Primary Healthcare Facilities

Baroness Winterton of Doncaster Excerpts

Monday 17th March 2025 Lords Chamber

[Baroness Merron (Lab)]

Although I cannot give a specific answer to the noble Lord on that point, I will be happy to look into it. As I mentioned earlier, in our discussions with the Ministry of Housing, Communities and Local Government we are, for example, looking at how we can lever greater contributions from developers who are working on new developments, where they will be providing much-needed health services and infrastructure. So we are taking a creative approach because we recognise the need to do more.

[Baroness Winterton of Doncaster (Lab)]

My Lords, my noble friend referred to creativity and the noble Baroness on the Lib Dem Benches talked about facilities in the community. Well, in Doncaster, we are already ahead of the game, as Mayor Ros Jones has worked with the local health community to provide a “health on the high street” facility, which will not only reduce pressure on the hospital but make it easier for patients to access services and, crucially, help regenerate the city centre. Will my noble friend join me in congratulating Mayor Ros Jones on this initiative, but also work with the local community to address the issue of urgent repairs that are still needed at the hospital?

[Baroness Merron (Lab)]

I am very pleased to congratulate Mayor Ros Jones on this initiative, as I would be pleased to congratulate such initiatives up and down the country. My noble friend is right to talk about the great benefits to local communities, which I myself remember, as will my noble friend, from the previous Government, in terms of walk-in health centres, which made a huge difference. To the point about repairs to the local hospital, it is vital, if we are to create the right NHS going forward through the 10-year plan, that we repair and rebuild the healthcare estate, which has a very considerable backlog maintenance bill after years of underinvestment. That is why the Chancellor confirmed extra investment for the backlog of critical NHS maintenance and repair upgrades.

Musculoskeletal Health: Chiropractors

Baroness Winterton of Doncaster Excerpts

Wednesday 26th February 2025 Lords Chamber

[Baroness Merron (Lab)]

I am glad that the noble Lord acknowledges the ongoing work, because we are indeed exploring how best to support dealing with MSK conditions—not least to encourage and provide greater parity in the support that is given. That will be alongside the 10-year plan and the long-term workforce plan. Of course, we keep all evidence continually under review.

[Baroness Winterton of Doncaster (Lab)]

My Lords, I take the point my noble friend the Minister makes about national commissioning and the ability of integrated care boards to do some commissioning, but would not the answer be for the integrated care boards to get all preventative healthcare practitioners to sit down together and work out local strategies? It may well be that one condition can have an effect on another, and perhaps that would make the commissioning of chiropractors easier and fit in with a local preventative healthcare strategy.

[Baroness Merron (Lab)]

My noble friend helpfully emphasises the point about the need to provide for local populations, and ICBs are in the pole position to do that. I am sure that noble Lords will recall that we recently announced changes in the NHS operating model to move power from the centre to local leaders. I particularly refer to the NHS planning guidance, whereby we follow the recommendations of the noble Lord, Lord Darzi, to take a whole new approach and reduce the number of national targets from 32 to 18. The reason for that is to give the local systems my noble friend refers to greater control and flexibility on how local funding is deployed. Indeed, one such model could be the one my noble friend referred to.

Mental Health Treatment: Waiting Times

Baroness Winterton of Doncaster Excerpts

Monday 3rd February 2025 Lords Chamber

[Baroness Merron (Lab)]

I certainly do, and with the NHS being such a large employer, that is one of the areas that we will be attending to. The long-term workforce plan will provide its report around the summer of this year and there will be much detail on how the workforce will be but also on the ways that we can improve its health and retention as well as recruitment.

[Baroness Winterton of Doncaster (Lab)]

My Lords, my noble friend Lady Warwick spoke particularly about young people and provision in schools. Does my noble friend the Minister agree that there is a key role for educational psychologists and school nurses in ensuring that diagnosis can take place early? Does she believe there could be a greater role for academies and schools working together at local level to provide that type of provision?

[Baroness Merron (Lab)]

I agree with my noble friend’s suggestions. Of course it is a team that provides the mental health support that is necessary, but I am particularly pleased that we are working to deliver a mental health professional in every school. That is a starting point, not necessarily the end point, so my noble friend makes some very helpful suggestions.

Community Pharmacy Closures

Baroness Winterton of Doncaster Excerpts

Tuesday 28th January 2025 Lords Chamber

[Baroness Merron (Lab)]

Commercial over the counter products will have a part to play. However, I take the point that the noble Lord makes. I am sure it is true that their vital role, and the opportunities that they offer, were not exploited as much as they could have been—when I say “exploited”, I mean that in a positive way. The Minister for Care, Stephen Kinnock, issued a press release today. In his last point he says:

“I am committed to working closely with Community Pharmacy England to agree a package of funding that is reflective of the important support that they provide to patients up and down the country. I am confident that together we can get the sector back on its feet and fit for pharmacies and patients long into the future”.

[Baroness Winterton of Doncaster (Lab)]

My Lords, the Government are on the right track in recognising the role that community pharmacists can play in public health by preventing illness and reducing the number of people turning up at A&E. However, is my noble friend the Minister aware of reports that some GPs have been unwilling to direct patients to community pharmacists, even under the Pharmacy First programme? Will she look at whether further action is needed to ensure that GPs work with community pharmacists to deliver services to patients?

[Baroness Merron (Lab)]

I am aware of the reports that my noble friend refers to. This is a new service; it needs to bed in. NHSE is working closely with ICBs, GPs and the community pharmacy sector to improve referrals. Funding has also been provided to ICBs for primary care network engagement leads, who should be well placed to support GP teams to refer into the service. We are aware of my noble friend’s point; we are acting on it and we will continue to keep it under review.

Health and Social Care: Winter Update

Baroness Winterton of Doncaster Excerpts

Tuesday 21st January 2025 Lords Chamber

[Baroness Merron (Lab)]

The noble Lord is right to remind us of the challenge of having people in the right place, rather than in hospital when they do not need to be there. We have already taken action, so I am pleased to be able to reassure him that, while the noble Baroness, Lady Casey, will look at long-term solutions for social care, she will present a report within a year from her commencement, which will add to the actions that we have already taken.

The noble Lord talked about unpaid carers—and I certainly share the respect that he holds for unpaid carers, so I am very pleased that we have given the biggest boost in income to family carers through eligibility for the carer’s allowance. That has meant an additional —on average, of course—£2,300 a year. That is the biggest boost since carer’s allowance was introduced in the 1970s. We are also legislating for a fair pay agreement, for the first time ever, which will help to tackle the number of vacancies, now standing at 131,000. There will be immediate action, because discharge requires being able to be in the right environment, which might be home but it might need an adaptation. Through the disabled facilities grant there will be a further 7,800 adaptations to homes both this year and next year. So we have taken the immediate action—and, yes, there is a lot more to do.

[Baroness Winterton of Doncaster (Lab)]

My Lords, my noble friend the Minister has just reiterated what the Statement said—that one of the key levers for easing winter pressures is NHS reform, particularly moving some hospital services into the community, which could deal with some of the issues raised by the noble Baroness, Lady Brinton, including X-rays, scans, tests and so on. Does she agree that this will require close collaboration between NHS trusts, hospital trusts, local authorities, ICBs and, sometimes, the private sector? Will she work with Ministers in other departments, not only to remove any obstacles there might be to this but to actively encourage it to happen at the local level? By the way, there are some good examples in South Yorkshire of this happening, and proposals for it to happen.

[Baroness Merron (Lab)]

My noble friend is quite right to highlight the good examples in South Yorkshire. There are good examples across the country and one of our challenges, as the Secretary of State has said, is taking the best to the rest. This is a very good example of that. I certainly agree with her observations. This requires joined-up working locally and nationally, which is why we work closely with other departments in both the immediate term and the longer term as we seek to reform health and social care.

Hospice Funding

Baroness Winterton of Doncaster Excerpts

Monday 6th January 2025 Lords Chamber

[Baroness Merron (Lab)]

As I mentioned, it has been confirmed that there will be funding for children and young people’s hospices for the forthcoming year, which I know had been hoped for but not actually delivered. I am very glad that the Secretary of State was able to confirm that. On long-term sustainability, Minister Kinnock is very much looking forward to meeting major stakeholders and is working with NHS England to find the best funding mechanism, in respect of the £100 million capital grant and more generally.

[Baroness Winterton of Doncaster (Lab)]

My Lords, it is very good news that the commission is in the safe hands of Sir Mike Richards, who I worked very closely with when I was a Health Minister. Could my noble friend set out the ways in which the Government might assist the hospice sector with training, because there must be a crossover in the different tasks undertaken? In particular, could some of the changes announced for social care workers be transferred to the hospice movement?

[Baroness Merron (Lab)]

My noble friend makes a very helpful point that I will certainly follow up. The fact that the majority of hospice care is provided through the NHS suggests that there is room for further co-operation between the independent hospice sector and the NHS. I am grateful for her comments and will follow that up.

NHS Plan: Consultation

Baroness Winterton of Doncaster Excerpts

Monday 2nd December 2024 Lords Chamber

[Baroness Merron (Lab)]

I thank the noble Lord. Yesterday, I was at an in-person event in Folkestone, and as with all such events up and down the country, it had used systems to find a wide range of people, including young people, who, as he rightly says, are often unlinked with the health service. I emphasise our continued monitoring and our efforts to reach the groups he speaks of. So far, we know that men, those aged under 35, and black Asian and black British people have engaged least with Change NHS. We are now stepping up our efforts.

[Baroness Winterton of Doncaster (Lab)]

My Lords, will my noble friend the Minister look at the role that pharmacists might play in any consultation? While they may not be an obvious source of reaching out, they are embedded in communities and talk to patients and users frequently. If they could be harnessed, it would much improve the consultation.

[Baroness Merron (Lab)]

I am very grateful to all those, including pharmacists, who have used all their networks and contacts to spread the word. That is why we have had over 60,000 responses and more than 1 million visits in what is the largest ever consultation in the history of the NHS. I call on all groups to continue their efforts to ensure that voices across all communities are heard loud and clear.

NHS

Baroness Winterton of Doncaster Excerpts

Thursday 23rd May 2024 Commons Chamber

[Victoria Atkins]

It is going better than it is in Wales. Under the Labour-run NHS in Wales, a quarter of people are on a waiting list in that part of the NHS. The number of patients waiting two years is higher in Wales than it is in England. Patients are waiting on average six weeks longer in Labour-run Wales than in England. If that performance were replicated here in England, waiting lists could be as much as six million higher. The choice is clear: unfunded Labour failure or a clear plan for a more secure future with the Conservatives.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call the Chair of the Health and Social Care Committee.

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[Victoria Atkins]

I thank the right hon. Lady for all her work. She may recall that, when the inquiry was announced by the then Prime Minister, my right hon. Friend the Member for Maidenhead (Mrs May), we had a debate on that matter where I spoke as a Back Bencher on behalf of a constituent; I very much hope that he and others gain some reassurance from the fact that I understand exactly the issues they have faced over many years. As Health Secretary, it is my responsibility, and indeed my privilege, to try to help them now.

In relation to the compensation schemes for those who have not yet received payments, I know that the right hon. Lady will have carefully pored through the responses of my right hon. Friend the Minister for the Cabinet Office and Paymaster General. We want to give the independent compensation authority—I underline independent because I am sympathetic to the sensitivities of families and victims around the role that the Department of Health and others played in their pain—and Sir Robert the chance to set up the scheme, assisted by the expert panel.

I promise the right hon. Lady that I have been discussing psychological support with the chief executive of NHS England for some time. We want to recruit the right people to conduct that incredibly sensitive work. It will take us a little more time, but I assure her that NHS England is acting quickly to bring in those services, we hope, by the end of the summer.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call the Father of the House.

[Sir Peter Bottomley (Worthing West) (Con)]

I thank the Secretary of State for her answer to the right hon. Member for Kingston upon Hull North (Dame Diana Johnson). I hope that the letter that her Department received from us will get a full reply, and I thank her for her interim words.

I hope that the Secretary of State will be able to come to the opening of the new integrated care centre by the town hall in Worthing—a local authority enterprise carried on by the present administration in Worthing. There has been great concern about dentistry in my constituency. The pressure is coming off, but not fast enough. Would she please encourage everyone in NHS England to ensure that dentists are encouraged to provide the kinds of service that all our constituents want?

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[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. I am extremely grateful for all the terribly kind comments, which means that I am a bit reluctant to say this, but we need to crack on, so I ask for brief questions and brief answers. [Interruption.] It appears that the Whips agree with me. They know that we have the business statement and then the Finance Bill to get through. A good example will be set by Sir Christopher Chope.

[Sir Christopher Chope (Christchurch) (Con)]

Thank you, Madam Deputy Speaker, for giving such as good example to this House, as always.

My right hon. Friend was kind enough to meet me and our right hon. and learned Friend the Member for Kenilworth and Southam (Sir Jeremy Wright) to discuss the plight of people who are victims of covid-19 vaccine damage. She sounded very sympathetic at the meeting and promised to look into the vaccine damage payment scheme, so it was rather disappointing this week to be told in answer to a written question:

“Formal consideration of whether any reforms to the VDPS are necessary will form part of Module 4 of the COVID-19 Inquiry”.

The inquiry will not be heard until January next year, and it smacks of kicking the can down the road and ignoring the victims, who need help. The sum paid—£120,000—has not been increased since 2007.

[Madam Deputy Speaker]

Order. I fear that my authority is draining away, so I will make another plea for brief questions. I thought the hon. Gentleman was going to set a superb example. However, I am sure the Secretary of State will now respond briefly.

[Victoria Atkins]

I very much share my hon. Friend’s concerns. I will take away what he has said, but I want to look into this issue, because I understand the points that he and our right hon. and learned Friend the Member for Kenilworth and Southam (Sir Jeremy Wright) have made.

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[Victoria Atkins]

That is an irresistible invitation, if I may say so, and I will very much look forward to visiting my hon. Friend’s constituency to support her in her campaign for a community diagnostic centre.

I think we are on the last question, Madam Deputy Speaker, so, as we enter into this general election period, may I give my sincere thanks to every single member of our NHS staff and to every single person working in social care across England? You all do amazing jobs, and it is my great privilege to serve as your Secretary of State. I wish everybody a very calm—not quiet—six weeks. The medics will understand what I mean by that.

[Madam Deputy Speaker (Dame Rosie Winterton)]

On that note, I thank the Secretary of State for her statement. Once again, I thank everyone who made very kind comments.

International Health Regulations

Baroness Winterton of Doncaster Excerpts

Tuesday 14th May 2024 Commons Chamber

[Andrew Stephenson]

I thank my hon. Friend for the constructive way in which he and other parliamentarians have engaged with this subject matter and the challenges it presents. As I said in my opening remarks, no text has yet been agreed. I set out some of our negotiating red lines, and I am happy to confirm from the Dispatch Box that the current text is not acceptable to us. Therefore, unless the current text is changed and refined, we will not be signing up to it.

My hon. Friend asks how the treaty will be ratified if we reach a position to which the UK Government could agree. The UK treaty-making process means that the accord is of course negotiated and agreed by the Government. As he will know, Parliament plays an important part in scrutinising treaties under the CRaG process and determining how international obligations should be reflected domestically. However, it is important to remember that, because the exact form of the accord has not yet been agreed, the parliamentary adoption process will depend on under which article of the WHO constitution the accord is adopted.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call the shadow Minister.

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[Andrew Stephenson]

The UK Government have been clear that we will not sign up to an accord or any international health regulation amendments that would cede sovereignty to the WHO in making domestic decisions on national measures concerning public health, such as domestic immunisation programmes or lockdowns. Respecting national sovereignty rights is a distinct principle in the current draft of the accord, and respecting the sovereign rights of states to adopt, legislate and implement legislation within their jurisdictions remains a distinct principle in the drafted amendments to the IHR. I genuinely believe that there is a window of opportunity to negotiate an accord that is in the UK national interest as well as in the global interest.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I thank the Minister for answering the urgent question.

Hospice Funding

Baroness Winterton of Doncaster Excerpts

Monday 22nd April 2024 Commons Chamber

[Peter Aldous (Waveney) (Con)]

I congratulate my hon. Friends the Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson) on so ably leading this debate and setting the scene.

While it is important to recognise the great work done across the eastern region by East Anglia’s children’s hospices, in the Great Yarmouth and Waveney areas, as represented my right hon. Friend the Member for Great Yarmouth (Sir Brandon Lewis) and me, there is at present a hospice vacuum. Throughout the rest of Suffolk and Norfolk, there are locally based hospices well embedded in and providing great services for their communities.

The good news is that plans are being carefully prepared to fill this vacuum and this void. A local partnership is evolving to build a local hospice led by St Elizabeth hospice, including the local NHS, councils, a community interest company, volunteers and fundraisers. For it to be successful, to open the hospice and then to run it, the national Government must join this partnership, and I hope my hon. Friend the Minister, who is currently not in her place, will in her summing up accept this invitation. The Waveney and Great Yarmouth areas desperately need a hospice. We have an ageing population and pockets of deprivation, and as Chris Whitty has highlighted, there are acute health inequalities in coastal communities that a hospice can help level out and remove.

As I have mentioned, a well-researched case for the hospice has now been prepared, though it is important to recognise the work done by so many over the years in supporting those in need of end of life care and their families—from the late Margaret Chadd, who founded East Coast hospice and had the vision of building a hospice on land bought at Gorleston, to Roberta Lovick, who founded the Louise Hamilton Centre, from which such great support is provided to patients with life-limiting conditions and their families; the James Paget University Hospital, where the Louise Hamilton Centre is based; and East Coast Community Healthcare, the Lowestoft-based community interest company that, in partnership with St Elizabeth, operates six specialist beds in Beccles Hospital, as well as providing care both in people’s homes and in care homes.

Building on the work of these local people and organisations, a framework is emerging through which a local hospice can be built. The cornerstone of this is, as we have heard, the Health and Care Act 2022, which sets out the legal requirement for ICBs to commission palliative and end of life care. The Norfolk and Waveney ICB has responded by carrying out a review of palliative and end of life care. This was completed last autumn, and it highlights the need for nine urgent and six medium to long-term actions. Last March, St Elizabeth hospice merged with East Coast hospice, and straightaway set about conducting a feasibility study into the viability of building up hospice facilities on the Gorleston site.

The study has just been completed, and the conclusion reached is that a hospice should be built in stages. Expressions of interest are now being invited from architects. That is an exciting landmark for which so many people have strived for many years. St Elizabeth is confident that it can successfully fundraise for a hospice capital appeal, but it is for the ongoing revenue cost of providing core clinical services for a full in-patient unit, as well as outreach community services, that national Government support is required. The Norfolk and Waveney ICB—indeed, all ICBs—need central Government support and a fundamental rebalancing of national policy, so that they can meet the projected growth in demand for palliative care.

It is good news that after so many false dawns over so many years we now have a coherent and well thought-through plan for filling the hospice void in the Waveney and Great Yarmouth area, but while we should be sanguine, we should also be realistic. We are not even at the starting point of the rest of England, as we have heard from other colleagues who have a hospice up and running—we do not. That is why the Government need to join the partnership that has evolved, and support Norfolk and Waveney ICB so that it can commission hospice services on a long-term, multi-year basis. I urge the Government to join us on that exciting journey.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call Steve Double.

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[James Sunderland]

I thank my hon. Friend and I agree completely. Nobody can plan in a vacuum, so this is about more money, earlier money and the ability to plan so we know where the delta is.

I will conclude now. Madam Deputy Speaker, thank you for the opportunity to speak this evening. We need more money, Minister, and I know you will give it to us.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call the SNP spokesperson.

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[Helen Whately]

I do congratulate those people on their fundraising efforts; although I hope their feet are all right!

As hon. Members know, the Government have provided dedicated additional funding to hospices; in the pandemic, when I played a part, we were helping them with energy bills and through the children’s hospice grant, which the NHS has confirmed will go to hospices for this financial year too.

Looking ahead, I fully appreciate the ask for longer-term certainty of funding—of course I understand that. However, funding for hospices, end of life care and many other things beyond the current financial year depend on a future spending review. I am sure that all hon. Members will understand that I cannot pre-empt such a review, and ICBs similarly will not know their funding until that review. Although committing funding beyond the spending review period is not in my power, I am pushing for our healthcare system to encourage and enable more advance planning by individuals to consider and set out what they want at the end of their life. Inevitably, some of us will die in hospital, and for some of us that will be the right place, but given a choice many people would rather die at home. We should all be setting out a plan that includes our preference of place of death and what sort of treatments we do and do not want. As my right hon. and learned Friend the Member for South Swindon (Sir Robert Buckland) and my fabulous health colleague my hon. Friend the Member for Colchester (Will Quince) said, we should talk more about death and plan for it.

To conclude, there are no easy answers to the questions raised this evening—there rarely are. I do not have a pot of money otherwise going unspent for hospices; neither do ICBs and nor does NHS England. I will, however, continue working with NHS England to ensure that palliative and end of life care is given the attention it deserves and needs so that it is considered important, just as we consider services that prolong life important, and that the NHS is held to account for doing that. I will continue to agree with hon. Members on the importance of hospices and the important work they do. I see this as a Minister, as a constituency MP and from my own family experience; I will never forget saying goodbye to my grandmother in a hospice near Yeovil, and I will always be grateful.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call Sally-Ann Hart to wind up.