Health Service Medical Supplies (Costs) Bill (Third sitting)

Julie Cooper Excerpts

Committee Debate: 3rd sitting: House of Commons
Tuesday 15th November 2016 Public Bill Committees

[Mr Dunne]

Rare praise indeed from the hon. Gentleman. That is definitely going to go down in the annals of the Wolverhampton Echo, which I am sure will attribute an appropriate front page to that praise for the Government from the Member of Parliament.

To revert to where I had got to, I am sure hon. Members appreciate that there is clearly a limit to the level of detail we are able to publish, and I am sure that hon. Members appreciate that. Any information that we publish will be at a consolidated level, protecting suppliers’ confidentiality, which I have touched on several times, but will allow the Secretary of State to be clear on the basis of the conclusions to his review. We will, of course, be able to use supporting information to evidence our conclusions.

Turning for a moment to the detail of the proposed new clause, while the requirements set out in it reflect the duties placed on the Secretary of State in the Bill, I must be clear that the content of such a report should not be restricted. It must be able to address key issues arising during the course of the year, in the case of the annual report, and during the seven-year duration of the information regulations, in the event that such implications might have an impact on the operation of the schemes. Flexibility is at the heart of our proposals to address the issue through regulations. It would not be appropriate for such a report to address matters relating to the NHS duty to promote innovation. That is the one point of more substantive difference that we have with the drafting proposed by the hon. Member for Ellesmere Port and Neston.

We have already discussed the Government’s position on innovation. We are very clear that we are for it, as is the hon. Gentleman. However, we do not think it is appropriate to link measures in the Bill to that issue, which is a wholly different and much more wide-ranging issue than the narrower one of pricing and the cost of the medicines and medical supplies.

[Julie Cooper (Burnley) (Lab)]

Does the Minister agree that there is a direct connection between control of the price of medicines and innovation, and that, if we do not achieve the correct balance, pharmaceutical companies will lack the motivation to invest in the extensive research and development that we all want to see?

[Mr Dunne]

I do not actually agree that there is a direct link. There is no question but that, in order to stimulate continued investment in R and D, it is appropriate for the industry to see a stable marketplace in a country as significant and important as the UK, and throughout the nations of the UK, for medicines and medical supplies. We are a large market. We spend more than £15 billion a year on pharmaceutical products, and we are also acknowledged by those companies to be a reference market for many other countries that do not have such a large or well-organised supply chain as we do. I accept that, in principle, it might be rather different if this were an emergent market.

Individual drugs are emerging through R and D programmes, but I do not think that is the same as the measures we are introducing, which are primarily designed to limit excessive abuses of pricing position, in which a company may be a monopoly supplier, in the case of the unbranded generics. For the branded products, we have a long-established procedure for recognising the recovery of R and D costs through the pricing mechanisms, and while we may not like paying for some of those branded products at the rate that we have to, we recognise that it is a competitive marketplace and, because of the cost of innovation—the cost of conducting clinical trials and so on—it is necessary to stimulate that innovation to ensure that those companies make a reasonable profit.

Promoting innovation is a high priority, not only for the Government and the NHS but for many other stakeholders in the industry. In our view, it would not be possible to quantify the contribution of the schemes in the Bill to that endeavour, for the reasons I have discussed. Trying to assess the impact on innovation is a much wider endeavour that does not just rely on price. For those reasons, I urge members of the Committee to reject the new clause.

Community Pharmacies

Julie Cooper Excerpts

Wednesday 2nd November 2016 Commons Chamber

[Julie Cooper (Burnley) (Lab)]

It is my pleasure to respond to this interesting debate. I was not feeling very well today so on my way here I called at my community pharmacy, and I am feeling much better now. This is a very important subject. I wish first to pay tribute to my hon. Friend the Member for Barnsley East (Michael Dugher) for his sterling work in standing up for community pharmacy, and to the chair of the all-party parliamentary group on pharmacy, my right hon. Friend the Member for Rother Valley (Kevin Barron), for ensuring that the contribution of pharmacy is always recognised.

I have to say that this subject is very dear to my heart. I worked with my husband, who is a pharmacist in community pharmacy, for 24 years. I must make it clear that I no longer own a community pharmacy, but I do have a clear understanding of the contribution that community pharmacies make to patients, communities and the wider NHS. Many members have spoken powerfully today about the pharmacies in their constituencies and how much they mean to the people they serve. We have heard from my hon. Friends the Members for Hyndburn (Graham Jones), for Bolton South East (Yasmin Qureshi), for Bristol South (Karin Smyth), for Stoke-on-Trent Central (Tristram Hunt), for Oldham West and Royton (Jim McMahon), for St Helens North (Conor McGinn), for Wirral West (Margaret Greenwood), for Sedgefield (Phil Wilson), for Bradford West (Naz Shah) and for City of Durham (Dr Blackman-Woods).

Make no mistake, community pharmacy is for many the gateway to the NHS, providing far more than prescriptions and paracetamol. As my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger) pointed out, it is a lifeline for many people. The Minister spoke last week about the need to move to a focus on quality and not just on the volume of scripts dispensed. He also spoke of the desirability of community pharmacies becoming an integrated part of the primary care team. I say to him that that has been happening for years. The fact that he does not know this is in itself proof that he needs to take his plans back to the drawing board.

The typical community pharmacy, whether it serves a rural or an urban population, provides a wide range of services to support the sick, the elderly and the disabled, together with a host of initiatives to promote health and wellbeing in the community. Community pharmacies have close working relationships with other members of the primary care teams, including GPs. Of all those health professionals, the community pharmacist, who employs a no-appointment-necessary approach, is the most accessible and often provides the only continuity of care in a health service that is struggling to recruit and retain staff.

On the subject of NHS staff, the promise of more than 1,000 additional pharmacists in GPs’ surgeries is a red herring. It is a separate issue and will do nothing to mitigate the loss of local community pharmacies. The Minister spoke last week of the need for pharmacists to move to a more clinical approach to healthcare. Again I say to him that that has been happening for years. All community pharmacies have consulting areas where patients can speak privately. They also provide a perfect space for the provision of a variety of important services. There is an ever-expanding list of services, which a number of Members have described in their speeches. My hon. Friend the Member for Garston and Halewood (Maria Eagle) mentioned the fact that pharmacists often go above and beyond the call of duty, sometimes delivering prescriptions at 8.30 in the evening. I well recognise that situation. The list is limited only by the Government’s unwillingness to engage and the clinical commissioning groups’ lack of funding to commission services.

Let me make it clear that community pharmacies, far from being a costly drain on NHS resources, actually save the NHS money through a variety of schemes, some of which have been mentioned today. The minor ailments service is already available in some areas, and I welcome the Minister’s suggestion that it will have a full roll-out. Medication use reviews carried out in the pharmacy often identify medicines that are routinely ordered but are no longer taken, and wasteful stockpiling of such items can therefore be avoided. In addition to the specific services, every prescription item dispensed presents the opportunity for a productive health intervention. Given that the average community pharmacy dispenses thousands of prescriptions each month, the potential impact is enormous and the professional advice of the pharmacist is undoubtedly invaluable in the promotion of health and wellbeing. The right hon. Member for North Norfolk (Norman Lamb) rightly identified the prevention work that pharmacists do, and mentioned the fact that the promotion of health and wellbeing can reduce demand on the NHS overall.

Despite statements to the contrary, community pharmacies have been making substantial efficiency savings in recent years. The vice-chair of the all-party group, the hon. Member for Plymouth, Sutton and Devonport (Oliver Colvile), mentioned a 40% increase in funding over the past 10 years, but he omitted to mention that prescription numbers have increased by 50% during the same period and that pharmacy funding has been static for the past two years.

Under the Government’s current plans, pharmacies would have to implement a year’s worth of cuts in four months with only six weeks’ notice. As someone with considerable experience of community pharmacy, I know that the plans will force the closure of many pharmacies and a service reduction in others. I do not know how many will close and neither does the Minister. The right hon. Member for North East Bedfordshire (Alistair Burt) suggested that the number could be as high as 3,000, and I can assure the Minister it will not be the large pharmacy chains that close but the small independents, the owners of many of which have put their heart and soul into providing an excellent service to the community.

Those that do not close will reduce services. An NPA survey of 250 pharmacies found that 76% are likely to reduce services from April 2017 if the cuts go ahead. The assessment of the financial impact of the closures is flawed and provides no evidence to support the Department of Health’s claim that access to services will not be compromised. It is clear that community pharmacies satisfy an ever-growing demand for services. When they close, that demand will not just disappear. Where will all the patients go? Some will pack out their GP surgery and others will head straight to A&E. The NHS is already in the throes of a staffing and funding crisis. Forcing community pharmacies to cut back services and close down is short-sighted in the extreme and could be catastrophic in the long term.

The Minister has frowned on the growth of pharmacy clusters, but he really needs to understand that clusters have grown, often in the most deprived areas, in response to considerable demand. My hon. Friend the Member for Bradford West outlined examples of such areas of deprivation. Is the Minister really suggesting that forcing the closure of such pharmacies is the most effective way to reduce demand for healthcare in deprived communities? The Minister has got this wrong. The proposals on the table are short-sighted and will do more harm than good. They will have a negative impact on patient care and will force extra demand on already stretched GP surgeries and hospitals. The proposals will not save money. They will not reduce the number of patients with long-term conditions or the number of medicines they require.

It is right to review the situation. I agree with the Government Members who said that it is right to examine the funding issues, but instead of forcing through damaging changes to a service that the Government clearly do not understand, I ask the Minister to listen to pharmacists and sit down with them to discuss how pharmacies can help to ease the burden on the wider NHS in a planned and cost-effective way. I ask the Minister to listen to his Conservative colleagues who spoke against these simplistic cuts, which have not been properly planned. I ask him to recognise that the access scheme will do little to protect the long-term future of urban or rural community pharmacies.

The Government have shown time and again an unwillingness to listen to professionals. I urge the Minister to listen to community pharmacists, to the pleas of Members and to people across the country, and to rethink the funding cut. I ask him to sit down with pharmacists and their representatives and work with them to develop and extend services that will take the burden off GPs and off the NHS. I ask that he do so now before he makes a decision that will devastate a whole sector and bring even more pressure to bear on our overstretched health service. I ask Members to support the motion.

Healthcare (Devon)

Julie Cooper Excerpts

Tuesday 18th October 2016 Westminster Hall

[Julie Cooper (Burnley) (Lab)]

I thank the right hon. Member for East Devon (Sir Hugo Swire) for tabling a debate on this important issue. It is heartening to see Members for Devon coming together with a unified voice on this subject. I, too, will mention Members who are not here today: the hon. Member for Totnes (Dr Wollaston), who has been mentioned, and my right hon. Friend the Member for Exeter (Mr Bradshaw). As we speak, they are questioning the Secretary of State for Health on finance for the NHS—a subject that cannot be totally separated from the issue at hand.

The healthcare challenges that Devon faces are immense, but I disagree with some of the points that hon. Members have made. I do not believe that the challenges are limited to this region; I believe they are systemic. Demand for NHS services is increasing nationally faster than ever before, fuelled in part by an increase in social deprivation and an ageing population. The need to address the increased demand, together with the need to keep pace with new technologies, is placing hitherto unseen financial pressures on NHS providers.

There are 280,000 people in Devon living with one or more long-term conditions, such as asthma, diabetes, hypertension and cancer; 150,000 people have a mental illness; and there are 40,000 people with cancer who need rapid access to high-quality services. Alongside that increased demand, there have been cuts to adult social care, and to public health and prevention budgets. If we are just to stand still, funding needs to be increased by an extra 2.6% above inflation. I am interested to see whether the Minister’s promised extra funding matches that; I doubt that it will. If no changes are made by 2020, the NHS in Devon will face a deficit in excess of £440 million.

In 2015, the Northern, Eastern and Western Devon success regime was introduced by Simon Stevens, the chief executive of NHS England, in an attempt to address the rising deficit and the failure to meet important health targets, including cancer waiting times. There is no doubt, as I am sure hon. Members agree, that there is a compelling case for change. Change is desirable; it would indeed be better for care to be more patient-centred, and of course it would be better to have more care needs met in the community. It is also true that the majority of patients receiving end-of-life care would prefer to die at home.

But, and it is a big “but”, change on this scale—massive, transformational change—needs leadership, transparency, a whole system change and, above all, investment. Making changes of this order—closing community hospitals with no proven plan for care in place—is downright reckless. That is why so many GPs in Devon are opposing the proposals, and have stated that they have

“grave concerns over patient safety.”

They say:

“we are concerned that the untried, untested closures of so many community hospital beds in this area could prove dangerous for a significant population of patients who might need to rely on community beds”.

The well-respected Chair of the Health Committee, the hon. Member for Totnes, has declared that she also cannot support the plans without an assurance that services will improve as a result of the changes.

People the length and breadth of Devon have expressed their concerns. The very active women’s institute in Devon has raised objections, as have communities across Devon. As we have heard from Members today, the consultation process has been woefully inadequate; there have been undersized rooms, and an online consultation. Frankly, it is not good enough.

Everybody is right to be worried. Only last week, the Care Quality Commission published its report, entitled, “The state of health care and adult social care in England”. The report states that

“the sustainability of adult social care is approaching a tipping point”.

In addition to the financial pressures, the sector is also experiencing massive problems with recruitment and retention of staff. The people of Devon are being asked to place their trust in a system that is on already on the brink and, quite understandably, they are not going to—and nor should they.

Local GPs have described the proposals as a “hasty cost improvement process”. This is the crux of the matter: the proposals as they stand, without adequate funding for alternative care, will save money, but they will not improve patient care, and may even compromise patient safety. I agree with the right hon. Member for East Devon that the cart is being put before the horse; that absolutely hits the nail on the head. Local NHS trusts in Devon are on their knees, desperately crying out for more funding to enable them to plan for the increased demand and changing needs of the population in the 21st century. This is not just about extra funding, but about making the kind of transformational change that is needed to deliver high-quality, excellent healthcare in the 21st century. It needs proper planning and proper systems in place, and that cannot be achieved on the cheap.

I am shocked that in this context, the Prime Minister is refusing to give the health and social care sectors more funding, which they desperately need. We have one of the lowest percentages of health and social care funding, as a proportion of our GDP, in the entire region of Europe. That cannot be right. I urge the Minister to use whatever influence he has with the Prime Minister to get her to revisit this issue, for the sake of the people of Devon, and for people across the country. This situation is not unique to Devon; we face many of the same problems in my region of Lancashire and, as I know from my work with the Health Committee, across the country.

I also ask that the consultation process be firmed up, and that people be offered a full, transparent and real consultation, rather than lip service being paid to having one. During Health questions the other day, the Under-Secretary of State for Health, the hon. Member for Warrington South (David Mowat), promised to visit Devon and to listen at first hand to stakeholders. I urge this Minister to take that away with him, and to look at making sure that the Government listen properly to the voices of Devon and the very legitimate concerns being raised in this debate. No one is trying to say that change is not needed, but one system cannot be taken away until there is a fully proven plan in place.

[Mrs Anne Main (in the Chair)]

I call the Minister. If possible, could you leave a minute or two at the end for the right hon. Member for East Devon (Sir Hugo Swire) to respond, Minister?

Oral Answers to Questions

Julie Cooper Excerpts

Tuesday 11th October 2016 Commons Chamber

[David Mowat]

The STP process is locally led, not led from the centre, but I would expect clinical judgments of the type mentioned to be made if they could be confirmed on the basis of scientific and trial-based evidence.

[Julie Cooper (Burnley) (Lab)]

Central to the aim of the five year forward plan for the NHS is a sustainable health service in which all patients receive the right care at the right time in the right place. With that in mind, can the Minister tell me what action he is taking to address the problem of delayed hospital discharges, which have risen by 20% so far this year? That amounts to an additional 926 people every day condemned to stay in hospital longer than is medically necessary.

[David Mowat]

First, may I welcome the hon. Lady to her post and wish her luck in the new job? There has been an increase in delayed discharges in England over the past year. Only a part of that increase is due to difficulties in the integration between social care and the NHS—a large part of it comes from within the NHS itself—but it is not uniform across local authorities. Indeed, many local authorities are improving in this regard. What is very clear is that those making the most progress the most quickly are those that have gone furthest in integrating social care and healthcare.

NHS Spending

Julie Cooper Excerpts

Wednesday 6th July 2016 Commons Chamber

[Julie Cooper (Burnley) (Lab)]

I want to begin by speaking about the NHS as experienced by my constituents. Getting an appointment to see a GP can be very difficult because recruitment of doctors in Burnley and Padiham is an enormous problem and many posts remain unfilled. This is not a temporary situation; this is how it is all the time.

The fact is staff do their best, but they are not magicians. Too often patients requesting an appointment are told to phone back the following day at 8.30 am and hope for a cancellation, and heaven forbid that a patient should want to have some continuity of care. This is especially difficult for the elderly and those suffering with mental illness. I tell the Minister that they really need to see a familiar face, and to have access to a GP with whom they have an established rapport. Sadly, they are denied this.

Unplanned admissions to hospital are also difficult. Patients often wait for hours on trolleys in cubicles and draughty corridors until a bed is available. This bed queue is the direct result of the fact that there is a shocking shortage of quality support for the elderly and mentally ill in need of care in the community.

The elderly and mentally ill really do bear the brunt of an NHS in crisis. Every week in my surgery I hear of their suffering at the hands of a poorly resourced and inadequately staffed NHS. One lady told me only a couple of days ago that she took her daughter, who is self-harming and threatening to hang herself, to the mental health crisis unit. The unit was so busy that she had to wait 23 hours for a diagnosis, after which it was decided that she needed to be sectioned and admitted. For the next four days, because no bed was available, she slept in an easy-chair. At that point a bed was found in Potters Bar, London. The family of this lady, including her five-year-old daughter, live in Burnley, at a distance of over 200 miles. They cannot afford the train journey to visit her.

I mention all of this not as a criticism of any of our NHS workers—far from it; they are at the sharp end doing their best in an impossible situation. They work in the health service because they care, and it pains them to see patients treated in this way. I mention all of this, none of which is untypical, because it is this misery that the Brexit campaign spoke to.

The leading Brexiteers, who have been mentioned in this place already today, played out the most cruel deception. They promised in their campaign that if the UK left Europe the NHS would receive a funding boost of £350 million per week. This untruth—that is what it was—was not a mistake or a miscalculation, although it was totally reprehensible; it was a deliberate attempt to deceive the British public. When deception of this magnitude is peddled by senior people, some of them Government members, who could blame people for believing that they would get a better NHS outside Europe?

Only hours after the referendum result was known the Brexit camp withdrew this promise of extra NHS funding because, of course, the fact is that it is this Conservative Government who starve the NHS of funding, not the EU.

World Autism Awareness Week

Julie Cooper Excerpts

Thursday 28th April 2016 Commons Chamber

[Mrs Gillan]

I am doubly grateful to my hon. Friend. He is absolutely right that the achievements of such organisations and programmes should be congratulated by all of us in the House.

Action is needed for the 700,000 people in the UK who are on the autism spectrum and their families. I am aware that the Government have invested £325,000 on autism awareness work, but that is a drop in the ocean if our aim is to ensure, as I believe it should be, that this generation of autistic children grows up in a world that understands them.

At this point, I want to pay tribute to the Minister. Quite honestly, he has attended every autism meeting and function that I have asked him to attend. He shows a great deal of understanding of this area, so I am looking forward to a really meaningful response from him when he winds up the debate at the end of the afternoon. More leadership is definitely needed from the Government.

[Julie Cooper (Burnley) (Lab)]

I am very grateful to the right hon. Lady for the work she does on this really important subject. Does she agree that it is extremely worrying that only 15% of adults suffering with autism are in full-time employment? Would it be right and proper for the Government to support the work of organisations, such as Ambitious about Autism, to help them in the transition into work that could be so crucial for so many?

[Mrs Gillan]

The hon. Lady is absolutely right. I will mention some of the organisations involved at the end of my speech. Ambitious about Autism is just one of the many organisations that are trying to help people with autism into employment. I want to mention that later as well, because it is very important.

To build on the intervention on the criminal justice system by the hon. Member for Cardiff West (Kevin Brennan), I should say that I recently visited Her Majesty’s young offenders institution in Feltham to see at first hand how a deeper understanding of the issues and how some adjustments in the physical environment can help people on the spectrum. The prison recently underwent accreditation from the NAS, and the prison staff’s enthusiasm in, and dedication to, helping the young people in their charge is absolutely admirable and really wonderful to see. I very much hope that members of the all-party group will go there on a visit to see exactly what Feltham has done. Custody can be a really traumatic experience for anyone, but without specific adjustments for those with autism, it is much harder for them to engage in their own rehabilitation. Familiarising staff with autism, allowing prisoners to use communal areas at quieter times, and reducing posters and notices to prevent over-stimulation are just some of the small things that can make a significant difference to the experience of autistic prisoners in custody.

I now want to pay tribute to the Minister for prisons, the Under-Secretary of State for Justice, my hon. Friend the Member for South West Bedfordshire (Andrew Selous), who wrote to every prison in this country asking them to undertake autism accreditation. Currently, over 20 have been in touch with the NAS and its accreditation team and, alongside Feltham, four are going through the process. We want this kind of Government leadership and we want such leadership to be sustained. When I ask the Government to do more on the awareness and understanding of autism, I expect to get this type of response. Far more could be done in the criminal justice system, particular in the Courts Service.

Following the example of Feltham, the public sector can and should do much more to make sure all its services and buildings are more accessible to autistic people, so that they and their families can feel confident that they can visit public buildings and use public services in the same way as everyone else. For example, I was very pleased at the weekend to read that Asda is piloting a “quiet hour” in one of its stores in Manchester, when it will turn off escalators, screens and music for an hour to create a more comfortable shopping experience for those with autism. That is to be commended.

At this point, it would be remiss of me not to mention that Parliament is itself working, under the leadership of Mr Speaker, towards an autism access award and to make sure that autistic visitors to our place of work feel confident that they will be understood and treated well right across the board. In the light of this positive work on the parliamentary estate, I hope the Minister will meet me and representatives from the all-party group and the NAS to discuss how, together, we can build on the early successes of the “Too Much Information” campaign and ensure that all public buildings become accessible to people on the spectrum.

I want to turn to one of the biggest issues facing people with autism and their families, which is the time it takes to get a diagnosis in the first place. I can see from the nods that that rings a bell with everyone in the Chamber. Recent research suggests that, on average, adults have to wait more than two years for a diagnosis. For children, the figure stands at 3.6 years. An autism diagnosis can be life-changing, explain years of feeling different and help to unlock professional advice and support. Government guidelines say that a diagnosis should not be a barrier to putting in place the right support, but 58% of people on the spectrum have told the NAS that a diagnosis led directly to getting new or more support. How can the right support be identified without the clarity of a diagnosis?

Dementia and Alzheimer’s Disease

Julie Cooper Excerpts

Tuesday 12th April 2016 Westminster Hall

[Julie Cooper (Burnley) (Lab)]

I am grateful for the opportunity to serve under your chairmanship, Mr Stringer, and to the hon. Member for Strangford (Jim Shannon) for raising this important subject.

Sadly, there is no cure for dementia, but diagnosis is important for understanding and so that support can be provided. Many welcome supportive initiatives have been developed in the community. For example, in my constituency, the local council has taken the lead in helping to make Burnley a dementia-friendly town and even offers free training to licensed taxi drivers. The initiative is part of a town-wide campaign to encourage residents and businesses to become more dementia-aware, helping Burnley to become a dementia-friendly town.

Raising awareness of dementia among transport services is vital. Some people living with dementia may lose the confidence to drive and become reliant on public transport. Taxi drivers may have friendly, familiar faces for people living with dementia and, if they have gone through a dementia information session, may be better equipped to understand their customers’ needs.

Suffering from dementia is difficult, as is caring for someone with it. It is important to recognise the needs of carers and to give them maximum support. I have seen the problems close up. My grandmother suffered dementia caused by Alzheimer’s disease. She moved from experiencing bouts of mild confusion to a total inability to cope unaided. As my family struggled to care for her, there was little if any specialist support or understanding, and eventually the family were forced to make the hard decision to admit her to residential care.

Things have improved since then: awareness has increased and more support is available. Projects such as the Butterfly project, which many hospitals have adopted and which helps to identify sufferers and to train hospital staff, are welcome developments. Sadly, however, carers are still too often undervalued and under-supported.

Last year, when doing research for my private Member’s Bill in which I tried to introduce free hospital car parking for carers, I talked to many carers, including several who were caring for loved ones suffering from dementia. I was affected by many of the stories I heard. One lady told me she had given up her full-time job to care for her husband who had developed dementia. At home, she fed, dressed and comforted him. When he fell and broke his hip and had to be hospitalised, she continued to provide the same care. She visited him every day, staying long hours, helping with his basic care and bringing calm. If she had not been able and willing to take on that role, it would have fallen to NHS staff.

It is estimated that carers save the NHS billions of pounds every year. At the same time, because caring duties may necessitate them leaving paid employment, many carers suffer financial hardship. I am shocked that the Government chose not to support my Bill, which would have offered some small assistance to carers. It would have sent a strong message of support to carers up and down the country that we value them. The way forward must be to increase awareness and to properly resource support for dementia sufferers and their carers.

Mention has been made of the Prime Minister pumping money into research, which is welcome, but while there is no cure, I would like the Prime Minister to pump money into improving care. That is not only the decent thing to do; it makes sound economic sense.

Oral Answers to Questions

Julie Cooper Excerpts

Tuesday 22nd March 2016 Commons Chamber

[Jane Ellison]

The hon. Lady is absolutely right to draw the attention of the House to the challenge of joining up thinking across the cancer pathway. That is exactly the approach that Cally Palmer and the taskforce implementation team are looking at. I recently had a conversation with her and with NHS England representatives in which we talked about how we get that joined-up approach. That is at the heart of the taskforce’s recommendations, and we will be taking it forward for all the reasons that the hon. Lady has eloquently expressed.

[Julie Cooper (Burnley) (Lab)]

Cancer Research UK has said that cancer waiting targets have been missed so many times that failure has become the norm. Does the Minister agree that failure to tackle that is undoing the good work of the last 15 years on survival rates?

[Jane Ellison]

These days, we are dealing with the fact that a hugely greater number of people are being diagnosed. The increase in the number of people being referred by GPs is extraordinary. For example, last year GPs referred nearly half a million more patients to see a cancer specialist. That is an increase of 51%. When it comes to waiting lists, of course we want to make sure that everyone is seen. The Government have committed more money to diagnostics, for example, but we expect the NHS to look urgently at any local dips in performance and to take action to make sure that all patients get access to treatment as quickly as possible.

End of Life Care

Julie Cooper Excerpts

Wednesday 2nd March 2016 Commons Chamber

[Julie Cooper (Burnley) (Lab)]

I am grateful for the opportunity to speak about such an important issue. Let me begin where the hon. Member for Totnes (Dr Wollaston) left off. I have been very impressed by what I have read. When end-of-life and palliative care in this country is at its very best, it is indeed the best in the world, which makes me proud to be British. However, it saddens me that that is not the case more widely. All the recent reports have demonstrated that access to the very best care varies tremendously, and is very patchy. It is for that reason that end-of-life care has been the subject of recent studies and reports, not least those of the Health Committee.

I understand that a very thorough piece of work was done before I became a member of the Committee last year, and that concerns were raised about this very issue. The “Choice” review body looked into it as well, and came up with various recommendations. I want to focus on one of those recommendations in particular. The review recommended that 24/7 care should be made available for people in a community setting. The point has already been made that it is hard to define the end of life and the timescale involved. Indeed, the British Medical Association makes the point that more funds are needed to train staff to a level at which they can better identify these things. The end of life can be a lengthy process, and people need support at this most important time of their life.

Most people who responded to questionnaires on this subject have said that they would prefer to die in the comfort of their own home, surrounded by their family. In order for that to happen with the maximum dignity and the highest standards, investment is needed in social care above all else. The recent cuts in social care budgets have been a matter of concern for most of us. Lancashire County Council is further reducing its spending on social care, and the elderly and disabled in my constituency and their families are already worried about the impact that this could have on them. However, we still aspire to have the highest possible standards for end of life care, and the two concepts simply do not add up.

I wonder why the Government are delaying their response to the “Choice” review. We desperately need to hear what their plans are, to determine whether they are really listening. The “Choice” review also recommended additional funding of £130 million, because the £8 billion that was allocated for spending in the NHS has already been well and truly spent many times over. County councils’ adult social care budgets are feeling the pinch.

Last year, in the run-up to the introduction of the private Member’s Bill tabled by my hon. Friend the Member for Wolverhampton South West (Rob Marris)—the Assisted Dying (No. 2) Bill—people in my constituency told me of their concerns about dignity at the end of life. Many of them asked me to vote to support the Bill because they were worried that a level of care that afforded them the dignity they wanted would not be available. They were worried about whether they might suffer and what the experience would be like for their families.

This issue is rightly at the top of the agenda, because this is the very least that we can do for the elderly and the sick. We do not like to talk about it, but everyone’s life is going to end and we need to think about this. The fact that we cannot do this better in 21st-century Britain makes me ashamed. We know that we could do it better, so I urge the Minister to read the recommendations put forward last year by the Health Committee and by the “Choice” review. In fact, I am sure that he has already done so. Almost 12 months have gone by, and this is a matter of urgency. It is quite shocking that we have not dealt with it before. I urge the Minister to look at the recommendations and to ensure that those who choose to die in their own homes in the community get the excellent care and support that they rightly deserve.

Junior Doctors’ Contract Negotiations

Julie Cooper Excerpts

Monday 8th February 2016 Commons Chamber

[Ben Gummer]

Yes, and I would add the 2,800 people who have had their operations cancelled. I wonder what answer they would get from the Opposition about whether they support or condemn those cancellations. As soon as we get an answer to that very simple question, it will be easier for us to know the official position of Her Majesty’s Opposition.

[Julie Cooper (Burnley) (Lab)]

Yesterday, the Secretary of State for Health accused the BMA of misleading junior doctors. Today, the Minister comes to the House and accuses the BMA of lying. Is he really asking us to believe that some of the most intelligent people in the country—junior doctors—cannot see for themselves what the Government are proposing? Does he not feel that the continued abuse directed at the junior doctors’ representatives is hindering any possibility of a settlement to this dispute and that that is damaging to patients?

[Ben Gummer]

The hon. Lady is also an intelligent woman, so let me ask her this. If a trusted body, such as the BMA, tells its members that they will have a pay cut of 30% and an increase in hours, but that statement is incorrect, does it constitute a lie? That is the question I would put back to her.