Stem Cell Transplants

Lindsay Hoyle Excerpts

Tuesday 24th January 2017 Commons Chamber

[Mark Tami (Alyn and Deeside) (Lab)]

It is a pleasure to rise at 6.33 pm. When I secured an Adjournment debate several years ago, I expected it to start at 7 o’clock, but I seem to recall that I got up to speak at 11.15 pm. Those were the days when we could debate European documents until any hour.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

History could well repeat itself.

[Mark Tami]

I hope that it will not do so tonight, Mr Deputy Speaker.

I declare an interest as co-chair of the all-party group on stem cell transplantation. I am very pleased to see my co-chair, the hon. Member for Enfield, Southgate (Mr Burrowes), in the Chamber; I am sure he will make some comments later. May I also put it on record that my oldest son received a life-saving stem cell transplant a number of years ago?

A stem cell transplant offers a last chance of life to people with a blood cancer or blood disorder. It works because stem cells have an incredible ability to replace damaged blood cells. This remarkable treatment has great potential in our healthcare system. There are different types of stem cell transplant. Some involve people taking back their own cells, while others involve cells from a donor, who can be a relative. Tonight I will talk about stem cell transplants that come from a donor.

About 2,000 people in the UK need such a transplant each year. Two thirds of them will not find a matching donor in their family and will therefore require an unrelated donor. In that regard, I pay tribute to Anthony Nolan trust, which provides patients with matching donors from its stem cell donor register. As well as sourcing transplants, it supports patients and, importantly, their families through the transplant journey and advocates on their behalf. Last year, Anthony Nolan helped to find a match for more than 1,200 people with a blood cancer or blood disorder. I know that the House will join me in thanking the selfless stem cell donors who made that possible, and all those who have joined the stem cell donor register and might donate in the future, of whom there are more than 600,000.

Sadly, one in eight people does not receive the life-saving transplant they need because there is no donor available or a donor cannot be found quickly enough. The odds drop dramatically for patients from a black, Asian or ethnic minority background. Anthony Nolan is working hard not only to build but to diversify its stem cell donor register to ensure that it is able to provide people with the best match. After a lot of work, the situation is much better than it was a number of years ago, but it is still shocking that the chance of finding a donor is so much slimmer for people from a BAME background than for white people. I am sure that the Minister will show her support for efforts in that area.

Despite the fact that stem cell transplants are a well-established treatment, the huge financial pressures on the NHS are causing problems for patients. The situation is most serious for those who need a second stem cell transplant. Sometimes, after having a first transplant, a patient’s blood cancer or blood disorder will come back or relapse. That is devastating news in itself. For about 20 patients a year, the clinician will recommend a second stem cell transplant as their best, and often only, chance of life.

It is worth emphasising that this is not some unknown, experimental treatment that people are simply taking a punt on. We know that one in three patients who receives a second stem cell transplant will reach the milestone of five-year survival, and the results for children are even better, as seven in 10 will reach that milestone. We know that the medical profession recommends the treatment, which is routinely available in other parts of the UK, as well as in countries across Europe and the United States. We also know that the treatment used to be available in England before 2013 and that many people are alive today, leading active lives with their families, because they received a second stem cell transplant.

NHS and Social Care Funding

Lindsay Hoyle Excerpts

Wednesday 11th January 2017 Commons Chamber

[Maria Caulfield]

I will not.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. If the hon. Lady wants to give way, she will. Unfortunately, she is not, but Members cannot just stand there—two at once—shouting all the time. It is recognised that if a Member is to give way, they will, but it is up to them.

[Maria Caulfield]

These problems are not new. I have also worked in out-patient settings where A&E targets have had an impact on patients waiting for elective surgery. The sheer determination to meet those targets due to pressure from the Labour Government led to patients with breast cancer having their elective operations cancelled time after time owing to emergency admissions. I had to tell a young mum, whose mastectomy operation following breast cancer had been cancelled three times while her young family were waiting for Christmas, that the only bed we had left was in a post-natal ward, where she woke up and recovered from her operation next to young mums learning to breastfeed. That was in an attempt to meet four-hour targets, so do not tell me that services have reduced. Targets were met, but staff were put under severe pressure not with quality of care but with targets in mind. I make no apologies in making that clear.

I am a supporter of four-hour targets. I was enthusiastic when they were introduced as a way of monitoring performance and improving the service, but they became the absolute king, above everything else. I congratulate the Secretary of State on introducing the consideration of outcomes. What happens to a patient when they are admitted? If they have to stay for four and a half hours to avoid admission or to get full care, what is the problem with that? If they can leave within two hours because they have been adequately treated, fantastic, but we should not be held to account by an arbitrary four-hour rule that has no clinical significance. I support the four-hour rule, but there are other measures that we also need to be aware of and that should be treated with equal status to the four-hour target.

Of course money is important. As our ageing population and our ability to treat more patients grows, we will need more funding for both healthcare and social care. It is worth noting that the trusts either side of my constituency receive the same funding and look after the same types and numbers of people. One is in special measures, is unable to deal with its discharges, has queues and is unable to meet its four-hour targets; the other, five miles along the coast, is rated outstanding, does not have the same pressures or four-hour waits and is able to discharge its patients speedily. There is something about what happens to the money, as well as about how much the money amounts to.

Labour did put huge amounts of money into the NHS over the years, but much of it was squandered—£10 billion on a failed IT project that never saw the light of day, and PFI deals that are still costing the NHS £2 billion a year. How much could be done with that £2 billion?

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[Dr Allin-Khan]

No, I will not. [Interruption.]

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. Let us just calm it down. Government Members did not give way before, and let us not get into the habit of shouting at each other. Let us have a nice, sensible debate.

[Dr Allin-Khan]

Many people who go to A&E know that they should not be there. I have had elderly patients saying to me, “I’m so sorry, doctor, for wasting your time.” But what other option are the Government leaving them? That is what we are debating today. The Secretary of State wants an honest conversation—well, let us have it. Let us talk about the impact that the current state of the national health service, which he has been in charge of for four years, is having on accident and emergency departments and throughout hospitals in this country. Let us talk about rock-bottom staff morale. Let us talk about the breakdown of staff marriages, a rise in depression among staff and the fact that waiting times are not the responsibility of patients. They are not to blame.

Rising waiting times are the Secretary of State’s responsibility, yet he blames them on the number of people going to A&E since the target was set. It is his responsibility to lead a national health service that can meet the needs of its people, but again he pleads innocence. He says that no other countries have such stringent targets, suggesting that it is unfair that we do. The meeting of the A&E target in particular, not watered down but in full, is what establishes the NHS as the best health service in the world, and one that we can, should and would be proud of under a Labour Government. After all, emergency departments’ ability to meet the four-hour target is directly related to the health of the NHS itself. It is simple: more people go to A&E when they have no other options available.

Contaminated Blood and Blood Products

Lindsay Hoyle Excerpts

Thursday 24th November 2016 Commons Chamber

[Sir Peter Bottomley]

Does the hon. Lady agree that, whoever administers the scheme, if there are anomalies or cases that come outside the rules, they should be free to tell the Government that they should change them?

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

May I interrupt? The winding-up speech is meant to be very brief. I do not mind, but there is a big debate to follow with a lot of speakers, and we are eating into that time.

[Diana Johnson]

I will be very quick. The ongoing payment of £3,500 for people with stage 1 hepatitis C is not a large amount of money for those affected. Under the Scottish model, a £30,000 lump sum payment is made if people have already received the £20,000 lump sum payment. Over the spending period, therefore, I am not sure that the Government can really say that the help that they are providing to people affected with stage 1 hepatitis C is greater than that provided to those in Scotland.

Question put and agreed to.

Resolved,

That this House notes the Government’s recent announcement on the reform of the support schemes for people affected by contaminated blood and blood products; recognises that the contaminated blood scandal was one of the biggest treatment disasters in the history of the NHS; believes that those people affected should have a reasonable standard of living and not just be removed from poverty; is concerned that bereaved partners of people who died with HIV/AIDS and those reliant on regular top-up payments will be worse off; is concerned that the new payments for people infected with Hepatitis C are not commensurate with the pain and suffering caused; notes that people who were infected with other viruses, those who did not reach the chronic stage of Hepatitis C and bereaved parents are not mentioned in this announcement; and calls on the Government to use the funds from the sale of Plasma Resources UK to bring forward revised proposals that are properly funded and which provide appropriate support to all affected people.

Reducing Health Inequality

Lindsay Hoyle Excerpts

Thursday 24th November 2016 Commons Chamber

[Relevant document: Second Report of the Health Committee, Public health post-2013, HC 140.]

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

There are 11 Back-Bench contributors to this debate. Will Members bear that in mind, in order to give everybody a good chance of having equal time?

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[Rebecca Pow]

rose—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. I do not want us to get into a forestry debate. I admire this love-in for the south-west, but I think we need to get back to health.

[Rebecca Pow]

I did actually go out on a boat up the Thames this morning with Greenpeace to look at the issue of microplastics in water, and we also saw some trees. Trees are important and serve a good purpose in taking in air pollution, which has an effect on health; we have a lot of asthma in our cities. If we plant more trees, we will help to combat all that.

It has been demonstrated that mental health can be aided through contact with nature. As a keen gardener, I can vouch that getting one’s hands in the soil, watching things grow, planting seeds and watching the seasons change definitely does lift the spirits and is a pick-me-up.

National Health Service Funding

Lindsay Hoyle Excerpts

Tuesday 22nd November 2016 Commons Chamber

[Jenny Chapman]

On a point of order, Mr Deputy Speaker. Is it in order for the Minister to imply that there was a lack of interest among Labour Members, given that the speaking time limit was cut to four minutes, and then—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. It has been put on the record, and it is a matter of public record, but I will say that speeches were made by nine Opposition Members and eight Government Members. Speeches were made by six Labour Members and eight Conservatives. That may help the House, and may prevent any further arguments.

[Mr Dunne]

Mr Deputy Speaker, the facts speak for themselves, as you have just told us: eight Conservative Back Benchers and only six Labour in an Opposition day debate—what a shambles.

I do not question the fact that the NHS faces a significant challenge. Increasing demand for healthcare is a consequence of our ageing and growing population. It is our determination to look after each and every NHS patient with the highest standards of safety and care. These all contribute to the challenge, but, despite increasing pressures, the NHS is rising to meet this challenge, carrying out more than 5,000 operations every day compared with 2010, and handling 780,000 more accident and emergency attendances in the second quarter this year. That is 15.1% more than in the same quarter in the last year that Labour was in office. Today it is the Conservative party that is the party of the NHS. That is why we pledged more than Labour and why we are delivering more funding, with a higher proportion of total Government spending going into health in each year since 2010.

Some hon. Members have drawn international comparisons on spending. I gently remind the more excitable Opposition Members that, according to the OECD, total health spending in the UK for 2014 is 9.9% of GDP, which is 10% above the OECD average of 9% and just above the EU15 average of 9.8%.

Several hon. Members have today also questioned the figures around the rises in funding that we are providing over the term of this Parliament. I welcome confirmation from my hon. Friend the Member for Totnes (Dr Wollaston), the Chairman of the Select Committee, that she can see how the Secretary of State arrives at his figures, and she graciously conceded that both sides are correct. I want to focus directly on the straightforward maths.

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[Ms Eagle]

Will the Minister give way?

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. If the Minister is not going to give way, the hon. Lady will have to sit back down.

[Ms Eagle]

The Minister should not talk about something like this and then refuse to give way.

[Mr Deputy Speaker]

Unfortunately, it is for the Minister to choose.

[Mr Dunne]

Thank you, Mr Deputy Speaker.

I remind all Members of the House that any reconfiguration proposals that emerge from the STPs will be subject to statutory consultation, and I encourage all Members to—

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[Ms Eagle]

rose—

[Mr Deputy Speaker]

Order. If the Minister wishes to give way, he will do so. The bottom line is that the hon. Lady is quite right to ask him if he will do so, but we cannot have people standing up and shouting—[Interruption.] We do not want people on one side saying no and people on the other side saying yes. The bottom line is, I want the Minister to get to the end. He may give way if he wishes to; otherwise, he should carry on.

[Mr Dunne]

Thank you, Mr Deputy Speaker. I have explained to the hon. Lady that I do not intend to give way to her. I have only a limited amount of time left, and I would like to remind her of what Chris Ham, the chief executive of the King’s Fund, said. He regards the STPs as

“the best hope to improve health and care services”.

Hon. Members referred to the role of the independent sector in the provision of NHS care. The test for commissioning decisions must always be the value provided for patients and taxpayers, not the type of provider. The vast majority of NHS care has been and will continue to be provided by public sector organisations, but Opposition Members would do well to listen to Stephen Dalton, the chief executive of the NHS Confederation, which represents commissioners and providers of NHS services, who wrote today in The Guardian, of all papers, that private and wider independent sector health care providers

“increase the system’s capacity to respond to demand, help meet waiting time targets and enable investment bring important benefits for patients—most of whom are entirely relaxed over who provides their care, so long as it’s of high-quality and remains free at the point of use.”

I entirely agree with him.

My right hon. Friend the Secretary of State and I have acknowledged that the NHS faces challenges, and I recognise concerns raised by many in the House today. As I have made crystal clear, however, this Government are fully committed to the NHS.

NHS Provision (Brighton and Hove)

Lindsay Hoyle Excerpts

Monday 24th October 2016 Commons Chamber

[Caroline Lucas]

That would be a very interesting issue to debate. The hon. Gentleman can get his own debate on Worthing hospital, but what I know about are the particular problems that are facing Brighton and Hove, and I will point again to the particular complex needs that come together when one has a city full of young people as well as very elderly people, a lot of people with mental health problems, homelessness problems, vulnerability problems and so on. If he will give me a little more time, I will set out for him what some of the problems are in Brighton and Hove and also, crucially, what some of the answers are.

I was talking about adult social care and about the fact that, unfortunately, the Government are cutting yet more money from local authority budgets that is supposed to cover those essential care services for vulnerable people.

The Government know that social care in places such as Brighton and Hove is on its knees, and that that has very direct knock-on effect on the NHS that no amount of financial smoke and mirrors can conceal. Brighton and Hove National Pensioners Convention has begun a valiant campaign to protect adult social care services from cuts, with unions such as the GMB fighting alongside it. I really hope that the Minister is listening, because this is a crisis that lets down everyone and there is no hiding from it. Where should responsibility for this catalogue of troubles lie?

What has happened to the city’s non-emergency patient transport service goes some way towards answering that question, and I wish to look at this in a bit more detail. It also demonstrates what can only be described as an utter dereliction of duty on the part of the Secretary of State for Health and I want to repeat my call for his Department to step in and for him personally to resolve an unacceptable and untenable situation.

I am referring to a service that takes people to essential non-emergency appointments—kidney patients going for dialysis, and cancer patients going to and from chemotherapy and radiotherapy. Since April, it has been run by a private company called Coperforma and a number of subcontractors. Coperforma faced intense criticism from the outset, with patients saying that they had experienced delays reaching appointments and subcontractors reporting that they had not been paid. Two of those subcontractors, Langfords and Docklands, went bust in September, leaving some ambulance drivers with up to six weeks’ worth of wages unpaid. In early October, drivers for another Coperforma subcontractor turned up for work only to be sent home again.

Last week, the Patient Transport Service was plunged into a fresh controversy after an investigation by our local paper, The Argus, revealed that one subcontractor may not even have been licensed to operate a fleet of 30 ambulances. I have the headline from the local paper, which Members can see very clearly. It says that ambulances are now in a total shambles—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Do you want to put that paper down on the Bench? Thank you.

[Caroline Lucas]

I am sure that The Argus will be sad to see itself relegated to the seat behind me.

The subcontractor is a company called Docklands Medical Services Ltd. This is apparently a phoenix company for the aforementioned Docklands. As I understand it, the new company seems to be suggesting that it was acceptable for it to operate under the Care Quality Commission licence that was issued to its predecessor, the bankrupt Docklands. The application process for a licence is carefully designed to ensure that standards for vehicles and other safety checks and safeguards have been met. Just allowing a new successor or phoenix company to inherit a licence is setting the bar dangerously low, exposing patients and staff to unacceptable risks.

As a result of this debacle, our struggling hospital trust—yes, the one in financial special measures—has incurred £171,000 of private ambulance costs so far this year to plug the gap left by Coperforma and its subcontractors. To recoup this cost, the trust has, quite rightly, invoiced the clinical commissioning group, which appointed Coperforma. No doubt other trusts similarly affected will have done the same, with serious consequences for the CCGs’ budgets and, therefore, for the money available for other services. Whichever part of the Department of Health ends up footing the Coperforma bill, it represents an unforgivable waste of money and resources, and their diversion away from patient treatment and care.

I trust that the Minister will agree that patients in Brighton, Pavilion or anywhere else should not be paying the price for the failure of private companies that are profiting from NHS contracts. Will he therefore ensure that the CCG is not out of pocket in turn as a result of Coperforma’s mismanagement? I would also like his Department to stop passing the buck when it was his Government who passed the legislation that required services such as non-emergency patient transport to be put out to tender. It is unacceptable for no one in the Department of Health to know whether a fleet of 30 ambulances were properly licensed to transport Sussex patients for three months over the summer. When the Minister responds, will he tell us whether he agrees?

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[Tim Loughton]

This is the first time I have intervened on the Minister, and we do have about an hour left in which to carry on this debate.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. I may be able to help the hon. Gentleman. That is only if the Minister wishes to speak for an hour, because nobody else will be allowed to do so.

[Tim Loughton]

Perhaps you will therefore indulge me on this intervention, Mr Deputy Speaker.

[Mr Deputy Speaker]

As ever.

[Tim Loughton]

I have no problem with the principle of outsourcing. The Minister is absolutely right that the level of outsourcing may go up and may go down, because it should be based on the quality of an alternative provider that is able to provide a quality service at an affordable price and is best placed to do so at the time. Will he acknowledge the whole issue with Coperforma? It has been a major issue for all of our constituents. Vulnerable people relying on regular treatment have just been left at home or dumped elsewhere, and have not been able to access services. This has been going on for so long that, when we put a contract to such organisations, much better due diligence needs to be done. There also needs to be a fall-back plan, because given that the ambulance service, which declined to take on the contract in the first place, is now clearly not in a position to take it on anyway, there is little option for somebody else to take on the service urgently and provide the level of care that our constituents desperately need and that has just not happened in this case.

Health Service Medical Supplies (Costs) Bill

Lindsay Hoyle Excerpts

2nd reading: House of Commons & Programme motion: House of Commons
Monday 24th October 2016 Commons Chamber

[Kevin Foster]

The hon. Gentleman tempts me, but I see you are now in the Chair, Mr Deputy Speaker, and you are very tough on any irrelevant points or points off subject, so that could be very dangerous territory.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

And you shall not be tempted.

[Kevin Foster]

That is good to know.

We have seen work the Government have done in other sectors, for example, on information in the energy sector. The Bill deals with a particularly unique practice, where there is, in effect, only one customer, the NHS, and only one supplier. I am struggling to think of many other industries where that is replicated. That is why these price rises are so disgraceful. This industry is about profiteering from illness and pain. There is nothing else like that.

Baby Loss

Lindsay Hoyle Excerpts

Thursday 13th October 2016 Commons Chamber

[Several hon. Members rose—]

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. Just before I bring in the next speaker, may I suggest that, although I am not imposing a time limit, we should aim to speak for no more than 10 minutes? In that way, everybody will have a fair speech time, and things will be equal across the Chamber.

NHS Sustainability and Transformation Plans

Lindsay Hoyle Excerpts

Wednesday 14th September 2016 Commons Chamber

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. I think we can spot that the hon. Lady has just given way to a Government Member and now she is giving way to an Opposition Member. We do not need the cheering to go with it.

[Steve McCabe]

I want to check this with my hon. Friend. The last time I checked, Simon Stevens had said that STPs were designed to make up the £22 billion shortfall that the Government are not prepared to put in. Is that not the case?

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[Ms Abbott]

In some cases, even local GPs have not been fully involved in decision making. Hon. Members may not take that seriously, but I assure them that their constituents will. [Interruption.]

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. It is up to the hon. Lady whether she wishes to give way or not. Shouting and screaming will not help with the debate, because Members on both sides want to hear. I am sure that, when she wants to give way, she will do so, but screaming will not help, and it certainly does not help my ears.

[Ms Abbott]

GP leaders in Birmingham said that it would appear that plans by the STP to transform general practice, and to transform massive amounts of secondary care work into general practice, are already far advanced. Only at this late stage have they been shared with GP provider representatives.

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[Richard Fuller (Bedford) (Con)]

On a point of order, Mr Deputy Speaker. Is it a requirement for a Member of this House to know the difference between a debate and a monologue?

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

It is for me to make that decision. I am quite happy for the shadow Secretary of State to decide whether she wishes to give way or not. In fairness, this is an Opposition debate, and the hon. Lady is leading it. Let us not have any more pointless points of order. I am worried about how many Members want to speak; I want to try to get everybody in.

[Ms Abbott]

So when the STPs talk about efficiency, they actually mean cuts. Increasingly at the heart of these STPs are asset sales of land or buildings to cover deficits. No wonder the leader of Hammersmith and Fulham Council, Stephen Cowan, has said of his local STPs that

“this is about closing hospitals and getting capital receipts”.

He went on:

“It’s a cynical rehash of earlier plans. It’s about the breaking up and the selling off of the NHS.”

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[Dr Wollaston]

Members on both sides of the House are aware of how valuable and important community hospitals are to our constituents. Taking that a step further, I would say that the best bed for any patient is their own bed, provided that they can be given the right package of care close to home. We know that there are many people even in community hospital beds who do not need to be there. They are there for want of the right social care package that could enable them to be at home.

In welcoming STPs, we should be realistic about the financial challenge that they also face and the costs sometimes of providing those services. That is a huge challenge for them. In my area alone the STP is facing a £572 million shortfall by 2021 if no action is taken. I can understand why, for example, it will look at the relative cost of providing care to people in acute hospitals, in community hospitals and at home, and make an argument that sounds very reasonable about how a larger number of people could be much better cared for at home.

I return to the point that the hon. Member for Central Ayrshire (Dr Whitford) made. Access to the transformation part of the sustainability and transformation plans is necessary to be able to put those services in place and very often to build the infrastructure that we need. For example, in Dartmouth in my area, the possibility of providing more care closer to home within a community hub will require the up-front funds to build a new centre that allows the workforce to be developed and more services to be provided closer to home. Unfortunately, what we often see is the closure of a much loved facility without the new service in place.

As the sustainability and transformation plans progress, I would like to see a genuine focus on the opportunities to provide more care closer to home. I fear that we will miss that opportunity because, as we have heard, £1.8 billion of the £2.1 billion sustainability and transformation fund is going towards the sustainability bit, for which read “plugging provider deficits”, and only £300 million is left nationally to put in place all these plans.

We know also that part of the way that the Government have managed to fulfil their promise to NHS England in respect of the funding that it asked for has been by taking funding out of capital budgets because those are essentially flat cash, and also by taking money out of Health Education England budgets and public health budgets. It concerns me that many of the principles behind the sustainability and transformation plans are put at risk by other parts of the system being squeezed. We have heard the point about prevention. Central to the achievements of the sustainability and transformation plans is the prevention piece—the public health piece. It is a great shame that public health budgets have been squeezed, limiting the ability of those aims to be achieved.

I know that many Members wish to speak so I shall move on and make some asks of the Minister, if I may. There is more that the Government can do. We on the Health Committee were very disappointed that none of the witnesses who came before us from NHS England, NHS Improvement or the Department of Health was able to set out the impact of cuts to social care on health planning. We need to do much better at quantifying the cost to the NHS of cuts to the social care budget.

The Minister needs to take the long view on prevention and help the service by implementing policies that could help local authorities to make changes. For example, I suggest making health a material consideration in planning and licensing, in order to provide the levers to make a difference. We need a much greater focus on workforce, because the STPs cannot achieve their aims if the workforce to achieve them is not in place. Finally, will the Minister kindly visit my area to look at the proposals in the sustainability and transformation plans in south Devon, and at the opportunities and how we would achieve them?

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. The next speech, in the same way, will not have a time limit, but after that it will be five minutes. Some people will not get in. Please explain to them why those who took advantage of the time did so—it is totally unfair.

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[Several hon. Members rose—]

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. There is now a five-minute limit.

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[Norman Lamb]

I will give way very briefly to the hon. Gentleman—[Interruption.] I am being given a clear signal by Mr Deputy Speaker that I should not—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. You have only 30 seconds to go.

[Norman Lamb]

I take your point, Mr Deputy Speaker, and I am sorry for my ill discipline.

I will conclude by saying that this is the right approach but it will be undermined because of the rushed process which does not involve the public, because it does not take people with it on the journey and because there is not enough money to deliver the transformation that is required.

[Several hon. Members rose—]

[Mr Deputy Speaker]

Order. I am dropping the time limit to four minutes in order to get everybody in.

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[Helen Whately (Faversham and Mid Kent) (Con)]

I welcome the new ministerial team to their places. I also welcome the shadow Secretary of State, the hon. Member for Hackney North and Stoke Newington (Ms Abbott), but may we have a more constructive debate about healthcare in future? She should not talk about cuts. She knows perfectly well that this Government will be putting an extra £10 billion a year into the NHS by 2020. That is not a cut. That is £10 billion extra of taxpayers’ money. Will she please not mislead people by talking about cuts? As she well knows, her party did not commit to spending anything like that on the NHS.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

I do not think that an hon. Member would try to mislead another. That is not a word that we would use.

[Helen Whately]

My apologies, Mr Deputy Speaker. I did not mean to use that word. The hon. Lady mentioned the £22 billion shortfall set out in the “Five Year Forward View” analysis, so will she clarify whether her party is now planning to make that up? If so, where will it find the money from? That was not entirely clear in her comments.

I will move on, because I sincerely believe we need a far more constructive debate about the real challenges the NHS faces and how to improve the care it provides to our constituents. The NHS is under pressure—no one here is denying that. I know it as well as anyone, as my grandmother spent five of the last six months of her life recently in hospital, and if the system had been better she would not have been there and would have had a much better end to her life. We know that people are living longer, with multiple conditions: about 70% of NHS spending goes on dealing with long-term conditions. The treatments available have increased vastly and are therefore more expensive than they were in the past, and patients expect far more of the NHS.

The NHS should not constantly be criticised, as is so often the case, as it is seriously rising to the challenge. It is performing thousands more operations, with thousands more patients being seen every day. In addition, in response to what happened at Mid Staffs and other such incidents, tens of thousands more doctors and nurses are working in the NHS. Skilled staff do not come about overnight; training takes years. A lot is therefore being done also to address the pressures on the NHS workforce. None of that should be overlooked, although it is also costly.

I ask us all to focus on talking about how the NHS rises to the challenges it faces, doing so in a financially sustainable way. We do not have a blank sheet of paper for this; the “Five Year Forward View” was published in 2014. As you may well know, Mr Deputy Speaker, I have previously asked questions about what was happening to drive forward that review at the pace and scale needed. The STPs are a vital part of the process, as across the country they are about putting the five year forward view into practice. They are doing that in an important way, looking at the place and the whole population, bringing together a diversity of organisations across the NHS and involving local authorities. We are talking about organisations that are rarely in the same room. In Kent, organisations have come together where previously people have literally not spoken together—chief executives have not previously been in the same room together. This is really important. The STPs are also putting public health at the core of the future plans for health and care across the region, and they are looking not just at treatment but at how the population can be healthier and how we can reduce health inequalities.

Finally, I urge all colleagues to do what I am trying to do, which is make sure that the STP in their area rises to the challenges and delivers the care that we all want for our patients in future.

Land Registry

Lindsay Hoyle Excerpts

Thursday 30th June 2016 Commons Chamber

[Lucy Allan (Telford) (Con)]

It is a pleasure to be called to speak in this really important debate. I thank the right hon. Member for Tottenham (Mr Lammy) for securing it, and all Members who have spoken in a very collaborative way—that is the way forward on issues such as this.

As is the case for many other Members who have spoken, the Land Registry has been an important employer in my constituency for many years. It is part of Telford’s fabric and success story. As Members may know, Telford is a new town, built in the 1960s on the coalfields of east Shropshire. Today, it is a thriving, dynamic, vibrant town at the cutting edge of new technology, with inward investment and innovation, but that has not always been the case.

Back in the 1980s, when the Land Registry came to Telford, it was an unemployment blackspot. The Land Registry gave Telford a much needed boost. Throughout its history, Telford has found ways of overcoming obstacles and meeting the challenges it has faced. The Land Registry has played a really important part in that, which is why my constituents have a genuine attachment to it and a genuine concern for its future.

I have met employees and their representatives to get a full understanding of those concerns. Although some people have sought to make this an ideological and political issue, my constituents, Land Registry employees and their families are rightly most concerned about retaining jobs in Telford and securing the Land Registry’s future. I share those concerns. As a constituency MP who is passionate about Telford’s future, securing those jobs for Telford matters to me most. The employees I have met are long-serving, highly experienced members of staff who have gained invaluable experience, expertise and knowledge of their roles over the years. They make an important contribution to that successful business.

Telford is a great place to live and work. Businesses move there all the time. It has a unique rural-urban identity, in the heart of rural Shropshire but with a vibrant urban twist. Close to the M54, with good links to Birmingham, it has clean air, green spaces and a quality of life second to none. Most of all, it has a community of hard-working people who want the best for their families and for Telford’s future. We live in a modern, changing world that will constantly evolve. Telford is used to change, and has always adapted to it, and that flexibility and resilience lie behind the success story that Telford is today. Like any successful business, the Land Registry will continue to evolve and modernise, as an efficient business.

I am grateful to the Secretary of State for Business, Innovation and Skills for taking the time to listen to me and hear my constituents’ concerns at a recent meeting. I will do everything I can in this place to ensure that Land Registry jobs stay in Telford. Although I have no ideological opposition whatever to any particular ownership structure, I could not support any sale that was not value for money for the taxpayer or risked jobs in my constituency. I recognise that no decision has yet been made. The consultation has only just ended and the responses are being considered. I do not want to get distracted by any ideological or party political arguments on this. I am sure that Members on both sides of the House agree that people and jobs are what matter, not politics.

As I have completely lost my place, I will ad lib. I once again thank the right hon. Member for Tottenham. I was slightly concerned by some parts of the motion, as over the past few weeks we have seen rather a lot of fear and scaremongering, which does not help my constituents, whichever side it comes from. I would really welcome a collaborative, cross-party approach on this, where we do not talk about dirty money, or tax havens, or the proceeds of crime—that does not benefit my constituents. I urge all Members to reflect on the fact that if we are to ensure that the Land Registry retains its current structure we must work together to urge the Government to consider all the issues that have been raised and take note of everything that colleagues have said.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. I understand that the spokesperson for the Scottish National party has already spoken, so I now call Bill Esterson.