Oral Answers to Questions

Philip Dunne Excerpts

Tuesday 17th October 2023 Commons Chamber

[Steve Barclay]

We are reforming the NHS workforce more fundamentally, looking at how we expand the roles that dental hygienists and dental therapists can perform. We are looking at how we can boost training, which is why we have made the commitment for more dentists in the long-term workforce plan, backed by £2.4 billion. How does that help? It increases the number of dentists being trained and we have a quarter more activity compared with last year.

[Philip Dunne (Ludlow) (Con)]

T2.   Can the Minister confirm that the £312 million capital investment to transform the Shrewsbury and Telford Hospital NHS Trust acute hospitals is on track through the NHS approval process, with its outline business case, to enable a full business case to be concluded in the coming months so that construction can commence during this financial year?

[The Minister for Health and Secondary Care (Will Quince)]

My right hon. Friend has long championed this cause. I hope it is good news that I am able to confirm that enabling works have recently been approved for the Shrewsbury and Telford Hospital NHS Trust hospital transformation programme and are expected to commence this financial year. I can also confirm that funding has been provided for the development of the full business case and is expected to be submitted in the coming months.

Huntington’s Disease

Philip Dunne Excerpts

Wednesday 9th November 2022 Westminster Hall

[Hilary Benn]

I say to my hon. Friend, which he is on this occasion, that I am grateful for his attendance today and I agree with every point he has made. I will discuss research towards the end of my speech.

Young people who grow up in the shadow of Huntington’s face daunting choices about genetic testing and whether to start a family. Should a young person tell a new partner about the condition? When should they tell their partner? How will the partner react? Many young people care for relatives while worrying that they will get the disease themselves. A Huntington’s family member put it like this:

“Huntington’s is a thief that slowly steals your body, energy, health, family, friends and the person you used to be.”

Last year, a community survey undertaken as part of the Huntington’s Disease Alliance UK and Ireland Family Matters campaign—that is quite a title—found that 98% of carers felt that Huntington’s had negatively affected their loved one’s emotional wellbeing; 88% said the disease had changed their relationship forever; and 70% went so far as to say that the impact had been either extremely difficult or life ruining, saying, “It has ruined our lives.”

The disease has a huge effect on family finances and on the ability to work of the person and those who care for them. Sufferers eventually cannot hold down a job, their carer may have to give up their job to look after them, and all the while the bills mount. Income support and financial assistance to meet the cost of equipment and home adaptations is available, but it is limited and difficult to access. That is particularly the case for someone with Huntington’s who does not yet display physical symptoms, and is therefore incorrectly believed not to be symptomatic and not entitled to financial support. That means that people who display only the less visible symptoms—say, mental health or cognitive ones—cannot get the help despite their debilitating effect. That cannot be right.

[Philip Dunne (Ludlow) (Con)]

I add my congratulations from the Government side to the right hon. Gentleman on securing this debate and raising awareness of this appalling condition, and on his very powerful speech. He is talking about the support services available to the families and victims of this disease; because there is no national guidance, that is now a matter for the individual integrated care boards, which have replaced clinical commissioning groups. Does he agree that one of the outcomes of his securing this debate might be that the Minister commits to at least consider encouraging the National Institute for Health and Care Excellence to establish national guidelines to ensure consistency of support throughout the country?

[Hilary Benn]

I am extremely grateful to the right hon. Gentleman for making that point; he anticipates my argument exactly. I and many other people think that is exactly what ought to happen for the very reasons he set out.

What needs to be done and how can the Minister help? That is why we are here today. First, we have to raise awareness of the impact of the disease and the suffering of those with it and their families. By acknowledging what it is and talking about it, we can help families who all too often choose the path of silence and shame because they do not want to talk about it to anybody else. We should say with one voice that no one should have to carry this burden alone.

Secondly, families need more support, including financial help and better care. There is some wonderful expertise in hospitals and a number of centres of excellence throughout the United Kingdom, including the Huntington’s Disease Centre at University College London, but outside those specialist centres it is a different story. At the moment, it is hit or miss; it was put to me recently that it is more miss than hit in areas without specialist support. Social care is of course vital to help those with Huntington’s to manage day-to-day life. The cost of private care for someone with Huntington’s can amount to thousands of pounds a week—who can afford that? Some councils provide specialist care homes, but not all.

Let us begin by having a care co-ordinator—a Huntington’s disease specialist—in every community to help to identify and keep in regular contact with Huntington’s families in their area and guide them through the range of support that they need to meet their requirements. They would also help to improve understanding of the disease on the part of other health and social care professionals. It is hugely complex, and how it presents itself and the sheer scale of support that sufferers require are much misunderstood.

Ambulance Pressures

Philip Dunne Excerpts

Monday 18th July 2022 Commons Chamber

[Steve Barclay]

The hon. Gentleman is right that the west midlands in particular has been under significant pressure, and 111 ambulance service response times are significantly challenged, which is driven by wider system pressure and delayed handing over of patients. The measures taken through the national support that is going in include handover delay improvements, on which works is taking place across all integrated care boards. NHS England has allocated an additional £150 million to support the system, and an extra £20 million of capital is going into fleet. Given that I am new in post, I am happy to meet the hon. Gentleman to discuss any specific issues about the West Midlands ambulance service’s performance.

[Philip Dunne (Ludlow) (Con)]

May I congratulate my right hon. Friend on his new role and say how important, given this particular crisis, his previous experience as Minister of State for Health is? He took over that role from me, and he had ministerial responsibility for ambulances.

On Friday, I attended an ambulance summit with other Shropshire and Telford MPs, West Midlands ambulance service and NHS leaders in Shropshire, where we were told that one of the critical issues in ambulance response is the handover wait times at hospitals. Royal Shrewsbury Hospital was averaging two and a half hours for handover in the first two weeks of July, and the Princess Royal Hospital in Telford was at three hours.

The problem is not so much conveyance by ambulance because it is hard to reach patients, but ambulatory walk-ins at our hospitals increasing the volumes of patients being seen in A&E. The problem with that increase in patient volume is patient flow and discharge at the far end. May I suggest that the quick win would be to increase resources for social care, particularly for domiciliary care workers who at present, particularly in rural areas, have to pay for their own transport to get from one patient to another? If we could improve those conditions, it would boost the ability to discharge patients.

[Steve Barclay]

My right hon. Friend, partly through the direct experience he brings to these issues, highlights the integrated nature of the challenge we face and in particular the importance of getting the right domiciliary care and care home support in place. Part of that challenge in the coming weeks, ahead of any autumn and winter pressure, will be to understand what the capacity is and what the constraints on it are, so that through the integrated care boards we can better focus on unlocking that capacity to relieve the pressure on ambulance handovers, as he sets out.

Ockenden Report

Philip Dunne Excerpts

Wednesday 30th March 2022 Commons Chamber

[Sajid Javid]

I agree with the hon. Lady, and she is right to raise the importance of the Morecambe Bay investigation. That report, which I believe was completed in 2015, contained 44 recommendations. Eighteen recommendations that were specifically for the trust have been implemented, and the 26 for the wider NHS are in the course of being implemented.

[Philip Dunne (Ludlow) (Con)]

I thank my right hon. Friend for both the tone and the substance of his response to this devastating report. Let me also add my voice to the consensus throughout the House that the way in which this is handled is vital, and that we must ensure that the NHS takes Donna Ockenden’s recommendations on board. She and her team of more than 90 experienced clinicians are properly being thanked for the work that they have done. They have painstakingly reviewed these cases going back some 20 years, which must have been harrowing for them, as of course it has been for all the families so tragically affected who have had to relive their tragedy.

In particular, I want to praise the courage and tenacity of Rhiannon Davies and Richard Stanton, who were my constituents when they lost their baby Kate in truly awful, and tragically avoidable, circumstances. It was they who kept pressing for answers from Shrewsbury and Telford Hospital NHS Trust. That led me to take them to see the then Health Secretary, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), who agreed to launch this review five years ago. They are no longer my constituents, and I understand that they are now understandably keen to focus their attention on their family, having been living with this trauma since 2009.

I have some questions for my right hon. Friend the Secretary of State. Does he recognise that the Ockenden review has raised fundamental questions for maternity services across the NHS over the culture of so-called normal birth, and that a focus on targets, under successive Governments, rather than on patient outcomes, can distort clinical best practice and, tragically, patient safety? Following his discussion with the trust’s current chief executive, which he has mentioned, is he satisfied that the current management and clinical teams have accepted the “local actions for learning” recommendations in the initial Ockenden report, and are committed to studying and rapidly implementing all further recommendations specific to the trust? Finally, what reassurance can he give the thousands of expectant mothers in Shropshire, Telford and Wrekin that the maternity services there are safe, and that patient safety is paramount?

[Sajid Javid]

I thank my right hon. Friend for the way in which he has worked with the Department and with my predecessor in representing his constituents throughout this investigation. He referred to “so-called normal birth” in his question, and he was right to do so: the only normal birth is a safe birth, which is what the NHS should be working towards, but that did not happen in this trust. The report has made that absolutely clear. Just as important are its recommendations, including some for my right hon. Friend’s local NHS trust. I can reassure him—partly as a result of my conversation earlier today with the current chief executive—that all the recommendations in the interim report have been implemented by his local trust, and all those in this report have been accepted.

Oral Answers to Questions

Philip Dunne Excerpts

Tuesday 23rd November 2021 Commons Chamber

[Philip Dunne (Ludlow) (Con)]

T6. The capital transformation of acute hospitals in Shrewsbury and Telford has been eight years in the making. Will the Secretary of State confirm what is now needed to start delivering the £312 million of capital committed by the Conservative Government to improve Shropshire’s healthcare facilities? Will he also confirm that it does not make sense to head down the rabbit hole of a new hospital and start this whole process all over again?

[The Minister for Health (Edward Argar)]

I am grateful to my right hon. Friend, who has taken a long-term and consistent interest in the matter. The strategic outline case for transforming the Royal Shrewsbury Hospital and Princess Royal Hospital Telford was received at the end of October 2021. It has been reviewed by the NHS and detailed feedback has been given; I look forward to it coming forward to me early next year. We remain committed to delivering the investment and improvement that Shropshire’s hospitals need and that he and his colleagues have helped to secure.

Health and Care Bill

Philip Dunne Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Edward Argar]

I want to make a little more progress. I will not give way to one of my hon. Friends or to the hon. Lady at this moment.

This will be done by amending the provisions to clearly describe the information that must be included in a personal budget so that individual contributions count towards the cap at the local authority determined rate, and to ensure that personal budgets and independent personal budgets work as they were originally intended when being used in conjunction with the cap.

Before turning to integrated care boards, let me put it on record that, once again, this must be regarded as part of a package of measures that improves significantly on the current provision in place for those funding care.

[Philip Dunne (Ludlow) (Con)]

I am extremely grateful to my hon. Friend for giving way. Before we leave the subject of the cap, can he just confirm that this proposal includes the costs of domiciliary care, which had not been included under the original Dilnot proposals that are exercising Labour Members?

Oral Answers to Questions

Philip Dunne Excerpts

Tuesday 19th October 2021 Commons Chamber

[Edward Argar]

In respect of the elective recovery fund and the thresholds, the hon. Lady recognised that they are an additionality alongside the record extra investment that we are putting into our NHS. We are putting more resources in, alongside reform and innovation, to deliver that increased capacity. The elective recovery fund is also designed to stimulate activity and to reward additional costs over and above that activity. We believe it is the right approach to generate that increased activity.

[Philip Dunne (Ludlow) (Con)]

The elective procedure backlog requires appropriate capacity for recovery and rehabilitation, much of which is provided by community hospitals, especially in rural areas. Is the Minister aware that on Friday, NHS Shropshire announced the imminent closure of Bishop’s Castle Community Hospital for patient safety reasons due to a lack of qualified nursing staff? Will he work with me to put pressure on the local NHS to develop a plan to recruit suitably qualified nurses and reopen the hospital as soon as possible?

[Mr Speaker]

On elective surgery.

Health and Care Bill

Philip Dunne Excerpts

2nd reading
Wednesday 14th July 2021 Commons Chamber

[Philip Dunne (Ludlow) (Con) [V]]

I am pleased to support the Bill. It is the first significant reorganisation of healthcare in recent years, and only the second since the Conservatives came into office following 13 years of Labour Administrations who reorganised the health services nine times, so we should not be taking lessons from the Opposition on the timing or the fact of putting things right.

The Bill is very substantial legislation that learns lessons from the way in which the NHS has had to work during the covid pandemic. In particular, the flow-through of patients discharged out of the acute sector as a result of much closer working with social care and local authorities is an integral part of creating the new integrated care boards. I very much welcome the fact that they are being established on a statutory footing and that there will be representation from local authorities and a role for health and wellbeing boards to provide local oversight. That is an essential step to allow the healthcare economy across our communities to collaborate effectively, and to remove some of the artificial barriers.

I will touch briefly on three other points. On the measures proposed for reconfiguration, we in Shropshire have been at the wrong end of a protracted reconfiguration process for our acute hospitals. Streamlining the process by which decisions are made will benefit patients. In Shropshire, it has taken several years to reach the point at which decisions can be made, and at every stage obstacles are put in place that add to delay and uncertainty. As a consequence of that, it is hard to attract staff to a system not working as well as it should, and the system has gone into special measures. The provisions to streamline difficult decisions are therefore very welcome.

Secondly, as my right hon. Friend the Member for South West Surrey (Jeremy Hunt), the Chair of the Health and Social Care Committee, said, the Bill is somewhat light on workforce, but it does include key measures to speed up the ability of physicians trained in other systems to be welcomed into the NHS or to return to the NHS and if they have retired. I urge Ministers in Committee to look carefully at what can be done—

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. I am afraid we are under huge time constraints.

Oral Answers to Questions

Philip Dunne Excerpts

Tuesday 13th July 2021 Commons Chamber

[Robbie Moore (Keighley) (Con)]

What steps he is taking to improve the infrastructure of the NHS estate.

[Philip Dunne (Ludlow) (Con)]

What steps he is taking to improve the infrastructure of the NHS estate.

[Tom Randall (Gedling) (Con)]

What steps he is taking to improve the infrastructure of the NHS estate.

--- Later in debate ---

[Philip Dunne [V]]

The Minister will be aware that, in March 2018, Shrewsbury and Telford Hospital NHS Trust was allocated over £300 million to undertake a radical transformation of its acute hospitals at Shrewsbury and Telford. Since then, the trust’s management have been engaged in finalising the strategic business case, but as a consequence of changes to the Green Book and clinical standards the cost will have increased. Will the Minister commit to meet with Shropshire and Telford MPs once the business case is complete to help to ensure that the project can still be delivered?

[Edward Argar]

NHS E&I and the Department of Health and Social Care wrote to the Shrewsbury and Telford Hospital NHS Trust on 19 November last year confirming we remain committed to supporting the scheme. This letter confirmed the allocation remains at £312 million at this time, and of course my right hon. Friend will recall that I committed to approving the request in principle for £6 million of early funding to continue to develop the scheme. It is an important scheme, we want to see it proceed and I am very happy to meet him and fellow Shropshire colleagues.

Covid-19 Vaccine Update

Philip Dunne Excerpts

Thursday 4th February 2021 Commons Chamber

[Nadhim Zahawi]

The hon. Gentleman is absolutely right that we need to share as much granular data as possible with local public health officials and, of course, make sure that local government can target home by home, individual by individual, as soon as possible. I want to see the CCG-level data published, and the NHS will be doing that very soon. We continue to make sure that we work closely with local government to understand what additional data is needed, and I mentioned Eleanor Kelly joining the team from local government. That is exactly my intention, and the hon. Gentleman raises a really important question, because if we are going to target and reach the hard-to-reach groups in the BAME community, we need that information.

[Philip Dunne (Ludlow) (Con) [V]]

I wholeheartedly congratulate my hon. Friend and all those involved in delivering over 10 million vaccines to the most vulnerable in our communities right across the UK, including at the vaccination hub opened on Tuesday at Ludlow racecourse with support to the local NHS from Royal Air Force medics, volunteers from Shropshire Fire and Rescue Service and Shropshire Council, and many community volunteers. May I ask my hon. Friend to consider most carefully, for those areas where deployment of the Pfizer-BioNTech vaccine proved especially difficult —for example, primary care networks covering remote rural areas, with small GP practices and a sparse population, and lacking suitable premises to host large numbers per day, such as in south-west Shropshire—whether deliveries of the Oxford-AstraZeneca vaccine can be prioritised to ensure that the priority group targets are met?

[Nadhim Zahawi]

My right hon. Friend will appreciate the importance of maximising the vaccine available to GPs by using both the Pfizer vaccine and the Oxford-AstraZeneca vaccine, but in recent weeks the volume of Oxford-AstraZeneca going to GP sites has been higher than that of Pfizer, allowing the flex to visit the housebound and care homes and to deploy at individual practices in rural areas, as he rightly points out. Any site that wishes to discuss its vaccine allocations should do so with its local system in the first instance, and thereafter with the NHS regional team, but I am very happy to look at any specific examples.