Oral Answers to Questions
Matt Hancock Excerpts(5 years, 1 month ago)
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Marion Fellows (Motherwell and Wishaw) (SNP)
The Secretary of State for Health and Social Care (Matt Hancock)
I am delighted that a deal has been agreed to provide Orkambi and other cystic fibrosis drugs on the NHS. This deal is great value for the NHS and backed by the National Institute for Health and Care Excellence, but crucially it will improve thousands of lives. My heartfelt thanks go out to many campaigners from right across the House who have pushed this agenda but especially to the Cystic Fibrosis Trust and the patients who, along with their families, have bravely campaigned against this devastating disease. I am thrilled that we can make this progress.
Christian Matheson
It may have taken a few years, but I warmly welcome the Secretary of State’s announcement and congratulate him on it. I echo his congratulations to all the campaigners, particularly my hon. Friend the Member for Dudley North (Ian Austin), who has led much of the campaign.
Ten per cent. of cystic fibrosis sufferers are still waiting for approval for another critical combination therapy, called Elexacaftor. Can the Secretary of State reassure me that eligible patients will not have to wait so long for that to be approved?
Matt Hancock
Of course I would have liked the deal to happen sooner, but I am glad that the company has now committed itself to engaging properly in the normal processes which mean that we obtain drugs nearly as fast as any country in the world. This result—this deal—shows that the system is working to get cutting-edge drugs into the NHS at good value for the NHS pound.
I join the hon. Gentleman in paying tribute to the hon. Member for Dudley North (Ian Austin). I also pay tribute to the hon. Member for Bristol East (Kerry McCarthy), and to other Members in all parts of the House who have campaigned on this issue. It is great to have made some progress.
Kerry McCarthy
I am obviously delighted by this news, and the Secretary of State will know how delighted my family were, because when the news broke I showed him the family WhatsApp with lots of exclamation marks and happy smiley-face emojis. As I have told him, my constituent Jake Ogborne, an 18-year-old boy, was in a similar situation earlier this year when he thought that he had been approved for the drug Spinraza—there is a an online video of him having a cake and a celebration—but then he found that according to the small print he was not eligible. I want his family to be as happy as my family are now, and I hope very much that the Secretary of State will be able to look into his case.
Matt Hancock
Absolutely. I pay tribute to the hon. Lady, who raised that case with me last night and gave me advance warning that she would raise it in the House today. I shall be happy to ensure that the relevant member of the team meets her with her constituent, if appropriate, so that we can get to the bottom of this.
Marion Fellows (Motherwell and Wishaw) (SNP)
I want to associate myself with the thanks to all the campaigners who worked so hard to ensure that these drugs would be available in England as well as Scotland. I never doubted that my Government would press and press, and I am delighted that the Secretary of State’s Government have followed suit. However, there are still great Brexit uncertainties. Given that people fought for so long, what reassurances can the Secretary of State give those who will obtain these life-saving drugs that they will be possible, affordable and sustainable?
Matt Hancock
The agreement that the hon. Lady’s Government—the UK Government—reached with Vertex means that this drug will be available in Wales and Northern Ireland as well. It is true that Scotland chose to go it alone and as a result has not received such good value for money, but what really matters is that the drug is now available throughout the United Kingdom.
Bim Afolami (Hitchin and Harpenden) (Con)
Will the Secretary of State pay tribute to campaigners in my constituency such as Matthew Dixon-Dyer, who campaigned very strongly and lobbied me very effectively? Will he also illuminate the House on how, in future, we can have smoother access to drugs such as Orkambi on the NHS?
Matt Hancock
My hon. Friend has campaigned long and hard and has talked to me an awful lot about how important it has been to obtain Orkambi and the other cystic fibrosis drugs that will save lives, and I pay tribute to his campaigning. As I have said, we now have a system that allows access to drugs for the NHS at some of the best value in the world, and that system is working. It is clearly getting the drugs that are needed into the NHS, and I think that we should all get behind it.
Vicky Ford (Chelmsford) (Con)
Children and their families throughout the UK will be saying a huge thank you for Orkambi. Will my right hon. Friend now turn his attention to phenylketonuria, or PKU, and the drug Kuvan, so that children like my constituent Cait, who is now 11, do not need to wait any longer?
Matt Hancock
I can assure my hon. Friend, who has campaigned long and hard on the issue of access to Kuvan, that we are working on that as well. I hope very much that we can come to a positive conclusion.
Daniel Zeichner (Cambridge) (Lab)
The system did finally work, but did it not take far too long, and is it not time to introduce transparency into this opaque system, particularly when the Americans are waiting to pounce on our pharmaceutical industry?
Matt Hancock
The NHS is off the table in trade talks and pharmaceutical pricing is off the table. Transparency over pharmaceutical pricing would not benefit this country at all because we get the best deals in the world because we can keep them confidential, so it is a slight surprise to hear a Labour Member argue for what would effectively lead to higher prices for drugs in the NHS. Instead, we will protect the NHS.
Bill Grant (Ayr, Carrick and Cumnock) (Con)
Margot James (Stourbridge) (Ind)
The Secretary of State for Health and Social Care (Matt Hancock)
We have changed the law so that specialist doctors on the GMC’s specialist register can now prescribe cannabis-based products. I have asked the NHS to undertake a rapid review of how this is working, and my Department is now working with delivery partners to implement the report’s recommendations.
Margot James
I thank my right hon. Friend for his answer, and for his work in this area, but leaving the decision to prescribe cannabis for medical use to individual doctors while NICE is saying that more evidence is needed risks the inertia that has led the MS Society to conclude that not a single person has yet benefited from the legalisation of cannabis for medical use, except those who are able to pay up to £1,000 a month. Will my right hon. Friend meet the MS Society and me to discuss more ways of accelerating the uptake of Bedrolite among patients who have a reasonable expectation of benefiting from it?
Matt Hancock
I am very happy to meet my hon. Friend and colleagues from the MS Society. She is right to say that we need to ensure we get the evidence that the clinicians understandably want, and in fact we have committed public funds, through the National Institute for Health Research, to establish clinical trials to develop that evidence base.
Fiona Bruce (Congleton) (Con)
Neil Coyle (Bermondsey and Old Southwark) (Lab)
The Secretary of State for Health and Social Care (Matt Hancock)
We have expanded access to PrEP—pre-exposure prophylaxis—so that everyone who needs it should have access. Thousands more places remain available on the trial. We are working closely with the NHS, Public Health England and local authorities, who have to play their part, to plan for a seamless transition from the trial to routine commissioning from April next year.
Neil Coyle
The Secretary of State gave a personal commitment that the PrEP trial would be extended. He has failed to meet that commitment, and men have contracted HIV as a direct result of the Government’s failure. What faith can people who need PrEP and organisations such as the Terrence Higgins Trust, the NHS and councils have that the Government’s national programme will be ready and able to meet the demand that exists?
Matt Hancock
This is an important issue and I care very much about getting the roll-out right. I chastise the hon. Gentleman slightly for his tone. The Minister met the Terrence Higgins Trust yesterday. It agrees with the approach that we are taking. The roll-out from a trial to routine commissioning will happen in April. There are some gaps where local authorities need to do more, but from an NHS perspective, there are thousands more places available on the trial. If the hon. Gentleman feels strongly about the issue, as I do, he should be working with us to get local authorities to do their part, because the NHS is doing its part.
Penny Mordaunt (Portsmouth North) (Con)
May I congratulate the Secretary of State on setting the 2030 target on HIV infections? Access to PrEP is vital for reducing new infections, but access to healthcare professional time is also critical. Does he therefore agree with me and the trust that we must do everything to remove the funding and logistical obstacles that are discouraging clinics from filling the many places that are now available on the trial?
Matt Hancock
I wholeheartedly agree with my right hon. Friend, who is absolutely spot on about this, but there is more that we need to do in ensuring that the health inequalities of people who are homosexual or LGBT are reduced across the board. We have a whole plan to make that happen. She played an important part in government, and I will rest at nothing to ensure that we address these problems, but we should not engage in the sort of scaremongering that we have heard from the Opposition.
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)
I hear what the Secretary of State has said, but data from the British Association for Sexual Health and HIV have shown that nine gay and bisexual men in Greater Manchester were diagnosed with HIV while waiting to access the PrEP trial. This is likely to be just the tip of the iceberg in terms of the number of people who have acquired HIV because they could not access the trial. He will agree that this is totally unacceptable and goes against the Government’s own commitment to eradicate HIV by 2030, so does he think that PrEP should be routinely commissioned before the trial ends in September 2020 and will he commit now to that happening?
Matt Hancock
We are switching to routine commissioning from April. It is a deep frustration of mine that some local authorities are not putting in place the necessary measures. I will look into Manchester in particular; I did not know about that example. I personally set the goal of our being HIV-free by 2030. I am delighted that, with the support of my right hon. Friend the Member for Portsmouth North (Penny Mordaunt) when she was the Minister for Equalities, we have made the progress that we have. I have absolutely no doubt that there is further road to travel and that we should all come together in support of equalities in health provision, especially in this area. I look forward to working with the hon. Lady and all those who are on the side of trying to make this change happen.
Mr Speaker
I call Tommy Sheppard. Where is young Sheppard? [Interruption.] He has withdrawn. I was not advised of that. Never mind, he is a most active beaver in the Chamber in normal circumstances. It does not matter that he is not here, because Mr Andrew Rosindell is.
Kelvin Hopkins (Luton North) (Ind)
The Secretary of State for Health and Social Care (Matt Hancock)
Since the last Health questions, we have announced 20 hospital upgrades; 40 new hospitals; £200 million for cancer diagnosis kit; £250 million for the NHSX artificial intelligence lab; a social prescribing academy, as mentioned by my right hon. Friend the Member for Wantage (Mr Vaizey); the launch of the “Every Mind Matters” public mental health campaign; a landmark agreement so that cystic fibrosis drugs, including Orkambi, can be available on the NHS; and the firm commitment from the Prime Minister that in any trade talks after Brexit, the NHS is—and always will be—off the table.
Kelvin Hopkins
There were 1.2 million hospital admissions related to alcohol consumption in England in 2017-18—3% up on the previous year. Hospital admissions due to alcohol-related liver disease have increased by 43% in the last 10 years, and alcohol problems now cost the NHS an estimated £3.5 billion every year in England alone. Why have the Government not properly recognised the enormous and growing scale of the country’s alcohol-related health problems, and why have they failed to bring forward serious and effective measures to address them?
Matt Hancock
The prevention Green Paper that we published in the summer specifically addresses what is needed. The effort that we put into supporting those who are hospitalised through their abuse of alcohol needs to be enhanced, and there is an enormous amount of effort under way to make that happen.
Sir David Evennett (Bexleyheath and Crayford) (Con)
Rachel Maclean (Redditch) (Con)
Matt Hancock
We will see shovels in the ground, I very much hope, from next year. I pay tribute to my hon. Friend, who has campaigned endlessly for these improvements to the hospital in Redditch. There is no better supporter of Redditch than her. She has badgered me endlessly, met me formally and bumped into me on the campaign. Every time I see her, she says, “Can we have the improvement to the hospital?” and the answer is yes.
Dr Philippa Whitford (Central Ayrshire) (SNP)
The Secretary of State says that the NHS is not on the table, but President Trump and his trade officials have been very clear that they will seek to more than double drug prices, driving up the bill from £18 billion to £45 billion a year. What discussions is the Secretary of State having, and does he accept that this is why devolved Governments must have input in trade deals?
Matt Hancock
The NHS is not on the table in any trade deal. Medicine pricing and drugs pricing is not on the table in a trade deal. Let me bring the hon. Lady’s attention to this quotation from the former US trade general counsel, Stephen Vaughn, who said that if the UK really is determined to make no changes at all on pharmaceuticals, we can absolutely hold that position and that that has nothing to do with them. Quite right —we do hold that position; they are off the table.
Mark Menzies (Fylde) (Con)
I welcome the announcement of Royal Preston Hospital being included in the hospital upgrades programme, but what plans does the Minister have for Blackpool Victoria Hospital, where services such as opthalmics are now over capacity and could do with some additional investment?
Mr Jim Cunningham (Coventry South) (Lab)
Matt Hancock
Getting this right is incredibly important. The change in the guidance last month allows every single NHS trust to introduce the flexibilities, immediately, to ensure that doctors can do the work and the overtime they need, get paid properly for it and not get penalised through the impact on the pensions system. That change came in at the start of last month. I will write to the hon. Gentleman with the details, so that he can tell all doctors that these flexibilities are available so that they can do the work that they need to.
Jeremy Lefroy (Stafford) (Con)
Earlier this year, the Secretary of State spoke about the importance of introducing new financing mechanisms to develop and deploy drugs and vaccines to tackle antimicrobial resistance. Will he update us on that, please?
Matt Hancock
Yes. In January, with my hon. Friend’s support, we launched the five-year plan to tackle antimicrobial resistance. We have now taken that to a global level; this is a global problem. We have appointed Dame Sally Davies, who recently stood down as the chief medical officer, to be our AMR tsar so that she can continue the drive both domestically and around the world.
Imran Hussain (Bradford East) (Lab)
Matt Hancock
We are putting record amounts of funding into the NHS across the country, including in Bradford. If the people of Bradford get their election—if Labour Members vote for it—and they want to know what is the best thing to do to support long-term investment in the NHS, I can tell them that it is to support the only true party of the NHS: the Conservatives.
Stephen Metcalfe (South Basildon and East Thurrock) (Con)
I note the recent announcement of the roll-out of the electronic prescription service. How will that benefit my constituents? When will it be rolled out, and how can my constituents use it to support their local community pharmacy?
Laura Smith (Crewe and Nantwich) (Lab)
Matt Hancock
That is an incredibly important matter. It was addressed in the Care Act 2014, but I am happy to look at any proposals, because it is important that we get fair treatment right across the country.
Several hon. Members rose—
Kevin Hollinrake (Thirsk and Malton) (Con)
Does the Health Secretary agree with the joint report produced by the Housing, Communities and Local Government Committee and the Health and Social Care Committee that the best way to fund adult social care is through a social care premium?
Christine Jardine (Edinburgh West) (LD)
Matt Hancock
As we discussed in the answer to an earlier question, I have both decriminalised the use of cannabis oil and introduced the National Institute for Health Research clinical trials. However, individual rules about prescriptions have to be for individual clinicians, and when it comes to funding it in Scotland, that has to be a matter for the Scottish NHS.
David Tredinnick (Bosworth) (Con)
Will the Secretary of State look at making greater use of chiropractors and osteopaths in support of orthopaedic surgeons?
Matt Hancock
How could I say no as my wife was an osteopath? I understand very strongly the importance and value of those professions.
Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)
Matt Hancock
I am of course engaged with the Treasury on this, but I would also say that these flexibilities are available right across the country and they must be used by trusts.
Several hon. Members rose—
Dr Sarah Wollaston (Totnes) (LD)
May I thank you, Mr Speaker, for all the support you have given to Select Committees during your time in the Chair?
After a long period of engagement with patients, staff and partner organisations, the NHS has come up with a clear set of recommendations to the Government and Parliament for the legislative reforms it needs. I hope all political parties are listening to that. Will the Secretary of State confirm that he will accept all its recommendations, including the one that recommends scrapping section 75 of the Health and Social Care Act 2012 and other provisions, which would end wasteful contracting rounds in the NHS?
Matt Hancock
I want to pay tribute to the hon. Lady for the work that she, her Health Committee and all its members have done on this legislation. I think that the legislation proposed by the NHS—with the support of the Select Committee, which will of course scrutinise it further—is an important step forward. I am delighted that Her Majesty committed in the Queen’s Speech to legislation on the NHS, of which these proposals will be the basis.
Mr Jeremy Hunt (South West Surrey) (Con)
Haslemere in my constituency has a busy minor injuries unit, used by 8,000 people a year, which is currently threatened with closure. Given that that would be catastrophic for the town of Haslemere and for the Royal Surrey A&E in Guildford, will the Secretary of State listen to the residents of Haslemere and agree not to close this vital facility?
Matt Hancock
My predecessor, my right hon. Friend, is an assiduous campaigner for South West Surrey. There is no better spokesman for South West Surrey than my right hon. Friend. He has raised this issue with me in private over recent weeks since these concerns were raised. I have in turn raised it with the chief executive of the NHS, and I can confirm that the walk-in centre will stay open.
Rachael Maskell (York Central) (Lab/Co-op)
The primary care mental health service in York is not being cut; it is being scrapped. Will the Secretary of State urgently meet me to save this service?
Sir David Amess (Southend West) (Con)
Does my right hon. Friend the Secretary of State share my concern that a highly paid health executive has been made redundant by Southend clinical commissioning group, given £200,000 and then employed somewhere else in the organisation? Disgraceful.
Matt Hancock
Today is the first time I have heard of this. National health service redundancy terms were capped at £160,000 in April 2015. We consulted on bringing that down to £95,000 and we have introduced powers in primary legislation to claw back contractual redundancy payments when someone returns to any public sector job within 12 months. I will raise the individual case with the NHS to ensure that taxpayers’ money is being used as well as possible.
Mr Steve Baker (Wycombe) (Con)
Will the Secretary of State visit Wycombe Hospital to discuss the future of our increasingly tired 1960s tower block?
Matt Hancock
I am absolutely happy to look at that. We have put in place the health infrastructure plan to ensure that there is a long-term plan for replacing ailing hospitals. That includes the ability to make new proposals that were not announced in the first round. I am happy to visit Wycombe, which is a beautiful town.
Bill Esterson (Sefton Central) (Lab)
The Government have repeatedly turned down plans for both a new health centre in Maghull and a new walk-in centre in Southport. Is not electing a Labour Government the only way my constituents and those of Members across the House will get the new facilities they so badly need?
Matt Hancock
On the contrary. I was in Southport last month and I saw the fantastic staff and what they do. I was able to talk to them about the improvements that we are planning in Southport. People in Southport and across the country know that unless we have a strong economy we cannot fund a strong NHS. The Labour party’s plans for the economy would sink it. Only with a strong Conservative Government can we have a properly funded NHS.
Several hon. Members rose—
Mr Mark Francois (Rayleigh and Wickford) (Con)
Mr Speaker, you won. Although we have not agreed on everything in the 18 years I have been in the House, I say most earnestly, from one midget to another, that I wish you a long and happy retirement.
Following the question of my hon. Friend the Member for Southend West (Sir David Amess), I point out that the individual he mentioned moved from being the accountable officer of the Southend CCG to the accountable officer of the Thurrock CCG. It was a sideways move for which he trousered a fifth of a million pounds of public money, which should have been spent on patients. Do not just cap the payment, sir, make him pay it back.
Matt Hancock
Again, we have the powers in primary legislation to claw back contractual redundancy payments. Nobody is keener to ensure the careful expenditure of taxpayers’ money than my right hon. Friend. The matter has been raised very powerfully by the voices of Essex in this question time.
Several hon. Members rose—
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
I was very distressed to learn last week that a higher than average number of people in Hull are having foot amputations, partly because of diabetic foot ulcers and despite excellent work by the vascular department. The message from that department is that it is underfunded, under-resourced and in desperate need of an infrastructure upgrade to its theatre. Time is running out, so instead of asking the Secretary of State to meet me, will he just act very quickly to give it the funding it needs to stop unnecessary amputations happening in Hull?
Matt Hancock
We have the largest infrastructure investment programme in a generation and I am very happy to look at the specific request from Hull to ensure it gets the infrastructure it needs.
Health and Social Care
Matt Hancock Excerpts(5 years, 1 month ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
The Department’s remit formally expanded from the “Department of Health” to the “Department of Health and Social Care” in January 2018. Our health and social care services continue to meet the challenges of rising demand and ever more complex need. In 2018-19, there were 24.8 million A&E attendances, 4.3 million more than were seen in 2009-10 and 1.7 million more within four hours. 1.8 million requests for adult social care support from 1.3 million new clients were received in 2017-18. This is down to the commitment, compassion and professionalism of the 1.3 million people who work in the NHS and the 1.6 million people working in adult social care services across the country. As at June 2019 there were over 17,300 more doctors and over 8,000 more nurses and health visitors since June 2010, with plans to recruit even more.
Since 2017, the Department has achieved a significant amount—continuing to drive forwards its strategic priorities to help people live more independent, healthier lives for longer. In July 2019, the Department reached an important milestone: the 100th anniversary since the Ministry of Health was established. It has also been working to ensure the health and social care system is as prepared as possible for EU exit.
A stronger NHS, driven forward by the ambitions set out in the NHS long term plan and significant funding commitments that support it. In July 2018 we celebrated the 70th anniversary of the NHS. Accompanying this significant milestone, the Government announced the single biggest cash increase made in the NHS’s history—an extra £33.9 billion a year by 2023-24 (compared with 2018-19). This backs the NHS’s clinically led long term plan (LTP), which sets out a bold and innovative vision, safeguarding our nation’s health for generations to come.
A healthier nation, with prevention at the heart of our strategy to tackle the causes of poor health and ongoing efforts to ensure we play a leading role in confronting global health challenges.
Prevention remains a high priority for the Department. Important progress has been made across a number of areas, including: the tobacco control plan published in 2018; extending the HPV vaccine to boys; a new £6 million scheme to improve outcomes for children with alcohol dependent parents; exceeding the NHS diabetes prevention programme commitment a year early; being one of the first countries in the world to achieve the UN’s “90/90/90” goals on HIV prevention; creating the first Minister for Suicide Prevention alongside the cross-Government suicide prevention workplan; and introducing the soft drinks industry levy in April 2018, which has been hugely successful—the average sugar content of drinks subject to the levy decreased by 28.8% between 2015 and 2018.
The Prevention Green Paper published in July 2019 signalled a new approach for the health and social care system. This included chapter 3 of the childhood obesity strategy and driving forward policies in chapter 2, such as ending the sale of energy drinks to children and exploring what additional opportunities leaving the European Union presents for front of pack food labelling in England.
The Government have continued to protect and promote the health of the nation, including through: consulting on proposals to reduce ill-health related to job loss; fully establishing the Northern Ireland abortion scheme in 2019; announcing a new network of eight walk-in FGM clinics; new legislation on organ donation; and leading the healthcare response to emergency incidents, such as the Novichok poisoning in Salisbury.
We continue to play a leading role in global health security, through our work with the G7, G20, World Health Assembly and the UN. The Government have published a 20-year vision and a 5-year national action plan for how the UK will contribute to containing and controlling antimicrobial resistance by 2040.
A transformation in care, to make sure we are supporting the most vulnerable in our community with joined-up, compassionate and modern services.
We have been supporting primary and community services through: investment which will grow faster than the overall NHS budget; a new 5-year contract for GPs; expanding evening and weekend GP appointments; rolling out the NHS comprehensive model of personalised care; improving diagnosis of dementia with record recent monthly figures; a new clinical negligence scheme for general practice; and we now have record numbers of GPs entering training, with 3,415 acceptances in 2018, we expect that trend to continue this year.
The Government and the NHS are continuing to make progress towards parity of esteem for mental health, including: spending on mental health rising to £12.5 billion in 2018-19; NHS LTP committing to spending a further £2.3 billion a year by 2023-24 to transform mental health services, and support 380,000 more adults and 345,000 children and young people (aged 0-25); publishing the 2017 Green Paper on children and young people’s mental health and creating the first wave of schools and college-based mental health support teams; modernising the Mental Health Act 1983; hosting a global ministerial mental health summit to put mental health on an equal footing with physical health; and contributing to the Government’s first strategy to tackle loneliness in England in October 2018. Overall, waiting time standards and the IAPT recovery rate continues to improve and we are consistently exceeding the targets: 52.1% of patients who finished a course of psychological therapy recovered in 2018-19 (up from 50.8% in 2017-18), this is the second reporting year in a row when the recovery rate has surpassed the Government target that 50% of eligible referrals to IAPT services should move to recovery; and 89.4% of people were seen within six weeks for their first course of treatment, against a target of 75% (an increase from 89.1% in 2017-18).
Tackling cancer remains a priority for this Government. In October 2018, the Prime Minister announced measures with the aim of seeing 75% of all cancers detected at an early stage by 2028 to save 55,000 lives a year. Survival rates are at a record high, increasing year-on-year since 2010. One-year survival rate for adults diagnosed in 2016 is over 70%, an increase of around 10 percentage points over the last two decades. A recent international study showed that the five-year net survival rate for breast cancer increased by 7% between 2000-04 and 2010-2014—among the fastest in western Europe. In 2018-19 the NHS carried out almost 23 million diagnostic tests, eight million more than in 2010 (an increase of 53%); 2 million people were seen by a specialist for suspected cancer, over 1 million more than in 2010 (an increase of 124%); and 310,700 patients started treatment for cancer, around 70,900 more than in 2010 (an increase of around 30%).
The Government have given councils access to up to £3.6 billion more dedicated funding for adult social care in 2018-19. In total, the Government have given councils access to around £10 billion more adult social care funding from 2017-18 to 2019-20. In the recent 2019 spending round we announced councils will have access to a further £1.5 billion for social care—£1 billion through a new grant and £500 million through the adult social care precept. This will support councils to meet rising demand and continue to stabilise the social care system. We ran two new national adult social care recruitment campaigns to raise the image and profile of the sector and encourage people with the right values to apply for current vacancies. In June 2018 we published the cross-Government carers action plan 2018-20.
We announced new landmark arrangements for community pharmacy, which came into force from October 2019. In addition, working with the branded pharmaceutical industry, represented by the ABPI, we agreed the 2019 voluntary scheme for branded medicines pricing and access, which began on 1 January 2019 and will run for five years. The NHS is expected to save around £930 million on its medicines bill for 2019 as a result.
In July 2019 the new NHS patient safety strategy set out NHS actions to continue to improve patient safety. We published the Health Service Safety Investigations Bill, which will establish the world’s first independent body to investigate patient safety concerns and share recommendations to prevent incidents.
A workforce fit for the future, created by recruiting, retaining and developing the people we need to deliver and by making the health and care system a rewarding place to work.
The interim NHS people plan, published in June 2019, set out proposals to grow and support the NHS workforce. As part of the 2019 spending round every nurse, midwife and allied health professional will receive a new £1,000 personal development budget over three years.
In September 2019, we agreed a new contract deal for junior doctors in England, successfully bringing an end to the junior doctors dispute, following a review of the 2016 contract.
In June 2018, we agreed a new multi-year pay and contract reform deal for agenda for change staff which benefits nearly 1 million NHS workers over three years.
Better technology and data, which will harness the full potential of technology to modernise and improve the way we deliver healthcare for the 21st century.
In October 2018, we published the Secretary of State’s technology vision “The future of healthcare: our vision for digital, data and technology in health and care”. In July 2019 NHSX became operational to drive transformation and lead policy, implementation and change—leading the largest digital health and social care transformation programme in the world; and in August 2019 we announced a new artificial intelligence lab, to help solve some of healthcare’s toughest challenges. In total, over £250 million will have been invested nationally to improve the cyber security of the health and social care system between 2016 and 2021.
We have supported and funded the ambitious and world-leading 100,000 genome project, reaching the goal to sequence 100,000 whole genomes in December 2018. We established the genomic medicine service in the NHS—the first of its kind in the world to integrate whole genome sequencing into the healthcare system.
The Department has maintained its focus on investing in infrastructure and research, through the National Institute for Health Research (NIHR). In 2018-19 there have been over 1 million participants in NIHR-supported health and social care research studies. We have maintained spending on dementia research and are on track to meet our commitment of £60 million spent annually to March 2020.
In December 2018, the Government, in collaboration with industry, launched the second life sciences sector deal, backed by a range of organisations from across the sector and £1.2 billion of new investment from industry.
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The National Health Service
Matt Hancock Excerpts(5 years, 1 month ago)
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Dr Philippa Whitford (Central Ayrshire) (SNP)
Before I start my speech, I would like factually to correct the Secretary of State, who claimed that Barnett consequentials in Scotland are not passed on. I reassure him they are all passed on. He talks about the figures as a percentage. Scotland spends £185 a head more on healthcare and £157 a head more on social care. Of course it is a smaller percentage but, in actual cash, Barnett consequentials are all passed on. I would be grateful if he would either improve his maths or stop repeating this narrative.
I really welcome some elements of the Queen’s Speech, particularly the Health Service Safety Investigations Bill. I was asked to serve on the Joint Committee, which I felt did an incredible job, but we completed that job last July; approaching a year and a half on, sadly, the Bill has still not come forward. I hope it will not be too tardy from this point.
Dr Whitford
Okay; I welcome that. However, I would suggest that the Healthcare Safety Investigations Bill is about looking at mistakes after they have happened. I invite the Secretary of State again to look at the Scottish patient safety programme, which is more than 10 years old and has reduced hospital deaths, including post-surgical deaths, by over a third because the aim is to prevent harm in the first place.
I welcome the Secretary of State’s reference to whistleblowers, but it is not just about having guardians in hospitals. It is critical that the Public Interest Disclosure Act 1998 is reformed. Only 3% of employment tribunals are successful. All Members who have dealt with any cases on this issue will know that the wreckage of whistleblowers’ careers acts as an absolute brake on people coming forward. You can say what you like, but they are faced with the question, “Do I speak up and risk my career, my family income and my home?” It is not just a matter of paying lip service to this issue; we actually need change.
I welcome the ending of the private finance initiative, which was originally brought under a Conservative Government, but was really accelerated, I am afraid, under Gordon Brown. We are now facing the fact that £13 billion-worth of hospitals in England will have cost £80 billion by the time they are paid off. I call on the Secretary of State not just to end the PFI going forward, but to look at whether these contracts could be ended and renationalised to avoid another £55 billion having to be paid over the next 30 years. This problem is UK-wide, so we were saddled with these contracts in Scotland as well. There are health boards across England that are spending up to 16% of their income on their PFI contracts, and that obviously undermines patient care.
The National Health Service
Matt Hancock Excerpts(5 years, 1 month ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Jonathan Ashworth
I need to move on because I think the House is getting slightly tired of our focusing on our constituency issues and I am abusing my position. I will try to give way again shortly, but I am testing the indulgence of the House on the issue of Leicester.
In the Queen’s Speech, there are also proposals on mental health, and we look forward to the mental health White Paper and hope that Sir Simon Wessely’s review is quickly implemented. He also called for significant capital investment in the mental health estate, yet none of the hospitals the Secretary of State has announced includes mental health trusts.
Jonathan Ashworth
No they don’t; none of the hospitals the right hon. Gentleman announced at the Tory party conference includes mental health trusts. He knows there are 1,000 beds in old-style dormitory-style wards in desperate need of upgrade. He knows that we have problems with anti-ligature works that desperately need doing in mental health trusts because they are putting lives at risk every day.
On social care, we were told we were going to have the big solution to social care. The Secretary of State was briefing that a previous Chancellor, the right hon. Member for Runnymede and Weybridge (Mr Hammond), was holding him back and he was going to give us a solution on social care. And what do the Government say? They say, “We have not got a social care Green Paper, we have not got social care proposals, we will get proposals on social care in due course.” The Secretary of State is kicking the can on social care down the road again.
Let me come to the Health and Social Care Act 2012. On Second Reading, it was described by the new Minister, the hon. Member for Mid Bedfordshire (Ms Dorries)—I welcome her to her elevation to the Treasury Bench; it was remiss of me not to do that earlier—as one of the most exciting Bills to be put before Parliament in the 62 years since the NHS was established. We were told that there was going to be legislation to undo the worst excesses of that Lansley Act, but all we are getting apparently is draft legislation, again, “in due course”—that is the wording in the explanatory notes to the Queen’s Speech.
The Secretary of State for Health and Social Care (Matt Hancock)
I rise in support of the Queen’s Speech, which has more action on health than any Queen’s Speech in a generation. At its heart it has five major legislative reforms that will set the course of health and social care for years to come. I will turn to each of these in a moment, but I just wanted to address something that the hon. Member for Leicester South (Jonathan Ashworth) said. Let me be completely clear: the NHS is not, and never will be, for sale under this Conservative Administration. The Prime Minister made it abundantly clear and the President made it clear: the NHS will not be on the table.
We know why the Labour party likes to spread this nonsense about the NHS: it has not got anything constructive to say. Labour Members do not want to talk about Brexit, because they have decided not to decide on their position, and instead they are trying to scare some of the most vulnerable people in our society—the very people they claim to represent. The nonsense we have just heard shows that Labour will stop at nothing to hide its Brexit position, which is just for more delay, more confusion and more indecision, and it shows that the Labour leadership is not up to the job of governing the party, let alone the country. By contrast, the Conservative party has protected and nurtured the NHS for 44 of its 71 years. We are the party of the NHS.
Sir Greg Knight (East Yorkshire) (Con)
When trying to assess what Labour might do if in government should we not look at the words of Nye Bevan when he said:
“Why gaze in the crystal ball when you can read the book”?
We have the book of the NHS under Labour control in Wales to look at; it is an appalling mess.
Matt Hancock
There is no doubt that when looking at the facts of the delivery of the NHS in Wales we see what happens to an NHS under Labour control. I support all those who work in the NHS in Wales—they do a great job—but, sadly, it is harder to deliver the NHS in Wales. There is another argument too: we know that we can fund good public services and the NHS only with a strong economy, and the plans of the Labour party would ruin it.
Tonia Antoniazzi (Gower) (Lab)
It is absolutely disgusting that the Secretary of State can stand there and say that about the NHS in Wales, when it is his Government who underfund the NHS in the whole of the UK.
Matt Hancock
I did find it surprising that the hon. Member for Leicester South did not mention the £33.9 billion largest and longest funding settlement in history, but I would also note this: funding for the NHS under the Welsh Government in Wales has risen more slowly than it has in England, because we have funded the NHS properly.
Greg Hands (Chelsea and Fulham) (Con)
I thank the Secretary of State for giving way, and I also thank him for his announcement earlier this year, first, on guaranteeing A&E services at Charing Cross Hospital and, secondly, on the floor-by-floor refurbishment of that hospital. Last month, Hammersmith and Fulham CCG told me that the popular Parsons Green walk-in centre would have to change to appointment-only after 31 December due to a rule change. Can he confirm that there is no need for it to do that and that the future of the walk-in centre at Parsons Green is as bright and rosy as that of Charing Cross Hospital?
Matt Hancock
Yes, I can give that confirmation. I have seen some reports from the local Labour party putting fears into people’s minds about the future of the Parsons Green walk-in centre. There are no plans to close the centre, and anybody who says so is simply scaremongering. I am absolutely delighted at the campaign that my right hon. Friend ran to save the A&E and to save the services in west London; it was thanks to him and his efforts that we managed to do exactly that.
Debbie Abrahams
Does the Health Secretary not feel ashamed that we have the highest rate of child mortality in western Europe? We also have a declining life expectancy; for women it is getting worse and for deprived areas it is getting worse. We are one of the only developed countries where that is happening, and it is partly as a result of the underfunding of the NHS but more widely because of austerity.
Matt Hancock
I have great regard for the campaigning that the hon. Lady does on many topics, but I am afraid to say that she was factually inaccurate in what she said just now; it is not true. We are putting the largest and longest investment into the NHS in its history, and I think that that is the right thing to do.
David Tredinnick
May I just tell the Secretary of State what an amazing job he is doing for Leicestershire and how proud the county is of this forward investment? May I draw his attention, however, to the NHS carbon footprint in England, which is around 27 million tonnes of carbon dioxide equivalents, and suggest that with the new hospital builds across the country, he ought to make better use of zero carbon medicines and treatments? That means embracing acupuncture, herbal medicine, homeopathy, chiropractic and osteopathy. Will he also ensure that the osteopaths and chiropractors who have been regulated by Act of Parliament since 1993 and 1994 work with the orthopaedic surgeons?
Matt Hancock
I am absolutely delighted to work with my hon. Friend on that subject, and also on the capital investment into Leicester. I do not want to spend too long on the issue of Leicester, because we almost had an Adjournment debate on that subject a few minutes ago. We have announced 40 new hospitals over the next decade, which we will ensure include carbon neutral and green elements; we have discussed that. While we are doing that, however, such is the hon. Member for Leicester South’s commitment to opposition that he even opposes the new hospital we are building in his constituency. He described the £450 million of investment on 29 September as “downgrading” when he talked about local opposition. This is long-term investment that the trust chief executive describes as “completely transformational”. The hon. Gentleman should rejoice at this excellent news. He is so good at opposition that I have a long-term plan for him, and that is to keep him in opposition for the long term.
Eddie Hughes (Walsall North) (Con)
The Secretary of State will be aware of the successful campaign that I fought to secure £36 million for the Manor Hospital in Walsall to get a new A&E department, so when he is passing junction 10 of the M6, will he come in to meet the staff with me? They are delighted with that investment.
Matt Hancock
It is thanks to my hon. Friend’s campaigning and bringing to light the importance of the upgrade to the A&E at Walsall Hospital that we have been able to make that investment. There is no greater spokesman for the people of Walsall than my hon. Friend, and I cannot wait to turn left at junction 10 to pay them a visit next time I am going up the M6.
Andrew Griffiths
The Secretary of State talks about rejoicing, and Opposition Members have talked about the hospitals that he should visit. He is welcome in Burton at any time. We had £22 million invested in the health village as a result of his last visit, and just this week he has announced another £11 million for two new operating theatres. That proves that it is this Government who are investing in our NHS. It is safe in our hands.
Matt Hancock
I will tell the House exactly what happened. My hon. Friend invited me to Burton, and I looked at the changes that needed to happen. I talked to the NHS and we then announced not one but two upgrades as a result, thanks to his campaigning.
Alex Chalk (Cheltenham) (Con)
Gloucestershire health managers, supported by around £50 million of public money, are in the process of reconfiguring hospital services in Gloucestershire. In the light of evidence suggesting that A&E in Cheltenham might be earmarked for closure, I, together with my hon. Friends the Members for Tewkesbury (Mr Robertson) and for The Cotswolds (Sir Geoffrey Clifton-Brown), have led a campaign to keep A&E at Cheltenham. I know that my right hon. Friend the Secretary of State has taken a close interest in this issue. Can he now give us an update from the Dispatch Box on the issue, which is so important to me, my constituents, my hon. Friends and, indeed, everyone in Gloucestershire?
Matt Hancock
Yes, I can. In the light of the extensive representations that my hon. Friend made regarding the A&E in Cheltenham, I have spoken to the chief executive of Gloucestershire Hospitals NHS Foundation Trust and I can announce that the A&E will remain open and that no proposals to close the A&E at Cheltenham will be part of the forthcoming consultation.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
The Secretary of State might need some help when I tell him that I am quite thankful, because after a massive and wonderful campaign in Huddersfield, we are keeping our A&E open. The £20 million that we got for that and for some other maintenance work is very acceptable, but will he accept an invitation to come to Huddersfield to see the potential for a new hospital that could be an absolutely iconic building in a future innovative national health service?
Matt Hancock
I will absolutely look at that, and I think that the new hospital is going to be absolutely terrific up in his part of the world. I will also put on record my gratitude to my hon. Friend the Member for Calder Valley (Craig Whittaker), who as a Whip has not been allowed to speak on this issue in the House, but who privately has been campaigning hard. This shows what happens when local MPs have a positive attitude towards the future of our NHS.
Ben Bradley (Mansfield) (Con)
While we are talking about positive hospital stories, I would like to raise with my right hon. Friend the case of Sherwood Forest Hospitals NHS Foundation Trust, which has gone from being in special measures to rated as good. It has now been nominated for the trust of the year award, which is a fantastic story for the NHS and those local services under a Conservative Government. I want to move my right hon. Friend on to the issue of health inequalities if I can. We had a Green Paper earlier in the year about smoking cessation. Mansfield has one of the highest levels of smoking in the country; we are the fourth worst area at more than 23%. We have set a target to try to reduce smoking levels by 2030, but that needs action. Will he take that action in the near future?
Matt Hancock
Yes. There is no greater spokesman for Mansfield than my hon. Friend, and he is absolutely right about smoking. We have set a target of ending smoking by 2030. It is a stretching target, and there is an awful lot that we need to do to achieve it.
Several hon. Members rose—
Matt Hancock
I will give way to my hon. Friend the Member for Telford (Lucy Allan), who has already intervened on the Prime Minister today. I hope that I can help out.
Lucy Allan (Telford) (Con)
I am grateful to my right hon. Friend for giving way, and for coming to Telford to have a look at the women and children’s unit. However, six months later, he signed off an approval to have it closed. It is galling to hear about all the “goodies for all” that are being distributed, but unfortunately not for Telford. I would like to invite him to come back and listen to the people of Telford and to hear why they value their women and children’s unit.
Matt Hancock
My hon. Friend has campaigned incredibly hard. As she knows, the local NHS brought forward the plan, which we are proposing to amend. I am working on that with her. However, I am delighted to announce that the Princess Royal in Telford will be benefiting from £4 million of winter capital funding that will come on stream for this winter, partly as a result of my hon. Friend’s campaigning.
Mark Pritchard (The Wrekin) (Con)
I am grateful to the Secretary of State for giving way. I get on very well with the shadow Secretary of State on a personal basis and do not expect an apology from him, but was he not wrong on the A&E at the Princess Royal Hospital in Telford? It is not closing. We are having the latest modern thinking on how A&E care is delivered through an “A&E local”, so will the Secretary of State put a little more flesh on the bones of what that means?
Matt Hancock
My hon. Friend is right that the local NHS came forward with its plans, but I want to ensure that A&E facilities continue in Telford. We are working on the details, and he will be the first to know.
Gareth Snell (Stoke-on-Trent Central) (Lab/Co-op)
When the Secretary of State goes to Telford, I suggest that he speaks to Councillor Shaun Davies, who will also tell him about Telford’s needs. As the hon. Member for Burton (Andrew Griffiths) said, Staffordshire is blessed with some first-class facilities that were supported by the last Labour Government, but our problem is that our CCGs are all in financial deficit. Half of the country’s failing CCGs are in Staffordshire. With the new money that is going into the health service, will the Secretary of State tell me what he is going to do to address the disparity in funding? Stoke-on-Trent rates 13th for social and health inequalities, but 48th for funding. If money follows need, we can dig ourselves out of our hole.
Matt Hancock
The hon. Gentleman raises the problem across Staffordshire. We are trying to ensure that the NHS in Staffordshire looks forward with confidence, and that includes addressing long-standing financial issues for which it has had extra support over the past few years. I pay tribute to all the NHS staff right across Staffordshire, who have done great work, especially in Stoke and Stafford, to ensure that the hospital provision there can look forward with confidence.
Stephen Kerr (Stirling) (Con)
My right hon. Friend was talking about spending on healthcare across the United Kingdom. Scotland has benefited due to increases in healthcare spending in England, but not all the money that comes to Scotland through the Barnett formula has been spent on healthcare. In fact, had spending increases in Scotland kept up with those in England, there would be half a billion pounds more to spend on Scotland’s NHS.
Matt Hancock
There speaks the voice of Scotland. As we have put record amounts of funding into the NHS in England, that funding proportionately flows through the Barnett formula to Scotland, but the Scottish Government have refused to increase NHS funding in Scotland. I wish that they would increase it as quickly as we have in England, where we have seen a faster increase in the numbers of doctors and nurses than in Scotland.
Dr Phillip Lee (Bracknell) (LD)
Will the Secretary of State help me by pointing me towards an online resource that provides the evidence base for his decisions on the locations of A&E departments and the like? Any medical professional will say that we need a regional and, dare I say, national plan in order to make sure that access to emergency care is equal for every citizen in England and Wales.
Matt Hancock
The hon. Gentleman makes an important point that capital investment needs to be strategic, and the new health infrastructure plan, which I was discussing at the Health and Social Care Committee yesterday, is intended to put in place that long-term plan for capital investment, and we are building 40 new hospitals over the next decade. It may be fair to say that I got some flak from Labour Members for proposing 10 years’ worth of new hospitals, because they said that only the first part of the health infrastructure plan—the so-called HIP 1—should be announced. I do not think that that is true, however, because we need a long-term approach to capital investment, with 40 new hospitals over the next decade.
Steve Brine (Winchester) (Ind)
I thank the Secretary of State for his vote of confidence in the NHS in Winchester. He has always been willing to listen. After a difficult Care Quality Commission report last year, we managed to secure investment to transform the A&E department, which the Minister for Care, the hon. Member for Gosport (Caroline Dinenage), visited recently. We are working with the sustainability and transformation partnership across Hampshire to reimagine what a district general hospital looks like. I encourage the Secretary of State to come down to Winchester—an hour on the train from Waterloo—to see where a new district general hospital is emerging to deliver long-term safe and sustainable services.
Matt Hancock
I would love to. I pay tribute to the hon. Gentleman’s work not only on the prevention agenda and public health in government, but on ensuring that the long-term plan approach to capital investment, with a new hospital in Winchester over the next decade, will give the time to ensure that that investment brings the whole health system together in Winchester and really delivers for the people. With him as the local representative, I have absolutely no doubt that that is what will happen.
Anneliese Dodds
On the subject of strategic capital investments, the Secretary of State will be well aware that static PET-CT cancer scanning equipment is world renowned for helping people, particularly at the Churchill Hospital, and is much more effective than mobile scanning technology. Why, therefore, have I discovered, having been told that there would be no privatisation of services at the Churchill and that we would not see that material change, that a private provider with mobile scanning equipment will be the back-up to the NHS service? It will be dealing with complex cases from across the Thames valley. Even worse, the chief exec of the local hospital has had to accept a non-disclosure arrangement around the contract negotiations. How can the Secretary of State justify that?
Matt Hancock
That is a decision taken by the local NHS. The proposals that we are putting forward in law, for debate under this Queen’s Speech, are to change the regulations. We must absolutely get the best solutions for local patients, and I will address the hon. Lady’s point before taking some more interventions, because I want to refer specifically to the amendment tabled in the name of Opposition Members. Not only is it unnecessary, but it is counterproductive. It would do the opposite of what they say that they intend.
The Government believe—I think this is true across the House—in a publicly funded NHS that is free at the point of use according to need, not ability to pay. The Opposition say that they want a publicly provided NHS. I think what matters is what delivers best for patients, and let us look at this point of—
Sir Geoffrey Clifton-Brown (The Cotswolds) (Con)
Will my right hon. Friend give way on that point?
Matt Hancock
Let me explain my argument and then I will give way. What is not currently publicly provided? What about drugs and pharmaceuticals? Is the hon. Member for Leicester South really saying that only drugs manufactured by the NHS can be used in an NHS hospital? That is what his amendment says. Will he go and tell that to the patients who use Brineura, aspirin or cutting-edge cancer treatments? What about the new breakthrough announced this morning that could delay the onset of Alzheimer’s? My grandmother died with dementia, and his amendment would stop access to new drugs because he is against anything that is not publicly provided. The Government reject that ideology. What about other things that the NHS buys? Will he only buy pencils that are manufactured by the NHS? What about all those blasted fax machines? Is he suggesting that the NHS starts to manufacture its own fax machines? I want to abolish fax machines in the NHS; he wants to nationalise them.
Mr Philip Dunne (Ludlow) (Con)
My right hon. Friend is making a powerful point. Does he agree that by insisting on public provision, the Labour party would also abandon virtually the entire primary care network in this country, which is provided by private businesses owned and run by doctors?
Matt Hancock
My right hon. Friend’s mind is so aligned with my own that that is the very next line in my speech. What of GPs, dentists, opticians and pharmacists? They are all privately provided into the NHS, and they have been since Bevan, but this hard-left amendment would nationalise them.
I like the hon. Member for Leicester South. He is a good and sensible man, so I can only assume that he has been captured by the militant hard-left within his party, whose aggressive proto-Marxist ideology I know, deep down, he has little sympathy for. He is far more right-wing than the right hon. Member for Islington North (Jeremy Corbyn), and I know it because we have it on the record. He used to say that
“there has always been a private element of health provision in this country.”
That is what he really thinks, but he is hostage to the hard-liners and has been captured by Corbyn.
Sir Mike Penning
My right hon. Friend knows full well what I am going to raise with him in my intervention, which is the prescribed medical use of cannabis. In my speech later, I will talk about the privatisation that took place under Labour, with the Darzi clinics, polyclinics and the PFI schemes. There is something we could do today for families who are desperate—families who are willing to go on hunger strike and sell their homes because they cannot afford the medication, which this Government have allowed to be prescribed for children who have severe forms of epilepsy and seizures. I know that a lot of work is going on, but these families are desperate. There will be hunger strikes soon and people are selling their homes. We must give them that opportunity to protect their children.
Matt Hancock
Yes, I entirely understand where my right hon. Friend is coming from, and he has been a tireless campaigner on this issue. On this point, I also want to welcome the cross-party approach set out by the hon. Member for Leicester South. This is an important thing to get right. Of course each decision for an individual patient has to be clinically-led; we cannot have MPs calling for specific clinical interventions, and I think my right hon. Friend and everybody else recognises that. But there is a problem in the system here, and I have asked the medical director of the NHS to lead the work to resolve the problem. We are working on it, and I look forward to meeting my right hon. Friend and others with an interest in this soon.
Sir Geoffrey Clifton-Brown
On behalf of my constituents, may I give a warm welcome to my right hon. Friend’s announcement this afternoon of extra funding to keep the A&E at Cheltenham open? My constituents already have to travel 25 miles to get to Cheltenham, and this announcement will be a huge relief to them.
Matt Hancock
I am delighted to have been able to give that assurance and I thank my hon. Friend for the work he has done.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
This is further to the point made by the hon. Member for Stirling (Stephen Kerr). As this Chamber has heard me say before, pregnant women have a 200-mile round trip to make from Caithness to Inverness to give birth. Some months ago, a mother gave birth to twins 52 miles apart on the A9 from Caithness. In the past two days, a pregnant woman came all the way down from Caithness only then to have hours of agony because there was no bed ready for her. I concede that this is a devolved matter, but would Her Majesty’s Government, for my sake and that of my constituents, share the best safety practice with the Scottish Government and with NHS Highland?
Matt Hancock
We will absolutely do that. The hon. Gentleman rightly says that this provision is a devolved matter, and we have already had a debate about the relative funding increases, but this case clearly needs looking at seriously. I will make sure I get in contact with my colleagues in the Scottish Government who are responsible for the provision of this service to make sure that it is looked at properly.
Mike Gapes (Ilford South) (IGC)
I enjoy the knockabout that has been going on, but will the Secretary of State accept that the NHS reforms brought in by Andrew Lansley led to fragmentation, duplication and inefficiencies, which we are now trying to remedy by reconstructing and bringing groups together, as we are doing in north-east London, and that therefore there is merit in that part of the Opposition’s amendment?
Madam Deputy Speaker (Dame Eleanor Laing)
Order. If the Secretary of State answers the intervention, I will say to him what I said to the Opposition spokesman, which is that he has been generous in taking interventions but having been at the Dispatch Box for nearly half an hour, I hope he will be careful not to incur the wrath of Back Benchers who will have to wait until 7 o’clock to speak.
Matt Hancock
Yes, I am trying to take as many interventions as is reasonable. I feel as though I have been sitting down for most of the half hour that I have technically been speaking for—
Matt Hancock
Hold on, I have not even answered the previous intervention. The truth is that the NHS has proposed measures that will make it easier to run the NHS, to reduce bureaucracy and to change the procurement rules that we discussed. Ultimately, these responses—there have been nearly 190,000 responses to the consultation—have the support of the royal colleges, the Local Government Association and the unions. They have all supported these legislative proposals, and we are working on the detailed plans. They do change some of the measures put forward in the Health and Social Care Act 2012. We will make sure we cut out that red tape and bureaucracy, streamline the procurement, support integration and make sure that the record investment we are putting in gets as much as possible to the frontline. They also help us with recruitment, and I can announce to the House the latest figures for GP recruitment, a matter that I know is of interest to lots of colleagues. Building on the record numbers in training last year, this year we have 3,530 GPs in training, which is the highest number in history. That is all part of our long-term plan.
The measures in the long-term plan Bill would also strengthen our approach to capital. We have discussed the 40 new hospitals in the health infrastructure plan, but I can also tell the House that the plan will not contain a single penny of funding by PFI—we have cancelled that. I have been doing a little research into the history and I want to let the House into a little secret that I have discovered. Who was working in Downing Street driving through Gordon Brown’s doomed PFI schemes, which have hampered hospitals for decades? I am talking about the PFI schemes that led to a £300 cost to change a lightbulb and that have meant millions being spent on debt, not on the frontline. Who was it, tucked away at the Treasury, hamstringing the hospitals? It was the hon. Member for Leicester South. So when we hear about privatisation in the NHS, we have culprit No. 1 sitting opposite us, who wasted all that money. We are cancelling PFI, and we are funding the new hospitals properly.
Tom Tugendhat
May I welcome the investment that my right hon. Friend is making in Kent, not just in hospitals, but in healthcare centres? We have a GP surgery that is no longer fit for purpose and, working alongside the county council, another wonderful Conservative institution, he is providing healthcare to people closer to home and nearer to where they want it. I welcome that enormously and urge him to do exactly the same for the hospital in Tonbridge, which he knows, because I keep nobbling him on this one, we need much more investment in, so that we can have those community beds close to home.
Matt Hancock
My hon. Friend is absolutely right about getting community beds closer to home. I wish to mention four other measures in the Queen’s Speech—
Mr Sheerman
On a point of order, Madam Deputy Speaker. The Secretary of State has made a serious allegation about my hon. Friend the Member for Leicester South. I have been in this House for a long time and I recall when PFI started under the John Major Government. [Interruption.]
Madam Deputy Speaker (Dame Eleanor Laing)
Order. That is a point of information, not a point of order. I will make no comment on it.
Matt Hancock
I will debate the hon. Gentleman’s involvement in PFI, which hamstrung the hospitals, every day of the week. Now, however, I wish to—
Jonathan Ashworth
I am delighted that the Secretary of State has elevated me; I was a 25-year-old adviser in the Treasury at the time. I remember sitting in that box as a special adviser listening to Tory shadow Health Secretaries calling for more PFIs in the NHS. The right hon. Gentleman was an adviser to George Osborne, so what about this quote from 2011:
“George Osborne backs 61 PFI projects…the chancellor, is pressing ahead with private finance initiative…on a multibillion-pound scale”.
The right hon. Gentleman should be apologising for PFI.
Matt Hancock
In 2011, I was the MP for West Suffolk. I opposed PFI in opposition and I have opposed it ever since, and I am delighted that the Government are cancelling it. It is just such a shame that the hon. Gentleman spent so many years driving through PFI when we could have built better hospitals for less money if we had properly put them on the books of the nation’s balance sheet, as we are doing now.
Several hon. Members rose—
Matt Hancock
I will take two more interventions and then I must get through dealing with the rest of the Queen’s Speech.
Vicky Ford
Just in mid-Essex we have 300 new nurse recruits, new specialist services cutting waiting times, amazing new mental health provision for women with post-natal depression, an amazing new A&E emergency village at Broomfield Hospital and the brand-new medical school, training the GPs of the future. I declare an interest, because I have joined the board since visiting it with the Secretary of State. I am shocked by this amendment today if it would stop us from being able to access new medicines. Will he look at a new approach to make sure that those medicines get to children with very rare diseases?
Matt Hancock
Yes. My hon. Friend is a brilliant advocate for her local community, and I visited the new medical school with her. She makes an incredibly important point about access to new medicines. We want to bring more access to new medicines, rather than saying that if it is not made by the state, people should not have it, which is the approach outlined in the amendment.
Let me turn to the medicines and medical devices Bill, which was in the Queen’s Speech. The intervention by my hon. Friend the Member for Chelmsford (Vicky Ford) was precisely on this point: the potential of technology to bring forward new treatments and new devices is more exciting now than at any point in generations. The new medicines and medical devices Bill will allow our world-beating life sciences industry to be world leaders.
I do not think that we should insist on a state-run medicine company and I do not think we should be requisitioning intellectual property. We should leave that aside, not least because we already have some of the cheapest medical drugs in Europe. The Opposition seem to want to create a British Rail-style drugs system—inefficient, always breaking down and arriving too late. The Association of the British Pharmaceutical Industry said that under Labour’s plans, $183 billion that the industry spends annually on research and development for new drugs would “disappear”. The ABPI is a sober and respected organisation. The proposals would cost taxpayers billions and risk all the work that goes into saving lives. The industry knows they are nonsense, we know they are nonsense, and in his heart the shadow Secretary of State knows they are nonsense. The country will see straight through him.
Andrew Griffiths
I thank the Secretary of State for giving way, because he gives me the opportunity to deliver on a promise that I made to the parents of four-year-old Michal in my constituency, who asked me personally to thank the Secretary of State because it was as a result of his intervention that Michal, who has Batten disease—childhood Alzheimer’s—has access to the drug that will save his life. It is a groundbreaking treatment, and it is because the Government are investing in the NHS that Michal’s life will be saved.
Matt Hancock
My hon. Friend is absolutely right. It was incredibly moving to meet, in my office downstairs here in the House of Commons, some children with Batten disease who needed access to world-class drugs. They are expensive drugs, but we needed to get them at a price that was affordable to the NHS. I met the parents and some of the children, and it was incredibly moving. I met some siblings—one had access to the drug and the other did not—and I saw the difference in their development. We negotiated with the company and got the drugs on the NHS. That is how we should be providing world-class drugs. That is how it has been done under sensible Labour Administrations, and I urge the Opposition to reconsider, because even if it may sound good when they look in the mirror, it is not sensible to undermine our world-class life sciences in this way. I hope they think again.
Geraint Davies (Swansea West) (Lab/Co-op)
On a point of order, Madam Deputy Speaker. The Secretary of State has been talking now for nearly half an hour, yet he has not really referred to the amendment in respect of the relationship between public health and trade, particularly the ability of tribunals and companies to sue.
Madam Deputy Speaker
No, it is not a point of order if I say it is not a point of order.
I encourage the Secretary of State to make progress. I appreciate his generosity to his colleagues, but we will have to make some progress.
Matt Hancock
Quite right. I am voting for you, Madam Deputy Speaker.
On the point made by the hon. Member for Swansea West (Geraint Davies), to whom I will not give way—
Matt Hancock
I am not going to give way after that nonsense, but on his point, perhaps he was not here at the start, but on the first page of my speech it says that
“the NHS is not, and never will be for sale under this government. The Prime Minster and the President have made it abundantly clear that the NHS will not be on the table in any trade talks.”
How many times do I have to say it? I will say it every day of the week.
Paul Masterton (East Renfrewshire) (Con)
My right hon. Friend will be aware of a number of women throughout the country, including Elaine Holmes in East Renfrewshire, whose lives have been ruined by vaginal mesh. One of the big problems they have had has been the poor response by the Medicines and Healthcare Products Regulatory Agency to patient concerns about device licensing. Will the Bill that he is talking about give us an opportunity to look again at how the licensing regime works, and in particular how it responds to patient concerns?
Matt Hancock
Yes, that will absolutely be addressed. We also have a report by Baroness Cumberlege that will look specifically in that matter, which is incredibly important for many people. We absolutely have to get it right.
I wish to touch briefly on three further measures: first, the Health Service Safety Investigations Bill. Millions of people receive life-saving care in the NHS, but saving lives also involves risk. It is important that we learn both when things go well and when things go badly. We want to create that learning culture right across the NHS. The legislation will establish in law the first independent body of its kind to investigate patient safety concerns and share recommendations to improve care. I pay tribute to my predecessor, my right hon. Friend the Member for South West Surrey (Mr Hunt), for all his ongoing work in this area.
Let me turn now to adult social care. We have already announced a new £1 billion grant for social care to address urgent needs, building on the 11% rise in social care budgets over recent years. We have to end the injustice that means that after a lifetime of hard work—of striving and saving—people are being forced to sell their homes to pay for care.
Margot James (Stourbridge) (Ind)
I commend my right hon. Friend for his work to improve patient safety. Will he also look into how whistleblowing is being managed in the NHS? We have had a concerning number of issues relating to whistleblowing in my local Dudley healthcare provider. I feel we have not yet managed to get a free and open environment for whistleblowers all the way through the NHS.
Matt Hancock
I very much agree with my hon. Friend. In many trusts, things have gone very well over the past few years and there is a much more open and less hierarchical culture, with less bullying and more openness to challenge. However, that is not the case in every part of the NHS, and that needs to change. The Health Service Safety Investigations Bill addresses that directly. After the welcome given by the shadow Secretary of State, I hope that Bill will proceed on an essentially consensual basis.
Matt Hancock
The hon. Gentleman is saying yes, which I am grateful for. I am open-minded to changes and improvements, and to listening to the experts and those with constituency cases that they can bring to bear, to make sure that the Bill is the best it possibly can be.
Sir Bernard Jenkin (Harwich and North Essex) (Con)
I hope very much to address the Health Service Safety Investigations Bill in my remarks later, but my right hon. Friend did not include one important element among the characteristics of the investigations, which is that they are to find the causes of clinical incidents without blame. It is not about satisfying a complaint; it is about finding without blame so that we can talk about things that have gone wrong without blaming people. It is about understanding the clinical, human factors that lead people to make perfectly understandable mistakes.
Matt Hancock
My hon. Friend is quite right. I was trying to shorten my speech, Madam Deputy Speaker, so I missed out a paragraph. I should have said that the purpose of the Bill is to enable staff to speak openly and honestly about errors without fear of blame or liability. That is exactly the point that my hon. Friend made and to which he paid an awful lot of attention in the drafting and prelegislative scrutiny of the Bill.
Finally, let me turn to the proposals on mental health. This country has been on a journey, over a generation, towards recognising that mental health is as important as physical health. There have been contributions to this change in mindset from all sides of the political debate—from Labour Members; especially from the right hon. Member for North Norfolk (Norman Lamb), to whom I pay tribute; and very much from Government Members, too.
I would like to take a moment to say how much I value the enormous contribution that the Duke and Duchess of Cambridge and the Duke and Duchess of Sussex have made to changing attitudes towards mental health on this journey. The Mental Health Act 1983 is nearly 40 years old and some of our law is still shaped by 19th century Acts and, indeed, their views of mental illness, and that is completely out of place in the 21st century.
Tracey Crouch (Chatham and Aylesford) (Con)
I am very grateful to my right hon. Friend for giving way. I think that people across the House will be united in ensuring that we reform the Mental Health Act. May I encourage him, as part of the proposals to improve respect and dignity for those who are in treatment, to look at individual care plans to make sure that everyone who is discharged from some sort of residential treatment receives an individual care plan and has access to home visits, especially in those first 72 hours?
Matt Hancock
Yes, I will look precisely into the matter that my hon. Friend raises, because care plans should be the norm. Across the country, a high proportion of people now leave in-patient care with a care plan in place. If the proportion is not high enough in her area, I will look into it, write to her and make sure that she gets the full details.
Mark Pritchard
I am grateful to the Secretary of State for giving way again; he is being very generous. What conversations has he had with the Secretary of State for Defence about people who are medically discharged with mental health issues from the military and who then transition into civilian life with healthcare provided in civvy street? How do we ensure that the pathway for care is unbroken, is consistent and provides a wraparound service for them as they transition out of the military?
Matt Hancock
This is another incredibly important point. I will be working with the new Minister for Defence People and Veterans, as well as the Minister for Mental Health, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), to address exactly that sort of concern. This is a long overdue—
Barbara Keeley (Worsley and Eccles South) (Lab)
Before the Secretary of State leaves mental health, will he address this issue of the 2,300 autistic people and people with learning disabilities who are in in-patient units, as it has been around for far too long? Last week, the Care Quality Commission announced that one in 10 of those units was inadequate. He knows—and I have written to him about it—that Bethany, a young woman, is in seclusion and still in a locked cell. When will he do something about those 2,300 people?
Matt Hancock
We are absolutely acting on the area that the hon. Lady quite rightly raises. The number of patients who are in in-patient facilities who have learning disabilities and/or autism has been falling—the number has fallen from 2,700 a couple of years ago to 2,250 on the latest figures. We have a plan to reduce that number further. We must ensure that everybody who comes out of in-patient facilities has the proper care plan and the community support to ensure that that is a sustained change in circumstance. It is something on which we are working incredibly hard. In fact, I was having a meeting with the Minister for Care only yesterday on precisely this issue, and I am very happy to ensure that the hon. Lady gets a full briefing on what we are doing.
Luciana Berger
I thank the Secretary of State for very kindly giving way, and I welcome the fact that he will be taking forward into legislation the recommendations of the independent review into the Mental Health Act. Will that be accompanied by Sir Simon Wessely’s recommendation that the sector needs £800 million of capital infrastructure to bring mental health settings up to the same standards as those of physical healthcare?
Matt Hancock
I want to pay tribute to the work that Sir Simon has done in bringing this matter forward. We are absolutely looking at the capital requirements, as well as the requirements for revenue funding, which have gone up in this area. We will be publishing a White Paper by the end of the year, and then we will bring forward the new mental health Bill as a draft Bill. Mental health is a priority for the Government. These reforms need to be done with care, and I hope again with consensus. The timetable for reform is that requested by the mental health community, but Members should make no mistake, we will act. I am very happy to talk to the hon. Lady with more details.
I do not think that I have ever taken more interventions in a speech, Mr Speaker, and I am now happily coming to my conclusion. This Queen’s Speech has health and social care at its heart. The reforms will help to improve the delivery of the NHS and to bring new cutting-edge treatments to work. They will make sure that our world-beating life sciences are supported; that we have a safer NHS, where we always seek to learn and to improve; that we have a permanent solution for social care, not just a short-term fix and dignity; and that we have dignity and support for everyone receiving mental health care as we put record funding into mental health services. All that will be properly funded, because we have turned the economy round—without a strong economy, we just cannot properly fund the NHS. Today’s debate has shown why we Conservatives are now regarded as the true party of the NHS and we will make sure that it is always there for generations to come up.
Debate interrupted.
Review of National Adult Screening Programmes
Matt Hancock Excerpts(5 years, 2 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
I would like to inform the House that Professor Sir Mike Richards’ review of adult screening has been published today. The review was commissioned in November 2018, following two high-profile screening incidents in the NHS breast and cervical cancer screening programmes.
Screening is an essential component of early diagnosis and a way of preventing more serious ill-health or death. Professor Richards recognises the value of our national screening programmes, which result in over 10 million screening appointments and save approximately 10,000 lives each year. The success of our programmes is in large part due to the expertise and dedication of staff across the NHS and Public Health England (PHE).
However, there is a serious need to improve the existing arrangements to achieve our vision for effective screening programmes and to harness powerful new technologies. We will use the findings from Professor Richards’ review, and other recent independent screening reviews, to inform the actions we need to take to improve our screening programmes and save even more lives.
I agree that there is a need for robust governance and clarity of responsibility and accountability for the different elements of screening. Working closely with Public Health England and NHS England we will ensure functions are located in the best place to deliver a high-quality service, building on the joint work that both organisations have already been implementing. I also agree it is important that screening programmes receive independent external scrutiny and we will continue to work with PHE and NHS England to design an optimum quality assurance process.
I agree with Professor Richards that there should be a single source of national expert advice on both population-wide and targeted screening. Public Health England, our national public health agency, hosts world-class scientific and expert advice on screening and will host this function, building on its current role providing support to the UK National Screening Committee. I have asked the chief medical officer for England, Professor Chris Whitty, to work with his counterparts across the UK to consider the detail of the proposed new advisory mechanism and how it could meet the needs of all four UK countries. By extending and consolidating our arrangements for providing independent expert advice on all screening programmes, we will improve delivery and exploit the huge scientific progress that is being made to deliver faster and better access to the latest and best screening interventions. NHS England will become the single body responsible for the delivery of screening services.
I would like to take this opportunity to pay tribute to the invaluable advice received from the current UK National Screening Committee on both existing and potential screening programmes to ensure the programmes achieve the right balance of benefit versus harm and that our national screening programmes are effective and of high quality.
In his report, Professor Richards also notes the need for significant investment in diagnostic capacity. I have recently announced £200 million investment in new cancer screening equipment, including x-ray mammography machines and MRI and CT scanners, with priority given to replacing the oldest machines with new cutting-edge technology. This will significantly improve the ability of the NHS to diagnose cancer and will support the commitment in the NHS long-term plan to ensure 55,000 more people survive cancer each year.
I recognise the immense value that research adds to our understanding of screening and I am determined to ensure we use cutting-edge data techniques. NHSX will lead the vital work to drive this forward to save more lives.
Professor Richards has delivered a significant body of work, together with a substantial number of recommendations. His full recommendations will need further consideration, taking into account the potential impact on current service delivery to ensure any changes can be delivered safely and consistently. We will consider the review’s report and recommendations and develop an implementation plan, which we will publish in due course.
I would like to record my thanks to Professor Richards for his report, and to colleagues across the health system who have contributed, and to pay tribute to all those who work to deliver the screening system across the country.
[HCWS11]
Continuity of Medical Supplies
Matt Hancock Excerpts(5 years, 2 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
This statement provides an update on my Department’s plans to support the continuity of supply of medicines and medical products into the UK if we leave the EU without a deal on 31 October.
The multi-layered approach put in place by my Department remains essential to help ensure the continuation of medicines and medical supplies across the UK if we leave without a deal. An update on the components are below.
My Department is today writing to pharmaceutical companies, medical device manufacturers and the adult social care sector. As part of working closely with the devolved Administrations (DAs) and Crown dependencies, communications will also be shared with healthcare providers across the scope of the programme.
Improving trader readiness for new border arrangements.
Companies need to ensure they are “trader ready” for the new customs procedures involved with importing and exporting goods that will come into place if we leave the EU without a deal. To support industry in their preparations, I am today announcing that, following engagement and feedback with trade associations, suppliers and distributors, the Government are establishing a dedicated trader readiness “support unit” to provide assistance to suppliers of medical goods. These teams of specialists will be able to provide traders operating in the health and social care sector with up-to-date advice and practical guidance on the steps they need to take to prepare. Details on how to access the support unit are being communicated to industry today.
Building up buffer stocks.
My Department’s approach to buffer stocks remains unchanged from 26 June and involves a range of national measures and asks of industry that are designed to provide contingent measures for medicines, medical devices and clinical consumables, blood and transplants, vaccines and countermeasures, supplies for clinical trials and non-clinical goods and services.
Procuring extra warehousing space for stockpiled medicines.
To help ensure sufficient space to store stockpiled medicines ahead of Brexit on 31 October if we were to leave without a deal, my Department previously agreed contracts for additional warehouse space, including ambient, refrigerated and controlled drug storage. We will continue to provide warehousing capacity.
Securing freight capacity.
The Department for Transport-led cross-government procurement for securing freight capacity by 31 October is progressing as planned. On 20 September, as announced by the Secretary of State for Transport, eight companies were successfully appointed to the freight procurement framework. These include ferry operators Brittany Ferries, DFDS A/S, Irish Ferries, P&O Ferries, Seatruck and Stena, as well as operators from the aviation and rail industries, Air Charter Services and Eurotunnel.
Also, on 20 September, DfT launched two call-off mini-competitions, which set out the Government’s freight requirements in preparation for leaving the EU. These provided freight operators on the framework the opportunity to bid for contracts to transport medicines and medical products—and other category one goods—into the UK in a no-deal scenario. The deadline for framework suppliers to submit bids was 1 October. Subject to evaluation, contracts with successful freight operators to provide capacity on specific routes will be agreed shortly. Once known, Government will inform industry of the details as soon as possible. In advance of this, the Department is today inviting suppliers of medicines and medical goods to register to access this freight capacity.
My Department is also leading a procurement for an “express freight service” to provide access to an end-to-end solution for medical products to deliver small parcel consignments and pallets. This is designed to be used only if suppliers’ own contingency measures encounter difficulties or there is an emergency need for specific medical products. The bid response window for this procurement has now closed and we are currently reviewing the bids. Again, my Department is looking to award the contract(s) as soon as possible.
Changing or clarifying regulatory requirements.
So that companies can continue to sell their products in the UK even if we leave without a deal, the Government have made changes to, or clarifications of, certain regulatory requirements. Statutory instruments, covering the regulation of human medicines, medical devices and clinical trials were considered and approved by Parliament.
Strengthening the processes and resources used to deal with shortages.
In addition to the normal shortage management routes, my Department has also put in place legislation to enable Ministers to issue serious shortage protocols that, where appropriate, enables community pharmacies to supply against a protocol, for example, to issue a substitute medication instead of the prescribed medication without going back to the prescriber first.
My Department will again be standing up a national supply disruption response (NSDR). The NSDR processes will monitor the supply situation and co-ordinate actions to address supply disruption incidents that occur after Brexit where normal procedures are unable to provide a resolution.
Message to NHS and the public.
Our message to the NHS, the adult social care sector, patients and the wider public remains unchanged.
My Department, working with partners across Government, industry, the health and social care system, devolved Administrations and Crown dependencies, are putting in place these arrangements to protect medical supplies from any potential disruption if we leave without a deal for the whole of the UK and its Crown dependencies, so that service providers, patients and members of the public do not have to take action themselves. Local or personal stockpiling remains unnecessary and could cause shortages in other areas, which could put patient care at risk. It is important that patients keep taking their medicines and order their repeat prescriptions as normal.
As the NAO’s recent report recognised, the scale of the challenge has been unprecedented and the Department, working with pharmaceutical companies and medical device manufacturers, has already achieved a great deal in preparing for leaving the EU, whatever the circumstances. I am confident that the Department is doing everything appropriate to prepare for leaving without a deal on the 31 October.
[HCWS1856]
Pensions: NHS Clinicians
Matt Hancock Excerpts(5 years, 4 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
The NHS pension scheme is a generous and valuable part of the package of pay, terms and conditions for NHS staff, which continues to compare favourably with schemes in other sectors. However, the interaction between the NHS pension scheme and the tapered annual allowance means some clinicians are facing unintended consequences. The tapered allowance rightly aims to see more higher earners contributing towards the public purse by reducing the amount they can save into their pensions tax-free.
The Government have been listening to concerns about the impact on patient care as clinicians decline to take on additional work or seek early retirement in response to the prospect of incurring pension tax charges, and evidence that some NHS clinicians are changing their working patterns due to this issue. The Government are determined to find a solution that provides the right balance of incentives for clinicians to provide the services that patients need. Retaining and maximising the contribution of our highly skilled clinical workforce is crucial to delivery of the ambitions for patient care set out in the long-term plan for the NHS.
The Government have therefore launched a full public consultation setting out proposals to make the NHS pension scheme more flexible for clinicians, to give them more control over their pension growth and tax liabilities. Greater pension flexibility will help clinicians avoid cutting their hours allow them to undertake additional shifts to reduce waiting lists, or take on further supervisory responsibilities.
The consultation proposes a 50:50 flexibility, which lets clinicians halve their pension contributions in exchange for halving the rate of pension growth, balancing simplicity with the need to offer flexibility. Following discussions with clinicians and employers, the consultation goes further and invites views on other measures that Government should consider.
For NHS pension scheme members who do incur annual allowance tax charges, the “scheme pays” facility offers an alternative to finding funds up front to meet any tax charges for saving into their pension while they work. Instead they can choose for the pension scheme to pay the tax charge. The pension scheme will then recoup the tax paid plus interest by deducting it from the value of their pension at retirement. The consultation proposes a potential improvement to the calculation of “scheme pays” deductions so that it is more transparent and staff can better assess the effect on their pension.
The consultation will listen to feedback on all potential ideas on pension flexibility before making changes in time for the new tax year.
[HCWS1799]
Oral Answers to Questions
Matt Hancock Excerpts(5 years, 4 months ago)
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Douglas Chapman (Dunfermline and West Fife) (SNP)
The Secretary of State for Health and Social Care (Matt Hancock)
Our highest priority is for patients to continue to have access to medicines and medical products in all Brexit scenarios. As a responsible Government, we will minimise any disruption in our exit, deal or no deal.
On 26 June, we set out our approach to ensuring continuity of supply. I discussed this last week with the head of the NHS, and Professor Keith Willett wrote to all NHS trusts yesterday to advise on no-deal planning.
John Mc Nally
Concerned breast cancer charities have asked me and others to ask the Secretary of State if he will confirm to us, and to them, whether he is leasing enough ferry capacity to ship in medicines in the very likely event of shortages in the UK when we leave the EU.
Matt Hancock
Yes, we secured the requirements ahead of a potential exit on 29 March, and we are doing the necessary work to ensure that capacity is available, whatever the Brexit scenario, on 31 October.
Douglas Chapman
My constituent Jonathan Fisher, known as the Bold Joff, has complex health needs due to a rare genetic condition called Lowe syndrome. He requires six regular medications, three of which come from the EU. They are all vital to his health, but one in particular, Epilim, is critical to his epilepsy care. What reassurances can the Secretary of State give to Jonathan and his mother, Fiona, that when we leave the EU there will be no disruption to his supply of this vital medication?
Matt Hancock
The assurance I can give is that, ahead of 29 March, we put in place the measures that are necessary to ensure that the hon. Gentleman’s constituent and others get the medicines they need, and we have taken forward those proposals and that work ahead of an exit from the European Union on 31 October.
Daniel Zeichner (Cambridge) (Lab)
The Secretary of State will be aware of the expert evidence, including from the BioIndustry Association, warning that, although we may be able to stockpile the bog-standard drugs, it will be very difficult to do so for specialist treatments. What guarantees can he give that we will have access to those specialist medicines?
Matt Hancock
Ahead of 29 March, we managed to put in place a full programme to ensure access to drugs. Of course, the approach is not just about ensuring stockpiles—there are adequate stockpiles for so many medicines all the time—but is about ensuring the flow of materials and finished drugs across the channel via ferries and, where necessary, aircraft.
Anne-Marie Trevelyan (Berwick-upon-Tweed) (Con)
Kirstene Hair (Angus) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
Across the UK, the number of registered nurses and doctors has increased over the past nine years. In England, there were over 112,000 doctors in NHS trusts in March 2019, 17,000 more than in March 2010, and over 8,000 more nurses than in 2010. There is more to do, and the NHS people plan will ensure a sustainable workforce for the long-term future of the NHS.
Kirstene Hair
As the Secretary of State may be aware, earlier this month—conveniently in the Holyrood recess—we learnt that medical students who come from the rest of the United Kingdom and want to apply for an undergraduate course at Scottish universities will find their chances greatly diminished. Most Scots are appalled by this policy. In fact, the British Medical Association, the Royal College of General Practitioners and medical schools are all expressing concern. Does the Secretary of State agree that the Scottish Government need to be attracting the brightest and the best—no matter where they come from across the United Kingdom—to address the GP crisis?
Matt Hancock
Yes, I do. I was surprised by the recent news that I read about medical schools in Scotland being told to discriminate against medical students from elsewhere in the UK. I understand that the Scottish National party itself accepts that this is discriminatory. I doubt that the policy will last and I look forward to an SNP U-turn.
Dr Rosena Allin-Khan (Tooting) (Lab)
Mitie recently signed a £150 million contract at St George’s Hospital, but staff are already facing job cuts. My union, the GMB, balloted its members; 99.6% of them voted to take industrial action. Will the Secretary of State commit to visiting staff on the frontline and show them solidarity during this very difficult time?
Matt Hancock
I am always very happy to visit hospitals around the country, including St George’s. Of course, the individual management of staff is a matter for the hospital itself. I look forward to discussing with the hon. Lady what more we can do.
Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)
The Secretary of State has quite rightly outlined the global progress that has been made on the medical and nursing workforces, but he will be aware that the picture is very different in mental health services, with the loss of 4,000 mental health nurses over the last decade. Indeed, the fill-rate for doctors entering higher training in child and adolescent mental health services this August is only 63% and only half the higher trainee posts in general adult mental health have been filled. What is the Secretary of State going to do to turn the very good rhetoric on mental health into a reality on the ground for patients?
Matt Hancock
The increase in funding for mental health services, which is the largest increase as part of the overall £33.9 billion increase, goes to mental health services. Of course, the vast majority of that will go towards employing more people. As my hon. Friend says, we need to encourage more people into training in mental health services and psychiatry, as well as mental health nursing, which is also under pressure. The expansion of these services ultimately means that we need to have more people doing the work: supporting people to improve their mental health and supporting people with mental ill health. My hon. Friend is absolutely right to raise this issue, which is right at the top of the priorities for the NHS people plan.
Peter Kyle (Hove) (Lab)
Sexually transmitted diseases such as syphilis and gonorrhoea are on the rise. Will the Secretary of State target more resources at staffing and investment to ensure that we tackle this rise?
Matt Hancock
We have recently announced that the way in which we are going to proceed with regard to sexual health services is co-commissioning between local authorities and the local NHS. This is the best way to ensure that we get the services on the ground. I would just slightly caution the hon. Gentleman; although he mentioned that some sexually transmitted diseases have been on the rise, others have been falling quite sharply. We have to ensure that we get the details of what we try to implement right, but I support the direction of travel that he proposes.
Andrew Selous (South West Bedfordshire) (Con)
What can we do to make the workload terms and conditions more attractive for salaried GPs and GP partners compared with locums? GPs in my constituency tell me that a great number want to be locums, but that not so many want to be salaried or GP partners because of the workload. What can we do about that?
Matt Hancock
My hon. Friend is dead right. This is an important part of the work that Baroness Dido Harding is leading in the NHS people plan to ensure that we can make careers in the NHS—whether as doctors, other clinicians or more broadly—the most attractive that they possibly can be. This week we announced a pay rise for doctors and earlier this month we announced a long-term agreement with junior doctors, which I am delighted they accepted in a referendum with over 80% support. But there is more work to do.
Martyn Day (Linlithgow and East Falkirk) (SNP)
The rules around annual and lifetime allowances are having an impact on the NHS workforce in Scotland, and the options contained in the recent consultation on doctors’ pensions do not provide the level of flexibility necessary to resolve this situation. We know that the solution lies with the Treasury, so what pressure can the current Secretary of State put on the Chancellor to ensure that urgent reform takes place to stop this terrible impact on our NHS workforce?
Matt Hancock
I have been working hard with the Chancellor of the Exchequer to ensure that we can resolve this important issue. The hon. Gentleman will have seen the consultation document that we put out yesterday to resolve the problem. The consultation is open and asks open questions about the best way to fix it. I am absolutely determined that we will fix it to remove some of the unintended consequences of changes in pension tax law. It is a pity, though, that the SNP spokesman did not stand up to accept that the proposal mentioned by my hon. Friend the Member for Angus (Kirstene Hair), which would discriminate against people from outside of Scotland, is wrong and should be withdrawn.
Julie Cooper (Burnley) (Lab)
The Secretary of State is in denial. There is a crisis in GP retention. In fact, there are now 1,200 fewer fully qualified permanent GPs than there were in 2010. Because of this, patients are waiting longer than ever to get a GP appointment. He has promised, as he did again today, to address this, but it is a fact that the situation is getting worse, with a pension system that is effectively charging GPs to work extra hours. Does he really believe that this is the best way to retain GPs in the NHS? Does he have a detailed plan, and can he explain how he is going to sort out this mess?
Matt Hancock
I think it is worth starting with a few facts. One fact is that I published a detailed plan yesterday, on which we are consulting, to tackle the pension issue. The other two facts that are worth noting, and that the House will want to know about, are the following. First, there is a record number of GPs in training—3,473. Secondly, the overall number of GPs is rising, with, as of March 2019, 300 more doctors working in general practice than a year earlier. I want to see that number continue to rise.
Afzal Khan (Manchester, Gorton) (Lab)
Karen Lee (Lincoln) (Lab)
The Secretary of State for Health and Social Care (Matt Hancock)
Question 10 is about workforce vacancies, and I can tell the House that one workforce vacancy has just been filled, because Boris Johnson has just been elected as the leader of the Conservative party.
The NHS employs more staff now than at any time in its 70-year history, with significant growth in newly qualified staff from 2012. Our full people plan will help to tackle these issues for the long term.
Karen Lee
Words are all well and good, but it is actions that actually count, and the Government are not creating a health service that supports its workforce. The striking health visitors in Lincolnshire have each lost more than £2,000 a year since they were transferred from the NHS to the Conservative-controlled county council and many have had their professional status downgraded. Does the Secretary of State agree that rather than shifting the responsibility for cuts to health services on to local government, the NHS should deliver fully resourced healthcare services and pay its staff properly?
Matt Hancock
The NHS is delivering healthcare services and it is paying its staff properly. It is working with local authorities to deliver the best possible health services right across the country. We absolutely need to recruit more people to the NHS and we are recruiting more people to the NHS.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)
The Secretary of State for Health and Social Care (Matt Hancock)
This week, the Department has released a consultation on the future of clinicians’ pensions, a new five-year deal to support our approach to community pharmacy, the Government’s prevention Green Paper and a £20 million collaboration with the Prince’s Trust on the NHS widening participation initiative, which will allow and support more apprentices into the NHS. There has been a lot done just this week, and there is a lot more still to do.
Mr Sweeney
Another item for the Secretary of State’s list might be to engage with his counterpart in Scotland on the issue of the NHS taper on the pensions programme. When I raised the issue with a Treasury Minister, she seemed unaware that there was more than one NHS in the UK. If there is some co-ordination and joint representation to the Treasury, that might assist matters. Would the Secretary of State agree?
Matt Hancock
Of course, in solving this problem, many of the changes can take place within the NHS, and we are working on that with the Treasury. I am happy to ensure that discussions take place with devolved colleagues, but of course, the NHS is devolved in Scotland.
Rachel Maclean (Redditch) (Con)
Jonathan Ashworth (Leicester South) (Lab/Co-op)
My I pursue the question asked by the Chair of the Select Committee, the hon. Member for Totnes (Dr Wollaston)? We know that obesity is a major cause of cancer and other diseases, and we know that we have severe rates of childhood obesity, so why does the prevention Green Paper say only that the sugar tax “may” be extended to milkshakes? The evidence is clear. Is the Secretary of State not kicking this into the long grass?
Matt Hancock
I have asked the chief medical officer to review the evidence to ensure that our policy for tackling obesity is evidence-driven. Follow the evidence: that is what we do on this side of the House.
Jonathan Ashworth
A year ago the Secretary of State said, to great fanfare, that prevention was one of his priorities. Now the prevention Green Paper has been sneaked out in the night on the Cabinet Office website. Health inequalities are getting wider and wider, and life expectancy is stalling, but the Secretary of State still cannot give us any clarification on the future of the public health ring-fenced grant. Is it not the truth that he has buckled under pressure from the sugar industry, is not taking on the alcohol industry, and is not taking on the tobacco industry? That is more about trying to get in with the new Prime Minister than putting the health needs of the nation first.
Matt Hancock
I thought that the hon. Gentleman would welcome the prevention Green Paper, which was published yesterday. We have been working very hard to publish a huge amount of policy, including the Green Paper, which contains about 80 different policies to ensure that we prevent people from becoming ill in the first place. However, it is also part of a broader drive, which Conservative Members support, to ensure that we are the healthiest of nations, and that people can take personal responsibility for their health, as well as relying on the NHS, so that it is always there when people need it.
Kevin Hollinrake (Thirsk and Malton) (Con)
Paul Masterton (East Renfrewshire) (Con)
I welcome the consultation on NHS pensions that was announced this week, and while I do not think that 50:50 is the ultimate solution, I welcome the invitation to present other proposals. However, given that this is causing an issue now, how quickly does the Department think that it will be able to turn the outcome of the consultation into action?
Matt Hancock
We are working very hard to turn it into action as soon as possible, and I can give my hon. Friend an absolute commitment that the new rules will be in place in time for the new financial year.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
Sarah Newton (Truro and Falmouth) (Con)
I greatly welcome the publication of the prevention Green Paper. How will that strategy enable people to keep well by living in warm homes?
Matt Hancock
Clearly, the need for join-up across Departments of Government is a vital part of this agenda, as my hon. Friend knows from her work across different Departments; the specific point she raises is one example of that, and we must drive it forward.
Chi Onwurah (Newcastle upon Tyne Central) (Lab)
Matt Hancock
Technology and the data that show these inequalities are an important part of the answer, but of course it is much broader than that, and tackling health inequalities is an underpinning part of the long-term plan for the NHS; it is absolutely critical in order to address the sorts of inequalities that the hon. Lady rightly raises.
Ruth George (High Peak) (Lab)
Life skills courses can be key to helping people out of depression, loneliness and isolation, and into work and training, yet the course in Glossop in my local area has been cut by the county council, in spite of it having a £2.8 million underspend this year. Do Ministers agree that local authorities should be looking to spend the public health money that they have, and to use it effectively?
Matt Hancock
Yes, emphatically we do, and there is a drive across the country for more of the sort of social prescribing that the hon. Lady talks about. The clinical solution to many people’s health issues, and in particular mental health challenges, is often about changes in behaviour and activity, and the support people are given, rather than just drugs. On the face of it, the project the hon. Lady mentions sounds very good; of course I do not know the details, but I would be very happy to look into it. However, we wholeheartedly and emphatically support the broad direction of travel of helping people to tackle mental illness both through drugs where they are needed and through activity and social prescribing.
Clive Efford (Eltham) (Lab)
I recently met three care workers who work for Sanctuary Care. Between them, they have 60 years of experience of, and dedication to, caring for vulnerable people, but Sanctuary Care has decided to cut their pay and conditions because they were TUPE-ed over from the Borough of Greenwich. Is this the way to treat dedicated care staff? Will the Minister meet me and those care staff to discuss what is going on at Sanctuary Care, whose chief executive gets a handout of almost a quarter of a million pounds a year, while it cuts low-paid staff’s wages?
Alison Thewliss (Glasgow Central) (SNP)
The prevention Green Paper talks about the risk of an opioid epidemic. In Scotland, we feel that that is already here, with 1,187 deaths in Scotland last year, 394 of them in Glasgow. Will the Secretary of State work with the Scottish Government and Glasgow health and social care partnership and support the opening of a medically supervised drug consumption room in Glasgow?
Matt Hancock
Yes, the risk of an opioid epidemic across the UK is a serious one. We have seen that risk materialise in the United States. I was as shocked as anyone to see the recent figures for the growth in opioid addiction in Scotland. While public health and the NHS are devolved to the Scottish Government, and they must lead on tackling this issue, for the UK elements of my responsibilities, we in England will do absolutely everything we can and put aside all party politics to tackle this serious problem.
Several hon. Members rose—
Ruth Cadbury (Brentford and Isleworth) (Lab)
In January the Health Secretary declared air pollution a health emergency, yet today, tomorrow and Thursday we will see ozone layers in the south and south-east of England that will be a health hazard to the old, the young and the sick. Unlike in equivalent situations in other countries, the Government have released no warnings to people or advised how they should take appropriate action. How bad does air pollution have to get before the Government use their not inconsiderable communications budget to warn people to take appropriate action?
Matt Hancock
We have. Through Public Health England, which is the responsible agency, we have absolutely put out communications, which I heard this morning. The communications that the hon. Lady asks for are out there. Of course air pollution is a significant risk to public health. I am delighted that it is falling to its lowest levels since the industrial revolution, but there is clearly much more that we need to do.
Thelma Walker (Colne Valley) (Lab)
Can the Secretary of State confirm that the Care Quality Commission has recently inspected Calderdale and Huddersfield NHS Foundation Trust, and that patient safety was raised as an issue during that inspection? If that is the case, what action is he taking?
47th Review Body on Doctors’ and Dentists’ Remuneration Report: Government Response
Matt Hancock Excerpts(5 years, 4 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
I am responding on behalf of my right hon. Friend the Prime Minister to the 47th report of the Review Body on Doctors’ and Dentists’ Remuneration (DDRB). The report has been laid before Parliament today (Cm148) and a copy can be viewed online at: http://www.parliament.uk/business/publications/written-questions-answers-statements/written-statement/Commons/2019-07-22/HCWS1765/ . I am grateful to the Chair and members of the DDRB for their report.
The Government are today announcing pay rises for doctors and dentists working across the NHS.
Building on our ambition to make the NHS the best place to work, as set out in the NHS interim people plan, this is a pay rise that recognises the hard work and dedication of doctors and dentists and puts forward an approach for a potential multi-year deal with contract reform for specialty and associate specialist (SAS) doctors to enhance recruitment, retention, morale and productivity for this group.
We have recently agreed multi-year deals for both non-medical Agenda for Change staff and doctors and dentists in training and this is part of our approach to make the NHS the best employer in the world while supporting the NHS workforce to deliver excellent patient care.
Thanks to the Government’s balanced approach to public finances—getting debt falling as a share of our economy, while investing in our vital services and keeping taxes low—we are able to continue our flexible approach to pay policy, allowing us to attract and retain the best people for our hospitals.
We consider all pay awards in light of wider pressures on public spending. Public sector pay needs to be fair both for public sector workers and the taxpayer. Around a quarter of all public spending is spent on pay and we need to ensure that our public services remain affordable for the future.
It is also vital that our world-class public services continue modernising to meet rising demand for the incredible services they provide, which improve our lives and keep us safe.
This pay rise represents one of the biggest uplifts in pay for medical staff for over a decade. In addition to their pay, medical staff continue to benefit from defined-benefit pensions, which are among the most generous available.
Today’s pay award is worth:
Between £1,940 and £2,630 for consultants
Between £970 and £1,820 for specialty doctors
Between £1,360 and £2,250 for associate specialists
The DDRB were asked not to make a pay recommendation for general medical practitioners as this is the first year of the recently announced five-year contract deal. As part of this agreement, core general practice funding will increase by £978 million per year by 2023-24 providing greater certainty for GMPs to plan ahead.
The Government’s response to the DDRB recommendations takes account of affordability in the context of the NHS long-term plan and the 2019 spending review. Given the NHS budget is now set for the next five years, there is a direct trade-off between pay and staff numbers and our response takes account of this trade-off.
The Government’s response is as follows:
Consultants
A 2.5% general uplift in pay backdated to April 2019.
The value of both national and old style local clinical excellence awards (CEAs) to be frozen.
Specialty Doctors (New Grade 2008) and Associate Specialist (Closed Grade) (SAS Doctors)
The Government take note of the DDRB’s comments on the particular issues of morale and motivation in relation to this group that led to their pay recommendation. We agree that investment in raising the profile and attractiveness of SAS doctor roles is important and we are committing to negotiations on a multi-year pay agreement, incorporating contract reform for SAS doctors. SAS doctors will receive:
A 2.5% general uplift in pay backdated to April 2019.
The potential for an additional 1% on top of the 2.5% already paid to be added to pay in 2020-21 conditional on contract reform, through a multi-year agreement.
Doctors and Dentists in Training
On 27 June the Government announced that junior doctors had overwhelmingly backed a four-year deal incorporating pay increases and improved flexibility and working conditions. This brings to an end the junior doctors dispute and the British Medical Association (BMA) and NHS employers have now collectively agreed the amended junior doctor contract.
The four-year deal guarantees pay increases of 2% per annum for the next four years and there will in addition be around £90 million of investment into the contract including a new pay point for the most senior doctors in training, an allowance for those working less than full time to support flexible working and increased pay for those working the most weekends or whose shifts end in the early hours of the morning. Taken alongside an 8.2% four-year pay rise, this will give junior doctors and current medical students the support they fully deserve.
General Dental Practitioners
A 2.5% general uplift in the pay element of their contract backdated to April 2019.
General Medical Practitioner Trainers and Appraisers
A 2.5% increase in full to the value of the GMP trainers grant and the GMP appraisers’ grant.
[HCWS1765]
NHS Pay Review Body 32nd Report: Government Response
Matt Hancock Excerpts(5 years, 4 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
I am responding on behalf of my right hon. Friend the Prime Minister to the 32nd report of the NHS Pay review Body (NHSPRB). The report has been laid before Parliament today (Cm 147). Copies of the report are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office.
This is the second year of the three-year Agenda for Change pay and contract reform deal (2018/19 to 2020/21); the NHSPRB was asked therefore not to make any pay recommendations for 2019/20.
The Government welcome the 32nd report of the NHSPRB and are grateful to the Chair and Members for all their work and helpful observations, on effective workforce planning and how best to support the development of the NHS workforce.
We are pleased that their observations broadly reflect the themes published in the Interim People Plan and will help inform the upcoming final People Plan.
[HCWS1764]