Oral Answers to Questions

John Howell Excerpts

Tuesday 21st March 2017 Commons Chamber

[Mr Hunt]

I agree with the hon. Lady and she makes her case very powerfully. We need to make progress and we need to make it fast, particularly for young people, as their recovery can be very closely linked with the potential of their parents to come to visit them. Nearby places such as the Sheffield Health and Social Care Foundation Trust, which do not serve her constituents, have eliminated out-of-area placements and saved £2 million in the process. It is about spreading that best practice.

[John Howell (Henley) (Con)]

16. Schools are often the first point of contact for young people with mental health problems. Does the Secretary of State share my view that we must ensure that school-age children have access to mental health services wherever they are?

[Mr Hunt]

My hon. Friend speaks very wisely on this matter. In the end, schools are a vital place in which to spot mental health conditions early. We know that around half of mental health conditions become established before the age of 14, and this will be a big part of the Green Paper that we publish later this year.

O’Neill Review

John Howell Excerpts

Tuesday 7th March 2017 Westminster Hall

[Kevin Hollinrake (Thirsk and Malton) (Con)]

I beg to move,

That this House has considered the O’Neill review into antibiotic resistance.

It is a pleasure to serve under your chairmanship, Mr Streeter. In advance of this debate, I penned an article for PoliticsHome titled, “Antibiotic resistance—the new Black Death?” As I was writing that headline, I could sense outraged people saying, “A typical politician grabbing a sensational headline to terrify the public once again,” but it reflects the devastating conclusions of the review on antimicrobial resistance, which involved some of the world’s leading scientists, academics and economists, including its chair, Lord O’Neill, the world-leading economist and former Treasury Minister.

The O’Neill review’s report states that bacteria are gradually becoming more resistant to antibiotics, and its most grim prediction is that 10 million lives will be lost globally every year by 2050. That is more than are lost to cancer and similar to the number of deaths caused in the 14th century by the black death, which killed some 75 million people between 1346 and 1353.

[John Howell (Henley) (Con)]

My hon. Friend cites 10 million deaths, but the effect will not be the same everywhere. Was he as shocked as I was to discover that the figure for Africa is more than 4 million? Does he think that more research should be done to ensure that the right resources are in the right places?

[Kevin Hollinrake]

My hon. Friend makes an excellent point. The key element of the fight against antimicrobial resistance is its global nature. We absolutely must not isolate ourselves from the rest of the world—we must collaborate—but we must take national action, too, and I will come on to that shortly.

That figure is of course a prediction—it could be lower, but it could also be higher. Predictions have been made about other contagions, such Ebola, Zika, HIV and Creutzfeldt-Jakob disease, and our scientists, academics and clinicians thankfully have managed to mitigate the worst effects and worst predictions for those diseases. But there are three reasons for us to be more alarmed this time: first, antimicrobial resistance is already happening; secondly, the problem is spreading rapidly and by all available means; and thirdly, research is not being carried out on anything like the scale required.

Oral Answers to Questions

John Howell Excerpts

Tuesday 7th February 2017 Commons Chamber

[David Mowat]

The answer I gave a moment ago was the results of the GP patient survey. The Government and I accept that the country needs more GPs. GPs are the fulcrum of the NHS, and we have plans for a further 5,000 doctors working in primary care by 2020. We intend to add pharmacists, clinical pharmacists and mental health therapists as part of the solution.

[John Howell (Henley) (Con)]

14. It is not just the need for GPs that is relevant. Surely there is a requirement for GPs to work at weekends, and that should be included in the assessment of demand for their services. GPs should also work with better technologies and work together as groups.

[David Mowat]

The Government are committed to GPs offering appointments seven days a week, 8 am until 8 pm, by 2020. By 2018, we will have rolled that out in London. Part of this is about GPs working smarter in integrated hubs of between 30,000 and 40,000 patients, thus enabling them to spread out and to offer services such as pharmacy, physio and social care.

Mental Health and NHS Performance

John Howell Excerpts

Monday 9th January 2017 Commons Chamber

[Mr Hunt]

First, I would like to thank the staff at Imperial, who, alongside other NHS staff, have done a fantastic job over a very difficult period. I would say to the hon. Lady that 50% of councils have no delayed discharges of care. It is a problem in many hospitals, but there are many areas that are managing to deal with it. I suggest that the local authorities that serve her constituency should look at the other parts of the country that are dealing with this problem.

[John Howell (Henley) (Con)]

I welcome the provision of mental health facilities and services for schools, but will my right hon. Friend ensure that the type of first aid that he is proposing will also be made available to MPs and their staff, given the number of people with mental health problems that we deal with during our surgeries?

[Mr Hunt]

That is an absolutely excellent suggestion, and I will be very happy to take it up.

National Health Service Funding

John Howell Excerpts

Tuesday 22nd November 2016 Commons Chamber

[John Howell (Henley) (Con)]

My starting point is that funding in the NHS must be used effectively and efficiently. To that end, we expect the NHS to deliver savings and best value for money.

There are a number of issues relating to social care in the NHS where there is considerable scope for solving existing problems, for ensuring that better health care is delivered and for achieving sustainability, and there is no better place to start the discussion of those issues than bed-blocking.

Oxfordshire’s historical performance on bed-blocking is poor. It came 151st in terms of headcount last November, with 158 people. Bed-blocking decreases the availability of beds and has adverse effects on patients, particularly when they are elderly—for example, incontinence in the over-65s increases, and muscle wasting in the over-80s after 10 days of hospitalisation is equivalent to 10 years of muscle wasting otherwise.

By September, the headcount had fallen to 113 people, improving the county’s performance to 108th—a massive improvement of 50 places over that period. That was achieved through a joint initiative by the clinical commissioning group, Oxford University Hospitals, Oxford Health NHS Foundation Trust and the county council, all working to move people out of hospital when they have been appropriately treated.

However, that improvement was also achieved by putting £2 million into funding extra temporary care beds in care homes, where people can stay until they are ready to return to their own homes, move to a permanent care home or receive care in their own homes. That joint and positive thinking is something I would encourage as we integrate social care and the NHS.

[Craig Whittaker]

Does my hon. Friend agree that one lever for discouraging bed-blocking would be to join up some of the budgets around health and social care?

[John Howell]

I do, and that is precisely what the organisations in Oxfordshire have been trying to achieve.

The second point I would make relates to how we produce better-serving hospitals. In my own area, the Townlands Memorial Hospital, which is in Henley but which serves the whole of south Oxfordshire, has recently gone through a major reprovision. It now has an increased number of facilities serving the population of the area, but the beds are not in the hospital. Although limited in number, they are in an adjoining care home, whose opening I happened to attend with the Duke of Gloucester only the other day. It is good to see the issues at the hospital finally resolved.

That is the way forward for local hospitals: better treatment for people in their home through a system of what has come to be called ambulatory care. Such a system prevents the problems I mentioned, with patients suffering when they stay in hospital for a long time. This view comes not from politicians but from clinicians both local and national. The national clinicians I would point to are those in the Royal College of Physicians, who are fully behind this process. This method costs more in the first instance but provides better value for money and increases better patient outcomes.

The third area I want to discuss is what can happen when we integrate the staff providing care who are employed by the county council and those who are employed by the NHS. This allows us to ensure that the pay and service requirements of both groups of people, who are doing exactly the same job, can be harmonised in a much more positive way. That sets out a good scope for efficiency in the operation of social care within the NHS model. I agree with my hon. Friend the Member for Calder Valley (Craig Whittaker), in that I would like to see them fully integrated, but until then I have set out a very good method of being able to operate in those circumstances and to co-operate in order to achieve the outcomes that I have mentioned.

Sustainability and transformation plans focus on organisations working together and are the best hope of improving health and social care services in the long term. That is not my view but that expressed by the King’s Fund when it looked at the plans. I fully agree with its assessment of the situation and of these plans, which are working towards achieving the same outcomes.

NHS Funding

John Howell Excerpts

Monday 31st October 2016 Commons Chamber

[Mr Hunt]

It is a vitally important investment. The first speech that I made as Health Secretary after the last election was made to GPs, and I said then that we wanted to deliver an extra 5,000 doctors working in general practice. It is vital that we eliminate hospital deficits, but we are making good progress in doing so.

[John Howell (Henley) (Con)]

Does my right hon. Friend agree that, when it comes to funding the forward view, the treatment of patients in their homes is not principally about cost-cutting but is part of a radical change in health provision for the future on which clinicians agree?

[Mr Hunt]

Absolutely. The simple principle for those of us who are not doctors is that it is much cheaper to nip illnesses in the bud than to wait until they progress. Treating someone at stage 1 or 2 of cancer is not only cheaper for the NHS, but much more likely to lead to a full cure. That is the whole foundation of the strategic change that we are making in the NHS.

Oral Answers to Questions

John Howell Excerpts

Tuesday 5th July 2016 Commons Chamber

[Mr Hunt]

First, I welcome the hon. Lady to her position. She is the third shadow Health Secretary I have faced in less than a year, and I am beginning to worry that it may be something personal. I wish her well; she knows the brief extremely well and has campaigned on it a great deal in her long parliamentary career. I will look into the case she brought up. I would not want anyone to be deprived of vital lifesaving drugs because of exchange rate fluctuations. The whole British economy, including the NHS, will have to deal with the economic shock that we may now face as a result of the Brexit vote. But now that the decision has been taken by the British people we must look for the opportunities for the UK and the NHS, and not simply worry about the uncertainties, although there will be lots of things we have to deal with.

[John Howell (Henley) (Con)]

4. What plans his Department has to increase capacity in general practice and primary care.

--- Later in debate ---

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

We will be investing an extra £2.4 billion a year in general practice by 2020-21, a 14% increase in real terms. The General Practice Forward View, published earlier this year, sets out a package of support for general practice to boost the workforce, drive efficiencies in workload and modernise primary care infrastructure and technology.

[John Howell]

General practitioners in Henley have recently written a letter to all their patients pointing out the difficulties they face in fulfilling their workload. Will the Secretary of State explain what the Government are doing about that and how what they are doing will help?

[Mr Hunt]

I am happy to do so. I recognise the picture that my hon. Friend paints—not just in Henley but across the country—of a huge increase in GPs’ workload, which they are finding extremely challenging. What have we done? We have almost 1,300 more GPs working and training in the NHS compared with 2010. We have said that by the end of this Parliament we will seek to make available an additional 10,000 primary and community care staff, including 5,000 doctors working in general practice and 1,000 physician associates. We recognise the problem and are doing something about it.

Alcohol Consumption Guidelines

John Howell Excerpts

Tuesday 28th June 2016 Westminster Hall

[Byron Davies (Gower) (Con)]

I beg to move,

That this House has considered guidelines on alcohol consumption.

It is a pleasure to serve under your chairmanship, Sir Alan. I am delighted to have secured this topical and timely debate following the conclusion of the public consultation on the proposed new guidelines on alcohol consumption. Given the scale of public interest and levels of public and industry concern about this important issue, I am pleased to see so many colleagues here this afternoon from across the House to support the debate.

I want to be clear from the outset. I recognise the necessity for sensible and effective guidelines to help consumers—our constituents—to make better informed decisions about the amount of alcohol they consume. Ministers were right to ask the chief medical officer to carry out a review of the guidelines, and it is important that the guidance reflects the most up-to-date scientific evidence that is available across the world and that that is properly communicated to consumers.

I declare an interest as a member of the all-party beer group—unashamedly, given that 30 million adults across the UK drink beer each year and 15 million of us visit the pub each week. But I also know that this issue is a matter of concern for anyone who enjoys a drink and wants to drink responsibly.

We have made great strides in this country in promoting responsible enjoyment of alcohol through a partnership approach with industry. That achieves much more than a draconian approach to taxation or heavy-handed regulation. As a Conservative, I want to treat adults as adults and let them have the freedom to make informed choices about how they live, what they eat and drink and how they enjoy their lives. As a responsible Conservative, I also know that industry has a role to play in promoting responsibility through advertising campaigns, voluntary labelling initiatives and provision of consumer information. We have achieved a great deal, successfully reducing alcohol harm for more than 15 years.

The Office for National Statistics confirms that binge drinking has fallen by 25% since 2007. According to Public Health England, alcohol-related and alcohol-specific deaths have fallen since 2008 by 7% and 4% respectively. The Office for National Statistics confirms that alcohol-related violent crime has fallen by 40% since 2007. The number of children drinking alcohol has fallen by more than 50% since 2003 and is currently at the lowest rate on record. According to Public Health England, under-18 hospital admissions due to alcohol have fallen by 41% in the past six years.

[John Howell (Henley) (Con)]

The statistics that my hon. Friend has produced are absolutely fascinating. Of course, in the popular press, the one place that is singled out for its continuation of the old culture of drinking is the Palace of Westminster. Does he have a view on what role we should play in setting an example and does he agree that over the past few years the Houses of Parliament have been behaving absolutely immaculately?

[Byron Davies]

I thank my hon. Friend for that intervention. I can only quote my own example, which is one of extreme caution with alcohol, but it has been thoroughly enjoyable at times in the 12 months since I have been here. Of course, we should not be complacent.

Stillbirth

John Howell Excerpts

Thursday 9th June 2016 Westminster Hall

[John Howell (Henley) (Con)]

I congratulate the hon. Member for North Ayrshire and Arran (Patricia Gibson) on securing the debate. She has spoken with great passion from a personal perspective. We have all been moved by what she has said. It was very powerful.

I want to make a short contribution on behalf of a constituent and a member of my family. My constituent wrote to me to tell me about how she lost her first child to stillbirth:

“This life altering event has led to us being placed into a world we never knew existed. Sadly, the baby loss taboo leaves many unsupported and prevention affected.”

She has been trying to get information from her clinical commissioning group on what is happening to ensure that such things do not happen again and that more women can be protected. What she has got back from the CCG so far has been a general statement of Government policy, which includes the four principal activities that CCGs are asked to concentrate on: reducing smoking in pregnancy; monitoring foetal growth; raising awareness of foetal movements; and improving foetal monitoring.

That is all very well—I put great emphasis on the improvement of foetal monitoring, so that the information is provided and is fed back to the individual concerned—but my constituent also wants detailed information about what the CCG is doing to ensure that the issue is addressed. The CCG operates across two obstetric units and four midwife-led units and has a small number of babies delivered at home each year. She has not been able to get detail about what that CCG will do to address the situation for the future. I hope we can send a strong message to CCGs around the country that concentrating merely on the Government’s four key objectives is not good enough. What we need is the detailed information on how they are going to go about dealing with this issue through their sustainability and transformation plans to provide reassurance for women who are in this situation.

I appreciate the effect that stillbirth has on women, but it is not exclusively a woman’s problem. The fact that stillbirth occurs is a problem that affects the whole family, and it affects men as well. I know that, to my own cost, through a family incident. It is essential to bear in mind the impact on the mental health of men who are involved in cases of stillbirth and simply do not know where to turn in what is a completely traumatic experience. I urge the Minister to concentrate on providing information about what the Government are doing for the whole family and for the wider community.

My next point is that essentially we are talking about an artificial distinction here. We are talking about the distinction between miscarriage and stillbirth and about a particular period, which comes at around 24 weeks. That is totally unfair. Before the 24 weeks, parents are given no chance to grieve for the baby who has been lost, or to go through the process of putting their lives back together again. We ought to look at that to see whether that distinction is still relevant.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

Does the hon. Gentleman agree that counselling should be available for the whole family on request? We should be seeking to take that forward across the whole UK.

[John Howell]

The hon. Lady is absolutely right. Counselling needs to be provided for the whole family unit to see them through a very traumatic experience.

[Ms Tasmina Ahmed-Sheikh (Ochil and South Perthshire) (SNP)]

I pay tribute to my hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) for introducing the debate and to the hon. Gentleman for his point about the effect that stillbirth has on the family. To add to that—I know I am not alone; there are women with whom I am sitting here who have suffered miscarriages, too—after you have suffered a miscarriage or a stillbirth, it is extremely difficult to enjoy any subsequent pregnancy. Every minute of every day is spent wondering whether you are going to lose the next child too. It is worth while bringing that point to bear in this debate to ensure that support is available for women after their loss.

[John Howell]

The hon. Lady makes a valid point. It is not just about the individual stillbirth, traumatic though that is; it is about the future and ensuring that individuals can go through another pregnancy in the full knowledge that they are more likely to be safe than not. Anything that we can do to help that, we should. We should take any opportunity to take things forward. That is all I wanted to contribute to the debate, and I am grateful to have had the chance to speak.

Southern Health NHS Foundation Trust

John Howell Excerpts

Wednesday 8th June 2016 Westminster Hall

[Suella Fernandes]

I am grateful for my right hon. Friend’s point and I thank her for her work and for standing up for her constituents who have been affected by the issue. We have met with members of the CQC and with NHS Improvement, and we put those points to them directly. I share her concern, particularly on behalf of families and relatives, who would like swifter action in future. However, I am grateful to those organisations for keeping us informed and for taking the time to ensure that MPs are briefed of their actions and plans.

The facts of the issue are well known to many of those here today and to those watching beyond Westminster. However, in opening the debate, it is important for me to recount the broad sequence of events and key facts to help those who may not be familiar with them and because they deserve to be put on the record as the backdrop to the rest of the debate. Let us begin at the beginning.

The tragic starting point of the story was the death of Connor Sparrowhawk. Connor, who had autism, a learning disability and epilepsy, was 18 when he was admitted to Slade House in Oxford in March 2013. The facility was a learning disability short-term assessment and treatment unit run by Southern Health, which had taken it over from the previous provider, Ridgeway, in November the previous year.

On 4 July 2013, Connor was found submerged and unconscious in a bath at the centre. Staff tried to resuscitate him and an ambulance took him to John Radcliffe hospital but, sadly, he died the same day. The initial post mortem examination concluded that Connor drowned as the result of an epileptic seizure. Southern Health carried out a serious incident requiring investigation report and an initial management assessment, and commissioned an independent consultancy to undertake an internal investigation. That investigation concluded that Connor’s death was preventable and stated:

“The failure of staff at the unit to respond to and appropriately profile and risk assess CS’ epilepsy led to a series of poor decisions around his care…The level of observations in place at bath time was unsafe and failed to safeguard CS.”

Following the publication of that first investigation report in February 2014, Oxfordshire Safeguarding Adults Board and NHS England had ongoing concerns about the quality and safety of learning disability services provided by Southern Health in Oxfordshire, and the improvements that needed to be made. They therefore commissioned a further report in June 2014, which was charged with looking at whether the way in which learning disability services were commissioned or managed contributed to Connor’s preventable death.

The new report was published in October last year and contained a number of criticisms. It stated that there had been warnings about the standard of care in facilities including Slade House, and criticised the management processes following the transfer of services to Southern Health. It found that

“for Southern Health to only rely on its normal reporting mechanisms without addressing the…warning and ensuring that information from local managers was accurate was a serious failure.”

It also found that

“the trust did not evaluate or address the known concerns about the quality of local leadership”,

and that:

“An over reliance on a ‘business as usual’ approach to this acquisition was not appropriate.”

The report concluded:

“Southern Health should have ensured that any deterioration in the quality of services could be identified quickly and by processes that Southern Health had confidence in.”

That was the first serious criticism of the overall management of the services.

[John Howell (Henley) (Con)]

My hon. Friend described a catalogue of disasters. From the conversations she has had, what confidence does she have that the situation has been put right? I represent an Oxfordshire constituency. Can we have confidence in doing business with Southern Health?

[Suella Fernandes]

From speaking to families, relatives and patients, it is clear that they are struggling to have confidence in the services provided by Southern Health. The very reason that the debate it happening is so that we can air those concerns and, hopefully, find a pathway to restoring public trust. That is clearly the challenge facing the organisation.