NHS Funding Bill
Dan Poulter ExcerptsTuesday 4th February 2020
(4 years, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Legislative Grand Committee (England) Amendments as at 4 February 2020 - (4 Feb 2020)
Justin Madders
I am sure that if my hon. Friend continues with his determined campaign, he will see that hospital appear. His point about health inequalities is really important. It is absolutely scandalous that we see such disparity in this country, and we want to see further and more determined action from the Government on that.
Patients ultimately pay for the increasing backlog. Between 2017-18 and 2018-19, there was a 25% increase in clinical service incidents. These incidents are caused by estate and infrastructure failure that leads to clinical services being delayed, cancelled or otherwise interfered with.
Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)
The hon. Gentleman is making some very fair points about the importance of investing in hospital infrastructure. A number of years ago, we were promised a paperless NHS, but the reality today is very different. In fact, NHS IT infrastructure is creaking at the seams. There has been a complete failure to invest adequately in that infrastructure, which is compromising patient care. Far too many staff hours are lost on IT systems that are not fit for purpose. Will he join me in urging the Government to take that issue very seriously, because it is about improving patient care as well as improving productivity and better using staff time?
Justin Madders
The hon. Gentleman makes an important point. We have all heard horror stories of workers in the health service having to turn on seven or eight different computer systems and use fax machines and pagers— there were so many fax machines in the NHS I used to think the previous Health Secretary was sponsored by Rank Xerox. It is a serious point though. If we are to improve patient outcomes, we will need to move with the times and get the benefits of technological improvements.
Anne Marie Morris
The hon. Lady makes an apposite and correct point. We cannot talk about mental health just within the health and care bucket, so to speak. What do we do to help young mums? What do we do in the school environment for youngsters, who are increasingly put under huge pressure, with cases of stress and depression growing daily? What are we doing in the workplace? Historically, mental health has been something that we do not talk about; indeed, people almost dare not to for fear of being demoted and losing their job. There are many aspects of mental health that need to be taken into account if we are truly to deliver parity of esteem. I would like to think that the Government, and perhaps the Minister when he responds to the debate, would acknowledge the breadth of the need to work together across Government Departments so that we look properly at the outcomes and at the different pieces that affect those outcomes, which go well beyond the Minister’s particular brief.
Dr Poulter
I thank my hon. Friend for giving way. She is making some very good points. An interesting amendment has been tabled by the hon. Member for Twickenham (Munira Wilson) on the need for greater transparency more generally in mental health funding. It is difficult to understand properly what level of investment is currently going into mental health services, be it CAMHS or general adult mental health services. Would it not be a good thing if the Government took on board the spirit of that amendment and published data on mental health spend on an annual basis across all mental health services, from CAMHS and general adult to older adult and learning disability services? That would help to make the argument that money is actually going into what has been a Cinderella service for far too long.
Anne Marie Morris
My hon. Friend is right in that the things that are relevant to mental health cannot exclude the budgets in other parts of the system. He is absolutely right, as the hon. Member for Twickenham (Munira Wilson) is, that these things need to be looked at together. Yes, I certainly agree that a written report that sets out what money is being spent where would be very welcome, but I guess that my amendment goes beyond that and says that we should be sure that we are getting something for that money, rather than simply putting in that money and not having any grasp as to whether it is actually making a difference, which is crucial.
Health and Social Care
Dan Poulter Excerpts(4 years, 10 months ago)
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Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)
I want to bring the Secretary of State back to social care. We have a duty in this Parliament to resolve this issue, which for many decades has been kicked into the long grass. Does my right hon. Friend agree that it is not just about funding, but what service we want to deliver for people? The discussion about the future of social care should also be about service delivery, putting together not just a sustainable funding model but a model of delivery that is driven by integration of the health and social care services. We often talk about that, but it has not been delivered for patients and people on the ground.
Mr Deputy Speaker (Mr Nigel Evans)
Before the Secretary of State answers that, may I just gently remind him that 40 people are trying to get in? It would be generous if he could at least keep that in mind as he takes interventions.
Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)
First, may I draw your attention, Mr Deputy Speaker, and that of all Members to my declaration in the Register of Members’ Financial Interests as a practising NHS psychiatrist?
Before I address the motion and speak in support of the Queen’s Speech and its focus on health and social care, I pay tribute to the hon. Member for Ealing North (James Murray). I have no doubt that he will have the eloquence of his predecessor—somebody we in the House knew for his many jovial speeches. I also have no doubt that he will match the diligence that his predecessor showed as a constituency MP in fighting for the needs of his local residents, not least by standing up for his local NHS and maintaining a health service locally that meets the needs of people in Ealing. I wish the hon. Gentleman very well in all that he does in this place.
Many commendable and positive things can be recognised in the contribution by my right hon. Friend the Secretary of State. He rightly talked about the need for increased investment in the health service and about the need to support the staff who work on the frontline. He rightly identified the need to improve mental health provision and talked about the need to find political consensus on social care.
I intend to talk briefly about a couple of those issues, but before I do so it is worth observing that we now have a new Prime Minister and the Government have a strong mandate. That is an opportunity to reflect on what we could do as a Government to improve the legislation that we ourselves have passed and that has perhaps had unintended consequences. There is a particular concern among patients and people who work in the NHS about the fragmentation of services, which has been the result of the sometimes market-driven approach to the delivery of healthcare and the encroachment of the private sector on the delivery of traditional NHS services.
As a clinician, what matters most to me is that we deliver the right services for patients. We need to recognise that the involvement of private sector provision has sometimes led to greater fragmentation and a lack of joined-up care for patients. In particular, if we look at how addiction services are commissioned, we see the impacts of that on increasing homelessness and people not getting treatment in a timely manner, or on the joined-up care with the NHS afterwards. If we look at how some sexual health services are now commissioned, we see that it is done in a fragmented way that often lets patients fall through the cracks. With a fresh mandate and a new Prime Minister, I hope we have an opportunity to look at that and be honest that the answer is not always in the market—that the answer is in well-funded, properly delivered public services that are free at the point of need and often run by the state. We have to be honest about that and recognise where we could do things better in future.
The second point I wish to make is on the need to value our staff. NHS staff have had a difficult period, with wage restraint and morale issues—for example, as a result of the junior doctor dispute. We also need to recognise the challenges relating to the NHS workforce which Brexit has brought into focus. We are very reliant, and have been historically, on the contributions made by members of the NHS who come from all over the world, from within the EU and from throughout the country, and frankly our NHS could not work without them. We are very grateful for those contributions and it is right that we support those people in our NHS.
Of course we need to focus on improving the number of British-trained graduates across the health service, but we also need to recognise that the staffing crisis is the biggest issue that we now face. If we want to realise the ambition to increase nursing numbers and GP appointments, we have to recognise that across the piece there is a need to take staff training, recruitment and retention seriously. We need to look at the fact that in different parts of the United Kingdom—for example, the north-west or the north-east—there are fundamental staffing challenges and a difficulty in recruiting and retaining staff that is much more acute than it may well be in the south of England. I know the Government want to look at that, but we need to come up with meaningful answers.
We need to look overseas at examples in Australia, where they have to cover a very large land mass. They have had challenges attracting staff to work in parts of rural Queensland and the Northern Territory; we need to take lessons from those healthcare systems and apply them here so that we can address workforce shortages on the frontline. Without the staff, we cannot deliver the care. It is all very well to talk about improvements in patient safety and other things, but unless we have the staff to do it, we cannot deliver it. I hope that there is now an opportunity for the Government to grip these issues. Staff planning takes more than just one parliamentary cycle until the next general election; it is a five or 10-year mission, but it is one that we need to grip now if we do not want to have lasting workforce shortages in many regions of this country.
In particular, I draw the attention of those on the Treasury Bench to the challenges that we face in mental health. It is absolutely right and commendable that we have focused on destigmatising mental health and on the importance of mental health liaison services. Professor Simon Wessely did a welcome review of the Mental Health Act 1983 that was long overdue. I am sure we will address those issues.
We have to recognise that community mental health services have been substantially the Cinderella of mental health services for far too long. If we want to improve care and prevent people with mental ill health from getting so unwell that they need to turn up at hospital, we need to recognise that the primary focus of investment in mental health services—indeed, one of the issues we face is a staffing crisis in mental health, with falling numbers of frontline mental health nurses in the community —must be in community services. They have been hollowed out for too long and now need investment.
Madam Deputy Speaker (Dame Eleanor Laing)
Order. I hesitate to interrupt the hon. Gentleman, but he has now spoken for seven minutes and we are on a six-minute time limit, so I know that he will finish soon.
Dr Poulter
Thank you, Madam Deputy Speaker. I am sure that Members on the Treasury Bench will take away and look at the issue I just outlined.
The Government are rightly looking for political consensus on social care and on finding a sustainable funding formula. However, as part of that, they should also consider how social care services need to look. It is no good bringing in money when the mode of delivery is wrong. I hope that, as part of the consensual approach, there will be a renewed focus on delivering care in the community in an integrated way, thus joining up the health and social care systems. I hope that that will be part of the important review and the approach to political consensus that the Government are trying to deliver.
Several hon. Members rose—