Community Pharmacies
Debate between Karin Smyth and Philippa Whitford(8 years ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Dr Whitford
I agree with the Government about looking for more services, but this is not the way to work with the profession, given that they want those in it to do more work and to work differently. Sadly, during my time in the House, we have repeatedly seen the Government not sitting down with a profession and saying, “Why not look for where savings can be made?”, but simply making a cut.
Karin Smyth (Bristol South) (Lab)
I was going to intervene on the Minister to follow up the point made by the Chair of the Health Committee. We are looking at bottom-up planning in England for the first time for a number of years with the sustainability and transformation plan process, so this is completely the wrong time to be making these irrational and random cuts.
Dr Whitford
We recently debated STPs and the potential they provide. The danger is that at the moment we are seeing finance-centred care, instead of patient-centred care. Going back to place-based planning, which is what we have kept in Scotland, where we still have health boards, means that we can look at integrating services, and pharmacies definitely need to be part of that. They have the potential to be a significant front-line player.
A&E Services
Debate between Karin Smyth and Philippa Whitford(9 years, 5 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Dr Whitford
The problem with moving patients into hospitals is being exacerbated by the reduction in in-patient facilities. Every new hospital seems to have fewer beds than the old hospital it replaces. The Scottish Government finally accepted the view of clinical staff that that could not go on. We now treat people in a different way. People used to get a hernia done and lie there for a week. My breast cancer patients used to come in and stay for 10 days. That has changed, which is great for those patients, but there is an inexorable rise in the number of older patients who have complex needs. The problem is not that we are living longer. I get quite upset at the phrase, “the catastrophe of living longer”. I suggest that Members think about what the alternative is. At medical school, I was definitely given the impression that people living longer was the point.
People are surviving their first major illness and, actually, their second major illness. They may present with breast cancer in their mid-70s to someone like me and have four co-morbidities. Such patients do not get in and out quickly for elective surgery, and they do not get out quickly when something major goes wrong, such as pneumonia or a chest infection. We therefore need to stop the downward trajectory in the number of beds, because we will not get the flow of patients if we go on cutting beds.
For me, the key things that we need are the co-location of GPs; an out-of-hours service for out-of-hours issues that are better dealt with in primary care; and enough beds in the right places. Finally, we need to smooth the way of our patients to get back to their homes. In Scotland, we have free personal care that allows us to keep more people at home and stop them going into hospital and to get more people back out of hospital.
I commend the “Five Year Forward View”. Much of it is taken from something that was written in Scotland several years ago called “2020 Vision”, which was about integrating health and social care.
Karin Smyth (Bristol South) (Lab)
I am not aware of the position on co-location in Scotland, but one barrier to the successful implementation of co-location in England is that the tariff and the funding mechanism mean that is it not efficient. Will the hon. Lady say what the position is in Scotland, because perhaps we can learn from that in England?
Dr Whitford
As I am sure the hon. Lady is aware, we have a totally separate system, for which I am grateful. We do not have a system of tariffs. We have a single NHS, so we can sit around a table and try to work out a solution. That is one of my concerns about the situation that the NHS in England faces and it is where I would veer away from the “Five Year Forward View”.
The principle of working together and integrating health and social care is commendable. The integration boards in Scotland started work in April because “2020 Vision” is a few years older than the “Five Year Forward View”, but we face the same challenge: local authorities are struggling with their budgets, which can end up eating away at the health side.
The four-hour target is still useful as a weekly target to provide a quick response to what is going on in our hospitals. However, it should not be used as a stick to beat staff or to beat ourselves in this House and make public capital. The NHS is too precious for that.