Oral Answers to Questions
Debate between Philippa Whitford and Matt Hancock(4 years, 6 months ago)
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Matt Hancock
We will see shovels in the ground, I very much hope, from next year. I pay tribute to my hon. Friend, who has campaigned endlessly for these improvements to the hospital in Redditch. There is no better supporter of Redditch than her. She has badgered me endlessly, met me formally and bumped into me on the campaign. Every time I see her, she says, “Can we have the improvement to the hospital?” and the answer is yes.
Dr Philippa Whitford (Central Ayrshire) (SNP)
The Secretary of State says that the NHS is not on the table, but President Trump and his trade officials have been very clear that they will seek to more than double drug prices, driving up the bill from £18 billion to £45 billion a year. What discussions is the Secretary of State having, and does he accept that this is why devolved Governments must have input in trade deals?
Matt Hancock
The NHS is not on the table in any trade deal. Medicine pricing and drugs pricing is not on the table in a trade deal. Let me bring the hon. Lady’s attention to this quotation from the former US trade general counsel, Stephen Vaughn, who said that if the UK really is determined to make no changes at all on pharmaceuticals, we can absolutely hold that position and that that has nothing to do with them. Quite right —we do hold that position; they are off the table.
The National Health Service
Debate between Philippa Whitford and Matt Hancock(4 years, 6 months ago)
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Dr Philippa Whitford (Central Ayrshire) (SNP)
Before I start my speech, I would like factually to correct the Secretary of State, who claimed that Barnett consequentials in Scotland are not passed on. I reassure him they are all passed on. He talks about the figures as a percentage. Scotland spends £185 a head more on healthcare and £157 a head more on social care. Of course it is a smaller percentage but, in actual cash, Barnett consequentials are all passed on. I would be grateful if he would either improve his maths or stop repeating this narrative.
I really welcome some elements of the Queen’s Speech, particularly the Health Service Safety Investigations Bill. I was asked to serve on the Joint Committee, which I felt did an incredible job, but we completed that job last July; approaching a year and a half on, sadly, the Bill has still not come forward. I hope it will not be too tardy from this point.
Dr Whitford
Okay; I welcome that. However, I would suggest that the Healthcare Safety Investigations Bill is about looking at mistakes after they have happened. I invite the Secretary of State again to look at the Scottish patient safety programme, which is more than 10 years old and has reduced hospital deaths, including post-surgical deaths, by over a third because the aim is to prevent harm in the first place.
I welcome the Secretary of State’s reference to whistleblowers, but it is not just about having guardians in hospitals. It is critical that the Public Interest Disclosure Act 1998 is reformed. Only 3% of employment tribunals are successful. All Members who have dealt with any cases on this issue will know that the wreckage of whistleblowers’ careers acts as an absolute brake on people coming forward. You can say what you like, but they are faced with the question, “Do I speak up and risk my career, my family income and my home?” It is not just a matter of paying lip service to this issue; we actually need change.
I welcome the ending of the private finance initiative, which was originally brought under a Conservative Government, but was really accelerated, I am afraid, under Gordon Brown. We are now facing the fact that £13 billion-worth of hospitals in England will have cost £80 billion by the time they are paid off. I call on the Secretary of State not just to end the PFI going forward, but to look at whether these contracts could be ended and renationalised to avoid another £55 billion having to be paid over the next 30 years. This problem is UK-wide, so we were saddled with these contracts in Scotland as well. There are health boards across England that are spending up to 16% of their income on their PFI contracts, and that obviously undermines patient care.
Oral Answers to Questions
Debate between Philippa Whitford and Matt Hancock(4 years, 10 months ago)
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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.
Listeria: Contaminated Sandwiches
Debate between Philippa Whitford and Matt Hancock(4 years, 10 months ago)
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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.
Oral Answers to Questions
Debate between Philippa Whitford and Matt Hancock(4 years, 12 months ago)
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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.
Social Media and Health
Debate between Philippa Whitford and Matt Hancock(5 years ago)
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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.
Access to Medical Cannabis
Debate between Philippa Whitford and Matt Hancock(5 years ago)
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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
Oral Answers to Questions
Debate between Philippa Whitford and Matt Hancock(5 years, 2 months ago)
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Matt Hancock
I have already given the assurance that if everybody does what they need to do, I am confident that supplies will be unhindered. In the case of insulin, the stockpiles are already double what we requested. However, on the point about the deal, the hon. Gentleman has a really important point about ruling out no deal being the best thing for people’s supply of medicines. He knows as well as I do that if we want to rule out no deal, we need to vote for a deal, so he and everybody in this House should vote for the deal.
Dr Philippa Whitford (Central Ayrshire) (SNP)
The serious shortage protocol statutory instrument would allow pharmacists to dispense alternative drugs when there is short supply, but, crucially, without consulting a GP. The problem is that they cannot access patients’ records and might dispense a drug that has previously caused serious side effects. Is the Secretary of State really expecting such extensive shortages that phoning a GP will be impractical?
Matt Hancock
This change is to respond to the shortages that happen from time to time regularly in the NHS. Given that the supply of 12,300 drugs is typical across the NHS, there are always some logistical challenges. This protocol is to try to ensure that we can respond to those challenges as well as possible. Pharmacists are highly trained in what they do and perfectly able to carry this out as proposed.
Dr Whitford
The problem is that the key issue is not consulting the GP. The medical legal responsibility for any problems normally lies with the prescriber, yet the General Medical Council was not even consulted on this SI. Does the Secretary of State really think that such a significant change should be pushed through with a negative resolution and no scrutiny and debate?
Matt Hancock
Well, it is getting scrutiny and debate now. The change that is being proposed is about making sure we can get people the drugs they need. Of course the responsibility is on the pharmacist to ensure that it is the appropriate drug and, if necessary, that the GP is involved. However, it is absolutely right that we make changes to ensure that we have an unhindered supply of medicines whenever there are shortages—whether that is to do with Brexit or not.
Oral Answers to Questions
Debate between Philippa Whitford and Matt Hancock(5 years, 3 months ago)
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Matt Hancock
We are working to ensure that the prioritisation of not just medicines, but medical products and other things needed for the health of the nation, is taken into consideration. There is detailed work under way that is clinically led; the medical director of the NHS is heavily engaged in that work and works very closely with the Department on it. I am very happy to go through the details of my hon. Friend’s constituency case to make sure that that is also being dealt with appropriately. I am glad that, because she does not want no deal, she will be voting with the Government tonight.
Dr Philippa Whitford (Central Ayrshire) (SNP)
Legislation was passed two years ago so that the Secretary of State could end profiteering by some drug companies. Now drug shortages after a no-deal Brexit could mean soaring costs across UK health services, so why have the Government not set the regulations from this legislation so that we can use the powers and avoid a black market in medication?
Matt Hancock
We have already taken action to ensure that the cost of drugs is reduced. I am very happy to write to the hon. Lady with the extensive details of the agreements that have been made. The legislation is indeed important; so, too, is working with the drugs companies to make sure that we keep those costs down and yet also get the drugs that people need.
Dr Whitford
As the precursors of medical radioisotopes have a half-life of less than three days, they cannot be stockpiled. I have frequently asked the Government how they will maintain a steady supply if there is a no-deal Brexit. Can the Secretary of State answer—and please don’t say “Seaborne Freight”?
NHS Long-term Plan
Debate between Philippa Whitford and Matt Hancock(5 years, 3 months ago)
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Dr Philippa Whitford (Central Ayrshire) (SNP)
I note that the Secretary of State referred to the Churchill Government in 1944, but had he looked at Hansard he might have seen that Churchill cited the Highlands and Islands Medical Service, which was the first national health service in 1913.
I welcome the long-term plan, but the integration to which it aspires is going to be frustrated if there is no reform of the internal market and the fragmentation continues. The Secretary of State cites the funding, which he describes as 3.4% per year. That is actually just back to what the NHS received prior to 2010. He talks about a million extra patients. With this enormous increased demand, does he not think that it would be more honest to describe funding per head, rather than just a total? Scotland spends £163 more per head. Perhaps he should aspire to spend the money on the patients and then perhaps the NHS would keep up.
Again, like the previous funding agreement, the funding is focused only on the NHS, with cuts to public health, no extra money for health education and still no Green Paper on social care. I totally agree that prevention is better than cure, so will the Secretary of State reverse the cuts to public health? In his own letter, which was circulated, he emphasised reducing cancer deaths, yet there was no mention of prevention at all. That is the best way to reduce cancer deaths. Public health is crucial, smoking cessation is crucial and tackling childhood obesity is crucial, so will he liaise with his colleagues in the Department for Digital, Culture, Media and Sport and set a nine o’clock watershed on advertising rubbish foods?
I agree with the aim of improving screening. Last year, the Government agreed that they would reduce the bowel cancer screening age from 60 to 50. Can the Secretary of State tell us when that will actually happen? Does he recognise that it will mean a bigger need for endoscopists and radiologists? So will he fund Health Education England to provide them and to provide the other doctors, nurses and staff that the NHS will need to deliver this long-term plan?
Matt Hancock
My response is yes on the cancer screening—it is in paragraph 3.53. I want to return to the point that was made by the hon. Lady and by my right hon. and learned Friend the Member for Rushcliffe (Mr Clarke) about the link to social care. Of course that is critical. The plan has a section on the link to social care and the social care Green Paper will then tie into the plan. Of course, the two come together and the Green Paper on social care will be provided soon.
Gosport Independent Panel
Debate between Philippa Whitford and Matt Hancock(5 years, 5 months ago)
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Matt Hancock
My hon. Friend is absolutely right that the number of complaints and concerns raised is not the material factor. A complaint that is actively welcomed and then acted on by management is merely part of the improvement process of any organisation. We should be open to them, welcome them and see them as an important part of the continuous improvement of NHS trusts, which is how many successful organisations see them. As I set out in the statement, medical examiners will be introduced from next April, but I am happy to give her more details of that whole policy.
Dr Philippa Whitford (Central Ayrshire) (SNP)
I, too, welcome the Secretary of State’s statement and the proposals in it. As he says, these 450—possibly even 650— deaths were not accidental, but deliberate.
I welcomed the Secretary of State’s attendance at our event yesterday, when we discussed the need for a just and learning culture in the NHS. Obviously, he heard the stories that were related during the event: stories of patients who had lost their lives, and families who have ended up spending their entire lives fighting for justice or change, so they have suffered over and above their bereavement. Staff were obviously not listened to. One witness compared a whistleblower with someone reporting to the police, or a state witness, and pointed out how shocked we would be if the police tried to shut that case up. Whistleblowers should be welcomed as people giving evidence against wrongdoing or failure.
I particularly welcomed the Secretary of State’s comment about reform of the Public Interest Disclosure Act 1998, which I think needs to be replaced. I think we need legislation that gives definite protection to people who come forward. As one who has been a clinician for more than 30 years, I can tell the Secretary of State that the long trail of clinicians who have reported concerns and then had their careers ended lies there like a threat to every whistleblower who thinks of speaking up.
If patient safety and the ability of people to speak up in safety are not enshrined in the NHS, we are all under threat. I am sure that not just the hon. Member for Leicester South (Jonathan Ashworth) but Members in all parts of the House would work with the Secretary of State to reform the legislation here and inspire the culture change that is needed in the NHS itself. I certainly would.
Matt Hancock
I agree with an awful lot of what the hon. Lady has said, and I appreciate the wisdom that she brings to this issue with her clinical experience.
The need for a just culture in the NHS is very clear, and the Gosport report makes it clearer still. A just culture means that, yes, there is accountability, but the accountability is established with the intent that the system will improve and people will learn; that people can come forward with concerns rather than covering them up; and that when concerns are expressed, they are welcomed.
I am also pleased about the hon. Lady’s attitude to potential legislation. I look forward to working with her, and, indeed, learning from some of the improvements that have been made in Scotland, to try to ensure that we can get this right.