(2 years, 4 months ago)
Commons ChamberI commend the hon. Lady for the work that she does through her all-party parliamentary group. The Government recognise the importance of these issues, which is why we recently committed £50 million to improve breastfeeding support in 75 local authorities. I should be delighted to meet the hon. Lady and the APPG.
The reimbursement of travel costs for NHS staff is covered by the NHS terms and conditions, which are agreed jointly by employers and NHS trade unions. The terms and conditions set out the process for reviewing the rate, and that process includes reviewing fluctuations in fuel prices.
Motorists across the country have seen the cost of fuel increase by as much as 60p per litre since this time last year. Fuel costs are penalising the many NHS staff who treat patients in the community for simply doing their job. The current reimbursement rate of 56p per mile drops to 20p after staff have travelled 3,500 miles, and that has not been adjusted since 2014. Does the Secretary of State agree that if the rate of reimbursement does not rise in line with prices at the pump, those staff can easily obtain jobs in the acute sector, where they will not face the extra fuel costs? Given that we want more people to be treated in the community, that would surely be a catastrophe both for staff and for patients at home.
This is an important issue, and it affects different parts of the workforce in different ways. The 56p is higher than the rate approved by Her Majesty’s Revenue and Customs, and, as the hon. Lady said, it drops to 20p after 3,500 miles have been travelled. Of course, the Government are taking other measures more widely in their fiscal response to the cost of living, such as cutting fuel duty, but there is a review mechanism in respect of the NHS specifically, which involves looking at these issues in the round.
(2 years, 5 months ago)
Commons ChamberI assure the hon. Lady that there is a lot of work happening on workforce across the whole of our health and social care services, whether in mental or physical health. Health Education England is working on the matter now and will publish a framework shortly. The workforce strategy set out in our White Paper is just the beginning. We will work closely with adult social care leaders and staff, and the people who draw on that care and support, to implement it now, and to take forward and build on those policies now and in the future. There is a lot of work, and we are serious about it; the hon. Lady can look forward to seeing a lot of documents before the end of the year.
NHS trusts have an integral role in the local health and care system. We expect appropriate engagement between integrated care boards, integrated care providers and the respective NHS providers in an area. An NHS trust is a formal partner of an ICB if it provides any services in the ICB area and has the function of participating in the nomination of members to the board. Regulations give details as to how to determine which trusts that provide services in an ICB area should participate in the nomination process.
Notwithstanding the Minister’s comments, Cheshire and Merseyside integrated care system has recently made the decision to stop my West Lancashire constituents accessing routine dermatology at St Helens Hospital, which is the only nearby provider. Due to geography, my constituents are in the Lancashire ICS, and are therefore not represented in Cheshire-Mersey—in place or local authorities.
My question, which I have asked several times, is: what is the Department doing to ensure that there is a mechanism for my constituents in Lancashire ICS to be represented in Cheshire-Merseyside’s decision-making process, which directly affects the care they are given? I have raised this point about cross-border difficulties so many times that I must question whether we any longer have a national health service, or whether we have a series of protected ICS kingdoms.
The hon. Lady and I speak regularly about different aspects of her local health system, and I am happy to do so again on this matter. I do not know the exact details behind the specific example, but I do not think it relates directly to how ICSs are configured in statute and guidance. I would be happy to meet her to understand the local factors that may have contributed to the situation.
(3 years, 4 months ago)
Commons ChamberI find it very worrying that the Government are choosing to reorganise the NHS during the third wave of the pandemic—a time of exhausted staff and huge pressure. The health service has been stretched to its absolute limits and the road back will be long and difficult. The NHS is scrambling to catch up, yet amid the chaos, the Government want to completely restructure it. Although I support the integration of healthcare and social care, that is not what the proposed integrated care boards and partnerships will achieve.
I am especially concerned that the Bill removes the duty to provide secondary care services, permits the deregulation of all health professions and encourages hospitals to discharge patients prematurely without the assessment of their care needs. In some areas, commissioning responsibilities are up for grabs or even promised to local authorities, which believe they can just use them without the benefit of NHS commissioning experience. There is no doubt that patients and staff will suffer amid the organisational chaos.
I am delighted that this appears to be the end of the disastrous competition of the Lansley Bill, but I doubt we can trust that the end of tendering will mean the end of privatisation. It could actually give rise to privatisation that is unregulated by the tendering process. The private contracts awarded in my constituency have been nothing short of a disaster. To be told that the culprit can have a voice in future decision making is simply unacceptable. How can we allow self-interested, profit-motivated company stakeholders to influence decisions that are supposed to be made with one person in mind—the patient? Remember, it is all about the patient.
I am very concerned about boundaries and the democratic deficit that they will throw up in my constituency. Primary care will be in the Lancashire integrated care system, while acute services will be in the Cheshire-Mersey ICS. My constituents will not be at the table at any point when their hospital services are discussed, as they are not in the Cheshire-Mersey footprint, although their hospitals are—so much for the primacy of place that everybody talks about.
This is a disaster waiting to happen. Many MPs voted for the Lansley Bill with deep and great misgivings. They were right then—the Bill is testimony to that. I implore them not to make the same mistake now.
(3 years, 7 months ago)
Commons ChamberThe National Cancer Registration and Analysis Service works closely with hospital trusts to determine sources of data that can be used to complete the cancer outcomes and services dataset. It also works with the software suppliers of cancer-management systems to ensure that data items can be recorded. Compliance with data standards is monitored by local CCGs, but I recognise that that is not enough, as data is incomplete after some eight years.
Currently, women with metastatic breast cancer are counted only when they die. That is despite the fact that, since 2013, it has been mandatory for trusts to collect data such as the number of women involved, how long they have survived and whether there are any health inequalities. It cannot be acceptable to count only the dead, not the living. Will the Minister commit to ensuring that the 2013 mandatory requirement to collect data on women with metastatic breast cancer is enforced?
Yes. As I explained in my earlier answer, one of the challenges is that there is not a consistent way of capturing the data. We need to sort that out: we need to make it simple; we need to make people understand what data we are collecting; and we need to make sure that, for both breast cancer patients and all metastatic cancer patients, we know where they are and that we are helping them with this disease as effectively as we can.
(3 years, 8 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
My hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) has eloquently summed up the very sad current situation we find ourselves in, so I will begin by stating the obvious: social care is in desperate need of proper levels of funding. Politicians agree that we need funding but then go on to torpedo any of the suggested solutions. When Labour produced a plan, the Tories called it a death tax, and when the Tories suggested a plan, it was rejected by the Opposition. The price of the war of words has been paid not in pounds sterling, but in the undeniable pain and hardship endured by those denied help and care. Calls for working together and royal commissions never amount to any more than words.
Although proper funding is crucial, it is not the whole story. We need a properly funded system that meets the needs of people receiving social care and that really and truly puts them first—one that is provided by a respected and valued workforce. Money will improve care only as the current system will allow. Social care reform needs to be first and foremost a transformation of the culture surrounding the social care sector. For far too long, care has been treated as the problem no one resolves. In 17 years, we have had 13 documents on social care reform, and over a decade of Tory austerity has left social care a far cry from what it needs to be. It is just not good enough in a civilised society.
The disparity between healthcare and social care only makes the problems worse. Many people in the social care sector feel that they are used as a care overflow or relief service, and that they are treated as secondary to the supposedly more important healthcare workers. On top of that, social care is not even reaching potentially hundreds of thousands with unmet needs.
The status of the social care workforce has declined and needs to be drastically improved. How can we expect underpaid, undertrained and overworked staff to give quality care? Staff turnover is huge, so we need a comprehensive workforce strategy, including proper registration and a regulatory body. That would be an important step in bringing social care workers in line with their healthcare colleagues, and in dispelling the misconception that it is a low-skill industry.
Unfortunately, the social care sector includes some unethical and unaccountable providers, who will happily reduce the standards of care, employee support and protection in the name of profit margins. Councils continue to give contracts based on the lowest price, because it works for their budgets. To many, it must seem that the system fails to directly consider the needs of the vulnerable people who rely on those services day in, day out.
We have an opportunity to put social care on a proper footing. We need to grab it with both hands and realise as a country that looking after those in need in our communities speaks volumes about our values and humanity. We need to act fast and act now.
(4 years ago)
Commons ChamberOur strategy is to suppress the virus and support the NHS and the economy until a vaccine can make us safe. Increased ventilation can help to reduce transmission, so it is an important consideration, among many others, for how we tackle this disease.
This Mouth Cancer Action Month is a timely reminder that everybody should seek advice if they are worried. Early in the first wave, dental services were suspended, but rapidly, over 600 urgent dental centres were set up to deliver care. Since June, dentists have continued to prioritise urgent treatment and vulnerable groups and to provide routine care across the dental network. They have worked hard to restore dental activities, while keeping patients and staff safe, owing to some aerosol-generating procedures that mean we have to take particular care in the dental sector.
I recognise the Minister’s comments that people are trying to get back to work in dentistry, but the reality is that there is massively reduced dental capacity; routine dental work is not going ahead as easily as people might imagine. Dentistry also plays a vital role in identifying mouth cancers. Following on from a previous question, I wonder what help the Minister can give dental surgeries to improve their capacity. Currently, they have to have an hour’s gap between patients. I understand that ventilation systems are available, which can help, but unfortunately they are very expensive. What help can Ministers give to enable dentists’ surgeries to purchase that equipment? Can grants be made available? This is a really urgent question.
I recognise the hon. Lady’s concern in this area. I assure her that I am working closely with NHS Improvement and the chief dental officer. I have held several meetings over the past week alone, and tomorrow I am meeting the chair of the British Dental Association. Some areas of challenge that she articulates, such as fallow time and so on, are things that we are actively working on at pace, as well as looking at specific testing solutions for dentistry. We are also looking at the issue of ventilation. I am happy to report when further work has been achieved.
(4 years, 1 month ago)
Commons ChamberThank you, Mr Speaker. Four British teenagers in Sicily continue to test positive after two weeks of isolation. In Britain, they would be back in the community spreading the virus, so does the Secretary of State recognise that a test, trace and retest system is needed to protect us? When could it be implemented? Also, what action can be taken to protect my West Lancashire constituents who have been alerted via social media to the fact that supporters who want to watch the Liverpool versus Everton match this Saturday intend to travel from nearby tier 3 areas into pubs in West Lancashire? This could be a super-spreading event leading to a public health disaster.
I will write to the hon. Lady on the first point. It is a very important point, but the proportion of people who are still infectious after two weeks if they do not have symptoms is thought to be very low. I cannot remember the figure off the top of my head, but it is very low. I will write to her and perhaps publish the letter to explain that scientific fact in full detail.
On the second point, I strongly agree with the hon. Lady. The principle behind the levels is that, if someone is resident in an area on a very high local covid alert level, that level applies to them wherever they are. If someone lives in a lower alert level area and they travel to a higher alert level area, the rules of the higher level apply if that is where they are. People who live in the Liverpool city region should not travel to West Lancs because the pubs are open there. That contravenes the regulations, and I look forward to working with her to try to ensure that that does not happen.
(4 years, 1 month ago)
Commons ChamberMy hon. Friend makes an important point. First, as the chief medical officer has confirmed, this issue does not affect the decisions taken last week, but of course we look at all those decisions each week, and, as my hon. Friend knows, we take as localised an approach as possible, so that rather than bringing in measures for the whole of Teesside, we brought in measures for Middlesbrough and Hartlepool, where the local councils had called for them—whether or not they mentioned that afterwards. We should keep working together and making sure we look at the data—the hospitalisation figures of course, as well as the test positivity, and of course the number of cases. Hospitalisation data is important, but it follows with a lag, so we have to look at the early indicators as well.
Constituents in West Lancashire are worried: constituents of mine were told they tested positive on Friday and they still have not been contacted by Track and Trace or the restaurant they work in. They worry that this is increasing the danger of the spread of covid. They are also worried that the stockpile of drugs held in the event of a no-deal Brexit may be being reduced because of this pandemic. Can the Secretary of State update us on both those points?
On the first point, for all those who test positive, receiving that result brings a duty under law to self-isolate. That is the primary way we keep people safe and that has worked. As I said in my statement, as of 9 o’clock this morning 51% of those had been contacted for contact tracing purposes. I very much hope the constituent the hon. Lady mentions will be contacted very soon, if not already. On the final question she asks, of course we have been replenishing the stockpiles of drugs that we used up during the peak. That has been a very important part of the work over the summer, as we prepare to leave the end of the transition period at the end of this year.
(4 years, 2 months ago)
Commons ChamberAgain, there has not been a reduction in capacity in Berkshire or anywhere else in the country. There has been an increase in capacity. My hon. Friend makes a good point, though, about prioritisation. The question is how to enforce prioritisation without putting in place barriers that slow down access to tests for people who need them. We are looking at that now.
Will the Secretary of State please explain the lack of availability of home testing kits, which has dropped dramatically in my area of West Lancashire? In the absence of home testing kits, very ill pensioners are being offered tests 80 or 100 miles away. The confusing message in the assurance that he is trying to give is that there are too many getting tested, but that, if in doubt, people should get tested. How does that deal with the asymptomatic carriers or spreaders? This is a huge hidden danger. In the light of the Secretary of State’s earlier comment, my constituents would genuinely love to get with the programme, get tested where necessary and stay safe—if only the Government’s words met their actual experience of the system.
The clarity that the hon. Lady calls for can be provided as follows. If you have symptoms, get a test. If you do not have symptoms, and you have not been asked to get a test, please do not use a test that somebody else needs because they do have symptoms—they might be elderly, for instance, and she rightly refers to her constituents—because the tests are there for them. The capacity is expanding every day, but we need to ensure that we get those tests to the people who need them.
(4 years, 4 months ago)
Commons ChamberIn the same way that these are judgments on the way in, they are judgments on their way out. We will have to make that judgment according to the spread of the virus and, in particular, the risk level imposed by people catching the virus. We will keep all these things under review.
The data currently has an in-built delay, but the ability to do test, track and trace effectively and with the greatest success requires the shortest time between testing and local action. Put simply, the more local control, the quicker things will happen. The more handovers there are, and the more time it takes, the less successful it is. So I would like to ask the Secretary of State why he does not trust local systems, including the NHS. There are those who think that this is an attempt to discredit NHS labs.