O’Neill Review

Chris Green Excerpts

Tuesday 7th March 2017 Westminster Hall

[Patrick Grady]

It is still a pleasure to be serving under your chairmanship, Mr Streeter.

Antimicrobial resistance was described earlier by another Member as a market failure. I have also seen it described as a “tragedy of the commons”, which is a phrase that some of us might associate with the hassle we have to go through because of the antiquated voting systems in this House. It is actually an economic term describing where individual users acting independently according to their own self-interest behave contrary to the common good by depleting a resource that should be there to serve everyone. That is precisely what has happened through the misuse of antibiotic medicines over the years. It shows that the resistance we are discussing today is an avoidable and man-made problem, and it is therefore in our gift to overcome the challenge.

[Chris Green (Bolton West) (Con)]

One of my concerns is that we view this as though there should be a proper market functioning. Does the hon. Gentleman agree that we do not actually want a functioning market, in that we want a new generation of drugs to become available and then, as far as possible, not to be used? We do not want the market to operate; we want the use of such drugs to be in reserve.

[Patrick Grady]

Absolutely. I wholeheartedly agree. That leads me nicely on to my first point about the particular challenge faced in developing countries.

All Governments in the world have an obligation under the sustainable development goals—it is in SDG 3—to ensure health and wellbeing for all, which includes access to safe, effective, quality and affordable medicines and vaccines. That is about access to medicines; it is not about the right to buy or sell them on the market, it is about treating them as a common good. That is precisely what we want to do, otherwise there is a real risk of backsliding on progress that has been made in tackling neglected and tropical diseases. We heard earlier about TB being responsible for more than 5,000 deaths per day, and about malaria, which is often treated by very strong antibiotics and affects more than 200 million people worldwide a year. That is why there needs to be a broad, co-ordinated response. Drugs that treat TB are often used to treat other infections as well, so in boosting research into neglected diseases there is an opportunity to supercharge the pipeline of development and make more drugs available for treatment as we need them.

I am glad the Minister is back in the Chamber. It would be interesting to hear what further commitments the Government can make. We welcomed the commitment to the global fund, but how is the Department for Health working with the Department for International Development on these issues? In particular, how much of her Department’s spending will be counted as official development assistance when it comes to tackling antimicrobial resistance? The Ross fund was set up by the former Chancellor, the right hon. Member for Tatton (Mr Osborne), who is no longer in his place, and I congratulate him on it. What progress is being made on that fund, and what support will there be for researchers on the ground in developing countries? I am not opposed to using the ODA budget to fund Departments other than DFID, but wherever possible it should be used to support research on the ground in developing countries.

I want to speak briefly about domestic responses. I recently met a constituent, Linda Brooks, who has become the chair of the Scottish steering committee for synthetic biology—an initiative supported by Scottish Enterprise. She is also a manager at the company Thermo Fisher, which supports research in the life sciences sector including pioneering work on antimicrobial resistance and, in particular, the technology of genome editing, which has huge potential. It would be interesting to hear whether the Government provide any support in those areas.

We all have responsibility for the effective use of antibiotics. During the hiatus in this debate I was able to sign up online to become an antibiotic guardian, which Public Health England supports with the encouragement of all the devolved Administrations. It includes a range of pledges to treat symptoms, to talk to pharmacists, to dispose of unused antibiotics carefully, to take the flu vaccine and to always complete the course—I hope everyone will sign up to that pledge.

Oral Answers to Questions

Chris Green Excerpts

Tuesday 7th February 2017 Commons Chamber

[David Mowat]

As I said, the symptoms are vague and there is no definitive test. As my hon. Friend the Member for Gillingham and Rainham (Rehman Chishti) pointed out, awareness of the condition among GPs is not as high as it could be, so we need to do more, with the NICE guidelines and the work of the British Polio Fellowship, on GP education, training and information.

[Chris Green (Bolton West) (Con)]

3. What progress he has made on improving hospitals in special measures.

[Lucy Frazer (South East Cambridgeshire) (Con)]

10. What progress he has made on improving hospitals in special measures.

[The Secretary of State for Health (Mr Jeremy Hunt)]

In the last four years, 31 trusts have been put into special measures—more than one in 10 of all NHS trusts. Of those, 16 have now come out, and I congratulate the staff of Addenbrooke’s and all at Cambridge University Hospitals NHS Foundation Trust, which came out of special measures last month.

Let me also take this opportunity to thank Professor Sir Mike Richards, who has announced his retirement as chief inspector of hospitals. His legacy will be a safer, more caring NHS for the 3 million patients who use it every week. He can feel extremely proud of what he has achieved.

[Chris Green]

Royal Bolton hospital was in special measures four years ago, but it has since come out following a huge amount of hard work. The trust is now running a surplus, which is being reinvested into patient care. Will my right hon. Friend join me in congratulating all the staff on their excellent hard work?

[Mr Hunt]

I am happy to do so. It is a fantastic example of what is possible in challenging circumstances with a lot of pressure on the frontline, so the staff should feel proud. Trusts put into special measures go on to recruit, on average, 63 more doctors and 189 more nurses and see visible improvements in the quality of patient care.

Oral Answers to Questions

Chris Green Excerpts

Tuesday 20th December 2016 Commons Chamber

[Mrs Theresa Villiers (Chipping Barnet) (Con)]

12. How the Government plan to show global leadership in tackling antimicrobial resistance.

[Chris Green (Bolton West) (Con)]

14. How the Government plan to show global leadership in tackling antimicrobial resistance.

[The Parliamentary Under-Secretary of State for Health (Nicola Blackwood)]

The UK is already a global leader in the fight against AMR. This Government’s leadership has secured a UN declaration on AMR and a commitment from the G20 to drive the development of new antimicrobials. We will continue to deliver international programmes to tackle AMR, including the Fleming fund and the Global AMR innovation fund, which represent more than £300 million of investment over the next five years.

--- Later in debate ---

[Nicola Blackwood]

I agree that we must focus on that as well, but we are currently focusing on reducing the need for antibiotics by minimising disease risk in animals through good animal husbandry and on-farm biosecurity. At present, antibiotics provide the only effective means of treatment for a number of animal diseases, and are therefore essential to ensuring the health and welfare of animals. However, we are also working on the matter in an international context with the World Organisation for Animal Health, and we will continue to drive forward the agenda.

[Chris Green]

What measures are the Government introducing to support the uptake of point-of-care C-reactive protein testing throughout the United Kingdom, given that it is a proven and cost-effective means of reducing levels of inappropriate antibiotic prescribing in primary care?

[Nicola Blackwood]

As my hon. Friend says, we must focus on innovation and better diagnostic tests, particularly bedside tests. The Government are actively reviewing evidence of the benefits of CRP tests. Pilot studies in the United Kingdom are contributing to that, and will be evaluated so that we can see how best to build on what can be shown to be working well.

--- Later in debate ---

[Nicola Blackwood]

My hon. Friend flatters me by saying he thinks I am a nanny—it is really quite a disturbing thought. However, what we have here is an obesity plan that balances the need to cut the sugar in young people’s diets, as a way to make sure they get a healthy diet, and individual choice, which we know is absolutely a Conservative ideal.

[Chris Green (Bolton West) (Con)]

T2. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health (Mr Jeremy Hunt)]

As we enter the challenging winter period, I want, on behalf of the whole country, to thank the 2.7 million people working in the health and care system—particularly those giving up all or part of their own Christmas day to look after patients. We are in their debt, and we wish them a merry Christmas, whenever they get the chance to celebrate it with their families.

[Chris Green]

Bolton A&E is employing new measures to cope with the staggering demand on its service. What are the Government doing to educate people that A&E is for serious and life-threatening conditions only, so that staff and resources can go where they are needed most?

[Mr Hunt]

That is an excellent question. We are doing a number of things. First, we have the Stay Well this Winter campaign, which has a lot of advice to go out to his constituents and all our constituents about how to avoid things that can lead to their having to go to A&E. However, we also urge the public to remember that accident and emergency departments are for precisely that.

Oral Answers to Questions

Chris Green Excerpts

Tuesday 11th October 2016 Commons Chamber

[Mr Hunt]

The hon. Gentleman will have noticed that in last year’s spending review the NHS got the biggest funding increase of any Government Department. We have committed to the NHS’s own plan, which asks for £10 billion more a year during the course of this Parliament in real terms. However, I do not disagree that there are still very real financial pressures in the NHS and particularly in the social care system. The trusts that are delivering the highest standards of care are those with the lowest deficits. Delivering unsafe care is one of the most expensive things people can do, which is why this is an important agenda.

[Chris Green (Bolton West) (Con)]

15. Will the Secretary of State join me in congratulating all the staff at Bolton NHS Foundation Trust, which has recently been rated “good” by the Care Quality Commission just four years after it was deemed to be a red risk. It is now in the top 25% of trusts.

[Mr Hunt]

The staff at Bolton have done a fantastic job. I absolutely congratulate them, and I thank my hon. Friend for his work in supporting them as well.

Oral Answers to Questions

Chris Green Excerpts

Tuesday 5th July 2016 Commons Chamber

[Jane Ellison]

There is consensus on the importance of this issue. It is worth highlighting the work that the Government are doing internationally, through the creation of the Fleming fund, in which we are investing £265 million, to help poorer countries to tackle drug resistance and to make sure that we have proper monitoring systems in place. Without a baseline to understand where we are even starting from, it is very difficult. We will respond more fully to all the issues highlighted by the hon. Lady when we respond formally to the O’Neill review, but it goes without saying that we are trying to take this work forward internationally and we are working towards further meetings at the United Nations this autumn.

[Chris Green (Bolton West) (Con)]

2. What assessment his Department has made of the uptake of the Target antibiotics toolkit among NHS commissioners and GPs.

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

Continuing with the same important theme, it is excellent to see Parliament taking such a close interest in antibiotic resistance. In England, 60% of clinical commissioning groups reported reviewing the Target toolkit, which has been designed to help GPs in particular, in a primary care survey in November 2014. A patient safety alert went to providers and commissioners in 2015, highlighting the importance of programmes such as Target. The House might be interested to know that the Target programme gives GPs help in understanding how to deal with the pressure from patients, because a lot of inappropriate antibiotic prescribing comes from the pressure from patients to walk away with an antibiotic script. Work is being done, but we know that we have more to do.

[Chris Green]

I thank the Minister for her reply. Disappointingly, the most recent data show Bolton to be one of the highest prescribers of antimicrobial agents in Greater Manchester, and it is in the highest quartile nationally. Although Bolton CCG has seen reductions in antibiotic prescribing following guidance given to GPs, when will the Target antibiotics toolkit be fully implemented across all CCGs in England?

[Jane Ellison]

Public Health England is doing a huge amount of work on this. There has been a very welcome drop in prescribing in the last year and that appears in the data available for this year. That gives us encouragement. Of course, 79% of antibiotic prescribing occurs outside hospital, so my hon. Friend is right to highlight general practices. I draw his attention to Public Health England’s Fingertips portal, which allows both providers and commissioners to assess how they are doing compared with other areas locally. That is allowing us to see where we have particular problems. It varies around the country and Public Health England is leading the action being taken in that regard.

Oral Answers to Questions

Chris Green Excerpts

Tuesday 10th May 2016 Commons Chamber

[Alistair Burt]

I do not think that anyone fails to recognise that the next couple of years in social care will be very tight, but that is why the better care fund is there. Work has been done to increase the amount of money available to meet the challenges that the hon. Lady raises. I have to repeat that to fund this properly there has to be a sufficiently strong economy. There has to be the commitment to funding that the Government have been able to make almost uniquely in the House. I sometimes think it would help if she recognised the strength of the economy that has been able to do that by assisting local authorities, rather than complain about the amount of money available.

[Chris Green (Bolton West) (Con)]

9. What steps his Department is taking to ensure provision of good quality A&E services.

[The Secretary of State for Health (Mr Jeremy Hunt)]

Although we are not currently hitting the national A&E target, hospital A&E departments continue to perform well under great pressure. Overall they are coping with 1.9 million more attendances annually compared with 2009-10, and the average wait to see a doctor remains just 38 minutes.

[Chris Green]

I thank my right hon. Friend for his answer. Many of my constituents are concerned about the temporary closure of the Chorley A&E department, which now only operates as an urgent care service. What assurance can he give my constituents on A&E cover in and around the Bolton West constituency?

[Mr Hunt]

May I reassure my hon. Friend that I am very aware of this issue, and I have had a number of meetings with hon. Members to discuss it? Patient safety has to be the utmost priority. We are working with the local trust, and we have been given an assurance that neighbouring hospitals will be able to absorb any extra activity, and that it is working hard to try to reopen the A&E department.