

[Mr Umunna]

I am grateful for the right hon. Lady’s intervention; I shall come on to those precise points shortly. I note, however, the public statements she herself made when she was a member of the Government. She criticised the way in which her fellow Ministers were going around making these big promises, perhaps on her behalf.

[Anna Soubry]

We must be very clear about this. During the referendum, we campaigned individually, not as Ministers on behalf of the Government. The hon. Gentleman is right that some Ministers campaigned for leave and made this promise—and indeed many other promises that I do not think they will be able to deliver—but there is a distinction to be made between the promises of the Government and those of people who now happen to be in government. It is really the leave campaign that must be held to account, not the Government.

[Mr Umunna]

The right hon. Lady pre-empts what I am about to say; I shall come on to that precise point.

To be clear, I want the Minister, on behalf of his Department, to give the same commitment that we are asking the Treasury to make, and to outline how his Department will make good on this pledge. I shall explain why this is a pledge that the Government should deliver. The Minister might give a number of reasons, perhaps echoing the right hon. Member for Broxtowe (Anna Soubry), to explain why the promise given by his ministerial colleagues during the referendum should not be treated as such. I will deal with each of the main possible reasons in turn.

First, there are those who claim that this was not a pledge at all. Nigel Farage, the interim leader of the UK Independence party, said that it was one of the mistakes that he thought the leave campaign made. The current Transport Secretary, who was also a member of the Government at the time of the referendum, has said that Vote Leave’s specific proposal was, in fact, to spend £100 million a week of the £350 million for the NHS that was originally hoped for, commenting that that would be an “aspiration” to be met. Let me tell the Transport Secretary that the poster that the Vote Leave supporters all stood next to did not say that this was an “aspiration”; it was a pledge—pure and simple. There was no qualification on the poster or on the big red bus. This statement was made, and the people who made it should be held to account for it.

Secondly, many leave campaigners deny ever using the £350 million figure. One of them said:

“I always referred to Britain’s net contribution of nearly £10 billion—some £200 million a week…rather than £350 million.”—[Official Report, 5 September 2016; Vol. 614, c. 20WH.]

It is true—my hon. Friend the Member for Ilford North (Wes Streeting) touched on this—that the Office for National Statistics said that the £350 million figure was misleading, but the head of the Vote Leave campaign said:

“the £350 million figure is correct and we stand by it.”

Vote Leave, whose banner Government Ministers campaigned under, carried on citing the figure, as my hon. Friend said, and those Ministers must now be held to account.

NHS Funding

Anna Soubry Excerpts

Monday 31st October 2016 Commons Chamber

[Mr Hunt]

Actually, what Mr Stevens said—I was there—was that social care and, indeed, public health provision needed to be maintained. We are increasing the social care budget by £3.5 billion over this Parliament. Although I accept that difficult cuts are being made to the public health budget, we are doing other things that do not cost money to make sure that we continue to improve this country’s excellent record on public health.

[Anna Soubry (Broxtowe) (Con)]

We all want a well-funded NHS. I congratulate the Secretary of State on making sure that we now have record spending in England. Last night, the A&E department of the Queen’s medical centre was tweeting that it effectively could not cope. We all of course congratulate and thank the hard-working staff in A&E, but the problem was demand. Does my right hon. Friend agree that the NHS can do much more to improve the way it signposts people? It was urging people to go to the urgent care centre, which does stitching and mends broken bones, all of which was news for many people in Greater Nottingham.

[Mr Hunt]

My right hon. Friend is absolutely right. That, of course, is why all parts of the NHS in England are embarking on the sustainability and transformation programme, which is designed to do precisely what my right hon. Friend says—to find smart ways to reduce demand. That will include, for example, better use of pharmacies, better use of GPs, more mental health provision—[Interruption.] Opposition Members are shouting, but why were they not prepared to put the money into the NHS to help us implement these plans? There would be no sustainability and transformation plans on the thin gruel that they promised for the NHS at the last election.

Community Pharmacy in 2016-17 and Beyond

Anna Soubry Excerpts

1st reading: House of Commons
Thursday 20th October 2016 Commons Chamber

[David Mowat]

This year we invested a further £5 billion in the NHS, three times the rate of inflation. In June the OECD noted we are now above average in terms of NHS and social care spend in the OECD. However much we spend, it is right we look to do it as efficiently and effectively as possible, to modernise this service and make it better for patients, and that is what we are doing.

[Anna Soubry (Broxtowe) (Con)]

The Minister knows my views: I do not think this 4% cut is a wise move. But I do note—and it is important that everybody reports this accurately—that that money is going to stay within the NHS, so it is not a cut. Can the Minister assure us about any incentives for pharmacies in the delivery of public health measures, notably preventive measures?

[David Mowat]

I thank my right hon. Friend for that comment and reassure her that for the first time we will be allowing pharmacists to access a quality fund, which means that the average pharmacy could earn up to £6,000 or £7,000 over and above what it gets just for dispensing. The fund will include specific measures around public health.

Community Pharmacies

Anna Soubry Excerpts

Monday 17th October 2016 Commons Chamber

[David Mowat]

That is speculation. We continue to look at the most recent communication that we have received from the negotiating body of the PSNC. I remind the House that 60% to 65% of these pharmacies are owned by public companies or private equity. The fact of the matter is that the Government have a responsibility to make sure that that money is spent effectively, and that is what we are going to do.

Finally, the hon. Gentleman said that GP access needs to remain good. I confirm and repeat the point that I made earlier: 1,500 additional pharmacists will be recruited into the GP sector by 2020. That is a massive investment, and it will make a big difference.

[Anna Soubry (Broxtowe) (Con)]

I should declare that Boots has its headquarters partly in my constituency and partly in Nottingham South. May I gently say to the Minister that there is great concern about the proposals? If there was ever a time to argue to increase the role of pharmacies, it is now. They perform a hugely powerful job in making sure that people do not, to be frank, bother their GPs and A&E with matters that are best dealt with by pharmacies because they are of a minor nature. The Minister makes a good point about clustering, but he has to get this right, because, if he damages pharmacies, there will be fewer of them, not just in poorer areas, but in remote rural areas. I urge the Government to take a hard good look at the issue, to make sure that this is the right approach as the pressures on the NHS increase.

[David Mowat]

I agree with my right hon. Friend. Boots makes a big contribution. It owns 1,724 pharmacies and is the biggest of the big four, which between them own 40% of all pharmacies. The Government’s position is that community pharmacists make a big contribution, but I repeat that the number of locations has increased by nearly 20% over the past decade, and each one gets £25,000 per annum just for being open and for being a pharmacy. One consequence is that we have seen a great deal of clustering, and 40% of pharmacies are within half a mile of three others. It is right that the Government look at that and make a judgment.

Baby Loss

Anna Soubry Excerpts

Thursday 13th October 2016 Commons Chamber

[Anna Soubry (Broxtowe) (Con)]

It is always with great care that one treads into some areas of one’s own life, but, like many hon. Members, I remember around that 21-week or 22-week point of pregnancy—obviously I am addressing the women Members in the Chamber—having that marvellous, magical moment of what the books describe as a fluttering. You suddenly realise then that the nightmare of morning sickness and the other afflictions that there often are in pregnancy are all about the new life there within you. I suspect that I am not alone in this but that many hon. Members of both sexes have had that moment of looking into the Moses basket and knowing that the next time you look into it that bundle of life that you bear will be in it. That is extremely exciting, and, the truth is, also really rather frightening, especially when it is your first child and so you have obviously never had a baby before. I absolutely cannot imagine what it must be like—something experienced by so many in this Chamber who have spoken today with such great courage—never to have that Moses basket filled with the joy of the child that you have borne for well over nine months.

I warmly congratulate my hon. Friends the Members for Eddisbury (Antoinette Sandbach) and for Colchester (Will Quince) not only on securing this debate but on the great work they have done. No one could been unaffected and unmoved by the incredibly sad stories of the hon. Members for Lewisham, Deptford (Vicky Foxcroft) and for North Ayrshire and Arran (Patricia Gibson). If I may say so—and I do so with no sense of lessening the terrible story we heard from the hon. Member for North Ayrshire and Arran—we were all particularly struck by what the hon. Member for Lewisham, Deptford experienced. I was not just struck with great sorrow, but, I have to say, I also felt anger rise within me. What happened to her was outrageous. I want to be made certain that what happened to her will never happen again to anyone in our society. Obviously, I extend that wish to the experiences related by everyone who brought to this place today either their own experiences or those of their constituents. We must learn the lessons from all of those experiences and do everything we can to make sure that babies do not die in the first place, so that we do not have the high rates of stillbirth that we have heard about or babies dying in the early months of their lives. But in addition, the treatment of both parents, as we have heard so eloquently expressed, must change.

I want to hold a spark of hope in my mind that what happened to the hon. Member for Lewisham, Deptford was a one-off, but sadly I have no doubt that it was not. But I would like to think that, given the passage of time, we can be confident that that kind of experience is now extremely rare. We must all work to make sure that no one ever again suffers what she did or what the hon. Member for North Ayrshire and Arran suffered.

I will make a short contribution about bereavement suites. My remarks are based entirely on the experience of two of my constituents. I first met Richard Daniels for reasons with which I need not trouble the House, and he and his wife have now become friends of mine. Members can imagine, as can anyone who hears their story, that there was much sympathy and real concern at the discovery that when their baby Emily was born in a stillborn birth at the Queen’s Medical Centre, in 2013, there was no bereavement suite. I had both my daughters there; I found that fact quite astonishing, as I know everyone else did who heard their story.

Hon. Members have already discussed this. There is no greater tragedy for any parent than the loss of a child, and, although there are no degrees of grief, I genuinely cannot imagine any greater tragedy and loss than to lose a baby in the circumstances that we are all now becoming more aware of. And then—and, let us be honest, this is almost cruel—while the rest of us are celebrating with balloons and relatives coming along, to be there with that terrible grief, which cannot really be described if it has not been suffered, and to have to sit with your loved one while all that jollity is going on around you because there is nowhere to go to grieve, and to have your private last moments with your baby before they are properly buried, is just appalling. I was horrified to learn from my hon. Friend the Member for Eddisbury that 25% of hospital trusts still do not have bereavement suites.

I am not one of those who says that it is just the role of the NHS to provide those suites. When a terrible tragedy happens, whatever it might be, human beings want to come together to make good of something that has been wholly horrible. I therefore have no difficulty in such circumstances with the idea of parents working hand-in-hand with hospital trusts that do not have a bereavement suite to create one.

Nottingham University Hospital Trust did much to make sure that when Richard and Michelle Daniels decided that they would raise money to fund such a suite, it was a relatively easy journey. It was not all easy—there were many bumps along the way—but they got through it. They started with a plan to raise £25,000 and within 18 months had raised more than £150,000. They did so by a variety of fundraising methods that we will all be familiar with. Emily died in 2013. They finally opened the Serenity suite at the Queen’s Medical Centre, with real joy and pleasure, in April this year. Such has been their dedication to Forever Stars, the charity that they founded, that even though they said that the fundraising would end, as they have been contacted by parents from other parts of the east Midlands—notably, from Derby, where there is no bereavement suite—they have decided to resurrect Forever Stars. They are embarking once more on a huge fundraising exercise to open a bereavement suite. I urge them to continue—I know they will. It is right that parents are involved. However, it is equally right that all those hospital trusts that do not have bereavement suites should now get on with getting them. They should not rely on a parent who has suffered such terrible loss to spark them into taking action to make sure that those suites exist and are fully equipped and their staff are fully trained.

I offer my absolute congratulations to all those who have spoken, and in particular to those who have laid bare the worst moments of their lives. They have put those experiences forward so that we can say to the Government—and I know that the Minister will be listening—that this is an area in which it is time for action, for all the reasons and in all the ways that have been described, as it is not just about bereavement suites. We must take that action so that we can be proud, as a nation, that we are reducing the number of babies who are born dead or who die in the first months of their infancy, and we are doing the right thing by their parents and families, for the sake of the future that they looked forward to but has been denied to them and their children.

NHS Sustainability and Transformation Plans

Anna Soubry Excerpts

Wednesday 14th September 2016 Commons Chamber

[Ms Abbott]

I need to make some progress.

The King’s Fund has said:

“There are some concerns that NHS leaders have focused their efforts on plans for reconfiguring a few hospital services, despite evidence that major acute reconfigurations rarely actually save money and sometimes fail to improve the quality of care.”

The BMA has said the same thing. The King’s Fund has also said:

“The cuts under the STPs are eye-watering”.

[Anna Soubry (Broxtowe) (Con)]

rose—

[Ms Abbott]

I am anxious to complete my remarks so that Conservative Members will all get a chance to intervene in the debate.

The Health Select Committee's recent report on the impact of the 2015 spending review stated:

“At present the Sustainability and Transformation Fund is being used largely to ‘sustain’ in the form of plugging provider deficits rather than in transforming the system at scale and pace. If the financial situation of trusts is not resolved or, worse, deteriorates further, it is likely that the overwhelming majority of the Fund will continue to be used to correct short-term problems rather than to support long-term solutions”.

[Sir Simon Burns]

rose—

[Anna Soubry]

rose—

[Ms Abbott]

Other aspects of the STPs that relate to cutting expenditure involve a combination of factors, including the use of new technology such as apps and Skype, patients taking more responsibility for their own health, “new pathways” for elderly care, increased reliance on volunteers and the downgrading of treatment by skills, responsibilities and pay bands. It seems to me that while some of these proposals might have some merit in themselves, it is delusional to imagine that they will deal with the financial black hole in the NHS. There is no evidence that among the patient population as a whole, increased use of apps, Skype and telemedicine can produce the efficiencies required while beds, units, departments and hospitals are being closed.

I remind Members, many of whom speak to their constituents in their advice surgeries on a weekly basis, that the truth about speaking to people face to face is that it is often towards the end of the conversation that people will come out with what really concerns them. My concern about the increased use of Skype is that many patients will not get the familiarity and comfortableness with their interlocutors to enable them to say at the end of the Skype session what it is that they are concerned about.

The STPs talk a great deal about increasing preventive medicine. That would indeed have the effect of lowering demand for acute NHS care, but it would also require a very substantial investment in public health programmes—and this Government have just cut public health funding. The elderly, the poor and patients for whom English is not their first language are the least likely to use these apps, telemedicine and Skype. It is inappropriate and unrealistic to assume that elderly patients who, I remind Members, are the biggest users of acute care and the fastest-growing demographic, will want to use Skype for any sensitive matter. “New pathways” for the elderly is sufficiently vague as an idea to raise alarm bells, given the projected rise in demand for geriatric services and continuing cuts in social care funding.

--- Later in debate ---

[Dr Murrison]

Will the hon. Lady give way?

[Anna Soubry]

Will the hon. Lady give way?

[Sir Simon Burns]

Will the hon. Lady give way, and if not, why not?

[Ms Abbott]

Let me now draw my speech to a close. It is absolutely right that health and social care stakeholders should come together to plan for the future. It is absolutely wrong that social transformation plans should be hatched in secret and used as a cover for cuts and hospital closures—and it is increasingly clear that STPs may be a stalking horse for more privatisation. Conservative Members may not take this issue seriously—[Interruption]—and Conservative Members’ response may be to shout, but I stress to the House that the consequences of these STPs will be very material for all our constituents.

[Anna Soubry]

Will the hon. Lady give way?

[Ms Abbott]

They will also be very material for those who work in the NHS. I take this issue seriously. [Interruption.] That is why we have called the debate, and I wait with interest to hear what Ministers have to say.