Oral Answers to Questions

Desmond Swayne Excerpts

Tuesday 23rd July 2019 Commons Chamber

[Stephen Hammond]

The hon. Gentleman is right, which is why the Green Paper will have long-term plans on mental health and, indeed, dementia. I think he will be pleased to see that when the Green Paper is released shortly.

[Sir Desmond Swayne (New Forest West) (Con)]

What can the Minister do to expedite the provision of primary care services in those rural areas where the population is growing fast as a consequence of new housing?

[Stephen Hammond]

My right hon. Friend is right to raise that point, which has been raised with me several times. The new funding formula that the independent advisory committee is setting up will take into account the growth in population. It will look at the growth in the electoral register every year, rather than over a five-year period, as it does now, so it will be able to respond more quickly than is currently the case.

Decriminalisation of Abortion

Desmond Swayne Excerpts

Tuesday 23rd July 2019 Commons Chamber

[Jackie Doyle-Price]

I thank the hon. Lady for the characteristically constructive spirit in which she has engaged with this issue. The nub of the point she makes is that decriminalisation must not be met with deregulation. Whatever we do, we must make sure that in repealing those sections of the 1861 Act—if that is what Parliament chooses to do—the regime that replaces it must not only guarantee the rights of women to take decisions for themselves but protect them and keep them safe. That is my priority in addressing this issue.

[Sir Desmond Swayne (New Forest West) (Con)]

My hon. Friend is aware—isn’t she?—that any proposal for repeal will be resisted as passionately in the country and on the Government Back Benches as it has just been advocated by those on the Opposition Benches?

[Jackie Doyle-Price]

I am very aware that this issue rouses passions on both sides of the argument, which is why I reassure the House that, from my perspective, I just want to make sure that I deliver Parliament’s instructions in a way that is safe. I should add that perhaps the way in which both sides of the argument have been debated in the House has not led to good lawmaking, because it has meant that the law has not been revisited in 50 years and has not kept pace with medical advancement.

Oral Answers to Questions

Desmond Swayne Excerpts

Tuesday 18th June 2019 Commons Chamber

[Seema Kennedy]

It is distressing to hear of such a case, and these situations are very distressing for patients and their carers. The NHS Business Services Authority has taken steps to make things clearer, including with an easy-read patient information booklet and an online eligibility checker. We are also running a national awareness campaign, but of course we do need to ensure that people are not claiming for things to which they are not entitled.

[Sir Desmond Swayne (New Forest West) (Con)]

I have constituents who are furious at repeatedly receiving penalty notices that subsequently have to be quashed. The system is rubbish, isn’t it?

[Seema Kennedy]

I do not agree with my right hon. Friend that the system is rubbish. If somebody does receive a penalty charge notice incorrectly, there are procedures in place to challenge that notice. If somebody thinks they have received a penalty charge that they should not have received, they should contact the NHS Business Services Authority.

Whorlton Hall

Desmond Swayne Excerpts

Thursday 23rd May 2019 Commons Chamber

[Mr Speaker]

Order. This is an extremely important and sensitive matter, but I am looking to move on to the business question at 11 o’clock, so short questions and short—though, I am sure, informative—replies are required.

[Sir Desmond Swayne (New Forest West) (Con)]

What happens at the Care Quality Commission’s headquarters when a story such as this emerges? Are the inspectors who so recently rated the facility summoned in for a meeting without coffee, or perhaps with the rough end of a pineapple?

[Caroline Dinenage]

The Care Quality Commission is taking the situation incredibly seriously. Some massive concerns were raised last night, and Paul Lelliott from the CQC apologised and said that the matter would be very thoroughly addressed and investigated by its team.

Medical Cannabis under Prescription

Desmond Swayne Excerpts

Monday 20th May 2019 Commons Chamber

[Sir Mike Penning]

I thank the hon. Gentleman for his intervention. That is what we are here for. Yes, we are frustrated and angry, but actually we are here to do something very important. The only reason the Home Office deregulated this drug and we are in this position today is that this House came together and, more importantly, because the families came together. Those families have young children—I am a father myself, like lots of colleagues in the House—and we all came together to say that the situation was fundamentally wrong. We asked why medical cannabis was illegal if we knew that it helped our children.

[Sir Desmond Swayne (New Forest West) (Con)]

Am I right in my assessment that Ministers have bent over backwards and we have acted in the Chamber to ensure that these products are now available, but that the problem is in the medical profession? What more can we do now? I know that this is interfering in the medical profession, but, frankly, that is now becoming necessary.

[Sir Mike Penning]

My right hon. Friend is absolutely right. The Secretary of State for Health and Social Care stood at the Dispatch Box during the urgent question and laid out in plain English that it is not illegal for a suitably qualified person to prescribe these medical products, so how are we still here?

Access to Medical Cannabis

Desmond Swayne Excerpts

Monday 8th April 2019 Commons Chamber

[Sir Desmond Swayne (New Forest West) (Con)]

If the principal issue is that doctors will not prescribe, is there a secondary problem when there is a prescription but the bureaucracy is failing to honour it?

[Matt Hancock]

I have heard that accusation being made by a couple of the parents. I am advised that that is not the case, but I am very much looking into it because in these circumstances I always think we need to listen to the people who are trying to resolve the issue. I am looking into that very point.

Oral Answers to Questions

Desmond Swayne Excerpts

Tuesday 26th March 2019 Commons Chamber

[Sir Desmond Swayne (New Forest West) (Con)]

4. What estimate he has made of the number of prescriptions for medicinal cannabis products that have been issued since November 2018.

[The Secretary of State for Health and Social Care (Matt Hancock)]

The data that my right hon. Friend asks for is not available, but it is important that we take action to make sure the right drugs are available for the right people.

[Sir Desmond Swayne]

Was it intended to make them as rare as hens’ teeth? What measures is the Secretary of State taking to support clinicians in actually prescribing?

[Matt Hancock]

I met the parents of some of the children whose needs are best met through the use of medicinal cannabis. My heart goes out to those who are fighting for this cause. We changed the law in the autumn to try to make it easier, and I am looking very closely at what we can do to make sure that the intention of that decision is met.

Leaving the EU: Tobacco Products and Public Health

Desmond Swayne Excerpts

Monday 7th January 2019 Commons Chamber

[Steve Brine]

I will briefly address some of the points that have been raised. The hon. Member for Washington and Sunderland West (Mrs Hodgson) says she hopes that no-deal contingency will not be needed. Fortunately, I have a cunning plan to ensure that it is not needed, which is to vote for the deal next Tuesday. I look forward to her support.

A number of Members talked about e-cigarettes. The best thing a smoker can do for their health—I have always said this—is to quit smoking. E-cigarettes are not harmless: the nicotine is toxic and addictive, and there are unanswered questions on the long-term effects of their use. There is, however, evidence that e-cigarettes are significantly less harmful to health than smoking tobacco. The control plan that I published last year commits to monitoring the safety, uptake, impact and effectiveness of e-cigarettes and novel tobacco products. We will review all the regulations as part of our post-implementation plan by May 2021. A number of Members referred to that, for which I am grateful.

My hon. Friend the Member for Harrow East (Bob Blackman), the hon. Member for Washington and Sunderland West and the hon. Member for Central Ayrshire (Dr Whitford) talked about the rotation of warning images and the deal with the Australian Government. The deal is indeed to use their picture warnings free of charge. That is very kind of our friends down under. The rotation of picture warnings so that people do not become desensitised to them is very important. We are aware of the benefits of rotating the warnings. In the medium to long term we will consider our options, and they may well include the option of developing new domestic picture libraries. My hon. Friend the Member for Harrow East said that there are plenty of images. I am sure we can access them domestically, and I will be looking at that.

My hon. Friend the Member for Harrow East talked about products that have already been notified. A new notification system, which will be in place on exit day in a no-deal scenario, has been developed. If there are novel products, they will be notified through the new system. Products notified between now and exit day will continue to be notified through the EU system. I have to say that I am not aware of any novel products that are due to be notified by the current or new notification processes, but they will be able to deal equally effectively with any novel products that appear on the market.

This is an important statutory instrument. The hon. Member for Central Ayrshire said that we must not in any way water down or lose our ambition on tobacco control. I think she knows me well enough to know that I certainly do not lack ambition in this space. One of the first things I did in this job was to publish the tobacco control plan. Tobacco is still our biggest preventable killer. She is absolutely right to say that, and it is why such a central part of the long-term plan is prevention. One of the simpler things we can do to prevent ill health and the cost it brings to our health service in England, as well as in Scotland, is to stop people smoking.

The hon. Lady asked whether the notification system will be ready. I think I said in my opening remarks that the feedback we have had from the industry is that that will be challenging, but the advice we get from experts is that it will be ready. She also asked about fees being charged on an ongoing basis. I will have to write to her on that point, but I will endeavour to do so this week so that she gets the answers she wants. I have already answered the question about lowering standards, which we most certainly do not want to do.

We are absolutely committed to the tobacco control measures I set out in the plan. I want to ensure that we maintain discipline and our focus on preventing ill health by driving down smoking rates, and we will review all our tobacco control legislation by 2021. Of course, if the House supports the deal next Tuesday, the draft regulations will not be necessary, but in the event that they are, we will be ready.

Question put and agreed to.

[Sir Desmond Swayne (New Forest West) (Con)]

On a point of order, Madam Deputy Speaker. We are about to debate a matter of huge constitutional significance. Hitherto, the sole criterion for voting in Committees of this House has been election. If this measure passes, we will change that to allow people who have not been elected to vote in Committees of this House. That would be a huge change, which we are about to rush through in 40 minutes, without proper scrutiny. The Government have already withdrawn one motion from today’s proceedings. Is there any way that, through your offices, you can ask the Government whether they would be prepared to withdraw this motion so that we can debate it fully and properly at an appropriate time?

[Madam Deputy Speaker (Dame Eleanor Laing)]

I fully understand and have some sympathy with the point the right hon. Gentleman makes. It is indeed the case that we have a very short amount of time for this important debate. Of course, as he knows, I have no power from the Chair to do anything about the timetabling of matters in the Chamber. As I look at the Leader of the House, I see that she has a determination to get on with this debate now. I can well understand that. It is in the power of the Government to change the business, but as the right hon. Gentleman knows, the House is very busy. All I would say is that I hope people will speak succinctly and briefly, and that it is unfortunate that the earlier business took so long, with so many people saying the same thing over and over again but insisting on having their voices heard, which has curtailed the debate on this very important piece of business.

Prevention of Ill Health: Government Vision

Desmond Swayne Excerpts

Monday 5th November 2018 Commons Chamber

[Matt Hancock]

On medicinal cannabis, I announced more research today and there is now a route in England. The hon. Gentleman will of course have to talk to the Scottish health service to ensure that a constituent in Scotland gets access, but I am very happy to look into specific English cases.

On the broader point about alcohol, it is important that we tackle alcohol abuse and it is vital that we do it in the right way. I do not want to punish people who drink responsibly at responsible levels, including myself. I occasionally drink at a responsible level, and I am sure that the hon. Gentleman does—certainly his colleagues enjoy a wee dram. Nevertheless, 5% of people in this country drink 30% of the alcohol. It is the small minority who present significant problems for the NHS and we need significant, targeted action.

[Sir Desmond Swayne (New Forest West) (Con)]

We have cut salt dramatically and the Secretary of State now wants to cut it further; life will certainly seem longer, will it not?

[Matt Hancock]

There are many ways to make one’s food taste good and make it healthy, too.

Hospice Funding and the NHS Pay Award

Desmond Swayne Excerpts

Wednesday 31st October 2018 Westminster Hall

[Liz McInnes]

My hon. Friend makes an important point: hospices seem to be facing a choice of asking the community to give them extra money, or reducing the service they provide.

[Sir Desmond Swayne (New Forest West) (Con)]

Am I incorrect in my understanding that hospices adopting the full Agenda for Change will receive Government assistance? Perhaps the Minister will clarify that. The difficulty for hospices in adopting it is that they lose control of their salary budget. The difficulty is in getting that balance right, and I hope that the Government will be able to help.

[Liz McInnes]

The right hon. Gentleman is absolutely right. I will explore the Agenda for Change later, because adopting it presents huge difficulties for non-NHS organisations.

The three points from the chief executive of Springhill Hospice were tabled as parliamentary questions. Sadly they received identical answers that included:

“We are considering carefully the impact of any agreement on non-NHS organisations such as hospices that may be affected by the proposed pay deal; however no decisions have been made. Staff in hospices do a fantastic job in delivering world-class care and the Department remains fully committed to improving palliative and end of life care.”

In July, I wrote to the Secretary of State for Health and Social Care, asking for an update on the issue. The response stated that he “understood concerns” that

“hospices may find recruitment and retention challenging if some of their staff choose to leave in favour of organisations that employ staff on the Agenda for Change contract”.

In summary, the Government will finance the pay award for non-statutory, non-NHS organisations only for organisations employing staff on the Agenda for Change contract, which is the nationally agreed set of terms and conditions for most NHS staff. The rationale for that was that:

“Additional funding relies on organisations employing staff on the Agenda for Change contract, because it is the Agenda for Change pay and non-pay reforms that together will help deliver the productivity improvements the Chancellor asked for in return for additional pay investment”.

What are the reforms that can only be made under Agenda for Change? On examination, it seems to be an emphasis on training and apprenticeships and a programme of appraisal and personal development. There is also a slightly vague statement on the improvement of the health and wellbeing of NHS staff, to improve levels of attendance, with a reference to

“positive management of sickness absence”,

whatever that may mean.

The response from Springhill Hospice was grim. The chief executive wrote to me:

“Very few charitable hospices employ their staff on Agenda for Change contracts, and as a result, Springhill Hospice, along with many other hospices, will miss out on the funding being set aside by the Government. This will place us at a considerable disadvantage in recruiting and retaining essential staff to deliver the services that we offer to people with life-limiting illness in this community, and will leave us with a significant additional cost.

Recruiting and retaining skilled staff is a critical challenge for us, and in order to remain competitive, we will have little choice but to increase pay for clinical staff. Over the course of the three-year NHS pay deal, we estimate that this will bring an additional cost to the hospice of in excess of £250,000. Without support from the Government, this extra cost can only be met by asking our communities to give more, or by reducing the services that we provide.

We are already asking our community for in excess of £2 million contribution each and every year, and in an area of high deprivation, I can only envisage that any additional ‘ask’ will not be able to be met by our community, so sadly we may have to look at service reduction, which in turn will place additional burden on an already stretched NHS.

NHS staff will start to see the pay increase reflected in their pay packets from this month onwards. Without government support, Springhill Hospice will see a significant additional cost fall to the charity as a consequence.”

--- Later in debate ---

[Liz McInnes]

I thank my hon. Friend: that is exactly the point that I wanted to make. A deal has been done in Plymouth for a social enterprise provider that is not a hospice but a provider of mental health services. Obviously, smaller deals are being done. My hon. Friend the Member for Plymouth, Sutton and Devonport is not able to be with us today, but I was very interested in the evidence that he sent me. The Department of Health and Social Care needs to look at the smaller deals that have been done and ask itself what on earth is going on.

To return to the issue of physiotherapists, they are clinical staff whose role in hospice care is sometimes forgotten. The CSP told me that its members overwhelmingly backed the pay changes when consulted earlier this year. It pointed out to me the importance of the physiotherapist’s role in enabling people with a terminal illness to stay active as long as possible—a really important role—and went on to say that with the current shortage of physiotherapists, it is relatively easy for staff to change roles if they wish to do so, and that employers who cannot broadly match NHS pay rates will find it increasingly difficult to recruit staff.

There is clearly real concern that the NHS pay award will have an unforeseen but damaging impact on charitable hospices and other organisations that are already at a significant disadvantage compared with other non-NHS providers in not receiving reimbursement for the costs of the care that they provide to NHS patients. A sustainable hospice movement is an essential component of delivering the improvements in end of life care that the Government have rightly sought. The Government must look again at the conditions imposed on non-NHS providers and consider how funding may be made available to prevent a diminution of the end of life care service.

[Sir Desmond Swayne]

May I therefore, through the offices of the hon. Lady, put in my bid to the Minister for just such a local agreement for Naomi House and the Oakhaven Hospice in Hampshire?

[Liz McInnes]

I thank the right hon. Gentleman for that intervention, but we want a national agreement rather than a piecemeal set of local agreements. I hope that that will be addressed today.

I shall conclude by quoting NHS Employers:

“Patients are at the heart of everything the NHS does.”

How does that square with the Department of Health and Social Care’s refusal to finance the pay award for hospices, and how is that refusal putting terminally ill patients, at the time when they are most in need of care, at the heart of our NHS?

--- Later in debate ---

[The Minister for Care (Caroline Dinenage)]

As ever, it is a great pleasure to serve under your chairmanship, Mr Davies. I add my voice to those congratulating the hon. Member for Heywood and Middleton (Liz McInnes) on securing a debate on this important matter, and congratulate every Member who has been involved, either through a speech or an intervention. As MPs, we are all aware of the crucial role that hospices play in supporting and caring for our communities at a time of great need. I understand the concerns that have been raised, and have listened carefully to the strong arguments that have been made.

Hospices across England are delivering excellent end of life care and contributing to their local communities, as they have for many years. The Care Quality Commission’s “State of Care” report, published on 10 October, is testament to that. That report showed that hospices have continued to provide high-quality care at the end of people’s lives, even improving on their performance last year, which saw them rated as the highest performing secondary care servicer, with 27% of hospices—more than a quarter—rated as outstanding. I know that Springhill Hospice in the constituency of the hon. Member for Heywood and Middleton was rated as good overall in the CQC’s most recent assessment, but was rated as outstanding in the delivery of care and effective services, and people spoke highly of the kindness and caring attitude of staff. That is why the hon. Lady is right to raise this debate. I add my thanks to all those working and volunteering in the hon. Lady’s hospice, and in hospices up and down the country, for the quality of care that they offer.

We all know that palliative care can take many forms, whether at home, in a hospice, or in a hospital. There is never a more important time to make sure people get the right level of care. My hon. Friend the Member for St Ives (Derek Thomas) spoke about the immeasurable support that was given to his mum by his local hospice, and he rightly mentioned the crucial role of local commissioners in ensuring that hospices can do their amazing work, which I will speak more about in a moment. My mum was responsible for fundraising to build the Naomi House children’s hospice that my right hon. Friend the Member for New Forest West (Sir Desmond Swayne) mentioned earlier.

[Sir Desmond Swayne]

Will the Minister address the question that was raised about local deals, and will she acknowledge the bid that I made?

[Caroline Dinenage]

Sadly, I cannot comment on individual cases. I am not aware of any individual deals being done with the Government, but of course, this could be a local arrangement. For 2019-20 and the remaining two years of the deal, funding will follow the usual route. It goes through CCGs, so I imagine that the instance that the hon. Lady mentioned is due to that, but I am keen to hear more.

--- Later in debate ---

[Caroline Dinenage]

That is a very good point. NHS England will bring forward its report on hospice care very shortly, in November.

I want to talk about staff funding. In common with much of the sector, I know hospices have faced financial challenges. I recognise the concerns of hospices that the recently announced NHS pay rise is putting them under pressure to match the uplift awarded to staff employed on the Agenda for Change contract not only to retain the incredible staff they already have, but to attract the staff they need. We have agreed that for 2018-19, non-NHS organisations that employ existing and new staff on the Agenda for Change contract will be eligible to receive additional funding. Most hospices do not employ their staff on the Agenda for Change contract because of the cost that would entail and so are ineligible.

[Sir Desmond Swayne]

Is it possible for a hospice to employ some staff on those contracts and then achieve the benefit of doing so without handing over its entire employment budget and losing control over it?

[Caroline Dinenage]

That is a very good question, which I will drop my right hon. Friend a note to answer, if he does not mind, as we need to make a few more inquiries about that.

It is important to stress that the Agenda for Change pay deal does not seek to make any distinction between the value we place on staff working in NHS and non-NHS organisations. Staff work incredibly hard to provide services, always putting patients and service users first. Funding is linked to the direct costs of implementing the Agenda for Change pay deal, which includes both pay and non-pay reforms. As the hon. Member for Heywood and Middleton mentioned, it is not just about headline pay. It is right that those organisations that employ existing and new staff on the Agenda for Change contract and must implement the entire pay deal should receive additional funding for 2018-19.

The hon. Lady is right to raise the matter, and I thank her again for doing so. I have listened carefully to the issues that have been raised, and we will look again at all of them and what we can do to better support our hospices to continue doing their vital work.