Healthcare (International Arrangements) Bill

Philip Dunne Excerpts

Wednesday 14th November 2018 Commons Chamber

[The Minister for Health (Stephen Barclay)]

With the leave of the House, I thank everyone who has spoken in the debate. This is a short and sensible Bill, which will ensure that the Government have the appropriate legal framework to give effect to a deal in relation to reciprocal healthcare arrangements, which so many of us, both here and abroad, enjoy. I am grateful for the support in principle for the Bill from both sides of the House, including from the Opposition Benches.

The level of interest in and the contributions to the debate demonstrate that it is clearly in the interests of the British public to ensure that reciprocal healthcare arrangements similar to those currently in place continue when we leave the EU. A number of questions have been raised in the debate, which I will endeavour to answer in my closing remarks. However, as my opposite number, the hon. Member for Ellesmere Port and Neston (Justin Madders), pointed out, we will have an opportunity in Committee to scrutinise those questions in more detail. He raised a number of very pertinent points, which I will be keen to explore with him.

I would like to reiterate the offer I made in a recent letter to all Members of the House to have meetings with me and the team of officials working on the Bill if they want to explore the Bill in more detail. I recognise—this point was picked up by my hon. Friend the Member for North Thanet (Sir Roger Gale)—that this issue genuinely concerns constituents of Members on both sides of the House. I am keen to engage with Opposition Members, the Chair of the Health Committee and other colleagues on the detailed issues they may wish to raise on behalf of constituents.

[Mr Philip Dunne (Ludlow) (Con)]

I am grateful to my hon. Friend, and I would like to take advantage of his offer, but I would also like to highlight another issue. I do not wish to extend the competence of the Bill unduly, but it is an opportunity for us to look at the reciprocal health agreements we have with the overseas territories, as mentioned by my hon. Friend the Member for Chichester (Gillian Keegan), and particularly with United Kingdom dependent territories—I am thinking here of the Channel Islands. Under the previous Labour Government, the reciprocal health agreement with Jersey was ripped up and terminated in 2009. Under the coalition agreement in 2011, it was reinstated. However, at present, there is no reciprocal health agreement with Guernsey, which is also responsible for Alderney and Sark. I ask the Minister to consider that during the passage of the Bill.

[Stephen Barclay]

I am grateful to my hon. Friend for raising that. Understandably, much of the debate today has focused on the EU element of the Bill, but he is quite right to recognise that the reciprocal element extends beyond the EU and particularly to Crown dependencies, overseas territories and countries such as Australia, New Zealand and elsewhere. I am very happy to have those discussions with him.

My opposite number, the hon. Member for Ellesmere Port and Neston, raised a number of points, one of which was the impact on people with long-term conditions. I agree that, without reciprocal healthcare, people with long-term conditions, including those who need dialysis, may find it harder to travel, which is the very essence of why the Bill is necessary, so that we can implement a reciprocal arrangement with the EU or, failing that, with individual member states to support the travel arrangements of those with long-term conditions.

The hon. Gentleman also questioned the £66 million figure that I referenced in my speech, and I am happy to point out that that was in relation to the 2016-17 value of claims made by the UK to EU member states. He also asked about cost recovery more generally and, since 2015, we have increased identified income for the NHS under reciprocal arrangements by 40%, and directly charged income has increased by 86% over the same period. I mentioned the increased focus on that to my hon. Friend the Member for Crawley (Henry Smith), which I hope gives a signal of intent as to the direction of travel on cost recovery.

The hon. Member for Ellesmere Port and Neston also mentioned the role of NHS Improvement, and I am happy to clarify that it is now working with more than 50 NHS trusts to improve their practices further, with a bespoke improvement team in place to provide on-the-ground support and challenge in identifying and sharing best practice.

The hon. Gentleman also mentioned an important point, and one that we will probably go into in more detail in Committee, on data. Again, the policy intent is continuity, rather than a change in our approach to data. Clause 4 expressly contains a safeguard for personal data, which can be processed only where necessary for limited purposes or funding arrangements. That covers, for example, where someone is injured while abroad, where personal data of a medical nature often needs to be shared to allow treatment to take place. At the same time, there are safeguards in the Bill, which I am sure we will explore.

My hon. Friend the Member for North Thanet expressed concern about cherry-picking, and I recognise his point. That is why we are looking for the reciprocal arrangements to continue, although even in the event of no deal and no bilateral deal, local arrangements often apply for healthcare, such as on the basis of long-term residency or previous employment. Those would be local factors, but obviously the policy intent is to have an arrangement with countries across the EU.

The hon. Member for Linlithgow and East Falkirk (Martyn Day) and my hon. Friend the Member for East Renfrewshire (Paul Masterton) spoke about the work of the devolved Assemblies and how we liaise with them. Indeed, I spoke with my Welsh counterpart just yesterday. In the other place, the Parliamentary Under-Secretary of State for Health has been working closely with the devolved Assemblies, as have colleagues and officials in our Department. How we work with the devolved Assemblies is a pertinent point, and we are keen to continue that active dialogue.

My hon. Friend the Member for Poole (Sir Robert Syms) correctly identified the importance of the EHIC card and of inward tourism to the UK. The point about continuity was reinforced by my hon. Friends the Members for Chichester (Gillian Keegan) and for Chelmsford (Vicky Ford) in their thoughtful contributions. It was also echoed by my hon. Friend the Member for Walsall North (Eddie Hughes) when he highlighted the importance of taking a practical approach to how these arrangements apply.

My hon. Friend the Member for Totnes (Dr Wollaston) raised a number of detailed points, and I am happy to have continued dialogue with her on them, although I hope she will draw some comfort from recent quotes and legislative developments in a number of EU27 states. For example, the French Minister for European Affairs said, “France will do as much for British citizens in France as the British authorities do for our citizens.” France has legislation under way. The Spanish Prime Minister said, “I appreciate, and thank very much, Prime Minister May’s commitment to safeguarding those rights. We will do the same with the 300,000 Britons who are in Spain.”

Again, I hope the fact that we actually pay out more to the EU than we currently receive, and the fact that both nations benefit from a reciprocal arrangement, gives an idea of the starting point of the discussions. Like my hon. Friend, I would welcome it if that were done across the EU27 as a whole.

My hon. Friend also raised the issue of dispute resolution, and the current arrangements between the UK and other member states require states to resolve differences, in the first instance, between themselves. That is the existing position that applies, but clearly it would be a matter for negotiation as to how a future UK-EU agreement might be governed. That is a cross-cutting issue; it is not one pertaining solely to this Bill.

It is clearly in the interests of the British public to ensure reciprocal healthcare, arrangements, similar to those currently in place, continue when we leave the EU, whether that happens through an agreement with the EU itself, as we very much want, or through individual arrangements with EU member states.

Oral Answers to Questions

Philip Dunne Excerpts

Tuesday 24th July 2018 Commons Chamber

[Steve Brine]

We are looking at the future of the cancer drugs fund as part of the new 10-year plan. There is a radiotherapy review at the moment, as the hon. Gentleman will be aware. Knowing him, he will be engaging with the review in his area. He talks about the latest radiotherapy and, of course, we have the new proton beam therapy treatment coming online in London and Manchester, for which children and patients are currently sent overseas. That is a great step forward, but there is an awful lot more to do, which is why the 10-year plan will have cancer at its heart.

[Mr Philip Dunne (Ludlow) (Con)]

18. What assessment he has made of the opportunity for artificial intelligence tools to improve the provision of healthcare.

[The Secretary of State for Health and Social Care (Matt Hancock)]

The Government believe that artificial intelligence and other digital technologies have the potential to transform health and care services. Our work on that includes investing over £400 million in tech transformation, which I announced last week. There is much more to do.

[Mr Dunne]

I also welcome my right hon. Friend to his new role. He will bring tremendous energy and enthusiasm, particularly into the information advantage that we know is needed to transform the NHS. Does he share my view that not only will this transform patient outcomes but we can use artificial intelligence to improve patient treatments? What are his initial views of the obstacles standing in the way of rapid uptake of such technologies?

[Matt Hancock]

There are huge opportunities for AI to improve patient outcomes and to make life easier for staff. In answer to the second part of my hon. Friend’s question, it is all about getting interoperable data rules and standards in place so that different systems can talk to each other in a secure, safe and innovative way.

Gosport Independent Panel: Publication of Report

Philip Dunne Excerpts

Wednesday 20th June 2018 Commons Chamber

[Mr Hunt]

There can be no justice unless the truth is put on the table. That is the crucial first step, and now justice must proceed. I thank the hon. Gentleman for his campaign for Mrs McKenzie. Perhaps the best words I can use are these of the panel in the report:

“Yes, we have listened and yes, you, the families, were right. Your concerns are shown to be valid.”

[Mr Philip Dunne (Ludlow) (Con)]

I echo the tributes to the work of Bishop James Jones and the integrity and diligence that he and the panel have shown in conducting this inquiry. The Secretary of State has rightly focused on the impact on families, and I was pleased to hear in his statement that there will be a helpline for families who suspect that they have been affected—not least because the immediate catchment area around Gosport includes a lot of retirement homes, and many families whose elderly relatives went to the area to retire may live some distance away. Given the publicity that the report has given rise to, a considerable number of people may need to get in touch. Will he ensure that the helpline is adequately resourced?

[Mr Hunt]

Yes, I will absolutely do that. I ought to say that I know my hon. Friend met many families and relatives during his time as a Minister in my Department, and he always dealt with those cases with a huge amount of compassion. The facts of the matter are, according to the report, that 650-plus people had their lives shortened, but we are in touch with only about 100 families, so we are expecting more people to come forward.

Oral Answers to Questions

Philip Dunne Excerpts

Tuesday 19th June 2018 Commons Chamber

[Stephen Barclay]

I fear that the hon. Gentleman wrote his question before yesterday’s announcement. I thought that he might have started by welcoming the additional £2 billion of investment that Scotland’s NHS will be receiving. We are making historic investment in recruitment, which is why we are opening five new medical schools in England, training 1,500 new medical doctors, taking initiatives such as on apprenticeships and opening new pathways into clinical roles.

[Mr Philip Dunne (Ludlow) (Con)]

While I welcome yesterday’s announcement and the workforce strategy that is coming out in the autumn, will the Minister comment on the Home Office’s new proposals to allow greater flexibility for professional clinicians coming to work in the UK, and on what impact that might have on filling vacancies?

[Stephen Barclay]

My hon. Friend is right to draw attention both to the Home Office’s welcome announcement on tier 2 visas and to the work on the workforce strategy, in which he played a key role. It will ensure that we have the right workforce for the NHS for the next 10 years.

NHS Long-Term Plan

Philip Dunne Excerpts

Monday 18th June 2018 Commons Chamber

[Mr Hunt]

It is funny, isn’t it: the hon. Lady says that this is not enough, but she did not say that when her own party was offering almost half the amount at the last election. She also says that every economic expert says that it is not enough. Let me tell her about one economic expert that does not say that—the Institute for Public Policy Research, left-leaning, in a piece of work done by Lord Ara Darzi, a former Labour Health Minister, who says that 3.5% is enough.

[Mr Philip Dunne (Ludlow) (Con)]

May I wholeheartedly congratulate my right hon. Friend on this historic achievement in securing a long-term funding increase for the NHS? I suspect that it is because he is now the longest-serving Health Secretary that he has the credibility within Cabinet to secure this achievement. I also congratulate him on proposing to get the NHS to develop a 10-year plan alongside a long-term workforce plan—which is such a critical element of this—and a long-term capital funding plan, because this needs to be seen coherently alongside the social care Green Paper. Bringing them all together at the right time must be the right thing to do. Will he, as part of the deployment of this new-found funding, look to use the data revolution to innovate to ensure that we have world-class data driving better patient outcomes?

[Mr Hunt]

As usual, my hon. Friend speaks very perceptively. When he was a Minister in my Department, he did a fantastic job in getting our capital funding and our workforce planning into a much, much better place. He is right. Although this is a big opportunity for the NHS, we must not make the mistake of solving yesterday’s problems tomorrow. A huge data and tech revolution is about to happen in healthcare all over the world, and we must make sure that we are at the forefront of it.

NHS Outsourcing and Privatisation

Philip Dunne Excerpts

Wednesday 23rd May 2018 Commons Chamber

[Jonathan Ashworth]

Let me make a bit of progress and then I will try to let others in.

If the Secretary of State brings forward legislation, we will work constructively with him.

The latest and perhaps most pernicious consequence of underfunding is the move to so-called wholly owned subsidiaries. Many are saying that this is a VAT scam. Hospital trusts feel that, because of underfunding, they have no option but to transfer staff to these so-called subsidiaries, set up at arm’s length but still owned by the trust. We have trusts paying management consultants a total of £3 million, according to freedom of information requests, for advice on setting up these new arrangements. That is money that should be going on patient care. It will mean a two-tier workforce as new joiners no longer need to be on “Agenda for Change” terms and conditions. That looks to many like forcing staff to pay for the Government-imposed financial crisis in the NHS.

[Mr Philip Dunne (Ludlow) (Con)]

I thank the hon. Gentleman for giving way. He is under a lot of pressure, rightly, in this debate. When he selected the motion for the Opposition debate today, was he aware, given the liturgy of supposed privatisation that he has alleged has taken place under this Government, that the proportion of spend on the independent sector under the Conservative Government in the last year was zero and that the proportion of spend on the independent sector in Wales, run by the Labour Administration, went up?

[Jonathan Ashworth]

I am grateful to the former Minister of State. We do miss him during our exchanges at the Dispatch Box. The figures that he has quoted are different from those provided by the Library. The Library says that the percentage of the total budget spent on private providers has gone up to 1% in Wales, but it has gone up by 2% in England in the past year. The Department of Health and Social Care may have different figures, but those are the figures from the Library.

Oral Answers to Questions

Philip Dunne Excerpts

Tuesday 8th May 2018 Commons Chamber

[Steve Brine]

Obesity has rightly had a strong outing today. We know that it is a leading cause of type 2 diabetes; supporting people to live healthier lifestyles can only reduce the incidence of the disease. So far, more than 170,000 people have been referred to the national diabetes prevention programme. Those who are referred receive tailored, personalised help, including education on healthy eating and lifestyle choices, and bespoke physical exercise programmes.

[Mr Philip Dunne (Ludlow) (Con)]

Is my right hon. Friend aware that following his decision to make the capital allocation to Shrewsbury and Telford Hospital NHS Trust before Easter, that trust has had sufficient confidence to successfully appoint five additional consultants in 10 days in April, thereby improving resilience in acute healthcare in Shropshire?

[Stephen Barclay]

I very much welcome the progress that my hon. Friend has shared with the House. Many of us will also want to pay tribute to his leadership during his time at the Department in recognising the opportunity for reconfiguration that the capital would unlock and is now delivering.

Breast Cancer Screening

Philip Dunne Excerpts

Wednesday 2nd May 2018 Commons Chamber

[Mr Hunt]

The hon. Lady has asked some important questions. I am sorry if what I said was not clear, but I do not think I said that there was no need to diagnose early. It is obviously incredibly important for cancer to be diagnosed as early as possible. What I said was that I had been advised that in many cases, because of advances in breast cancer treatment, it would not make a difference to the particular women affected in this case. I fully accept that in some cases it will, and of course it is very important to diagnose all cancers as early as possible.

I will find out from Oxford University the dates on which it expects to report the full outcome of the AgeX trial. Obviously we all want to hear the results as soon as possible. I will also inform the hon. Lady of the exact date on which Scottish Government officials were informed. Let me reassure her that if there are any additional costs to the Scottish health system, it will of course be recompensed.

We do not think that major pressures will be created in the Scottish screening programme, and we are confident that we will be able to contact everyone in the UK who is registered with a GP—whether in Scotland, Wales, Northern Ireland or England—by the end of May. We have had very productive discussions with Scottish officials about the IT exchange that will be necessary to ensure that women living in Scotland also receive their letters by the end of May. We cannot guarantee that every single one of them will have been contacted by then—some will have moved abroad, and some will not be registered with a GP for whatever reason—but we think that we can contact the vast majority, and the helpline will be open for anyone to call if they think they may have been affected.

[Mr Philip Dunne (Ludlow) (Con)]

I think that Members on both sides of the House have appreciated the measured way in which my right hon. Friend has come to the House and revealed detailed commitments to helping the women who have suffered as a result of this terrible, unfortunate IT event. I also think that the measured response from the hon. Member for Leicester South (Jonathan Ashworth) properly reflected the concern that everyone shares.

My right hon. Friend referred to additional screening capacity to ensure that there is no impact on other, younger women. What undertakings can he give to any women who have been affected, and who find that they are suffering from a malignant growth in their breast, that they will be able to receive the appropriate treatment as rapidly as possible?

[Mr Hunt]

I thank my hon. Friend for the work that he did on cancer when he was working at the Department of Health, and for his broader work in supporting the hospital sector. He is absolutely right: additional people will come forward for treatment, so one of the other matters that we have been looking into is our treatment capacity. We certainly intend to ensure that people are treated within the normal short period if a cancer is detected, and the first step in that process is to ensure that everyone has a scan in the next six months. During that period, we will make certain that they are able to look forward to the same rapid treatment that all other people whose cancers are detected can be confident of receiving.

National Bereavement Care Pathway

Philip Dunne Excerpts

Tuesday 24th April 2018 Commons Chamber

[Will Quince]

I thank my hon. Friend for that intervention and for the considerable work that she has put into both the formation and the ongoing work of the all-party group. She makes a really good point. Those services are not always religious, although most of them tend to be in some way, shape or form, and they are hugely important and comforting to families. I know that she has organised several, and various charities organise them too. They are about not just the religious element but people being able to come together and pay their respects to the children they have lost. They bring about a community and show people that they are not alone and that there are others who have gone through the same or very similar experiences. Long-lasting friendships often flow from them. I remember a service that I attended with my wife—I think it was the year after we lost our son. There was a lady there in her 80s who still came to the service every year to remember the child she lost in her late teens. That shows that the experience stays with people forever, and that these services are really important.

With the evidence showing that the pathway is making a really big difference in improving the quality of bereavement care in the hospital trusts in which it is being piloted, the aim is to roll it out across the country in October. As I said at the beginning, 11 sites launched last October and a further 21 last week, and a nationwide launch in October is very much the ambition. Sands established the project on behalf of the core pathway group, entirely thanks to £50,000 of funding from the Department of Health and Social Care. I am extremely pleased to see my hon. Friend the Member for Ludlow (Mr Dunne), the former Care Quality Minister, in his place, because he did so much with the Secretary of State to help secure that funding.

[Mr Philip Dunne (Ludlow) (Con)]

I hesitate to rise after that generous tribute, but may I say that I am absolutely convinced that without the work of my hon. Friend and his colleagues in the all-party group, we in the Department would not have given this issue the prominence that it has achieved under their leadership? In particular, I wish to mention the role that Sands has played in driving this agenda forward. I pay tribute to that organisation and all the bereaved parents that it represents, and I congratulate my hon. Friend on securing yet another debate on this topic.

NHS Staff Pay

Philip Dunne Excerpts

Wednesday 21st March 2018 Commons Chamber

[Mr Hunt]

We would have more nurses in mental health if we had not had to deal with the crisis at Mid Staffs and pronounced short staffing in our acute hospitals. Since I have been Health Secretary, we have 15,000 more nurses in the NHS and we are also finding more money to go into mental health. It is time that the hon. Lady recognised that, rather than trying to paint the opposite picture.

[Mr Philip Dunne (Ludlow) (Con)]

I add my voice to those congratulating the Secretary of State and his ministerial team on a tremendous achievement in discussions with the Treasury to secure this additional funding. I invite him to comment on the work that has been done by the health unions and the Royal College of Nursing, in particular, in helping to deliver this agreement and particularly to give many of the people on starting salaries a significant uplift, which he referred to earlier. This will make it easier to attract people to the vital starting roles for future generations.

[Mr Hunt]

I would like to pay tribute to my hon. Friend because, when he was working in my Department, he laid a lot of foundations for this deal. He chaired some very important meetings. In particular, one of the most important areas of consensus that has emerged, which he should take enormous credit for, is that we are saying today that the minimum salary for anyone working in the NHS will go up by £2,000. That is going to make a huge difference—100,000 people will benefit from that important change—and he should be very proud of that.