(9 years, 11 months ago)
Commons ChamberIt takes seven years to train a GP, so the long-term solution is to train an additional 5,000 GPs, which is what the Government have decided to do and have announced. While they come on stream, this additional money will fund up to 20,000 additional posts, a number of which will be in the community.
I congratulate my right hon. Friend on his emphasis on prevention. Has he had a chance to read Public Health England’s report “From evidence into action”? It encourages him to place greater emphasis on risk factors that contribute to an early death, such as tobacco, blood pressure, diet, inactivity and alcohol, rather than the actual conditions that people die from. That would cut demand for services.
That document is very powerful and I have said before that I hope that in our lifetimes this will become a smoke-free country. It is shocking that we still have 85,000 deaths every year linked to smoking. However, we are a free country so this is about supplying the information, incentives and nudges and not about compelling people.
(9 years, 12 months ago)
Commons ChamberWe will not take any lessons from the Labour party about general practice. It is not just the disastrous 2004 GP contract. The president of the Royal College of General Practitioners says that the shadow Health Secretary’s plans
“could destroy everything that is great and that our patients value about general practice and could lead to the demise of family doctoring as we know it.”
13. What steps he is taking to increase patient choice.
This Government are committed to patients having greater choice and control over their health care, and decisions as to which treatments are available on the NHS are taken by GPs on the basis of available scientific evidence.
Does my right hon. Friend have any plans to increase personal health budgets, and will he ensure that there is greater awareness of the health professions that are regulated by the Complementary and Natural Healthcare Council, the Health and Care Professions Council and the Professional Standards Authority, which has recently accredited the Society of Homeopaths and the British Acupuncture Council?
(10 years, 1 month ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I talked about having a more measured debate, but I think I was speaking a trifle too soon, judging by what we have just heard. The right hon. Gentleman obviously was not listening to what I actually said, so let me just repeat to him that the Government warmly welcome this report. I talked about it as a “blueprint” for the future. He did not agree with setting up NHS England, and I do not think he agreed with the appointment of Simon Stevens as the chief executive, but we did that so that we would have a body that would think strategically about the long-term future of the NHS at arm’s length from the Government. That is what it has done, and the report is excellent.
The right hon. Gentleman and I have a sometimes slightly fractious relationship, but I would like to congratulate him this morning on his Houdini-like spin in the way he is approaching this report. He has been constantly telling this House that the NHS is on the point of collapse, but the chief executive of NHS England says that the NHS has been “remarkably successful” in weathering the pressures of recent years. The right hon. Gentleman has told this House constantly that the biggest threat to the NHS is privatisation and competition. This report, a five-year forward view, by bodies at arm’s length from the Government, contains not one mention of competition and privatisation as a threat, yet he says this report endorses Labour’s plans.
The right hon. Gentleman says, as has his leader, that the first thing he would do in government is repeal the Health and Social Care Act 2012 and strip clinical commissioning groups of their powers. He really should read the report carefully on that. He now says he welcomes the report, but it begs him not to carry out further big structural changes; it does not call for the repeal of the 2012 Act, and this is the report which he warmly welcomes today.
Then we need to consider money. The right hon. Gentleman told this House repeatedly that it was irresponsible to increase spending on the NHS, but now we have a report that says that the NHS needs real-terms increases, along the lines that this Government have been delivering in this Parliament. What does he say? He says, “It is great to have our plans endorsed by NHS England.” This report does not endorse Labour’s narrative; it exposes it for the shallow party politicking that we have had from him.
Let me say to the right hon. Gentleman that the really important message of this report is something we can agree on, and he should be talking about that. We both agree about the integration of health and social care, which is now happening. We both agree about improving investment in primary care. We both agree that we need more GPs. We both agree that we need more care closer to home. I think the public would say that we would have a more measured, intelligent and sensible debate—the kind of debate they want to hear—if we started talking about the things we agree on a bit more instead of constantly pretending there are vast disagreements.
My right hon. Friend has welcomed this report, which says, among other things, that there have to be new ways of working and breaking down barriers. The Royal London Hospital for Integrated Medicine—part of the University College London Hospitals NHS Trust—which is about a mile away from here, is Europe’s largest public sector provider of integrated medicine. Will he go there and see its 13 care pathways, which use qualified complementary and mainstream practitioners, because then it will be clear to him how we can reduce costs in the health service and take the pressure off practitioners? Will he make that part of his package?
I congratulate my hon. Friend on finding every opportunity to promote integrated care. What the report says is that we need much more person-centred care. It welcomes the kind of models that we see in Tower Hamlets, where the new clinical commissioning groups, led by inspiring leaders such as Sam Everington, are carrying out social prescribing. GPs are actually prescribing social solutions to problems as well as medical ones. This report is a big stepping stone towards that type of integrated care.
(10 years, 5 months ago)
Commons ChamberAs the hon. Lady knows, local service changes are the responsibility of the local NHS, but when they get referred to me, through local authorities, I will never take a decision that is against the interests of patients, including her constituents. Were such a proposal to come to me, I would indeed listen to any representations that she makes.
Does my right hon. Friend agree that a critical problem that A and E units will face in the future is antibiotic resistance? Is he aware that the Science and Technology Committee, of which I am a member, has been looking at this issue, and it also interests the Health Committee, of which I am also a member? Can he assure me that he is talking to the Prime Minister about how to stimulate new antibiotic research, and will he also remember that nature has its own remedies, such as tea tree oil?
My hon. Friend is right about the seriousness of the issue of antimicrobial resistance. Some 25,000 people die in Europe every year as a result of the failure of antibiotics—more than die in road traffic accidents. I raised the issue at the World Health Assembly and I have discussed it closely with the Prime Minister.
(10 years, 7 months ago)
Commons ChamberIn his travels to the People’s Republic of China, what has my right hon. Friend the Secretary of State learned about the integration of western medicine with traditional Chinese medicine?
What I have learned is that the most important thing is to follow the scientific evidence. Where there is good evidence for the impact of Chinese medicine, we should look at that, but where there is not, we should not spend NHS money on it.
(11 years ago)
Commons ChamberWe want to ensure that no hospitals are penalised and that we end up with a solution for the whole local health economy that is sustainable for the long term. The comfort that I think the hon. Gentleman can draw from today’s announcement is that, as a result of the openness and transparency and the rigorous independent inspections that will be happening at all the hospitals his constituents use, poor care, where it exists, will come to the surface and be dealt with much more quickly.
The improved transparency and increased accountability will do much to right the wrongs of the past. When will the health care certificates for nursing assistants be introduced, and has my right hon. Friend considered giving hospital managers discretion to appoint individual nurses to the under-75s?
We are looking at improving care for people in all age groups, but we started the focus on the over-75s because they are the most vulnerable older people. Implementation of the care certificate is a very big change that will apply to several hundred thousand people, so it will not be an immediate process, but we want to get on with it. I think that it will give them a big boost and more professional confidence. We also want to improve the pathway into nursing, which is why we will be encouraging use of the phrase “nursing assistants”, rather than “health care assistants.”
(11 years ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Mr Speaker, I will tell the right hon. Gentleman what complacency is: it is refusing to have a public inquiry into Mid Staffs, where staff in A and E departments were bullied and harassed when they tried to speak out. He did not think it was worth having a public inquiry into the poor care that his Government swept under the carpet and which we are doing something about. There is one figure that he refused to mention: the A and E performance figures published last week of 96.4%—hitting the target, higher than the previous week, higher than this time last year. That sums it up: in a good week he wants to run down the performance of hard-working staff whereas this Government are backing them.
Why are we having an A and E review? It is to clear up the mess and confusion caused by 13 years of Labour mismanagement of our emergency services. The right hon. Gentleman talks about walk-in centres. Why were they introduced? Because of the disastrous mistake over the GP contract. The brave thing for his Government to have done would have been to admit they got that wrong and reverse it, but they did not. They introduced a whole new raft of services, which confused the public: A and E, walk-in centres, GP surgeries, telephone helplines. Tomorrow we will sort out those problems. Yes there are difficult decisions, but they are decisions his Government ducked and left the public exposed as a result.
Before the right hon. Gentleman runs down our A and E services, let me just gently remind him that he talked about a recruitment crisis, but we have 300 more A and E consultants than when he was Health Secretary, we have nearly 2,000 more people—[Interruption.] I am sorry that this is difficult for those on the Opposition Front Bench to listen to. We have nearly 2,000 more people being seen within four hours every single day than when the right hon. Gentleman was Health Secretary —that is some 700,000 more people every year. We have more hospital doctors, more hospital nurses, more treatments and fewer long waits than when he was Health Secretary, and he should celebrate that improvement in our NHS’s performance, instead of trying to run down the people on the front line.
I will tell the right hon. Gentleman something else we are doing. We are tackling the long-term causes of pressure in A and E that his Government absolutely failed to do: not just the GP contract but also the integration of the health and social care system, the lack of which means that hospitals are not able to discharge people from their beds on time, causing huge pressure. Today, the shadow Health Secretary has shown his true colours. The man whose Government made so many wrong decisions about A and E is exposed as trying to make political capital while this Government sort out his mess.
How many extra lives does my right hon. Friend expect to save through consolidating the A and E facilities in London, by having a smaller number of hospitals with more doctors? Does he expect to replicate that across England?
My hon. Friend is absolutely right. The changes we announced in north-west London will save hundreds of lives, by using principles that we will hear more of from Sir Bruce tomorrow. In particular, we are putting 800 extra people into out-of-hospital care, which will help the frail elderly, many of whom should never go to A and E—it is the most confusing place that someone with advanced dementia can go. If we can treat them at home, it is better for them and for our hard-working A and E departments.
(11 years, 4 months ago)
Commons ChamberWe welcome and accept the Francis report’s recommendations on safe staffing and we recognise that that involves having doctors. We recognise and are pleased that our protection of the NHS budget means that there are 6,000 more doctors than when the hon. Gentleman’s Government were in power. If he looks at what is happening in his own Wales, he might find that there are a few lessons that the NHS in Wales could learn.
Sadly, the problems at George Eliot hospital go back well over a decade, so these special measures will be very welcome, but is not one of my right hon. Friend’s fundamental problems dealing with a culture of secrecy, where in the past a board with a problem would talk to a strategic health authority board and nobody would know what was going on? Is not sunlight the best disinfectant?
It is, absolutely. That is the big change. My hon. Friend speaks wisely. That is the big change that we have to make in our NHS. When there is failure, we must be open about it. It has to be public—we have to keep the public in the picture, because that is the best way of putting pressure on the system and on the politicians to make sure that they sort it out. That is not what happened before; it is going to happen now.
(11 years, 5 months ago)
Commons ChamberThe answer is this needs to be a mix of both; this needs to be about clinical excellence and issues such as accessibility and travel. A wide range of factors are involved. I accept, and this is widely accepted, that it is particularly difficult with specialist services to interpret mortality rates in a meaningful way, but that does not mean we should not look at them and seek to learn what we can.
My right hon. Friend’s statement will have given great hope to all those in and around Leicestershire who campaigned to keep Glenfield hospital, and we welcome the acceptance that the original site selection was flawed and the implicit acceptance of bias against the east midlands and against the east of the country in general. On a positive note, if we are going to have the clinical case for change accepted and consolidation in the future, what is his understanding of the number of lives that would be saved if we have to go through this painful process?
I do not want to pluck a number out of the air; I want to listen to the clinical evidence on that. However, it is important to say that as a result of the excess mortality identified at Bristol the Kennedy report said that up to 170 lives could have been saved over a 10-year period in just one location. That is why it is so important that we get this decision right.
(11 years, 6 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I have not seen any plans for the closure of St Helier. I know that NHS London is looking at possibilities to improve services in those areas, but, as the hon. Lady will know and should take comfort from, if a major reconfiguration is proposed and then referred to the Secretary of State by the local overview and scrutiny committee, I will not approve the change unless I am convinced that it will improve patient care.
Does my right hon. Friend agree that we could make better use of the ambulance service and that if we had more fully trained ambulance men who could assess whether a patient needed to go to hospital, we could reduce A and E admissions that way?
My hon. Friend rightly draws attention to the importance of the ambulance service, which is also feeling the pressure on A and E departments. We need to help the ambulance service to do its job better too. One thing that it always strikes me would make a huge difference to ambulance services is if staff could access the GP records of someone they were picking up on a 999 call, so that they would know that the patient was a diabetic with mild dementia and a heart condition, for instance. That kind of information can be incredibly helpful. I hope that by sorting out the IT issues with which the last Government struggled, we can help ambulance services to do that.
(11 years, 6 months ago)
Commons ChamberIn challenging circumstances, the NHS is performing extremely well. Front-line staff are making heroic efforts to control costs as they cope with the pressures of an ageing population and when 1 million more people are using A and E every year than at the time of the last election.
The Opposition run down NHS performance, but the reality is a service delivering more than it ever did on their watch: 400,000 more operations every year than under Labour; the number of people waiting more than a year for an operation down from over 18,000 in May 2010, to just 665 at the end of February; MRSA infections halved; mixed-sex accommodation nearly abolished; dementia diagnosis rates going up; and more than 28,000 people receiving life-saving drugs from the cancer drugs fund that Labour refused to set up. As we debate health, care and support today, I take the opportunity to commend and thank all the dedicated professionals who work extraordinary hours, day in, day out, for their part in making this happen.
If we are to prepare for the future, however, we need to do more. In our generation, the number of over-85s will double, the number of people with dementia will pass the 1 million mark, and 3 million people will have not one, not two, but three chronic conditions to cope with, on top of the other pressures of old age. We must be there for each and every one of them—the founding values of the NHS would accept nothing less—and to do so we must be able to answer three big questions: how can we be certain that people receive compassionate care even when they are not able to speak for themselves; how can we deliver joined-up care to people who use the NHS and social care system on a regular basis; and how can we ensure that sustainable funding is in place for care and support?
The Secretary of State will be aware of widespread concern among the herbal medical community that there is no statutory regulation on that area in the Care Bill. Does he agree that if polymorbidity is to be dealt with we must have firm regulation, and that just licensing herbs, as the European Union wants, would destroy the industry?
My hon. Friend follows such matters extremely closely and I reassure him that the Government will update the House on that issue very soon.
The Care Bill will take a critical step forward in addressing each of the big questions that I raised, so let us consider how. First is compassionate care. Labour’s target culture led to warped priorities in our NHS and appalling human tragedy. No one disputes the value of targets, and the four-hour target played an important role in improving A and E departments. We do not, however, need targets at any cost, as we saw at Stoke Mandeville, Maidstone and Mid Staffs.
(12 years ago)
Commons ChamberWe will publish a sexual health strategy at the end of this year that will look at variation in services across the country and at the kind of problems the hon. Lady raises. It will be led by the public health Minister, my hon. Friend the Member for Broxtowe (Anna Soubry), who will be happy to meet the hon. Lady to discuss the issue further.
My right hon. Friend’s statement will be widely welcomed, especially his emphasis on an integrated system based on the needs of people. Does he not agree, however, that there is far too little use of complementary medicine outside private health care, and that greater use of herbal medicine, acupuncture and the much under-utilised resource in this country of homeopathic medicine, homeopathic doctors and the Society of Homeopaths, would be a good thing? Seventy per cent. of pregnant women in France use homeopathic medicine.
There are parts of the country where acupuncture is available on the NHS. This will be clinically led. It needs to be driven by the science, but where there is evidence, and where local doctors think that it would be the best clinical outcome for their patients, that is what they are able to do.
(12 years, 1 month ago)
Commons ChamberWe have a clearly set out programme for all those trusts, to make sure that they get back to the proper financial controls and proper governance structures that they need. We do not want to get into the business of bailing them out; we want them to stand on their own two feet. That is the vision of the Health and Social Care (Community Health and Standards) Act 2003, passed by the hon. Gentleman’s party when it was in government.
Will my right hon. Friend extend the scope of personal budgets? They help not only patients, giving them wider choice, but carers, allowing them to leave their post.