NHS Long-Term Plan: Implementation
Matt Hancock Excerpts(5 years, 5 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
Mr Speaker, I would like to update the House on the implementation of the NHS long-term plan and the delivery of improvements to the health service. Today marks the 100th anniversary of the Ministry of Health, founded under the Liberal and Conservative coalition of Lloyd George, and the Department has been staffed by brilliant, impartial civil servants ever since, and is today.
I can tell the House that on Thursday last the boards of NHS England and NHS Improvement agreed the long-term plan implementation framework. Alongside the clinical review of standards, and the interim workforce plan, published last month, this framework is a critical step in delivering on our 10-year vision for the NHS, and in transforming our health service with the record funding that this Government are putting in. The document sets out the framework within which each of the 300 commitments in the long-term plan will be delivered, and it also sets out the 20 headline commitments and how we will monitor the delivery of the plan. In the past, there have been criticisms that NHS plans have not led to full delivery. We are determined to ensure that the long-term plan fulfils its potential to transform the health service for the better, and I am placing a copy of the implementation framework in the Libraries of both Houses.
I wish to draw attention to three particular areas, the first of which is cancer care. I thank my hon. Friend the Member for Basildon and Billericay (Mr Baron) for his efforts to ensure that we focus on the vital indicator of cancer survival. The Prime Minister set out the ambition that by 2028 three quarters of all stageable cancers are detected at stage 1 or stage 2. Early detection and diagnosis are essential to the enhancement of people’s chances of surviving cancer.
Since 2010, rates of cancer survival have increased year on year. However, historically our survival rates in the UK have lagged behind the best-performing countries in Europe. The implementation framework sets out our goal of measuring the one-year cancer survival rates as one of the core metrics for the long-term plan. The one-year survival rate is how we measure our progress in achieving the ambitions set out in the plan. To realise those ambitions and ensure that we do everything we can to give people diagnosed with cancer the best chance of survival, the framework sets out first, a radical overhaul of screening programmes; secondly, new state-of-the-art technology to make diagnosis faster and more accurate; and thirdly, more investment in research and innovation.
From this year, we will start the roll-out of rapid diagnostic centres throughout the country, building on the success of a pilot with Cancer Research UK, so that we can catch cancer much earlier. NHS England is further extending lung health checks, targeting areas with the lowest survival rates, and Health Education England is increasing the cancer workforce, which will lead to 400 more clinical endoscopists and 300 more reporting radiographers by 2021. With these steps, our ambition is that 55,000 more people will survive cancer for five years, each year from 2028. Improving the one-year survival rate is how we ensure that the NHS remains at the forefront of cancer diagnosis and treatment and continues to deliver world-class care.
The second area is mental health. The Prime Minister and her predecessor rightly prioritised the treatment of mental health so that we can ensure that mental health finally gets parity with physical health. The £33.9 billion cash-terms settlement, which is the longest and largest cash settlement in the history of the NHS, includes a record £2.3 billion extra in real terms for the expansion of mental health services. The framework sets out how 380,000 more adults and 345,000 more children and young people will get access to mental health support. I pay tribute to the mental health Minister, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), who has done so much work to put the issue on the agenda.
We are introducing four-week waiting-time targets for children and young people and testing four-week community mental health targets for adults. The implementation framework refers specifically to the vital improvements to community mental health services that we all know are needed. Those improvements include services for adults living with serious mental disorders, including eating disorders, and for those coping with substance misuse. The framework also sets out how we will create a new workforce of mental health support teams to work with schools and colleges to help to identify young people who need help and reach them faster. In all, it is a fundamental shift in how we treat mental illness and how the NHS will prioritise mental health services.
The third area that I wish to touch on is people. Three quarters of the NHS budget goes on staff, because people are the most valuable resource that we have in the NHS. We need not only the right numbers but to ensure that staff have the right support. The long-term plan sets out our ambition to recruit, train and retrain the right numbers of staff over the next decade. Last month, Baroness Dido Harding set out the interim people plan, which sets out how we will build the workforce we need and create the right culture, so that doctors, nurses and other NHS staff have the time to care for patients and for themselves.
Last week, the British Medical Association accepted in a referendum the new agreement with junior doctors that will improve both pay and working conditions. Thanks to the hard work of my predecessor, we are already taking steps to increase the number of clinical training places by opening five new medical schools and increasing the number of routes into nursing through apprenticeships and nursing associates. Last year, more than 5,000 nursing associates started training through apprenticeships. This year, it will be up to 7,500.
Those are just three of the most vital areas from the 10-year vision for the NHS set out in the long-term plan. Across England, based on the implementation framework, local strategic plans are now being developed and will be brought together as part of a national implementation plan by the end of the year, and all of this will be underpinned by technology. Today sees the official opening of NHSX, the new part of the NHS, which will drive digital transformation to give citizens and clinicians the technology they need and save and improve lives. I am delighted that NHSX has received such a warm welcome across the NHS because it has so much potential to transform every part of health and social care for patients and staff.
The forthcoming spending review will settle budgets for health education, public health and NHS capital investment, and the settlements will feed into the final implementation of this plan. As part of the spending review, we will also review the current functioning and structure of the better care fund, which is rising in line with NHS revenue growth.
On this the 100th anniversary of the foundation of the Ministry of Health, this framework sets out how we will go about securing the foundations of the national health service into the next century and the creation of an NHS that delivers world-class care for generations to come. I commend this statement to the House.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
I am grateful to the Secretary of State for an advance copy of his statement. I had hoped for a greater sense of urgency from him. He talks about the 100-year anniversary of the Ministry of Health, but this year is the first time in 100 years that the advances in life expectancy have begun to stall, and even go backwards in the poorest areas. Just the other week, we saw that infant mortality rates have risen now for the third year in a row. As this is the first time that they have risen since the second world war, I would have hoped for a greater focus on health inequalities in his statement today, not least because public health services—the services that, in many ways, lead the charge against health inequalities—are being cut by £700 million. Now he says that we should wait for the spending review for the future of public health services, but we do not know when the spending review is. The Chief Secretary to the Treasury has said that it will be delayed, so it could be next year.
In the past, the Secretary of State has talked about a prevention Green Paper. Will that prevention Green Paper be before the spending review or after the spending review? Will he also tell us whether it is still the intention of the Department to insist that local authorities fund their public health obligations through the business rates?
At the time of the publication of the long-term plan last year, the then Secretary of State for Health said that we cannot have one plan for the NHS without a plan for social care, yet we still have no plan for social care. We have been promised a social care Green Paper umpteen times. We are more likely to see the Secretary of State riding Shergar at Newmarket than see the social care Green Paper. Where is it?
The Secretary of State talks about the better care fund revenue increase. May I press him further on that? Is he saying that the clinical commissioning group allocations to the better care fund, which tend to be the bulk of the better care fund, will increase in line with the NHS revenue increase, or is he saying that there will be new money available for the better care fund? Adult social care has been cut by £7 billion since 2010 under this Tory Government, which is why hundreds of thousands of elderly and vulnerable people are going without the social care support that they need. Presumably, we will have to wait for the spending review for proposals on social care.
The Secretary of State talks about the workforce. We have 100,000 vacancies across the NHS. We have heard about the interim people plan, but of course we have seen the bursary cut, the pay restraint, and the continuing professional development cut. That plan is all good and fine, but when will it be backed up by actual cash?
The Secretary of State talks about IT systems and apps—we know that he is very fond of that—but again he gives us no certainty on capital investment. Hospitals are facing a £6 billion repair bill—ceilings are falling in and pipes are bursting. The repair bill designated as serious risk has doubled to £3 billion. When will we have clarity on NHS capital?
We broadly welcome what the Secretary of State said about mental health, but 100,000 children are currently denied mental health treatment each year because their problems are not designated as serious enough, and over 500 children and young people wait more than a year for specialist mental health treatment. He talks of a fundamental shift, so can he guarantee that clinical commissioning groups will no longer be allowed to raid their child and adolescent mental health services budgets in order to fill wider gaps in health expenditure? On mental health resilience and prevention, only 1.6% of public health budgets is currently spent on mental health, so will he mandate local authorities, when setting their public health budgets, to increase the money they spend on mental health?
On cancer, we broadly welcome what the Secretary of State has said, but patients are waiting longer for treatment because of vacancies and out-of-date equipment. Today we learned that consultant oncologists with shares in private hospitals are referring growing numbers of patients to those hospitals. Is that not a conflict of interest? When will we see tougher regulation of the private healthcare sector?
The Secretary of State talked about the clinical review of standards that is being piloted in 14 hospitals, yet those hospitals are not publishing the data. If he wants to abandon the four-hour A&E target, will he insist that those pilot hospitals publish all the data? He did not mention waiting lists. We have seen CCGs rationing treatment because of the finances. We have seen 3,000 elderly people refused cataract removals. We have seen CCGs refusing applications for hip and knee replacements. We have even seen a hospital that until last week was inviting patients to pay up to £18,000 for a hip or knee replacement—procedures that used to be available on the NHS. When is he going to intervene to stop that rationing of treatment, which we are seeing expand across the country because of the finances?
Finally, there are many laudable things in the long-term plan that we welcome. Alcohol care teams were a Labour idea. Perinatal mental health services were a Labour idea. Gambling addiction clinics, which the Secretary of State announced last year, were a Labour idea. Today he is talking about bringing catering back in-house, which is also a Labour idea. Why does he not just let me be Heath Secretary, and then he could carry on being the press secretary for the right hon. Member for Uxbridge and South Ruislip (Boris Johnson)?
Matt Hancock
Well, it is great that by the end of his questions the hon. Gentleman finally got to the future of the NHS, which is what we are here to discuss. However, what I did not hear—unless I missed it—was a welcome for the extra £33.9 billion that we are putting into the NHS. I did not hear him welcome the fact that life expectancies are rising, or our plan to drive up healthy life expectancy still further. I did not hear him say whether the Labour party supports our efforts to ensure that the NHS is properly funded and supported not only now but into the future, because that is what this Government are delivering.
I will go through some of the questions that the hon. Gentleman did raise. He asked about the prevention Green Paper. Indeed, he will know that preventing people getting ill in the first place is a central objective of mine, and it will be forthcoming shortly. He mentioned the better care fund. I was very precise in what I said about the better care fund, because its funding is rising in line with NHS revenue growth. In fact, the overall funding available to deliver social care in this country has risen by 11% over the past three years. Of course there is more to do to ensure that we have a social care system that is properly funded and structured to ensure that everybody can have the dignity of the care they need in older age, and that people of working age get the social care they need, but the Labour party ought to welcome the increase in funding, as well as the aim of ensuring that we get the best possible value for every pound.
The hon. Gentleman mentioned the clinical review of standards, which he welcomed when it was announced recently. The pilots that he mentioned started just four weeks ago, and of course we will be assessing the results and ensuring that we get the right structures in place in future. I am glad that he welcomed it, but in relation to publishing data, after just four weeks it is unsurprising that we are still in the early stages.
The hon. Gentleman asked me to ensure that the increase in funding for mental health will happen and that CCGs will be required to see that increase flowing through to make sure that patients get better service. I can confirm that NHS England is already intervening. The £2.3 billion increase that we have set out in the long-term plan will be required to flow through to the frontline. This implementation framework is part of the system that we are putting in place to make sure that that happens.
Mr John Baron (Basildon and Billericay) (Con)
I very much welcome the Secretary of State’s announcement on putting the one-year cancer metric at the very heart of cancer services as a means of encouraging earlier diagnosis. You will be well aware, Mr Speaker, that the all-party parliamentary group on cancer has long championed the need to put this metric at the very heart of our services in order to encourage earlier diagnosis. The inconvenient truth is that despite the best will of those on both sides of this debate on the need to focus on process targets, we have failed to close the gap on international averages in our cancer survival rates. I chaired the APPG for 10 years, and I know that the current chair, the hon. Member for Scunthorpe (Nic Dakin), is waiting to speak as well. Will the Secretary of State ensure that sufficient funds are allocated to the one-year metric, because history would suggest that this metric has been there, or thereabouts, in the mix before, but because the money has been attached to the process targets, local NHS systems have ignored it?
Matt Hancock
I pay tribute to the work that the APPG, so ably led, has done in putting the measurement of improvements of cancer services at the forefront of the debate. I particularly acknowledge the point about early diagnosis. Here in the UK, we are one of the best countries in the world at treating cancer once it is diagnosed, but we are behind the curve on early diagnosis. Putting a one-year cancer diagnosis metric at the heart of the implementation of the long-term plan is a critical step in making that happen. What is going to happen now is that each of the local systems will feed into the framework in terms of how they will be putting this into action. The full implementation plan, which will be published shortly after the spending review, will take that into account, as well as all the budgets that need to be settled in the spending review. I would recommend to my right hon. Friend—my hon. Friend—[Interruption.] Just for now. I recommend that he keep up this campaign, because we have made significant progress in the implementation framework but there is still more to do.
Mr Speaker
The hon. Gentleman was temporarily elevated to the Privy Council by his right hon. Friend on the Treasury Bench. He might—who knows?—regard that as an earnest of what is to come.
Diana Johnson (Kingston upon Hull North) (Lab)
There is no reference to GPs in the statement—I have just been looking through it. This comes at a time when my constituents are telling me that they are having to wait three weeks to get a GP appointment. Faith House GP surgery on Beverley Road, which I have raised with the Secretary of State directly, is now due to close. It is all very well training doctors for the future, but what is he going to do about the crisis in primary care now?
Matt Hancock
I picked out three of the 20 areas that we are particularly focused on in this implementation framework, one of which is the number of GPs and the broader primary care workforce, because it is not just about GPs but about all those who also support primary care across the board. We have a clear target of 5,000 more GPs, based on the 2015 baseline. We have a record number of GPs in training. Last month, the Minister for Health, my hon. Friend the Member for Wimbledon (Stephen Hammond), announced the consultation on changes to the pension to remove some of the unintended consequences of pension tax changes for GPs to ensure that we retain our highly trained, highly qualified GPs. There is a whole load of work in the people plan being led by Baroness Dido Harding to make sure that we have the number of GPs that we need and the wider primary care health workforce that is necessary.
Sir Peter Bottomley (Worthing West) (Con)
As my right hon. Friend said, the first Minister of Health was Christopher Addison, then a Liberal, who abolished his position as President of the Local Government Board to succeed himself as the first Minister of Health in 1919, but the first Secretary of State to hold up a White Paper saying “national health service” was the Conservative Sir Henry Willink in 1944. We must give credit to the Labour party for bringing in the health service, agreed by the coalition Government, in 1948, although we have to recognise that Aneurin Bevan decided to nationalise the hospitals and not the GPs, when most people expected it to be the other way round.
In the experience of my wife, who did five years as Minister for Health and Secretary of State for Health, we should be praising all those who support the clinicians—the support workers, administrators and others who help doctors, nurses and other professionals—to look after us at all stages of our lives. We must have the extra money. I am glad that we have gone beyond the Labour party’s ambitious targets to meet our own ambitious targets, and that we can look forward to doing more, because we have to recognise that health will require a greater proportion of our wealth as we live longer and want better services.
Matt Hancock
I wholeheartedly agree with the entirety of what my hon. Friend said. It is true that for the majority of its 71-year history—71 this week—the NHS has been run by Conservative Secretaries of State, and the largest cash injections have come from this party. It is a truly national institution that we should all support, and we have to support not only the doctors, who lead many parts of the NHS, and the nurses, but all the health service staff, because it is a true team effort.
Norman Lamb (North Norfolk) (LD)
The Secretary of State may remember that I brought a group of mental health reformers to see him, to make the case for culture change in mental health services to address clear human rights abuses such as locking people up when they do not need to be locked up, often for a long period, shunting people around the country in ways that would never happen with physical health and the endemic use of force in mental health services. We argued that ending inappropriate institutional care would free up money for better prevention and early intervention. He said he loved that approach. Is he doing anything to actually implement it?
Matt Hancock
Yes. First, in terms of the review led by Simon Wessely of the legal powers set by the Mental Health Act 1983, there will be a Government response and then legislation in due course. We want to get that legislation right and bring it forward on an open basis, to ensure that we get a consensus behind it before introducing it formally to the House. On the administrative side, a programme of work is under way to deliver exactly what the right hon. Gentleman mentioned. In my statement, I specifically referenced the expansion in community mental health services that must happen, which will be good value for money and, of course, much better for many patients.
Several hon. Members rose—
Matt Hancock
I thank my right hon. Friend for his question. The shadow Secretary of State is so nice behind the scenes that he sometimes has to get a bit spiky in public, just to prove to his masters in the Leader of the Opposition’s office that he is on their side.
Over the rest of this year, we will deliver the plan to ensure that these targets are put in place. The truth is that we can only manage what we measure, and having a target for access to mental health services and pilots on how we do that for children’s health services is an incredibly important part of ensuring that the system lines up behind the rapid availability of mental health services, which, as I imagine every Member knows from constituency casework, is critical.
Nic Dakin (Scunthorpe) (Lab)
I very much welcome the ambition of this plan, the recognition that it will need appropriate resources—it very much needs appropriate staffing, because the human resource is most important—and the emphasis on cancer and early diagnosis. May I ask the Secretary of State how he will ensure that improvements in early diagnosis for less survivable cancers are central to the target to diagnose 75% of cancers at stage 1 and stage 2? There is a concern that the less survivable cancers will get neglected, given the nature of the plan at the moment.
Matt Hancock
I am grateful to the hon. Gentleman for the tone that he takes, and he is absolutely right in his analysis. I know he met the cancer Minister, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for South Ribble (Seema Kennedy), last week on this point. We absolutely will address it, and we will not miss the less survivable cancers. Indeed, the focus on early diagnosis will of course help survivability, but it is also a focus across all cancers equally, rather than just on those where survivability has improved so much.
Mrs Pauline Latham (Mid Derbyshire) (Con)
This long-term plan for the NHS has been developed by the NHS, not imposed by Government. Does my right hon. Friend agree that this sets the plan apart and means it is much more likely to work for staff and patients alike?
Matt Hancock
Yes, my hon. Friend is absolutely right. The plan is of the NHS by the NHS for the NHS. We in Government will absolutely facilitate it and support it, and of course we are putting in the money, but the NHS as a whole should be very proud of what this plan proposes and the way the implementation is being done in such a rigorous fashion.
Mr Chris Leslie (Nottingham East) (Change UK)
May I press the Secretary of State a little further on the section of the plan that relates to prevention and early intervention? We are all waiting still for the prevention Green Paper. In particular, there are some diseases and illnesses, such as stroke, where apparently four out of five cases could be prevented by such early action, whether it is diagnosis of atrial fibrillation, or blood pressure and cholesterol testing devices. What more can be done for this Government to show they are serious about preventing ill health, such as stroke?
Matt Hancock
I completely agree with the hon. Gentleman. The whole plan—the whole NHS long-term plan—is about prevention as well as cure. The focus of the NHS needs to switch more towards prevention as well as, of course, helping people get better when they get ill. Taking the example of stroke, there is a lot on the prevention of stroke in the draft prevention Green Paper—just to give him a bit of a teaser for that. At the core of improving prevention of stroke is both behaviour change but also better use of data, because being able to spot people who have symptoms that are likely to lead to stroke can then help much more targeted interventions. I find it striking that with the big stroke charities, as with the big heart charities, their big ask is for better and more access to data.
Sir Bernard Jenkin (Harwich and North Essex) (Con)
May I thank my right hon. Friend for his statement and his commitment to this implementation plan, alongside the commitment to increase clinical standards? That is not a criticism of the medical professions; it is just a determination to make sure that the NHS is an infinite learning organisation and can learn from its mistakes. In that respect, will he recommit to HSIB—the healthcare safety investigation branch of his Department—which is devoted to doing clinical investigations without finding blame, so that these problems can be surfaced and the learning can be implemented across the NHS? In particular, will he recommit to the legislation, which has been through prelegislative scrutiny and is still waiting to be introduced?
Matt Hancock
Yes, I am looking forward to that legislation being introduced. The work that my hon. Friend’s Select Committee—the Joint Committee on the Draft Health Service Safety Investigations Bill—did in the prelegislative scrutiny was incredibly important. The HSIB Bill promises to improve patient safety, which is an important part of the agenda, and I look forward to its being brought forward to the House.
Janet Daby (Lewisham East) (Lab)
I have recently become the vice-chair of the all-party parliamentary group on sickle cell and thalassaemia. Sickle cell is very much a hidden disability which is lifelong. Some people take up to five medications a day, which is very costly. If they have a relapse, they can be hospitalised, but it is more cost-effective and preventive to have free prescriptions than to end up in hospital. Will the Secretary of State review the matter and do what is both best for those patients and in the public interest?
Matt Hancock
I will certainly look at the matter. When I was on a night shift with a London ambulance crew, we attended a patient who suffered from sickle cell, and it was horrific to see the degree of pain that they were in. I have therefore seen at first hand exactly how horrific the condition can be and I will look into the hon. Lady’s suggestion.
Sir Hugo Swire (East Devon) (Con)
I was delighted to be able to show the Secretary of State the health and wellbeing hub in Budleigh Salterton and the opportunities at Ottery St Mary community hospital, and that he confirmed that both places had a role to play in the future of health provision in East Devon. However, last week, the National Audit Office found that community hospitals and GP surgeries were struggling to pay the rents charged by NHS Property Services and that, nationally, outstanding debt has almost tripled since 2014 to £576 million. If my right hon. Friend is interested in securing a legacy before he moves on to even higher political office, will he please look at that, particularly in advance of the review planned for 2021?
Matt Hancock
I certainly will. I also draw my right hon. Friend’s attention to an announcement, which we made last month, to allow local hospital trusts to request property from NHS Property Services so that it can be transferred to the trusts if it can be used better and more flexibly locally, in the way that the hub I saw at Budleigh Salterton absolutely delivers. I can also see such an opportunity for the potential hub at Ottery St Mary, which was a community hospital and has enormous promise for delivering services closer to the community.
Jim Shannon (Strangford) (DUP)
I thank the Secretary of State for the statement and the substantial moneys that the Government have committed to the NHS long-term plan, particularly given the need for the cancer strategy to be fully implemented. On rare diseases, will he confirm that drugs such as Orkambi, Spinraza and medicinal cannabis will be simple to apply for and accessible for those who desperately need them now, when time is not on their side?
Matt Hancock
I understand the importance of those drugs. Each one is in a slightly different part of the process. We have opened up availability of medicinal cannabis. Indeed, I was talking this morning to the head of NHS England to ensure that our plans to normalise access to medicinal cannabis for those with a clinical need for it can be brought forward. The hon. Gentleman should expect to hear more news soon on the progress that NHS England and the National Institute for Health and Care Excellence have made. On Orkambi, we are still engaged with the company, Vertex, to try to bring that to patients in a cost-effective way. I greatly hope that Vertex will make some progress.
Vicky Ford (Chelmsford) (Con)
It has been great to hear my right hon. Friend mentioning the new medical schools. The one in Chelmsford is fantastic. It is 12 times oversubscribed for next year—we would love an increase in places. It was lovely to meet three of the medical students last week, when they raced across the high street to have selfies taken with my right hon. Friend’s predecessor.
We are also doing well on nurse apprenticeships, but there is an issue, especially with mature students coming in to study adult nursing. Will my right hon. Friend look again at how to give them financial assistance?
Matt Hancock
I thoroughly enjoyed visiting my hon. Friend’s local medical school and seeing the expansion that has taken place. The two of us walked into a room occupied almost entirely by dead bodies, which was quite an experience. [Interruption.] It was nothing like this place. On the specific and substantive questions she asks, we are looking at both the funding for the expansion of medical schools and how we ensure that we get the nurses we need into the profession. That will be part of the spending review process with the settlement of the budget for Health Education England.
Chris Bryant (Rhondda) (Lab)
Having been diagnosed earlier this year with a stage 3B melanoma, I always get a bit sweaty when people start talking about how important it is to have early diagnosis to ensure survival rates, but of course they are absolutely right. The number of people, in particular men, with melanoma is rising and people are still dying. I have heard horrific tales of people going to GPs five, six or seven times before a GP was able to send them on to see a dermatologist. I have heard about dermatologists saying, “I’ll look at this mole here, but I’m not going to look at that one because you haven’t been referred for that one. That will have to be a separate referral.” I have heard of people waiting six or seven weeks for histopathology to come back. All those things delay the process. Do we not need to have a wholesale approach to melanoma to ensure that we save more people’s lives?
Matt Hancock
Yes, the hon. Gentleman is absolutely right. I agree with what he says. There is a need for the whole medical profession to be constantly up to date with the latest treatment and diagnostic science. I am determined that part of the drive for early diagnosis is about not just diagnosis once referred, but better referral. We all have a part to play in that—wider society, as well as primary care.
Martin Vickers (Cleethorpes) (Con)
Many people in my constituency find it difficult to obtain NHS dentistry. While that is part of the short-term plan, on the ambitions outlined in the plan for long-term improvements to oral health, what assurance can the Secretary of State give that NHS dentists will be in place to deliver them?
Matt Hancock
NHS dentistry is incredibly important. Ultimately, dentistry is part of prevention; it prevents oral ill health. We are doing a lot of work on what further we can do to support oral health. In fact, I had a meeting with the Minister with responsibility for public health on that subject this morning. I would love to meet my hon. Friend to discuss it further.
Justin Madders (Ellesmere Port and Neston) (Lab)
The Secretary of State clearly identified three critical areas for improvement to cancer survival rates. He is absolutely right about early diagnosis. I do not want to make my hon. Friend the Member for Rhondda (Chris Bryant) any more sweaty than he already is, but it cannot be repeated enough times that spotting these issues early on is critical to improving survival rates. The Secretary of State is also right about the importance of mental health. The third point he touched on was that the workforce is key to underpinning all this. In that regard, does he know how many specialist mental health and specialist cancer nurses we will have at the end of the 10-year period?
Matt Hancock
The answer to that question is being worked on as part of the people plan, which Baroness Dido Harding is putting together. We published the interim plan last month. The full people plan will be available after we have settled, in the spending review, the budget of Health Education England. The hon. Gentleman raises an incredibly important point.
Jeremy Lefroy (Stafford) (Con)
I very much welcome the plan, with £33.9 billion being committed by 2022-23. My slight concern is where the money is going to come from. I wonder whether my right hon. Friend has had assurances from the Treasury that that will indeed be the case. With all the other pressures on spending and revenues in the coming years, that might be a little difficult. We have to find ways to ensure that the revenue is there because this money must be spent.
Matt Hancock
Yes, it will in all circumstances. This is a firm commitment, supported right across this House and right across our party, and it will be delivered. There is absolutely no question about that.
Toby Perkins (Chesterfield) (Lab)
We know that areas of greater deprivation have greater health needs than other areas. Will the Secretary of State tell us what more there is in the long-term plan specifically about increasing the resources for GP practices that serve areas of greater deprivation? They have longer waiting times and greater vacancy lists and we need specific action to support those practices.
Matt Hancock
Making sure that we have the right allocations for CCGs across the country that reflect the needs of the local population is a very important responsibility for NHS England—as the commissioner of those services—to make sure that the money follows need. After all, the principle of the NHS is that it is available to everybody according to need, not ability to pay.
Bim Afolami (Hitchin and Harpenden) (Con)
We all know that the Secretary of State is a great fan of technology and of improving the mental health of young people, and all people across the country. In my constituency, a man called Richard Lucas has set up a new online system called govox, which is a revolutionary, technologically enabled way of improving mental health among young people. Will the Secretary of State advise the House how innovative new technological solutions at a local level can best get into CCGs and the local NHS, so that we can improve mental health for everybody?
Matt Hancock
My hon. Friend has raised with me before the new technology developed by Mr Lucas. A new technology such as this can be picked up by all sorts of different parts of the NHS—by different CCGs or mental health trusts—which can then use it. One of the reasons that we have brought in NHSX, which opens today, is to make sure that there is a central place to which people with a good idea for how to improve the health of the nation by using technology can go to find a way into the NHS, so that great practice and good technology can be promulgated across the NHS as quickly as possible.
John Grogan (Keighley) (Lab)
Speaking of revenue, what is the Secretary of State’s attitude to NHS trusts that set up subsidiary companies, if one of the main motives is clearly seen to be VAT avoidance, as in the case of Bradford trusts where nearly half the extra revenue of setting up a company in the first five years would be VAT-related?
Matt Hancock
If the hon. Gentleman writes to me with the specifics of the case, I will be very happy to look into it. The use of subsidiaries in the way that he described in principle has been available to NHS organisations for some time, and I am very happy to take up the case that he asked about.
Robert Halfon (Harlow) (Con)
I strongly welcome the 10-year plan and particularly what the Secretary of State said about apprenticeships, and I urge him to push more degree apprenticeships in the NHS. If it is right to have a 10-year long-term plan for the NHS in England, does he agree that we also need a long-term NHS plan for my constituency of Harlow? The only way that we can achieve that is by having a new hospital health campus. He has visited our hospital and realises that it is not fit for purpose.
Matt Hancock
Few people make the case for their constituencies better than my right hon. Friend, and nobody makes the case for Harlow better than him. He invited me around Harlow hospital. I went into the basement to see some of the work that is needed, and the basement of Harlow hospital is in a worse state of disrepair than the basement of this building. That means that it needs work, so I am considering his proposal. The future NHS capital budget will be settled in the spending review, so I suggest that he has a conversation with Treasury Ministers as well. I look forward to seeing the case progress.
My right hon. Friend is also right about how important degree apprenticeships are. Both of us are former Skills Ministers and have heralded the arrival of degree apprenticeships as a route for people into high-paid, high-quality jobs without them having to go to university.
Rachael Maskell (York Central) (Lab/Co-op)
Delayed discharge has a knock-on effect on the whole NHS. The fact that the Secretary of State has said today that all he will do is review the better care fund and that he will not publish a White Paper on social care shows what a low priority this is. When will we see the White Paper on social care for which we have been waiting not just months, but years?
Matt Hancock
The statement was about the implementation of the NHS long-term plan, to which of course the future of social care is vital, which is one reason why the spending power available within social care has risen by more than 10% over the past three years. We continue to work on the long-term future of social care. We will have to wait for a new Prime Minister before publishing the Green Paper—I think that is fairly obvious—but it would also be good to get a bit of cross-party collaboration. When my right hon. Friend the Member for Ashford (Damian Green) made some proposals that were in line with the cross-party work of two Select Committees of this House, within half an hour the shadow Secretary of State’s friend, the shadow Chancellor, had rubbished the idea—I do not think he took the time even to read it. We could do with a bit of cross-party work on the future of social care in this country.
Alex Chalk (Cheltenham) (Con)
Thanks to the record funding boost for the NHS, Cheltenham General Hospital can plan for the future with confidence, but local trust managers consistently cite difficulties with recruiting emergency medicine doctors as a reason for not being able to expand A&E provision. Does the Secretary of State agree that some of the additional resources must go into training additional A&E doctors so that we can give Cheltenham General Hospital the resources it requires?
Matt Hancock
Yes, I agree very strongly with that. When I said that my right hon. Friend the Member for Harlow (Robert Halfon) was one of the best constituency advocates, I forgot my hon. Friend the Member for Cheltenham (Alex Chalk), who is also one of the best, and certainly the best advocate for Cheltenham, that the House has ever seen. He is absolutely right in the substance of his question, which is that we must have the support for the workforce we need, including in emergency medicine, to ensure high-quality emergency facilities near to people—where they are needed—and he makes that case with respect to the expansion of services at Cheltenham Hospital, which he supports incredibly strongly.
Mike Amesbury (Weaver Vale) (Lab)
Is the privatisation of the urgent care centre in the Runcorn-Halton part of my constituency part of the Secretary of State’s NHS plan?
Matt Hancock
I am not sure what specific case the hon. Gentleman is referring to, but I will tell him this about privatisation: I support the NHS being free at the point of delivery so that everybody can use it, and the most important principle at stake is how to deliver the best possible services for our constituents. That is what I will keep doing.
Mr Philip Hollobone (Kettering) (Con)
The success of the NHS long-term plan in Northamptonshire will depend on urgent short-term reform of the combined health and social care system in the county. There are 1,400 hospital beds in the two hospitals in Northamptonshire; 900 are occupied today by stranded and super-stranded patients as a result of delayed transfers of care. This is the worst situation in the country. The number of patients staying more than seven days in a hospital bed is twice the national average. Northamptonshire’s over-65 population is the fastest growing in the county. We need to take advantage of local government reform to establish an integrated health and social care pilot, but this requires the personal attention of the Secretary of State. Without that, we will not make any progress. Will he meet Members of Parliament from the county this month to get this under way?
Matt Hancock
Yes, and I suggest we meet also with the Secretary of State for Communities and Local Government. I have met the Northants MPs to progress this, and I have also meet the Communities Secretary about it. My hon. Friend is dead right. There is a serious problem, but there is also an opportunity for much more integrated health and social care. If Northants MPs, the Communities Secretary and I can find an opportunity to meet, perhaps we will be able to crack through this one.
Mr Bob Seely (Isle of Wight) (Con)
I thank the Secretary of State for his announcement. I have two questions. First, do he and his Department accept that there are additional costs in providing healthcare on an Island that is of an equal standard to that provided elsewhere? Secondly, will he and his officials agree to meet Island officials to discuss plans for a pilot scheme to help integrate healthcare, adult social care and other local government services to ensure maximum efficiency in the delivery of services, as my hon. Friend the Member for Kettering (Mr Hollobone) just talked about, and to ensure that as much money as possible goes to frontline services?
Matt Hancock
Yes, I shall be happy to ensure that that meeting happens. As for Island healthcare costs, my hon. Friend is right to say that the Isle of Wight is unique in its health geography, and that there are places in this country—almost certainly including the Isle of Wight—where healthcare costs are higher because of the geography. There is a programme for smaller hospitals that are necessarily smaller because of the local geography, as they need special attention.
As I have said, I shall be happy to ensure that the meeting goes ahead, and I shall continue to talk to my hon. Friend, who makes the case for the Isle of Wight better than any other.
Luke Graham (Ochil and South Perthshire) (Con)
Tomorrow I shall attend the funeral of my Auntie Bib, who has just died of cancer. It was discovered at quite a late stage. May I press my right hon. Friend to ensure that rapid access diagnosis centres are rolled out as quickly as humanly possible, and to give the House more details? May I also—as is my job—remind him that he is, of course, the Secretary of State for Health and Social Care for this entire United Kingdom, and ask him how he intends to engage with devolved authorities when targets are being missed to ensure that standards are maintained across the island? Our constituents are all British citizens, and they all require and deserve the same level of support.
Matt Hancock
I am sure that the whole House will want to pass our condolences to my hon. Friend, to his family, and to friends of his aunt. In a way, it is fitting to end this session with a very personal example of why early diagnosis matters.
As for my hon. Friend’s second point, ensuring that we have high-quality health services throughout the UK is, of course, vital. It is true that there has been a smaller increase in funding for the NHS in Scotland, and a consequent smaller increase in the number of healthcare professionals there. We need an improvement right across this country. We are delivering that in England, and I am sure that my hon. Friend will continue to make the case for better health services in Scotland from the Scottish National party Government, who receive the money from the UK Treasury but do not put all of it towards the NHS.
Junior Doctors Contract Review
Matt Hancock Excerpts(5 years, 5 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
I am delighted to tell the House that we have successfully brought to an end the junior doctors dispute, following a review of the 2016 contract. The British Medical Association announced yesterday that junior doctors had overwhelmingly—by 82%—backed a four-year deal incorporating pay increases, and improved flexibility and conditions. The vote by BMA members means that the BMA and NHS employers will now move to collectively agree the amended junior doctor contract.
Throughout negotiations we have worked closely with the NHS and the BMA to agree an offer which recognises the dedication of our 39,000 junior doctors to their patients and our nation’s health.
The agreement also includes improved working conditions. The contract changes prioritise doctors’ physical and mental wellbeing through introducing new limits on working hours, more breaks and making it easier to get time off for important moments in their lives.
This is a “something for something” deal—guaranteed pay increases in return for contract reform which will help improve productivity, recruitment, retention and motivation. There will 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.
The NHS would be nothing without its dedicated workforce. For our junior doctors, as well as all our staff and volunteers, I want the NHS to be an incredible place to work. This deal marks another step in our long-term plan for the NHS, which will safeguard our health service and benefit us all for generations to come.
[HCWS1668]
Oral Answers to Questions
Matt Hancock Excerpts(5 years, 6 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
To increase the access to new technology across the NHS, we have expanded the accelerated access collaborative to get the best technologies in faster, and NHSX is delivering our tech vision to drive forward digital transformation of the NHS.
James Cartlidge
I welcome the way my right hon. Friend has really put a stamp on ensuring that technology is at the heart of his health policy. Can he tell me whether the accelerated access collaborative will engage locally, particularly with the sustainability and transformation partnerships, so that it eventually leads to better outcomes for our constituents?
Matt Hancock
Yes, my hon. Friend is absolutely right. There is a reason why we care about using the very best technology in the world in the NHS, and that is that it improves treatment for patients. The regional delivery of better technology is critical. The 15 regional academic health science networks are a key part of the AAC and they work closely with local hospitals.
Lucy Powell (Manchester Central) (Lab/Co-op)
Matt Hancock
Yes, 100%. One of the reasons we have put NHSX in place is to drive exactly this policy agenda, where we can get better treatment for patients and save money.
Henry Smith (Crawley) (Con)
Earlier this year, the Secretary of State attended the launch of a report on artificial intelligence by the all-party parliamentary group on heart and circulatory diseases. Can I get a commitment from him that AI is very much part of the future through the NHS long-term plan?
Matt Hancock
A most enthusiastic commitment! My hon. Friend has led on this agenda and driven it, because it is all about using technology to save lives. The report that he mentions is optimistic about the power of using data better to ensure that people can live longer.
Catherine McKinnell (Newcastle upon Tyne North) (Lab)
On new technology and saving lives, I met the Secretary of State last month to discuss making the innovative enzyme replacement therapy Brineura— the only treatment available for Batten disease—available on the NHS urgently. I have heard nothing since that meeting, and the wait is agonising for the families, so what will he do urgently to make this life-saving treatment available to children in England?
Matt Hancock
I had an incredibly moving meeting with the hon. Lady, my hon. Friend the Member for North East Somerset (Mr Rees-Mogg) and others, and some of the families and children who have Batten disease. I have since met the chief executive of the NHS. The decision on the availability of the drug in question is, of course, one for the National Institute for Health and Care Excellence and NHS England, but I have had those meetings and I continue to make the case.
Mr Philip Hollobone (Kettering) (Con)
The electronic prescription service is now used by more than 90% of GP practices, and more than 70% of prescriptions are issued in that way. As well as providing a better patient experience, how much money has this saved for the NHS?
Matt Hancock
My hon. Friend is dead right to say that this provides a better service and saves money. I do not have the figure at my fingertips, but I will write to him with the answer and ensure that it is published for the whole House to see.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
Patients in my constituency have to travel vast distances—often in excess of a 200-mile round trip—to be seen at Raigmore Hospital. As and when properly working visual teleconsultations are brought into being, when that technology is developed, may I appeal to the Government to share the technology with the Scottish Government and with NHS Highland?
Matt Hancock
Absolutely. Places like Caithness are a great example of where GP consultations that can be done over the phone or over a video conference can save people hours and hours. Of course they sometimes need to see their GP in person, but not always. We are driving this agenda hard in England, and I would be happy to work with the NHS in Scotland to ensure that that technology is taken up there, too.
Conor McGinn (St Helens North) (Lab)
Nigel Huddleston (Mid Worcestershire) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
The interim people plan that we published this month puts the workforce at the heart of the future of the NHS and will ensure that we have the staff needed to deliver high-quality care.
Nigel Huddleston
The Secretary of State will be aware that recruitment and retention is particularly difficult for hospitals in special measures, such as the Worcestershire Acute Hospitals NHS Trust, which he recently visited. Such hospitals have to rely heavily on agency staff, which puts pressure on their finances. What specific steps is he taking to help those hospitals with their financial and recruiting pressures?
Matt Hancock
We are working closely with that trust, and it was good to visit and see just how hard working the staff are. They are dedicated to the cause and well supported by their MPs. My hon. Friend is quite right to make that case, and we have a direct package of support for the Worcestershire Royal Hospital and the trust more broadly because it faces unique challenges, some of which are not at all of its own making. The staff at Worcester are working incredibly hard to deliver for their local citizens.
Ruth George (High Peak) (Lab)
My constituents find it very difficult to access their GP, as we have a recruitment shortage in the constituency. The “General Practice Forward View” pledged to boost the GP workforce by 5,000 by 2020. Are the Government on course to meet that target?
Matt Hancock
We retain that target of 5,000 more GPs. We have managed to increase the number of staff working around GPs, because a GP does not need to do everything in primary care, so we have a more mixed workforce with physios and practice nurses working alongside GPs. There is more work still to do, and the NHS long-term plan sets out how we will make that happen.
Joseph Johnson (Orpington) (Con)
The leadership team at King’s College Hospital NHS Foundation Trust has asked for assistance from NHS Improvement to put in post a clinical director at the emergency services department, which has just been rated inadequate by the Care Quality Commission. This vital post, however, remains unfilled. What assurances can my right hon. Friend give that NHS Improvement can help trusts when they request assistance in this way?
Matt Hancock
My hon. Friend makes an important point. This is a vital post in a hospital and a hospital trust that does amazing work—some of the best medicine in the world is done at King’s—but it also has significant challenges with delivery, especially with respect to meeting financial targets and delivering value for money. King’s needs that support, which we are putting in place. I will raise the specific issue of the post he mentions with the head of NHS Improvement.
Gareth Snell (Stoke-on-Trent Central) (Lab/Co-op)
The Royal Stoke University Hospital, in partnership with Staffordshire University and Keele University, is training the next generation of clinicians, but the Secretary of State will know those universities need to be properly resourced to continue that vital training. What conversations is he having with the Department for Education to make sure that partnership thrives?
Matt Hancock
The hon. Gentleman raises an important point. We have expanded the number of medical training places; we have more people going into medicine; and we have a record number of GPs in training. This takes time, of course. I spoke to my right hon. Friend the Secretary of State for Education about this recently, and I will make sure that we keep pushing hard.
Kirstene Hair (Angus) (Con)
Our future immigration policy will be key to ensuring that our NHS is sufficiently staffed across the country. What discussions has my right hon. Friend had with the Home Secretary specifically on the £30,000 annual minimum income? I believe that limit is very detrimental to the sector.
Matt Hancock
I have had those discussions, and the Migration Advisory Committee has raised a specific concern about social care. We need to deliver better social care, with people coming from all around the world in addition to domestically trained people. I take on board my hon. Friend’s point.
Yvette Cooper (Normanton, Pontefract and Castleford) (Lab)
Pinderfields Hospital in Wakefield has struggled to retain midwives. As a result, the trust has proposed to cut and close the popular midwife-led maternity unit in Pontefract. Local mums are up in arms, as it is completely unfair. We keep seeing this pattern. When the NHS is under pressure from austerity, from shortages or from management issues, it is the services in towns that are hit. What will the Secretary of State do to make sure we have enough midwives across the country so that we can keep Pontefract’s midwife-led unit open and so the NHS can continue to sustain services that are vital to our towns?
Matt Hancock
The right hon. Lady, as always, puts the case for Pontefract very powerfully. The truth is that we will need more nurses and more midwives, as well as other health professionals, over the next five years because we are putting in a record amount of funding. More people are needed to deliver better services, and I am happy to meet her to discuss this specific case. Coming from and representing towns myself, I understand the importance of keeping services such as maternity services close to the people they serve.
David Tredinnick (Bosworth) (Con)
Will my right hon. Friend make sure that his interim people plan looks again at the hugely underutilised resource of the allied health professions, including osteopaths and chiropractors? What is the point of having a professional standards authority to regulate them if the Department will not use them?
Matt Hancock
My hon. Friend makes an important point, one that we have frequently discussed. As he knows, I am married to an osteopath, so I do recognise the value that osteopaths bring to all of us.
Dr Philippa Whitford (Central Ayrshire) (SNP)
Research shows that the ratio of registered nurses to patients is one of the most important factors in patient safety, so members of the Royal College of Nursing are calling on the Secretary of State to follow Wales and Scotland and to bring in safe staffing legislation. What is his answer to them?
Matt Hancock
Of course we need to have the right number of nurses. We need to make sure that we also put in the funding. If the SNP Government in Scotland had put the same funding increases into the NHS in Scotland, there would have been half a billion pounds more there over the last five years. So let us start with getting the money in that we are putting in in England, but is not fully being reflected by the SNP Government in Scotland.
Dr Whitford
The SNP in Scotland spends £185 a head more than England, so the Secretary of State should check his figures. At over 11%, the nurse vacancy rate in England is more than double that in Scotland. Whereas student nursing numbers have increased every year in Scotland, there are 570 fewer nursing students this year in England. Is it not time to follow Scotland’s approach, reintroduce the nursing bursary and end tuition fees?
Matt Hancock
I am not going to let the SNP spokesman get away with this. Normally, she brings a thoughtful contribution to health debates, but she said that there is more spending in Scotland per head. The truth is this: the increase in spending in England over the last five years is 17.6%, but in Scotland the increase is only 13.1%. That represents half a billion pounds less: the increase in spending that we have seen in England that they have not seen in Scotland. She should recognise that fact.
Peter Heaton-Jones (North Devon) (Con)
Justin Madders (Ellesmere Port and Neston) (Lab)
The Secretary of State for Health and Social Care (Matt Hancock)
This week is Children’s Hospice Week, Loneliness Awareness Week, National Breastfeeding Week and Learning Disability Week, and today is International Fathers Mental Health Day. The Government have made plans to more than double funding for children’s palliative care and end-of-life care services, developed a loneliness strategy and launched a consultation on folic acid in flour to support expectant mothers, and yesterday the Prime Minister announced a package of further work to support people from all backgrounds in the UK with their mental health. I and my brilliant ministerial team will continue to drive forward the health of the nation.
Justin Madders
I want to bring to the Secretary of State’s attention some mental health waiting times that my constituents have recently come to me with. Someone with an urgent referral for trauma counselling is looking at a minimum six-month wait. A teenager who has attempted to take her own life is waiting over a year to see a psychiatrist. Several adults have been told there is a three-year wait just to get a diagnosis of attention deficit hyperactivity disorder. These waits are appalling. The Secretary of State billed himself as the leadership candidate for the future, but he is the Secretary of State for Health now. What is he going to do to address this appalling waiting system?
Matt Hancock
The hon. Gentleman is right that we need to ensure that access to mental health services improves. As part of the increase in funding we are putting into the NHS, the biggest increase is in mental health services, and it is a critical part of what we need to do to address the sorts of problems he rightly raises.
Mr Marcus Fysh (Yeovil) (Con)
Jonathan Ashworth
Indeed.
I dare say that this is the Secretary of State’s final outing at Health questions, because we believe he has secured transfer to pastures new. In his time here, he has failed to deliver a social care Green Paper and failed to deliver a prevention Green Paper, while he is privatising Oxford cancer scanning services and we have hospitals charging £7,000 for knee replacements. Does he really think that is a record deserving of Cabinet promotion?
Matt Hancock
I am agog—and aghast. Over the last year, we have not only delivered £33.9 billion of increased funding, but we have produced the long-term plan for the future of the NHS. Starting this year, with the money already flowing, we are seeing the biggest increase in funding for community, primary care and mental health services. We have developed our work on the prevention agenda, and we have instituted a new verve and energy into the adoption of new technology in the NHS. I look forward to driving forward all these things in the future.
Jonathan Ashworth
Will the Secretary of State tell us about the verve and energy in his own constituency in Suffolk, where 32 health visitors are being cut because of his cuts? He is apparently now supporting a candidate who wants £10 billion-worth of tax cuts for the richest in society. Will that not mean further cuts to public health, further cuts to social care and, ultimately, cuts to the NHS as well?
Matt Hancock
For the majority of its 71-year history, the NHS has been run under the stewardship of a Conservative Secretary of State. At this moment, it is getting the biggest funding increase and the longest funding settlement in its history, along with the reforms to make sure that everybody can get the health care that they need.
Neil O’Brien (Harborough) (Con)
Diana Johnson (Kingston upon Hull North) (Lab)
Matt Hancock
The hon. Lady is quite right. As part of the long-term plan, we have considered the best way to commission sexual health services, which were moved over to local authorities five years ago. We think that the responsibilities are sitting in the right place, but we need to see far more co-commissioning, where local authorities and the NHS together ensure that there is more joined-up provision, rather than the siloed provision that she mentions.
Alan Mak (Havant) (Con)
Matt Hancock
My hon. Friend is quite right to celebrate the development of the NHS app. More than 80% of people are now able to use the NHS app to link to their GP practice. Our plans for the year ahead include API-based connections to a number of third-party products, including the NHS app. More importantly, I want the opening of this system to allow other innovators to be able to develop products for patients to use in a way that we have not imagined before. I want a load of innovations so that people can get the best possible access to their NHS.
Rachael Maskell (York Central) (Lab/Co-op)
Jo Swinson (East Dunbartonshire) (LD)
Matt Hancock
I wish my hon. Friend, with whom I have worked closely and whom I admire very much, great success in her leadership bid. I wish her more success than I had. With the hon. Member for Streatham (Chuka Umunna) sitting next to her, I am sure they will run a great race. I want to reassure her that, as I said the week before last, the NHS is not on the table in trade talks. We now have that assurance from the Americans. NHS data must always be held securely, with the appropriate and proper strong privacy and cyber-security protections.
Mr Speaker
I am sure the Secretary of State means well, but I am not entirely sure that the hon. Lady’s joy at the endorsement from the right hon. Gentleman was undiluted.
Stephen Lloyd (Eastbourne) (Ind)
Matt Hancock
I am very grateful to the hon. Gentleman for raising this case. The ministerial team has not seen the details in advance, but if he would like to write, the appropriate Minister will of course meet him.
Andrea Jenkyns (Morley and Outwood) (Con)
The inquiry into the contaminated blood scandal, the biggest treatment disaster in the history of the NHS, is currently taking place in Leeds. What is the Department doing to compensate the victims of this scandal and to make sure their voices are heard?
Tonia Antoniazzi (Gower) (Lab)
As the Minister will know, two weeks ago I went to the Netherlands with Teagan Appleby’s mother, Emma, to collect one month’s supply of medical cannabis. The Department laid down the requirements for Emma to meet with Border Force, and she met them by providing a UK prescription. Will the Secretary of State and Ministers meet me to ensure that there is no more ambiguity in a policy that currently criminalises parents in possession of a UK prescription bringing their much-needed medicine into the country?
Matt Hancock
As the hon. Lady and other colleagues know from having worked on this important issue, we acted swiftly to change the law to make sure that medicinal cannabis was available. Those patients for whom it is clinically appropriate can now be prescribed medicinal cannabis. As she knows, whether to prescribe is a clinical decision, but those prescriptions are available and flowing and are being issued where it is judged clinically appropriate for the patient. We will continue to work on this to make sure we get it right.
Several hon. Members rose—
Mr Jacob Rees-Mogg (North East Somerset) (Con)
My constituent Max is aged eight and has Batten disease. He is one of only two sufferers of this disease who are not receiving the medicine that can improve their quality of life and keep them alive. Eleven other children in this country with Batten disease are receiving the drug, which is very effective but very expensive. The drug manufacturer has offered six months’ free supply to Max and the other person not getting it and has made other proposals to NHS England, which is currently refusing even to have meetings with the drug company to discuss how my constituent, this dying child, may receive the drugs he needs. Will my right hon. Friend intervene and use whatever reserve powers he has to ensure that my constituent gets this life-saving drug?
Matt Hancock
My hon. Friend speaks for the whole House about the need for these rare diseases to be given the attention they need so that sufferers such as Max can get the medicines if at all possible. As he knows following our meeting, the formal legal responsibilities lie with NHS England and NICE. I have raised this case, and that of others mentioned earlier, with the chief executive of NHS England and will raise it once again following this Question Time. We will do all we can to resolve this.
Stephen Morgan (Portsmouth South) (Lab)
Thousands of my constituents will be left without access to dental care because a Swiss-owned investment firm has decided to shut three practices in my city. What is the Department doing to ensure that the people of Portsmouth have access to vital oral health services?
Marion Fellows (Motherwell and Wishaw) (SNP)
Regardless of which type of Brexit we face this autumn, bureaucracy, customs charges and stockpiling costs will inevitably drive up the price of imported drugs and medical devices. Will the Secretary of State undertake to provide additional funds for NHS England and the devolved nations to cover those Brexit-induced costs and to avoid cuts in clinical services?
Matt Hancock
Additional funds have already been provided to ensure that medicines are available throughout the country, whatever the Brexit scenario.
Brendan O’Hara (Argyll and Bute) (SNP)
Given the increased likelihood that the next Prime Minister will be determined to leave the European Union at the end of October, deal or no deal, will the Secretary of State update the House on what preparations are currently being made to protect the import of critical supplies such as insulin and radioisotopes?
Matt Hancock
Meeting the need for unhindered medicine supplies was an incredibly important piece of our Brexit planning, which was successfully completed ahead of 29 March. Of course we are updating those plans as we speak, but the ability to reassure people that there will be no impact on the supply of medicines is an important part of that work.
Listeria: Contaminated Sandwiches
Matt Hancock Excerpts(5 years, 6 months ago)
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Jonathan Ashworth (Leicester South) (Lab/Co-op) (Urgent Question)
To ask the Secretary of State for Health and Social Care to make a statement on the listeria outbreak related to contaminated sandwiches in hospital trusts.
The Secretary of State for Health and Social Care (Matt Hancock)
I would like to update the House on the actions the Government are taking to protect the public following cases of listeria in hospitals linked to contaminated food. The NHS has identified nine confirmed cases of listeria in seven different hospitals between 14 April and 28 May this year, all linked to contaminated sandwiches from a single supplier. All the known cases involve in-patients. Very sadly, five people have died. I would like to express my condolences to the families of those who have lost a loved one. I promise that there will be a full and thorough investigation, with severe consequences if there is any evidence of wrongdoing.
Lab testing indicated a link between two cases in Manchester Royal Infirmary and one case in Liverpool. Contaminated sandwiches were identified as the likely cause by Public Health England. The manufacturer—The Good Food Chain—and its supplier, North Country Cooked Meats, have withdrawn the sandwiches, and voluntarily ceased supply of all products on 7 June. They are both complying with the Food Standards Agency on a full product withdrawal. The other cases have been identified at these hospitals: Royal Derby, Worthing, William Harvey in Ashford, Wexham Park, Leicester Royal Infirmary, and St Richards in Chichester.
The risk to the public is very low, but any patients or members of the public with concerns should contact NHS 111 or, of course, 999 if they experience severe symptoms. Listeria infection in healthy people may cause mild illness but is rarely fatal. However, for certain groups it can be much more serious, as we have tragically seen. The NHS, Public Health England and the Food Standards Agency have acted swiftly to identify, contain and investigate the cause of this listeria outbreak. These deaths should never have happened. People rightly expect to be safe and looked after in hospitals, and we must ensure that we take the necessary steps to restore that trust that the public deserve to be able to hold.
This is not just about ensuring that the food we serve in hospitals is safe—the NHS served 140 million main meals to in-patients last year—but, importantly, is also about ensuring that food given to patients is healthy, nutritious, and aids their recovery. So I can inform the House that we are launching a root-and-branch review of all the food in our hospitals—both the food served and the food sold. The Government will work with the NHS to build on progress in three vital areas. First, there is eliminating junk food from hospitals. Since the introduction of the NHS action on sugar scheme, we have halved the sale of high-sugar soft drinks, and trusts are taking action to remove unhealthy food and drink items and replace them with healthier alternatives. After all, hospitals are places for good health. Secondly, on improving nutrition, new national standards for all healthcare food will be published this year. All patient menus will have to ensure that minimum patient nutrition standards are met. Thirdly, on healthier choices, we will work closely with the Hospital Caterers Association and others to ensure that healthier food choices are available across the NHS.
The review will identify where we need to do more, where we need to do better to improve the quality of food in our hospitals, and how we help people to make healthier choices. I know that this is an issue that many colleagues in the House feel strongly about, as do the public. We will do everything we can to ensure that the food we eat in hospitals is both safe and healthy.
Jonathan Ashworth
Let me say at the outset that despite our often sharp political differences across the Dispatch Box, the Secretary of State has my commiserations over his entirely noble ambition to want to be the Prime Minister of this country—but perhaps, given Brexit, he has had a lucky escape.
Moving on to the substance of what we have to discuss today, our thoughts really must be with the families of those who have lost their lives. This is, first and foremost, an issue of patient safety and standards of care. Every patient deserves the very safest possible care and absolute confidence about the quality and safety of the food that they are offered. I am pleased that there is an investigation, and I welcome what he said about serious consequences if wrongdoing is found. I am also pleased that he talked about a root-and-branch review, which we have been calling for. As I understand it, NHS Improvement was already reviewing the hospital food plan, which was delayed from April. Is this a new review or an existing review that now has new obligations? Can he explain to the House how the review he has announced interacts with the existing NHS Improvement review?
I know that the investigation will want to get to the bottom of what went wrong and why, and it will no doubt make recommendations for the future, but we would be grateful if the Secretary of State offered some clarification. The first case showing symptoms of listeria was on 25 April, and sandwiches and salads were withdrawn on 25 May. When were Ministers informed, and what action was taken?
I am grateful that the Secretary of State listed the other hospital trusts affected, which include the one in my Leicester constituency. As I understand it, the Good Food Chain was supplying sandwiches to 43 trusts. Can he tell us the status of investigations or what investigations have gone on in the other trusts that he has not listed today? Does he expect cases to emerge in more trusts, and what action is currently under way to contain the spread?
What advice has the Secretary of State received from officials that microbiological controls for listeria need to be improved with respect to pre-packaged sandwiches? Will he consider introducing mandatory testing on all batches of high-risk food? Of course, this is not the first time that there has been a listeria outbreak. There was an outbreak back in 2016, and in response, the Food Standards Agency investigated and issued a report warning Ministers of the dangers posed by pre-packed sandwiches. Can he outline what measures were taken by Ministers in response to that report in 2016?
I have been speaking to hospital catering staff in recent days, and they raised concerns that tight finances and years of capital cuts have left kitchens substandard, which has driven a move to greater outsourcing of catering, with sandwiches and soups steadily replacing hot meals. Recent data show some hospitals spending less than £3 per patient per day. Does the Secretary of State agree that the review he has announced today should be backed up by investment in hospital catering facilities and legally backed, clear minimum-quality standards for hospital food? Healthcare is not just about medicine, surgery, bandages and procedures; it is about nutrition and hydration too. Patients will need urgent reassurance. Can he provide that today?
Matt Hancock
The shadow Secretary of State raises important questions, and I will try to address them all. Ultimately, I strongly agree with him that this is about standards of care. People deserve to be able to trust that the food they eat and are given in hospital is safe and, indeed, nutritious and good for their health—that is an important part of this too. Clearly, the most acute aspect of what we are discussing is safety and the lack of listeria in food, but it is part of a much bigger picture, which is why we are having a root-and-branch review.
The hon. Gentleman asked about the hospital food plan, which NHS Improvement has been leading. The review will be wider than, but will encompass, some of the existing work that is ongoing. It is about not only how food is procured by hospitals, but the quality of food. Work on the national standards in hospital food is important. It has been ongoing for several years and will come to fruition very soon. More broadly, dozens of hospital trusts have brought their catering in-house and found that they get better quality food that is more likely to be locally produced and is better value for money. We will be examining that model closely, because I am very attracted to it, and it has the potential to reduce the risk of safety concerns such as this.
The hon. Gentleman asked about timings. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for South Ribble (Seema Kennedy), was made aware of this outbreak on 4 June. I was informed on 6 June, and we published the details of the outbreak on 7 June.
Before that, Public Health England very swiftly identified that there was a link between these particular listeria outbreaks. It is only because of recent advances in genomic medicine and testing that we could work out—that Public Health England could work out—that the outbreak in Liverpool and the outbreak in Manchester were connected, and therefore identify that the source was outside those hospitals, rather than inside the hospitals, and that is what then identified that this was from the food source. The truth is that there are just over 150 listeria cases a year. It is a notifiable disease, so we are confident that we are properly notified of the various cases. Frankly, it was cutting-edge work by Public Health England that allowed us to connect these different cases and work out that a single source was causing these deaths.
The hon. Gentleman mentioned the 43 trusts that we know bought from the Good Food Chain. We have of course been in contact with all hospital trusts, whether or not they bought from this individual company, to try to make sure that we have confidence in their supplies. The Good Food Chain has confirmed that it has followed advice and has disposed of all products. That is what the Good Food Chain company has said to us, but we are of course reconfirming that with the trusts because we want to get this right.
Finally, the hon. Gentleman asked about investment in food and catering facilities. The truth is that it is important to have the best-quality food in hospitals. I am completely open to upgrading hospital equipment if that is what is necessary, and if it provides value for money. I have been struck by the number of hospital chief executives who have said that from the point of view of patient satisfaction, staff morale, and nutrition and the quality of food, bringing such food supplies in-house is the best thing they have done.
Sir William Cash (Stone) (Con)
The Secretary of State will be aware that in my constituency of Stone, where the Good Food Chain is situated, there is obviously very deep concern, not least because we had the horrendous Mid Staffs hospital crisis. I had to campaign on that against the Labour Government’s refusal to give a full public inquiry, which our Government did give.
Having said that, is it not the case that the Good Food Chain is only responsible for the products that the patients consumed, and that the bacteria came from another company, which I am given to understand is called North Country Cooked Meats in Salford? I do commend Public Health England and the Secretary of State for the rapid way in which they identified the connections between these different places. Whereas it is absolutely essential that we have the root and branch review the Secretary of State has provided, is it not also the case that while the companies concerned will have to accept responsibility as far as it falls on them, at the same time there are really important reasons to identify exactly what did happen—where the food was contaminated, how it was contaminated—and then to exonerate the Good Food Chain, if in fact that is the case, because it is very unfair for companies to be caught up in something when it was not entirely their fault?
Matt Hancock
My right hon. Friend—[Interruption.] Not yet. My hon. Friend rightly raises the question of the supply chain, and it is true that the food in question came from North Country Cooked Meats. In turn, we are trying to identify the suppliers to North Country Cooked Meats to get to the real root of this outbreak. He is quite right to identify that this is a supply chain issue, and that there is a complex supply chain in operation.
I join my hon. Friend in commending the work of Public Health England. Within days, it spotted the links between individual cases and, from a local incident, made this into a national incident. At the appropriate moment, it raised the issue with the chief medical officer and with Ministers in the Department, and we could then explain the problem to the public. Its work has identified the problem, and undoubtedly it has potentially saved lives.
Mr Speaker
I hope the hon. Member for Stone (Sir William Cash) will not be saddened by the fact that he is not yet a member of the Privy Council. After all, he is a Staffordshire knight, he has served his constituency without interruption in this House for 35 years, and I remind the House that the hon. Gentleman has a whole chapter named after him in the late Hugo Young’s estimable tome on Britain’s relationship with Europe. There is a chapter in the name of Mr Bill Cash.
Dr Philippa Whitford (Central Ayrshire) (SNP)
I, too, would like to express our sympathies with the families of the five patients who lost their lives, but also the four who remain critically ill. Obviously, we do not know what outcome they face.
As the shadow health spokesperson highlighted, these sandwiches were sold to 43 trusts, and while there have been no cases since 25 May, the incubation period of listeriosis is 70 days, so will surveillance of those 43 trusts continue alongside the Health Secretary’s investigation?
The Food Standards Agency published a report in 2014 about the dangers of hospital food. It cited 32 failures, including sandwiches spending hours outside fridges, and fridges often not being cold enough. Indeed, it has been highlighted that hospital sandwiches have been the commonest source of listeria outbreaks over the past two decades.
As the Health Secretary says, simple cases are often a matter of people being unwell for a few days, but listeria poses a major threat to pregnant women, who may lose their child, and is life-threatening for people who are already ill. Will the Health Secretary therefore pay particular attention in his review to why on earth people who were seriously ill or frail were being fed sandwiches? Someone who has no appetite and is recovering from illness is simply not going to be tempted by a pack of sandwiches. That really makes the case for bringing food preparation in-hospital and producing tempting meals, because nutrition is critical to recovery.
Matt Hancock
I entirely agree with and endorse what the hon. Lady has said. She is quite right to point out that a meal has to be appetising as well as nutritious. The best hospitals deliver that, and I would like that practice to be much more widespread.
I reassure the hon. Lady that the 2014 report by the Food Standards Agency was, as I understand it, looked into in great detail and assurances have been made that what it raised has, correctly, been followed through. Obviously, that was before my time as Health Secretary but I have taken advice on precisely the point she raises and I have been assured that what was necessary happened. I am open-minded, however, on what may have happened and what more needs to be done, and the review will absolutely look into that question.
Finally, the hon. Lady is absolutely right about the incubation period. We remain vigilant. Because listeria is a notifiable disease, Public Health England is told of every case and is able to analyse the links from every new case to existing cases. Notification of most cases takes place after the fact, given the nature of the disease, but we are then able to find genetic links, where they exist, and find out whether different cases have the same source.
Damian Green (Ashford) (Con)
As my right hon. Friend said in his opening remarks, one of the cases took place at the William Harvey Hospital in my constituency, and my constituent Tanya Marston, who is, happily, recovering from listeria, says that there should be a very urgent inquiry, so I welcome the announcement that my right hon. Friend has made today. On the specific safety aspect, however, rather than the wider inquiry on nutrition, what is the timescale for coming to some kind of conclusion so that people can be reassured that hospital food is safe?
Matt Hancock
I am grateful to my right hon. Friend and erstwhile campaign manager for his question. I am glad to hear that the patient who is his constituent is recovering. I am informed that all patients are either stable or have recovered, but for the five who tragically died. On the timescale, the urgent task at hand is to ensure that there are no further cases and that there is no more of the food that we know has the potential to cause problems in the food supply chain. That is what is going on right now. The timescale for the review will be a matter of months.
Lucy Powell (Manchester Central) (Lab/Co-op)
As the Secretary of State knows, two of the tragic deaths occurred at Manchester Royal Infirmary. Our hearts go out to the families. Nothing could be worse than going to hospital poorly and trying to get better, and then dying because of a sandwich provided by the hospital to aid recovery. Like the Secretary of State, I want to pay tribute to Public Health England and the Manchester Royal Infirmary for acting so quickly in identifying the source and closing it down. As others have said, however, there are some wider questions. First, we need a bit more transparency. It is only today that we have learnt which other trusts have been affected. The what, the why and the how—there are still many questions we do not know the answer to. On food outsourcing, I welcome the review he identifies today, but surely we have to be a lot firmer in identifying that the growth in outsourcing food supplies is leading to some real safety issues and, potentially, to deaths.
Matt Hancock
I agree with the hon. Lady on the need for food to be produced in-house whenever possible, especially as the evidence from some of the best hospitals in the country is that it is also very good value for money. There really is no case for not doing that and I look forward to best practice spreading across the NHS. I will, like her, do what I can to make that happen. She asks about transparency. I made it clear that there are hospitals trusts where further information needs to be published. There is a need to tell patients first, which is why the information has come out at the pace that is has. That duty of candour is important, but of course the review will lead to full transparency. All that everybody wants to do is get to the bottom of this and learn lessons for the future.
Sir Peter Bottomley (Worthing West) (Con)
May I join those who have praised Public Health England? Not every hospital involved has necessarily had fatalities or major problems, but it was very important that Public Health England notified all those who might have been supplied by the same people. May I put it to the Secretary of State that we should not just think that there was one cause of listeriosis? It can come from processed vegetables, processed meats, ice cream and other things. May I ask him to recommend to everyone that people try to ensure there is safe handling, safe cooking and safe consumption to reduce the risk of cross-contamination? When an outbreak happens, that is the way, as well as through the work of Public Health England, that people can help to ensure it does not affect them.
Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)
What is happening in hospitals? Surely we should be role-modelling fresh and healthy produce? Giving people packaged produce, including sandwiches, to eat gives them the wrong message about health and rehabilitation. Surely we should be role-modelling correct behavioural choices at every opportunity when somebody goes into hospital? Will the Secretary of State speak to the Government’s behavioural insights team to consider taking that forward? In my experience, kitchens in hospitals do exist. If he looks deeply into the issue, he will find that staff and visitors often have restaurants in hospitals. However, fresh food from those restaurants is not always made available to patients. We need to tackle and stop that inequality, particularly when patients are fragile, frail and elderly.
Matt Hancock
I will happily look into the last point for the hon. Lady. She is absolutely right that a hospital should be a role model of fresh and healthy food, because after all, what is a hospital but a place to try to make us all healthy?
Maria Caulfield (Lewes) (Con)
Although there is no evidence that cost is behind the tragic cases that we have heard about, will the Secretary of State look in his root-and-branch review at the price that hospitals are paying for food? Spending £1 per meal is not enough for a healthy, nutritious meal for patients. Some trusts are spending less than £5 a day on a patient’s food. Will he also look at legislating for safe staffing levels, so that there are enough nurses on wards to feed patients? About a third of patients are eating less than half the food that is served to them and are suffering from malnutrition. Will he look at both those issues to improve patient safety?
Matt Hancock
Making sure that there are enough nurses on wards is incredibly important for delivering good patient care not just in relation to food, but more broadly. My hon. Friend raises the question of price per meal. It is interesting that the hospitals that have brought food production in-house and source not necessarily locally distributed food but locally produced food, have often found that that reduces costs rather than raises them. This is a question not of resources, but of good practice.
Nigel Huddleston (Mid Worcestershire) (Con)
I welcome the announcement of the root-and-branch review and I know that patient safety continues to be a top priority for the Secretary of State, but can he reassure me and my constituents that the overall risk of listeriosis remains low?
Matt Hancock
Yes, of course. Millions of meals are served in NHS hospitals each year. While we regret any death, especially a death that could have been avoided, the overall food in hospitals absolutely is safe.
Mr Philip Hollobone (Kettering) (Con)
The NHS is a pioneer of and, increasingly, an international authority on the new science of genomics. Will the Minister confirm that without this NHS expertise, the source of the outbreak would not have been identified nearly as quickly and that we could well have been looking at far more deaths than in fact occurred?
Matt Hancock
My hon. Friend makes an incredibly important point—even more than he says. Without genomics, which the UK is the world leader in, it would have been impossible to link the different listeria deaths. They would have looked like individual cases in separate, individual hospitals. It is only because through genomics it could be worked out that the exact strain of listeria was the same in cases in different hospitals that we could then work out that there must have been a factor at work that was not internal to the hospital. When it was then identified that the food provider provided food to many different hospitals, that link could be made, too. Science and scientific progress are saving lives here.
Health
Matt Hancock Excerpts(5 years, 7 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Matt Hancock)
It is a great pleasure to respond to this Opposition day debate on health. It is worth saying at the start that, for all we have heard from the hon. Member for Leicester South (Jonathan Ashworth), today’s debate gives the House the chance to discuss the record £33.9 billion of extra funding that we are putting into health services in the UK, how we are going to spend that money and what we will do to improve the nation’s health.
I will respond to the many points that the hon. Gentleman made and explain why it is important to look at the facts when debating these things, but let me start by being crystal clear about what he is trying to do. This debate should start from a point of welcoming the record investment that is going into the NHS. Instead, all we get is Opposition Members talking down the NHS. I will get on to the details but, before I do, let us remember why we can put £33.9 billion extra into the NHS. It is because we have a strong economy, with record employment, not through increasing the tax that people pay, but by having more people in work paying income tax. [Interruption.] I hear those on the Opposition Front Bench say “No”, but just this morning we have seen record numbers of jobs—yet again, record numbers of women in work and record numbers across the board—which means that we can have this money.
It was Gordon Brown who said, “When you lose control of the public finances, it’s the most vulnerable who pay the price”. It is certainly true that we have had to do a big job of fixing the public finances, but now we are able to put in this record investment to be able to make sure that the NHS is always there in the future.
Anna Soubry (Broxtowe) (Change UK)
I am grateful that the right hon. Gentleman has confirmed that this investment in the NHS, which we should all welcome, is as a result of an improvement in our economy and has absolutely nothing to do with what was written on the side of a bus. In other words, whether or not we leave the European Union, does he agree that this money is guaranteed to go to the NHS and it has nothing to do with Brexit?
Matt Hancock
Yes. We can only fund a stronger health service and we can only fund strong public services if we have a strong economy and that would be put at risk by the recklessness of the Labour party. Let us talk about the details of how we are going to improve healthcare in this country, but let us say first and foremost that we can fund public services only if we can ensure that the economy is run well.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
Would the Secretary of State like to address the issues that my hon. Friend the Member for Leicester South (Jonathan Ashworth) raised? We are seeing a flatlining of life expectancy, with the infant mortality rate having increased for the first time in 100 years. Will he address that in his response, please?
Matt Hancock
As I have said, I will come on to the details because there is undoubtedly work to do. Normally, we work on these issues in a fairly non-partisan way across the aisle. If we take tackling the problems of children of alcoholics, the hon. Member for Leicester South and I have worked together on that, and I pay tribute to the work he has done. In fact, he normally comes to this Chamber—as he did yesterday, for instance—in a spirit of discussion and objectivity to try to improve the health of our constituents. He is normally an extremely reasonable man. He is a very nice man. I know that he agrees far more with me than he does with his own party leader. Generally, he takes the approach of being constructive. I accept, and we accept, that improvements need to be made and we on this side of the House are determined to make those improvements, but we have to start from a basis of objective fact.
Rebecca Pow (Taunton Deane) (Con)
The Secretary of State is making a really powerful case. On mortality, I would say that, far from the age going down in Somerset, it is going up. This is a good thing, but the conditions from which people are suffering are getting more complex. This is something we have to address. Indeed, I know the Government are seriously looking at it with many of the models they are bringing in.
Matt Hancock
I will give way in a moment, if I may just make a bit of progress.
Of course extending healthy life expectancies is a central goal of the Government, and we will move heaven and earth to make it happen. Yes, that does involve ensuring that the entire budget of the NHS—not just the public health budget, important though it is, but the entire budget of the NHS—and all those who work in it are focused more on preventing ill health. The entire long-term plan of the NHS, which sets out how we are going to spend all the extra taxpayers’ money that is going in, is about focusing the entire NHS more on prevention than on cure. To choose just to look at the public health grant—it is important, but it is smaller by far than the entire budget of the NHS—is entirely to miss the point.
Clive Efford
The right hon. Gentleman must accept that it is not acceptable that, in the fifth richest economy in the world, life expectancy has flatlined across the country and in some areas has actually gone backwards. Is that not an indication that wider policy approaches by this Government than just those on health are not working?
Matt Hancock
It is true that across the western world the incredible rise in life expectancy is continuing but the rate of improvement has slowed. Our task here is to ensure that we extend healthy life expectancies.
Matt Hancock
I have taken the hon. Gentleman’s point. That is the purpose of the entire prevention agenda: to help people to stay healthy in the first place.
Let me give a few examples. The hon. Member for Leicester South talked about deaths of despair, and each one of those suicides is a preventable tragedy, but he did not mention that the suicide rate in this country is the lowest it has been in seven years. We should be celebrating that while also resolving to drive it down further. Similarly, he talked about some of the sexually transmitted infections that are rising around the world, including in America, France and Belgium, but he did not mention that STIs overall are down. Indeed, HIV is down very significantly, and the UK is one of the leading countries in tackling HIV. It is important to look at the objective facts and not just pick out some. Of course there are STIs that we must tackle, and we will, but we must look at the overall picture. I will give one more objective fact: the number of attendances at sexual health clinics has gone up. That is one of the reasons why STIs overall are down.
Neil Coyle (Bermondsey and Old Southwark) (Lab)
When will the Secretary of State meet his commitment to expand the PrEP—pre-exposure prophylaxis—impact trial? He made that commitment some time ago but it has still not been delivered.
Matt Hancock
Yes, I have made that commitment and we have made that available. The NHS is doing its part but some local authorities have not yet chosen to make that available and, because sexual health services are delivered through local authorities, I cannot direct that to happen. What I can do is ensure that I play my part, and I have.
Neil Coyle
I thank the Secretary of State for giving way again; he is being generous. The bottom line here is that there are men who have contracted HIV as a direct result of PrEP not being available. He must get a grip on the situation because he cannot keep passing the buck to local councils. He does have the resources and it is his commitment.
Matt Hancock
We have made those resources available. The resources from the NHS to make PrEP available have been put forward. I find it deeply frustrating that in many areas that has not yet been delivered by local councils. We are working with local councils and urging them to take up the offer that is already available from the NHS. I totally understand and share the hon. Gentleman’s frustration. We are working to push local authorities to do this, but responsibility for public and sexual health services was transferred to local councils, as a result of a decision taken by this House. I am doing my part. I would love to work with him to ensure that it can actually be delivered on the ground because he is absolutely right that it is the right thing to do and the right direction to go in.
Rushanara Ali (Bethnal Green and Bow) (Lab)
The objective fact is that the public health grant has gone down by £700 million between 2014-15 and 2019-20. If a person gets on the tube at Westminster station and travels to Whitechapel station in my constituency, average life expectancy drops by six months at every stop. That is the reality in constituencies such as mine. My appeal to the Secretary of State, if he is serious about tackling health inequalities, is to back local authorities with the resources they need.
Matt Hancock
The public health grant is of course an important part of this, but it is only one part. The overall funding of the NHS is rising by £33.9 billion, the first £6.2 billion of which came on stream last month. I understand the hon. Lady’s point. That is on the money. On the health inequalities, I entirely agree with her that they should be tackled. Doing so is at the heart of the NHS long-term plan. It is a vital task that we do not shirk. Indeed, we embrace it and are addressing it.
Let me turn to the details of the motion. While I care deeply about making sure that we have the best possible health in this nation and the strongest possible NHS—and we are prepared to put the resources in to see that happen—I also care about good governance of the nation. The way that we are run is one of the reasons this country has been strong over generations, and I believe that using the Humble Address to undermine the ability of experts, clinicians, and civil servants to give me the benefit of their frank and wise advice not only undermines me as Secretary of State, but makes it harder to make good decisions. I know the shadow Secretary of State sits on the Front Bench with revolutionaries, but I thought he was a grown-up. I do not know what his mentor, Lord Mandelson, would make of his posturing today. Of course, we will object to the motion and, if he searched the depths of his heart, he would too.
The hon. Gentleman has obviously had a missive from the Leader of the Opposition’s office—LOTO, as it is called—telling him to present the Humble Address, but it is not his style. I hope that we can get back to debating these issues on a proper motion in the future. I respect and like the hon. Gentleman: he is a really nice guy. If he had asked for the information directly—perhaps he could have sent me a message on the app—
Matt Hancock
Now that is an insult! There are only two types of people in the world—the people who are on the Matt Hancock app and the people who are not on the Matt Hancock app yet. I can see that the hon. Gentleman falls into the latter category. I digress.
If the hon. Gentleman had asked for the information directly, I would have been more than happy to provide it. To show willingness, I am happy to provide the House with the information requested in the motion. We will republish the impact assessments on the public health grant. They have already been published, but I am happy to do that. We will republish the Office for National Statistics stats and the Public Health England report on life expectancy. We will publish a statement on the “Agenda for Change” decision that he mentioned. It had been released already this week, as it happens, before we saw the motion.
If the hon. Gentleman wants to know about the “Agenda for Change” pay rises, I am delighted to keep talking about them. Perhaps he should ask the 1 million NHS staff who last month received a pay rise of up to 29%, including £2,000 extra a year for new full-time nurses. That came into force at the start of last month. I will debate with him the “Agenda for Change” pay rises any day of the week. Because the Government are running a strong economy, we can afford to put the money in to make sure that under “Agenda for Change” nurses get the pay rise they deserve.
Jonathan Ashworth
I am delighted that the Secretary of State wants me to join his Make Matt Hancock Great Again WhatsApp group. Please add me to it. Perhaps in the group I can get some style tips from him, because he looked rather Alan Partridge-esque in the photos on Friday. I digress.
On Agenda for Change, it was reported in the Health Service Journal that the Government will not honour the pay rise for public health staff such as health visitors, sexual health staff and school nurses—all the sort of staff we have been talking about this afternoon—and that there was a dispute between NHS England and the sector about who will fund that £50 million pay rise. Is he telling us today that the Government will honour that pay rise for public health staff working in public health services?
Matt Hancock
We are honouring the pay rise proposed—of course we are. I love the HSJ, which is an absolutely terrific journal, but it was wide of the mark on that. We are putting in record funding.
John Redwood (Wokingham) (Con)
The Secretary of State has done well in getting the extra money that the NHS needs. Will he briefly summarise what extra service and capacity we will get for that money? It is important to spend it wisely.
Matt Hancock
My right hon. Friend anticipates my very next point. It is important to get value for the extra taxpayers’ money we put in. I always try to refer to it as taxpayers’ money, because there is no Government money or NHS money. Every single penny we put into the NHS—rightly, in my view—comes from the taxes that people pay, and it should be treated with the respect that that deserves.
Geraint Davies
The thesis of a strong NHS is based on a strong economy, yet will he accept that under this Government since 2010 overall debt has gone from 45% of GDP to nearly 90% of GDP? It is not about tax; it is just borrowed money from a failing economy.
Matt Hancock
No. I agree with the hon. Gentleman about the importance of clean air, but I gently point out that dealing with the deficit—the annual amount by which the Government was overspending—is, and must be, the precursor to getting the debt down. Now, thankfully, the debt is falling relative to the economy, but there has been an awful lot of hard work to get us there.
Let us look at some of the things the NHS is delivering. The entire population now has access to evening and weekend GP appointments. More than a million GP appointments a month are now booked online, and consultation increasingly takes place online. More than three million repeat prescriptions are done online. There are more than 2 million more operations a year than in 2010, and we see 11.5 million more out-patient appointments than in 2010. Since last year, more than 500 extra beds a day have been freed up in hospitals.
When it comes to the future, only yesterday we announced that a new treatment aid for brain cancer can be rolled out across the country, benefiting up to 2,000 patients, all because of the extra money we are putting in. My right hon. Friend the Member for Wokingham (John Redwood) is quite right that in return for the extra taxpayers’ money we are putting in, we must get extra out, too.
Dr Paul Williams (Stockton South) (Lab)
Extra investment in the NHS is welcome, but when will the Secretary of State start talking about health visitors, school nurses, drug treatment services and other services funded out of the public health grant—the topic of the debate?
Matt Hancock
The public health grant is settled in the spending review. The NHS settlement has come before the spending review, and the public health grant is only one part of the approach to public health. In 2015, this House agreed, with broad acceptance across parties—I know the hon. Gentleman was not in the House then—that local authorities should take responsibilities for public health, to ensure that the entirety of local authority activity could be focused on better public health.
Public health is not just what happens in the NHS, with councils or in GP surgeries or hospitals. For instance, the Government have taken a global lead in getting social media companies to remove suicide and self-harm content online because of the danger that poses to people’s mental health, and in particular that of children and young people. That is a public health issue. Likewise, the efforts we are making to reduce air pollution in the environment Bill—a broader piece of legislation than just a clean air Act—are about a public health matter. It is not in the public health grant, but it is a public health matter.
Anna Soubry
As a former Public Health Minister, I understand the huge remit of what we call public health. The Secretary of State is right that we should invest more in prevention, particularly with regard to certain diseases and conditions, but the real concern about the Government’s plan is that, while that is happening, all the other important services not in the “prevention is better than cure” envelope, such as sexual health and the treatment of alcohol and smoking, delivered at a local level, will be cut in real terms.
Matt Hancock
I respect the right hon. Lady’s work as Public Health Minister—she was excellent in that role—and I was going to turn to this point. It is very important that we understand the base we are starting from, but we also have the spending review, in which these budgets will be settled, and that is clearly an important cross-Government question that we will be addressing in the coming months.
Smoking cessation services have been mentioned. Now, the smoking rate has fallen since 2010 from 20.1% of the population to 14.9%, which is excellent, although it is part of a fall over a generation, not just the last 10 years. Likewise, the drug use rate has fallen from over 10% to 8.5%. We have to provide the services for those we still need to get off smoking and to support people to stop using drugs, but the number of people smoking and using drugs has fallen too.
On clean air, the World Health Organisation has called the clean air strategy we published an example for the rest of the world to follow, so I think in this area the necessary action we are taking should be being welcomed across this Chamber.
Geraint Davies
I know the Secretary of State accepts that the environment Bill is the vehicle to deliver cleaner air, but is he aware that, as it stands, it does not include indoor air quality? Given that we spend 90% of our time inside and that the medical research now shows a cocktail effect of outdoor dirty air conflating with indoor air that has poisons in it—from sprays, cleaning products, chemicals in furniture and all the rest—if we are to properly tackle the problem of dirty air causing 64,000 deaths a year, indoor air quality has to be included in the environment Bill. Will he press the Secretary of State for the Environment, Food and Rural Affairs to ensure that it is?
Matt Hancock
The Secretary of State for Environment, Food and Rural Affairs and I are working incredibly closely on this because clean air is a public health matter. The challenge is that, although measuring outdoor air quality is essentially a public matter and in public buildings it may well be a public matter, inside most people’s homes it is far harder to make a direct intervention, but I accept the premise of the hon. Gentleman’s point. It may be something we can look at in public spaces. [Interruption.] He mentions schools and hospitals. I accept the premise of that point and I think it is something we can take away. The same is true inside vehicles, but that is a wider question.
Anna Soubry
I want to come back to the Secretary of State’s answer to my intervention. I am worried because, if I may say so, it is rather simplistic to say—I think this is what he said—that because the levels are falling we can accordingly reduce the amount of money being spent on those services. I would suggest that he listen to the experts and the evidence, because I suspect they will say that we must continue to invest to make sure those reductions continue and to take account of any eventualities. Police spending is a good example of how Government can cut too far.
Matt Hancock
I am glad I took that intervention because that was not the intention I was trying to convey at all. We need to do more to tackle smoking, and we will, and we need to continue to tackle the abuse of drugs, and we will. My argument is that this House decided that public health was better delivered through a broad approach by local councils working with the NHS than separately. On sexual health services, I gently say that many such services—for instance, the provision of PrEP—are preventive, not just reactive. However, the boundary between what is prevention and what is cure in sexual health services is, by nature, more complicated.
Nick Smith (Blaenau Gwent) (Lab)
May I take up that issue of prevention? Earlier this afternoon, the Secretary of State said that he would move heaven and earth to achieve healthy outcomes. When will we see a ban on junk food advertising before the watershed?
Matt Hancock
We have not discussed obesity much during this debate, but the Government have a whole programme to tackle it. That includes tackling advertising and, in particular, tackling the pro-obesity environment in which too many children grow up. There is a broad range of actions on our agenda, with more to come.
Rachael Maskell (York Central) (Lab/Co-op)
Will the Secretary of State give way?
Matt Hancock
I will give way one final time, but I want to leave some time for Back-Bench speeches.
Rachael Maskell
The Secretary of State has boasted about the amount of money that is going into the NHS, but the Government have transferred public health services to local authorities, whose funding is being slashed, and as a result funding for those services is also being cut. Can the Secretary of State say how much of that NHS money will support the role of local authorities in delivering the public health agenda?
Matt Hancock
Local authorities and the NHS work very closely in delivering a huge number of services, and authorities often commission services back from the NHS. I can tell the hon. Lady that between 2013 and 2017, the number of attendances at sexual health centres increased by 13%. The suggestion made by many Opposition Members that there has been a cut in the number of such attendances is not supported by the facts.
We will not rest until we can solve these problems.
Matt Hancock
We are putting money in, and we are putting commitment in. The NHS was proposed from this Dispatch Box by a Conservative Minister, under a Conservative Prime Minister, and its expansion has been overseen by Conservative Governments for most of its 71-year history.
Madam Deputy Speaker (Dame Eleanor Laing)
Order. The Secretary of State is not giving way, and we are running out of time.
Matt Hancock
Once again, a Conservative Government are expanding the NHS and planning for the future to ensure that it will always be there for us, with a record £33.9 billion investment and a focus on preventing ill health in the first place. I believe that, from the bottom of our hearts, we all know that we need to deliver.
Several hon. Members rose—
Tessa Jowell Brain Cancer Mission
Matt Hancock Excerpts(5 years, 7 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
I would like to update the House on the progress we have made in tackling brain cancer, including on a new innovation that is now available across England.
For far too long, tackling brain cancer has been put in the “too difficult” box, and we are determined to change that. I want to pay tribute to the Petitions Committee, which did so much work on this; my hon. Friend the Member for Mid Norfolk (George Freeman), who picked up the subject in Government as Life Sciences Minister; my hon. Friend the Member for Castle Point (Rebecca Harris), the former chair of the all-party parliamentary group on brain tumours, which brought parliamentarians together; my hon. Friend the Member for St Ives (Derek Thomas), the current chair of the APPG; and, of course, Baroness Tessa Jowell, who campaigned passionately and tirelessly while battling the illness herself, and who, sadly, passed away a year ago.
Brain cancer is the most common cause of cancer-related deaths in children and young people under 19. Baroness Jowell called for all patients to benefit from 5-aminolevulinic acid, or “pink drink” as it is otherwise known: a dye that makes cancerous cells glow under ultraviolet light, thereby making it easier for surgeons to target the right areas. Trials have shown that, when the dye is used, surgeons can successfully remove a whole tumour in 70% of cases, compared to 30% of those without.
I am pleased to inform the House that we have now rolled out this ground-breaking treatment aid across England, with the potential to save the lives of 2,000 patients every year. That is part of the £33.9 billion extra that we are putting into the NHS and the NHS long-term plan. This procedure will now be expanded to every neurological centre in England. That is a fitting testament to Tessa Jowell’s memory.
It is worth pausing for a moment to remember the courageous words that Tessa Jowell used to urge us to rise above our differences. She said that this
“is not about politics but about patients and the community of carers who love and support them. It is…about the NHS but it is not just about money. It is about the power of kindness”.—[Official Report, House of Lords, 25 January 2018; Vol. 788, c. 1169.]
That represents the very best of our democracy and of our Parliament. On behalf of all those who have died of brain cancer, all those—children and adults alike—who have campaigned, and all those seeking to do research, of which there is more to come in future, we are acting.
I want to mention three further areas in detail. The first is research. In the past, not enough research was done into the causes of and treatments for brain cancer. In the last year, the Government have made an unprecedented £40 million available to fund cutting-edge research of new treatments and drugs through the National Institute for Health Research. That will build on our outstanding reputation for neuroscience and oncology research, and increase the quality, quantity and diversity of brain cancer research. That funding was further enhanced by Cancer Research UK committing an additional £25 million to support brain tumour research. The size of those pledges will cement the UK’s position as a leading global centre.
Secondly, on our NHS cancer workforce, the number of specialist cancer staff in the NHS is set to grow as we put the £33.9 billion into the NHS over the next five years. Health Education England’s cancer workforce plan, and our upcoming NHS people plan, will set out in detail the steps we are taking to recruit a world-class cancer workforce. We made available an additional £8.6 million in the cancer workforce last year, and we aim to have 300 more radiographers start training by 2021.
Finally, on empowering patients, we have worked closely with the Tessa Jowell Brain Cancer Mission, Jess Mills and others to ensure patients are at the heart of all these efforts. The mission brings together Government, the NHS, researchers, pharmaceutical companies and patients to ensure that data is shared and disseminated properly so that more patients in the UK and around the world can benefit from what is learned. Due to the complexity of brain cancer, we must provide joined-up care that meets each patient’s unique needs. The NHS is focused on improving care for brain cancer patients to ensure they have access to dedicated out-patient clinics and consultations, wherever they live.
I hope the whole House will recognise the important progress made over the past year in rising to the challenge set by Baroness Jowell and the families of those who have lost loved ones to brain cancer. That progress has been possible only through the collective effort of patients, the NHS, charities and industry. That work is and will continue to be collaborative.
In her final speech in the other place last January, Tessa Jowell said:
“I am not afraid. I am fearful that this new and important approach may be put into the ‘too difficult’ box, but I also have such great hope.”—[Official Report, House of Lords, 25 January 2018; Vol. 788, c. 1170.]
That hope was an inspiration to us all. We will rise to the challenge that she left us. We must not waiver in that task. I commend this statement to the House.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
I thank the Secretary of State for an advance copy of his statement. We warmly welcome today’s announcement. His tribute to our much-missed friend and colleague was moving and powerful. It is an extraordinary testament to Tessa’s bravery that in the final harrowing months of her life, faced with a highly aggressive and very-difficult-to-treat cancer, and in full knowledge of the life expectancy associated with such a devastating cancer, Tessa led from the front to campaign for better brain cancer treatment for others. She spoke with extraordinary courage in the Lords, she brought the then Secretary of State and me together, and she convinced Ministers to shift policy, not by garnering sympathy, understandable though that approach would have been, but by persuasion based on facts and policy argument. It was typical Tessa.
Tessa would have been delighted by the Government’s announcement—some 2,000 brain cancer patients a year will now benefit from the “pink drink” solution—but she would be keen to go further still. Almost 11,000 people are diagnosed each year with a primary brain tumour, including 500 children and young people, which is 30 people every day, and more than 5,000 people lose their lives to a brain tumour each year. Brain tumours reduce life expectancy by around 20 years, which is the highest of any cancer, and are the largest cause of preventable blindness in children.
We live in hope of dramatic improvements, but further research is needed, given that less than 2% of the £500 million spent on cancer research is dedicated to brain tumours. I welcome the Secretary of State’s commitments on research, but does he agree that we also desperately need more involvement in clinical trials? The number of brain cancer patients taking part in clinical trials is less than half the average across all cancers. How will the Government encourage more trials and data sharing?
Finally, we know that the NHS remains under considerable strain generally. The 93% target for a two-week wait from GP urgent referral to first consultant appointment was not met once last year. Neurosurgery is no exception. In March 2019, the 18-week completion target for referral to treatment pathways stood at 81.3% for neurosurgery— 5% lower than the average for all specialties—which made neurosurgery the worst performing specialty. This is a question of both resourcing and staffing. I know the Secretary of State has his answer on revenue resourcing—we disagree, but we will leave our political arguments for another day—but on workforce there are vacancies for more than 400 specialist cancer nurses, chemotherapy nurses and palliative care nurses, and there are diagnostic workforce vacancies too.
Meanwhile, the staff who are there are reliant on outdated equipment, and we have among the lowest numbers of MRI and CT scanners in the world. Failing to diagnose early is worse for the patient and more costly for the NHS, so will the Secretary of State update us on when we can expect Dido Harding’s workforce plan? Can he reassure us that the cancer workforce will be a key part of that plan? On equipment and MRI scanners, can he guarantee that the NHS will see increased capital investment budgets in the spending review so that it can upgrade existing equipment and increase the number of MRI and CT scanners?
Overall, however, we welcome today’s announcement. It is a fitting tribute to our friend Tessa Jowell, and like Tessa herself will touch the lives of so many.
Matt Hancock
The cross-party tone of this discussion demonstrates what we can achieve when we work together. This is not just about Baroness Jowell, who did so much and was so brave in how she made her case—in the last few months in particular, but before that as well. It is about the many others who have worked together, including the many who were inspired by her words to work harder on brain cancer.
In truth, the amount of research money going into brain cancer—and therefore the number of clinical trials, which the hon. Member for Leicester South (Jonathan Ashworth) mentioned—was too low. There were so few clinical trials because research overall was too low. That is partly because brain cancer is a very difficult disease to treat. Just because it is difficult, however, does not mean we should not try, so we have increased the amount of research money, and I am determined to see an increase in the number of clinical trials and to make sure that the data from them is properly used and openly disseminated.
The hon. Gentleman asked about the cancer workforce. As I mentioned, of course we will need more people to treat cancer. That is partly what the £33.9 billion extra is all about.
The hon. Gentleman is also right to say that we need more early diagnosis. The truth is that, while the NHS is very good at treating cancer once it has been spotted—indeed, it is one of the best in the world—our cancer survival rates in this country need to improve through early diagnosis. That means giving more support to community services, strengthening primary care and ensuring that we have the diagnostic tools that he mentioned. We have more MRI scanners and more Linux machines for treatment purposes, but of course there is always more that we can do.
Steve Brine (Winchester) (Con)
During my time as the cancer Minister, I had the pleasure of meeting Tessa. You will recall, Mr Speaker, a very special debate that we had in the Chamber last April, when Tessa was back in the House of Commons, sitting in the Under-Gallery with her lovely family and listening to the debate.
Obviously I welcome the roll-out of 5-aminolevulinic acid—5-ALA—which allows surgeons to tackle some of the most difficult cases while ensuring that the healthy cells remain untouched. Does the Secretary of State agree that the exciting new frontier in cancer treatment is not only allowing people to survive it—more people are doing that for longer than ever before—but enabling them to live really well after treatment? It is no good surviving cancer if it is a rubbish time afterwards. Is that not the real promise of this?
Matt Hancock
My hon. Friend is a former colleague and dependable Minister, and I regret not having mentioned the work that he did in my opening remarks. The hon. Member for Leicester South said that he and my predecessor as Secretary of State had worked together on this issue, but the person who did the hard yards was my hon. Friend, and I pay tribute to him.
My hon. Friend is completely right: it is not just about surviving cancer, but about living well both with and after it. We must make sure that we learn that lesson and put the needs of patients at the heart of the process—not only their medical needs, but their non-medical and social needs. One of the humorous and amusing things that Tessa would talk about was the importance of the shape of the wig and the colour of the headscarf to a person who is going through chemotherapy, and that should be at the heart of treatment.
Neil Gray (Airdrie and Shotts) (SNP)
I welcome the statement, and thank the Secretary of State for giving me advance sight of it. I join Members on both sides of the House in remembering Dame Tessa Jowell, her lifetime of public service and, of course, her brave campaigning during the final months of her life.
This research funding is very welcome, and it was good to see Edinburgh University’s Dr Steven Pollard involved with the Tessa Jowell mission. Will the Secretary of State expand on what he said about research spending being UK-wide, and on the implications of that? Will he also say something about how his Department has worked with the Scottish Government in this important area?
I am sure that the Secretary of State is aware of the statement made this morning by Medac, which manufactures the “pink drink”, and its concerns about medical supplies post Brexit. Will he update the House on the work that he is doing to ensure the smooth continuing supply of that very important medicine?
Matt Hancock
It shows the power of bringing people together that we can agree with the Scottish National party’s Front Bencher on the importance of this agenda. I am delighted that the research spans the whole UK. The National Institute for Health Care Reform is reserved, and health research takes place throughout the country, and indeed internationally—throughout Europe and the world as a whole. Much of the best research is global, and that must continue. I shall be happy to work with colleagues in the SNP Government to further this mission and this end. Innovations of this kind are of course available to the NHS in Scotland, but the decision on whether to roll them out there will be a matter for Scottish Ministers, as that element is devolved.
As for the question of Brexit, I have absolutely no doubt that whatever form Brexit takes, we will do everything we can to ensure the continued and unhindered flow of medicines. We did an enormous amount of work to ensure that was the case ahead of 29 March. I have seen the comments the hon. Gentleman mentions from the company that supplies this drug. I see absolutely no reason to think that Brexit should have any impact at all on the ability to use this cutting-edge drug to save people’s lives.
Rebecca Pow (Taunton Deane) (Con)
First, may I thank everyone in Taunton Deane who was involved in raising money for the new MRI scanner? It was a huge local team effort. May I also welcome today’s announcement and the use of this dye, which will potentially save 2,000 patient lives and which is to be rolled out into all those neurological centres? That is wonderful news and demonstrates that where there is a will in this place there usually is a way.
I also want to highlight the following. Does the Secretary of State agree that when we are talking about this issue, we should also remember cancers that spread from other parts of the body to the brain—it is called metastasis? This is a very complex area and it needs more input in just the way that we have looked at this issue. Does the Secretary of State agree that we ought to look at that in more detail? Unfortunately, I speak about this from experience, with a close family member being involved.
Matt Hancock
I know about my hon. Friend’s, sadly, personal experience with this horrible disease and pay tribute to her for speaking up because it is not easy. She is right to raise another frontier that we must cross, and I am fully open to research bids in this area to work not just on brain cancer but on brain cancer that is a secondary cancer, because that is a very important area to get right, too.
Helen Hayes (Dulwich and West Norwood) (Lab)
I welcome the announcement today and the progress made over the past year since Tessa so sadly passed away. I also welcome the announcement as someone who lost both my paternal grandparents to brain cancer. I want to pay tribute in particular to Tessa’s daughter, Jess Mills, who has worked with unswerving determination and energy to drive forward progress in Tessa’s name over the past year. May I say on behalf of my constituents in Dulwich and West Norwood, who Tessa represented for 23 years, how proud we are of her powerful legacy on brain cancer and the difference her work will make for thousands of people for generations to come? Throughout the whole of Tessa’s 23 years in Parliament, she was a tireless champion of King’s College hospital, which is currently in a very challenged financial position. May I encourage the Secretary of State in continuing his commitment to £33.9 billion of additional funding to look at how this national support may also be marshalled to secure Tessa’s legacy at local level?
Matt Hancock
Baroness Jowell’s successor in her parliamentary seat speaks very powerfully and the hon. Lady is right to highlight the role of King’s in this research. King’s has been developing this treatment for years, and as a result of its work, it can now be rolled out nationally. It is a hospital that, as the hon. Lady says, needs to address some of its local challenges, but we should not take away from some of the globally cutting-edge work that it does and the positive impact it has: potentially 2,000 people alive each year who would otherwise die. That is testament to the importance of this research.
Sir Peter Bottomley (Worthing West) (Con)
The first person I know who had a brain tumour and cancer and died was John Davies, who had been the MP for Knutsford shortly after I was first elected.
The NHS website is very good about the possible symptoms of brain tumours. May I strongly recommend that everyone who thinks they may have a worry consult their medical practitioners so that either they can be cleared or they can get early treatment, and is it not right that early diagnosis is the best way forward for those who may have the condition?
Matt Hancock
My hon. Friend is absolutely right about that: early diagnosis is critical to improving the proportion of people who survive cancers, because of course it is easier to treat people if diagnosis is early. We are reviewing all cancer screening programmes because they are not working well enough; the National Audit Office set that out in some detail recently, and we accept those findings. We want to get early diagnosis and screening right, and it is a top priority for the new Public Health Minister, my hon. Friend the Member for South Ribble (Seema Kennedy), to make sure we do so that more people can survive.
Sarah Jones (Croydon Central) (Lab)
As the Secretary of State said, last weekend marked a year since the death of Tessa Jowell. We all heard the moving interview that Jess did at the weekend, which showed the commitment that she still has for taking on this issue and fighting for her mother’s legacy. On 19 April last year, we were in this place for a Back-Bench debate, with Tessa sitting in the Under-Gallery. I had sponsored the debate, alongside the right hon. Member for Old Bexley and Sidcup (James Brokenshire), and I should also like to thank you, Mr Speaker, for helping us at that time. We heard many moving speeches, and we were all glad to be there to pay our tributes to Tessa.
I am privileged to sit on the board of the Tessa Jowell Brain Cancer Mission, and I want to thank the Department of Health and Social Care for its support and for the roll-out of the pink drink that we have all been talking about. That is one of the many important initiatives that the mission has prioritised. Will the Secretary of State give us his assurance that the Department will provide the same amount of support and commitment to the other initiatives that we have identified? He has talked about some of them. They include the national roll-out of the integrated multidisciplinary care model, support for the first adaptive trial for brain cancer and the Tessa Jowell fellowship programme for oncologists. The NHS is one of the few care systems in the developed world that does not train or employ experts in brain tumour treatment. Rather, brain tumour patients are typically cared for by colleges and radiologists who predominantly treat other cancers. This strategic programme is really important, as it will revolutionise the skills in the health service to tackle this difficult problem.
Finally, I worked for Tessa Jowell, and I also worked for Mo Mowlam. They were two of the most powerful, wonderful women in this House, and they both had brain tumours. We need to find a faster cure, to ensure that people with brain tumours live well for longer so that women like those two amazing parliamentarians can continue to contribute for much longer. I thank the Secretary of State for the work that he has done, and I ask him to carry on doing it.
Matt Hancock
The hon. Lady expresses the thoughts of the whole House. She, too, has done an awful lot. I should of course have mentioned my right hon. Friend the Member for Old Bexley and Sidcup (James Brokenshire), who used his enforced sabbatical from the Cabinet due to cancer to push this agenda. I add his name to the tributes. It is absolutely true that campaigners on this subject who have had personal experience of brain cancer either themselves or in their loved ones and friends, as I have, feel very strongly about it, and this is absolutely not the end of the drive. I wanted to update the House on what we have done in a year, but there is still plenty more to do.
Chris Bryant (Rhondda) (Lab)
Melanoma is one of the cancers that can metastasise into the brain, because it can travel either through the blood or through the lymphatic system. We also know that, although it can kill, especially in the circumstances we are talking about, it is very preventable. I just wonder whether there is not considerably more that the Government could do to ensure that every child covers up in the sun and that more people use sunscreen, perhaps by taking VAT off sunscreen that is higher than SPF30 or SPF50. We must also ensure that we have enough dermatologists in this country to check moles and other growths that people might have on their bodies.
Matt Hancock
Yes, I agree with all that. Of course, protection from too much exposure to the sun is part of the prevention agenda in healthcare, as well as being an absolutely sensible thing to do.
Wes Streeting (Ilford North) (Lab)
Like others, I want to congratulate the Government and everyone involved in the Tessa Jowell Brain Cancer Mission on making a painful anniversary for Tessa’s friends and family a bit more bearable for knowing that her vigour and energy are still very much alive and kicking through the mission. This is also a painful time of year for my constituents, Scott and Yang Lau, who lost their young daughter Kaleigh to a diffuse intrinsic pontine glioma, a particularly pernicious brain tumour that largely affects children. They are working with Jess Mills on fighting that particular form of brain tumour. What more can the Department do, generally and specifically through the Tessa Jowell Brain Cancer Mission, to focus on childhood brain tumours, particularly rare tumours such as DIPG, so that other families do not have to suffer what my constituents and others have had to go through?
Matt Hancock
The hon. Gentleman is right to say that, and I send my condolences to his constituents. The truth is that brain cancer is one of the most, if not the most, predominant cancers among children. Although it is relatively rare among all cancers, that is not true among children. Thousands of people still die from brain cancer, which is why it was right that Parliament and Tessa Jowell came together to highlight the lack of research in the area—something that we are determined to put right.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
May I too thank the Government for today’s statement? I was heartened by the answer given to the hon. Member for Worthing West (Sir Peter Bottomley), because early diagnosis is incredibly important. There are certain things that people can recognise, such as the effect on vision. Ironing a pinstripe shirt, for example, can lead to an odd effect, which is an early sign. Early screening in built-up areas and cities is quite easy, but it is harder in rural areas, so I make a plea for the Government to consider sparsely populated regions such as mine.
Matt Hancock
The hon. Gentleman is right that screening is vital. One of the reasons why we are looking at the whole screening programme is that the use of technology has not been nearly good enough. For many people, but not all, that can be valuable, especially in rural areas. Technology is not only used for the screening itself, but for notification and for ensuring that we get to everybody who needs to be reached. Professor Sir Mike Richards is undertaking the review of all screening, and I would be happy to put Sir Mike in contact with the hon. Gentleman to ensure that the review properly considers the impact of rurality on the need to get screening to everybody who needs it.
Mr Speaker
I thank the Secretary of State, the shadow Secretary of State, the hon. Member for Leicester South (Jonathan Ashworth), and all colleagues for both the content and the spirit of the exchanges that have just taken place. Let us hope that Tessa’s husband David and children Jess, who has rightly been referred to, and Matthew will derive some succour from knowledge of the continuing interest in Tessa’s passionate crusade that exists in the House. We know in our heart of hearts that that continued interest will endure for as long as is necessary, both because of the supreme importance of the cause and because we are united across the House in this. We have huge respect for the courage, stoicism and unrelenting determination to make progress on this subject that Tessa Jowell, in extreme adversity, exhibited at all times.
Oral Answers to Questions
Matt Hancock Excerpts(5 years, 7 months ago)
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Grahame Morris (Easington) (Lab)
The Secretary of State for Health and Social Care (Matt Hancock)
Our radiotherapy modernisation programme has so far delivered 80 upgrades or replacements, with more to come.
Grahame Morris
One in four people currently receive radiotherapy—a number that will increase if the Government achieve their early diagnosis targets. Ministers dispute that 20,000 people in England annually miss out on appropriate access to life-saving radiotherapy. What is the Secretary of State’s estimate? Will he commit to meeting representatives of the Radiotherapy4Life campaign to discuss how we can improve radiotherapy provision in England?
Matt Hancock
I am absolutely happy to meet the group. According to the latest figures, about four in 10 of all cancer patients are treated with radiotherapy; it is a critical treatment to tackle cancer. As I say, there has been an investment programme to replace and upgrade radiotherapy equipment, with 80 upgrades or replacements over the past three years, but there is clearly more to do to make sure that people with cancer get the best possible treatment.
Sir David Evennett (Bexleyheath and Crayford) (Con)
Matt Hancock
Yes, that is exactly right. That is why we have put in place the new LINACs—linear accelerators, the equipment that is being rolled out across the country in a £130 million programme. We are always looking at what more we can do to help people to beat cancer.
Tim Farron (Westmorland and Lonsdale) (LD)
Will the Secretary of State agree to look personally at the case for a new satellite radiotherapy unit at Westmorland General Hospital, tied to the Rosemere unit in Preston? I had the privilege last week of driving my constituent Kate Baron to her treatment at Royal Preston Hospital. Wonderful treatment though it is, it is a three-hour round trip that she has had to take on 15 separate occasions—I went with her only the once. Hundreds of people in the south Lakes have to make debilitating, lengthy round trips to get treatment day after day, which is damaging to their long-term health and to their ability to access radiotherapy at all.
Matt Hancock
I am grateful to the hon. Gentleman for raising that point. He did not raise the individual case with me in advance, but I can see the point he is making. The public health Minister, who is responsible for cancer policy, will be very happy to meet him.
Lilian Greenwood (Nottingham South) (Lab)
George Freeman (Mid Norfolk) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
Providing patients with modern digital services that are safe, effective, convenient and personalised is central to our NHS long-term plan.
George Freeman
I thank the Secretary of State for that answer and for the energy that he brings to this brief. Does he agree that digital health not only improves healthcare systems but also provides a platform for place-based and population-based prevention, better diagnosis, patient empowerment, novel mental health therapies and accelerated access to the innovative treatments that I introduced as a Minister? This is now being pioneered in some parts of the country. Will he meet me and the Birmingham health partners to look at an interesting idea for digital place-based health impact bonds?
Matt Hancock
Yes, I am always happy to meet my hon. Friend to talk about interesting new policy innovations like that. It sounds right up my street. In fact, I met the Mayor of the West Midlands combined authority to discuss this subject only last week. There is a huge amount of enthusiasm and energy in this policy area, which will enable us to improve patients’ lives across Birmingham and, indeed, the whole country.
Andy Slaughter (Hammersmith) (Lab)
As the Secretary of State knows, because he is a member, the Babylon Health GP at Hand digital service is based in Hammersmith and Fulham. By the end of this year, it will have run up a deficit of about £35 million for my clinical commissioning group. Given that the clinical commissioning group is cutting GP hours and closing an urgent care centre overnight because it is so short of funds, when are we going to be reimbursed for that £35 million?
Matt Hancock
I do not recognise the number that the hon. Gentleman talks about, but we are changing the way in which the GP contract works to ensure that this new technology can be most effectively harnessed to deliver patient need in a way that also works for the NHS. I am slightly surprised that he has not yet got up to say thank you for our announcement on primary care services in his part of London, which we are going to be expanding while stopping the closure of A&E. A little bit of gratitude for that would also go down well.
Huw Merriman (Bexhill and Battle) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
Wherever possible, the National Institute for Health and Care Excellence aims to publish recommendations on new drugs within a few months of licensing and now publishes draft guidance on cancer drugs even before licensing. Many thousands of patients have benefited from rapid access to effective new drugs as a result.
Lyn Brown
The Secretary of State will know that Maryam is now nine months old. We have been waiting nine long weeks for NICE to announce a decision that I am told it has already made. Spinal muscular atrophy babies have been waiting 16 months for the care they need, which is longer than many SMA babies live without treatment. There is another closed-door meeting tomorrow. If NICE finally decides to provide Spinraza on the NHS, how long will it be before Maryam and the other babies get their first dose?
Matt Hancock
The hon. Lady rightly raises an important case, and I have met her about it and followed it closely. As she says, there is work ongoing and happening this week to try to make progress. NICE is currently developing technical appraisal guidance on the use of the drug Spinraza, to which she refers. We are working to ensure that we can get it right.
Simon Hoare (North Dorset) (Con)
As chairman of the all-party parliamentary group on multiple sclerosis, may I urge my right hon. Friend to ask NICE to expedite its perfectly proper processes on the licensing of cannabis-based drugs, particularly for the treatment of multiple sclerosis, Parkinson’s and motor neurone disease?
Matt Hancock
Yes. My hon. Friend raises another important area where progress is being made on the ability for people to get access to drugs that could help them. We now have a medicinal cannabis programme in place, as we discussed in this Chamber a couple of weeks ago, so that those with acute conditions and with clinical support for using medicinal cannabis can get it. We are also working as rapidly as we reasonably can to normalise the ability to use medicinal cannabis within the NHS.
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)
Kuvan, Orkambi and Spinraza—these are just three life-changing drugs to which thousands of patients are being denied access on the NHS. Patients have waited far too long for the drugs they desperately need, and for some, as we have heard, it is a matter of life and death. Does the Secretary of State agree that the NICE appraisal process for rare diseases is just not fit for purpose?
Matt Hancock
I do agree it is important that NICE constantly tries to get those decisions made objectively, robustly and as fast as possible. There is cross-party support, and I hope continuing cross-party support, for these judgments being made independently so that they are taken not by Ministers but by clinicians. We can all agree that this has to be done as quickly and as efficiently as possible.
Sir Nicholas Soames (Mid Sussex) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
Mr Speaker, I share your ambition in reaching Question 17 to be able to say that the long-term plan for the NHS sets out ambitious goals to embed a culture of quality improvement of which my right hon. Friend would be proud.
Sir Nicholas Soames
Thank you very much, Mr Speaker, for getting this far down the list of questions. I know that my right hon. Friend the Secretary of State has a serious ambition to try to drive this plan forward, but it is unacceptable that best practice is not better disseminated throughout the NHS. It is completely unacceptable that there are such wide divergences in standards between hospitals, and it requires the everyday attention of the Secretary of State himself to drive this change through.
Matt Hancock
I agree entirely and enthusiastically with my right hon. Friend. The need to improve services in the NHS just to bring them up to the best that is in the NHS is vital and urgent. We can lift the quality of care that all our constituents get simply by learning from the best. We have schemes such as the “getting it right first time” programme, which is brilliant at teaching hospitals how to do things the way the best hospitals do them, and we want to see more.
Dr Philippa Whitford (Central Ayrshire) (SNP)
A recent report in the British Journal of Surgery demonstrates that the introduction of the Scottish patient safety programme resulted in a 36% drop in post-surgical deaths. Will the Secretary of State join me in congratulating all the surgeons, anaesthetists, theatre teams and ward staff who achieved this, and would he like to visit Scotland and see the programme in action?
Matt Hancock
I always love visiting Scotland and would love to come and see this programme in action; I have heard and read about it. In improving quality across the NHS, we need to improve the ability of the NHS to look everywhere—outside the NHS in England, as well as at other hospitals—to find and emulate best practice.
Mr Speaker
This is a general question about best practice in the NHS, into which the hon. Member for Bosworth (David Tredinnick) could legitimately shoehorn his concerns about acupuncture, chiropractic therapies, osteopathy and other non-drug based, non-addictive options for pain management, about which I think he is keen to expatiate.
David Tredinnick (Bosworth) (Con)
Matt Hancock
Mr Speaker, I am glad that you have used your considerable flexibilities to bring this question in, because I wanted to say that NICE is in the process of developing a guideline on the management of chronic pain, which will look at the biological, physiological and social factors, including some treatments mentioned by my hon. Friend. There is progress in this space, and I am glad that we have been able to raise this matter in the House today.
Rachael Maskell (York Central) (Lab/Co-op)
As well as looking at best practice in the NHS, it is vital that we look at best practice in social care. Given that 70,000 people with dementia were admitted to hospital unnecessarily with falls, dehydration and infections just last year, how is the Secretary of State going to put a laser-beam focus on standards in social care?
Matt Hancock
The hon. Lady is absolutely right. I am glad that this discussion of improving quality across the NHS and social care has united the House in its enthusiasm to see best practice and ensure that people learn from it. We have seen an awful lot of learning in social care, as most social care is delivered by private sector providers, but there is more to do and there are different levers that we can pull. When social care providers lose their good or outstanding status, they also often lose their contracts, so there is an awful lot of pressure on them to learn from best practice around the country, and I would only emulate that.
Antoinette Sandbach (Eddisbury) (Con)
Mr Laurence Robertson (Tewkesbury) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
It is the goal of the Department to support everyone to live longer, healthier lives. I will be working right across the health and social care sector to deliver the goal of five years of extra healthy life for people in the UK. In doing that, I am delighted that we will now have on the ministerial team the enthusiasm and assistance of the Under-Secretary, my hon. Friend the Member for South Ribble (Seema Kennedy).
Mr Robertson
In achieving those goals, the Secretary of State will be concerned that while many patients can obtain GP appointments for emergency cases on the same day, quite a lot of people have to wait three or four weeks for non-emergency appointments. Can the Government do anything to improve that situation?
Matt Hancock
Yes, I entirely understand my hon. Friend’s concerns. We are acting to make sure that there is better access. We have a review of access to primary care. But, more than that, the biggest increase of the £39.9 billion of extra taxpayers’ money that we are putting into the NHS is in GP access, primary care and community care to make sure that we get ahead of the curve and help people to stay healthy rather than just treat them in hospital.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
Can the Secretary of State explain why 200,000 nurses have left the NHS since 2010 and why today we are short of 40,000 nurses?
Matt Hancock
The good news is that we have record numbers of nurses in the NHS. We have more staff in the NHS than at any time in its history. While of course in any very large organisation like the NHS there is always turnover, what matters is having the people we need. We are putting more money in, we are going to need more people, and we are developing a plan to make that happen.
Jonathan Ashworth
We have about 90 nurses a day leaving the NHS, so rather than posing for the newspapers by the stables like a character from a Jilly Cooper novel, why does the Secretary of State not show some actual leadership and reverse the cuts to development, reverse the cuts to training places and reverse the abolition of the training bursary so that we can start to recruit the nurses and midwives our NHS needs today?
Matt Hancock
What I will not reverse is the increase in the number of people who are helping to improve lives and save lives in our NHS. It is only because of the extra money that we in this Conservative Government have put into the NHS that we can be confident that we are securing its future to deliver better care for every single person whom we represent in this House.
Priti Patel (Witham) (Con)
Matt Hancock
My right hon. Friend is right to raise that. That money is already committed. Of the extra £33.9 billion that is going into the NHS, the biggest increase is going into community and primary care, because I understand how important it is for people to get decent access to their GP services in Witham and across England.
Patricia Gibson (North Ayrshire and Arran) (SNP)
Matt Hancock
No, the NHS is going to be there for us no matter what the outcome of Brexit is. The British people voted for Brexit, and we are going to deliver Brexit, and then we are going to get on to doing all the other things. Even over the last few months, we have been able to put extra money into the NHS to ensure that its future is guaranteed.
Paul Masterton (East Renfrewshire) (Con)
Mr Speaker
The only thing that is weighty about the hon. Gentleman, in my experience as a county colleague, is his brain.
Matt Hancock
I would be delighted to encourage that which my hon. Friend encourages. One thing that leads to people putting on weight is high levels of stress, so perhaps we could put some contentious issues behind us to reduce stress levels and allow all of us to lead healthier and happier lives.
Several hon. Members rose—
Lucy Powell (Manchester Central) (Lab/Co-op)
It was a magnificent and very important goal, Mr Speaker.
I would like to put it on record that my husband is an A&E consultant. The Secretary of State will know that one of the massive factors in gaps in rotas is that A&E doctors and other hospital doctors are facing notional tax rates of 90% or more from taking on extra shifts. It is not a very Tory policy, this. What is he doing about it?
Matt Hancock
This policy has come up a couple of times in questions today, and rightly so. I am having discussions with the Chancellor. It is a tax policy, and I do not think that my right hon. Friend would be incredibly enthusiastic about me announcing tax changes at the Dispatch Box. It is something that we are talking about and working on. It is the unintended consequence of tax changes that were designed for other parts of the economy.
Tom Pursglove (Corby) (Con)
The appropriate and safe disposal of drugs and medical equipment has recently been raised with me by my constituents in Corby. Will he keep in mind these concerns when reviewing policy in terms of both awareness of what to do and the ease with which it can be done?
Ellie Reeves (Lewisham West and Penge) (Lab)
It is deeply concerning that in the past 10 years the number of prescriptions for opioid drugs has risen by 9 million. In this time, codeine-related deaths have more than doubled to over 150 a year. While I welcome moves to label opioid medicines, what further measures will the Secretary of State take to protect people from the dangers of opioid addiction?
Matt Hancock
As the hon. Lady may know, I am very concerned about this. We are working on what we can do to ensure that opioids are prescribed and used only when they are the most appropriate and right treatment. Opioids save people from significant pain and are used every day right across the NHS, but opioid addiction is a very serious problem. Some other countries have got this wrong, and we must get it right.
Jeremy Lefroy (Stafford) (Con)
I thank my right hon. Friend the Secretary of State for coming to County Hospital in Stafford on Saturday. Does he agree that he saw there the importance of small accident and emergency departments sustaining the whole of the regional health economy by giving support to the larger ones?
Matt Hancock
Yes. It was brilliant to go to County Hospital in Stafford and see the hard work and team work and to be able to thank NHS staff both in Stafford and across the country working over the long weekend. My hon. Friend is a brilliant and diligent voice of Stafford. I have already stopped A&E closures in west London. I do not think that we should be seeing the closure of small A&E units, and I will work with him on the issue.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
As the Minister is aware, I have become concerned about the rising number of suicides in my constituency. When I talk to professionals in the area, they tell me that it is not just funding that is causing some of the problems but the lack of staff. What more can the Minister do to ensure that we have the mental health staff that we desperately need?
Rachel Maclean (Redditch) (Con)
The Secretary of State has been kind enough to visit Worcestershire Royal Hospital, which serves people in my constituency. He saw for himself how small the emergency department is there. With £20 billion going into the NHS, does he agree that there is a good opportunity to look again at returning services to Redditch—in particular, the maternity and A&E departments, which have been removed?
Matt Hancock
It was brilliant to visit Worcester hospital—another medium-sized hospital, but with a small A&E department that was working incredibly hard given the facilities. I pay tribute to all the work of staff there and very much take on board the points that my hon. Friend has made.
Several hon. Members rose—
Social Media and Health
Matt Hancock Excerpts(5 years, 7 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Matt Hancock)
I would like to update the House on yesterday's social media summit and the progress we have made on tackling online harms to health. We called this summit to bring together the principal social media companies, including Facebook, Instagram, Twitter, Pinterest, Google and others, as well as the Samaritans and the eating disorder charity Beat. It was the second such meeting I have held, along with the Education Secretary and the Minister for suicide prevention, on how we can protect people—particularly children—from online content that promotes eating disorders and self-harm and suicide, as well as on how we address the growing problem of anti-vaccination misinformation.
Social media companies have a duty of care to people on their sites. Just because they are global, it does not mean that they can be irresponsible. We have been resolute that we will act to keep the internet safe, especially for children, and I am grateful to the companies for their engagement.
We have all seen and heard about tragic cases of vulnerable children turning to self-harm and even taking their own lives after accessing graphic images online that promote and even encourage suicide and self-harm. In the same way, we know that online content on eating disorders can be extremely harmful to vulnerable children and young adults. I have met the parents of children, brought up in loving homes, who had no idea of the dangers that their child was being exposed to on their smartphone or tablet while they were supposed to be safe at home. We all know of parents whose children have been affected, and for all of us this is very close to home.
We must do everything we can to keep our children safe online, so I am pleased to inform the House that, as a result of yesterday’s summit, the leading global social media companies have agreed to work with experts from the Samaritans to speed up the identification and removal of suicide and self-harm content, and to create greater protections online. They will not only financially support the Samaritans to do the work; crucially, suicide prevention experts from the Samaritans will determine what content is harmful and dangerous, and the social media platforms committed to either removing it or preventing others from seeing it, and to helping vulnerable people get the positive support they need.
The mainstream media already have well-established codes of practice and training for removing material that promotes suicide and self-harm. In my experience, the British media act with great responsibility on the matter, and it is time that social media companies did the same. This partnership marks, for the first time globally, a collective commitment to act, to build knowledge through research and insights, and to implement real changes that ultimately will save lives.
The social media companies also gave us an update on the actions they have already taken. Following the first summit in February, Instagram now has a policy globally of removing all graphic self-harm imagery, and other sites have also taken action, but there is much more to do and more content to remove. Importantly, the commitments that the companies made at yesterday’s summit are what the Samaritans asked for, and they are a positive step forward. The progress that we have made so far shows that we can effect positive change, but I know that the House feels strongly that just because these companies are global does not mean that we as a House cannot determine society’s rules and expectations. On this we are prepared to act too.
My right hon. Friend the Home Secretary and my right hon. and learned Friend the Secretary of State for Digital, Culture, Media and Sport recently published the online harms White Paper, which sets out the proposed regulatory framework for addressing online harms. It sets out a new statutory duty of care to require companies to take more responsibility for the safety of their users and tackle harm caused by content or activity on their services. Compliance with this duty of care will be overseen and enforced by an independent regulator, which will be responsible for producing codes of practice that will explain what companies need to do to fulfil their duty, and the robust action they need to take to remove illegal or harmful content. The White Paper also proposes the sharing of information, research and best practice to improve the understanding of harmful content across the industry.
The summit also allowed us to discuss how we can work together to tackle another online danger: the spread of anti-vaccination misinformation. Since Edward Jenner’s discovery, vaccination has saved hundreds of millions of lives around the world. Few innovations have reduced human misery so much. After clean water, vaccination has prevented more deaths and disease than anything else in human history. The science is settled: vaccination saved lives. It protects not only our children but other vulnerable people who cannot do anything about it themselves. Failure to vaccinate puts their lives at risk. The rise of social media now makes it easier to spread lies about vaccination, so there is a special responsibility on social media companies to act.
Coverage for the measles, mumps and rubella vaccine in England decreased for the fourth year in a row last year, to 91%. There was a steep rise in confirmed measles cases last year, from 259 to 966. We forget that measles is a horrible disease. We have one of the most comprehensive vaccination programmes in Europe. The well-documented problems in America and on the continent are worse than here, but we are determined to get ahead of the problem, because failure to vaccinate has real and devastating consequences. Our action to promote vaccines is not limited to removing anti-vaccination misinformation online; we are promoting the objective facts about the importance of vaccination and increasing funding to primary care to improve access, and our prevention Green Paper will set out further actions.
Social media can be a great force for good and can help us promote positive messages, but it is the responsibility of us all to ensure that this new technology, with all its great potential and power, is moulded to the benefit of society. We will not duck this challenge. I commend this statement to the House.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
I am grateful to the Secretary of State for advance sight of his statement. These social media platforms must be made to take responsibility for the harm caused by the dangerous fake news they host, because they are helping to fuel a public health crisis. He talks about the actions that platforms such as Instagram have taken since February, but I have just searched on Instagram and found images and videos of graphic self-harm; there are 8 million posts with the hashtag #suicide—from a quick glance, many are distressing—226,000 posts with the hashtag #killmyself, and 249,000 posts with the hashtag #selfinjury. I found similar pro-anorexia posts and the normalisation of eating disorders. I am sorry to have to share those examples with the House, but I think that we have to understand the scale of the challenge we face. As the father of two beautiful daughters, aged seven and five, I would be devastated if they saw such posts as they grow up.
Dangerous content should be blocked and taken down. I look forward to the Samaritans’ recommendations, so can the Secretary of State update us on the timescale? He talked about the online harms White Paper, but we need action immediately, so can he tell us when the proposed legislation will come before the House? When will the new regulator and duty of care be enforced? Can he guarantee that there will be criminal sentences for executives for serious breaches? In what circumstances would the maximum fine of 4% of global turnover be applied? If, God forbid, something similar to what happened to Molly Russell—I am sure that the whole House will want to praise her father for his brave campaigning—should happen to another child, what action would be taken against the social media companies?
I have also been able to find dangerous anti-vaccination propaganda on platforms such as Facebook, at a time when measles outbreaks are on the increase across Europe and the United States and in parts of the United Kingdom. Unvaccinated children are being turned away from schools in parts of Italy and banned from public areas in parts of New York. I would hate to see that happen here. UNICEF has warned that more than half a million children have missed their measles vaccination, which means the UK now has the third-worst ranking of all high-income countries. As the Secretary of State said, take-up of the MMR vaccine has now declined for the fourth year in a row, making coverage for the vaccine the lowest it has been since 2011-12.
I know that the Secretary of State said on the radio last week that he was considering banning unvaccinated children from schools in England, but we urgently need a clear vaccination action plan from the Government. This cannot be about penalising families. Yes, we need intervention with social media platforms when the legislation is in place, but while we wait for the legislation will he consider instructing Public Health England to launch an online social media campaign, on the platforms that are currently sharing anti-vaccination propaganda, to challenge those dangerous myths?
Will the Secretary of State also accept that our falling vaccination rates are not just about online activity? Public health services have been cut by £800 million. Our health visitors have been cut by 8% in recent years, and our school nurses by 24%. General practice has faced a funding squeeze, and GP numbers are down by 1,000 since 2015. At the same time, 2018-19 marks the first year that we have seen a reversal in the percentage of children receiving vital health check-ups on time since the measurement of these figures began: 14.5% of children are not receiving a six to eight-week review on time; 24% are not receiving a 12-month review on time; and the number of mothers over 28 weeks pregnant receiving their first face-to-face antenatal contact with a health visitor has fallen for the second year in a row. Will he therefore commit today to reversing public health cuts and restoring health visitor numbers, and will he invest in general practice so that we can meet the 95% national vaccination coverage rate, as recommended by the World Health Organisation? When does he expect us to meet that 95% rate?
Children are 20% of our population but 100% of our future. We must always put their health and wellbeing first. Yes, there has been some progress, but we need further action from the Government today.
Matt Hancock
I pay tribute to the hon. Gentleman, who has provided leadership on this agenda from his position as shadow Secretary of State. I am glad, listening to his response, that we agree very broadly on the direction we need to take. The agreement across the House is valuable in demonstrating to social media companies the clear consensus on the need for them to act, and to every parent in the land the importance of vaccination. That cross-party support is very, very valuable.
I join the hon. Gentleman in paying tribute to Ian Russell, the father of Molly Russell, whom the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), the Minister for suicide prevention, met this morning. He has been brave and eloquent in bringing these issues to light. I pay tribute to him and thank him for how he has spoken about what needs to be done. I know he is as determined as we are to ensure that action translates into saving more lives.
We agreed, after the meeting yesterday, to reconvene in two months’ time, by which time I expect further action from the social media companies. As I said in my statement, we have already seen some progress. I am glad that some of the global algorithms and global terms and conditions have been changed as a result of action taken by the UK Government. It is very important that we keep the pace up. In two months’ time, we expect to see further action from the social media companies and progress by the Samaritans on being able to define more clearly the boundary between harmful and non-harmful content. In each area of removing harms online, the challenge is to create the right boundary in the appropriate place. It is the challenge when tackling terrorist and child abuse material online, so that social media companies do not have to define what is and is not socially acceptable, but we as society do. I am delighted that the Samaritans will formally play that role on material relating to suicide prevention and self-harm, and that Beat will do so on material relating to eating disorders.
The hon. Gentleman asked about the online harms White Paper. We are currently in the middle of a 12-week consultation. I hope he and everybody listening to this who has an interest will respond to it. We are clear that we will have a regulator, but we also genuinely want to consult widely. This is not really an issue of party politics, but of getting it right so that society decides on how we should govern the internet, rather than the big internet companies making those decisions for themselves. I have to say that the tone from the social media companies has changed in recent months and years, but they still need to do an awful lot. I look forward to working with him and others across the House to ensure we can deliver on this agenda.
Maria Caulfield (Lewes) (Con)
I welcome the Secretary of State’s work on this issue. Will he comment on stand-alone posts, tweets or messages which on their own do not seem that intimidating or threatening, but which have a cumulative effect that is nothing short of bullying, harassment and intimidation that can cause mental health problems for many of our young people? Will he ask social media companies to not just look at single posts, but at the cumulative effect of people trying to intimidate others?
Matt Hancock
Yes, my hon. Friend is absolutely right. In fact, the cumulative effect of posts on mental health, in particular eating disorders, came up in the discussion yesterday. We have to look at what the social media companies call the density of content—I think my hon. Friend put it rather better as the cumulative impact of lots of different posts. Social media companies’ algorithms are powerful enough to understand that and pick up on it. We need rules in place so that action can be taken when it is spotted by those algorithms.
Dr Philippa Whitford (Central Ayrshire) (SNP)
I too welcome the statement, the two summits that have already been held and, in particular, the announcement of funding to Samaritans. However, the scale of the task is absolutely huge. The scale of the donation to Samaritans is actually quite small by comparison both with that and with the profits the companies make. They are expected to make profits of £50 billion just this year. It is important to talk about preventing the promotion of eating disorders, self-harm and suicide, and I welcome that approach.
As chair of the all-party group on vaccinations for all, I particularly welcome, in World Immunisation Week, the Secretary of State talking about anti-vaccination. As the shadow Secretary of State said, the drop in uptake is caused not just by online, but by complacency. People have forgotten that measles is a killer. It used to kill 2.5 million people a year across the world. We have seen an outbreak in Europe, where 82,000 cases have led to over 70 deaths. It is important that we tackle misinformation. It is also important that we make it easy for busy mothers to get their children vaccinated by having health visitors and district nurses who try to help. It is partly that that has allowed Scotland to keep the rate above 95%, but we, like everywhere else, are still seeing that rate drip down and fall by 0.5% or 1%.
On the online harms White Paper, I welcome the talk about a regulator. I hope it will actually be a regulator and that there will not be voluntary or self-regulation. I would like to know when it is actually going to happen. Like many other pieces of proposed legislation, it is still in the long grass and the situation is urgent.
Matt Hancock
The regulation of online harms will indeed be statutory. As I said, we are in the middle of a consultation on how, rather than whether, to put that in place. I am sure the hon. Lady will want to feed back, although I know her SNP colleagues in the Scottish Government in Edinburgh have been kept abreast of developments.
The hon. Lady raises complacency and financial resources. I will address both points. She is absolutely right that part of the problem is a complacency about some killer diseases, partly because we have hardly known them in this country for generations. As I said in my statement, measles is a horrible disease and a killer; it is deeply unpleasant. So, too, is rubella. Rubella might be hardly noticed by a pregnant woman. There might be a rash for three or four days which comes and goes, but the impact on the baby is permanent and very, very serious. On measles, rubella and other diseases, we have to be absolutely clear with the public about the consequences not only for their children but, even worse, for vulnerable children and adults who, maybe because they are immunosuppressed or very young, cannot have the vaccination. Their lives are directly threatened by a parent who chooses not to vaccinate. We need to be very clear and stark about that.
The hon. Lady mentions that the social media companies have contributed to Samaritans. That was Samaritans’ ask for this stage of putting together the organisation and experts it needs to provide clarity on the boundary of what is and is not acceptable in this space. I would, of course, be perfectly prepared to go and ask for more if more is needed. What is more, we are bringing forward a digital services tax. Historically, the global tax system has not worked well in taxing such companies fairly, because of the nature of how they make their money. We have worked for years to try to get a global consensus on how to tax them. We are now clear that we will bring forward the tax next year in the UK, regardless of whether we can get global consensus.
Tim Loughton (East Worthing and Shoreham) (Con)
I applaud the Secretary of State for taking this initiative, and I certainly endorse the comments about the good of vaccination. However, I hope that the warm words of the social media companies that he recounted are matched by actions, because I am afraid that that is not the experience of the Home Affairs Committee, which again saw a woeful performance from the Facebook, Twitter and YouTube representatives who appeared before us last week.
Is the Secretary of State aware that it is not only a question of taking down or not allowing content on which those companies are not doing their job properly, but of the algorithms that they use actively promoting more extreme versions of what people may be searching for, whether that is material on the extreme right wing, terrorism, radicalisation or self-harm? Is he convinced that those companies will actually put their considerable money where he thinks their mouths are and make sure that serious interventions are made to stop this stuff being promoted to some of our most vulnerable citizens?
Matt Hancock
My hon. Friend is a man after my own heart on this. Am I convinced? I am convinced that social media companies have committed to it, and it is our job to keep them to those commitments. That is why I have pushed for a long time for a statutory regulator in this space, and I am delighted that the Government are bringing one forward.
For years, we in the House asked social media companies to do something, and there was an argument that, because they are global, we cannot really impact how their algorithms work. That is just rubbish. We are the legislator for this country—we set the rules, and we have a big role in setting the norms and expectations of what happens here. Just because a platform is global does not mean that it can be outside the rule of law of this country, so we will legislate in this space, and there will be a regulator that will be able precisely to keep track of those commitments and make sure that they are followed up. Having said that, the last two meetings have been positive, and we have seen changes as a result. What we have not yet seen is all this content being removed, so there is clearly a long way to go.
Yvette Cooper (Normanton, Pontefract and Castleford) (Lab)
I welcome the work that the Secretary of State is doing. However, following the question of the hon. Member for East Worthing and Shoreham (Tim Loughton), a fellow member of the Home Affairs Committee, surely it is time to do much more on these algorithms, which push people into more and more extreme behaviour? I heard from a mum whose daughter had suffered from an eating disorder who was still being targeted with dieting videos on Instagram. That material was not too extreme to remove, but it certainly should not have been targeted at her daughter. The mum could get nothing done about it.
Our Select Committee staff set up a new YouTube account and were searching for news or politics, but they were increasingly targeted by extreme far-right material promoted by YouTube. Those algorithms push people to extremes—for profit. Surely it is time for much greater transparency and accountability on the entire business model and the way that it promotes all sorts of problems?
Matt Hancock
The short answer is yes. My responsibilities as Health Secretary are to do with the impact on health, especially mental health, and eating disorders and self-harm are part of that. A separate but connected matter is anti-vaccination messages, which are a type of misinformation, or in some cases disinformation —actively pushed false information.
The social media companies say that they are removing this material from being promoted. For instance, graphic self-harm imagery will be taken down from Instagram. Our challenge is to make sure that that is done properly, because ultimately only if social media companies change their algorithms can we make this happen. That is why the new regulator is so important.
Julian Knight (Solihull) (Con)
I welcome the Secretary of State’s initiative in this area and what he has told the House today. Through my work on the Digital, Culture, Media and Sport Committee, I have been utterly horrified looking at online content relating to bulimia and eating disorders, and to what I describe as extreme online misogyny. That relates to the algorithms that Members have mentioned. Does the Secretary of State agree that we need to see inside those companies’ black boxes? Unlike areas such as taxation, in which companies go to the easiest regime, if we set the bar high on online content, they have to comply and put their house in order.
Matt Hancock
I pay tribute to the work that the Digital, Culture, Media and Sport Committee has done in this area, both when I was Culture Secretary and since. Its work and the approach it has taken are groundbreaking, and that has played a part in the change in attitudes that we have seen from the social companies, which at least now accept that it is their responsibility, as well as the principle that they have a duty of care to people on their sites.
As my hon. Friend says, there is clearly an awful lot to do to get to where we need to be. If we step back from this whole question, the technology that has brought about social media companies is still relatively new; it is only 15 or 20 years old. Around the world, the way in which society has responded to it has not yet matured. The good social media companies now get the fact that they have such an impact on society that a regulatory framework is necessary, and in fact have welcomed the White Paper that we introduced as an approach that could be replicated around the world. My hon. Friend is quite right that, once one country or jurisdiction gets this right, it will be taken as a model elsewhere, so that, ultimately, the power of this amazing new way in which we communicate—by God, Mr Speaker, in this House we all use it—can be for the good, and we can mitigate all the downsides that come with it.
Rushanara Ali (Bethnal Green and Bow) (Lab)
I, too, welcome the Secretary of State’s statement, but for too long internet companies have been too slow to protect children from the risks of suicide and other harms such as online hate and the threat of far-right and religious extremists and terrorists. He will be aware that, internationally, companies such as Facebook have fallen very short and were accused by the United Nations of playing a “determining role” in the genocide in Burma. This is a massive problem, and it is right that Britain should lead the way. Is he speaking to his counterparts in other Departments? Will he make sure that the legislation actually ensures that companies are responsible for content, as well as ensuring that there are strong, large fines if they continue to fail?
Matt Hancock
We have proposed fines as called for by the hon. Lady, and of course this is a cross-Government effort. My responsibilities are the health impacts, but technology has an impact right across the board, including on the quality of debate in our democracy, which is a Cabinet Office issue, and with regard to terrorism content, which is a Home Office issue. The Department for Digital, Culture, Media and Sport leads across the board and the Prime Minister herself has led global debates on this. The hon. Lady is quite right to point out that there is a broad range of impacts, and we work together to tackle them.
Rachel Maclean (Redditch) (Con)
The shadow Secretary of State referred to the proliferation of pro-anorexia content online. Is the Secretary of State aware that tech giant, Amazon, sells books under the category of “pro-ana”, which purports to show anorexia as a healthy lifestyle? Does he share my revulsion that those books are available online, and will he call on Amazon to take this content down immediately? Will he look at whether tech giants such as Amazon can be brought into the remit of the online harms White Paper?
Matt Hancock
I will absolutely look at the matter raised by my hon. Friend, as it is alarming and distressing to hear about it. Amazon sells physical goods for the most part and surely has a duty of care to those who buy them, in the same way that a shop has a responsibility for what it sells. My hon. Friend makes an important point, which I will follow up. I will write to her with more details.
Christine Jardine (Edinburgh West) (LD)
I, too, welcome the statement by the Secretary of State, not least because I survived measles as a very small child and my family talked for a long time about how worrying and scary it was. On the other issue, as well as taking action against the social media companies, the long-term NHS plan talks about an increase in proportionate spending on child and adult mental health services. What will he do about that? What will the proportion be? I ask because it is crucial to fighting this problem.
Matt Hancock
The hon. Lady is absolutely right that there will be an increased spend on mental health services across England—a £2.3 billion increase. It is the fastest-growing area of spend in the long-term plan. We are investing £33.9 billion in the NHS in cash terms, and the fastest proportionate rise in spend is in mental health services. That is an important part of this, although there is an awful lot that the social media companies can do to reduce the demands on those services by reducing the negative impact on mental health. The whole House can agree that the hon. Lady being alive and here, having survived measles, is another reason why it is important to get this right. It would have been the House’s loss had the measles won.
Bob Blackman (Harrow East) (Con)
The drop in vaccination rates is not only an annual problem but a cumulative problem, as more and more young people in society are not immunised against these childhood diseases. Can I urge my right hon. Friend not only to undertake a social media campaign to encourage parents and children to take up the vaccinations, but to target the messages so that people know where they can go to get them, how they can do it and the importance medically of doing so?
Matt Hancock
My hon. Friend is exactly right; in fact, that work is under way. I should have mentioned in response to the shadow Secretary of State that Public Health England has a targeted programme of positive information. We can use data and social media better to target messages at those who need them in exactly the way that he proposes. That work is in hand.
Chris Elmore (Ogmore) (Lab)
I welcome the Secretary of State’s statement and the consultation. I am grateful to my right hon. Friend the Secretary of State for Health and the suicide prevention Minister for taking part in the launch of my all-party parliamentary group report on new filters and the impact of social media on young people’s mental health. I am also grateful to the Secretary of State for agreeing to have a meeting with me next week to discuss the content of the report. One thing that is not in the consultation and which has not been mentioned today is the idea of a social media-health alliance bringing together social media companies and other groups—not just groups such as the Samaritans but young people’s groups and social work groups—that can formulate, collate and undertake more research into the impact of social media on young people. Would he consider this idea and even take a lead in forming it, as his Department does with gambling and other compulsive disorders?
Matt Hancock
I will certainly consider it and I look forward to talking to the hon. Gentleman about the idea more next week. Dialogue in this area is critical, but we should not only have dialogue; we also need concrete legislative action, but I am grateful for what he has said about the work that has been done. I am glad that he is also working in this area, and I look forward to discussing it with him more.
Mike Wood (Dudley South) (Con)
Three million of the four million videos taken down by YouTube in the last six months were identified and removed by artificial intelligence. What greater role does the Secretary of State see for technological development in helping to reduce online harm and keep people safe online?
Matt Hancock
Artificial intelligence clearly has a role in identifying material that needs to be removed in the same way that it is now being used to remove terrorist content. We are talking to companies that may be able to do this, but we also need to identify what material should be taken down and what should be left up. Defining that boundary is critical to training artificial intelligence to do its job, hence the importance of the decision to ask the Samaritans to do the work of identifying the boundary so that we can train artificial intelligence to identify what needs to be taken down.
Alison Thewliss
Thank you, Mr Speaker. My tactic of wearing a dress so big I can hide a colleague behind it is working.
Will the Secretary of State look at the harm that celebrity endorsements on social media can do to young people? The Empowered Woman project in Scotland highlighted how Marnie Simpson of “Geordie Shore” had been plugging Thermosyn diet pills, which are marketed as “skinny caffeine”. When I asked the Secretary of State for Digital, Culture, Media and Sport about that, he said that the UK Government were looking at
“user-generated content, not necessarily commercial activities”—[Official Report, 8 April 2019; Vol. 658, c. 73.]
Celebrity endorsement veers into the commercial area, however, and has a very significant effect on young people in terms of body image and eating disorders.
Matt Hancock
My colleague the suicide prevention Minister is looking at this area, particularly endorsements of cosmetics, and I am sure she would be very happy to talk to the hon. Lady.
Huw Merriman (Bexhill and Battle) (Con)
My generation growing up might have feared bullying in the playground, but largely home was a refuge and place of safety. The problem for the current generation is that they can find themselves being bullied 24/7 because of social media. It is little wonder that when I contacted Twitter after seeing some rather libellous material it told me that in its view it was not abusive, even though it was against the law in this country. Does the Secretary of State agree that until social media companies understand that they have to operate under the norms and laws of this country, and not just abide by Californian norms, they will never reform?
Matt Hancock
My hon. Friend puts it exactly right. That is what the duty of care is all about. The argument—we hear it less and less, to be honest—that these are international companies and so will abide by somebody else’s laws, thanks very much, is wrong and out of date, as the online harms White Paper makes clear. We must establish a proper enforcement mechanism to ensure that it is the rules that this House sets—occasionally amended by the other place—that define the law of the land and that we do not have a wild west. This action to protect people’s health is just one part of the response needed to make the internet safe, especially for children.
Carol Monaghan
Thank you for calling me so early, Mr Speaker. [Interruption.] It couldn’t be any worse.
My son contracted measles one month before he was due to receive his MMR vaccine because of a dip in numbers being vaccinated, so I very much welcome the Secretary of State’s statement about tackling anti-vaccination posts on social media. Last year, the Select Committee on Science and Technology carried out an inquiry into the impact of social media on young people’s health, and one of the statistics presented to us was quite disturbing: 50% of young people between the ages of 11 and 16 had seen pornographic images, and many of them had stumbled across them. When I spoke to my 11-year-old daughter, she confirmed that she had seen images that upset her but had been too scared to speak to me about it. What is the Secretary of State doing to alert parents to the dangers of social media and to give them guidance on how to speak to their children and identify when they might have seen things online that have upset them?
Matt Hancock
Mr Speaker, that question was so good it is only a pity it was not asked earlier in our exchanges.
I want to address two important points. First, the hon. Lady’s son is a case in point of how, if parents do not vaccinate, they endanger not only their own children but other people’s. It is because of a failure to vaccinate that these diseases still exist, and it is children who are too young to be vaccinated who are at risk. She has made the case more powerfully than anybody for the importance of vaccinating and keeping vaccination rates up, and I am grateful to her for sharing that personal experience. On the second point, she is quite right that we all have a responsibility to act, and act we will.
Robert Courts (Witney) (Con)
It is a privilege to have the last word.
The whole House is concerned about the effect that the internet can have on young people’s mental health, and I welcome the action that the Secretary of State is taking. Is there truth and accuracy in the reports that Wikipedia did not attend yesterday’s summit? If so, does he share my disappointment, and does he feel that Wikipedia must take this issue seriously and engage with it?
Matt Hancock
Unfortunately, those reports are true. I share my hon. Friend’s disappointment that Wikipedia did not attend either of the two summits, despite having been invited. At yesterday’s summit, we agreed that we would get in touch with Wikipedia in robust terms, because it is not acceptable for it to shirk its social responsibilities either.
If I may say so, I think that the statement and the responses to it have shown that there is unanimity in the House. Every speaker has mentioned the need to tackle anti-vaccination misinformation and the social media organisations’ responsibility and duty of care in relation to the health—mental and otherwise—of people on their platforms. The House speaks with one voice, and the social media companies, and the internet companies that have not yet engaged should listen.
Access to Medical Cannabis
Matt Hancock Excerpts(5 years, 8 months ago)
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Sir Mike Penning (Hemel Hempstead) (Con)
(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the return of medical cannabis that was seized from Emma Appleby at Southend airport on Saturday 6 April and which is needed to treat her very ill daughter Teagan’s extreme epilepsy, and to take steps to make sure that medical cannabis is available for prescription around this great country.
The Secretary of State for Health and Social Care (Matt Hancock)
My sympathies go out to the patients and their families who are desperately seeking to alleviate their symptoms with medicinal cannabis. We are working hard to get the right approach. The law was changed on 1 November last year to ensure that it is now legal for doctors on the specialist register of the General Medical Council to prescribe cannabis-based products for medicinal use in the UK.
Whether to prescribe must remain a clinical decision to be made with the patients and their families, taking into account the best available international clinical evidence and the circumstances of each individual patient. Indeed, prescriptions have been written for the products that the family attempted to bring into the country and these have been supplied to patients. Without clinical authorisation, it is of course not possible to import controlled drugs, which is why the products were seized by Border Force on Saturday. However, we have made available the opportunity for a second opinion and the products have been held but not destroyed, as would normally be the case.
In relation to childhood epilepsy, the British Paediatric Neurology Association has issued interim clinical guidance. NHS England and the chief medical officer have made it clear that cannabis-based products can be prescribed for medicinal use in appropriate cases, but it must be for doctors to make clinical decisions in the best interest of patients, to balance the risks and benefits of any proposed treatment—including cannabis-based products—and to make a decision with patients and their families on whether or not to prescribe.
To date, research has centred on two major cannabinoids, tetrahydrocannabinol and cannabidiol. There is evidence that CBD may be beneficial in the treatment of intractable epilepsy, and over 80 children have already been supplied with CBD products in the UK on the basis of a specialist doctor’s prescription. I entirely understand how important this issue is to patients and I have met and listened to families. I know just how frustrated they are. Therefore, after meeting parents, I have taken the following actions.
First, I have asked NHS England rapidly to initiate a process evaluation to address barriers to clinically appropriate prescribing. Secondly, to improve the evidence base and to get medicinal cannabis to patients in need, I have asked the National Institute for Health Research and the industry to take action to produce that evidence in a form that will support decisions about public funding. The NIHR has issued two calls for research proposals on medicinal cannabis and I look forward to the responses to those consultations. That is in addition to the training package being developed by Health Education England to provide support to clinicians to enable them to make the best decisions with their patients.
This is a very difficult area, with some heart-rending cases. I look forward to working with all Members of this House to ensure that patients get the best possible care.
Sir Mike Penning
I thank you for granting this urgent question, Mr Speaker, on behalf of constituents around the country who need help from medical- prescribed cannabis, and I thank the Secretary of State for coming to meet the families and their loved ones who feel that medical cannabis on prescription may help.
Some of these young children—though we are not talking only about children—have 300 seizures a day. They are given drugs that do not seem to work at all. There is not a cure, but these medical oils can and often do reduce the number of seizures. Many colleagues in the House will know of the case of Alfie Dingley—the only young boy that has an NHS prescription for the medical use of cannabis oil. He is now a relatively naughty boy. He has learned to ride a bike. His sister has a brother she has never really experienced before.
This is not a cure, but these parents are absolutely desperate. When the Government did the right thing and changed the law, they thought the situation was going to get better. In my capacity as joint chair of the all-party parliamentary group on medical cannabis under prescription, I warned them that this was just the start of the journey, and that it would be a long one.
Anyone who saw the footage from Southend airport at the weekend—any father, any parent, anyone who has a loved one in their family who suffers—would understand what that family were trying to do. Cannabis had been prescribed by a consultant abroad because it could not be obtained in this country. Many families are relying on charity to raise the money—in some cases, £1,500 a month—to obtain it on prescription. As the Secretary of State knows, prescriptions are being issued by the relevant experts, but the clinical commissioning groups and the trusts are refusing to honour those prescriptions. It is a disgrace that that should happen in this country, and we should all be ashamed.
I welcome the trials and I welcome the review, but, sadly, people need these medicines now. Can we unlock the door? The Border Force staff at Southend airport were very polite and very helpful. They thought they were doing their duty. We should do our duty, and get that medical cannabis back to Teagan.
Matt Hancock
I pay tribute to my right hon. Friend and the all-party parliamentary group for their work in bringing this issue to the attention of the House and the country, and in supporting the parents involved. My right hon. Friend has been characteristically emphatic and reasonable in providing that support, and I entirely understand his concern. Meeting some of the parents as part of the APPG delegation was a very emotional experience.
Of course the Border Force staff were doing the right thing—and I am glad that they were doing it in a reasonable way—according to the existing rules, under which if a controlled drug is to be imported it needs a licence, and the import of an unlicensed controlled drug therefore requires a prescription from a specialist doctor. There are just over 95,000 registered specialist doctors in the UK. Any one of them who has the relevant experience can prescribe the drug, and it will be then allowed in. That can happen now. The guidance is not a barrier, and it is not a barrier to prescription. However, it is clear to me that this process is not working. I have therefore initiated a process evaluation, which is NHS language for looking at exactly why it is not working and what we need to do about it.
Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)
It is shameful that we saw those scenes at Southend airport, and that families continue to suffer because the arrangements are so slow. It is, however, appropriate that we are discussing this issue on the day on which my hon. Friend the new Member for Newport West (Ruth Jones) has taken her seat, because her predecessor, my friend Paul Flynn, was an indefatigable campaigner for many important causes, including the legalisation of cannabis for medical use.
Last year Charlotte Caldwell, the mother of another sick child, Billy Caldwell, said:
“It’s absolutely incredible, it’s amazing. The compassion and speed that the Home Secretary has moved with is just incredible.”
That is the impression that Ministers sought to give, but it was a misleading impression, as the plight of the Applebys revealed this weekend.
Is the Secretary of State aware that cannabis oil is not the same as cannabis, and that it has no psychoactive or addictive effects? Is he aware that in other jurisdictions a range of conditions qualify for treatment with cannabis oil and related products, including cancer, AIDS, muscular dystrophy, Crohn’s disease, epilepsy, Parkinson’s disease and arthritis? Is he aware that the Home Secretary has previously commissioned Sally Davies to examine the scheduling of cannabis as a whole? She reported as long ago as June 2018. Is the Secretary of State aware that Ms Davies’s report has been with the Advisory Council on the Misuse of Drugs since that time? Is the House to understand that the Home Secretary has just been sitting on it?
What is the Secretary of State going to do to speed up the processes around this issue? Parents will not be impressed to hear of further reports or further enquiries. We need to resolve the Appleby case quickly, but we also need to make sure that no other families of sick children have to suffer in the way the Appleby family is suffering.
Matt Hancock
I did set out the answers to those questions in my initial response. There are a number of smaller active agents in medicinal cannabis, but there are two major ones: THC and CBD. The vast majority of those who now have access to medicinal cannabis have access to CBD, and that is different as an active agent. Clinicians have to make a judgment according to the personal circumstances and needs of the patient, and I am trying to remove all the barriers to those clinical decisions.
We have taken action. I absolutely understand the history here, because the Home Secretary and I signed off on the decision to allow medicinal cannabis to be available at all on 1 December, following the chief medical officer’s report. What we need to do now is ensure that there are no further barriers to prescription where a clinician judges that that is the right thing to do.
James Cartlidge (South Suffolk) (Con)
My right hon. Friend will be aware of the case of my constituent Indie-Rose Clarry. She is a four-year-old girl who suffers from Dravet syndrome, a very severe form of epilepsy. Her parents, Anthony and Tannine, are also crowdfunding on the internet to raise thousands of pounds to buy drugs from Holland. That is not because they are criminals, but because they love her, they want to ease her pain and they are desperate.
On Friday, as it happens, I met Indie-Rose’s consultant—not only her consultant but one of the leading specialists in the country in severe forms of child epilepsy. He made the point that there is a barrier to prescribing cannabinoids that include THC, because there is insufficient evidence in that case. Will the Secretary of State confirm that there is evidence on CBD but not THC, which Indie-Rose’s parents have found has the greatest impact in reducing seizures?
Matt Hancock
Characteristically, my hon. Friend makes an excellent point. The clinicians consider that there is a much less evidence on THC, as opposed to CBD. I have therefore instructed the National Institute for Health Research to do the research. Doing the research will of course require some cases where the drugs can be legally tested. I had already put that in place, and I am telling the House about it today.
Dr Philippa Whitford (Central Ayrshire) (SNP)
I am glad this urgent question has moved from the Home Office to Health, where it should be, but one has to ask why drugs are being seized when they are no longer illegal—that is what changed in November.
In medicine, we use many controlled drugs, such as heroin, morphine, ketamine and diazepam which have a street value, but that has never stopped them being used in medicine. The problem is that the way cannabis was treated for 50 years means we have had almost no research and almost no experience.
The problem is also that expectations were raised in November, as if every GP would be able simply to write a prescription, but a prescription for what? We have to have a pharmaceutical quality of drug so that we know exactly how much CBD and how much THC we would be prescribing. That is not yet generally available. It is important that we look, through the Government, to get that pharmaceutical grade licensed, with reliable formulations.
This issue is under inquiry in the Health Committee, and we have heard from patients who were advised to go to Holland to get drugs, costing them £30,000 per visit. That is unacceptable. The Government will have to stimulate research, and I am grateful that calls for research are going to go out. However, we need specialist centres in paediatric neurology for children with epilepsy, we need adult neurology for multiple sclerosis, and we need pain specialists for chronic pain.
These preparations are unlicensed; that means there has been no testing on their efficacy—whether they work—and on whether they are safe. That is quite scary for doctors, particularly as if it is an unlicensed drug, they have to sign a form to say that they accept personal liability. I can tell the House that that is quite intimidating, as I have done it myself. The Government need to push for centres of excellence to help to stimulate the research they say they are calling for. That is the only way we will get randomised controlled trials, and get the answers that will lead to these drugs being licensed, rather than our just having a temporary fix for now.
Matt Hancock
In an outbreak of cross-party unity, I agree entirely with the hon. Lady. The approach she has taken is incredibly sensible; it is also the one that has been recommended to me by my clinical advisers. We need to ensure that we take an evidence-based, pharmaceutical-grade approach to prescription. I will take away her idea about centres of excellence, because I entirely see the point there. In the case of most drugs, it is the pharmaceutical industry that pushes for, and pays for, the randomised controlled trials. In this case, because the industry is in a different shape for other reasons, it is we who are making this happen, and we are pushing it as fast as we can
Richard Harrington (Watford) (Con)
I would like to thank my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) for bringing this question forward, and I thank the Secretary of State for his answer. My constituents the Levys came to see me about their daughter, Fallon, who has LGS epilepsy. Her consultant neurologist has told the family that
“the actual logistics of the prescribing has not yet been worked out”.
Why is this the case, and what can be done to ensure that Fallon has access to the necessary medication as soon as possible?
Matt Hancock
I should like my hon. Friend to write to me with the exact details of that case. The process for prescription by someone on the specialist register is well trodden; it is used for all sorts of unlicensed drugs, and it should be available. We are making a second opinion available to ensure that it can be brought to bear in cases such as these. I am interested in hearing about specific cases—this applies to everyone, not just to my hon. Friend—so that we can ensure that the appropriate clinical decisions can be made.
Mr Speaker
There was I thinking that the Secretary of State would be the first to congratulate the hon. Member for Watford (Richard Harrington) on his prodigious efforts and output as a Minister, but I am sure that that will come ere long.
Dr Sarah Wollaston (Totnes) (Ind)
I warmly welcome the measures announced by the Secretary of State today, but will he go further in discussing the importance of clinical trials and answer some of the many questions about striking the right balance between THC and CBD? We have heard in the Select Committee that some pharmaceutical companies are refusing to make their products available for clinical trials. Will he look specifically at that point? We need to ensure that safe and consistent products are regularly available and that they are of a predictable pharmaceutical grade, as we have heard.
Matt Hancock
If I may, Mr Speaker, I would like to add to my previous answer by congratulating my hon. Friend the Member for Watford, the former Business Minister, on all that he did to support business, enterprise and the case for capitalism while he was in his former job. I regret his departing from the Government, because he was a brilliant Minister.
On the question ahead of me, so to speak, the Chair of the Select Committee, the hon. Member for Totnes (Dr Wollaston), is right to say that it is vital to bring forward these clinical trials, and that the pharmaceutical companies that provide the oils have not pushed forward the trials in the way that would normally happen. We have therefore stepped in to try to make them happen, but we do need the calls to be answered.
Mr Ben Bradshaw (Exeter) (Lab)
The Secretary of State talks about removing barriers, but it is clear to me that the main barrier is the British Paediatric Neurology Association itself. When its president came to give evidence to the Health and Social Care Committee a couple of weeks ago, he was arrogant, he was dismissive of the families’ experience, and he misled our Committee by denying that Members of this House had sought a dialogue with him, which he had refused. What is the Secretary of State going to do to remove the obstacle of the BPNA?
Matt Hancock
I am sure that the BPNA will have heard that testimony from the right hon. Gentleman. Of course, the BPNA is independent of Government, and we have to follow the clinical judgments made by the relevant organisations, whether a royal college or, as in this case, an association. What I have done is ensure that a second opinion is available, because the BPNA guidance is merely guidance; it is not absolute. A clinician on the specialist register can make a decision according to what they think is best for the patient in front of them.
Rachel Maclean (Redditch) (Con)
Can the Secretary of State give some more detail on the time line for this very welcome review? I am sure that we all sympathise with parents such as Mrs Appleby, who is doing everything she can for her daughter.
Matt Hancock
Yes, the call for randomised control trials and the process evaluation are both being conducted very urgently by NHS England.
Ronnie Cowan (Inverclyde) (SNP)
There are lots of warm words circulating here today. My question relates to the point that was just made. We have this problem today, but clinical trials will take six months, nine months or a year. What can we reasonably do legally to get certified products that we know will work into the hands of parents with children who desperately need them today?
Matt Hancock
I entirely understand the hon. Gentleman’s point, and I feel the same way as he does about the urgency of these cases. The need to get a second opinion can be actioned immediately, and it will be, because the crucial point is that unlicensed medicines cannot be prescribed without a clinician. There are just over 95,000 clinicians on the specialist register, and any of those who have expertise in this area can, if their clinical judgment allows, make these prescriptions. That can happen right now.
Tim Loughton (East Worthing and Shoreham) (Con)
I was very supportive of the case of Alfie Dingley and the change in the law. The Secretary of State is absolutely right that this must be based on clinical decisions. However, given that there are several hundred children suffering from severe intractable epilepsy, is not the problem that the guidance from NHS medical bodies is just too stringent? Is it true that only two NHS prescriptions have actually been issued to date? Given that Teagan Appleby has had at least a dozen prescribed drugs—I will not list them, to avoid stressing Hansard—as well as a nerve stimulator, what would be the downside of allowing her access to medical cannabis now?
Matt Hancock
My hon. Friend makes a good point. More than 80 prescriptions have been made, but that is for both THC and CBD. Of course, THC brings risks—the active elements within cannabis do bring risks. There are also benefits, as I have seen very clearly. It must be for a clinician to decide the balance of those risks. I have enormous sympathy for the families, having heard their personal testimony about the massive benefits for their children, who sometimes, as my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) said, have 300 seizures a day. Having seen that and looked them in the eye, I understand the benefits. However, it has to be a clinician who makes that judgment. I am not medically qualified and cannot overrule a clinician, but there are clinicians available who can provide a second opinion, and that is what I can ensure.
Thangam Debbonaire (Bristol West) (Lab)
I am grateful to the Secretary of State for what he has said so far, but I have spoken with a neurosurgeon in my constituency who says that one of his anxieties is not being able to give good advice to parents whom he suspects might be trying to access medical cannabis through not wholly legal routes, because he is unsure what the law is. I agree with the Secretary of State on the need for clinical evidence, so what more information can he give us on the timescale? When will we see the health education research that he talks about? In the meantime, why can we not use the evidence of clinical trials conducted elsewhere?
Matt Hancock
The evidence of clinical trials from elsewhere can and should be used. All international clinical evidence should be brought to bear on such decisions and has been in the case of CBD. As for how quickly things will happen, the answer is, as the hon. Lady would imagine, as soon as possible.
Michael Fabricant (Lichfield) (Con)
The SNP spokesman was spot on. This is about not just drugs such as ketamine and diazepam, but beta blockers, which can also be extremely dangerous in the wrong hands. Will my right hon. Friend speak to the Home Secretary and say, “Look. This is a medical treatment. It shouldn’t be a controlled drug as such”? This treatment should not be stopped at our borders, particularly when it appears that not enough people are prepared to prescribe it.
Matt Hancock
I spoke to the Home Secretary this morning about the issue, and we proposed to see it as a health matter, not a borders matter. The Border Force officers were merely following the rules, and the question is about whether the drug is licensed. If it is not licensed, but it is controlled, the question is about whether it has clinical sign-off. The truth is that the compound does have negative effects, so it must be a controlled drug. I do not support the legalisation of all cannabis. Unless one supports the legalisation of cannabis in all cases, it has to be a controlled drug, which leads us to where we are. We must get the evidence of the medical and clinical benefits that the families have emphatically explained, and I want to see this situation dealt with properly.
Caroline Lucas (Brighton, Pavilion) (Green)
Some reports suggest that even Alfie Dingley, whose case gave rise to the new legislation, probably would not be eligible for medicinal cannabis under the new regulations because they are so strict. The Health and Social Care Secretary says that 95,000 clinicians are ready and waiting to sign off prescriptions, but can he explain why they are not doing so? If it is as easy as that, surely they would be doing it, so what else will he do to look at the barriers?
Matt Hancock
We have ensured that all the patients who received access to medicinal cannabis on an exceptional basis before the law changed on 1 November can continue to access it. If that is not the case in any instance, I want to know about that so that we can fix it. Alfie Dingley would be eligible for these drugs if a clinician were prepared to sign off the benefits for Alfie, and such decisions must be led by clinicians. I am doing everything I can to get the evidence and second opinions in place and to ensure that the process works as well as possible. That is what I can do. What I cannot do—it would be unreasonable for any Health Secretary to do so—is overrule clinical decision making in individual cases. That would be wrong, and I do not think that any Member of this House would propose that I should do it.
Chris Heaton-Harris (Daventry) (Con)
A number of us have been written to by constituents about such cases, and I have corresponded with the Secretary of State about Julie and Stuart Young, the parents of Lloyd, for example. Clinical trials have been mentioned across the House, but a piece of legislation is already in place. The Access to Medical Treatments (Innovation) Act 2016, which was sponsored by me in the Commons and by Lord Saatchi in the other place, seems ideally suited to help us through this sticky situation.
Matt Hancock
Yes, we are looking carefully at how we can use that legislation as effectively as possible. Understanding the medical consequences of any use of a drug is incredibly helpful evidence for where it should be prescribed further, and that is the thrust of the 2016 Act.
Tim Loughton
My hon. Friend the Member for Daventry (Chris Heaton-Harris) was a good Minister, too.
Tonia Antoniazzi
I will not use that word, but I totally agree with my right hon. Friend. I say to the Secretary of State that this has got to stop. We cannot wait for clinical trials. There is medicine out there—get it to the children who need it.
Matt Hancock
The BPNA is going to have to answer for itself about the way in which its representatives conducted themselves in front of the Select Committee. It is independent. Understandably, in medicine the bodies that make clinical guidance do not direct the answer for that clinical guidance to the Secretary of State. I understand the hon. Lady’s strength of feeling and that of others. I also understand the strength of feeling of the parents. I understand what a desperate situation they are in, and I am trying to make sure that it can be resolved and that they can get the drugs. I make one point to the hon. Lady: the very exercise of a clinical trial requires us to get the drugs to some children. I very much hope, therefore, that the start of a clinical trial can help to get the drugs to the people who need them. We do not have to wait for the results.
Vicky Ford (Chelmsford) (Con)
Although medicinal cannabis can have great benefits for some epileptic children, we should not forget the devastating impact that cannabis can have and its long-term impact on psychosis and schizophrenia. [Interruption.] I speak from personal experience of living with an affected family member. It is right that this is dealt with on a case-by-case basis. How soon will updated training be available for our health professionals?
Matt Hancock
The updated training will be available imminently. There are risks as well as upsides, and it is absolutely right that it is clinicians who make the judgment in respect of every decision and based on the individual patient. That, I am afraid, is the way in which medicine always has been—and, I imagine, always will be—practised in this country.
Sir Edward Davey (Kingston and Surbiton) (LD)
Will the Secretary of State confirm whether it is true that if a Dutch mother brought the same medicine to the United Kingdom, she could administer it to her own Dutch child without the import licence that Emma Appleby is saying that she must have? If that is true, is this not just another example of how shambolically this policy is being implemented?
Matt Hancock
I do not know whether that is true—that is a question of Home Office policy on controlled drugs—but all in all that does not change the fact of the matter, which is that we need to resolve this issue as soon as possible.
Sir Desmond Swayne (New Forest West) (Con)
If the principal issue is that doctors will not prescribe, is there a secondary problem when there is a prescription but the bureaucracy is failing to honour it?
Matt Hancock
I have heard that accusation being made by a couple of the parents. I am advised that that is not the case, but I am very much looking into it because in these circumstances I always think we need to listen to the people who are trying to resolve the issue. I am looking into that very point.
Stephen Twigg (Liverpool, West Derby) (Lab/Co-op)
I have previously raised the case of my constituent, 11-month-old Nathaniel Leahy, who, owing to his extremely rare form of epilepsy, lives in great pain. His mum told me today:
“I am living in fear each day that Nathaniel will not make it to the next day. We were promised in November of last year that this medicine would be available.”
Does the Secretary of State understand the powerful sense of frustration felt by families such as Nathaniel’s, and will he address the question of the guidelines so that we can have fewer stringent guidelines, to benefit patients?
Matt Hancock
I entirely understand that sense of frustration. I went to meet some of the parents to hear directly from them the pain and suffering that they and their children are feeling, which I entirely understand. That is one of the reasons why we are pushing so hard to try to resolve this. Resolving the questions around the guidelines is also important but, as the hon. Gentleman knows, those guidelines are written independently of Ministers.
Charlie Elphicke (Dover) (Con)
My constituent Teagan Appleby suffers horrendously with one of the worst cases of child epilepsy in the United Kingdom. It has been heartrending to go round to her house to see her suffering. To see how her mother, Emma, copes with the challenge is inspiring.
Legal heroin, morphine, has been prescribed in this country for many decades. Why can we not have legal cannabis, too? Is it not high time that the NHS got on with changing the guidelines to make sure that medicinal cannabis is available, rather than wasting time arresting Emma at Southend airport, which is quite the wrong thing to see?
Matt Hancock
My hon. Friend represents Teagan Appleby, her family and her parents, and he speaks for the whole House in what he says. He has captured the essence of this debate. I am trying to resolve it to his satisfaction and to the family’s satisfaction as soon as possible. There are barriers to that resolution, and I am happy to work with him, with the APPG and with all others who have constituency cases to try to resolve this significant problem.
Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)
The Secretary of State will be aware of the case of my constituent Cole Thomson, aged six, who has battled repeated epileptic seizures every night and has had terrible periods of deterioration. In order to gain the prescription, we have had to battle the system as well as the illness. Parents do not have the energy, when they are looking after a sick child, to battle the system, so can the Secretary of State ensure the streamlining of this process to make sure that specialist training is available? In the meantime, will he make available to parents a register of the specialists who can prescribe medicinal cannabis? The postcode lottery cannot go on.
Mr Simon Clarke (Middlesbrough South and East Cleveland) (Con)
I commend the Secretary of State for his statement. I, like many others in this House, have had constituents visit me to make powerful, personal cases on the impact they think cannabis oil could have for their children. Will he join me in praising the work of the campaign group End Our Pain, which has done such a good job of highlighting this issue and making sure that we in this House are aware of the situation and of the benefits it can bring?
Matt Hancock
I have already paid tribute to the APPG, and today’s urgent question has demonstrated the breadth of concern in this House. Those who are independent of Government need to make sure that they listen to this level of concern. I am certainly determined to do everything I can to try to resolve this issue.
Paula Sherriff (Dewsbury) (Lab)
It has always been the case that the Home Secretary could issue a special licence to allow the medical use of cannabis oil. I understand that the Health Secretary may be seeing him this evening, and I wondered whether he will ask him to consider this course of action.
Matt Hancock
One of the great frustrations for me, for the Home Secretary and, of course, for the families is that, before the law was changed on 1 November, that course of action was open. For a few dozen cases, the Home Secretary made those special licences to allow for the use of medicinal cannabis. He and I changed the law together to try to make sure that medicinal cannabis is available on a mainstream basis. Now it is available on a mainstream basis, as a normal drug, it therefore needs clinical sign-off. The problem is there are so many cases where that clinical sign-off has not been forthcoming. That is a source of immense frustration to me, as I hope the hon. Lady can imagine, and it is what we are trying to resolve.
Luke Graham (Ochil and South Perthshire) (Con)
Does my right hon. Friend agree that we should be led by evidence? As our scientific knowledge continues to progress, so should the views and the laws made in this House. Will he provide more clarity, not just in this instance but as new and more radical drugs become available in the near future, on how our constituents and this House could benefit and push through laws more quickly?
Matt Hancock
My hon. Friend makes a very important point. To ensure that the use of medical cannabis becomes mainstream, we need to ensure that the evidence base is there. Essentially, doctors think there is a much deeper evidence base for CBD than for THC. There is a broader point, which is that the medical profession and this House need to keep up to speed with the evidence as it is developed. In this case, that means going out of our way to develop the evidence and to have clinical trials in which some of the patients who want the drug can participate. That will provide the evidence base that allows the vast array of specialists to prescribe it.
Diana Johnson (Kingston upon Hull North) (Lab)
It was clear from the evidence given to the Health and Social Care Committee that the Government raised public expectations when they rescheduled medical cannabis. I wonder whether it is time for the Secretary of State to ensure that there is a public awareness campaign, with full information about what the Government are trying to do.
Matt Hancock
I will look at that idea and discuss it with the NHS. The training programme that we are putting in place is intended to raise awareness of the evidence and the change in rules among the profession—among doctors and the specialist prescribing doctors on the register. Ultimately, it is only with clinical sign-off that we allow any drug to be prescribed. That is where the training needs to be in the first instance, but I will look at the hon. Lady’s suggestion of doing it more broadly.
Rebecca Pow (Taunton Deane) (Con)
Anyone who goes through the heart-rending experience of seeing a very sick family member suffer will know that they would do anything to help that person, often reaching the point of desperation. People need to be confident that they can get hold of cannabis-based medicines if it is appropriate and that those medicines are safe. In this instance, there is a lot riding on the shoulders of our doctors. Will my right hon. Friend assure us that doctors are being given the right guidance to do what is right for patients, but also that they will not be blamed if something goes wrong?
Matt Hancock
Yes, I think that is exactly the right approach and it is what we are working towards.
Christine Jardine (Edinburgh West) (LD)
I thank the right hon. Member for Hemel Hempstead (Sir Mike Penning) for raising this important issue, which affects one of my constituents, Murray Gray, directly. His mother is one of those parents who is now desperate, having been given hope.
Does the Secretary of State agree that we have the evidence from abroad that these medicines can work and we have the willingness of everybody in this House to make it work, but somehow there is a gap between our willingness and our ability to make it happen? Will he assure the House that he will speak to the Home Secretary and to the devolved Administrations who have NHS responsibility to try to get some kind of action through co-operation to reassure the parents who are desperate not just because their children will suffer but because they may not survive?
Matt Hancock
Yes, of course; I am very happy to do that. Perhaps I should take this opportunity to welcome the new public health Minister, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for South Ribble (Seema Kennedy) to her post. She will, no doubt, have listened to all the questions today. She and I will be working on making this happen.
I would add to the hon. Lady’s list, because this is not just about the Home Office and the Department of Health and Social Care; it is about making sure that the independent medical establishment has confidence in the evidence that is presented. It is not enough for her and I to have confidence as lay politicians; it is important that the professionals who put their signature on the line have confidence in the evidence as well.
Mr Philip Hollobone (Kettering) (Con)
Does the Secretary of State appreciate the public’s concern that, at a time when several police forces have openly admitted that they will not take action against those involved in recreational cannabis use, the full weight of the Home Office’s Border Force is deployed to intercept medication for a seriously ill young child? Surely getting medication to a seriously ill young girl should never be a crime.
Matt Hancock
My hon. Friend makes an important point. The Border Force should not be criticised in this case, because it was following the rules: if a clinician has not signed something off it cannot come in. It is incumbent on us on the health side to sort out this problem. He makes a broader point, however, that this is a completely separate issue to the recreational use of cannabis. I do not support a change in the rules on the recreational use of cannabis; this is about the specialist provision of drugs to some children who are the most vulnerable people in society, and the need to ensure that the medical benefits of such drugs can be brought to bear on people who really need them.
Alex Norris (Nottingham North) (Lab/Co-op)
Like many colleagues, I have spoken with parents of children who have profound challenges that could be ameliorated by medicinal cannabis. They are at their wits’ end, and it is no surprise to find that some in this country resort to desperate measures. I have listened for 45 minutes now and I cannot tell the answer to this question: is the Secretary of State really saying that we have a clear, universal, safe and compassionate approach to this issue and, if we do not, when will we?
Matt Hancock
I am saying that if a patient needs medicinal cannabis, and if a clinician will sign off on that need, the prescription can happen. The guidance from the association does not override the individual judgment of that clinician. That can happen but, because it has not been happening in many cases that have been brought to light, some privately and some very publically, I am putting in place a system of second opinions to ensure that we can get that clinical decision right, at the same time as developing a stronger evidence base for the future.
Tommy Sheppard (Edinburgh East) (SNP)
Reuben Young is an 11-year-old boy in my constituency who suffers from myoclonic astatic epilepsy, which is a severe and rare form of epilepsy. His mother, Emma, is at her wits’ end. Conventional medicines do not work and she has tried to get a prescription for Epidiolex, which is a cannabis-derived medicine. She tells me that she is unable to get it because the physicians involved say that the guidelines prevent them from prescribing it. I do not know why, but for some reason the change in policy last November is not leading to a change in practice. I ask the Secretary of State to speak with the Home Secretary and to have an urgent—I mean in days or weeks—review to see how the existing guidelines can do better.
Matt Hancock
Those guidelines are not a matter for the Home Secretary; they are guidelines in the health space, although the association that writes them does not report directly to me but is independent. Those guidelines do not prevent a physician who is on the specialist register of the General Medical Council from prescribing. If anybody has been told that they do, they do not; it is up to the individual professional judgment of a specialist clinician on the register to prescribe or not.
Mary Glindon (North Tyneside) (Lab)
Lara Smith, my constituent, is really upset about what happened to Teagan and her family at the weekend. Lara travels to Holland every three months to get a schedule 2 drug, Bedrocan, for her seriously debilitating illness. It could be imported but, if it was, unfortunately, she would have to bear the licence fee. Will the Minister say whether anything can be done for her?
Matt Hancock
Yes. My heart goes out to the hon. Lady’s constituent and her family. One of the purposes of the evidence gathering that we are doing, and of the calls of the national institute for trials, is to provide the evidence on which the NHS could routinely provide those medicines. At the moment, we have the ability for specialists to prescribe in the interim, but I want to get the evidence base in place for the longer term.
Alison Thewliss (Glasgow Central) (SNP)
One of my constituents—one of many who has been in touch with me about this issue—has multiple sclerosis and found previously that cannabis helped his symptoms immensely, but he does not want to break the law and he cannot get a prescription. What would the Secretary of State advise him to do?
Matt Hancock
If the hon. Lady will write to me with the case, we will get a second opinion from a clinician who may be able to make that prescription.
Jeff Smith (Manchester, Withington) (Lab)
I agree that we need to remove the barriers for clinicians. We need evidence, but the problem with randomised control trials is the nature of cannabis. The fact that it contains many different compounds that interact makes it difficult to isolate the compounds that work for individuals. Cannabis is a unique treatment, and should really be in a licensing and scheduling category of its own to allow different approaches. I urge the Secretary of State to encourage observational trials so that we can allow patients to get access to the medical cannabis that will work for them.
Matt Hancock
We looked at observational trials, but the problem is that they do not build the evidence base that a full RCT does. A full RCT also allows some patients to get access while the trial is ongoing, so it is in fact a better proposal. It means that some patients can get the treatment now for the purposes of the trial, and then we can get a full evidence base for the long term, as was mentioned previously.
Kevin Brennan (Cardiff West) (Lab)
The law may be an ass, but it does not have to be applied in an asinine way, as it was in the case of Emma Appleby. Will the Secretary of State have words with the Home Secretary to make sure that it is not repeated? My constituent, Bailey Williams, is 16 years of age and suffers from the most severe form of epilepsy. He has multiple seizures every day. His parents, Rachel and Craig, are absolutely convinced that we need observational trials and more immediate action. I accept that this was unintended, but sadly the change in the law has made things worse, not better, for those parents. What will the Secretary of State do to turn that around quickly?
Matt Hancock
It is a source of deep frustration to me that the change in the law to normalise the use of medicinal cannabis has, exactly as the hon. Gentleman says, meant that, because a clinical decision is needed for a prescription, and because in many cases clinical decisions are not forthcoming, many parents who entirely understandably think that their child would benefit from medicinal cannabis now find that they cannot get a clinician to sign it off. That is at the root of the problems that we are trying to tackle today.
Alan Brown (Kilmarnock and Loudoun) (SNP)
Although the Secretary of State is adamant that the guidelines are not a problem, it is clear that they and the associated liability are an issue. Let us hope that the review will pick that up. Four-year-old Logan Chafey in my constituency is the only child in the whole of Europe who has chromosome 7p duplication syndrome. One of the current rules is that there needs to be a proven benefit before a clinician can prescribe medicinal cannabis. How can we get to a position where Logan can get medicinal cannabis?
Matt Hancock
He will be able to get it now if a clinician is prepared to sign off on it being the right thing for him. If that is not forthcoming now, I have announced today a system of second opinions to allow people to get the clinical sign-off that they need.
Matt Hancock
They must be taken into account. It comes down to the question of the complexity of cannabis and the many dozens of active agents in it; CBD and THC, which we have mostly been discussing today, are the main ones. Many drugs have similarly complex interactions. Modern science and medicine are capable, in a controlled environment, of getting to the bottom of which ones have the effect. That is why it is better to do a full RCT with the full scientific structure around it, rather than an observational trial. That will get the drugs to the people who need them quickly, and will provide the evidence base. I hope that that satisfies the hon. Gentleman that, in that space, we are doing as much as we can. On the timing, I want it to happen as quickly as possible.
Stuart C. McDonald
It was a very wise decision. Thank you, Mr Speaker.
I, too, have constituents who have been exiled to the Netherlands to secure medicinal cannabis for a severely epileptic child, and others who are spending a fortune importing cannabis oil from Canada to help slow the progression of a terminal brain tumour. Will families such as these soon be able to take part in proper clinical trials, as they would be able to elsewhere, so that they can have some hope and we can all benefit from the evidence that will be gained?
Matt Hancock
Yes, absolutely. If the hon. Gentleman will write to me about the specific case, I will ensure it is dealt with appropriately.
Oral Answers to Questions
Matt Hancock Excerpts(5 years, 8 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lucy Powell (Manchester Central) (Lab/Co-op)
The Secretary of State for Health and Social Care (Matt Hancock)
The Department of Health and Social Care works across government to ensure every child can have the best possible start in life. This includes a significant increase in mental health support in schools.
Lucy Powell
I thank the Secretary of State very much for that reply. May I first pay tribute to the former Minister, the hon. Member for Winchester (Steve Brine)? I think his actions last night were very honourable, and he has been an exceptional Health Minister.
May I ask the Secretary of State also to look at how we can join up services much more strongly on the ground? Whether it is early years, child mental health or special educational needs and disability support, time and again we hear problems about how services are not joined up.
Matt Hancock
I agree with the hon. Lady on both counts. My hon. Friend the Member for Winchester (Steve Brine) was an excellent Public Health Minister, who did exemplary work and drove the agenda with great passion and determination, and he has behaved honourably in every sense.
On the point about cross-government working, the hon. Lady is completely right. The need to join up, breaking down the barriers of silos that sometimes exist between agencies, is vital. There is a huge amount of work under way in all of the areas she mentioned, and I am determined to see that work.
Tracey Crouch (Chatham and Aylesford) (Con)
On Friday, I met two clinical commissioning groups that cover my constituency specifically to discuss mental health and children’s health and wellbeing. While it is an extremely complex issue, does the Secretary of State agree with me that, with the perceived rigorous spending rules requiring health providers to spend only on pure health services, it will remain extremely challenging for them to work with other agencies to support methods, such as those to build resilience, that improve outcomes for children’s health?
Matt Hancock
My hon. Friend is absolutely right to raise this. The most forward-looking CCGs in the country are working with all sorts of partners—the voluntary sector, charities, local authorities—to deliver better services that make people healthier, even if they are not purely medicinal in the first instance. For instance, tennis lessons may sometimes help people, Mr Speaker, as may all sorts of other activities. This is all part of a broadening social-prescribing agenda to get people healthy, however that is best done.
Chris Elmore (Ogmore) (Lab)
The Secretary of State will be aware that, last Monday, I published my report, with the Royal Society for Public Health, on children’s mental health and social media. May I place on the record my thanks to him for his tweet in support of the report? I have asked Education Ministers and I will be doing this with the devolved institutions as well, but would he agree to a meeting with me—and with the Mental Health Minister, the Under-Secretary of State for Health and Social Care, the hon. Member for Thurrock (Jackie Doyle-Price)—to look at the report and the recommendations so that we can start working across Departments and across devolved institutions?
Matt Hancock
I would be very happy to meet the hon. Gentleman and his all-party group on social media and young people’s mental health and wellbeing. It is an incredibly important topic. We must make sure that social media is safe and that we protect children’s mental health, which the evidence increasingly shows can be negatively impacted by the wrong use of social media. Social media can be a great, powerful force for good, but it also has its downsides and we need to mitigate those, and there is a lot more coming from the Government soon.
Theresa Villiers (Chipping Barnet) (Con)
May I ask the Secretary of State to meet the Sport and Recreation Alliance to hear its ideas on how we ensure children and young people lead healthier and more active lives?
Matt Hancock
Yes, I would love to. I think this is an incredibly important agenda. It ties in directly with the question from my former ministerial colleague when I was at the Department for Digital, Culture, Media and Sport, my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch). There is lots to do on this agenda.
Dr Rosena Allin-Khan (Tooting) (Lab)
There has been an alarming rise in the need for the use of baby banks for children. While I am proud that organisations such as Little Village in Tooting are doing such amazing work, it is shocking that we even need baby banks in this day and age. Does the Secretary of State agree with me that it is a stain on this Government and highlights the drastic inequalities seen in our society?
Matt Hancock
We are determined to do everything we can to support people, especially at the time—in the first 1,000 days—that is so critical to people’s whole lives, and that is an incredibly important part of the work. Improving maternity services is important, but the link-up with other broader agencies is also important, and we should not denigrate or downplay the vital role that charities too can play in supporting people.
David Tredinnick (Bosworth) (Con)
I thank my right hon. Friend for coming to Hinckley to see co-ordination and social prescribing in action. Will he be taking steps to further develop personal budgets, which save money and improve lives?
Matt Hancock
Yes, absolutely. Driving the social prescribing agenda, which is based on increasingly strong evidence of the power of social prescribing to help people stay healthy and get them healthy again when they are ill, will also involve wider use of personal budgets. Almost 1 million people have personal budgets.
Dr Paul Williams (Stockton South) (Lab)
I join my hon. Friend the Member for Manchester Central (Lucy Powell) in paying tribute to the very hon. Member for Winchester (Steve Brine), and I also pay tribute to my hon. Friend the Member for Ellesmere Port and Neston (Justin Madders). Has the Secretary of State seen Professor Clare Bambra’s research in the Journal of Epidemiology & Community Health this month, showing that inequalities in infant mortality between deprived and more affluent areas fell between 1999 and 2010 when there was a Labour Government, and then increased from 2011 to 2017? Is it not true that only Labour has the range of co-ordinated, cross-governmental policies that reduce inequalities in child health?
Matt Hancock
No. The NHS long-term plan has a whole swathe of policy to reduce health inequalities. The best thing we can do to reduce health inequalities is ensure that more people are in work, and the record number of jobs that have been delivered is a vital part of that agenda.
Derek Thomas (St Ives) (Con)
Sir Desmond Swayne (New Forest West) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
The data that my right hon. Friend asks for is not available, but it is important that we take action to make sure the right drugs are available for the right people.
Sir Desmond Swayne
Was it intended to make them as rare as hens’ teeth? What measures is the Secretary of State taking to support clinicians in actually prescribing?
Matt Hancock
I met the parents of some of the children whose needs are best met through the use of medicinal cannabis. My heart goes out to those who are fighting for this cause. We changed the law in the autumn to try to make it easier, and I am looking very closely at what we can do to make sure that the intention of that decision is met.
Mr Ben Bradshaw (Exeter) (Lab)
The Health Committee heard last week that patients are dying unnecessarily and up to a million families are being driven to criminality by getting medical cannabis illegally, and the situation has got worse since the Government changed the law in November. When are these families going to get access to medical cannabis for their children and other sufferers that they would have access to if they lived in Germany, the Netherlands, Canada or the United States?
Matt Hancock
As the right hon. Gentleman knows, I supported and indeed participated in the decision to ensure that access was made legal in the autumn, and I am working right now on trying to make sure that some of the challenges in the system are unblocked. Ultimately, these things have to be clinician led, but my sympathy is with those who are campaigning, whom I have met, because I know of the anguish that this problem is causing.
Mary Glindon (North Tyneside) (Lab)
Mr Stephen Hepburn (Jarrow) (Lab)
The Secretary of State for Health and Social Care (Matt Hancock)
On 11 March, I held a meeting with all the parties to discuss how best to ensure that people with cystic fibrosis and their families can benefit from the best drugs as soon as possible. Vertex, the National Institute for Health and Care Excellence and NHS England met on Thursday and have agreed to take those discussions forward.
Mr Hepburn
Does the Secretary of State support immediate interim access to Orkambi while the negotiations are going on, and has he asked NHS England, NICE and Vertex to consider this option?
Matt Hancock
We are having constructive discussions—I am delighted that finally Vertex has agreed to participate in them; the parties have committed to providing the data needed for an objective assessment of the drugs in question, and I look forward to the discussions proceeding effectively.
Rachel Maclean (Redditch) (Con)
A constituent of mine came to see me in my surgery. He had been born with cystic fibrosis and told me what a transformative effect the drug had had on him. He was lucky enough to be accepted on the trial, but he says we need to raise awareness because millions of people are not getting the drug. What response can the Secretary of State give to him and fellow sufferers?
Matt Hancock
My hon. Friend’s constituent is absolutely right about raising awareness of the issue and the need for these drugs. I know the impact that cystic fibrosis can have on people and of the hope that these drugs will save lives. We have made a significant offer to the pharmaceutical company, Vertex, to allow these drugs to be provided in the UK, and I very much hope we can come to an agreement.
Catherine McKinnell (Newcastle upon Tyne North) (Lab)
On NICE decision making, my young constituents Nicole and Jessica Rich have the life-limiting rare condition Batten disease. Last month, NICE turned down a proven treatment for the condition after a year of deliberation. I and several cross-party colleagues wrote to the Secretary of State to ask if we could discuss this urgent matter, but we received a reply from the Under-Secretary of State for Health and Social Care (Baroness Blackwood), saying that she could not meet us because of diary commitments. This is insulting. Will the Secretary of State meet us to discuss this urgent issue?
Matt Hancock
Yes, of course I will. I understand exactly where that process has got to. It concerns a different drug from the one in the question, but it is also a very important consideration for a number of people.
Luke Hall (Thornbury and Yate) (Con)
Will the Secretary of State agree to or consider temporary interim access to Orkambi while the negotiations continue, and has he had any discussion so far on that subject?
Matt Hancock
I am happy to consider all options that can secure access in a way that provides value for money based on an objective assessment of what is clinically right. That is the basis of our discussions.
Kerry McCarthy (Bristol East) (Lab)
I am glad that the Secretary of State is taking a personal interest in this matter. In Thursday’s debate, I mentioned the case of Oli Rayner, who gave evidence to the Health Select Committee. He fell ill in his 30s and was given Orkambi just to make him well enough to undergo a lung transplant operation. Is it not ludicrous to wait until people are virtually at death’s door before being prepared to give them the drug?
Matt Hancock
That is one very important consideration. Having met people suffering from cystic fibrosis and heard directly the stories they tell about the impact on their lives and how it potentially shortens their lives, I think it is very important that we find a solution, which is why I was so determined to bring the parties together.
Stephen Crabb (Preseli Pembrokeshire) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
The new five-year national action plan to tackle antimicrobial resistance contains the commitment to support more research into new and alternative treatments, including vaccines and diagnostic tests, to promote broader access to vaccines for both humans and animals.
Stephen Crabb
Stopping the spread of diseases such as TB by using vaccines will play a key role in tackling AMR worldwide, so what plans does my right hon. Friend have for building on the excellent work of the UK Vaccine Network, with all the funding that goes with that, to ensure continued UK leadership in vaccinology?
Matt Hancock
My right hon. Friend is right to raise this issue. Of all the challenges facing the world, the risk that antibiotics will fail to work in the future is a huge one that we cannot afford to allow to come to pass. We are putting significant research money into the production of new antibiotics and ensuring that we roll out vaccines so that antibiotics do not have to be used.
The use of antibiotics in the chicken population in the United Kingdom has fallen by more than 70% over the last five years. This is doable: we will provide the money that is necessary to ensure that people can use antibiotics well into the future.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
May I beg the Secretary of State to snap out of the trance that he now seems to be in and wake up to the fact that many of the key researchers in this area are going back to their European homes because of the threat of Brexit? We are losing Spanish nurses, for instance, on whom my constituents absolutely depend for healthcare. Up and down the country, our health system is haemorrhaging talent because of the Secretary of State’s lack of action. Wake up, Secretary of State, and smell the coffee!
Matt Hancock
I am afraid that I profoundly disagree with the hon. Gentleman, who used to be so sensible. Antimicrobial resistance is a global problem and we contribute to global funds, because only by coming together as a whole world will we be able to tackle it— and that is what we are going to do.
Andrew Lewer (Northampton South) (Con)
Justin Madders (Ellesmere Port and Neston) (Lab)
The Secretary of State for Health and Social Care (Matt Hancock)
It is a great pity to see the hon. Gentleman back up there on the Back Benches as he was such a force—and a rare force—for reason and progress on the Opposition Front Bench until recently.
Standards in the NHS should be based on clinical evidence, and NHS England’s proposals will be rigorously field-tested to gather further evidence on clinical, operational, workforce and financial implications, all with the goal of improving the quality of care.
Justin Madders
I thank the Secretary of State for his tribute—although it is not going to change the question I am going to ask. He will be aware that since July 2015 the four-hour A&E target has not been met and last month saw the worst performance on record, so regardless of any clinical reviews, is it not time that Ministers admitted that the four-hour A&E target has effectively been abandoned?
Matt Hancock
Of course, we are aiming to meet and improve against the targets, including with the injection of the extra money—£34 billion extra in cash terms over the next five years. At the same time, we must make sure that the standards to which we hold the NHS are the right ones clinically for the times, and that is what this review of standards is all about.
Mary Robinson (Cheadle) (Con)
Helen Whately (Faversham and Mid Kent) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
Primary and community care are set to receive an additional £4.5 billion a year of taxpayers’ money as part of the NHS long-term plan, to ensure that we can get the best possible access to GPs.
Helen Whately
In parts of my constituency, it is very difficult for people to see their GP. For example, in the area of Park Wood, there is just one GP for 4,000 patients. I welcome the extra money going into primary care that my right hon. Friend just mentioned, as well as the additional GP training places and the fact that a Kent medical school is coming our way, but we need more nurses, physios and other health professionals in primary care. What is he doing to ensure that people can see the right health professional when they need to do so?
Matt Hancock
This is an incredibly important agenda that is close to my heart. It is at the core of the prevention of ill health to ensure that we have the right primary care services. Yes, that includes more GPs, but it also includes more of the other health professionals who support them. We have 1,000 extra non-GP clinical staff already working in general practice compared with just two years ago, but there is much more to do.
Derek Twigg (Halton) (Lab)
But what is the Secretary of State doing about retaining GPs? This is a real problem, and we have seen more and more GPs taking early retirement in recent years. What is he doing specifically to support retention?
Matt Hancock
This is a core question that Baroness Dido Harding’s workforce review will be looking into, and work is going on right across government to try to fix it.
Kevin Hollinrake (Thirsk and Malton) (Con)
GPs are the first line of defence against superbugs and antimicrobial resistance, and the Secretary of State is already proving to be a world leader in this area. The idea of a resistance tax has the support of other world leaders including Lord O’Neill and Dame Sally Davies. Would he consider this approach?
Matt Hancock
I am happy to look at all approaches to how we can reduce the overuse of antibiotics to preserve them so that they work effectively where they are needed. Of course GPs have a role to play in that, and the number of antibiotics prescribed by GPs has fallen in recent years, but again there is much more work to do.
Jim Shannon (Strangford) (DUP)
Will the Minister outline whether his Department is willing to enter into an agreement with medical students to wipe out their student loans if they contract to carry out five years of GP service?
Matt Hancock
That is an interesting proposition and I would be happy to talk to the hon. Gentleman more about the idea. I was in Northern Ireland last week looking at medical services there and at what we can learn, and that might be another idea.
Jeff Smith (Manchester, Withington) (Lab)
Vicky Foxcroft (Lewisham, Deptford) (Lab)
The Secretary of State for Health and Social Care (Matt Hancock)
We are pursuing a multi-agency approach to prevent and tackle serious violence. Healthcare is of course one of the important and relevant agencies that need to work together right across government to reduce knife crime.
Vicky Foxcroft
The Government are committed to a public health approach, but we heard the Secretary of State dismiss it just a few weeks ago. What assurances can he give that he is now fully signed up to the approach? What evidence is his Department collating? How is the Department working with the Home Office to ensure that we have a long-term strategy for keeping our young people safe?
Matt Hancock
I am a huge fan of the public health approach to tackling knife crime. In fact, I was in Croydon yesterday to talk to charities and to students at Croydon College about the role the NHS can play in tackling the scourge of knife crime. I am a big fan of this agenda, and I look forward to working with the hon. Lady and colleagues from across the House.
Lloyd Russell-Moyle (Brighton, Kemptown) (Lab/Co-op)
Stephen Crabb (Preseli Pembrokeshire) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
We all in this House have huge admiration for the dedicated staff who work night and day to deliver world-class care to patients in our NHS. We should recognise that today marks the 75th anniversary of the publication of the White Paper on the establishment of the NHS, delivered in this House by a Conservative Minister, under a Conservative Prime Minister.
Stephen Crabb
The prescription of powerful painkillers has soared, as has the number of overdoses and deaths from these prescription drugs, with some of the worst statistics in the poorest areas of the country. What is my right hon. Friend doing to reverse this worrying trend?
Matt Hancock
My right hon. Friend is absolutely right to raise this. There has been a rise in opioid-related deaths, and we need to work across government to tackle the problem. Public Health England is reviewing prescription drug dependence, including opioid dependence, and we recently announced a review of over-prescription in the NHS to make sure patients are taking the right medicines for the right amount of time.
Barbara Keeley (Worsley and Eccles South) (Lab)
There are still 2,295 patients who are autistic or who have learning disabilities in hospital in-patient settings, despite a Government pledge in 2012 that no one would be in inappropriate settings by 2014. In 2015, the Government said they would close up to 50% of these in-patient places, and they failed to meet that pledge, too, because of a lack of social care funding. Will the Secretary of State now commit to proper social care funding for this programme and renew the pledge to end the misery of these placements by 2022?
Kirstene Hair (Angus) (Con)
Matt Hancock
I will certainly do that, and I am very surprised and disappointed to hear what my hon. Friend has to report. I pay tribute to her work in leading on this agenda, including setting up the all-party parliamentary group. She has campaigned hard to get the Scottish Government to act. Given the progress we have made on the target—by 2021, 95% of children and young people with an eating disorder receiving treatment within one week for urgent cases and four weeks for routine cases—we are on track to meet it. That is something we should be discussing, at the very least, with our Scottish colleagues.
Gavin Newlands (Paisley and Renfrewshire North) (SNP)
Matt Hancock
We have a range of work going on to improve access to innovative new treatments, both pharmaceutical treatments and the broader treatments that the hon. Gentleman describes, including ensuring, through an accelerated access collaborative led by the former Labour Minister Lord Darzi, that we drive innovation and that those innovations are taken up by other parts of the NHS.
Several hon. Members rose—
Greg Hands (Chelsea and Fulham) (Con)
Matt Hancock
My right hon. Friend was not only a very good Whip, but is a very good constituency MP. He has made his case very well. “Shaping a healthier future” is no longer supported by the Department of Health and Social Care, NHS Improvement or NHS England. The NHS will look at parts of the proposals that are in line with the long-term plan, such as the aspects that are focused on expanding the treatment of people in the community. As for the changes in A&E in west London that are part of “Shaping a healthier future”—for instance, those at Charing Cross Hospital, which he mentioned—these will not happen.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
Daniel Kawczynski (Shrewsbury and Atcham) (Con)
Will the Secretary of State give an evaluation of the “Future Fit” programme? We have secured more than £300 million for investment in our local hospital trust. What is his understanding of where the “Future Fit” programme has got to?
Matt Hancock
I have called in the independent review panel and asked it to consider all the evidence, at the request of the local council, to ensure that we properly assess all the evidence. We have made the money available, but we must ensure that the plans are the best ones possible for both Shrewsbury and Telford.
Ian Mearns (Gateshead) (Lab)
Fiona Bruce (Congleton) (Con)
Can Ministers outline the latest steps to support the children of alcohol-dependent parents? In the forthcoming alcohol strategies, will greater support be promoted for the families of alcoholics, who are often best placed to help to reduce alcohol harm in their loved ones?
Matt Hancock
Absolutely. My hon. Friend is right to stress the role of families in supporting the children of alcoholics. We made progress on that and were able to announce funding just last week. I pay tribute to my hon. Friend the Member for Winchester (Steve Brine) for all his work—I enjoyed doing it with him—to do everything we can to support the children of alcoholics.
Gareth Snell (Stoke-on-Trent Central) (Lab/Co-op)
Matt Hancock
The relative funding across the country for different areas is assessed independently, and by law NHS England makes that assessment. I am happy to write to the hon. Gentleman with the precise details of how those allocations are devised—I am sure that he has got them; they are widely available—and an explanation of the conclusion that NHS England independently reached.
David Tredinnick (Bosworth) (Con)
What is being done to improve co-ordination between orthopaedic surgeons, osteopaths and chiropractors to reduce the burden on surgeons?
Matt Hancock
It is an important part of the agenda that we look right across the piece at interventions that can benefit patients. I know full well, not least because I am married to a former osteopath, the positive impact that that can have.
Mr Adrian Bailey (West Bromwich West) (Lab/Co-op)
In a debate on 24 January in this Chamber, many contributors outlined the dangers of using graded exercise therapy in treating ME. What conversations has the Department had with NICE on that issue before the proposed publication of the revised treatment guidelines in October 2020?
Julia Lopez (Hornchurch and Upminster) (Con)
I met the Secretary of State to discuss my campaign for a new health centre in Hornchurch and I welcome his subsequent announcement that NHS trusts can apply for NHS property assets. Will my right hon. Friend let me know how and when they can make those applications and whether he will consider fast-tracking any bid we make, given how close we were to receiving capital funding?
Matt Hancock
There is no better advocate for Hornchurch in the Chamber than my hon. Friend. She made her case with passion and commitment and I was very impressed by it. I will write to her with the full details, once they are published, of exactly how the process will work, and I look forward to working with her.
Tim Farron (Westmorland and Lonsdale) (LD)
The north-west of England has only half the number of ambulances per head of population as London. In rural Cumbria, the situation is far worse. Will the Secretary of State agree to our proposal for an additional two ambulances for Westmorland so that we can keep our communities safe?
Ms Karen Buck (Westminster North) (Lab)
With a throwaway answer to the right hon. Member for Chelsea and Fulham (Greg Hands), the Secretary of State has just pulled the west London strategic health framework, which has governed the delivery of hospital and community services for most of the last decade, absorbed tens of thousands of hours and cost hundreds of millions of pounds. Why has he not thought it appropriate to bring forward a statement so that the many of us who are concerned with this issue have an opportunity to interrogate the many very serious implications that this has for the delivery of healthcare across west London?
Matt Hancock
The hon. Lady and the hon. Member for Hammersmith (Andy Slaughter), who is sitting next to her, have run, over a number of years, totally inappropriate scare stories about what they said were potential changes to A&E in west London as part of “Shaping a healthier future”. It has been one of the worst aspects of local parliamentary campaigning and I am absolutely clear that the changes in A&E in west London as part of “Shaping a healthier future” will not happen. However, there are elements of “Shaping a healthier future” that are about more community services and treating more people in the community. We look forward to working with the local NHS on those parts of the proposal.
Andrew Griffiths (Burton) (Con)
Will the Secretary of State, on behalf of this House, thank doctors and nurses in the NHS for the amazing news that death rates from breast cancer are falling at a faster rate here than in the six largest countries in Europe and that, since 2010, death rates have fallen by 17.7%? He will know that I raised the issue of my constituent Nicola Morgan Dingley, who is suffering from terminal breast cancer. He very kindly wrote to me. Will he agree to meet Nicola so that she can describe to him the challenges faced by women with triple negative breast cancer?
Matt Hancock
Yes, of course, I would be delighted to meet my hon. Friend and his constituent. He is right that the fall in deaths from breast cancer is huge progress that we have made as a country. I pay tribute to the work of the NHS on that but, of course, every such death is a tragedy and we need to do yet more.
Andy Slaughter (Hammersmith) (Lab)
“Shaping a healthier future” was the biggest hospital closure programme in the history of the NHS, with the loss of two major hospitals, including Charing Cross in my constituency. It was fully supported by the Conservative party not only nationally, but locally, as the right hon. Member for Chelsea and Fulham (Greg Hands) well knows. After seven years, millions of pounds wasted in consultants, staff leaving through insecurity and 2 million people across west London threatened with the loss of essential and world-class hospitals, is that it today? Abandoning “Shaping a healthier future” is a victory for the people of Hammersmith, for the Save our Hospitals campaigners and for our Labour council, but there has been appalling judgment by a succession of Governments and Secretaries of State. Will this Secretary of State now apologise to my constituents?
Matt Hancock
It is astonishing, is it not? My right hon. Friend the Member for Chelsea and Fulham (Greg Hands) has made this case with objective clarity and reasonableness, is supporting his constituents and led to a very positive outcome, keeping the A&Es open but still doing the positive work in the community, and all we continue to get is information that I regard as erroneous from the hon. Gentleman, who has campaigned in the most terrible way on this over many years.
Andrea Jenkyns (Morley and Outwood) (Con)
A nine-year-old constituent of mine, Lydia Heptinstall, is a very brave sufferer of hypermobile Elhers-Danlos syndrome. She suffers from joint pain, headaches and numerous other symptoms and cannot do the things that other children can do. Will the Minister meet me to discuss Lydia and what the Government are doing to raise awareness of this condition?
Matt Hancock
Yes, of course, I would be very happy to meet my hon. Friend and talk about her constituent’s concerns.
Alison Thewliss (Glasgow Central) (SNP)
I am wearing purple today for Epilepsy Day. What assessment has the Secretary of State made of the causes of ongoing shortages of epilepsy medications? What action is being taken to address those problems and what impact will Brexit have on the supply of those medicines?
Matt Hancock
I, too, am wearing purple—purple socks in my case—to support this important campaign. Of course, we have done enormous amounts of work across the NHS. I pay tribute to the NHS and to suppliers for working to ensure that, whatever the Brexit outcome, there will be the continued supply of medicines, but there is one thing that the hon. Lady can do if she really wants to make sure that we put this issue to bed once and for all—vote for the deal.
Several hon. Members rose—